National Traumatic Occupational Fatalities Research Articles

Political Economy of US States and Rates of Fatal Occupational Injury

We investigated the extent to which the political economy of US states, including the relative power of organized labor, predicts rates of fatal occupational injury. We described states' political economies with 6 contextual variables measuring social and political conditions: "right-to-work" laws, union membership density, labor grievance rates, state government debt, unemployment rates, and social wage payments. We obtained data on fatal occupational injuries from the National Traumatic Occupational Fatality surveillance system and population data from the US national census. We used Poisson regression methods to analyze relationships for the years 1980 and 1995. States differed notably with respect to political-economic characteristics and occupational fatality rates, although these characteristics were more homogeneous within rather than between regions. Industry and workforce composition contributed significantly to differences in state injury rates, but political-economic characteristics of states were also significantly associated with injury rates, after adjustment accounting for those factors. Higher rates of fatal occupational injury were associated with a state policy climate favoring business over labor, with distinct regional clustering of such state policies in the South and Northeast.

Effects of the Occupational Safety and Health Administration’s control of hazardous energy (lockout/tagout) standard on rates of machinery-related fatal occupational injury

Objective:To evaluate the impact of the United States’ federal Occupational Safety and Health Administration’s control of hazardous energy (lockout/tagout) standard on rates of machinery-related fatal occupational injury. The standard, which...

The Use of Sentinel Injury Deaths to Evaluate the Quality of Multiple Source Reporting for Occupational Injuries

This study sought to develop an efficient method for evaluating the validity and completeness of routinely available sources of occupational injury fatality data. Deaths due to falls from elevations, machinery, and electrocutions were selected as sentinel injuries likely to have occurred at work. Deaths from these injuries were identified from Maryland vital statistics over 7 years. The work-relatedness of these injuries and sensitivity of reporting were determined from death certificates, medical examiner reports, the National Traumatic Occupational Fatality System (NTOF), the Maryland Occupational Safety and Health Administration (MOSH), and Workers' Compensation (WC) data. A total of 527 deaths were identified for ages 16 and above, of which, 45% were work-related. Identification of work-related deaths varied by source: medical examiner (100%), death certificates (89%), NTOF (68%), MOSH (59%), and WC (44%). Reporting differed by age, cause of injury, year, occupation, and industry. Examination of work-relatedness for deaths from certain causes is an efficient means of evaluating the quality of occupational injury reporting source data. These sentinel injuries uncovered significant underreporting in sources used by national surveillance systems, resulted in improved NTOF reporting, and suggest the need to make more use of medical examiner data when available.

The Economic Cost of Fatal Occupational Injuries in the United States, 1980–97

According to the National Traumatic Occupational Fatalities (NTOF) surveillance system, occupational injuries claimed the lives of over 100,000 American workers from 1980 to 1997. Previous estimates presented aggregate values of life, providing no information on the cost variations for different case or worker characteristics. This research developed an interactive computer program that estimates comprehensive national costs for all occupational fatal injuries reported through NTOF, nearly $85 billion for 1980–97, and specific estimates for the burden on selected groups and characteristics of the fatality. These estimates provide an additional basis for targeting and evaluating the effectiveness of investments in prevention of occupational fatalities. (JEL I18)

Assessing the accuracy of OSHA's projections of the benefits of new safety standards

In the preambles to the safety and health standards that it has issued since 1987, the Occupational Safety and Health Administration (OSHA) projected that new safety standards would prevent over 2,600 death each year. For six safety standards issued since 1990, we compare OSHA's projections of the impact of full compliance on fatalities with actual fatality changes and examine the reasons for the differences. We reviewed the preambles to OSHA standards and the Regulatory Impact Analyses (RIAs) prepared for them to identify the baseline and the prevention factor that the agency used to project the number of deaths that would be prevented. We used three data sources to track the relevant categories of fatalities: the Census of Fatal Occupational Injuries (CFOI), the National Traumatic Occupational Fatality program, and OSHAs Fatality/Catastrophe investigations. For all six standards, OSHA appeared to overestimate the number of deaths prevented. The availability of CFOI led to better estimates of the fatality baseline, but the prevention factor was always overestimated, especially for standards which emphasized training. OSHA needs to develop better methods for projecting injury impacts. Research is needed to help OSHA predict the effects of behavioral requirements (e.g., training) on actual work practices and injury outcomes. For non-fatal injuries, new methods of data collection will be required.

