Occupational Mortality Research Articles

The trend of occupational injuries mortality and Disability Adjusted Life Years (DALYs) in Hamadan Province between 1990 and 2021

Background and Objectives: Occupational injuries are considered as one of the most important health, social and economic risk factors in industrial and developing societies. Therefore, the aim of the present study was to investigate the trend of mortality and Disability Adjusted Life Years rates due to occupational injuries in Hamedan province during 1990 to 2021. Methods: In this cross-sectional descriptive study, the trend of changes in the mortality and Disability Adjusted Life Years rates due to occupational injuries in Hamedan province in a period of 32 years was investigated using join point regression and Join Point Regression software version 5.1.0. Results: The Disability Adjusted Life Years (due to premature death and disability) from occupational injuries in Hamedan province decreased from 496.75 years per thousand population in 1990 to 229.98 years per thousand population in 2021 (the average annual percent changes (AAPC) was -2.40%). This decreasing trend in DALY caused by occupational injuries was also evident in men and women (the AAPC in men and women was -2.40% and -1.10%, respectively).On the other hand, the mortality rate due to injuries in both sexes had decreased from 7.55 cases per 100,000 population in 1990 to 3.46 cases per 100,000 population in 2021 (AAPC was -2.50%). Conclusion: Generally, the trend of mortality and Disability Adjusted Life Years rates due to occupational injuries in Hamedan province had a decreasing trend, which was consistent with other studies conducted in Iran and the world.

Building and system design's impact on thermal resilience to overheating during heatwaves: An uncertainty and sensitivity analysis

Rising heatwaves necessitate thermally resilient buildings to mitigate occupant heat-stress and mortality, ensuring habitable conditions during thermal shocks. This study's aim and novelty is to identify key design parameters affecting three thermal resilience aspects -(i) shock impact or SET-Dh i.e., degree hours above standard effective temperature threshold of 28 °C (ii) absorptivity time (tabs) and (iii) recovery time (trec) across varying degrees of shock intensities (doS-low, medium and high). A reference Belgian apartment is simulated with varying design parameters (building orientation, envelope and glazing properties, glazing percentage, airtightness, operation and control of passive strategies, cooling systems) during three types of heatwaves. Uncertainty analysis quantified the impact of design variations on thermal resilience, while global sensitivity analysis pinpointed key parameters affecting resilience during different shocks. The study shows that while 87 % of design variations remain thermally resilient during shorter shocks, only 21 % do so during longer shocks and that WWR, cooling capacity, and passive strategies (operation of natural night ventilation and solar shading) have twice the impact on thermal resilience compared to building orientation and glazing properties. While tabs is affected by heat build-up factors (e.g., WWR, solar shading), trec is influenced by heat removal factors (e.g., cooling capacity, NNV). Parameters such as heavy thermal mass extend heat absorption but also delays heat dissipation during prolonged heatwaves. This study guides designers and architects to focus on interventions that enhance buildings' thermal resilience during both short and long heatwaves, aiding in climate adaptation and the ability to withstand future extreme heat periods.

Pre-task planning for construction worker safety and health: Implementation and assessment.

Compared to other industry sectors, construction workers experience a disproportionately high rate of occupational injuries and fatalities. As research findings suggest, most of these incidents could be prevented if hazards were proactively recognized and properly addressed. In the construction industry, pre-task planning (PTP) is a preventive process intended to describe each step of work, identify associated safety and health hazards, and recommend controls to eliminate or mitigate the hazards before work begins. Despite its importance, the construction industry lacks comprehensive guidelines to design and implement PTP in a consistent and effective manner. To fill this gap, this study pursued two objectives: (1) identify shortcomings in current PTP practices and explore recommended solutions from practitioners' perspectives and (2) translate research findings into an applied tool to help practitioners assess and improve the quality of their PTP process. To fill the gap, 28 construction safety and health professionals and 104 workers were interviewed, and seven onsite PTP sessions were directly observed. Shortcomings of current PTP practices as well as recommended solutions were categorized as (1) planning and implementation, (2) all-trades coordination, (3) engagement and buy-in, (4) training and logistics, (5) workforce diversity and the language barrier, and (6) PTP content accessibility. An effective PTP process should be based on workers' direct involvement and input on task requirements and hazards. It needs to be regularly updated to reflect the changing work conditions. In addition to task-related information, to increase workers' awareness, PTP should paint a holistic view of the project and other trades' scopes.

