Doctor of Philosophy(PhD) / Background: There is no on-going information on the number, rate or circumstances of work-related fatal injury in Australia. This thesis reports on a study aimed to identify and describe all work-related fatalities that occurred in Australia during the four-year period 1989 to 1992, in order to make a significant contribution to the effectiveness of activity designed to prevent work-related traumatic death. Methods: A broad definition of work was used, with particular focus on workers and bystanders. The study also included the injury-related deaths of volunteers, students, persons performing home duties and persons fatally injured on farms but not due to obvious farm work. The data were obtained primarily from coronial files. Files were found for 99.7% of the deaths of interest. Detailed results are presented on the work-related deaths of workers, bystanders and persons fatally injured while engaged in home duties. The results for workers are also compared with those from an earlier study of work-related fatalities in Australia, which covered the years 1982 to 1984 inclusive. Other aspects of work-related deaths are considered in detail, including the effect of employment arrangements; their coverage by occupational health and safety and compensation agencies; their handling by the coronial system; the role of External Cause codes in identifying and monitoring work-related injury deaths; and the reliability and validity of the definitions used to classify work-related injury deaths. Results: There were 2,413 persons fatally injured while working or commuting during the study period (1,787 working; 626 commuting), with a rate of death for working persons of 5.5 per 100,000 persons per year. This compared to the rate of 6.7 for working deaths during 1982 to 1984, with just under half of the decline probably due to changes in the industry distribution of the workforce. Another 802 persons were fatally injured as a result of someone else’s work activity, and 296 persons aged 15 years and over were fatally injured while undertaking active tasks in an unpaid and informal capacity in their own home or in someone else’s home. Thirty-four percent of working deaths were not covered by either occupational health and safety (OHS) or compensation agencies. A consideration of External Cause codes for the period 1979 to 1997 inclusive suggested there was a yearly decrease in the rate of workplace deaths of 2.6% per year, with less than half of this change due to industry changes in the workforce. Deaths occurring in a small number of particular circumstances were found to pose classification problems. Conclusion: Fatal work-related trauma remains an important problem for the Australian community. By understanding how and why these deaths occur, appropriate steps can be taken to prevent similar incidents recurring. It is expected that the results reported here, and other information that has arisen from the study, will make an important contribution to developing this understanding and preventing the occurrence of work- related traumatic death in Australia.

