Occupational Injury

Risk, Prevention And Intervention

Anne Marie Feyer, A Williamson

• Publisher: CRC Press
• Year: 1998
• ISBN:
  9781135739140
• Edition: 1
• Topic: Technologie et ingénierie
• Subtopic: Ingénierie industrielle

Occupational injury is a major and often preventable health problem in the work environment. Each year throughout the world millions are affected by traumatic occupational injuries and many thousands are actually killed in work-related incidents. This book provides a diverse and multi-faceted look at some of the themes directing late-1990s research

PART ONE
The data speak but what do they tell us?

INTRODUCTION

Accurate and reliable occupational injury data are considered to be the essential starting point for developing injury prevention programs. Such data tell us about who gets injured as well as how, when and where the injury occurred. These data therefore have the potential to identify targets for preventive efforts. Injury data also hold considerable potential as tools in the evaluation of progress towards achieving prevention goals.

Harnessing the potential that occupational injury data offer for assisting in prevention is clearly a key requirement in the field. Many of the methodological problems involved have been discussed in the literature (e.g. Pollack and Keimig, 1987; Driscoll, 1993). The fundamental expectations for injury data are that they should provide accurate information about the nature, extent and distribution of the problem. The chapters in this part consider aspects of using routinely collected data to describe the problem more effectively and to provide possible directions for preventive efforts.

The first chapter, by Macaskill and Driscoll, takes up the issue of examining options for improving and expanding the current framework for national occupational injury data obtained from routinely collected data. While the specific examples are drawn from data sources in Australia, the basic issues discussed in the chapter are generic. These authors conclude that even considering routinely collected data, the current framework could be extended. In particular the authors advocate linkage between routinely collected data sources because, individually, such sources only cover a subset of cases. With linkage, the unique strengths of various data sources could be combined to give more comprehensive coverage of the scope of the problem.

Better utilization of existing routinely collected data is also taken up in the chapter by Stout. This chapter describes the coding process employed to use narrative data obtained in surveillance systems more effectively. Such data are routinely included because of their potential to allow better understanding of the circumstances of injury and hence provide clearer directions for control of the hazards. Although most systems include collection of narrative data describing at least theimmediate circumstances of injury, their analysis is generally perceived to be prohibitively time-consuming. Consequently, the narrative data are often not fully utilized. In this chapter Stout provides a method for using narrative data efficiently, as well as examples of application of the method. As Stout argues, the examples demonstrate the value of using narrative fields in surveillance systems to more specifically identify sources of injury.

The final chapter in this part provides the perspective of an end-user of occupational injury data, i.e. those responsible for developing prevention programs. These authors take up the issue of one major limitation of routinely collected injury data, namely that these data often reflect practical collection concerns rather than concerns about what information is needed to support development of preventive strategies. They describe a project which attempted to use compensation-based data for identifying target areas for preventive efforts in the coal-mining industry in Australia. While the data were able to be manipulated to be more useful for highlighting possible directions for prevention, the project also highlighted some limitations for industry users of routinely collected injury data.

The potential of injury and accident data to play a more effective role in the development of preventive strategies is discussed elsewhere in this volume. Part Four takes up the issue of the emergence of a more systems-based approach to safety. A major implication of this for understanding the causes of injury is that the influences that need to be considered are rather more far-ranging than is obvious in the immediate circumstances of accidents and injury. While epidemiological descriptions of the nature, distribution and rate of work injury provide the important starting point for identifying risk of injury, by their very nature they provide only limited information about the wider circumstances of accidents. To be maximally useful in the process of developing prevention programs, occupational injury data need to be considered in the broader context of a system-based approach to safety in which injury data can provide much richer information about the causes of injury (Reason, 1990; Feyer and Williamson, 1991; Laflamme et al., 1991; Kletz, 1993; Chapter 10).

The chapters in this part take up the issue of how routinely collected data can be better utilized to provide information about the nature and extent of occupational injury, and information about where preventive efforts might be best targeted. Improvements to routinely collected sources of information and their use are both possible and desirable. The chapters in this part provide some insights into the directions such improvement might take.

References

DRISCOLL, T.R. (1993) Are work-related injuries more common than disease in the workplace? Occupational Medicine, 43, 164–166.

FEYER, A.-M. and WILLIAMSON, A.M. (1991) A classification system for causes of occupational accidents for use in preventive strategies. Scandinavian Journal of Work, Environment and Health, 17(5), 302–311.

KLETZ, T.A. (1993) Accident data—the need for a new look at the sort of data that are collected and analysed. Safety Science, 16, 407–415.

LAFLAMME, L., Doos, M. and BACKSTROM, T. (1991) Identifying accident patterns using the FAC and the HAC: their application to accidents at the workshops of an automobile and truck factory. Safety Science, 14, 13–33.

POLLACK, E.S. and KEIMIG, D.G. (eds) (1987) Counting injuries and illnesses in the workplace: proposals for a better system, Washington DC: National Academy Press.

REASON, J. (1990) The contribution of latent failures to the breakdown of complex systems. Philosophical Transactions of the Royal Society of London B, 327, 475–484.

CHAPTER ONE
National occupational injury statistics: what can the data tell us?