Diversity of trends in occupational injury mortality in the United States, 1980–96

Objectives: Although the United States has generally enjoyed declining rates of fatal occupational injury, the rate of decline has not been uniform. To examine the heterogeneity of trends, changes in...

External cause‐specific summaries of occupational fatal injuries. Part I: An analysis of rates

Industries and occupations vary with respect to the incidence of fatal injuries and their causes. Fatalities from the National Traumatic Occupational Fatality database (years 1983-1994) serve as the basis for examining external cause of death code specific rates. Industries and occupations are compared with respect to rate and frequency of fatal injuries. In addition, external causes of injury (E-codes) are examined across all industries and occupations as well as within industries and occupations to evaluate which events would be identified by frequency ordered comparisons versus injury rate ordered comparisons. Machinery, electric current, homicide, falls, and transportation-related events are identified by high frequency and rate of occurrence. The external cause categories of homicide, machinery-related, motor-vehicle-related, electric current, and falls, account for over one-half of all occupational fatal injuries. Targeted interventions in homicide may be especially warranted in sales and service occupations and in the retail trade and services industries. In addition, younger workers might be targeted for special interventions designed to identify hazardous practices, procedures, and solutions to reduce fatalities associated with electrocution or falls from buildings.

External cause-specific summaries of occupational fatal injuries. Part II: an analysis of years of potential life lost.

Fatal injury surveillance data provide an opportunity to assess the impact of occupational injuries and may indicate which industries or occupations are appreciably more hazardous than others, and thus should be given priority in public health intervention. Fatalities from the National Traumatic Occupational Fatality surveillance system served as the basis for examining external cause (E-code) specific impact summaries. Years of potential life lost (YPLL) were calculated for fatal injuries in the years 1983-1994. Industries and occupations were compared with respect to frequency of fatal injuries. In addition, injuries in categories of external causes are examined across all industries and occupations. Machinery, electric current, homicide, falls, and transportation-related are the external cause groups highlighted by high frequency/rate of occurrence. Electric current event groups are also characterized by high average YPLL. Poisoning, conflagration, and lightning were also identified in several occupations as having high associated average YPLL. The external-cause-specific analysis of average YPLL identified industries and occupations where, on average, younger workers were dying in fatal injuries. Noteworthy in this assessment were homicides and falls. The YPLL measure coupled with more commonly employed indices (e.g., rates) may provide a fuller description of the impact of occupational fatal injuries.

Comparison of two fatal occupational injury surveillance systems in the United States

Introduction: Using different methods, two national systems compile fatal occupational injury data in the United States: the National Institute for Occupational Safety and Health (NIOSH) National Traumatic Occupational Fatalities (NTOF) surveillance system, and the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI). The NTOF uses only death certificates, while CFOI uses multiple sources for case ascertainment. Methods: Through overall and case-by-case comparisons, this study compares these systems and evaluates counts for the nation and by state for worker and case characteristics. Results: From 1992 through 1994, NTOF reported an average of 84% of the number of traumatic occupational fatalities reported in CFOI. This percentage changed somewhat when a case-by-case comparison was conducted—88% of the NTOF cases were matched directly to the CFOI cases. Although CFOI captured a larger number of fatalities annually, the additional fatalities did not follow a discernable pattern. Impact on industry: By understanding the distribution of fatalities, targeted efforts to reduce them will benefit all industries.