Cannabis policy bundles and traffic fatalities in the American States over time.

Since 1996, 38 US states have legalized access to cannabis (medical and/or adult-use recreational). We aimed to estimate the effect of three dimensions of state cannabis policy design - pharmaceutical, permissive and fiscal - on levels of overall, alcohol-impaired, occupant, light truck and pedestrian fatality rates. Observational study of US states' overall, alcohol-impaired, occupant, light truck and pedestrian fatalities between 1994 and 2020. The unit of analysis was at the state level, consisting of 50 states and 27 years of time series data, resulting in a total of 1350 state-year observations. Fatality rates associated with alcohol-impaired, pedestrian, total occupant, passenger car and light truck fatality rates were obtained from the Fatality Analysis Reporting System of the National Highway Traffic Safety Administration and normalized per 10 billion vehicle miles traveled. State cannabis policies are measured in three bundles (scales): pharmaceutical, permissive and fiscal. The pharmaceutical bundle was associated with increases in all fatality rates [β = 0.145; 95% confidence interval (CI) = 0.116-0.173; P < 0.000]. The permissive bundle was associated with lower overall fatality rates (β = -0.319; 95% CI = -0.361 to -0.277; P < 0.000). The fiscal bundle was generally associated with higher fatality rates (β = 0.062; 95% CI = 0.043-0.081; P < 0.000), occupant (β = 0.070; 95% CI = 0.042-0.098; P < 0.000), light trucks (β = 0.049; 95% CI = 0.026-0.072; P < 0.000). US state cannabis regulations influence traffic safety. Greater permissiveness in US state cannabis regulations does not appear to correlate with traffic fatality rate increases, but greater medicalization and fiscal operation does.

Motor vehicle traffic fatalities by race and ethnicity (2010 – 2021)

Motor vehicle traffic fatalities (MVTFs) are a public health issue that substantially affects the growing Black or African American, Indigenous, and People of Color (BIPOC) population. To further understand the racial discrepancies that exist in MVTFs, data from the Fatality Analysis Reporting System (FARS) and U.S. Census were utilized to explore factors such as rurality, urbanicity, restraint use, and alcohol-impairment. Calculations considered yearly driver and occupant fatality rates per 100,000 population for each race and ethnicity from 2010 through 2021. A Poisson regression model was used to quantify the relationship between the MVTF rates and the factors of interest. Results demonstrated that the American Indian or Alaska Native population was statistically the most overrepresented group in fatality rates across all factors explored. Additionally, the American Indian or Alaska Native population and Black or African American populations were the only groups to have statistically significant increases in fatality rates in recent years when accounting for factors such as unrestrained vehicle driver/occupants and alcohol-impaired fatality rate. In contrast, the Native Hawaiian or Pacific Islander population has consistently experienced one of the largest statistically significant reductions in driver and occupant fatality rates over time. Further analysis is necessary to develop and implement countermeasures that may reduce the increasing fatality rates of the most vulnerable populations while continuing to decrease rates for others as well. Despite limitations of FARS and population data, these results provide a pathway to reducing MVTFs and associated racial inequities that exist in the nation, particularly as the BIPOC population continues to grow.

Risk assessment for perfluorooctanoic acid (PFOA) in air, blood serum and water: mortality from liver and kidney disease

BackgroundCancer and non-cancer associations have been observed with PFAS (perfluoroalkyl and polyfluoroalkyl) substances in the general population, in populations from locally contaminated environments and in exposed workers.MethodsA quantitative risk assessment...

Urban-rural differences in the association between occupational physical activity and mortality in Chinese working population: evidence from a nationwide cohort study

