Lesson 4: Epidemiology of Accidents
Unintentional injuries (accidents) are the leading cause of death among all individuals aged from one to thirty – four years. Hilgenkamp (2006) looks at unintentional injuries as events that because of errors in judgment, poor health, or physical inability to prevent them, cannot be avoided. This definition supports the labeling of these injuries as accidents or events that are not deliberate. These types of injuries lend themselves to evaluation by epidemiologists in terms of time, place, and person. By using these tools in a careful evaluation of a worksite, public health agencies can begin to forecast unintentional
The most prevalent and perhaps the most preventable occupational fatal injuries (NIOSH, 2009) result from falls, motor vehicle accidents, and being struck by objects.
Christoffel and Gallagher (2006) found that unintentional injuries constitute over two – thirds of all injury deaths and one – third of all emergency department visits, and they also point out that motor vehicle and fall injuries are very important in the occupational setting.
These most prevalent types of accidents in the workplace (falls, motor vehicle accidents, and being struck by an object) need to be evaluated in order to develop prevention programs that have a good chance of success.
The BLS (2005a) reports that fatal work injuries involving falls increased 17 percent in 2004, following two years of decline. The 815 falls reported in 2004 constituted the highest annual total ever reported for this injury category. Fatal falls from a roof increased by almost 40 percent and fatal falls from a ladder increased 17 percent. Almost 90 percent of the fatal falls from roofs involved construction workers.
The epidemiological implications of these data are supportive of the development of prescreening programs and better education programs for workers concerning the major causes of falls in the workplace. This educational initiative needs to address where and when the falls usually occur and what the worker was typically trying to do at the time of the fall. The equipment available to prevent serious falls must be evaluated, and consideration must be given to the limitation of the damage to the person if a fall does occur in the workplace. If employees are not using the proper equipment to prevent or limit damage from falls, then consideration must be given to establishing a workplace policy concerning falls and to determining how to best enforce this policy.
Motor Vehicle Accidents
Occupational motor vehicle accidents also increased in 2004 after falling for the previous two years. The BLS (2005a) reported 1,374 fatal highway accidents in 2004, which represented 25 percent of the fatal work injuries in 2004. Almost 40 percent of motor vehicle accidents are a direct result of driving under the influence of alcohol, illegal drugs, or prescription drugs. A large number of these motor vehicle accidents occurred while traveling to and from work and while traveling as an employee on work-related business. The implications of these data are that driver education is needed and also strong workplace policies concerning using seat belts and not driving under the influence of alcohol or drugs. By applying the Haddon matrix and sound epidemiological principles to these problems, a prevention program can be developed to reduce motor vehicle accidents in the workplace and reduce disability and death if these accidents do occur.
Being Struck by an Object
The number of workers fatally injured by being struck by objects rose 12 percent in 2004, led by a rise in the number of workers who were fatally injured by contact with falling, rolling, or sliding objects (BLS, 2005a). The implications of these data are that being struck by an object has become a dangerous and common occurrence in many workplaces. Again, the Haddon matrix allows an evaluation of the entire process required for this accident to happen so frequently to workers.
The key to preventing accidents in which people are struck by an object is the development of educational programs concerning the causes of such accidents and what the employer and employee need to do to prevent occurrences. This is another example of how important the pre-injury phase is in preventing the accident from happening or at least reducing disability and death when this type of accident does happen.