Logging injuries in Louisiana: nature,trends, and rehabilitation considerations

Logging is a dangerous occupation, as documented through reported injuries and fatalities. Accidents in the logging industry account for pain, suffering, employee turnover, and high insurance costs. Worker injuries and high insurance costs, in addition to other factors, may be minimized and reduced through safety education and improved logging practices. Furthermore, the injured logger, or logger with a disability may return to logging or other employment through development of viable medical and vocational rehabilitation planing. This article addresses the economic impact of logging, reviews logging injuries, describes a safety program designed to reduce logging injures, discusses rehabilitation considerations for specific injuries, and outlines particular reemployment prospects for loggers with disabilities.     

Managing Employee Absence

ABSTRACT

Employee absences represent a major concern for employers due to financial losses, both direct and indirect. Absences occur for several reasons; however, perhaps the most significant loss of work time is attributed to work related injuries. This paper addresses losses due to injury and proposes a plan of action for effective cost containment involving rehabilitation case management and early return to work.     

Will Australian workers' compensation insurance management get better soon?

A study of Australian experience in the state of New South Wales (NSW) suggests that private sector underwriting of workers' compensation insurance risk plus insurer competition on premium price may put downward pressure on benefits for injured workers, inhibit rehabilitation, and cause related cost increases for taxpayers and employers. Insurer underwriting also increases workers' compensation administrative costs and means an unnecessary loss of investment income for government and industry. An emerging and better alternative for the Australian community is for government and industry to underwrite a national workers' compensation scheme and to fix premium and benefit requirements which are competitively administered by insurers. In such a regulatory environment insurer inability to compete on premium price should promote competition to provide effective services to help employers prevent injury, assist rehabilitation and contain cost. National standards are necessary to enable widespread dissemination of comparable, reliable information on the outcome of health, rehabilitation, dispute resolution and return to work services. This is required to assess the competitive performance of service providers in order to ensure effective operation of the market to achieve scheme objectives. Holistic, multi-skilled and objective rehabilitation professionals are needed who can clearly demonstrate the effectiveness of their actions in assisting injury prevention, worker rehabilitation, and safe return to work across a range of industry contexts.     

Effectiveness of a screening tool to detect injuries during Army Health Care Specialist training

The purpose of this project was to evaluate the effectiveness of an initial screening and referral process in reducing the impact of musculosketetal injuries among soldiers attending Health Care Specialist training. Musculoskeletal injury among Army Health Care Specialist students have been reported to be approximately 24% for men and 24-30% for women. The highest student visit rate to the troop medical clinic for musculoskeletal injuries, for men and women, occurs during the first week of training. Anecdotal reports indicate that many students arrive for training with existing injuries or symptoms. This project was designed to assess whether formalized early screening, referral, and intervention could 1) identify arriving students who need musculoskeletal injury-related medical attention, 2) reduce the number of students receiving limited duty status during their 10-week training, 3) decrease the total number of limited duty days for students, and 4) decrease the number of students who cannot graduate due to musculoskeletal injury. Students (N=291) from one company were divided into three groups of 97 students. Three methods were used to screen and refer students for medical intervention: 1) traditional (T), 2) by health care providers (HCP), or 3) by Drill Sergeants (DS). Screening by HCP and DSs involved using a new screening tool to identify and consequently refer students with symptoms to a troop medical clinic (TMC) for early evaluation and intervention. Using the screening tool, HCPs identified 92% of students with injuries, while DSs accurately identified 80%. The screening did not reduce the number of students receiving limited duty status, total limited duty days, or the number of students that could not graduate due to musculoskeletal injury ("holdovers") (p>0.05). The screening tool demonstrated good sensitivity and specificity whether conducted by HCPs or DSs. It failed to demonstrate efficacy in reducing the impact of musculoskeletal injuries among Combat Medic soldiers, as measured by limited duty days and holdovers.     

The manual transport of load and the commercial aviation in Brazil

The Brazilian commercial aviation industry has grown strongly in the last decades, increasing passenger capacity and operational safety. While several studies focus on flight safety and passenger comfort, few are dedicated to the manual transport of loads. Although apparently this sector has low relevance, every year nearly 9% of their workers are injured. It is estimated that these injuries cost more than 10 million dollars a year to the companies involved. This study assesses quantitatively the risk of injury on employees. NIOSH method was used to evaluated the possibility of injury in different tasks. Factors such as the pace of activity, horizontal and vertical displacement, and asymmetries were evaluated during loading and unloading of luggage. This study showed that the frequency of repetitions of loading was excessive in all cases analyzed. However, the use of conveyors reduced the risk of employee injury, reducing this possibility to acceptable levels. The study shows that simple measures can help reduce the number of injuries and hence the cost that this entails.     

