Approximately 4.2 million workers were injured in the United States in 2005, costing employers over $171 billion, a figure under-estimating the true cost. This retrospective descriptive occupational injury study analyzed existing health and safety data from 2002 through 2006 at a large US manufacturing employer. All work-related injuries from six geographic locations were included in the study. A total of 36,611 injuries involving 20,738 employees were analyzed using descriptive statistics to characterize the injuries, and general estimating equations (GEE) and multivariate logistic regression analyses to identify risk factors affecting the severity of occupational injuries.Nearly two-thirds of injuries reported were recorded on the OSHA log. Forty percent of occupational injuries resulted in restricted days, and 21% resulted in lost days. Three-quarters of the occupational injuries occurred among Production and Maintenance employees. Various injury characteristics and personal/work characteristics influenced recordability of occupational injury, restricted activity and lost days following occupational injury. Repetitive motion and over-exertion injuries were most commonly associated with recordable injuries and injuries with restricted or lost days. Employees with injuries due to repetitive motion in shop operations were more than twice as likely to experience lost days following injury as workers with most other types of injuries. Men were six times as likely to sustain a repetitive motion injury in shop operations. Union affiliation increased the likelihood of having an injury being recorded on the OSHA log or incurring restricted or lost days; however, significant interaction terms that included union status and other variables, suggest that the results should be viewed cautiously. Production & Maintenance workers were at greatest risk for incurring multiple injuries.Results of this study can be used to enhance prevention programs already in place in this company. Targeting future repetitive motion and over-exertion injuries and ensuring proper treatment and prevention interventions may reduce the severity and recurrence of injuries.

Background: Agriculture remains one of the most hazardous occupations in Canada. Approximately one-half of all agricultural injuries are due to machinery. The etiology of machinery-related injury remains poorly understood. Objectives: (1) To evaluate the relative importance of two representative safety practices (i.e. safety device use and routine maintenance) and their relationship with machinery-related injury;(2) To evaluate the roles of situational factors and safety practices in the occurrence of entanglement injuries caused by machinery. Methods: Objective 1. Participants were administered the Saskatchewan Farm Injury Cohort Study baseline survey for a one-year period of recall (2006). Relationships between the machinery-related injury outcome and two safety practices were analyzed cross-sectionally using the farm as the unit of analysis; Objective 2. A descriptive case-series was analyzed for factors surrounding 41 machinery entanglements using data from the Case-Control Farm Machinery Injury Study (2000-2005). Results: Objective 1. Limited use of safety devices on machinery during farm operations was associated with higher risks for injury (RR 1.94; 95% CI 1.13 to 3.33; ptrend=0.02). Lower routine maintenance scores were associated with significantly reduced risks for injury (RR 0.54; 95% CI 0.29 to 0.98; ptrend=0.05). Objective 2. The majority of entanglements occurred during a few machinery-related tasks, namely (1) field adjustments of machinery; (2) product handling and conveyance; and (3) driveline attachments and servicing. Both expected and unanticipated hazards inherent to these tasks affected the behaviour of farmers, leading to entanglements. Conclusions: Objective 1. The first finding implies that injury prevention programs require continued focus on the use of safety devices on machinery. The second finding could indicate that maintenance itself is a risk factor, or that more modern equipment that requires less maintenance places the operator at lower risk. These findings provide etiological data that confirm the practical importance of operational safety practices as components of injury control strategies on farms. Objective 2. Systemic changes are required to improve existing machinery safety practices through engineering, work methods and work practice modifications. In addition to design solutions, occupational health and safety strategies should consider activities associated with hazardous situations to inform the content of training and educational efforts. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2009-09-03 10:51:31.608

My graduation thesis focuses on health protection and safety at work, which is currently being considered along with environmental policy one of the most important issues in the management and organization every developing society. The thesis aims to highlight the issues related to compliance with safety regulations, with which the company ČZ, a.s. fumbles too. With its experts will cooperate and whose data and information will be used. In my work I will therefore deal with assessment and analysis of the level of occupational safety and health protection in this society and in Division Auto using analysis such as industrial accidents, causes, that it implicate and factors that affect it. I will analyze the health and safety policy in the establishment of assessment activities of departments in implementing safety implementation, its development and technical security. By location some deficiencies will be my goal to try to suggest measures leading to the improvement. Achieving the targets will be reached by comparing the current legislation with the situation in a particular society, then comparing the legislative requirements for health protection and safety and security management system according to the principles of "Safe Company", based on the OHSAS 18001 health and safety policy in the ČZ, a.s.

