Fatal and nonfatal railway injuries in eastern Türkiye: evaluation of seventeen years experience*

Pedestrian and bicycle plans and the incidence of crash-related injuries

Each year in the United States, an estimated one in six residents requires medical treatment for an injury, and an estimated one in 10 residents visits a hospital emergency department (ED) for treatment of a nonfatal injury. This report summarizes national data on fatal and nonfatal injuries in the United States for 2001, by age; sex; mechanism, intent, and type of injury; and other selected characteristics.January-December 2001.Fatal injury data are derived from CDC's National Vital Statistics System (NVSS) and include information obtained from official death certificates throughout the United States. Nonfatal injury data, other than gunshot injuries, are from the National Electronic Injury Surveillance System All Injury Program (NEISS-AIP), a national stratified probability sample of 66 U.S. hospital EDs. Nonfatal firearm and BB/pellet gunshot injury data are from CDC's Firearm Injury Surveillance Study, being conducted by using the National Electronic Injury Surveillance System (NEISS), a national stratified probability sample of 100 U.S. hospital EDs.In 2001, approximately 157,078 persons in the United States (age-adjusted injury death rate: 54.9/100,000 population; 95% confidence interval [CI] = 54.6-55.2/100,000) died from an injury, and an estimated 29,721,821 persons with nonfatal injuries (age-adjusted nonfatal injury rate: 10404.3/100,000; 95% CI = 10074.9-10733.7/ 100,000) were treated in U.S. hospital EDs. The overall injury-related case-fatality rate (CFR) was 0.53%, but CFRs varied substantially by age (rates for older persons were higher than rates for younger persons); sex (rates were higher for males than females); intent (rates were higher for self-harm-related than for assault and unintentional injuries); and mechanism (rates were highest for drowning, suffocation/inhalation, and firearm-related injury). Overall, fatal and nonfatal injury rates were higher for males than females and disproportionately affected younger and older persons. For fatal injuries, 101,537 (64.6%) were unintentional, and 51,326 (32.7%) were violence-related, including homicides, legal intervention, and suicide. For nonfatal injuries, 27,551,362 (92.7%) were unintentional, and 2,155,912 (7.3%) were violence-related, including assaults, legal intervention, and self-harm. Overall, the leading cause of fatal injury was unintentional motor-vehicle-occupant injuries. The leading cause of nonfatal injury was unintentional falls; however, leading causes vary substantially by sex and age. For nonfatal injuries, the majority of injured persons were treated in hospital EDs for lacerations (25.8%), strains/sprains (20.2%), and contusions/abrasions (18.3%); the majority of injuries were to the head/neck region (29.5%) and the extremities (47.9%). Overall, 5.5% of those treated for nonfatal injuries in hospital EDs were hospitalized or transferred to another facility for specialized care.This report provides the first summary report of fatal and nonfatal injuries that combines death data from NVSS and nonfatal injury data from NEISS-AIP. These data indicate that mortality and morbidity associated with injuries affect all segments of the population, although the leading external causes of injuries vary substantially by age and sex of injured persons. Injury prevention efforts should include consideration of the substantial differences in fatal and nonfatal injury rates, CFRs, and the leading causes of unintentional and violence-related injuries, in regard to the sex and age of injured persons.

Commercial fishing is a high-risk occupation. The West Coast Dungeness crab fishery has a high fatality rate; however, nonfatal injuries have not been previously studied. The purpose of this report was to describe the characteristics of fatal and nonfatal traumatic occupational injuries and associated hazards in this fleet during 2002-2014. Data on fatal injuries were obtained from a surveillance system managed by the National Institute for Occupational Safety and Health. Data on nonfatal injuries were manually abstracted from Coast Guard investigation reports and entered into a study database. Descriptive statistics were used to characterise demographics, injury characteristics, and work processes performed. Twenty-eight fatal and 45 nonfatal injuries were reported between 2002 and 2014 in the Dungeness crab fleet. Most fatalities were due to vessel disasters, and many nonfatal injuries occurred on-deck when fishermen were working with gear, particularly when hauling the gear (47%). The most frequently reported injuries affected the upper extremities (48%), and fractures were the most commonly reported injury type (40%). The overall fatality rate during this time period was 209 per 100,000 full-time equivalent workers and the rate of nonfatal injury was 3.4 per 1,000 full-time equivalent workers. Dungeness crab fishermen are at relatively high risk for fatal injuries. Nonfatal injuries were limited to reported information, which hampers efforts to accurately estimate nonfatal injury risk and understand fishing hazards. Further research is needed to identify work tasks and other hazards that cause nonfatal injuries in this fleet. Engaging fishermen directly may help develop approaches for injury prevention.