How was a national moving and handling people guideline intended to work? The underlying programme theory

In healthcare, moving and handling people (MHP) often cause musculoskeletal disorders. To prevent musculoskeletal disorders due to MHP, many national evidence-based guidelines have been developed. However, little is known about how these guidelines were intended to work, i.e. their ‘programme theory’, how implementation by intended users is influenced by contextual factors and mechanisms to produce outcomes. This paper identifies the programme theory of a national MHP guideline (MHPG) using thematic analysis of the MHPG document, three organisational planning documents, and interviews with MHPG developers. The analysis identified the intended users of the MHPG as health and safety managers and MHP coordinators. The programme theory comprised contextual factors, potentially hindering (e.g. budget constraints) or facilitating (e.g. changing demographics) implementation, being influenced by mechanisms mainly based on ethical (quality of care, evidence-based practices), and economic reasoning (reducing cost of MHP, return on investment) to reduce injuries caused by MHP – the intended outcome.     

A five year retrospective analysis of occupational injuries and incidence reported at a research intensive Canadian university

Limited information of occupational injury statistics within academic settings exists. Universities and colleges are an important and insightful work environment due to the varied nature of the work performed by employee groups. The objective of this study was to describe occupational injuries for all work groups in a large research intensive university. A retrospective database analysis was conducted on 2029 employee incident reports over a five year period (2000-2004) to determine general and departmental prevalence of injury types, locations, and mechanisms. Demographic analysis revealed an average age of 42 years and 9 years of work experience. Overall, the most frequent injuries were to the hand (40%), were musculoskeletal in nature (42%), and resulted from being "struck or contacted by" (33%). The greatest number of incidents occurred in food services, followed by physical plant and staff services. Closer examination of incidents reported by food services indicated 53% of injuries occurred to the hand and 72% required first aid. Notable too was that 19% of physical plant injuries occurred to the back, but these reports accounted for 40% of total back injuries and 50% of all lost time claims in the total database. Further epidemiological research in academic institutions is needed to better understand the inherent injury risk in this work sector.     

How to use programme theory to evaluate the effectiveness of schemes designed to improve the work environment in small businesses

Due to the many constraints that small businesses (SBs) face in meeting legislative requirements, occupational health and safety (OHS) regulatory authorities and other OSH actors have developed programmes which can reach out to SBs and motivate and assist them in improving the work environment. A number of conceptual models help to enhance our understanding of OHS interventions in SBs and their effectiveness. However, they have mainly been evaluated on output rather than the process relating to the change theory underlying the intervention, and hence have seldom been rigorously evaluated. Thus little is known about how particular features of SBs can be taken into account when designing and implementing national programmes. This paper shows how realist analysis and programme theory may be used as a framework for evaluating, developing and improving national intervention programmes for the improvement of the work environment and reducing injuries in SBs. It illustrates this for a specific New Zealand intervention: the Workplace Safety Discount scheme and its implementation in the agriculture sector. In practice, realist analysis should be performed during the planning, implementation and management stages so that ongoing findings can be fed back to the participant social actors to help them make appropriate changes to enhance the likelihood of success.     

Participatory ergonomics: determining injury control "buy-in" of US Army cadre

Overuse injuries account for the majority of lost duty time profiles for soldiers attending Advanced Individual Training (AIT) to become a Combat Medic at Ft. Sam Houston (63% for men and 74% for women). An intervention program was initiated with two AIT Battalions (BN) in an effort to reduce overuse injuries. The purpose of this paper is to describe methods of tracking the participation of supervisors during the intervention program. Methods used to monitor participation included recording the number of coordinating meetings, keeping minutes of advisory committee meetings, and conducting perception surveys. Over an 18-month period, the number of coordinating meetings decreased. Surveys identified the opinions, values, and self-identified roles of supervisors (drill sergeants and cadre) in regard to injury prevention with their assigned student-soldiers before and after an intervention program. At the initiation of the injury control program, 103 individuals completed a 27 question, anonymous survey to assist planners with developing a strategy that would encourage participation of cadre and drill sergeants in preventing injuries. One year later, 191 individuals from the same battalion completed the same survey. Results revealed a slight, statistically insignificant, decrease in supervisors' perception of the presence of overuse injuries in their BN (31.4% vs. 27.4%, p>0.05), and the level of acceptable injuries moved from the 16-30% range to the 1-10% range (chi2=4.65, p<0.05). Post-intervention, more supervisors believed their physical training programs could impact overuse injuries (pre 20.4% vs. post 31.6%, Chi2=6.7, p<0.01). The results reveal several methods to track the involvement of participants, to develop intervention strategies, and to monitor cultural shifts necessary to the injury control process.     

