Fatality Assessment And Control Evaluation Research Articles

Surveillance of traffic incident management–related occupational fatalities in Kentucky, 2005–2016

ABSTRACTObjective: Traffic incidents occurring on roadways require the coordinated effort of multiple responder and recovery entities, including communications, law enforcement, fire and rescue, emergency medical services, hazardous materials, transportation agencies, and towing and recovery. The objectives of this study were to (1) identify and characterize transportation incident management (TIM)-related occupational fatalities; (2) assess concordance of surveillance data sources in identifying TIM occupations, driver vs. pedestrian status, and occupational fatality incident location; and (3) determine and compare U.S. occupational fatality rates for TIM industries.Methods: The Kentucky Fatality Assessment and Control Evaluation (FACE) program analyzed 2005–2016 TIM occupational fatality data using multiple data sources: death certificate data, Collision Report Analysis for Safer Highways (CRASH) data, and media reports, among others. Literal text analysis was performed on FACE data, and a multiple linear regression model and SAS proc sgpanel were used to estimate and visualize the U.S. TIM occupational mortality trend lines and confidence bounds.Results: There were 29 TIM fatalities from 2005 to 2015 in Kentucky; 41% of decedents were in the police protection occupation, and 21% each were in the fire protection and motor vehicle towing industries. Over one half of the TIM decedents were performing work activities as pedestrians when they died. Media reports identified the majority of the occupational fatalities as TIM related (28 of 29 TIM-related deaths); the use of death certificates as the sole surveillance data source only identified 17 of the 29 deaths as TIM related, and the use of CRASH data only identified 4 of the 29 deaths as TIM related. Injury scenario text analysis showed that law enforcement vehicle pursuit, towing and recovery vehicle loading, and disabled vehicle response were particular high-risk activities that led to TIM deaths. Using U.S. data, the motor vehicle towing industry had a significantly higher risk for occupational mortality compared to the fire protection and police protection industries.Conclusions: Multiple data sources are needed to comprehensively identify TIM fatalities and to examine the circumstances surrounding TIM fatalities, because no one data source in itself was adequate and undercounted the total number of TIM fatalities. The motor vehicle towing industry, in particular, is at elevated risk for occupational mortality, and targeted mandatory TIM training for the motor vehicle towing industry should be considered. In addition, enhanced law enforcement roadside safety training during vehicle pursuit and apprehension of suspects is recommended.

The construction FACE database — Codifying the NIOSH FACE reports

IntroductionThe National Institute for Occupational Safety and Health (NIOSH) has published reports detailing the results of investigations on selected work-related fatalities through the Fatality Assessment and Control Evaluation (FACE) program since 1982. MethodInformation from construction-related FACE reports was coded into the Construction FACE Database (CFD). Use of the CFD was illustrated by analyzing major CFD variables. ResultsA total of 768 construction fatalities were included in the CFD. Information on decedents, safety training, use of PPE, and FACE recommendations were coded. Analysis shows that one in five decedents in the CFD died within the first two months on the job; 75% and 43% of reports recommended having safety training or installing protection equipment, respectively. ConclusionComprehensive research using FACE reports may improve understanding of work-related fatalities and provide much-needed information on injury prevention. Practical ApplicationThe CFD allows researchers to analyze the FACE reports quantitatively and efficiently.

Fatal falls and PFAS use in the construction industry: Findings from the NIOSH FACE reports

This study analyzed the Construction FACE Database (CFD), a quantitative database developed from reports of the Fatality Assessment and Control Evaluation (FACE) program conducted by the National Institute for Occupational Safety and Health (NIOSH). The CFD contains detailed data on 768 fatalities in the construction industry reported by NIOSH and individual states from 1982 through June 30, 2015. The results show that falls accounted for 42% (325) of the 768 fatalities included in the CFD. Personal fall arrest systems (PFAS) were not available to more than half of the fall decedents (54%); nearly one in four fall decedents (23%) had access to PFAS, but were not using it at the time of the fall. Lack of access to PFAS was particularly high among residential building contractors as well as roofing, siding, and sheet metal industry sectors (∼70%). Although the findings may not represent the entire construction industry today, they do provide strong evidence in favor of fall protection requirements by the Occupational Safety and Health Administration (OSHA). In addition to stronger enforcement, educating employers and workers about the importance and effectiveness of fall protection is crucial for compliance and fall prevention.

