Issues related to the wearing of fall-arrest harnesses in the construction industry

Work-related falls continues to be one of the leading causes of fatalities in the Australian construction industry, and the failure to use fall protection equipment, such as fall-arrest harnesses and arresting devices, has been found to be a contributing factor. In an attempt to gain an understanding of the issues surrounding the use of fallarrest harness systems by construction workers a study involving semi-structured interviews of 15 male construction workers was carried out at three construction sites. The majority of interviewees commented that there was discomfort in wearing a fall-arrest harness; that there were a number of problems when anchored via an arresting device; and that using a fall-arrest system reduced productivity. Most of the interviewees considered that they needed safety precautions against falls, and they expressed the view that workers’ attitudes towards safety depended critically upon their supervisors’ attitude towards safety. It was also found that workers were not trained in rescue procedures. Interviewees expressed concern that retrieval of a suspended worker may not be carried out in time to prevent the onset of suspension trauma. A number of issues were identified which require further research, such as, investigation into suspension trauma, harness and arresting device design, training provided to workers, and the provision for rescues.

Reliability of scores between stroke patients and significant others on the Reintegration to Normal Living (RNL) Index

Purpose: This study measured reliability between stroke patients' and significant others' scores on items on the Reintegration to Normal Living (RNL) Index and whether there were any scoring biases. Method The 11-item RNL Index was administered to 57 pairs of patients and significants six months after stroke rehabilitation. The index was scored using a 10-point visual analogue scale. Patient and significant other demographic information and data on patients' clinical, functional and cognitive status were collected. Reliability was measured using the intra-class correlation coefficient (ICC) and percent agreement. Results: Overall poor reliability was found for the RNL Index total score (ICC=.36, 95% CI. 07 to .59) and the daily functioning subscale (ICC=.24, 95% CI -.003 to .46) and moderate reliability was found for the perception of self subscale (ICC=.55, 95 % CI .28 to .73). There was a moderate bias for patients to rate themselves as achieving better reintegration than was indicated by significant others, although no demographic or clinical factors were associated with this bias. Exact match agreement was best for the subjective items and worse for items reflecting mobility around the community and participation in a work activity. Conclusions: Caution is needed when interpreting patient information reported by significant others on the RNL Index. The use of a shorter scale to rate the RNL Index requires investigation.

Impact of bronchopulmonary dysplasia, brain injury, and severe retinopathy on the outcome of extremely low-birth-weight infants at 18 months

CONTEXT: Despite more than 2 decades of outcomes research after very preterm birth, clinicians remain uncertain about the extent to which neonatal morbidities predict poor long-term outcomes of extremely low-birth-weight (ELBW) infants. OBJECTIVE: To determine the individual and combined prognostic effects of bronchopulmonary dysplasia (BPD), ultrasonographic signs of brain injury, and severe retinopathy of prematurity (ROP) on 18-month outcomes of ELBW infants. DESIGN: Inception cohort assembled for the Trial of Indomethacin Prophylaxis in Preterms (TIPP). SETTING AND PARTICIPANTS: A total of 910 infants with birth weights of 500 to 999 g who were admitted to 1 of 32 neonatal intensive care units in Canada, the United States, Australia, New Zealand, and Hong Kong between 1996 and 1998 and who survived to a postmenstrual age of 36 weeks. MAIN OUTCOME MEASURES: Combined end point of death or survival to 18 months with 1 or more of cerebral palsy, cognitive delay, severe hearing loss, and bilateral blindness. RESULTS: Each of the neonatal morbidities was similarly and independently correlated with a poor 18-month outcome. Odds ratios were 2.4 (95% confidence interval [CI], 1.8-3.2) for BPD, 3.7 (95% CI, 2.6-5.3) for brain injury, and 3.1 (95% CI, 1.9-5.0) for severe ROP. In children who were free of BPD, brain injury, and severe ROP the rate of poor long-term outcomes was 18% (95% CI, 14%-22%). Corresponding rates with any 1, any 2, and all 3 neonatal morbidities were 42% (95% CI, 37%-47%), 62% (95% CI, 53%-70%), and 88% (64%-99%), respectively. CONCLUSION: In ELBW infants who survive to a postmenstrual age of 36 weeks, a simple count of 3 common neonatal morbidities strongly predicts the risk of later death or neurosensory impairment.

Injury related risk behavior - a study of Australian skydivers

Risk taking behaviour has been identified as an important host-related determinant of injury in young adults. The aim of this study is to clarify the relationship between the two key elements of risk taking behaviour - ie, risk assessment and risk acceptance - in participants of a high risk sporting activity. Skydivers registered with the Australian Parachute Federation were sampled at several jump meetings held at three 'drop-zones' in North Eastern Australia. A cross sectional survey of 215 skydivers ascertained each subject's risk assessment of each of nine hypothetical sky diving scenes and whether or not they would jump in the described conditions. Variables which independently predicted an individual's risk assessment were age group (p < 0.05), gender (p < 0.05) and scene details (p < 0.001). Risk assessment was found to be a statistically significant predictor of the decision to jump, with a 22% decrease in the odds of jumping with every unit increase in risk assessment (OR = 0.78: 95% Cl; 0.76, 0.80). Gender was also found to be a statistically significant predictor of the decision to jump, with males being 19% more likely to jump than females, after controlling for age, experience, currency and risk assessment (OR = 1.19: 95% CI; 1.04, 1.38). The importance of these results is that, by quantifying the relationship between two key elements of risk taking behaviour and several important host factor determinants, they facilitate more informed discussion about the possible role of risk taking behaviour in the causation of injury.