Doctor of Philosophy (PhD) / Injuries to people living and working on farms in New South Wales continue to be a significant burden on the health system, Workers’ Compensation system, agricultural industries and farming families. Strategies to reduce the number and severity of injuries suffered by farmers and people working on farms rely on accurate information. Unfortunately there is no one dataset available to describe the circumstances surrounding farm injuries and the size of this burden in Australia. Hence, a number of different data sources are required to provide a picture of farm injuries. To date, there has been very little critical examination of what value each of these datasets provides to describing farm injuries. This Thesis aimed to: • Undertake surveillance of injuries occurring to people on farms or during agricultural production in NSW using data from an Emergency Department, NSW Hospital Separations information, NSW Workers’ Compensation Claims, and ABS Deaths data. • Critically examine the utility of Emergency Department, Hospital, Workers’ Compensation, and ABS Deaths Data for the surveillance of farm injuries in NSW. • Critically examine data classification systems used in Emergency Department, Hospital, Workers’ Compensation, and ABS Deaths data collections to describe the breadth of farm injuries in NSW. • Define the priority areas for farm injury prevention initiatives in NSW based on the information obtained from the examination of the data from Emergency Department, Hospital, Workers’ Compensation, and ABS Deaths. • Evaluate the effectiveness of the NSW Rollover Protective Structure (ROPS) rebate scheme and examine the utility of the data currently available in NSW to measure the performance of the program. Four datasets, Tamworth Emergency Department, Hospital Separations, Workers’ Compensation and the Australian Bureau of Statistics (ABS) Deaths data were used to provide information on the surveillance of farm injuries, describe the breadth of classifications used to describe farm injuries, and define priorities for the prevention of farm injuries. There were 384 farm-related injuries which presented to the Emergency Department at the Tamworth Base Hospital between 1 September 1997 and 31 August 1998. Emergency Department data collected in this study used the Farm Injury Optimal Dataset (FIOD) for classification, which allowed for a comprehensive picture of the circumstances surrounding the injury event. The three most common external causes of injury were related to horses, motorcycles, and animals. Commonly people were working at the time of injury. Children represented 21% of the people injured. The average number of injuries per 100 farms per annum was 34.7. An examination of hospital discharge data for NSW was undertaken for the period 1 July 1992 to 30 June 2000 where the location of the injury was a farm. Classification of cases in this dataset conformed to the International Classification of Disease (ICD) versions 9 and 10. There were 14,490 people who were injured on a farm during the study period. The three most common external causes of injury were motorcycles, animals being ridden and agricultural machinery. Children represented 17% of all farm injury cases. The rate per 1,000 farms ranged from 19 to 42 per annum. An examination of Workers’ Compensation claims for agricultural industries in NSW between 1 July 1992 and 30 June 2001 was undertaken. The ‘Type of Occurrence’ classification system was used to code the claims. There were 24,332 claims of which the majority were males (82%). The incidence of injury / disease in agriculture per annum varied from 37 per 1,000 workers to 73 per 1,000 workers. The rate per 1,000 agricultural establishments varied from 54 to 76. The average cost of a claim was $10,880 and the average time lost per claims was 9.2 weeks. There were 81 deaths and 3,158 permanent disabilities. The three most common agents were sheep / goats (5%), ferrous and non-ferrous metals (5%), crates / cartons / boxes / etc (5%). Using ABS deaths data to examine the deaths of people working and living on farms was limited to males whose occupation was recorded as ‘farmer and farm manager’ and ‘agricultural labourer and related worker’. There were 952 deaths over the period 1 January 1991 and 31 December 2000. The information provided a consistent series of cases over time. Areas where prevention should be directed included motor vehicle accidents; falls; agricultural machinery; other machinery; firearms; poisoning; and drowning. Using any one of the datasets alone to examine people injured on farms not only underestimates the number of people injured, but also misses particular types of agents involved in farm injuries. Each of the datasets used in this Thesis provides a different perspective of farm injury in NSW. By examining the information together, there are a number of areas which are consistently represented in each dataset such as falls and agricultural machinery. While no one dataset provided all the information that would be useful for the prevention of injuries, the available information does provide direction for the development of prevention strategies. The overall weakness of the information provided is that it misses a number of risk factors that contribute to farm injuries such as fatigue and training. The lack of appropriate denominator information also makes it difficult to directly compare the datasets and estimate the size of the problem. There are a number of additional coding categories that could be included in each dataset that would provide a better understanding of the different groups at risk of sustaining an injury on a farm or during agricultural work. These coding categories include activity at time of injury, admission to hospital, and occupation. An example of the use of data to determine the effectiveness of a farm injury prevention program is the ‘NSW Rollover Protective Structure (ROPS) Rebate Scheme’ evaluation. Tractor rollover deaths have been identified as an issue for prevention by Farmsafe Australia; however, such deaths were not identified in any of the datasets used in this Thesis due to coding limitations in the ABS data. In this Thesis information about the evaluation of the ‘NSW ROPS Rebate Scheme’ is presented. The scheme was successful in fitting 10,449 ROPS to tractors and the following lessons were learnt: when providing a rebate, the administration (i.e. sending the cheque) needs to be done well; advertising is important and should be co-ordinated, increase the awareness of the risk(s) the intervention is aiming to prevent and effectiveness of subsequent solution (s); the program should ensure there is an increased awareness of the outcome the intervention is aiming to prevent; if regulation is part of the program, enforcement needs to undertaken; and should address any barriers to uptake. The information provided in this Thesis highlights the substantial burden that farm injury places on the agricultural and rural sector of NSW. While there is no one data source that can describe the circumstances and the burden of farm injuries, the currently available datasets do provide an insight into the circumstances of farm injuries and the burden these injuries place on health, Workers’ Compensation, agricultural industries and farming families.

