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INTRODUCTION: Workers' compensation injuries entail burdensome financial and social costs. This study's objective was to describe cost and frequency of workplace injuries in aviation manufacturing in the state of Kansas using workers' compensation data. Manufacturing incurs more workers' compensation claims in Kansas than any other industry, and aviation contributes more of those claims than any other sub sector. METHOD: Workers' compensation insurance and reporting are required in the state of Kansas. Data were provided by the Kansas Department of Labor (KDOL) and included all closed workers' compensation claims entailing indemnity and medical costs filed in the state from 2014 to 2022. Cost of claim data were normalized to 2022 U.S. dollars and data were analyzed as a function of percentage and claim cost by body part, type of injury, cause of injury, specific musculoskeletal disorder type, and as a function of age and gender injury rates. RESULTS: Aviation claims entailed a median total cost of $26,941 and represented 8% of all closed claims filed in the state from 2014 to 2022. The grand total direct cost over the nine-year period was $75,404,147. Medical costs comprised 48.6% of all costs, indemnity 45.0%, and legal 6.4%. The most frequently injured body part was the hand/wrist (35.9%) followed by the shoulder (20.6%), and the most expensive body parts were related to the back. Overexertion (38.6%) was the most common cause followed by repetitive motion (22.8%). Work-related musculoskeletal disorders were the most common type accounting for 67.4% of all claims. Men and workers aged 55-64 incurred slightly higher claim rates than average. A sharp decrease in number of claims closed in 2021 coincided with production shutdowns the previous year related to the Covid-19 pandemic and design issues. CONCLUSIONS: Aviation manufacturing is a key industry in Kansas and this study is the first known to describe costs and frequencies of workplace injuries in the sector using workers' compensation data. PRACTICAL APPLICATIONS: This guide to the most problematic and costly injuries in aviation manufacturing helps practitioners prioritize prevention strategies to most effectively reduce workplace injury and helps safety and health practitioners in prioritizing prevention efforts to reduce the most severe and costly aviation manufacturing injuries and illnesses. It also brings attention to some special considerations when working with safety data from 2020 to 2022 related to the Covid-19 pandemic.

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A compressed air nozzle has the potential to result in lethal injuries when handled inappropriately. Owing to the rarity of colorectal perforations due to barotrauma, no clear pathway to managing them has been established. We report an incident of a 33-year-old male patient who presented with tension pneumoperitoneum due to rectosigmoid perforations after being subjected to transanal compressed air insult. An emergency laparoscopic exploration with primary repair of the rectal perforation and Hartmann procedure were performed resulting in a smooth postoperative course. We hereby conclude that laparoscopy is a safe and effective approach associated with faster recovery and fewer adverse events.

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PURPOSE: Rates of return to work (RTW) are declining in the Australian workers compensation system alongside significant economic and social costs, disputes, and secondary psychological injury. Non-medical assessment of workplace injuries now considers psychosocial and workplace factors, and worker participation in the assessment process is limited. This scoping review examines studies regarding non-medical assessment during the acute phase of rehabilitation in terms of costs, disputes, secondary psychological injury, and worker participation. METHOD: An electronic and manual search of relevant articles across four databases was conducted using PRISMA guidelines, followed by quality assessment. RESULTS: Of the 1,630 studies retrieved, 12 met the inclusion criteria with most focused on assessment for risk of obstructed or delayed RTW. CONCLUSIONS: Non-medical assessment in the acute stage of rehabilitation identifies risk for delayed or complicated RTW, overlooking potential for the process of assessment to contribute to disputes and development of secondary psychological injury. Doubt around the capacity of workers to participate objectively in assessment persists. These are aspects of assessment worthy of further exploration for their impact on RTW outcomes.

Early assessment of injured workers is a key aspect of the rehabilitation process and there have been calls for greater injured worker involvement in their rehabilitation.Rehabilitation professionals should consider an injured worker's phase of disability when conducting assessment for support needs.Consideration of psychological vulnerabilities of injured workers should be incorporated into assessment of support needs.Rehabilitation professionals should seek out ways to increase participation of injured workers in assessment of their support needs.

