Sleepiness/fatigue and distraction/inattention as factors for fatal versus nonfatal commercial motor vehicle driver injuries.

A retrospective population-based case-control study was conducted to determine whether driver sleepiness/fatigue and inattention/distraction increase the likelihood that a commercial motor vehicle collision (CVC) will be fatal. Cases were identified as CVC drivers who died (fatal) and controls were drivers who survived (nonfatal) an injury collision using the Kentucky Collision Report Analysis for Safer Highways (CRASH) electronic database from 1998-2002. Cases and controls were matched on unit type and roadway type. Conditional logistic regression was performed. Driver sleepiness/fatigue, distraction/inattention, age of 51 years of age and older, and nonuse of safety belts increase the odds that a CVC will be fatal. Primary safety belt law enactment and enforcement for all states, commercial vehicle driver education addressing fatigue and distraction and other approaches including decreased hours-of-service, rest breaks and policy changes, etc. may decrease the probability that a CVC will be fatal.

Performance and evaluation of small construction safety training simulations.

BACKGROUND: Back- and fall-related injuries occur frequently in construction and are costly in terms of workers' compensation claims and lost productivity. Interventions are needed that address the susceptibility to these injuries. AIMS: The purpose of this study was to develop and test a safety training intervention for small construction companies (

Equipment dealers' perceptions of a community-based rollover protective structures promotion campaign.

Farming is one of the most hazardous occupations, and tractor overturns are the leading cause of agricultural fatalities. This article examines a community-based injury intervention designed to increase the number of rollover protective structures (ROPS) and seat belts on tractors and to promote safe operation of farm tractors in two counties. Equipment dealers who sell retrofit ROPS kits to farmers were a critical component of the intervention. Interviews were conducted with dealers after the 31-month intervention period to understand their perceptions, any difficulties they experienced as a result of the project and how a similar project could be improved. Comments were analyzed in relation to theories of persuasion. Results indicated that dealers believed the intervention was successful in producing behavior change among some farmers. Dealers also provided important insights into why some farmers continued to resist retrofitting tractors with ROPS. Recommendations are offered for designers of community-based interventions beyond the ROPS project described here.

Fatal injuries caused by logs rolling off trucks: Kentucky 1994-1998.

BACKGROUND: Logging is one of the most hazardous occupations and fatality rates are consistently among the highest of all industries. A review of fatalities caused by logs rolling off trucks is presented. METHODS: The Kentucky Fatality Assessment and Control Evaluation Project is a statewide surveillance system for occupational fatalities. Investigations are conducted on selected injuries with an emphasis on prevention strategy development. Logging was an area of high priority for case investigation. RESULTS: During 1994-1998, we identified seven incidents in which a worker was killed by a log rolling off a truck at a sawmill, accounting for 15% of the 45 deaths related to logging activities. These cases were reviewed to identify similar characteristics and risk factors. CONCLUSIONS: Investigations led to recommendations for behavioral, administrative, and engineering controls. Potential interventions include limiting load height on trucks, installing unloading cages at sawmills and prohibiting overloaded trucks on public roadways.

Potentially productive years of life lost (PPYLL) in Kentucky due to occupational fatalities, 1994-1996.

A population-based occupational fatality surveillance system was used to identify 452 work-related fatalities in Kentucky over a 3-year period. Three hundred eighty-six workers less than 65 years old were included in this analysis of potentially productive years of life lost (PPYLL). A total of 9,275 years of potentially productive life were lost due to these occupational fatalities, costing the state economy $148 million in lost wages. Most of this loss (70%) was in the industries of transportation/communication/public utilities, manufacturing, mining and construction. The transportation/communication/public utilities division alone accounted for 21.4% of the total lost earnings. The agriculture/forestry/fishing division exceeded all others in potentially productive years of life lost. However, because of its lower mean income and older ages at death, that division ranked fifth in lost earnings. This article demonstrates that prevention resources should be directed at the agriculture, transportation, and logging industries, and to the prevention of fatalities caused by tractors, motor vehicle crashes, and falling objects, to be most effective in reducing the enormous economic burden of occupational fatalities.

Occupational fatalities in Kentucky--1994.

In Kentucky, seven out of nine industry groups exceed the national average fatality rates; in 1994, the agriculture/forestry/fishing industry rate of 80/ 100,000 was more than three times the national average. This paper describes the occupational fatality data collected during the first year of operation (1994) of the Fatality Assessment and Control Evaluation (FACE) Project in Kentucky. Investigators used multiple reporting sources to identify incidents, which were then systematically recorded and updated. On-site investigations were conducted for certain categories of fatalities. One hundred sixty-six occupational fatalities were recorded for 1994. Motor vehicle incidents were the most common cause of death, followed by machine-related incidents. Ages of victims ranged from 15 to 86 with a median of 46. Investigators completed 22 on-site visits during the period. In this article, descriptive statistics are presented, as well as suggestions for ways the medical community might contribute to the occupational fatality prevention effort.

Finding homes without smoke detectors: one step in planning burn prevention programs.

Residential fires are the leading cause of burn-related deaths in the United States. Smoke detectors could save many of these lives. A 1993 telephone survey of 661 Kentucky households included questions on residential smoke detectors. Statewide, 16.4% of households did not possess a functioning smoke detector; however, in nonmetropolitan Appalachian counties, 30.5% of households lacked detectors. Characteristics associated with lack of a functioning smoke detector, as determined by multivariate logistic regression, were as follows: living in a nonapartment dwelling (odds ratio [OR] = 4.14, 95% confidence interval [CI] = 1.42 to 12.01); having an annual household income of $20,000 or less (OR = 2.34, CI = 1.49 to 3.68); being unmarried (OR = 1.73, CI = 1.12 to 2.69); living alone (OR = 1.69, CI = 1.02 to 2.80); and living in a nonmetropolitan county (OR = 1.68, CI = 1.05 to 2.69). Knowledge of these population-based characteristics can assist planners of burn prevention programs to target at-risk populations.