Work Injuries Research Articles

An Osteopathic Approach to Complex Regional Pain Syndrome (CRPS)

Abstract Complex Regional Pain Syndrome (CRPS) is a chronic neuropathic pain condition in a region of the body where the pain experienced by the patient is disproportionate to the stimuli preceding the pain. In this case, a 52-year-old post-menopausal woman presents with chronic distal limb pain due to a left ankle contusion from a work injury. Previous treatments that focused on specific symptoms failed. However, the patient was then evaluated and treated comprehensively by an osteopathic physician. Treatment was tailored to individual patient needs based on the five models of osteopathic care. Within a 1.5 years period of integrative osteopathic treatment that utilized osteopathic manipulative treatment (OMT) in addition to medications and supplements, the patient was able to start walking again with only mild discomfort. This individualized approach seemed to improve her quality of life, and overall satisfaction with her health, psyche, and well-being. The patient is now discharged from the practice, has resumed normal daily activities, and is working full-time as a cashier.

Interpretable deep learning for roof fall hazard detection in underground mines

Roof falls due to geological conditions are major hazards in the mining industry, causing work time loss, injuries, and fatalities. There are roof fall problems caused by high horizontal stress in several large-opening limestone mines in the eastern and midwestern United States. The typical hazard management approach for this type of roof fall hazards relies heavily on visual inspections and expert knowledge. In this context, we proposed a deep learning system for detection of the roof fall hazards caused by high horizontal stress. We used images depicting hazardous and non-hazardous roof conditions to develop a convolutional neural network (CNN) for autonomous detection of hazardous roof conditions. To compensate for limited input data, we utilized a transfer learning approach. In the transfer learning approach, an already-trained network is used as a starting point for classification in a similar domain. Results show that this approach works well for classifying roof conditions as hazardous or safe, achieving a statistical accuracy of 86.4%. This result is also compared with a random forest classifier, and the deep learning approach is more successful at classification of roof conditions. However, accuracy alone is not enough to ensure a reliable hazard management system. System constraints and reliability are improved when the features used by the network are understood. Therefore, we used a deep learning interpretation technique called integrated gradients to identify the important geological features in each image for prediction. The analysis of integrated gradients shows that the system uses the same roof features as the experts do on roof fall hazards detection. The system developed in this paper demonstrates the potential of deep learning in geotechnical hazard management to complement human experts, and likely to become an essential part of autonomous operations in cases where hazard identification heavily depends on expert knowledge. Moreover, deep learning-based systems reduce expert exposure to hazardous conditions.

Evidence mapping of clinical research on 28 Chinese patent medicines for tension-type headache

In this study, the evidence mapping methodology was used to systematically retrieve and sort out the clinical research evidence of Chinese patent medicines in the treatment of tension-type headache(TTH), and to understand the distribution of evidence in this field and the basis and quality of evidence. Chinese and English articles on the 28 Chinese patent medicines for TTH, which were recorded in National Essential Medicines List(2018), Medicine Catalogue for National Basic Medical Insurance, Work Injury Insurance, and Maternity Insurance(2020), and Chinese Pharmacopoeia(2020), were retrieved from China National Knowledge Infrastructure(CNKI), Wanfang, VIP, China Biology Medicine disc(CBMdisc), PubMed, EMbase, and Cochrane Library from the establishment to June 2021, followed by descriptive analysis. Then, tables and bubble charts were plotted to analyze the distribution characteristics of evidence. A total of 129 eligible articles were yielded: 126 randomized/non-randomized controlled trials, and 3 systematic reviews. The functions, indications, and composition of the 28 medicines, as well as the proportion of related articles, publication trends, intervention measures, and outcome indicators were compared and analyzed. The results showed that the 28 Chinese patent medicines, composed of 128 Chinese medicinals, can be classified into six categories in terms of function: reinforcing healthy Qi, tranquilizing mind, dispelling stasis, regulating Qi, treating wind, and resuscitating. There are ongoing efforts to study the treatment of TTH with Chinese patent medicine in China, despite of little evidence. The clinical positioning of Chinese patent medicine for TTH is not clear, and clinical research fails to highlight the advantages of Chinese medicine. In addition, the outcome indicators have not been standardized and unified, and there is a lack of evidence on the long-term efficacy of Chinese patent medicine for TTH. This study is the first exploratory application of evidence maps to compare the characteristics and clinical research progress of 28 Chinese patent medicines for TTH, which can provide a reference for research on the optimization of Chinese medicine strategies for TTH.