Fire and flame related events with multiple occupational injury fatalities in the United States, 1980–1995

The National Traumatic Occupational Fatalities surveillance system recorded 1587 fire and flame related occupational fatalities among the civilian workforce in the United States between 1980 and 1995. Of these fatalities, 433 resulted from 127 incidents that involved two or more victims. For purposes of this study, these victims were categorized into one of three cause-of-death classifications: burns, inhalation or other traumatic injury. The classification ‘Burns’ accounted for 232 or just over one-half of the fatalities and an additional 172 cases were coded as inhalation. Other traumatic injury was named as the cause of death for another 23 fatalities or five percent of the multiple victims. The cause of death for the remaining six fatalities could not be determined from the death certificates. This study revealed the similarities and disparities of the demographic and employment characteristics associated with these three cause-of-death classifications.

A Graphical Analysis of Mortality Rates and Years of Potential Life Lost

One challenge in assessing occupational fatal injuries is choosing a summary measure of the impact of these injuries. Each metric emphasizes different aspects of health risk, and fatal injury reports often focus on only one summary measure at a time. Deaths from the National Traumatic Occupational Fatality database were combined into external cause of death (e-code) groups. Graphs comparing average years of potential life lost (YPLL), mortality rate, and their product, “YPLL-rate”, are presented for e-code groups overall, industries and occupations, and e-code groups within selected industries and occupations. This integrated analysis of fatal injury characteristics allows identification of the portion of the workforce at highest risk. Homicides and electrocutions (e-code groups) had high mortality rates, average YPLL, and YPLL-rates, both overall, and within several of the industries and occupations examined. The industry and occupation of Agriculture, Forestry, and Fishing experienced a very high mortality rate and the lowest average YPLL for both industries and occupations. Laborer was the most hazardous occupation for young workers with an average YPLL near 40, and a mortality rate greater than 15 deaths per 100,000 worker-years.

Fire- and flame-related occupational fatalities in the United States, 1980-1994.

The National Traumatic Occupational Fatalities surveillance system recorded 1518 fire- and flame-related occupational fatalities among the civilian workforce in the United States between 1980 and 1994. The fatalities resulted from 1221 separate incidents, of which 122 involved more than one victim and accounted for 419 of 1518 deaths. Nearly 4 of 10 fatalities resulting from a multiple-victim fire were workers in the manufacturing industry. Similarly, the highest frequency of fatalities in single-victim events, over one fourth, were in manufacturing. For one fourth of the fatalities within each event category, the usual occupation of the deceased was a precision production, craft, and repair worker. Although this study sheds light on selected characteristics of these fatalities, additional research on the causal factors associated with single- and multiple-victim events is needed to present specific recommendations for prevention efforts.

Fatal occupational injuries associated with forklifts, United States, 1980-1994.

This paper describes deaths of American workers involving forklifts during the 15-year period from January 1, 1980 to December 31, 1994. Death certificate data were obtained from the National Institute for Occupational Safety and Health's (NIOSH's) National Traumatic Occupational Fatality (NTOF) surveillance system. The narrative fields on the death certificate were searched for keywords indicating that a powered industrial vehicle (PIV) or forklift was involved in the death. This study examined the circumstances of the forklift-related deaths, the nature of the injury, and the decedent's age, gender, race, occupation, and industry. Average annual employment data from the Bureau of the Census were used to calculate civilian fatality rates by age, gender, industry, and occupation. A total of 1,021 deaths were identified. The average age of the fatally injured worker was 38 years; the 1,021 forklift-related deaths resulted in a total of 27,505 years of productive life lost. The three most common circumstances of the fatalities were forklift overturns (22%), pedestrian struck by forklifts (20%), and worker crushed by forklift (16%). The greatest proportion of the fatalities (37%) occurred to workers in Manufacturing, followed by Transportation, Communication, and Public Utilities, (TCPU), (17%), Construction (16%), Wholesale Trade (8%), and Agriculture, Forestry, and Fishing (AFF) (7%). The highest forklift-related fatality rates per ten million workers occurred among transport operatives (34.0) and laborers (32.0). Many of the fatalities resulting from forklift "overturns" might have been prevented if the operator had been restrained with a lap/shoulder belt. Careful consideration should be given to separating pedestrian and forklift traffic, and restricting the use of forklifts near time clocks, exits, and other areas where large numbers of pedestrians pass through an area in a short time. Additionally, systematic traffic control, including rules for pedestrian and forklift traffic, will be necessary to reduce the enormous injury and death toll associated with forklifts. Am. J. Ind. Med. 36:504-512, 1999. Published 1999 Wiley-Liss, Inc.