Development of Occupational Health Measures for the National Health Security Preparedness Index.

Development of Occupational Health Measures for the National Health Security Preparedness Index.

Toxicology Testing in Fatally Injured Workers: A Review of Five Years of Iowa FACE Cases

Toxicology testing of fatally injured workers is not routinely conducted. We completed a case-series study of 2005–2009 occupational fatalities captured by Iowa’s Fatality Assessment and Control Evaluation (FACE) Program. The goals of our research were to: (1) measure the proportion of FACE cases that undergo toxicology testing, and describe the factors associated with being tested, and (2) measure the rate of positive toxicology tests, the substances identified and the demographics and occupations of victims who tested positive. Case documents and toxicology laboratory reports were reviewed. There were 427 occupational deaths from 2005 to 2009. Only 69% underwent toxicology testing. Younger workers had greater odds of being tested. Among occupational groups, workers in farming, fishing and forestry had half the odds of being tested compared to other occupational groups. Of the 280 cases with toxicology tests completed, 22% (n = 61) were found to have positive toxicology testing. Commonly identified drug classes included cannabinoids and alcohols. Based on the small number of positive tests, older victims (65+ years) tested positive more frequently than younger workers. Management, business, science, arts, service and sales/office workers had proportionately more positive toxicology tests (almost 30%) compared with other workers (18–22%). These results identify an area in need of further research efforts and a potential target for injury prevention strategies.

Multiple jobholder mortality patterns in Kentucky: An examination of occupational fatalities

The percentage of multiple jobholders was elevated in Kentucky compared to the US from 2002 to 2010. Kentucky Fatality Assessment and Control Evaluation (FACE) multiple jobholder fatality data were analyzed to identify contributing injury factors from 2002 to 2010. Kentucky's total occupational fatality rates were higher than US rates for all years (2002-2010). Kentucky multiple jobholder fatalities averaged 8.4 deaths per 100,000 employees compared to the total average occupational fatality rate of 6.5. Almost half of multiple jobholder fatalities (47%) occurred in the agricultural industry and management occupation as the primary industry and occupation; 67% were tractor-related. The most prevalent secondary industry and occupation were the construction industry and management occupation. Increased surveillance of multiple jobholder injuries is needed to improve safety and health on the job. Future investigations should include the relationship between multiple jobholding and agricultural employment as farm owners.

Evaluation of a nationally funded state-based programme to reduce fatal occupational injuries

BackgroundThe Fatality Assessment and Control Evaluation (FACE) programme was established by the National Institute for Occupational Safety and Health to help prevent occupational traumatic fatalities by funding states to conduct...

Avoiding harm on the farm: Human factors

The high accident rate in agricultural work, especially for older farmers, indicates a need for increased safety and prevention research. This can contribute to increased safety on the farm, from engineering to human factors and ergonomics. Methods The current set of studies used two distinctly different research approaches to identify areas most linked to agricultural safety incidents. Focus groups including older farmers and an analysis of archived data produced descriptions of where, when, and how accidents occur, and what hazards contributed to these accidents. The database used was the Fatality Assessment and Control Evaluation (FACE) database of fatal farm-related accidents. This database contains a structured narrative account of each accident. Cases were coded to capture the demographics of the victim, the environmental conditions during the accident, the machinery involved, and other variables related to the accident. The average age of farmers involved in fatal accidents was over fifty years and many of them were using decades-old equipment when they died. These data are presented in terms of frequencies and a cluster analysis was performed to identify patterns of accident types. Focus group discussions identified the knowledge and attitudes of older farmers related to their work and equipment. Results In general, older farmers understood that they had slower reaction times than when they were younger; however, the prevailing attitude was that a task must be accomplished by any means necessary. This included working in poor visual conditions, past the point of fatigue, and using equipment for tasks other than for which it was designed. Last, older farmers were aware of numerous accidents related to their profession and expressed an acceptance of risk as well as the attitude that those who had accidents were not careful enough. Conclusion The findings from these studies can be used to motivate influential safety research. Older farmers stand to benefit greatly from applied work in this area once their general behavior patterns with farming technology are understood. The goal of the current studies was to link the information from farming accidents with the knowledge, attitudes, and behaviors of older farmers to direct the solving of safety problems through engineering, human factors, and industrial design.