Work injury rehabilitation in Guangzhou: 380 case cohort study

Work injury rehabilitation is a new concept in Mainland China. In 2001, the first work injury rehabilitation centre was established in Guangzhou under the management of the Guanghzhou Bureau of Labour and Security. This paper reviews the profile of a cohort of workers with injuries who received rehabilitation services at this centre. The changes in the physical capacity, daily function, and quality of life of the workers with injuries before and after the treatment services were also reviewed. A total of 380 were extracted from the database which occupied 79% of the total patient population admitted to the centre between 2003 to 2004. The assessment results suggested that workers with injuries showed increases in physical capacity in terms of the range of motion, muscle strength and walking tolerance. The daily functioning by using Barthel Index was also improved. Quality of life assessed with the WHOQOL also demonstrated an increase in the physical and psychological domains. Work injury rehabilitation in Guangzhou is at its infancy stage. The cooperation between the rehabilitation centre, employers and workers is of the utmost importance for a successful return to work outcome. The workers' compensation and rehabilitation policy also dictates the future of success of the rehabilitation services.     

Work injury rehabilitation and the tendency to return to work of workers with injuries in Mainland China

This paper aims to describe the current situation of the work injury rehabilitation system in China with its drawbacks, especially relating to the employment services for workers with injuries and bringing up the topic of the need for more work to attempt to construct a modern work injury occupational rehabilitation system: perfecting the administration mechanism of policy, establishing an occupational rehabilitation pattern with Chinese characteristics, establishing the socialization service network as the core of occupational rehabilitation and establishing a practical professional team and academic communication platform. These creative thoughts may shed light on the development of the work injury rehabilitation system as well as the return to work for workers with injuries in China.     

He Wero: The Challenge of Putting Your Body on the Line: Teaching and Learning in Anti‐Racist Practice1

This paper explores ways in which social workers, community workers and social work educators have developed anti‐racist practice in relation to indigenous issues in Aotearoa/New Zealand. A brief history of anti‐racism training in Aotearoa/New Zealand is provided, showing how this has been reflected in the Massey University Bachelor of Social Work programme. The core of the discussion describes the application of a structural analysis model to engage students in identifying their own culture and how they situate their experiences in relation to the indigenous Maori in Aotearoa/New Zealand. Processes of Maori tikanga (custom) and whole person/soul learning are utilised to prepare students to engage with the Bicultural Code of Practice of the Aotearoa New Zealand Association of Social Workers, which mandates partnership under the Treaty of Waitangi, acknowledging Maori as the indigenous people of Aotearoa/New Zealand.     

Summary report of action research on occupational rehabilitation and community re-integration of migrant workers with work injuries in Mainland China

This article is a summary of an action research exploring the strategies to initiate the occupational rehabilitation and community re-integration of migrant workers with work injuries in Guangdong Province, China. Using two cases of rehabilitation intervention for workers with work injury, a case management model of occupational rehabilitation and community re-integration was illustrated, in the different phases of rehabilitation. Finally, some key elements in supporting occupational rehabilitation and community re-integration for migrant workers with work injury in China were highlighted.     

Factors affecting the organizational responses of employers to workers with injuries

The organizational responses of employers to work-related injuries is one of several significant influences on return-to-work outcomes. Thus, understanding the factors that lead to better or worse organizational responses to work injuries may ultimately help to improve success in this area. The purpose of this study was to systematically explore factors that might influence the organizational responses of employers to injured workers, based on employee perceptions. Cross-sectional survey data were collected from 2,943 subjects with work-related injuries which had occurred less than eight weeks prior to survey completion. Measured variables included pre-injury demographic and job factors, injury circumstances, and a measure of post-injury events that comprised the organizational response. Multivariate linear regression results show that age, gender, job dissatisfaction before injury, prior difficulty performing job tasks, injury severity, back injury and lost time were all associated with negative organizational responses, suggesting potential opportunities for intervention.     