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OBJECTIVE: A workers' compensation claim may have significant negative impacts on an injured worker's wellbeing. Wellbeing provides a good global measure of potential effects of a claim on an individual, and is important for contemporary economic modelling. The purpose of this study was to synthesize knowledge about the wellbeing of injured workers after the finalization of a workers' compensation claim and identify gaps in the current literature. METHODS: A systematic scoping review was conducted. RESULTS: 71 full-text articles were screened for inclusion, with 32 articles eligible for this review. None of the included articles evaluated overall wellbeing. Included articles did evaluate a variety of constructs inherent in wellbeing. Injured workers were generally disadvantaged in some manner following claim finalization. The literature recommends a focus on reducing negative impacts on injured workers after finalization of a compensation claim, with a need for regulatory bodies to review policy in this area. CONCLUSION: There appears to be potential for ongoing burden for individuals, employers, and society after finalization of a workers' compensation claim. A gap in knowledge exists regarding the specific evaluation of wellbeing of injured workers following finalization of a workers' compensation claim.

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OBJECTIVES: This paper sought to determine risk factors of occupational injury in the Irish dairy farming sector and to estimate the roles of both dairying expansion and the discipline of agricultural extension in influencing reducing injury occurrence. METHODS: Data for this study was obtained via the Irish National Farm Survey (NFS). In total, 260 farm (83.6% of NFS dairy farm sample) workplace injury survey questionnaires were completed by NFS recorders by interviewing principal farm operators for year 2017. Injury survey data was analysed for 48 variables in conjunction with NFS core farm socio-economic, physical and financial data. Additionally, core data from 2010 for 78.5% of farms surveyed in 2017 was included in the study. Data were analysed using a three-step statistical testing process which met all Binary Logistic Regression assumptions. RESULTS: The study found that dairy farms had a higher farm workplace occupational injury level compared to a previous study. The study data indicates occurrence of elevated injury levels on farms which expanded and which were intensively managed from a milk production perspective. Farm expansion was associated with increased labor units used and increased investment per hectare. The study also found that use of extension services and farm discussion group participation were not associated with injury occurrence. CONCLUSIONS: This study demonstrates how a retrospective farm workplace occupational injury survey of Irish dairy farms, analysed in combination with farm business data can be used to identify injury risk factors, including those associated with production expansion. Irish dairy farms have a heightened farm workplace occupation injury level while dairy production expansion increased injury levels. Extension engagement did not influence on injury levels. Approaches to improve farm safety on dairy farms are outlined.

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BACKGROUND: Musculoskeletal disorders are common among surgeons, and affect most neurosurgeons over the course of their career. Although all subspecialist neurosurgeons may be affected by physical strain, spine surgeons and skull base surgeons have a high propensity for workplace injury as a result of long procedures with repetitive movements in strained physical positions. METHODS: In this review, the prevalence of musculoskeletal disorders in neurosurgery, the state of innovation to improve ergonomics in the operating room for neurosurgeons, and potential limitations in advancing technology with the goal of maximizing neurosurgeon longevity are discussed. RESULTS: Innovations such as robotics, the exoscope, and handheld devices with more degrees of freedom have allowed surgeons to maneuver instruments without exerting excessive effort, all while maintaining neutral body positioning, avoiding joint and muscle strain. CONCLUSIONS: As new technology and innovation in the operating room develop, there has been a larger emphasis placed on maximizing surgeon comfort and neutral positioning, by minimizing force exertion and fatigue.

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BACKGROUND: Nurses are exposed to potentially psychologically traumatic events which can lead to operational stress injuries (OSI). Workplace reintegration after an OSI can be challenging, especially with repeated exposure to potentially traumatic scenarios and workplace demands. A workplace reintegration program (RP) originally developed for police officers may be of benefit for nurses returning to work after an OSI. The purpose of this study is to investigate the perceived need for an RP for nurses, and its potential contextualization and implementation in the nursing context using an implementation science approach. METHODS: This mixed-methods study collected data via questionnaires and focus groups from acute care nurses in Canada (N = 19). Data analysis was conducted using descriptive statistics, thematic analysis, and an organizational readiness assessment. RESULTS: Study participants indicated that formalized processes were rarely used to support nurses returning to work after time off due to mental health challenges. Themes included (1) "The Perfect Storm": the current state of return-to-work, (2) Integral Needs, and (3) A Break in the Clouds: hope for health. CONCLUSIONS: Exploration of innovative programs such as the RP may provide additional support to nurses affected by OSIs. Further research is needed regarding workplace reintegration for nurses, and contextualization and evaluation of the RP.

