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Introduction: Although occupational injuries are among the leading causes of death and disability around the world, the burden due to occupational injuries has historically been under-recognized, obscuring the need to address a major public health problem., Methods: We established the Liberty Mutual Workplace Safety Index (LMWSI) to provide a reliable annual metric of the leading causes of the most serious workplace injuries in the United States based on direct workers compensation (WC) costs., Results: More than $600 billion in direct WC costs were spent on the most disabling compensable non-fatal injuries and illnesses in the United States from 1998 to 2010. The burden in 2010 remained similar to the burden in 1998 in real terms. The categories of overexertion ($13.6B, 2010) and fall on same level ($8.6B, 2010) were consistently ranked 1st and 2nd., Practical Application: The LMWSI was created to establish the relative burdens of events leading to work-related injury so they could be better recognized and prioritized. Such a ranking might be used to develop research goals and interventions to reduce the burden of workplace injury in the United States., (Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Developing nations bear a substantial portion of the global burden of injury. Public health surveillance models in developing countries should recognize injury risks for all levels of society and all causes and should incorporate various groups of workers and industries, including subsistence agriculture. However, many developing nations do not have an injury registration system; current data collection methods result in gross national undercounts of injuries, failing to distinguish injuries that occur during work. In 2006, we established an active surveillance system in Vietnam's Xuan Tien commune and investigated potential methods for surveillance of work-related injuries. On the basis of our findings, we recommend a national model for work-related injury surveillance in Vietnam that builds on the existing health surveillance system.

Background: Developing nations carry a substantial portion of the global burden of injury, but without reliable injury surveillance, there is no way to characterize or prioritize the causes of work-related injury for prevention., Methods: Injury data from 52 treatment sites in the Xuan Tien Commune, Vietnam with over 10,000 inhabitants were collected between January 1 and December 31, 2006. Injured residents were interviewed to determine work-relatedness, relevant causes, disability, and burden., Results: Five hundred four work-related injuries were reported from formal treatment sites (incidence rate of 87 per 1,000 FTE) with a mean lost work day of 11 days. Four thousand five hundred seventy-four lost work day equivalents were estimated based on actual days lost to recover plus work days lost earning income to pay for medical costs, accumulating a total direct burden to the community of 8,641 lost work day equivalents. Almost half of that burden was caused by work in manufacturing. First aid boxes placed in 40 manufacturing enterprises yielded the 2nd highest reporting source., Conclusion: This study demonstrated the feasibility and value at the local level to build an active injury surveillance system which could have a large impact on preventing the burden of injuries in workplaces in Vietnam., (Copyright © 2011 Wiley Periodicals, Inc.)

Objective: Examine uses of US workers' compensation (WC) data for occupational safety and health purposes., Methods: This article is a summary of the proceedings from an invitational workshop held in September 2009 to discuss the use of WC data for occupational safety and health prevention purposes., Results: Workers' compensation data systems, although limited in many ways, contain information such as medical treatments, their costs and outcomes, and disability causes that are unavailable from national occupational surveillance sources., Conclusions: Despite their limitations, WC records are collected in a manner consistent with many occupational health and safety surveillance needs. Reports are available on the use of WC data for surveillance and research purposes such as estimating the frequency, magnitude, severity, and cost of compensated injuries. Inconsistencies in WC data can limit generalization of research results.

Objectives: We explored the impact on work-related injuries of workers splitting time between industry and agriculture, a common situation in developing countries., Methods: In 2005, we administered a cross-sectional survey to 2615 households of Xuan Tien, a developing rural community of Vietnam, regarding self-reported injuries and hours worked for 1 year. We defined groups as working in industry, agriculture, or a mix of both., Results: Overlapping employment (part time in agriculture and up to full time in industry) increased the risk of injury in both agricultural and industrial work. This pattern held across all work groups defined by the relative amount of time worked in agriculture. Those working fewer than 500 hours annually in agriculture had an agricultural injury rate (872 per 1000 full-time equivalents) that was more than 4 times higher than the average rate overall (203 per 1000) and the rate for workers employed only in industry (178 per 1000)., Conclusions: Working in agriculture for short durations while working in industry increased the risk of injury substantially in both types of work.