Pain coping is the purposeful effort people use to manage and minimize the negative impacts of pain. The scientific literature on pain coping conceptualizes its role in recovery as a reciprocal interactive process of psychological, social, and biological factors. The objective of this dissertation was to investigate how workers cope with pain and how coping relates to recovery. Paper one-How Do Injured Workers Cope with Pain? A Descriptive Study of Injured Workers with Occupationally Related Long Term Pain, aimed to identify pain coping strategies used by workers and identify characteristics related to each strategy. This study hypothesized that workers coping may be a function of biological, social, and psychological factors. The results indicated that the most frequently used coping strategy was coping self statements, followed by praying and hoping, and catastrophizing. Additionally, coping strategies differed according to gender, marital status, education, part of the body injured, levels of depressed symptomatology, and pain. The objective of paper two, Predicting Recovery for Workers with Chronic Pain: Does Pain Coping Matter?, was to measure the prognostic values of pain coping strategies, using polynomial logistic regression and Cox regression, on two commonly used measures of recovery, self perceived disability and time to suspension of benefits. The adjusted polynomial models showed that coping self statements predicted moderate disability. The Cox regressions showed that increases in diverting attention, pain related behaviours, and perceived control meant small but significant decreased chances of suspended benefits. Paper three, Self Perceived Disability in Workers with Chronic Pain: Does Depression Matter?, sought to identify factors associated with self perceived disability at the beginning of rehabilitation. Depression and pain interacted to affect disability therefore, two multivariable models were built. For depressed workers, every one point increase in pain was associated with a 58% increased odds of moderate disability and a 258% increased odds of severe disability, compared to low disability. Pain control was protective for moderate and severe disability. For non-depressed workers, a one point increase in pain was associated with a 97% increased odds of moderate and a 109% increased odds for severe disability. However, Pain control was non-significant. / Epidemiology

Previous research has shown that firefighters and emergency services personnel are at increased risk of fatal and non-fatal occupational injury compared to other U.S. workers. Analyses of injury and workers’ compensation claims data in this population has demonstrated that injuries are both common and an economic burden on the fire service, especially those caused by overexertion and that lead to sprains/strains. The increased risk of injury is associated with specific job tasks, including physical exercise, patient transport and fireground work, and with personal characteristics such as physical fitness. The economic evaluation of injury and injury prevention can help inform decision making on the part of leadership, including the identification and evaluation of potential targets for injury prevention programs. The aims of the current study were to: 1) evaluate a fitness intervention for new firefighters in terms of health, fitness, injury outcomes as well as workers’ compensation claims costs; 2) to analyze workers’ compensation claims data for trends in cause and injury type, as well as the effect of worker age; and 3) to model the expected change in back injury frequency and costs among emergency medical services personnel following the implementation of electrically powered stretchers. Primary data for the current study, including injury surveillance and workers’ compensation claims data, were provided by the Tucson Fire Department (TFD), Tucson, Arizona. The Probationary Firefighter Fitness Program (PFF-Fit) was designed by University of Arizona researchers in partnership with TFD. The program was implemented in the 2012 recruit academy. Outcomes, including measures of health and fitness, injury, workers’ compensation claim frequency and claims costs, were measured over 17 consecutive months for the intervention class, and compared to outcomes from controls comprised of the three most recent TFD recruit classes for the same time period. Comparing the intervention class to controls, health and fitness outcomes were statistically equivalent. The intervention group experienced statistically significantly fewer injuries, filed significantly fewer claims, and accrued aggregated claims costs approximately $33,000 less than the controls with an estimated equivalent reduction in indirect costs for a total of $66,000. The program implementation costs were nearly $69,000, leading to a one-year return on investment of -0.52 if based only on direct costs (workers’ compensation claims) or -0.048 if an estimate of indirect costs is included. Injury in the U.S. fire service has been the subject of many previous studies but the pattern of workers’ compensation claims has been studied much less frequently. Specifically, the effect of increasing worker age on the frequency and cost of claims has not been studied in this population. Routine injury surveillance and workers’ compensation data from TFD were merged and costs were described by mechanism of injury, injury type, body region and by age of the worker. The analysis of claims data shows that acute overexertion injuries are significantly more costly than injuries caused by other mechanisms, and that sprain/strain injuries are significantly costlier than other injury types. Results also show that age is an important predictor of claims cost in this population, with claims costs for firefighters over age 50, 120 to 144% greater than claims for workers under age 30. Back injury is common and costly among emergency services employees, including firefighters and emergency medical services providers, who transport patients. Previous research has demonstrated that electrically powered stretchers (EPS), which lift and lower the patient and stretcher between the loading and transport positions, are an effective means of reducing back injury among emergency medical services (EMS) providers, but to date no economic evaluation of this device has been conducted. A Markov decision analysis model simulation of a cohort of emergency services employees for incident back injury, disability and associated costs was used to compare outcomes with and without the use of the EPS. Implementation of the EPS resulted in an average cost savings of $4,617-$5,422 per emergency services employee over the service life of the equipment. Results of the current study show the PFF-Fit program may be a worthwhile program to reduce injury and claims costs but further research is needed to better understand the program’s potential effectiveness. We observed reductions in injury frequency and compensation costs among PFF-Fit program participants compared to controls; however, the mechanisms by which the PFF-Fit program were believed to be effective did not appear to be responsible for this difference. Workers’ compensation claims data analysis results continue to highlight the importance of targeting injuries caused by acute overexertion and injuries that result in sprain/strain. The results also indicate that targeting injury prevention efforts toward the specific needs of older workers may lead to important cost savings for the fire service. The EPS is likely an effective intervention to reduce back injuries and claims costs among fire and emergency services personnel, but further research is needed to evaluate injury and claims costs following implementation at several departments.