Commuting accidents while walking: a women occupational risk

there are few studies in occupational health literature addressing the issue of work injuries among women. the purpose of this study is to examine gender differences in the occurrence and causes of one type of work injuries which is more frequent among women: the commuting accident while walking. this study is based on the data of recognized commuting while walking injuries in the industrial and service sectors recorded by the Italian National Institute for Insurance against Accidents at Work during the last five years (2014-2018). Italy; all compensated workers for commuting while walking injuries. number of injuries, rate incidence, incidence rate ratio, odds ratio. commuting while walking injuries in the last five years were three times more frequent among women, with an increasing incidence over the years and by age (women: 1,31‰ vs men 0,40‰; IR 3,24; 95%CI 3,19-3,30). Women were more often injured going to work, in winter, on Mondays, in the North-Western areas of the country. Female mail-carriers, cleaners, care givers, public administrators were particularly vulnerable, especially the less young (>=50 years old). Females were at a higher risk for fractures particularly of wrist, elbow, and foot, while males had a higher risk for hand, knee, and chest injuries. Gender difference in incidence rate and type of commuting while walking injuries may be also due to a diverse work and home exposures together with fall dynamics. commuting while walking work injuries show the higher incidence rate among women and the need to gender oriented prevention.

Sex and Gender Differences in Occupational Hazard Exposures: a Scoping Review of the Recent Literature.

Purpose of ReviewComparative research on sex and/or gender differences in occupational hazard exposures is necessary for effective work injury and illness prevention strategies. This scoping review summarizes the peer-reviewed literature from 2009 to 2019 on exposure differences to occupational hazards between men and women, across occupations, and within the same occupation.Recent FindingsFifty-eight studies retrieved from eight databases met our inclusion criteria. Of these, 30 studies were found on physical hazards, 38 studies on psychological/psychosocial hazards, 5 studies on biological hazards, and 17 studies on chemical hazards. The majority of studies reported that men were exposed to noise, vibration, medical radiation, physically demanding work, solar radiation, falls, biomechanical risks, chemical hazards, and blood contamination; while women were exposed to wet work, bullying and discrimination, work stress, and biological agents. Within the same occupations, men were more likely to be exposed to physical hazards, with the exception of women in health care occupations and exposure to prolonged standing. Women compared to men in the same occupations were more likely to experience harassment, while men compared to women in the same occupations reported higher work stress. Men reported more exposure to hazardous chemicals in the same occupations as women.SummaryThe review suggests that men and women have different exposures to occupational hazards and that these differences are not solely due to a gendered distribution of the labor force by occupation. Findings may inform prevention efforts seeking to reduce gender inequalities in occupational health. Future research is needed to explain the reasons for sex/gender inequality differences in exposures within the same occupation.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40572-021-00330-8.

Recreational Marijuana Sales Legalization and Monday Work Injury Claims

Abstract An important stylized fact in the literature is that more Workers’ Compensation claims for difficult-to-diagnose injuries are filed on Monday than on any other day of the week. This paper studies the impact of recreational marijuana sales legalization on Monday work injury claims. Using restricted-use Workers’ Compensation claim data in Oregon and a Difference-in-Differences (DiD) model, I find the probability of overall Monday injuries increase by 4 percentage points after recreational marijuana sales legalization. The event study graphs suggest the medium-term effects appear to equal the short-term effects. Additionally, I do not find strong evidence to support those difficult-to-diagnose Monday injuries disproportionately increase after recreational marijuana sales legalization, suggesting a limited moral hazard of Monday injury claiming behavior after recreational marijuana sales legalization.