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Industrial tasks that involve frequent sitting/standing transitions and squatting activities can benefit from lower-limb industrial exoskeletons; however, their use is not as widespread as their upper-body counterparts. In this review, we examined 23 articles that evaluated the effects of using Wearable Chair (WC) and Squat-assist (SA) exoskeletons. Evaluations mainly included assessment of muscular demands in the thigh, shank, and upper/lower back regions. Both types of devices were found to lessen muscular demands in the lower body by 30-90%. WCs also reduced low-back demands (~ 37%) and plantar pressure (54-80%) but caused discomfort/unsafe feeling in participants. To generalize outcomes, we suggest standardizing approaches used for evaluating the devices. Along with addressing low adoption through design upgrades (e.g., ground and body supports/attachments), we recommend that researchers thoroughly evaluate temporal effects on muscle fatigue, metabolic rate, and stability of wearers. Although lower-limb exoskeletons were found to be beneficial, discrepancies in experimental protocols (posture/task/measures) were discovered. We also suggest simulating more realistic conditions, such as walking/sitting interchangeability for WCs and lifting loads for SA devices. The presented outcomes could help improve the design/evaluation approaches, and implementation of lower limb wearable devices across industries.

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Background Otolaryngologists in high-volume children's hospitals developed their operating room workflow practices based on the factors of safety, efficiency, and surgeon preference. Recent data show important benefits and potential reduced risks of proper ergonomic positioning for surgeons to prevent injury. These data suggest that the current operating room workflow practices, in addition to prior training, should be monitored and hopefully improved for surgeons' health. Surprisingly, recent studies have suggested the benefits of standing versus sitting on cognitive function. Objective This study reports the workflow norms for seven operating procedures in pediatric otolaryngology. We seek to identify 1) surgeon preferences, 2) when practices become norms, and 3) whether procedure positions are associated with surgeon discomfort or injury. Methods The Otolaryngology Section of the American Academy of Pediatrics was queried employing a 23-question survey. We included demographic information, reasons for preferences, and surgeon-reported pain. We focused on three workflow issues: 1) length of procedures, 2) site selection (operating room bed vs. transport stretcher), and 3) position of the surgeon (sitting vs. standing). Results Sixty-nine American Academy of Pediatrics members completed the survey. The length of the procedure had minimal effect, with 90% sitting for short procedures such as bilateral myringotomy with tubes, myringoplasty, tonsillectomy, and adenoidectomy. All sit for direct laryngoscopy and bronchoscopy. Most stand for the removal of nasal foreign bodies, drainage of neck abscess procedures, and thyroglossal duct cyst excision. Residency training (75%) and personal comfort (81%) were the more frequently cited reasons for preference. Fewer than one in five (16%) reported preexisting neck or back pain, but this doubled (35%) throughout their otolaryngology practice. Conditional distributions of pain showed reports of pain were greater for individuals in practice for over 20 years. Conclusions Pediatric otolaryngologists develop their operating room preferences early during residency training. High rates of neck and back pain (35%) may develop during a surgeon's career. We suggest improved understanding of ergonomics in concert with operating room workflow should be considered during otolaryngology residency training since recent data suggest potential benefits of standing on cognitive function.