Despite emerging studies suggesting that occupational physical activity (OPA) might be harmful to health, the available evidence is not definitive. Most of these research studies were conducted in high-income Western countries or in urbanized setting. In China, where over one-third of the population resides in rural area, the impact of OPA on health is not well understood. The goal of this study is to investigate how the association between OPA and mortality vary by urban-rural settings. Baseline data on OPA was gathered using the Global Physical Activity Questionnaire from 30,650 urban and 49,674 rural working adults as part of the 2013-2014 China Chronic Disease and Risk Factor Surveillance. Participants were followed for a median of 6.2 years, and death records were retrieved from the National Mortality Surveillance System until December 31, 2019. The multivariable Cox proportional hazard model was used to examine urban-rural differences in the association between OPA and all-cause and cardiovascular disease (CVD) mortality. Subgroup analyses were performed by sex, socioeconomic status, leisure time, transportation, and non-occupational physical activity. During the study period, 1342 deaths were recorded, of which 426 were caused by CVD. In rural area, working adults engaging in occupational moderate-to-vigorous physical activity (MVPA) for ≥40h per week, compared to those without any, had an adjusted hazard ratio of 0.60 (95% CI: 0.49-0.73) for all-cause mortality and 0.55 (95% CI: 0.37-0.83) for CVD mortality. However, no significant association was found in urban area (0.84 [0.61-1.15] for all-cause mortality, Pinteraction=0.036; and 0.94 [0.53-1.66] for CVD mortality, Pinteraction=0.098). The negative associations of occupational MVPA with mortality were more pronounced in women, non-smokers, and those with less non-occupational physical activities. Hypertension, heart rate, and diabetes were important contributors to the relationship between occupational MVPA and mortality. The findings from the current study did not support the notion that high levels of OPA would induce harm. On the contrary, in rural setting, higher levels of OPA were associated with lower mortality risks. Furthermore, the observed urban-rural differences in the association between OPA and mortality underscored the need for context-specific public health guidelines on physical activities. R&D Program of Beijing Municipal Education Commission (KM202210025026),National Key Research and Development Program of China (2021YFC2500201), and Young Elite Scientist Sponsorship Program by BAST (BYESS2023385).

Survival analysis under imperfect record linkage using historic census data

BackgroundAdvancements in linking publicly available census records with vital and administrative records have enabled novel investigations in epidemiology and social history. However, in the absence of unique identifiers, the linkage of the records may be uncertain or only be successful for a subset of the census cohort, resulting in missing data. For survival analysis, differential ascertainment of event times can impact inference on risk associations and median survival.MethodsWe modify some existing approaches that are commonly used to handle missing survival times to accommodate this imperfect linkage situation including complete case analysis, censoring, weighting, and several multiple imputation methods. We then conduct simulation studies to compare the performance of the proposed approaches in estimating the associations of a risk factor or exposure in terms of hazard ratio (HR) and median survival times in the presence of missing survival times. The effects of different missing data mechanisms and exposure-survival associations on their performance are also explored. The approaches are applied to a historic cohort of residents in Ambler, PA, established using the 1930 US census, from which only 2,440 out of 4,514 individuals (54%) had death records retrievable from publicly available data sources and death certificates. Using this cohort, we examine the effects of occupational and paraoccupational asbestos exposure on survival and disparities in mortality by race and gender.ResultsWe show that imputation based on conditional survival results in less bias and greater efficiency relative to a complete case analysis when estimating log-hazard ratios and median survival times. When the approaches are applied to the Ambler cohort, we find a significant association between occupational exposure and mortality, particularly among black individuals and males, but not between paraoccupational exposure and mortality.DiscussionThis investigation illustrates the strengths and weaknesses of different imputation methods for missing survival times due to imperfect linkage of the administrative or registry data. The performance of the methods may depend on the missingness process as well as the parameter being estimated and models of interest, and such factors should be considered when choosing the methods to address the missing event times.

Occupational physical activity, all-cause, cardiovascular disease, and cancer mortality in 349,248 adults: Prospective and longitudinal analyses of the MJ Cohort