Analisis Postur Kerja Operator Dengan Metode RULA dan REBA Di Juragan Konveksi Jakarta

Juragan Konveksi is a home industry whose production process is still conventional. Based on the initial observations, there are 3 workstations whose operators often experience injuries, including the pattern cutting station, the sewing process station, and the finishing station. The purpose of this study was to determine the level of work injury on the operator. The methods used are RULA (Rapid Upper Limb Assessment) and REBA (Rapid Entire BodyAssessment). From the results of the NBM (Nordic Body Map) questionnaire calculation, there are four operators who have a high level of risk, namely the pattern cutting process with a score of 80 and 77, and the sewing process with a score of 71 and 73, and two operators have a very high-risk level in the finishing process. with a score of 92 and 103. From the RULA score on the sewing process operator, a score of 6 was obtained, which means that further investigation is needed, and changes must be made immediately. Then for the REBA score on the pattern cutting and finishing process operators get a value of 8 and 10 which means there is a high risk of injury/muscle disorders. This means that it is necessary to make improvements to the productionprocess to reduce work injuries for operators.

9.L. Workshop: Injury epidemiology, treatment, costs and legislation during the COVID-19 pandemic

The recent lockdown and containment measures have brought about major changes in the daily routines of people and this resulted in profound changes in the cause of injury (e.g. traffic, falls, interpersonal violence) and nature of injury (e.g. hip fracture, traumatic brain injury). Despite the changes in the aetiologies, injuries remained frequent throughout the pandemic. Evidence from the COVID-19 period suggest a decrease in road traffic crashes, work and leisure injuries and a noteworthy increase in interpersonal violence and self-harm. These different causes and patterns of injury have brought about changes in the clinical characteristics and demand of health services. Hospitals have experienced organisational constraints with redeployment of medical staff in different units and suspension of non-emergency medical activity. At the same time, new priorities have been set for hospital admissions and new protocols have been developed to guide the emergencies' pathways and clinical/health services approach. Non-essential medical treatment has been postponed with increased risk of delayed treatment, late recovery and mortality from causes different than COVID-19, including injury complications. The impact of COVID-19 in the provision and coverage of health services needs to be urgently mitigated, including the treatment and rehabilitation from physical and psychological effects of untreated injuries. This is expected to place additional pressure on the health systems and increase health care costs. Hospital discharge data are a potentially valuable source of information for injury prevention planning yet there is much work to be done on the improvement of hospital and injury data quality.The workshop aims to discuss the effect of COVID-19 lockdown on the epidemiology and clinical characteristics of injuries, as well as the barriers of maintaining (or even improving) data quality during the different phases of the pandemic. The workshop will further discuss hospital demand and will identify the challenges for the health systems in handling the complex needs of vulnerable patients under serious restrictions. The workshop will also highlight the legal and regulatory measures taken and their level of efficacy in promoting free movement of workers within EU but also the right to work guaranteed under ECHR and ILO Conventions and Declaration. The high human and societal costs as well as inequalities of injury mortality and burden will be highlighted based on comparisons with long-term trends. The workshop will contribute to the identification of evidence-informed strategies and will promote effective planning and optimization of health services response for future pandemics.Key messages The new map of injuries resulting from COVID-19 pandemic is likely to affect health care targets and priorities.Evidence-informed strategies are necessary to capture the magnitude and address the after-COVID effects and the health burden of untreated conditions.