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職業災害補償制度乃保護勞工之生命財產安全，而非以故意或過失為補償構成要件，制度目標為職災預防、勞工傷病補償以及災後勞工重建。各國政府長久致力於建構一套完善的職業災害補償制度，保護因工作災害導致傷病之勞工，補償損失並提供醫療支援，協助重返工作崗位維持穩定生活。澳大利亞為聯邦制國家，職業災害補償制度採地方分權主義，由各省立法管轄制度運作，聯邦政府的角色則為全國政策之指導與調和。職災補償以強制保險課以雇主保護照顧責任，勞動者依地區、身份之別，各別適用澳洲境內十種職業災害補償制度。地方政府依該省職災補償相關法規，設立職災補償局管理制度運作，職災保險則由政府或民營保險業者辦理，故澳洲各省間形成彼此獨立之職災補償體系。 隨著職災補償制度發展與勞動市場環境變遷，各省職業災害補償制度的異質性，逐漸影響制度辦理之成效，造成法律適用難度增加、勞工與雇主各省間差別對待、行政錯誤與詐領風險提高等問題。而新興工作型態勞動人數的增加亦衝擊制度管理，使得傳統定義下的適用對象，有擴增範圍及統一各省定義之必要。因此，未來澳洲職災補償制度之發展，聯邦政府應試圖以縮小省分間之差異性為政策方向，職災補償制度仍由地方管轄，惟應漸進式統一職災補償法令有關基本之定義範圍、福利架構、職災重建協助措施等，使全國各省的勞工職災補償制度具有整體一致性規範。此外，澳洲職災補償與安全衛生預防、災後重建三者間制度連結之特色，可作為台灣加強職災預防、重建之參考，包括職災保護法令單獨立法、宣導傷病管理計畫、相關機構整併與功能強化，健全我國職災補償事前防治機制及事後補償重建之完整性。 / The fundamental aim of workers’ compensation system is to protect labors’ right to survive in the Constitution, so it is not based on someone’s negligent and fault. Workers’ compensation system is set for preventing from occupational injury, compensating labors’ loss, and rehabilitation after the injuries. The worker’s compensation system of Commonwealth of Australia is governed by the territories while the federal government of Australia is in charge of making national policy and harmonizing state’s system. Workers’ compensation system requires most employers to insure against their statutory liability to compensate employees for work-related injury or illness. According to the district and state, there are ten workers’ compensation schemes in Australia. Workers’ compensation funding operates by government and authorized private insurance. Each state has its own workers’ compensation laws, and operates workers’ compensation arrangements independently. As each jurisdiction has developed its own arrangements and transition of labor market environments, this has resulted in numerous inconsistencies and problems in the each jurisdiction’s include application of workers’ compensation laws, inequities in treatment to workers and employers, and increase risk of errors and fraud etc. The increase of precarious workers also impacts the system, so it is necessary to enhance and definite coverage of workers’ compensation scheme. Consequently, workers’ compensation system in Australia would be narrow inconsistencies of territories. The system is still governed by each of territory, however. There should be harmonized all of the definition, benefit structure, rehabilitation program etc, so that workers’ compensation system in Australia has a united rule to follow. Besides, the advantage of arrangement in Australia that integrates compensation with prevention and rehabilitation can be a model for Taiwan to enhance function of prevention and rehabilitation. Other suggestions are like integrating the laws related to occupational injury and compensation, encouraging injury management plan and enforcing role of insurer to fulfill function of prevention and rehabilitation of workers’ compensation in Taiwan.