3: Rehabilitation principles for treating chronic musculoskeletal injuries

Evaluation of patients for rehabilitation after musculoskeletal injury involves identifying, grading and assessing the injury and its impact on the patient's normal activities. Management is guided by a multidisciplinary team, comprising the patient, doctor and physical therapist, with other health professionals recruited as required. Parallel interventions involving the various team members are specified in a customised management plan. The key component of the plan is active mobilisation utilising strengthening, flexibility and endurance exercise programs. Passive physical treatments (heat, ice, and manual therapy), as well as drug therapy and psychological interventions, are used as adjunctive therapy. Biomechanical devices or techniques (eg, orthotic devices) may also be helpful. Coexisting conditions such as depression and drug dependence are treated at the same time as the injury. Effective team communication, simulated environmental testing and, for those employed, contact with the employer facilitate a staged return to normal living, sports and occupational activities.

Economic Analysis of Occupational Risk Prevention in the Construction Sector

The construction sector has one of the worst occupational safety and health records in Europe. The costs of this scenario are very high, namely costs for workers and their families, costs to organizations, resulting from the absence of workers due to illness, insurance premiums, costs resulting from reduced productivity, cost of replacement and training of workers, etc., and costs to society, which in turn increases the costs of health systems. This paper presents and discusses the development of a methodology for economic evaluation in the context of risk management, which will allow senior management to support decision making. The possible application of this methodology to the construction sector is discussed.

Economic analysis of occupational risk prevention: a case study in a textile company

Work accidents affect business and society as a whole. Fewer accidents mean fewer sick leaves, which results in lower costs and less disruption in the production process, with clear advantages for the employer. But workers and their households bear also a significant burden following a work accident, only partially compen-sated by insurance systems. Furthermore, the consequences of work accidents to the State and Society need also to be considered. When an organization performs an integrated risk analysis in evaluating its Occupational Health and Safety Management System, several steps are suggested to address the identified risk situations. Namely, to avoid risks, a series of preventive measures are identified. The organization should make a detailed analysis of the monetary impact (positive or negative) for the organization of each of the measures considered. Particularly, it is also important to consider the impact of each measure on society, involving an adequate eco-nomic cost-benefit analysis. In the present paper, a case study in a textile finishing company is presented. The study concentrates on the dyeing and printing sections. For each of the potential risks, several preventive measures have been identified and the corresponding costs and benefits have been estimated. Subsequently, the Benefit/Cost ratio (B/C) of these measures has been calculated, both in financial terms (from the organisa-tion’s perspective) and in economic terms (including the benefits for the worker and for the Society). Results show that, while the financial analysis in terms of the company does not justify the preventive measures, when the externalities are taken into account, the B/C ratio increases significantly and investments are fully justified.

Integration of risk management in occupational health and safety systems

Risk management can be considered as part of the Occupational Health and Safety System (OHS) of an organization and can be used to develop and implement the OHS policy and manage the associated risks. The success of the integration of risk management in OHS depends on both technical and human aspects. Thus, this paper presents and discusses the case of a company working in the area of solid waste treatment. This company was certified in 2009 with an Integrated Management Systems for Quality, Environment, Occupational Health and Safety. The evolution of accidents before and after the implementation of the integrated system was analysed and a questionnaire was used to capture the perceptions of the technicians on the risk management system. The analysis of the findings showed that the frequency of accidents increased since 2009 but the severity has been reduced. Several interrelated causes and consequences were analysed and discussed. Furthermore, the analysis of the opinions of the company’s technicians permitted to highlight some important aspects on the integration of risk management in the OHS system of the company. In line with this discussion some hypothesis have been formulated.

Economic evaluation of occupational safety preventive measures in a hospital

BACKGROUND: When an organization performs an integrated analysis of risks through its Occupational Health and Safety Management System, several steps are suggested to address the implications of the identified risks. Namely, the organization should make a detailed analysis of the monetary impact for the organization of each of the preventive measures considered. However, it is also important to perform an analysis of the impact of each measure on society (externalities). OBJECTIVE: The aim of this paper is to present a case study related to the application of the proposed economic evaluation methodology. METHODS: An analysis of the work accidents in a hospital has been made. Three of the major types of accidents have been selected: needle stings, falls and excessive strain. Following the risk assessment, some preventive measures have been designed. Subsequently, the Benefit/Cost ratio (B/C) of these measures has been calculated, both in financial terms (from the organization’s perspective) and in economic terms (including the benefits for the worker and for the Society). RESULTS: While the financial ratio is only advantageous in some cases, when the externalities are taken into account, the B/C ratio increases significantly. CONCLUSIONS: It is important to consider external benefits to make decisions concerning the implementation of preventive measures in Occupational Health and Safety projects