Injury Patterns among Forestry Workers in Croatia

Timber harvesting, especially motor-manual felling, in Croatia, as in many other countries, is one of the most hazardous economic activities. Consequently, the aim of this paper is to analyse and compare the latest trends and risk factors related to the incidence of work-induced injuries in structural organization units of national forest enterprise. A combined approach of literature review and assembled secondary data was applied to gather data on workplace accidents over the years 2014–2020. Work-induced injuries data were drawn from the records of the national enterprise Croatian Forests Ltd. which manages state forests (76% of total forest area). A total of 1626 work-induced injuries were processed and entered into the database. Data analysis was conducted using statistical and descriptive methods. Research results have proven a significant difference in the injury rate over the years 2014–2020 in the Croatian forest enterprise. During the analysed period the highest number of workplace accidents (51.35% of all recorded workplace accidents) occurred during the forest harvesting phase, i.e., during motor-manual felling. Trends in the incidence of work-induced injuries in the observed period do not show any significant improvement. The key findings have pointed out that forest administrations which practice even-aged forest management have 25% or more injuries than forest administrations which practice selective forest management. Related to the average rate of change by forest administration, the largest annual increase or decrease of the selected safety indicators is recorded for smallest forest administrations. Related to total number of injuries, the smallest forest administrations have the least injuries and show statistically significant difference compared to large forest administrations. When comparing the number of injuries per 1000 employees, medium sized forest administrations have the highest value of indicator and show statistical significance. Discussion and conclusion of the paper emphasizes the need for systematic research in the field of ergonomy, safety and health of forest workers in Croatian forestry sector. Additionally, the development and inclusion of proactive safety culture is recognized as a mechanism that can further reduce work injuries and improve occupational safety which should have a significant role in the process of certification of forest management according to the FSC standard.

Cognitive and Emotional Appraisal of Motivational Interviewing Statements: An Event-Related Potential Study.

The counseling process involves attention, emotional perception, cognitive appraisal, and decision-making. This study aimed to investigate cognitive appraisal and the associated emotional processes when reading short therapists' statements of motivational interviewing (MI). Thirty participants with work injuries were classified into the pre-contemplation (PC, n = 15) or readiness stage of the change group (RD, n = 15). The participants viewed MI congruent (MI-C), MI incongruent (MI-INC), or control phrases during which their electroencephalograms were captured. The results indicated significant Group × Condition effects in the frontally oriented late positive complex (P600/LPC). The P600/LPC's amplitudes were more positive-going in the PC than in the RD group for the MI congruent statements. Within the PC group, the amplitudes of the N400 were significantly correlated (r = 0.607–0.649) with the participants' level of negative affect. Our findings suggest that the brief contents of MI statements alone can elicit late cognitive and emotional appraisal processes beyond semantic processing.

Occupational Health, Productivity and Evidence-Based Workplace Health Intervention

Occupational Health, Productivity and Evidence-Based Workplace Health Intervention

Injury severity and influence factors in surface mines: A correspondence analysis

In this study, injury data from surface mines in Ghana was analysed using correspondence analysis. The overall objective of the study was to investigate the association between five injury levels, namely fatality, permanent disability, temporary disability, days away from work and restricted work injury, and four accident factors, namely job title, location, time and cause. The four accident factors exemplify the well-known accident classification scheme of who, where, when and why. 206 accidents resulting in a minimum of restricted work injury were analysed. Preliminary analysis showed that days away from work was the dominant injury, and most of the accidents occurred after 6 h of work. With respect to location, job title and cause; fixed workshop, mechanic/repairmen and moving components/parts respectively accounted for most of the injuries. Results of the correspondence analysis showed that locations, job titles and hazards related to actual mining operations precipitate high consequence accidents such as fatalities and disabling injuries than the other job titles, locations and hazards. From the correspondence analysis, it was observed that “involvement in actual mining operations”, “night shift”, and “after 6 h of work” are hidden causes of high consequence accidents, and priority areas for accident reduction. These results offer opportunities for developing injury prevention strategies and their practical implications have been discussed. Specifically, the study was able to identify some hidden causes of accident, which are important prerequisite for accident prevention. For instance, “6 h of work” was identified as a hidden cause of accident, suggesting that safety measures are required to protect workers who work more than 6 h in a day, and are involved in actual mining operation, since they have a higher risk of injury than other workers.

Upholding labor productivity with intensified heat stress: Robust planning for adaptation to climate change under uncertainty