Narrative text analysis of Kentucky tractor fatality reports

Narrative information in fatality investigation reports contains data elements not routinely analyzed with coded occupational injury surveillance data. A narrative text analysis of 69 Kentucky Fatality Assessment and Control Evaluation (FACE) agricultural tractor fatality reports from 1994 to 2004 was performed. The FACE reports were developed using the National Institute for Occupational Safety and Health, Division of Safety Research-recommended FACE report format that incorporates Haddon's matrix. Haddon's matrix separates the fatal incident into three event phases and is used to develop points of intervention based on human, organizational, and environmental factors. A multivariate logistic regression analysis for association between identified exposure variables and the outcomes of interest was undertaken. The operation of a tractor with an attached bucket, muddy terrain, and being thrown from the tractor were independent risk factors for being declared “dead at the scene”. A tractor rollover and operation of a tractor on a slope were independent risk factors for being “crushed” by a tractor. Narrative text analysis of FACE fatality investigation reports is a valuable tool for the identification of additional factors contributing to tractor fatalities that can inform farm safety training, identify new areas for agricultural interventions, and support the development of new agricultural engineering strategies.

Aerial lift fall injuries: A surveillance and evaluation approach for targeting prevention activities

Problem Work on aerial lift platforms exposes workers to fall hazards. The objective of this study was to identify the most common injury scenarios and determine current research gaps for addressing fall incidents associated with aerial lifts. Methods Three databases were searched: Census of Fatal Occupational Injuries (CFOI), NIOSH Fatality Assessment and Control Evaluation (FACE) reports, and OSHA Incident Investigation Records. Results The majority of falls/collapses/tipovers were within the height-category of 10–29 feet. Tipovers comprised 44–46% of boom-lift falls and 56–59% of scissor-lift falls. Constructing and repairing activities were most commonly associated with fall/collapse/tipover incidents. Discussion CFOI and OSHA/FACE show convergent data, suggesting similar scenarios for aerial lift tipovers. Impact on Industry The analysis provides the aerial lift industry information to prioritize their efforts on aerial lift design.

An Assessment of Gases in Oxygen-Deficient Hay Silos and the Effects of Forced Ventilation

Many modern tower silos used in the agricultural industry for hay and grain storage are oxygen-limiting by design. Forced-air ventilation using a forage blower is a method commonly used to decrease concentrations of toxic and asphyxiant gases and to increase the O2 content within a silo headspace prior to worker entry. This article describes the methods used to measure gas concentrations and the results obtained from a pilot study by the Washington Fatality Assessment and Control Evaluation (FACE) program of two oxygen-limiting forage tower silos in eastern Washington State. The silos were monitored for oxygen (O2), nitrogen dioxide (NO2), and carbon dioxide (CO2). Measured O2 concentrations were low in all areas of the headspaces monitored for both silos. After beginning forced-air ventilation, O2 concentrations within the silo headspace returned to ambient levels within 8 to 20 min. Nitrogen dioxide levels exceeded the Washington Industrial Safety and Health Act (WISHA) short-term exposure limit (STEL) in the silo that was filled six days earlier (silo 2), but not in the silo that was filled four days earlier (silo 1). The NO2 concentration in silo 2 decreased to below the WISHA STEL within 15 min of starting ventilation but began to rise shortly after ventilation was stopped. Carbon dioxide, which was only measured in silo 1, was detected at 2% within the headspace of this silo. The carbon dioxide concentration decreased to <1% within 3 min of starting ventilation.

Identification and characterization of Kentucky self‐employed occupational injury fatalities using multiple sources, 1995–2004

Identification and characterization of occupational injury fatalities in self-employed workers typically relies on a single data source and thus may miss some cases. Kentucky self-employed worker injury fatalities were identified using Fatality Assessment and Control Evaluation (FACE) program data (1995-2004) and compared to non self-employed worker data. Occupations and industries listed on death certificates were compared to those in which the decedent was actually engaged. Of 1,281 Kentucky worker injury deaths, 28% were self-employed. Death certificates failed to identify 31% of these deaths as work-related; industry and occupation were incorrectly identified in 27% and 16%, respectively. Fifty-seven percent of the deaths were in agriculture, primarily tractor-related. For Kentucky, the self-employed crude death rate was higher (27.6/100,000) than the non self-employed worker (5.4/100,000) rate or the US (11.5/100,000) self-employed rate. Multiple information sources improve identification of self-employed status in work-related injury fatalities. Effective prevention requires accurate surveillance and examination of contributing factors. Self-employed worker injuries in high-risk industries should be more fully examined for development of effective injury prevention programs.