BackgroundEvidence on the health benefits of occupational physical activity (OPA) is inconclusive. We examined the associations of baseline OPA and OPA changes with all-cause, cardiovascular disease (CVD), and cancer mortality and survival times. MethodsThis study included prospective and longitudinal data from the MJ Cohort, comprising adults over 18 years recruited in 1998–2016, 349,248 adults (177,314 women) with baseline OPA, of whom 105,715 (52,503 women) had 2 OPA measures at 6.3 ± 4.2 years (mean ± SD) apart. Exposures were baseline OPA, OPA changes, and baseline leisure-time physical activity. ResultsOver a mean mortality follow-up of 16.2 ± 5.5 years for men and 16.4 ± 5.4 years for women, 11,696 deaths (2033 of CVD and 4631 of cancer causes) in men and 8980 deaths (1475 of CVD and 3689 of cancer causes) in women occurred. Combined moderately heavy/heavy baseline OPA was beneficially associated with all-cause mortality in men (multivariable-adjusted hazard ratio (HR) = 0.93, 95% confidence interval (95%CI): 0.89–0.98 compared to light OPA) and women (HR = 0.86, 95%CI: 0.79–0.93). Over a mean mortality follow-up of 12.5 ± 4.6 years for men and 12.6 ± 4.6 years for women, OPA decreases in men were detrimentally associated (HR = 1.16, 95%CI: 1.01–1.33) with all-cause mortality, while OPA increases in women were beneficially (HR = 0.83, 95%CI: 0.70–0.97) associated with the same outcome. Baseline or changes in OPA showed no associations with CVD or cancer mortality. ConclusionHigher baseline OPA was beneficially associated with all-cause mortality risk in both men and women. Our longitudinal OPA analyses partly confirmed the prospective findings, with some discordance between sex groups.

Twenty-five year occupational homicide mortality trends in North Carolina: 1992–2017

IntroductionDetermining industry of decedents and victim–perpetrator relationships is crucial to inform and evaluate occupational homicide prevention strategies. In this study, we examine occupational homicide rates in North Carolina (NC) by...

Occupational physical activity and risk of mortality in women and men: the Tromsø Study 1986–2021

ObjectiveAssociations between occupational physical activity (OPA) and mortality risks are inconclusive. We aimed to examine associations between (1) OPA separately and (2) jointly with leisure time physical activity (LTPA), and...

Characteristics of fatal occupational injuries in migrant workers in South Korea: A machine learning study

ObjectiveAnalysis of occupational injuries is essential for developing preventive strategies. However, few studies have evaluated severe occupational injuries in migrant workers from the perspective of gender. Therefore, using a new analytical method, this study was performed to identify gender-specific characteristics associated with fatal occupational injuries among migrant workers; the interactions between these factors, were also analyzed. In addition, we compared the utility of explainable artificial intelligence (XAI) using SHapley Additive exPlanations (SHAP) with logistic regression (LR) and discuss caveats regarding its use. Materials and methodsWe analyzed national statistics for occupational injuries among migrant workers (n = 67,576) in South Korea between January 1, 2007, and September 30, 2018. We applied an extreme gradient boosting model and developed SHAP and LR models for comparison. ResultsWe found clear gender differences in fatal occupational injuries among migrant workers, with males in the same occupation having a higher risk of death than females. These gender differences suggest the need for gender-specific occupational injury prevention interventions for migrant workers to reduce the mortality rate. Occupation was a significant predictor of death among female migrant workers only, with care jobs having the highest fatality risk. The occupational fatality risk of female workers would not have been identified without the performance of detailed job-specific analyses stratified by gender. The major advantages of SHAP identified in the present study were the automatic identification and analysis of interactions, ability to determine the relative contributions of each feature, and high overall performance. The major caveat when using SHAP is that causality cannot be established. ConclusionDetailed job-specific analyses stratified by gender, and interventions considering the gender of migrant workers, are necessary to reduce occupational fatality rates. The XAI approach should be considered as a complementary analytical method for epidemiological studies, as it overcomes the limitations of traditional statistical analyses.

Causes of Death Among Health Care Professionals in the United States.

Specific causes of mortality among various types of health care professionals (HCPs), including those characterized by age, gender, and race, have not been well described. The National Occupational Mortality Surveillance data for deaths in 26 US states in 1999, 2003-2004, and 2007-2014 were queried to address this question. Proportionate mortality ratios (PMRs) were calculated to compare specific causes of mortality among HCPs compared with those among the general population. HCPs were less likely to die from heart disease (PMR 93, 95% confidence intervals [CI] 92-94), alcoholism (PMR 62, 95% CI 57-68), drugs (PMR 80, 95% CI 70-90), and more likely to die from cerebrovascular disease (PMR 105, 95% CI 104-107) and diabetes (PMR 107, 95% CI 105-109). HCPs aged 18-64 years were more likely to die by suicide (PMR 104, 95% CI 101-107), whereas those aged 65-90 years were less likely to die by suicide (PMR 84, 95% CI 77-91), with physicians (PMR 251, 95% CI 229-275) and other HCPs having high PMR for suicide. Among all HCPs, suicide PMR was similarly increased, whereas heart disease PMRs are similarly decreased among Black compared with those among White HCPs and those among male compared with those among female HCPs. HCPs as a group and specific types of HCPs demonstrate causes of mortality that differ in important ways from the general population. Race and gender-based trends in PMRs for key causes of mortality among HCPs suggest that employment in a health care field may not alter race and gender disparities noted among the general population.