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BACKGROUND: Improvement of visualization tools in neurosurgery such as the exoscope has raised the question of how this technology compares to the conventional microscope for surgeon ergonomics, discomfort, and patient outcomes. Exoscopes have the advantage of greater optical zoom, resolution, and illumination at a lower light intensity. Heads-up display for both the primary surgeon and other assistants permits neutral positioning of the surgeons while placing the camera in more angled positions. In a survey sample, this study assesses the surgeon experience utilizing 3D exoscope in general neurosurgery cases. METHODS: Data weere recorded by 8 surgeons at 5 separate hospitals utilizing a mobile phone application survey. Surgeons recorded information about case type, intraoperative clinical outcomes such as blood loss and extent of resection, whether fluorescence visualization was used, as well as surgeon pain when compared to matched cases using conventional tools. RESULTS: A total of 155 neurosurgical cases were recorded in this multisite study, including 72% cranial cases and 28% spinal cases. Of the cranial cases, 76% were brain tumor resections (31% of which were brain metastases). Surgeons reported significantly less neck (P < 0.0001) and back (P < 0.0001) pain in cases when using the robotic exoscope compared with the conventional microscope or surgical loupes. Surgeons did not convert to a microscope in any case. CONCLUSIONS: The exoscope provides excellent delineation of tissue with high resolution. Surgeon pain was markedly reduced with the robotic exoscope when compared with conventional technology, which may reduce work-related injury and fatigue, potentially leading to better patient outcomes.

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Workplace aggression can escalate from verbal to physical, adding risk of physical injury to negative psychological impact. Understanding escalation is necessary to develop effective violence intervention/prevention programs, but its occurrence is not well documented. An online survey determined if and how aggression escalates in occupational therapy (OT) workplaces. Because local culture can influence workplace events we compared surveys from northeastern states with the lowest rates of homicide to southeastern states with the highest. Ninety four OTs working in southeastern or northeastern states reported details of the most recent verbal and/or physical aggressive event initiated by clients (NIOSH Type 2) or staff (NIOSH Type 3) they witnessed or experienced in the workplace within the last year. Aggressor status, motivation, actions; therapist reactions, injuries and psychological sequelae were queried in logical order. Behavior inter-correlation followed by cluster analysis determined if levels of escalation could be detected. Analyses grouped events into five escalation levels in which progressively more hostile or damaging behaviors were added at each successive level. Higher levels involved known risk factors: Younger, reactively angry clients with prior aggression histories escalated attacks to involve restraint, calls for help and physical injury. Southeastern aggressor/target interactions appeared more combative, seemingly regardless of personal risk. Remarkably, northeastern OTs reported significantly more positive and fewer negative feelings across levels of escalation. OT workplace aggression occurs frequently, can escalate to injurious levels and requires prevention/intervention. How therapists maintain positive attitudes in the face of violence deserves further study.

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BACKGROUND: The overall information on occupational health and safety (OHS)-related knowledge and workplace practices are scarce in Bangladesh. This study aimed to (i) examine the prevalence of occupational injuries, (ii) explore the level of OHS-related knowledge and practice among workers and associated factors, and (iii) investigate the socioeconomic factors and OHS-related knowledge and practice scores as determinants of injury among metal workers at a community setting in Bangladesh. METHODS: This was a cross-sectional study conducted on all the functional metal workshops in a community of a town. The sociodemographic characteristics, history of injury and its consequences, and the state of knowledge and practice were measured using descriptive statistics. Univariate and multivariate analyses were used to measure the association between practice scores and sociodemographic factors and knowledge. Logistic regression was conducted to get the odds ratio of getting injured. RESULTS: A high annual rate (82.9%) of occupational injuries was documented in a one-year timeframe and the majority (81.1%) of injured workers lost more than three working days (median 20 days). Workers working in workshops with more than three workers were 3.3 times more likely to be injured [AOR = 3.33, 95% CI = 1.16, 9.58] compared to the workers in factories with one to three workers. Most of the workers had the basic knowledge related to OHS but the mean practice score was very low, 1.86 (SD 1.17). Higher education, lower monthly family income, and being an owner significantly led to higher practice scores. CONCLUSIONS: The OHS-related knowledge was not properly translated into good workplace practices in small informal metal workshops because of the absence of implementation of OHS policies and monitoring by the relevant authority. Government should support the informal metal working sector to increase awareness and skills for the prevention and proper management of injuries and risks, and to ensure access to safety equipment and a safe environment.