Identifying Work-related Fatalities in the Agricultural Production Sector Using Two National Occupational Fatality Surveillance Systems, 1990-1995

Workers in the agriculture industry have consistently been identified as being athigh risk for death and injury. Production agriculture, the segment of the agricultureindustry that represents farming, has been shown to have higher rates of fatalities thanthe agriculture industry as a whole. The purpose of the manuscript was to provide adescriptive analysis of agricultural production fatalities for the years 1990 through1995. Two national occupational fatality data sources were used to calculate agriculturalproduction fatality rates: the National Traumatic Occupational Fatalities (NTOF) andthe Census of Fatal Occupational Injuries (CFOI). Employment estimates forcalculating fatality rates came from the Current Population Survey (CPS). Themajority of agricultural production worker decedents were white male farmers. Theleading sources of injury were farm tractors, followed by trucks and harvestingequipment. Older agricultural workers (65+ years of age) were at high risk for death,with the most likely fatal event being the overturning of a tractor in a non-highwayenvironment. Black workers in the agricultural production industry, and the occupationof black farmers in particular, were identified as having high fatal injury rates by race.Young Hispanic workers also exhibited a high fatality rate. Farm tractors were a leadingsource of injury resulting in death for males and females; however, there were genderdifferences in other types of fatalities. Females, while accounting for a small percentageof the total fatalities in agriculture production, had a higher proportion of deaths due toanimals than did males, and also had a higher proportion of deaths due to being caughtin running equipment than males. The two national occupational fatality surveillancesystems, while showing differences in overall numbers, generally identified similarpatterns of death for agricultural production workers. Finally, no clear downward trendfor agricultural production fatalities was found, which is contrary to trends seen in thegeneral worker population over the same time period.

Years of Potential Life Lost Due to Occupational Fatal Injury in the United States

Fatal injury surveillance data coupled with life expectancy data may be used to assess the impact of occupational fatal injuries on years of potential life lost (YPLL).We compare three definitions of YPLL and trends over time in YPLL. Two definitions determine YPLL as expected life lost to fixed life expectancies of 65 or 85 years. The third definition uses actuarial adjustments of life expectancy given survival to a given age stratified by gender and race. Fatalities from the National Traumatic Occupational Fatality (NTOF) database are used to illustrate the three definitions of YPLL.The three YPLL measures were similar in magnitude and direction of the trend in YPLL over 1980-1992. Proper interpretation of these trends can only be made in conjunction with other measures (e.g., rates). Almost all YPLL trends are declining, implying that over time fatal injuries are shifting to older workers. The exception is the increasing trend in YPLL for the retail trade industry, injury rates have also been increasing over time for this industry. Mining and construction have the highest YPLL among all industries. This analysis suggests efforts to prevent the occupational fatalities of younger workers should focus on the retail trade, mining, and construction industries.