Quantifying disparities in fire-related mortality of US career and volunteer firefighters: A 43-year database study

There is no consensus on the leading causes of occupational disparities in firefighter mortality risk and whether these disparities have changed over time. This article prioritizes fire-related risks associated with mortality among US career and volunteer firefighters to inform targeted prevention efforts. We collected records of 3724 firefighter fatalities from the database between 1979 and 2021. Grey relational analysis was adopted to reveal the interrelationships between occupational risks and mortality. Firefighter mortality differed by occupation; the primary fire-related causes changed over 43 years for both career and volunteer firefighters. Volunteer firefighters exhibited higher risks across multiple variables than their career counterparts. These variables include alarm response/return, sudden cardiac death, age exceeding 60, and years of service below 10 or surpassing 30. These findings quantified disparities in the temporal evolution and fire-related occupations with elevated risk factors for deaths between career and volunteer firefighters, highlighting the need for targeted interventions.

Longitudinal Patterns of Postfracture Outpatient Physical Therapy and Occupational Therapy Use and Its Association With 3-Year Mortality Among Adults With Cerebral Palsy.

Fragility fractures are common among adults with cerebral palsy (CP), but clinical rehabilitation use after fracture and its effect on long-term health outcomes have not been sufficiently studied. The objectives of this study were to identify patterns of the use of physical therapy, occupational therapy, or both in the 6-month postfracture period and the association with 3-year mortality in adults with CP. This retrospective cohort study included adults who were ≥18years old, had CP, and had sustained an incident fragility fracture between January 1, 2014, and December 31, 2016, as identified from a random 20% Medicare fee-for-service dataset. Six-month outpatient physical therapy or occupational therapy use patterns after fracture were identified using group-based trajectory modeling. Cox regression determined the association between physical therapy or occupational therapy use trajectory patterns and mortality from 6months to 3years after fracture, adjusting for confounders. Effect modification by key characteristics was tested, including age, sex, and the modified Whitney Comorbidity Index (mWCI), which is a CP-specific comorbidity index that better captures overall medical complexity. Of the 2429 participants included, the majority (73.2%) were characterized as having little to no probability of physical therapy or occupational therapy use, whereas 16.0 and 10.7% were characterized as having early initiation and later initiation, respectively. Compared to the mortality rate for the little to no physical therapy or occupational therapy group, the mortality rates were 26% lower for the early physical therapy or occupational therapy initiation group (hazard ratio [HR] = 0.74; 95% CI = 0.55-1.00) and were 20% lower for the later initiation group (HR = 0.80; 95% CI = 0.57-1.12). There was effect modification by the mWCI. The mortality rate was lower when the early initiation and later initiation groups were compared to the little to no initiation group across all mWCI values examined (median and interquartile range), but the effect was stronger (ie, lower mortality rate) for lower mWCI values for both early initiation and later initiation groups. Most adults with CP underutilize outpatient physical therapy or occupational therapy services within 6months postfracture. Early or later initiation versus little to no physical therapy or occupational therapy use was associated with a lower HR of mortality, although the effect was stronger and statistically significant among those with less medical complexity. Throughout their lives, the use of rehabilitation services in individuals with CP, including physical therapy and occupational therapy, dramatically declines despite the need for continued rehabilitation across their lifespans. This study characterized longitudinal physical therapy or occupational therapy use patterns in the 6months following a fragility fracture among adults with CP and found that nearly 3 in 4 adults with CP had little to no physical therapy or occupational therapy use during this critical window to optimize postfracture health and function. Further, those who more regularly used physical therapy or occupational therapy services, regardless of the timing of initiation (early vs later), had significantly improved survival up to 3years after fracture, suggesting the need for greater access to and delivery of clinical rehabilitation services.