This study, through a random national survey in the U.S., explored how corporate financial decision-makers perceive important workplace safety issues as a function of the size of the company for which they worked (medium- vs. large-size companies). Telephone surveys were conducted with 404 U.S. corporate financial decision-makers: 203 from medium-size companies and 201 from large companies. Results showed that the patterns of responding for participants from medium- and large-size companies were somewhat similar. The top-rated safety priorities in resource allocation reported by participants from both groups were overexertion, repetitive motion, and bodily reaction. They believed that there were direct and indirect costs associated with workplace injuries and for every dollar spent improving workplace safety, more than four dollars would be returned. They perceived the top benefits of an effective safety program to be predominately financial in nature - increased productivity and reduced costs - and the safety modification participants mentioned most often was to have more/better safety-focused training. However, more participants from large- than medium-size companies reported that "falling on the same level" was the major cause of workers' compensation loss, which is in line with industry loss data. Participants from large companies were more likely to see their safety programs as better than those of other companies in their industries, and those of medium-size companies were more likely to mention that there were no improvements needed for their companies., (Copyright © 2009 Elsevier Ltd. All rights reserved.)

Background: Health and injury surveillance data of the highest achievable quality are needed in order to appropriately allocate scarce resources at the local and national levels., Methods: This is the first reported surveillance study of injury using a complete community sample in Viet Nam. Workplaces in Xuan Tien Commune most likely to benefit from intervention were identified and ranked by the magnitude of the problem (or highest injury count), the risk (highest incidence rates) and the burden (the effect of injuries on the livelihoods of workers)., Results: 591 injuries occurring in the month prior to survey administration were recalled, which satisfied the injury case criteria of this study (the annualised incidence rate (IR) was 681 per 1000 residents). 482 were attributed to work activities (82%), yielding an annualised IR of 1001/1000 full time employee equivalents (FTE). The highest number of injuries occurred in the manufacturing sector (n=299), followed by agriculture with far fewer injuries (n=70). The highest rate of injury was in the transport, storage and communications sector (annualised IR 1583/1000 FTE), followed by manufacturing (1235/1000 FTE) and agriculture (844/1000 FTE)., Conclusion: This study identified patterns of risk which, because data collection reflected work culture, are believed to be more reliable than those from previous studies. Interventions in the manufacture of machinery and equipment sector (the largest industry in the commune) would have the most impact in reducing occupational injuries. Despite the trend towards manufacturing, agriculture is still a high priority with a continuing substantial impact.

Estimating the burden of occupational injury in developing countries might provide support for strengthening injury prevention during industrialization. A cross-sectional survey was administered to all households in the Xuân Tiên Commune in Vietnam to collect information on the characteristics of work and injuries in the month before the survey. Of all households, 2615 (99%) completed the survey, comprising 10,416 residents and 5485 workers with 8478 jobs. Respondents reported 591 injuries (an annualized incidence rate [IR] of 681 per 1000 residents), 482 (82%) of which occurred during work activities (annualized IR of 1011 per 1000 full-time equivalents). Nonagricultural work was considerably more hazardous than agricultural work (1033 vs. 844 injuries per 1000 full-time equivalents, respectively). Working at home was prevalent, with 28% of households having a family-owned business. The injury IRs in this study were approximately 10 times higher than those reported in prior studies from Vietnam. High injury rates represent a substantial economic and social burden on a rapidly industrializing country and underscore the importance of injury prevention guided by surveillance data.

This study, through a random national survey, explored how senior financial executives or managers (those who determined high-level budget, resource allocation, and corporate priorities) of medium-to-large companies perceive important workplace safety issues. The three top-rated safety priorities in resource allocation reported by the participants (overexertion, repetitive motion, and bodily reaction) were consistent with the top three perceived causes of workers' compensation losses. The greatest single safety concerns reported were overexertion, repetitive motion, highway accidents, falling on the same level and bodily reaction. A majority of participants believed that the indirect costs associated with workplace injury were higher than the direct costs. Our participants believed that money spent improving workplace safety would have significant returns. The perceived top benefits of an effective workplace safety program were increased productivity, reduced cost, retention, and increased satisfaction among employees. The perceived most important safety modification was safety training. The top reasons senior financial executives gave for believing their safety programs were better than those at other companies were that their companies paid more attention to and emphasized safety, they had better classes and training focused on safety, and they had teams/individuals focused specifically on safety.