The NIOSH Fatality Assessment and Control Evaluation (FACE) Program

The New York Fatality Assessment and Control Evaluation (FACE) program is designed to identify and study fatal occupational injuries in New York State. The New York FACE program is supported by the National Institute for Occupational Safety and Health (NIOSH) and administered by the New York State Department of Health (NYS DOH) in cooperation with Cornell University. New York FACE investigators evaluate information from multiple sources, conduct objective on-site investigations, and then summarize their findings in narrative reports that include recommendations for preventing similar events in the future. These recommendations are distributed to employers, workers, and other organizations as an educational tool for promoting workplace safety. The following case study involved a 53-year-old dairy farm owner who was fatally injured while transferring manure from an underground storage pit to a manure lagoon. At the time of the incident, the farmer was utilizing a manure pump that was connected to a tractor via a power take-off (PTO) shaft. The farmer reached across the unshielded PTO shaft in order to operate a hand crank that adjusted the manure pump chute. As he did this, his clothing became entangled in the PTO shaft, wrapping the farmer's body around the shaft. New York FACE investigators concluded that to help prevent similar incidents from occurring in the future: PTO-powered equipment should not be operated unless the PTO shield is in place and in good condition; Power to equipment should be turned off prior to making mechanical adjustments; Manure handling systems should be designed to facilitate operator safety; Farm workers should be healthy and well rested prior to performing hazardous activities and; Dairy farm workers should be trained in manure handling safety and knowledgeable about other manure hazards.

School Nurses: A Resource for Young Worker Safety

On average, 67 youths under age 18 die at work in the United States each year, and many more suffer work-related injuries. In 1998, an estimated 77,000 young workers suffered work injuries that required treatment in hospital emergency rooms. It is estimated that only one third of work-related injuries are seen in emergency departments; therefore, the National Institute for Occupational Safety and Health (NIOSH) estimates that nearly 230,000 youths suffer work-related injuries each year. Through NIOSH's Fatality Assessment and Control Evaluation (FACE) program, NIOSH investigators identified poor knowledge of child labor laws, lack of safety training and supervision, inappropriate job assignment, and lack of employer compliance with labor laws as factors contributing to young worker deaths. School nurses serve as a resource to other professionals, parents, employers, and students and can help foster safer working conditions for youth by providing these groups with young worker safety information.

School Nurses: A Resource for Young Worker Safety

On average, 67 youths under age 18 die at work in the United States each year, and many more suffer work-related injuries. In 1998, an estimated 77,000 young workers suffered work injuries that required treatment in hospital emergency rooms. It is estimated that only one third of work-related injuries are seen in emergency departments; therefore, the National Institute for Occupational Safety and Health (NIOSH) estimates that nearly 230,000 youths suffer work-related injuries each year. Through NIOSH’s Fatality Assessment and Control Evaluation (FACE) program, NIOSH investigators identified poor knowledge of child labor laws, lack of safety training and supervision, inappropriate job assignment, and lack of employer compliance with labor laws as factors contributing to young worker deaths. School nurses serve as a resource to other professionals, parents, employers, and students and can help foster safer working conditions for youth by providing these groups with young worker safety information.

Preventing Young Worker Fatalities

During the period between 1992 through 1998, the Bureau of Labor Statistics identified an average of 67 work related deaths of individuals younger than 18 each year. This article describes the Fatality Assessment and Control Evaluation (FACE) program and summarizes indepth data collected on 59 young worker fatalities in 26 states. These investigations were conducted between May 1986 and February 2002. Young workers ranged in age from 9 to 17 years, with a mean age of 15.3 years: 21 were working in the agriculture, forestry, and fishing industry; 12 in construction; 10 in manufacturing; 8 in services; and 8 in the retail industry. The majority worked as laborers. Ninety-three percent were young men. Each investigation resulted in the formulation and dissemination of strategies to help prevent future similar occurrences. As an example of state FACE activities, the article describes the Wisconsin FACE program's efforts to foster collaboration between regulatory agencies, researchers, educators, and occupational safety and health professionals, and to integrate efforts aimed at improving safety for young workers.