Improving Crew Overboard Recovery for Commercial Fishing in the Gulf of Mexico

ABSTRACT Occupational fatality rates in the commercial fishing industry in the United States remain more than 20 times higher than the national average. The burden of commercial fishing fatalities due to unintentional falls overboard is highest in the Gulf of Mexico (GOM) shrimp fishery. The objective of this quasi-experimental, pre-/post-test project design was disseminating recovery slings to GOM captains/deckhands, training in their use, and assessing the attitudes, beliefs, and intentions of fishermen in their adoption. Due to the COVID−19 pandemic, a land-based simulation was used to train commercial fishermen at three port locations in use of crew overboard (COB) recovery slings. A survey was developed to assess the attitudes, beliefs, and intentions of commercial fishermen in COB recovery. Purposive sampling was employed to recruit 30–50 fishermen at each location. Following pre-/post-training surveys, fishermen received one recovery sling per vessel along with a task list of instructions for use of the sling. A third survey and task list questions were performed at 12–18 months. There were 119 recovery slings and training in their use provided to 123 commercial shrimp fishing vessel owners/captains and deckhands along the Texas and Louisiana Gulf Coast. Repeated measures analysis of variance of the three surveys showed that positive change in normative beliefs was significant for the importance of quickly and safely maneuvering the vessel to the crew member. This change was most significant over the period from the initial training and receipt of the recovery sling by the vessel captain/deckhand, to the time of follow-up 12–18 months later (p = .03). Regarding control beliefs, training was associated with immediate statistically significant improved confidence that, with assistance, the fisherman would be able to use the sling and other equipment to hoist the COB (p = .02). However, this confidence waned significantly over time (p = .03). Attitudes and beliefs of commercial fishermen in the GOM can be favorably influenced toward a COB recovery device, as well as their confidence, and intention to use such devices. However, results show that attitudes and beliefs may wane over time, emphasizing the importance of repeated training and survival drills in this industry.

Cohort profile: ORICAMs, a French cohort of medical workers exposed to low-dose ionizing radiation.

Medical personnel represent the largest group of workers occupationally exposed to ionizing radiation. Although the health risks associated with occupational exposure to low doses of ionizing radiation in the medical field have been investigated in several national cohorts, no study has been conducted in France to date. The ORICAMs (Occupational Radiation Induced Cancer in Medical staff) cohort is a nationwide French longitudinal cohort of medical workers exposed to ionizing radiation aiming to investigate the risk of radiation-associated cancer and non-cancer mortality. The ORICAMs cohort was set up in 2011 and includes all medical personnel monitored for ionizing radiation exposure with at least one dosimetric record in the SISERI database (the national registry for monitoring ionizing radiation exposure in workers) over the period 2002-2012. Causes of death were abstracted from death certificates and coded according to ICD-10. The follow-up ended on 31/12/2013. Standardized mortality ratios (SMRs) were calculated by cause of death to compare the mortality in the cohort to that in the French population, by gender, age group and calendar period. Among the 164,015 workers included in the cohort (60% women) a total of 1,358 deaths (892 in male and 466 in female) were reported. The observed number of all-cause deaths was significantly lower than expected based on national rates in both male (SMR = 0.35; 95% CI: 0.33, 0.38; ndeaths = 892) and female (SMR = 0.41; 95% CI: 0.38, 0.45; ndeaths = 466). This analysis leads to the conclusion that mortality in French workers exposed to medical radiation is significantly lower than the national reference rates. However, these results based on a comparative analysis with national rates may be impacted by the healthy worker effect towards low SMRs, and do not enable to establish a potential relationship between occupational exposure and mortality risk, even if we may suspect an impact of high SES of these professionals on the observed decreased mortality. Thus, further dose-response analyses based on individual ionizing radiation exposure and job's type will be conducted to characterize correlation between risk of cancer mortality and occupational exposure.

Canadian Ultralight Accidents in Water (1990 to 2020).