OHSAS 18000 Occupational Health and Safety Assessment System Series have a special importance to mining. OHSAS standardization aims to provide secure, more tranquil and healthier working space to the employees by means of establishing an assessment system. As mining activities are generally carried out in high risk environments, OHSAS has been improved and has increased its importance for mining in the world. In this study, Bigadi&ccedil / Boron Work is taken as a case for the application of OHSAS 18001. Theoretical information about OHSAS and risk assessment is provided, and some exemplifying mines that implemented this standard are given to illustrate their benefits. All possible hazard sources are identified and a &ldquo / Hazard Source Inventory&rdquo / is proposed. Together with this hazard source inventory, a risk assessment method is developed for Bigadi&ccedil / Boron Work. Several tasks are evaluated according to this proposed form. In order to define policy, principles and structure of Occupational Health and Safety Assessment System, an &ldquo / OHSA Manual&rdquo / is prepared. Several sets of standard forms were prepared and recommended for Bigadi&ccedil / Boron Work. Consistency throughout the organization was established by means of these created standard documents, procedures and forms. Proposed Job Safety Analysis form can be used to identify, analyze and record the steps involved in performing a specific task, and the existing or potential safety and health hazards associated with each step. Several safe job procedures were also prepared with the help of the risk assessment process. In addition to this, an &ldquo / Emergency Plan&rdquo / is proposed for enterprise to prevent loss of life, property and information, and provide safety in case of any emergency or natural disaster. An &ldquo / OHS Audit Instrument&rdquo / is suggested for the Bigadi&ccedil / Boron Work that will play a key role for continuous improvement of the system. Audits are integral part of OHSAS in order to identify hazards, improve health and safety conditions, and check compliance with regulations. These studies also show that there are some problems in the implementation of the system. The main problem is ineffective data recording and keeping. Lack of consciousness of employees and low commitment of top management constitute another important difficulty. Although these problems are commonly encountered in practice, applying OHSAS 18000 standard is still worthwhile method of improving work environment.

The objective of this study is to examine lean production and its effects on general working conditions and occupational health and safety. Lean production is considered either as a humane way of production with positive effects on workers or to have negative consequences for workers&#039 / and their job quality. This study investigates the increasing workload of the workers as a result of the unlimited performance demands of lean production as the first hypothesis. Secondly, there is the question of whether lean production provides a reduction in the number of occupational accidents because of the fact that occupational accidents are seen as waste, thus eliminated at all costs. The last hypothesis which will be assessed is that the number of occupational diseases increases after the implementation of lean production. To that end, a case study was carried out in an automotive plant by a qualitative research method using tools of observation, document analysis, in depth interview and structured interview. As a conclusion, the implementation of lean production in a plant in automotive industry has resulted in the reduction of the occupational accidents and improvement of ergonomic conditions even though the main incentive for these improvements is to reduce the wastes and costs and to increase the profitability and competitiveness. Based on the interviews, workers do not consider that their workload is increased after the implementation of lean production. Besides, workers feel work autonomy and job satisfaction. They also claim that they do not feel job stress in contrast to the literature.

<p> The purpose of this project was to partner with a community mental health outpatient clinic, locate a potential funding source, and write a grant to obtain funding for a clinic wide wellness program. The proposed program aims to support mental health providers and employees at a mental health outpatient clinic to prevent and decrease burnout among mental health providers. A literature review was conducted to discuss the history of burnout, burnout symptoms and consequences, and interventions to reduce burnout. The Weingart Foundation was identified as a potential funding source for the program. The host agency chosen for this project is Western Youth Service West Clinic which provides comprehensive mental health services to children and families dealing with mental illness. The actual submission or funding of this grant was not required for the successful completion of this project.</p>

This exploratory study examines the lived experience of Green Cross traumatologists deployed to the New York City World Trade Center disaster. The deployment took place five days after the terrorist attacks on September 11, 2001. The author was a member of a ten member advance team that provided crisis stabilization services to an international union in Lower Manhattan. Disaster Mental Health Services and community outreach were provided for a month. The purpose of the study was to describe in an anthropologically holistic perspective the lived experience of traumatologists, who as Americans were also affected by the terrorist disaster. Thirty-one traumatologists participated in the study. Ethnographic methods included participant observation and informal interviews during the first week of the deployment. In-depth interviews were conducted after deployment and ranged from one to three hours in length. Interviews were audio taped, transcribed and analyzed with the assistance of N-vivo software. The author's story is among the narratives. Narratives of lived experience reflect the continuity of life and give meaning to experience within a cultural context. Findings reveal the shared meaning attributed to lived experience in a disaster environment, cultural continuity and change and impact of disaster deployment on the health and safety of the helper. Recommendations for future research, policy and training are offered.

This dissertation is based on ethnographic fieldwork conducted in San Pedro Amuzgos, Oaxaca and on La Coasta Hermosillo, Sonora, Mexico. In it I trace the movements of migrant farmworkers who come from southern Mexico to work in the grape fields of Sonora. Within that context of movement and change, I focus on understanding how illnesses are perceived and how they are healed. First I explore this issue, in depth, in their homeplace in rural Oaxaca. I follow specific illness events among residents of Amuzgos and I allow individuals actions and their reflections on those actions act as a corrective to static notions of the "Latino Folk Illnesses" that exemplify the way in which residents of this small village conceptualize their bodily problems. Local understandings of illnesses are embedded in the village as a specific Place where the topography of the village is inhabited by dangerous spirits that cause health problems for the Amuzgos. To heal, is to heal the Place where negative things occurred as well as the bodies that manifest negative symptoms. Following the Amuzgos up to the fields of Sonora, I focus on how the changing environmental context influences their perceptions of the sources of illnesses and the ways in which they treat them. In particular, I focus on the ways in which they conceptualize the health problems that arise from exposures to the pesticides that are ubiquitous in the fields and camps where they live and work.