Injuries pose a threat to health and well-being and are a major source of medical spending in the United States for children and youth 0 to 21 years of age. This study provides national estimates of the incidence of fatal and nonfatal childhood injuries and comprehensive cost estimates by age, gender, race, family income, metropolitan residence, and place of incident. Eight years of National Health Interview Survey data (1987 to 1994) were used to estimate nonfatal injury incidence rates among children and youth 21 years of age and younger. The survey documents all medically attended or temporarily disabling injuries within the 2 weeks before the interview. Injuries were defined as diagnoses 800-995 in the International Classification of Diseases, Ninth Revision, excluding late effects cases. Fatality counts came from 1994 Vital Statistics. Estimates of the costs of injuries (1994 US dollars) included medical spending, lost future work, and lost quality of life. Medical payments included spending on hospital and professional services, rehabilitation, prescriptions, home health care, and medical equipment. Lost future work and lost quality of life consisted of the present value of work that children will be unable to do as adults if they are killed or permanently disabled combined with the pain and suffering that children and their families experience because of the injury. Cost estimates excluded parental income losses from work missed, property damage, legal costs, and insurance claims-adjustment costs related to permanent disability and death. INCIDENCE. A total of 3,073 injury episodes for 3,058 children were obtained from 8 years of National Health Interview Survey data. This represents 20.6 million children in the United States who were injured each year, or approximately 25 per 100 children. This translates to 56,000 nonfatal injury episodes each day that require medical attention or limit children's activity. For fatal injuries, the rate was 38 children per 100,000. The nonfatal injury rate for males (mean: 30; 95% confidence interval [CI]: 29,31) was higher than the rate for females (mean: 20; 95% CI: 19,21); the fatal injury rate for males was more than twice that of females. Injury rates increased with age. Children 0 to 9 years of age had the lowest rate of nonfatal injury. Rates for nonfatal injury among children 0 to 4 years of age were lower (mean: 20; 95% CI: 18,21) than those for the 5 to 9 age group (mean: 22; 95% CI: 20, 23). However, the rate for fatal injuries (21 per 100,000) among the 0 to 4 age group was higher than the 5 to 9 age group (9 per 100,000). Nonfatal injury rates for children 10 years of age and older were higher, with the highest estimated injury rates in late adolescence (15-19 years; mean: 31; 95% CI: 29,33). Nonfatal injuries occurred at higher rates among white children (mean: 27; 95% CI: 26,28) than black children (mean: 19; 95% CI: 17,21) or children from other racial backgrounds (mean: 13; 95% CI: 10,16). The reverse was true for fatal injuries, with higher fatality rates among black children (59 per 100,000). Children in families with incomes under $5,000 had the highest rate of nonfatal injury (mean: 31; 95% CI: 27,35), followed by those in the $35,000 to $49,999 income range (mean: 25; 95% CI: 23,27). The rate of nonfatal injuries in the other income brackets were fairly similar, with those in the highest income bracket having the lowest rate (mean: 14; 95% CI: 13,15). Fatality rates by family income were not available. The nonfatal injury rate in nonmetropolitan areas (mean: 10; 95% CI: 9,11) was higher than in metropolitan areas (mean: 8; 95% CI: 7,8); the same was true for fatal injury rates (33 per 100,000 in nonmetropolitan areas vs 25 in metropolitan areas). Males consistently had higher injury rates than females across all places of injury. Youth 15 years of age and older had higher rates for injuries that occur on the public roads, in recreatio