A repeated measures 2 x 2 factorial design using a psychophysical experimental methodology was performed to quantify the effect of shaft design (straight and bent shaft) and shoveling technique (forward and backward progression) on heart rate, perceived exertion, productivity, trunk kinematics and load kinetics. Ten male subjects performed four 8-min trials of snow shoveling on a paved asphalt surface. The most notable finding was significantly less trunk flexion with the bent shaft (41.4 degrees ) than with the straight shaft design (49.2 degrees ). The study results led to a recommendation of a bent-shaft shovel for the purpose of reducing trunk flexion. In the absence of any strong positive evidence and due to poor subjective response to backward progression while shoveling, this technique was not recommended.

A previous experiment by the authors investigated the effect of the design of pliers on productivity. A simulated wire-twisting task performed at five heights between 10 inches above and 10 inches below elbow height formed the basis of the comparison. Pliers designed according to the American National Standard for long nose and long reach pliers were compared to bent-handled pliers designed at the Western Electric (WE) Co. The WE pliers, designed to reduce ulnar deviation during a wire-twisting task, resulted in productivity decrements between 1.4 and 17% across the five heights studied. The current experiment was a continuation of that study, adding orientation of the workplace in the sagittal plane as an independent variable. Wrist deviation in two planes were additional dependent measures, and the experiment was performed by female subjects with a mean age of 48.1 years. The results did not indicate a significant difference between productivity levels for the two pliers designs. Work height and work orientation, as well as their interaction, tended to have the strongest effects on productivity and wrist deviation. In general, productivity was inversely related to measures of discomfort and postural deviation.

The main objective of this paper is to give an overview of basic concepts and definitions of terms related to the 'measurement of slipperiness' from the onset of a foot slide to a gradual loss of balance and a fall. Other unforeseen events prior to falls (e.g. tripping) are sparingly dealt with. The measurement of slipperiness may simply comprise an estimation of slipping hazard exposures that initiate the chain of events ultimately causing an injury. However, there is also a need to consider the human capacity to anticipate slipperiness and adapt to unsafe environments for avoiding a loss of balance and an injury. Biomechanical and human-centred measurements may be utilized for such an approach, including an evaluation of relevant safety criteria for slip/fall avoidance and procedures for validation of slip test devices. Mechanical slip testing approaches have been readily utilized to measure slipperiness in terms of friction or slip resistance but with conflicting outcomes. An improved understanding of the measurement of slipperiness paradigm seems to involve an integration of the methodologies used in several disciplines, among others, injury epidemiology, psychophysics, biomechanics, motor control, materials science and tribology.

A number of human-centred methodologies--subjective, objective, and combined--are used for slipperiness measurement. They comprise a variety of approaches from biomechanically-oriented experiments to psychophysical tests and subjective evaluations. The objective of this paper is to review some of the research done in the field, including such topics as awareness and perception of slipperiness, postural and balance control, rating scales for balance, adaptation to slippery conditions, measurement of unexpected movements, kinematics of slipping, and protective movements during falling. The role of human factors in slips and falls will be discussed. Strengths and weaknesses of human-centred approaches in relation to mechanical slip test methodologies are considered. Current friction-based criteria and thresholds for walking without slipping are reviewed for a number of work tasks. These include activities such as walking on a level or an inclined surface, running, stopping and jumping, as well as stair ascent and descent, manual exertion (pushing and pulling, load carrying, lifting) and particular concerns of the elderly and mobility disabled persons. Some future directions for slipperiness measurement and research in the field of slips and falls are outlined. Human-centred approaches for slipperiness measurement do have many applications. First, they are utilized to develop research hypotheses and models to predict workplace risks caused by slipping. Second, they are important alternatives to apparatus-based friction measurements and are used to validate such methodologies. Third, they are used as practical tools for evaluating and monitoring slip resistance properties of footwear, anti-skid devices and floor surfaces.

Pressures from 3 sources are combining to advance workplace safety and health throughout the globe. Firstly, an increasingly widespread growth in a State's interest in the individual, both in and outside the workplace. This leads to regulations, which are rapidly changing from prescriptive to enabling (performance) regulations. An increasing acceptance of sophisticated accounting procedures which will drive the real costs of poor health and safety to the bottom line of corporations. Finally, the trend to globalization, both of manufacturing and of marketing, has led to an increasing demand from consumer societies for product attributes beyond price. In many countries there is an expectation that working conditions in producing countries are not inferior to those in the consuming countries.