Cost-effectiveness of a prework screening program for the University of Illinois at Chicago physical plant

A post-offer screening program jointly developed by the Occupational and Physical Therapy Departments (University of Illinois at Chicago) was first implemented in March 1998. A total of 712 screens were completed from 3-01-98 through 2-28-01. A quasi-experimental design was utilized to analyze changes in Workers' Compensation costs between the three-year period prior to, and the three-year period following program inception. Additionally, injury rates and mean cost per injury were compared between injuries sustained between 3-98 and 3-01 which were incurred by workers who had passed screening and those that had not been screened. Finally, the tabulated cost per screen and reduction in Workers' Compensation costs allowed derivation of a dollar spent/ dollar saved ratio. Dramatic declines in number of injuries, total costs and mean cost per case occurred in the three-year period following program inception. Mean cost per case also dramatically declined comparing injured workers who had passed screening versus those who had never been screened. Cost savings were over US dollars 18 per dollar spent on the program. While a number of mitigating variables may have accounted for some of the profound effects noted, decrease in average cost per case (indicating possible reduction in severity of injury) was consistent with existing literature.     

Work-related mild-moderate traumatic brain injury and the construction industry

Background: Consequences of traumatic brain injury underscore the need to study high-risk groups. Few studies have investigated work-related traumatic brain injuries (WrTBIs) in the construction industry. Objective: To examine WrTBIs in Ontario for the construction industry compared to other industries. Methods: A retrospective study of individuals who sustained a WrTBI and had a clinical assessment as an outpatient at a hospital-based referral centre. Data were collected for a number of factors including demographic, injury and occupation and were analyzed according to the Person-Environment-Occupation (PEO) model. Participants: 435 individuals who sustained a WrTBI. Results: There were 19.1% in the construction industry, 80.9% in other industries. Compared to other industries, individuals in the construction industry were more likely to be male, to not have attained post-secondary education, and experience multiple traumas. WrTBIs in the construction industry were commonly due to elevated work. The construction occupations involved included skilled workers and general labourers, and compared to other industries, WrTBIs occurred most often for those employed for a short duration in the construction industry.Conclusions: Construction industry workers experience serious WrTBIs that are amenable to prevention. Use of the PEO model increased our understanding of WrTBIs in the construction industry.     

An on-site ergonomic program: A model for industry

Work related conditions caused by overexertion or repeated trauma affect millions of American workers. These conditions can result in time off from work, decreased productivity, and high financial costs, not to mention impairment of the worker. According to the Occupational Safety and Health Act (OSHAct) of 1970 [26], employers are required to provide hazard free workplaces for their employees. Fortunately resources exist to help employers set up on-site ergonomic programs to reduce the hazards that contribute to cumulative trauma disorders (CTDs) or other injuries. Companies that have implemented comprehensive ergonomic programs have reported benefits, most significantly, decreased injuries, and cost savings. A model is described for industry on starting and managing a successful on-site ergonomic program.     

Socioeconomic evaluation of a correctional programme in Sweden—long-term effects Samhällsekonomisk utvärdering av ett kriminalvårdsprogram i Sverige—långsiktiga effekter

The present article focuses on the long-term socioeconomic outcome of a correctional programme in Sweden, called KrAmi (n=62), using a systematic comparison with a control group of probation clients (n=51). The evaluation, which had a quasi-experimental design, was based on actual costs for each client (n=113) for a period of five years, from 1995 to 1999. The follow-up period was two years, during which the socioeconomic costs decreased step-wise for both groups, probation groups more so than programme groups. The deteriorations were 70–80% compared to the period before treatment. Rehabilitation to labour market, measured in pension points, was more successful for programme groups than for control groups. Thanks to this, as well as lower costs during the treatment period, the programme groups’ socioeconomic profitability, measured with a 15-year cost–benefit analysis (CBA), was greater than that of the control groups. The cost–effectiveness analysis (CEA) shows that the KrAmi groups are better off in work rehabilitation, depreciation time (one year compared with two and a half years for probation groups) and repayment ratio (14 SEK compared to 6 SEK for probation groups) although cost savings are greater for probation groups.     

To live an ordinary life: resource needs and additional costs for people with a physical impairment

Disabled people face increased risks of living in poverty largely due to lower incomes and extra resource requirements compared to non-disabled people. This study incorporated the social model of disability with an economic approach to costing to estimate the additional costs required by people with a physical impairment to achieve an adequate standard of living in New Zealand. Budgets estimating the additional equipment, modifications, transport, support and time required to achieve an adequate standard of living were developed and validated through focus groups with community members. The findings suggest that reducing barriers involves substantial costs ranging from NZ$645–$2,348 per week.