Estimating fatality rates in occupational light vehicle users using vehicle registration and crash data

Objective: To estimate occupational light vehicle (OLV) fatality numbers using vehicle registration and crash data and compare these with previous estimates based on workers' compensation data. Method: New South Wales (NSW) Roads and Traffic Authority (RTA) vehicle registration and crash data were obtained for 2004. NSW is the only Australian jurisdiction with mandatory work-use registration, which was used as a proxy for work-relatedness. OLV fatality rates based on registration data as the denominator were calculated and comparisons made with published 2003/04 fatalities based on workers' compensation data. Results: Thirty-four NSW RTA OLV-user fatalities were identified, a rate of 4.5 deaths per 100,000 organisationally registered OLV, whereas the Australian Safety and Compensation Council (ASCC), reported 28 OLV deaths Australia-wide. Conclusions: More OLV user fatalities were identified from vehicle registration-based data than those based on workers' compensation estimates and the data are likely to provide an improved estimate of fatalities specific to OLV use. Implications: OLV-use is an important cause of traumatic fatalities that would be better identified through the use of vehicle-registration data, which provides a stronger evidence base from which to develop policy responses.

Occupational skill level and hazardous exposures among working Victorians

This paper examines the patterning of exposures to occupational hazards in relation to occupational skill level as a proxy for pay rate, testing the general hypothesis that exposures to occupational hazards increase in prevalence with decreasing skill level. A population-based telephone survey was conducted on a random sample of working Victorians (N = 1,101). A set of 10 indicators of exposure to occupational hazards were analysed individually and as a summary scale in multivariate regression models. A significant increasing trend in hazardous working conditions from the highest to lowest occupational skill level was observed, with those in lower skill level jobs twice as likely to be exposed as those at the highest skill level. This overall trend was driven primarily by higher exposure in the middle skill level group (technicians and skilled trades) as well as the lowest (labourers and elementary clerical), the two main bluecollar groups. Findings provided partial support for the hypothesised relationship.

Impact of HIV-associated conditions on mortality in people commencing anti-retroviral therapy in resource limited settings

Objectives: To identify associations between specific WHO stage 3 and 4 conditions diagnosed after ART initiation and all cause mortality for patients in resource-limited settings (RLS).

Design, Setting: Analysis of routine program data collected prospectively from 25 programs in eight countries between 2002 and 2010.

Subjects, Participants: 36,664 study participants with median ART follow-up of 1.26 years (IQR 0.55–2.27).

Outcome Measures: Using a proportional hazards model we identified factors associated with mortality, including the occurrence of specific WHO clinical stage 3 and 4 conditions during the 6-months following ART initiation.

Results: There were 2922 deaths during follow-up (8.0%). The crude mortality rate was 5.41 deaths per 100 person-years (95% CI: 5.21–5.61). The diagnosis of any WHO stage 3 or 4 condition during the first 6 months of ART was associated with
increased mortality (HR: 2.21; 95% CI: 1.97–2.47). After adjustment for age, sex, region and pre-ART CD4 count, a diagnosis of extrapulmonary cryptococcosis (aHR: 3.54; 95% CI: 2.74–4.56), HIV wasting syndrome (aHR: 2.92; 95%CI: 2.21 -3.85), nontuberculous mycobacterial infection (aHR: 2.43; 95% CI: 1.80–3.28) and Pneumocystis pneumonia (aHR: 2.17; 95% CI 1.80–3.28) were associated with the greatest increased mortality. Cerebral toxoplasmosis, pulmonary and extra-pulmonary
tuberculosis, Kaposi’s sarcoma and oral and oesophageal candidiasis were associated with increased mortality, though at lower rates.

Conclusions: A diagnosis of certain WHO stage 3 and 4 conditions is associated with an increased risk of mortality in those initiating ART in RLS. This information will assist initiatives to reduce excess mortality, including prioritization of resources for
diagnostics, therapeutic interventions and research.

Occupational safety in China: safety climate and its influence on safety-related behavior

The improvement of health and safety standards within the organizational context is an important issue of global concern. China’s occupational health and safety (OHS) has increasingly drawn national and international attention as it has not kept pace with its globalization of production and trade. The traditional approach to managing workplace safety in China has focused on the technical aspects of engineering systems and processes, and it has attributed the majority of workplace accidents and injuries to unsafe working conditions instead of the unsafe work practices of employees. However, there has been a fundamental shift in the safety management research carried out in many countries and across diverse industries, which aims to measure the impact of attitudinal, organizational, cultural, and social dimensions on occupational safety. This article examines the relationship between safety climate and safety-related behavior in the Chinese context and draws implications for the management of occupational safety in China.