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INTRODUCTION: The purpose of our study is to assess workplace-related musculoskeletal (wrMSK) injury trends by utilizing Bureau of Labor Statistics (BLS) data. We hypothesize that trunk injuries are the most commonly reported, injuries occur most frequently in the manufacturing sector, and that injury type occurrence differs according to body region affected. METHODS: This study assessed wrMSK injury data provided by the BLS from 1992 to 2018. The three main body regions analyzed were lower extremity (LE), upper extremity (UE), and trunk. Injury data was also assessed by industrial sector (Agriculture, Manufacturing, Healthcare, and Construction) and injury type (fractures, multiple injuries, sprains/strains/tears, tendonitis, cuts/lacerations, pain/soreness, and bruises). Negative binomial regression and pairwise comparisons with a Benjamini-Hochberg adjustment were utilized to compare calculated incidence rate ratios for wrMSK injuries. Exponentiated beta estimates were used to calculate the estimated annual percent changes of wrMSK injuries within each industrial sector. RESULTS: Occurrence of wrMSK injuries from 1992 to 2018 was significantly lower for LE when compared to both upper extremity and trunk (p < 0.001). Manufacturing is shown to be the industry with the most wrMSK injuries in each of UE, LE, and trunk. wrMSK injuries were shown to decrease in each industrial sector over the timespan assessed, with the greatest percent change occurring in the manufacturing sector. Lacerations and tendonitis were the most common diagnosis types in UE, while pain/soreness and strains/sprains/tears were most common in trunk and bruises were most common in LE. DISCUSSION: From 1992 to 2018, trunk injuries were the most frequently occurring wrMSK injury, but not to a significantly higher degree than upper extremity injuries. wrMSK injury types that may require orthopedic surgical care affect specific body regions to different degrees, with cuts/lacerations and tendonitis most commonly affecting the upper extremity. Thus, it appears that wrMSK injuries in the upper extremity are of particular importance from an orthopedic care perspective.

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This article explores how meanings around risk, health/safety, and workers' bodies are constructed in an academic context. I do so through the study of a single academic in Australia who sustained a back injury at work. Through an analysis of in-depth interviews and documents, I attempt to show the embodied experience of an injured worker's struggle for care, recovery, and survival in the neoliberal academy. Writing from the nexus of workplace health and safety and critical management literatures, the raw testimony of this injured academic lays bare the violences that are enabled within a wider culture of self-discipline, individualism, and performativity in the university. The story presented in this article exposes how physiological and psychological injuries can be exacerbated through the very health and safety procedures that are designed to prevent and alleviate harm. Please note that this article contains references to suicide and suicidal ideation.

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BACKGROUND: Occupational hazards for emergency physicians are widely known, but the risk of work-related mortality is not clear. The COVID-19 pandemic generated new concerns about the risk of occupational mortality, particularly in the setting of inadequate personal protective equipment. The perception of increased risk generated ethical concerns regarding emergency physicians' duty to treat and employers' duty to protect their employees. We performed this scoping review to define prepandemic emergency physician occupational mortality. METHODS: We performed a scoping review of peer-reviewed publications from PubMed, EMBASE, and Cochrane databases in September 2020. RESULTS: Of the 747 unique articles identified in the 3 databases, 1 article met inclusion criteria and was included in the final analysis. CONCLUSION: The baseline risk of occupational mortality for emergency physicians is not established in the scientific literature. Further study is needed to quantify risk, as this information would be useful to shape policy and ethical considerations.

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BACKGROUND: Paramedic work has periods of intermittent high physical demand, a risk of workplace injury, may be confounded by inherent fitness of the paramedic. OBJECTIVE: This study aimed to identify the nature of workplace musculoskeletal injury, and determine if there was a relationship between pre-employment physical capacity testing (PEPCT) scores and risk of workplace musculoskeletal injury within the paramedic industry. METHODS: A retrospective case review using PEPCT scores and workplace injury (WI) manual handling data collected from 2008 to 2015 by an Australian pre-hospital emergency care provider (Ambulance Victoria), enabled comparison and analysis of two distinct data sets. RESULTS: A total of 538 paramedics were included for analysis with 34 paramedics reporting a workplace musculoskeletal injury from manual handling. The mean time to injury from commencement of employment was 395.4 days (SD 516.2). Female paramedics represented 53.0%and male paramedics represented 47%of the sample. Mean total PEPCT score for the entire sample was 19.1 (SD 2.9) with a range from 16.2-22, while for those reporting injuries it was 18.3 (SD 2.6) with a range from 15.7-20.9. CONCLUSIONS: Musculoskeletal injury amongst Victorian paramedics is more prevalent where the paramedic is female, and/or within three years of commencement of employment. The PEPCT score did not differentiate those at risk of subsequent injury.