This paper presents several models that further define the concept of occupational injury. While traditional models have proved successful in isolating specific research questions and health phenomena, the conceptual model presented permits a broader view of all injury morbidity. This model is based on both the level and frequency of energy transfers. A process model of occupational injury is also presented to describe the basic pathophysiological relationships associated with tissue effects/damage and recovery/repair. Numerous tradeoffs exist in variable selection, and a third model explores some of these tradeoffs. Differences in terminology and fundamental principles can limit the progress of occupational injury research. Accordingly, an argument is made for consolidation and consensus of terms. Finally, considerations for research are suggested, with an emphasis on the severity of the injury, the risk ratio, and the population at risk.

Setting priorities for workplace health and safety research depends upon accurate and reliable injury and illness data. All occupational health databases have limitations when used to summarize the national scope of workplace hazards. The comparison of data from multiple sources may produce more credible estimates of the leading occupational injuries and illnesses. The purpose of this paper is to describe the strengths and weaknesses of six data collection systems that record occupational injuries and illnesses on a national level and to compare the leading estimates from these systems for 1990. The six systems are: 1) National Traumatic Occupational Fatalities database, 2) the Bureau of Labor Statistics Census of Fatal Occupational Injuries, 3) The Bureau of Labor Statistics Annual Survey data, 4) a large workers' compensation database, 5) the National Council on Compensation Insurance data, and 6) The National Electronic Injury Surveillance System. Occupational injuries, as defined herein, predominate over illnesses in terms of the number of cases and the overall costs. Databases that provide information on the antecedents of injuries suggest how these injuries may be prevented and warrant more attention and refinement.

The significance of occupational falls is established through analysis of workers' compensation data of a major insurance company. The data covered 11% of the American privately insured workforce and exposure estimates were based on Bureau of Labor Statistics demographics. The number of incidents and the relative cost of falls were examined by age, gender, industry, climate and geographic region and empirical data are presented. These data establish the enormous cost of falls measured in terms of individual pain and suffering and in losses to industrial organizations.

Criteria have been suggested to reduce the incidence, or severity of low back pain disability. Five underlying theories for such criteria have been identified in the literature, and a critical review of the validity of these criteria has been carried out. Despite attributions elsewhere, peer-reviewed validation of the various criteria range from modest to nil. The need for a validation criterion for use in workplace design in order to reduce low back pain disability, or severity, is identified and the need for an international protocol to allow cross-study validation of present and future criteria is suggested.

Occupations which normally involve a fixed workstation and can be effectively operated from a sitting position would appear to be highly compatible with the lack of mobility of paraplegics. However, owing to the traditional operational-control configuration of many machines which require use of the lower limbs, employment for paraplegics is limited in these occupations. A speed-control mechanism suitable for use by paraplegics was designed and compared with the traditional treadle speed control used on industrial sewing machines. This control was operated by chest movement displacing a lever in contact with the subject in the region of the sternum. Subjects for this study were twenty non-handicapped individuals primarily without any previous sewing experience. Data were collected by questionnaires, anthropometric measurements, and performance on sewing tasks. There was no significant difference between the two control devices in accuracy and task-completion time. The chest-control device required significantly fewer machine stops during task performance. The chest-control device produced less overall postural stress than the traditional treadle control. Overall preference for the two control devices was divided equally among the subjects. The chest-control device will enable many of those unable to use their lower limbs to operate any one of a series of stitching-related machines by providing access to, and control of, the machine. The control device appears to provide the potential for both the handicapped and non-handicapped to achieve performance equal to that achieved by the latter group with conventional treadle controls. It is suggested that the alternative control could be used not only with industrial sewing machines, but also with other machines that require a fixed workstation and can be operated from a sitting position.

The multidisciplinary nature of ergonomics requires the organisation of component disciplines into a recognisable technology for industrial practice, the development of methodologies for use by ergonomists and the specification of criteria for training courses. A simple model is presented and illustrated which has been developed and used in industrial practice and in training for industrial practice.

The problem of introducing ergonomics into a major chemical industry was tackled by a novel approach which allowed the industry concerned access to a wide range of ergonomics skills. This allowed appropriate expertise to be applied as necessary to the variety of problems arising in the design of a plant. The problems included equipment design and layout, thermal, auditory and visual environments, job design and training aids. The difficulties of identifying the benefits of such an introduction were dealt with by the use of a senior management seminar which employed a 'paired presentation' format to describe both the various contributions made by the ergonomists to the industry and the evaluation by the individual recipients of such contributions.