#56 Tractor-related deaths among west virginia farmers

PURPOSE: The agriculture industry has a high number of occupational deaths and a significantly high death rate compared to other industrial sectors. From 1995 to 2000, the US Bureau of Labor Statistics' Census of Fatal Occupation Injuries has shown that about 8% (550) of all annual work-related deaths (WRDs) were in agricultural production (farming). About one-third of these deaths were attributed to tractor incidents. Approximately three-quarters of these incidents involved rollover, overturn, or run over events. The purpose of this study was to describe tractor-related deaths among West Virginia farmers. METHODS: Data from the West Virginia Fatality Assessment and Control Evaluation (FACE) Program was reviewed to identify specific cases from January 1997 through January 2002. RESULTS: During the 61-month period, West Virginia experienced 276 WRDs, of which 4% (11) were in farming occupations. Nine of the eleven deaths involved machine-related (tractor; E-code 919.0) incidents: rollover (7), overturn (1), and run over (1). Three of the victims were livestock farmers (SIC 0219), three were beef and cattle farmers (SIC 0212), two were dairy farmers (SIC 0241), and one was a crop farmer (SIC 0191). The average age at death was 56 with a range from 38 to 82. All victims were male. Of the 4 cases investigated, none of the tractors were equipped with roll over protective structures (ROPS) or seat belts. CONCLUSIONS: ROPS are the single best method of preventing tractor-related deaths, yet only about one-third of tractors on US farms are equipped with ROPS. The estimated cost (approximately $900) of retrofitting older tractors is a major factor impacting the increased use of ROPS.

Baler and Compactor-Related Deaths in the Workplace--United States, 1992-2000

Equipment that compacts and bales loose solid waste materials into denser, more easilytransported units is common in refuse disposal and recycling and is used routinely at recycling centers, manufacturing facilities, and retail and wholesale stores to compress paper, textiles, metals, plastic, and other material. Persons operating balers and compactors can become caught by the powered rams of the compression chambers while using these machines. Risk factors resulting from these incidents have been identified through surveillance findings and results of investigations conducted by CDC's National Institute for Occupational Safety and Health (NIOSH) Fatality Assessment and Control Evaluation (FACE) program and the Bureau of Labor Statistics Census of Fatal Occupational Injuries (CFOI), a nationwide multisource reporting system for occupational deaths. This report describes the results of two baler and compactor-related investigations conducted during 1992-2000, summarizes surveillance data from 1992 through 1998, which indicated that some employers and workers may have been unaware of the hazards of operating or working near compacting and baling equipment, and suggests safety recommendations for preventing future incidents.

Injury Risk Factors Associated with AgriculturalWorkplace Fatalities

Agriculture has consistently ranked among the top four industries in both frequency and rate of death from workplace injuries. Analysis of a case series of 119 field investigations of occupational agricultural fatalities, conducted through the NIOSH State Fatality Assessment and Control Evaluation (FACE) program, indicated the presence of multiple injury risk factors for 90% of the incidents. The most common risk factors were unrecognized or unaddressed injury hazards, safety equipment not being available at the worksite, and the use of equipment or work methods that contributed to the worker’s exposure to injury risk. The risks identified here are amenable to a variety of prevention strategies, including educational programs and engineering controls.

Deadly rescue: The confined space hazard

Rescue operations in confined spaces can expose the person(s) attempting rescue to hazardous atmospheres or to physical hazards such as engulf- ment, which are potentially fatal. Two sources of data in the United States on work-related fatalities — the National Institute for Occupa- tional Safety and Health (NIOSH) National Traumatic Occupational Fatalities (NTOF) surveillance system and investigations performed under the NIOSH Fatality Assessment and Control Evaluation (FACE) program — were used to examine confined space-related deaths. For the years 1980 through 1988, there was an average of 89 work-related deaths in confined spaces per year, and approximately 23 (25.5%) of those who died were persons attempting rescue. Asphyxiation by atmospheric hazards was the primary cause of death of those persons attempting rescue. Those persons who were attempting rescue and who died were more likely to be co-workers than public safety or emergency medical service (EMS) personnel. Since rescue operations in confined spaces present unique hazards, proper training of personnel and the availability of specialized equipment are required to protect persons attempting rescue from injury and death. Safety supervisors and public safety and EMS personnel should be familiar with the recognition of confined space hazards and the use of appropriate rescue techniques.