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BACKGROUND AND AIM: The health care and social assistance industry has one of the highest rates of non-fatal occupational injuries and illnesses, both in California and nationally. In the coming years, the health care industry will face added pressure as both the population and workforce age. The aim of this study is to identify targeted populations that may benefit from interventions to prevent future injuries, keep the workforce healthy, and decrease injury-related costs. METHODS: This retrospective study analyzed California workers' compensation claims from 2009 to 2018 in the health care and social assistance industry. RESULTS: Across the four industry sub-groups, the highest number of claims came from hospitals (n = 243 605; 38.9%), followed by ambulatory care (n = 187 010; 29.9%), nursing/residential care (n = 133 206; 21.3%), and social assistance (n = 62 211; 9.9%). Nursing/residential care settings reported the highest proportion of both lifting injuries (15.8%) and low back injuries (16.9%) as compared to the other settings. Across all settings within California, nurses had the highest proportion of injuries (22.1%), followed by aides/assistants (20.4%), services staff (13.2%), administrative staff (11.0%), and technicians (10.3%). Thirty-five of California's counties had an increasing rate of population-adjusted claims during the study period. CONCLUSION: This study found that while hospitals have the highest number of injuries, ambulatory care employee injuries are increasing. Employees involved in non-patient care tasks, such as those working in facility service roles, would likely benefit from additional injury prevention interventions.

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OBJECTIVES: This study sought to examine whether the experience of occupational injuries was associated with depressive symptoms and whether the rejection of workers' compensation claims was associated with depressive symptoms among Korean firefighters. METHODS: We conducted a nationwide survey of 6793 Korean firefighters in 2015. Based on the experience of occupational injuries and workers' compensation claims over the past year, respondents were classified into four groups: "Not injured", "Injured, not applied", "Injured, applied, but rejected" and "Injured, applied, and accepted." Depressive symptoms over the preceding week were assessed using the 11-item version of the Centers for Epidemiologic Studies Depression Scale. RESULTS: Compared to firefighters who did not get injured, injured firefighters had a higher prevalence of depressive symptoms (PR 2.01, 95% CI 1.83, 2.22) after controlling for confounders including job assignment. Also, when we restricted the analysis to injured firefighters, a higher prevalence of depressive symptoms was observed among "Injured, applied, but rejected" (PR 1.70, 95% CI 1.11, 2.59) group, compared to "Injured, applied, and accepted" group. CONCLUSIONS: This finding suggests that rejection of workers' compensation claims, as well as the experience of occupational injuries, may increase the risk of depressive symptoms among Korean firefighters.

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Identification of occupational workplace injury risk factors is dependent on gaining sufficient and reliable data on both injury occurrence and associated workplace factors. Assessing workplace injury risk factors associated with farming is challenged by non-collection, non-reporting, or under-reporting by farmers, particularly those operating family farms in a self-employed manner. A supplementary (or add-on) farm operator (FO) workplace injury survey was undertaken in association with the Irish National Farm Survey (NFS), which is responsible for provision of Irish farm-level data to the European Commission (EC) Farm Accountancy Data Network (FADN). Data from this add-on survey were analyzed in association with farm and socio-economic data routinely collected by NFS as a component of the FADN. The combined data-set was analyzed using both descriptive and inferential statistical techniques including multivariate logistic regression to identify risk factors for occurrence of farm operator workplace injuries (FOWI). FOWI levels were significantly higher on farms where both the FO and their spouse engaged in Off Farm Employment (OFE). More generally, FO injury levels were associated with farm workload and investment levels. The study demonstrates how FADN farm and socio-economic data can be combined with additional FO workplace injury data to identify workplace injury risk factors. The study identifies a risk factor for FOWI occurrence where both FO and spouse engaged in OFE. More generally, it indicates that farm workplace injuries are associated with farm management-related factors.

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