The intensification of heat stress in a changing climate poses great threats to both human health and labor productivity. It is of great practical importance to assess the impacts of climate-induced heat stress on labor productivity and to develop effective adaptation strategies. In this paper, an integrated optimization-based productivity restoration modeling framework is proposed for the first time to develop the optimal policies for adaptation to climate change. To address underlying uncertainties associated with climate and labor management systems, we take into account ensemble projections from five global climate models (GCMs) under two Representative Concentration Pathways (RCP2.6 and RCP8.5) and inexact system costs. The system costs, including direct and indirect costs such as management costs, energy costs, and labor costs, are presented as interval numbers due to inherent uncertainty caused by population growth, technology development, and other social-economic factors. Uncertain information can be effectively communicated into the optimization processes in this study to generate optimal and reliable decision alternatives. We find that the increased Wet-Bulb Globe Temperature (WBGT) will lead to a large reduction in labor capacities over China except for the Tibetan Plateau under both RCPs by the end of the 21st century. The less developed regions tend to achieve the minimum system cost by having labor productivity recovered through working overtime due to the relatively low cost of overtime. This could result in more heat-related work injuries in the less developed regions. Since the less developed regions are not heat-prone areas in China, the changing climate would be a more dangerous threat and cause more damages to these regions where the residents are less acclimatized to heat stress. Moreover, we obtain a range of minimum system costs from 1.86 to 8.97 billion dollars under RCP2.6 and from 9.42 to 32.31 billion dollars under RCP8.5 (about 0.2% of China's GDP in 2019, 0.01% of China's GDP projected in 2100 under a sustainable socio-economic development scenario) for the restoration of labor productivity in a warming climate. We argue that urgent actions are needed to mitigate global warming impacts on labor productivity.

Cohort profile: the Ontario Life After Workplace Injury Study (OLAWIS)

PurposeThe substantial economic burden of work-related injury and illness, borne by workers, employers and social security programmes, is primarily attributed to the durations of work disability among workers whose recovery...

Сравнительный анализ концепций культуры безопасности на производстве

The main concepts of safety culture at work and the problems of their adaptation to specific conditions at the enterprises of PJSC LUKOIL and PJSC SIBUR Holding are considered. Safety culture is a broad concept that includes a set of knowledge, beliefs, moral values, habits, skills, as well as a set of legislative and normative acts. Individual elements of a safety culture can be implemented in various combinations. However, not all the organizations have a specific concept for implementing safety culture programs in their workplaces. In this regard, the study of the efficiency of the activities of the enterprises of PJSC LUKOIL and PJSC SIBUR Holding was conducted to improve the culture of occupational safety. The dynamics of incidents and its dependence on the introduced measures for the implementation of programs for the culture of safety at work were assessed. The objectives of this work are to establish afore-mentioned dependence at work, as well as to identify the best practices for introducing an occupational safety culture. The causes of injuries and their relationship with the safety culture at work, as well as the influence of individual tools of this culture on the frequency and severity of incidents are considered. It is established that the use of only informational tools, as is done at many Russian enterprises, does not reduce injuries. Simple information does not lead to an improvement in occupational safety and efficiency of the enterprise, and sometimes even causes the opposite effect. The most promising and efficient tool for the occupational safety culture is the assessment of occupational risks, i.e., identification of incidents that potentially lead to injury or incident. The conducted analysis of the implementation of various programs on the culture of occupational safety will help enterprises to choose the concept of safety culture that is optimal for themselves and, as a result, reduce the level of work injuries.

The prevalence, seriousness, and causes of teenage work accidents: A gender difference?

Teenage workers are prone to a higher injury risk than adult workers, and adult men are prone to a higher risk of work injuries than adult women. This study aims to examine whether gender differences exist in teenage work accidents, the level of the accidents, their causes, and the types of the injuries. A survey was sent to a sample of 2,800 13-19-year-olds, randomly selected from Registers Iceland. The response rate was 48.6%. A chi-square test, CI 95%, was applied to measure gender differences. In total, 16.3%of the respondents had at least one work accident, and 1.2%, an accident that lead to more than one week's absence from work. No gender differences were observed in the level of the accidents, but appeared in the types of injuries and their causes. Cuts were the most common injuries of the boys, but burns of the girls. Bone fractures were the most serious injuries of the boys, but sprains of the girls. Work accidents among teenagers are a particular threat to public health. Therefore, all stakeholders need to work together to prevent teenage work accidents in the future; and to keep in mind the gender diversity of the group.

Workplace bullying: is there a difference by enterprise size?