Construction workers are frequently exposed to various types of injury-inducing hazards. There are a number of injury prevention interventions, yet their effectiveness is uncertain. To assess the effects of interventions for preventing injuries in construction workers. We searched the Cochrane Injuries Group's specialised register, CENTRAL (issue 3), MEDLINE, Embase and PsycINFO up to April 2017. The searches were not restricted by language or publication status. We also handsearched the reference lists of relevant papers and reviews. Randomised controlled trials, controlled before-after (CBA) studies and interrupted time-series (ITS) of all types of interventions for preventing fatal and non-fatal injuries among workers at construction sites. Two review authors independently selected studies, extracted data and assessed their risk of bias. For ITS studies, we re-analysed the studies and used an initial effect, measured as the change in injury rate in the year after the intervention, as well as a sustained effect, measured as the change in time trend before and after the intervention. Seventeen studies (14 ITS and 3 CBA studies) met the inclusion criteria in this updated version of the review. The ITS studies evaluated the effects of: introducing or changing regulations that laid down safety and health requirements for the construction sites (nine studies), a safety campaign (two studies), a drug-free workplace programme (one study), a training programme (one study), and safety inspections (one study) on fatal and non-fatal occupational injuries. One CBA study evaluated the introduction of occupational health services such as risk assessment and health surveillance, one evaluated a training programme and one evaluated the effect of a subsidy for upgrading to safer scaffoldings. The overall risk of bias of most of the included studies was high, as it was uncertain for the ITS studies whether the intervention was independent from other changes and thus could be regarded as the main reason of change in the outcome. Therefore, we rated the quality of the evidence as very low for all comparisons.Compulsory interventionsRegulatory interventions at national or branch level may or may not have an initial effect (effect size (ES) of -0.33; 95% confidence interval (CI) -2.08 to 1.41) and may or may not have a sustained effect (ES -0.03; 95% CI -0.30 to 0.24) on fatal and non-fatal injuries (9 ITS studies) due to highly inconsistent results (I² = 98%). Inspections may or may not have an effect on non-fatal injuries (ES 0.07; 95% CI -2.83 to 2.97; 1 ITS study).Educational interventionsSafety training interventions may result in no significant reduction of non-fatal injuries (1 ITS study and 1 CBA study).Informational interventionsWe found no studies that had evaluated informational interventions alone such as campaigns for risk communication.Persuasive interventionsWe found no studies that had evaluated persuasive interventions alone such as peer feedback on workplace actions to increase acceptance of safe working methods.Facilitative interventionsMonetary subsidies to companies may lead to a greater decrease in non-fatal injuries from falls to a lower level than no subsidies (risk ratio (RR) at follow-up: 0.93; 95% CI 0.30 to 2.91 from RR 3.89 at baseline; 1 CBA study).Multifaceted interventionsA safety campaign intervention may result in an initial (ES -1.82; 95% CI -2.90 to -0.74) and sustained (ES -1.30; 95% CI -1.79 to -0.81) decrease in injuries at the company level (1 ITS study), but not at the regional level (1 ITS study). A multifaceted drug-free workplace programme at the company level may reduce non-fatal injuries in the year following implementation by -7.6 per 100 person-years (95% CI -11.2 to -4.0) and in the years thereafter by -2.0 per 100 person-years (95% CI -3.5 to -0.5) (1 ITS study). Introducing occupational health services may result in no decrease in fatal or non-fatal injuries (one CBA study). The vast majority of interventions to adopt safety measures recommended by standard texts on safety, consultants and safety courses have not been adequately evaluated. There is very low-quality evidence that introducing regulations as such may or may not result in a decrease in fatal and non-fatal injuries. There is also very low-quality evidence that regionally oriented safety campaigns, training, inspections or the introduction of occupational health services may not reduce non-fatal injuries in construction companies. There is very low-quality evidence that company-oriented safety interventions such as a multifaceted safety campaign, a multifaceted drug workplace programme and subsidies for replacement of scaffoldings may reduce non-fatal injuries among construction workers. More studies, preferably cluster-randomised controlled trials, are needed to evaluate different strategies to increase the employers' and workers' adherence to the safety measures prescribed by regulation.