INTRODUCTION: Recently, an analysis of Canadian seaplane accidents terminating in water (1995-2019) was conducted, but ultralight water accidents were excluded due to differences from general aviation operations. This is the first literature that reports a series of ultralight accidents that occurred in water. The purpose of this paper is to identify the circumstances surrounding ultralight water accidents in Canada and to identify actions with the potential to improve survival.METHODS: Ultralight water accidents that were reported to the Transportation Safety Board of Canada between 1990 and 2020 were reviewed.RESULTS: Of the 1021 accidents that involved ultralights, 114 terminated in water, involving 155 occupants and 8 fatalities, yielding an occupant mortality rate of 5%. Of the accidents, 52% occurred during landing. There was less than 15 s warning in 78% of cases, which included five (63%) fatalities. The aircraft inverted in 40% of the accidents and, in 21%, it sank immediately. Loss of control was the terminal cause of the accident in 43% of cases, while adverse environmental conditions were reported in 38% of accidents. Little or no details were included on lifejacket or restraint harness use, status of emergency exits, water temperature, or occupant diving experience or underwater escape training.CONCLUSIONS: The mortality rate in ultralight aircraft water accidents was less than half that of helicopter and seaplane ditchings, but the lack of warning time was similar. All pilots and passengers need to have a well-practiced survival schema before strapping in and can benefit from underwater escape training.MacDonald C, Brooks C, McGowan R, Rosberg A. Canadian ultralight accidents in water (1990 to 2020). Aerosp Med Hum Perform. 2023; 94(6):437-443.

Sector of Employment and Mortality: A Cohort Based on Different Administrative Archives.

Administrative data can be precious in connecting information from different sectors. For the first time, we used data from the National Social Insurance Agency (INPS) to investigate the association between the occupational sectors and both non-accidental and accidental mortality. We retrieved information on occupational sectors from 1974 to 2011 for private sector workers included in the 2011 census cohort of Rome. We classified the occupational sectors into 25 categories and analyzed occupational exposure as ever/never have been employed in a sector or as the lifetime prevalent sector. We followed the subjects from the census reference day (9 October 2011) to 31 December 2019. We calculated age-standardized mortality rates for each occupational sector, separately in men and women. We used Cox regression to investigate the association between the occupational sectors and mortality, producing hazard ratios (HRs) and 95% confidence intervals (95%CI). We analyzed 910,559 30+-year-olds (53% males) followed for 7 million person-years. During the follow-up, 59,200 and 2560 died for non-accidental and accidental causes, respectively. Several occupational sectors showed high mortality risks in men in age-adjusted models: food and tobacco production with HR = 1.16 (95%CI: 1.09-8.22), metal processing (HR = 1.66, 95%CI: 1.21-11.8), footwear and wood (HR = 1.19, 95%CI: 1.11-1.28), construction (HR = 1.15, 95%CI: 1.12-1.18), hotels, camping, bars, and restaurants (HR = 1.16, 95%CI: 1.11-1.21) and cleaning (HR = 1.42, 95%CI: 1.33-1.52). In women, the sectors that showed higher mortality than the others were hotels, camping, bars, and restaurants (HR = 1.17, 95%CI: 1.10-1.25) and cleaning services (HR = 1.23, 95%CI: 1.17-1.30). Metal processing and construction sectors showed elevated accidental mortality risks in men. Social Insurance Agency data have the potential to characterize high-risk sectors and identify susceptible groups in the population.

Risk and Protective Factors for Cancer Mortality among United States Service Members and Veterans (2001-2018).

Prior research linking military factors with cancer-specific mortality has shown inconsistent findings, with few studies examining these associations among U.S. service members and veterans who served in Operation Iraqi Freedom/Operation Enduring Freedom conflicts. Cancer mortality between 2001 and 2018 was ascertained from the Department of Defense Medical Mortality Registry and National Death Index for 194,689 Millennium Cohort Study participants. Cause-specific Cox proportional hazard models were used to examine links between military characteristics and cancer mortality [overall, early (<45 years), and lung]. Compared with individuals who deployed with no combat experiences, non-deployers had a greater risk of overall [HR = 1.34; 95% confidence interval (CI) = 1.01-1.77] and early cancer mortality (HR = 1.80; 95% CI = 1.06-3.04). Enlisted individuals had a greater risk of lung cancer mortality compared with officers (HR = 2.65; 95% CI = 1.27-5.53). No associations by service component, branch, or military occupation and cancer mortality were observed. Higher education was associated with reduced overall, early and lung cancer mortality risk and smoking and life stressors were associated with elevated overall and lung cancer mortality risk. These findings are consistent with the healthy deployer effect in which military personnel who were deployed tend to be healthier than those who did not deploy. Further, these findings highlight the importance of considering socioeconomic factors, such as military rank, that may have long-term implications for health. These findings highlight military occupational factors that may predict long-term health outcomes. Additional work is necessary to investigate more nuanced environmental and occupational military exposures and cancer mortality.