While relationships between working conditions, bullying and health issues have been proven, most studies have investigated these relationships in large enterprises (> 250 employees). Indeed, only a few studies have analyzed this issue in small firms, despite the fact that the latter differ from the former at multiple levels. Therefore, our objective was twofold: to assess whether the size of a firm had an impact on the frequency of workplace bullying and to identify whether the effects of bullying on workers' health differed according to the size of the company. Data from the 2010 SUMER French periodical cross-sectional survey were analyzed (N = 31,420 for the present study). Bullying at work was measured based on nine possible hostile attitudes derived from the French version of the Leymann Inventory of Psychological Terror. Two other questions measured colleague-to-colleague verbal violence and sexual or physical assaults. Anxious or depressive episodes were measured using the Hospital Anxiety and Depression scale (HAD). Other health issues were: perceived health status, sickness absence (at least one absence lasting more than eight days), and work injuries. Our findings show that bullying at work was less frequent in micro enterprises (< 10 employees). Anxiety/depression, perceived health status, sickness absence (at least one lasting more than eight days) were significantly associated with workplace bullying, but the effects of bullying were significantly higher in micro enterprises (statistical interaction). This study highlights how a firm's size influences workplace bullying and, in particular, the prevalence and consequences of bullying in micro enterprises. The implication and guidelines for practice are discussed.

It Is Time to Implement Primary Prevention in the Workplace to Ameliorate the Ongoing U.S. Opioid Epidemic.

The United States’ opioid public health crisis continues having disastrous consequences on communities, including workers and employers. From May 2019 to May 2020, the largest number of drug overdose deaths was recorded over a twelve-month period. The “twindemics” of COVID-19 and opioids underscore the urgent need to address workers’ physical and mental health. Although much has been written about the negative impacts of the opioid epidemic on the workplace, few initiatives have focused on primary prevention, addressing work-related root causes of opioid use disorders (e.g., injury, stress) that may lead to prescription or illicit opioid use. We suggest primary prevention efforts to address the connection between workplace hazards and opioid misuse, dependence, and addiction such as examining patterns of work injury and stress with records of opioid prescription. Government funding should be expanded to support primary prevention and research efforts to strengthen the evidence-base to support workplace primary prevention endeavors.

Returning to Work After an Injury or Illness.

When we experience an injury or illness, it can affect our ability to work. Work rehabilitation helps people return to work after an illness or injury. When possible, work rehabilitation can also help people stay at work as they manage their illness or injury. To understand how physical therapists can best support people as they return to work, experts in work rehabilitation reviewed all the available research and discussed what the research means. These experts shared their findings and recommendations in "Clinical Guidance to Optimize Work Participation After Injury or Illness: The Role of Physical Therapists," published in JOSPT in August 2021. J Orthop Sports Phys Ther 2021;51(8):382. doi:10.2519/jospt.2021.0506.

Social protection and the platform economy: The anomalous approach of the French legislator

AbstractAddressing the social protection of platform workers, the French legislator in 2016 and then in 2019 made moves to incorporate these workers into the general social security regime with regard to certain covered risks (work injury and occupational diseases), and to improve adequacy (enabling possible access to complementary coverage). However, these moves rest on radically opposed perspectives. Rather than reasserting the legal responsibility of the employer vis‐à‐vis workers’ health and safety, we see responsibility placed with the platform, but only on a voluntary basis under the aegis of corporate social responsibility. This risks fragmenting social benefits, to be determined by each platform, thus weakening the practices of mutual protection and risk pooling among enterprises and workers that lie at the heart of social security. In doing so, the legislator has broken the link that had as its historic objective the goal of social inclusion and has encouraged in different ways the privatization, or a re‐commodification, of social security in the commercial interest of private insurance companies. Moreover, this has been done using the Trojan Horse of the French labour code. This approach is in contrast to the converging position of international organizations, such as the European Union, International Labour Organization or the Organisation for Economic Co‐operation and Development, recommending that States establish a right to social protection for all atypical workers and non‐salaried workers. Instead of identifying the common challenges that face workers who work for platforms, and offering responses specific to their situation, rather, it considers platform work as one of the new forms of atypical work undertaken by those who may have the status of employee or self‐employed.