From the Feds: Research, programs, and products

Occupational Injuries among U.S. Correctional Officers, 1999-2008

To compare fatal and hospitalized nonfatal work-related traumatic injuries by occupation and cause. Fatal and hospitalized nonfatal injuries occurring from 1991-1995 were identified from Washington State workers' compensation claims data. Nonfatal injuries were classified as severe if they had at least one of the following criteria: a brain or spinal cord injury, an Injury Severity Score of >/=16, or were hospitalized for more than 7 days. The frequency and rate of fatal and severe nonfatal injuries were then described by industrial risk class and cause. The study identified 335 fatal injuries and 4,405 hospitalized nonfatal injuries, of which 1,105 were classified as severe. Tree topping and pruning, carnival work, roofing, and metal siding and gutters risk classes had several severe nonfatal injuries, but few, if any, fatalities. Causes of fatal and severe nonfatal injuries were notably different for the roofing, restaurant, and orchard workers risk classes. The inclusion of severe hospitalized injuries in occupational injury surveillance systems will provide a broader view of high-risk occupations and profile of injury causation with which to direct occupational injury prevention efforts.

Aging populations are a dramatically increased worldwide trend, both in developed and developing countries. This study examines the prevalence of fatal and non-fatal work-related injuries between young (<45 years old) and older (≥45 years old) workers. A systematic literature review aimed at examining studies comparing safety outcomes, namely fatal and non-fatal injuries, between older and younger workers. Results show that 50% of the reviewed papers suggest that fatal injuries are suffered mainly by older workers, while the remaining 50% show no differences between older and younger workers. Regarding non-fatal injuries, 49% of the reviewed papers found no relationship between workers’ age; 31% found increased age as a protective factor against non-fatal injuries; and 19% showed that older workers had a higher risk of non-fatal injuries than younger ones. This review suggests that older workers experience higher rates of fatal injuries, and younger workers experience higher rates of non-fatal injuries.

This study describes injuries related to assaults and violence that occurred in Washington State workplaces in 1992. Nonfatal injuries are emphasized. High-risk industries and occupations are described. Fatalities caused by work-related violence were identified using the 1992 U.S. Department of Labor Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries. Nonfatal injuries were identified using the BLS Annual Survey of Occupational Injuries and Illnesses and the Washington State workers' compensation system. Thirteen occupational fatalities resulted from assaults or violent acts in 1992. BLS data identified 784 nonfatal injuries that resulted in one or more day off work; workers' compensation data identified 2,395 claims. Industries experiencing the highest claim rates were Social Services (148 per 10,000) and Health Services (106 per 10,000). Nonfatal violent injuries were common and appeared to have different risk factors than fatal injuries. Industries in which injuries occurred were often predictable and suggested specific strategies for prevention efforts.

The study investigated trends in traffic crashes with fatal and non-fatal injuries in Arkhangelsk, Russia in 2005–2010. Data were obtained from the road police. Negative binomial regression with time regressor was used to investigate trends in monthly incidence rates (IRs) of crashes, fatalities, and non-fatal injuries. During the six-year period, the police registered 4955 crashes with fatal and non-fatal injuries, which resulted in 217 fatalities and 5964 non-fatal injury cases. The IR of crashes with fatal and non-fatal injuries per total population showed no evident change, while the IR per increasing total number of motor vehicles decreased on average by 0.6% per month. Pedestrian crashes constituted 51.8% of studied crashes, and pedestrians constituted 54.6% of fatalities and 44.5% of non-fatal injuries. The IRs of pedestrian crashes and non-fatal pedestrian injuries per total population decreased on average by 0.3% per month, and these were the major trends in the data.