Work-Related Fatal-Injury Risk of Construction Workers by Occupation and Cause of Death

To assess cause- and occupation-specific risks of work related fatal injuries among U.S. construction workers, the National Traumatic Occupational Fatalities (NTOF) surveillance system and Current Population Survey were used to obtain injury and employment data for the years 1990 through 1994. Risks were assessed by both rate and working lifetime risk. The occupation found to have the highest fatal-injury rate in construction was electrical-power installers and repairers (96.6 deaths/100,000 workers), followed by structural-metal workers (86.4) and operating engineers (41.0). The occupation found to have the largest numbers of fatalities was construction laborers (1133 deaths), followed by carpenters (408), and construction supervisors (392). The leading causes of death varied by occupation. Construction in general has experienced a decline in fatal-injury rates over the years; however, this decline did not occur equally across occupations and causes of death. The presentation of working lifetime injury risks provides a measure of risk for occupational injuries that can be compared with occupational illness risk assessments. This study is the first to provide a comprehensive national profile of work-related fatal-injury risks among United States construction workers by occupation and cause of death. The results will be useful in focusing research and prevention efforts on specific hazards in high-risk construction occupations.

Estimates of Lifetime Risk of Occupational Fatal Injury from Age-Specific Rates

The lifetime risk of fatal workplace injury is a critical issue in the evaluation of occupational hazards. Recently, Fosbroke, Kisner, and Myers (1997) described a metric for working lifetime risk (WLTR) to determine the probability that a worker will die due to a work-related fatal injury in a year over a certain number of years of employment. This quantity was defined assuming that the annual rate of fatal injuries will be the same each year during employment. Recognizing the fact that annual fatal injury rates differ with the age of the worker along with other factors, modification of the definition of working lifetime risk is derived. We obtain the estimates of the lifetime risk using age-categorized annual fatality rates and derive an estimate of the standard error of the WLTR estimator and a confidence interval for the WLTR. We illustrate these calculations by estimating the lifetime risk for work-related fatal injuries for workers in four high risk industries: agriculture-forestry-fishing, mining, construction, and transportation public utilities. The estimates are based on employment data from the Bureau of Labor Statistics and an updated version of fatality data from the National Traumatic Occupational Fatalities surveillance system.

Trends in rates of occupational fatal injuries in the United States (1983-92).

OBJECTIVES: An updated version of a national surveillance system of traumatic occupational fatalities was used to explore adjusted and unadjusted trends in rates of fatal injury. METHODS: Data from the...

Occupational injury deaths of 16 and 17 year olds in the US: trends and comparisons with older workers.

OBJECTIVE: To examine patterns of occupational injury deaths of 16 and 17 year olds in the United States for the three year period 1990-2, examine trends since the 1980s, and...

Modeling fatal injury rates using Poisson regression: A case study of workers in agriculture, forestry, and fishing

Injury surveillance data serves as the foundation of many safety studies. These studies frequently gather information on the number of injuries along with the number of employees at risk of injury in each of several strata where the strata are defined in terms of a series of important predictor variables. It is common for analyses of such data to examine injury rates separately for each predictor variable. The analysis of the crude or unadjusted injury rates give an overall indication of injury rate changes as a function of a particular predictor variable; however, further insights may be gained from analyses using Poisson regression models. Poisson regression models are described as a means of analyzing rates adjusting for one or more predictor variables. In these models, the log rate of injury is expressed as a linear function of predictor variables. The interpretation of model parameters is given along with a presentation of the basic formulation of such models. Testing for trend, evaluation of confounding, and effect modification are illustrated using surveillance data describing occupational fatal injury rates as a function of year (1983–1992), gender and age for White workers employed in agriculture, forestry, or fishing. Data for this analysis were obtained from two sources: the National Traumatic Occupational Fatality (NTOF) database from the National Institute for Occupational Safety and Health provided counts of the fatal injuries, while data from the U.S. Bureau of Labor Statistics (BLS) provided counts on employment. Using an unadjusted trend model, a statistically nonsignificant decline in fatal injury rates over 1983–1992 is observed. Further analysis using Poisson regression revealed an interaction between gender and calendar year with males experiencing a weak, albeit significant, decrease and females experiencing a strong and significant increase.