Over the past two decades, violence at work has become the object of an increasing level of attention. The objective of the thesis is to analyse how the development of violence at work as a social problem might be understood. The studies in the thesis examine trends in exposure to violence at work among different occupational groups (I), the attention focused on violence at work in trade journals (II), the measures proposed to combat the problem in trade journal articles (III) and in the occupational injury reports made by the victims themselves (IV). The first study shows that, according to victim surveys, levels of exposure to work-related violence have increased since the beginning of the 1980s. The increases are greatest in relation to the female-dominated occupations found in the care provision sectors. Study II presents a quantitative content analysis of trade journals from the period 1978–2004. The results show that there has been an increase in the amount of attention focused on violence at work. The results indicate that definitions of violence have expanded and that attention has become focused on new groups of victims and perpetrators. Study III examines the ways in which trade journals describe measures to combat violence at work. The results indicate that there has been a shift from viewing violence as a problem that should be resolved at the workplace as a health-and-safety issue, to increasingly viewing it as a problem that should be resolved externally with the help of the justice system. Study IV is based on an analysis of occupational injury reports from staff in the care sector who have been exposed to violence at work. Irrespective of the nature of the risk situation that preceded the violent incident, the staff who have been exposed to violence at work would prefer to see the problem resolved internally at the workplace. / Våld i arbetslivet har under de senaste två decennierna fått en större uppmärksamhet. Syftet med avhandlingen är att analysera hur utvecklingen av våld i arbetslivet som samhällsproblem kan förstås. I fyra delstudier behandlas omfattningen och utvecklingen av utsatthet för våld i arbetslivet bland olika yrkesgrupper (I), hur våld i arbetslivet uppmärksammats i facklig press (II) och vilka åtgärder som förespråkas i facklig press (III) samt i arbetsskadeanmälningar (IV). Gemensamt för avhandlingens studier är att de tar upp frågor som rör förändring över tid, hur utvecklingen kan förstås och vilka konsekvenser förändringarna för med sig. I den första studien visas att utsatthet för arbetsrelaterat hot och våld enligt svenska offerunderökningar har ökat sedan 1980-talets början. Ökningarna är störst för de kvinnodominerade jobben inom välfärdssektorerna. I studie II görs en kvantitativ innehållsanalys av facklig press 1978-2004. Resultaten visar att uppmärksamheten för våld har ökat och pekar på vidgade definitioner av våld och att nya grupper uppmärksammas som offer och förövare. I studie III undersöks hur åtgärder mot hot och våld i arbetslivet uppmärksammas i facklig press. Resultaten indikerar att våld i arbetslivet har gått från att ses som ett problem som skall lösas som en intern arbetsmiljöfråga på arbetsplatsen till att allt oftare ses som ett problem som ska lösas externt med hjälp av polis och rättsväsende. Det har skett en förskjutning mot ett förrättsligande när det gäller hur våld i arbetlivet ska åtgärdas. Utvecklingen kan sammanfattas som en rörelse ett arbetsmiljöproblem till ett brottsproblem. Studie IV utgår från en analys av arbetsskadeanmälningar från vård- och omsorgspersonal som utsatts för våld i arbetet. När man ser till de åtgärdsförslag som de utsatta själva föreslår för att undvika att våldet skall inträffa igen så framgår att det finns en diskrepans mellan de åtgärder som uppmärksammas i facklig press och de åtgärder som personalen efterfrågar. De våldsutsatta ser främst att våldsproblemet, oavsett vilken risksituation som föregått våldet, löses internt på arbetsplatsen. Adekvata resurser i form av tid och personal för att utföra arbetet efterfrågas gång på gång. Insatser av externa aktörer såsom polis och rättsväsende efterfrågas däremot inte. / At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 4: Submitted.

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