Fatal and non-fatal occupational injuries are one of the most important public health problems all over the world. Its number greatly varies from country to country over the years. Worldwide approximately 4% of global gross domestic product (GDP) is lost due to occupational injuries. It has also been estimated that daily, approximately 1 million workers get injured, and more than 5000 workers die due to their occupation. In this research work, using modern data analytics techniques, we have tried to explore the current situation and time trend of fatal and non-fatal occupational injuries globally and in India. Using the open-source data available at the International Labour Organization (ILO) database and the Government of India open database, analysis was performed systematically using R and Python programming languages. Data have been accessed by December 31, 2022. To make a representative sample population for this article, four countries from Europe and Central Asia region (Russia, France, Germany, and United Kingdom), four countries from the Asia-Pacific region (India, Australia, Japan, and Republic of Korea), and two countries from Americas (United States and Argentina) are selected for a meaningful comparison purpose. Since 2000, the time trend of fatal and non-fatal occupational injuries has been increasing trend globally. The yearly average (± standard deviation) of fatal and non-fatal injuries per country per million population was 256 (±68) and 83380 (±41280). The number of fatal injuries in India has increased over the years, but the number of non-fatal injuries in India is decreasing trend. According to the ILO database, it has been revealed in this article that, on average yearly, 83380 per million population total occupational injuries are reported worldwide. Among them, yearly, 256 per million population (0.3%) workers per country succumbed to injuries. According to Government of India database, there was an average of 271 deaths per year between 2000 and 2021. For evidence-based decision and policy making and subsequent program implementation, the availability of timely, good-quality data from every industrial sector of society is most important. It can only be achieved by implementing integrated occupational injury surveillance programs at national and global levels.

Urban areas significantly impact crash injury severity due to high traffic density and complex road patterns. This study analysed factors influencing fatal and non-fatal injuries in single-vehicle crashes on urban roads in Ghana from 2017 to 2020, using data from the Driver and Vehicle Licensing Authority (DVLA). The Random Parameter Logit Model revealed that younger drivers (under 20) are at higher risk for both fatal and non-fatal injuries. Crashes involving saloon cars, pickups, and minibuses had higher injury risks. Severe frontal damage increases the likelihood of both non-fatal and fatal injuries. Newer vehicles (under 5 years) showed lower injury risks. Crashes at controlled intersections and daytime crashes were less likely to result in fatal injuries. Failure to yield the right of way and mechanical failures were significant contributors to injury severity. The study highlights the need for targeted road safety interventions.

ABSTRACTThis paper investigates determinants of the probability of non-fatal and fatal crew injuries in container vessel accidents. The determinants are deduced from an estimated probit regression equation based upon 2001–2008 U.S. Coast Guard container vessel accident data. The estimation results suggest that a crew member is: (1) less likely to have a non-fatal injury in containership and ro-ro container vessel accidents if the vessel has a steel hull and the vessel accident occurs at nighttime, (2) more likely to have a fatal injury if fire is involved in containership and ro-ro container vessel accidents, and (3) less likely to have a fatal injury in containership and ro-ro container vessel accidents if the vessel is U.S. flagged, steel hulled, and powered by a diesel engine. These results are critical in developing new policies in reducing non-fatal and fatal crew injuries in container vessel accidents.

Objective:To characterize the full spectrum of pediatric firearm injury in the United States by describing fatal and nonfatal injury data epidemiology, vulnerable populations, and temporal trends.Background:Firearm injury is the leading cause of death in children and adolescents in the United States. Nonfatal injury is critical to fully define the problem, yet accurate data at the national level are lacking.Methods:A cross-sectional study combining national firearm injury data from the Centers for Disease Control (fatal) and the National Trauma Data Bank (nonfatal) between 2008 and 2019 for ages 0 to 17 years. Data were analyzed using descriptive and χ2 comparisons and linear regression.Results:Approximately 5000 children and adolescents are injured or killed by firearms each year. Nonfatal injuries are twice as common as fatal injuries. Assault accounts for the majority of injuries and deaths (67%), unintentional 15%, and self-harm 14%. Black youth suffer disproportionally higher injuries overall (crude rate: 49.43/million vs White, non-Hispanic: 15.76/million), but self-harm is highest in White youth. Children <12 years are most affected by nonfatal unintentional injuries, 12 to 14 years by suicide, and 15 to 17 years by assault. Nonfatal unintentional and assault injuries, homicides, and suicides have all increased significantly (P < 0.05).Conclusions:This study adds critical and contemporary data regarding the full spectrum and recent trends of pediatric firearm injury in the United States and identifies vulnerable populations to inform injury prevention intervention and policy. Reliable national surveillance for nonfatal pediatric firearm injury is vital to accurately define and tackle this growing public health crisis.