Assessing data sources for state-level occupational fatality rates: Oregon, 2003-2007.

BACKGROUND: This study assesses state-level data sources for numerators and denominators in occupational fatality rates. Data from Oregon Fatality Assessment and Control Evaluation, 2003-2007, are used to assess numerators, and to produce fatality rates using different data sources for denominators. METHODS: Data sources for state-level occupational fatalities and the employed population are described. A statistical test for interrater reliability is applied in the comparison to Census of Fatal Occupational Injuries data. Odds ratios are calculated in the presentation of incident rates by age. RESULTS: Comparison of occupational fatality data sources demonstrates substantial differences. Acquiring appropriate state-level denominator data are limited, particularly for stratified groups. CONCLUSIONS: Although not decisive, occupational fatality rates may help confirm areas of concern to guide necessary field work. This assessment of data sources and identification of several priority areas of concern in Oregon may help state researchers direct their own efforts to target priorities for effective interventions.

Defining critical safety behaviors in a point-of-view video observation study of tree fallers at work.

This study aimed to characterize the use of five critical safety behaviors by tree fallers at different skill levels, and to test the feasibility of using a helmet camera to observe work activities directly in a remote environment. Small cameras were mounted on standard hard-hats. Video data were obtained for pairs of fallers at four different skill levels, from beginning students to professional fallers. Critical action steps during tree episodes were coded and compared. Critical action steps for fallers were successfully distinguished during work activities. Notable differences were observed among fallers in different skill categories and between individual fallers. This study found that the helmet camera worked well for observing faller work behavior, and that point-of-view video observation may be used to evaluate student loggers and training programs. We also found that professional fallers may have been exposed to increased hazard; care should be observed with helmet cameras designed for professionals.

Screening for elevated lead levels in childhood and pregnancy: an updated summary of evidence for the US Preventive Services Task Force.

BACKGROUND: In 1996, the US Preventive Services Task Force provided recommendations for routine screening of asymptomatic children and pregnant women for elevated blood lead levels. This review updates the evidence for the benefits and harms of screening and intervention for elevated blood lead in asymptomatic children and pregnant women. METHODS: We searched Medline, reference lists of review articles, and tables of contents of leading pediatric journals for studies published in 1995 or later that contained new information about the prevalence, diagnosis, natural course, or treatment of elevated lead levels in asymptomatic children aged 1 to 5 years and pregnant women. RESULTS: The prevalence of elevated blood lead levels among children and women in the United States, like that in the general population, continues to decline sharply, primarily because of marked reductions in environmental exposure, but still varies substantially among different communities and populations. Similar to the findings in 1996, our searches did not identify direct evidence from controlled studies that screening children for elevated blood lead levels results in improved health outcomes, and there was no direct evidence identified from controlled studies that screening improves pregnancy or perinatal outcomes. No new relevant information regarding the accuracy of screening for lead toxicity was identified during the update, and we did not identify evidence that demonstrates that universal screening for blood lead results in better clinical outcomes than targeted screening. Substantial new relevant information regarding the adverse effects of screening and interventions was not identified. CONCLUSIONS: There is no persuasive evidence that screening for elevated lead levels in asymptomatic children will improve clinical outcomes. For those children who are screened and found to have elevated levels, there is conflicting evidence demonstrating the clinical effectiveness of early detection and intervention.

Career risk of hepatitis C virus infection among U.S. emergency medical and public safety workers.

OBJECTIVE: A probabilistic model was used to analyze the cumulative risk of occupational hepatitis C virus (HCV) infection among U.S. public safety workers. METHODS: A model for the career risk of HCV was developed using the frequency of parenteral exposures to blood, the population seroprevalence of HCV, and the risk of seroconversion after exposure. Estimates of key input variables were obtained from published studies. RESULTS: Calculated estimates of the 30-year risk of infection ranged from <0.1% for police, firefighters, and corrections officers to 1.9% among paramedics and emergency department personnel in high-risk communities. Infrequent exposure to high-risk blood seems to present a greater risk of infection than more frequent contact to low-risk populations. CONCLUSIONS: Use of a probabilistic risk assessment model using published data can assist in policy decisions designed to protect the health and safety of workers. Further efforts to document the frequency of occupationally acquired HCV are needed.

Dermatitis in a printed-circuit board manufacturing facility.

Dermatitis complaints are frequently encountered among workers in the microelectronics industry and have been associated with a variety of physical, chemical and psychosocial causes. Employees working in the silk-screening and kiln-drying areas of a printed-circuit board manufacturer complained of recurrent itching and rashes. This case report describes those symptoms and the results of a brief survey of the affected employees, which provided useful data regarding the likely aetiology. A brief epidemiological survey instrument was used to gain information regarding the pattern, duration and frequency of employee symptoms. Data from the survey were used to identify seasonal variations in symptoms that correlated with specific environmental factors in the plant. A brief epidemiological investigation using a self-reported symptom survey was an efficient tool to catalogue the character, pattern, duration and frequency of complaints that correlated with specific environmental factors in the plant (temperature and low humidity), which were likely causes of the outbreak.

Hepatitis C in urban and rural public safety workers.

A sample of 719 Oregon public safety personnel (police officers, firefighters, and corrections officers) was tested for hepatitis C virus (HCV) antibody after completing a risk questionnaire. Seven of nine positive enzyme immunoassay tests (78%) were confirmed with recombinant immunoblot assay, yielding confirmed prevalence estimates of 1.2% (95% confidence interval, 0.4 to 2.8%) among the 406 firefighters and emergency medical technicians, and 0.7% (95% confidence interval, 0.1 to 2.6%) in 274 corrections personnel. No cases were observed in the 29 participating police officers. Self-reports of the number of workplace exposures to blood were not associated with HCV positivity, and the number of years of public safety employment seemed to be slightly less for HCV-positive subjects. Two of the seven (28.6%) HCV-positive individuals reported having at least one nonoccupational risk factor (odds ratio, 4.3; 95% confidence interval, 0.4 to 27.1), suggesting the greater relative importance of nonoccupational exposures.