Respirators are used to minimize the exposure to air contaminants. A good fit is essential for the effective functioning of a respirator. The Occupational Safety and Health Administration (OSHA) requires an annual respirator fit testing. Respirator fit can be assessed either qualitatively or quantitatively. Two studies were conducted to assess the fit testing program with specific objectives to: (1) assess leak rates in full and half mask respirators; (2) assess the effectiveness of "feedback"1 on the quality of fit; (3) evaluate the effect of daily beard growth on respirator leak rates. In the first study, it was found that the half mask respirator has a significantly lower leak rate than the full face respirator. A significant reduction in leak rate in both respirator types with "feedback" was also observed. The finding that half mask respirators have lower leak rates directly contradicts American National Standard Institute's (ANSI) guidelines of higher Assigned Protection Factor (APF) for full mask respirator. Further studies are necessary to determine these findings and to amend respirator recommendations in the future. As expected in the second study, beard growth was associated with respirator leak rate. The effect of daily growth on leak rate over a period of twelve days could be defined by a second order regression equation. An attempt was made to describe some characteristics of beard that affect the leak rate. After 12 days of beard growth, it was found that the aspect ratio (length/diameter) of hair was inversely correlated with leak rate (r = 0.64). 1Feedback: A numerical value measuring the minimum leak rate that can be gotten from a respirator fitting with a normal donning.

<p> The Occupational Health and Safety Administration (OSHA) estimates that half a million surgical staff are exposed to laser smoke or plume each year. It has been suggested that the type and intensity of exposure is dependent in part on the way a laser is used during surgery. The purpose of this study was to estimate emission rates of the gas phase constituents of laser generated air contaminants using a validated emission chamber methodology while differentiating the effects of the laser operational parameters power, pulse-repetition frequency, and beam diameter, and ultimately to model a set of plausible occupational exposures. </p><p> An emission chamber was designed, fabricated, and validated to quantify the emission rates of gases and particles associated with laser generated air contaminants (LGACs) during a simulated surgical procedure. The emission chamber was built of inert materials, including a glass hood section connected to a duct section for collection and allowing for lasing of tissue. The performance, plume capture, and air flow of the emission chamber system were validated. This validated emission chamber and methodology enabled accurate estimation of emission rates with low experimental variability that can be used in mathematical modeling of exposure. </p><p> Two medical lasers (Holmium Yttrium Aluminum Garnet [Ho:YAG] and carbon dioxide [CO₂]) were set at varying operational parameters in a simulated laser surgery on porcine skin to generate a plume in an emission chamber. Porcine skin was pyrolyzed with a medical laser set to a range of surgically plausible operational parameters. Consistency in the rate and depth of incision was established by a system to control the speed of laser movement and aim angle of the laser tip, and was validated by measurement of tissue loss. The plume was sampled for seven gas phase contaminants of combustion products (volatile organic compounds [VOC], formaldehyde, hydrogen cyanide [HCN], carbon dioxide (CO₂), carbon monoxide [CO]). The effect of each operational parameter was determined using a fractional factorial design coupled with a sequential screening process that evaluated the parameters for their influence on emission rates. </p><p> Measured concentrations of the gas phase contaminants were below the limit of detection (LOD). Confined to the experimental conditions of this investigation, results indicated that beam diameter was significantly influential to emission rates when using the Ho:YAG laser but not with the CO₂ laser. Power and pulse repetition frequency were not influential to emission rates of these gas phase contaminants. </p><p> Emission rates of LGAC from the experimentally determined concentrations were used to estimate a range of physically plausible occupational exposures to surgical staff. A two-zone semi-empirical model was implemented with input variables varied over a range based on the general requirements of a laser surgical suite in compliance with regulatory agencies. Twenty-minute time weighted averages were developed for the near- and far-field zones within the surgical suite as estimates of the occupational exposure to LGAC. These values were compared to relevant occupational exposure limits; estimated exposures were at least three times in magnitude less than the exposure limits and thus do not appear to present an occupational hazard.</p>

No description available.