PETRA MACASKILL AND TIM R.DRISCOLL

1.1 BACKGROUND

A recent inquiry into occupational health and safety in Australia was very critical of current national reporting of occupational health and safety (OHS) statistics, which are, at present, largely based on successful workers’ compensation claims for five or more days off work (Industry Commission, 1995). Major deficiencies were identified in the area of occupational disease data, particularly for diseases of long latency. Such criticisms are not unexpected given the well-known methodological difficulties associated with the study of disease. However, despite the much better data available for occupational injury, a number of important limitations were noted, including the lack of coverage of self-employed workers, the lack of data on less severe injuries, missing data, non-compliance with data standards, the restricted number of variables and limitations imposed by the coding used for those variables.

The criticisms outlined above raise questions as to what we require of national occupational injury statistics and how we can obtain data to meet those requirements. The aim of this chapter is to provide an overview of potential sources of routinely collected data for work-related injury in Australia and outline a number of methodological and practical issues associated with obtaining national statistics from these data. In examining the options for improving and expanding the current framework for national occupational injury data, we must address the issue of what we can realistically expect the data to tell us. Although this paper is based on the Australian experience, the issues are relevant to many countries.

1.2 INFORMATION NEEDS AND EXPECTATIONS

Information needs vary according to the area of interest and responsibility of the person or agency requiring the information. To a large extent these needs determine the expectations of what the data should be able to tell us. Although these expectations vary, an underlying requirement is that the data should provide an accurate and representative picture of occupational injuries across levels of severity ranging from traumatic fatalities to minor injuries. Common aims and expectations of data-collection systems for injury surveillance include:

• estimating the extent of the problem and monitoring injury rates over time;
• identifying patterns in injury rates;
• identifying groups to be targeted through prevention measures;
• aiding in the development of prevention measures;
• evaluating the effectiveness of prevention activities;
• identifying new or emerging hazards; and
• providing data in a timely fashion.

Occupational injury data provide a basis for comparing OHS performance across jurisdictions and industries at a point in time, and monitoring trends and changing differentials between groups over time. Accurate and reliable data are required to set goals for injury prevention and monitor progress towards achieving those goals.

1.3 POSSIBLE DATA SOURCES

The information needs outlined above can only be met through utilizing a range of data sources (Macaskill et al., 1995). Common sources that are used in many countries for occupational injury surveillance and statistical reporting include death records, coroners’ reports, hospital in-patient records, hospital emergency department data, workers’ compensation claims, OHS agency investigation reports and surveys. This paper will focus on the first five of the above sources as these represent the major sources of routinely collected data that can contribute to OHS surveillance in Australia.

The likelihood of identifying an injury case through routine data collections increases with the severity of the injury, and hence routinely collected data often represent the major source of data for fatalities and serious non-fatal injuries. All fatalities are recorded in death registries and most serious non-fatal injuries are likely to come in contact with either the hospital system or the workers’ compensation system (or both). Because the number of cases increases sharply as the severity of the injury decreases, survey methods provide a means of obtaining data on less severe but far more common work-related injuries.

In Australia, the eight state and territory governments have responsibility for most routine data-collection activities. This has led to inconsistencies in information systems between jurisdictions in terms of what items are collected and the methodology used. As a result, reaching agreement between the jurisdictions on data standards is an important prerequisite for pooling data at the national level.

1.4 DATA STANDARDS

For each data set, combining the data at a national level depends on common data items, definitions and coding. A common core or ‘minimum data set’ must be defined, with which the jurisdictions that collect the data are both willing and able to comply. In Australia, such agreements are in place for workers’ compensation (National Occupational Health and Safety Commission, 1987) and also health-sector data (National Health Data Committee, 1995). Although these agreements provide a basis for compiling consistent national data, full compliance with these standards has not yet been attained. Maintaining compliance over time is also problematic. For example, the standard for the National Data Set for Compensation-based Statistics (NDS) specifies that information be recorded for all successful claims for five or more days off work. However, a number of states have recently moved to a threshold of 10 days’ lost time. These changes reflect changing policies/ priorities at the state level, which can have a major impact on national data collection activities. The difficulties associated with obtaining and also maintaining compliance with date standards are considerable.

By adopting data definitions and codes that are compatible with recognized national and international standards, it is possible to achieve comparability at a national and also international level. However, it is important to recognize that these data-coding standards are subject to change over time in response to factors such as changing categories of work and categories of injury. For instance, the International Classification of Diseases (ICD) is updated periodically, as are the Australian standard codes for occupation and industry as defined by the Australian Bureau of Statistics. Data codes reflect the state of knowledge and/or situation at the time they were developed. Not only does this mean that they must be reviewed and updated from time to time, but it also means that new or emerging issues may not be apparent in the data because of the constraints imposed by the coding scheme. The inclusion of a narrative field that allows for a brief written description can provide qualitative data that can be used in conjunction with the coded variables to obtain greater insight (Stout and Jenkins, 1995).

Where such changes to data-coding standards are a simple extension of the existing codes, they are not problematic. However, if the revised codes do not map onto the previous ones, problems arise in maintaining ...

Table of contents

• COVER PAGE
• TITLE PAGE
• COPYRIGHT PAGE
• FOREWORD
• PREFACE
• CONTRIBUTORS
• PART ONE: THE DATA SPEAK BUT WHAT DO THEY TELL US?
• PART TWO: ERRORS, MISTAKES AND BEHAVIOUR
• PART THREE: THE ROLE OF RISK IN SAFETY
• PART FOUR: ORGANIZATIONS, MANAGEMENT, CULTURE AND SAFETY
• PART FIVE: SAFETY INTERVENTIONS
• PART SIX: RULES OR TRUST: ENSURING COMPLIANCE
• PART SEVEN: THE COMPENSATION SYSTEM IN AUSTRALIA: HELP OR HINDRANCE?