The Epidemiology, Cost, and Occupational Context of Spinal Injuries Sustained While ‘Working for Income’ in NSW: A Record-Linkage Study

This study aimed to describe the epidemiological characteristics, the occupational context, and the cost of hospitalised work-related traumatic spinal injuries, across New South Wales, Australia. A record-linkage study of hospitalised cases of work-related spinal injury (ICD10-AM code U73.0 or workers compensation) was conducted. Study period 2013–2016. Eight hundred and twenty-four individuals sustained work-related spinal injuries; 86.2% of whom were males and had a mean age of 46.6 years. Falls led to 50% of the injuries; predominantly falls from building/structures, ladders or between levels. Falls occurred predominantly in the construction industry (78%). Transport crashes caused 31% of injuries and 24% in heavy vehicles. Half of all the transport injuries occurred ‘off road’. The external cause was coded as ‘non-specific work activity’ in 44.5% of cases; missing in 11.5%. Acute care bed days numbered at 13,302; total cost $19,500,000. High numbers of work-related spinal injuries occurred in the construction industry; particularly falling from a height. Off-road transport-related injuries were significant and likely unaddressed by ‘on-road’ prevention policies. Medical record documentation was insufficient in injury mechanism and context specificity. Workers in the construction industry or those using vehicles off-road were at high risk of spinal injury, suggesting inefficient systems approaches or ineffective prevention policies. Reducing the use of non-specific external cause codes in patients’ medical records would improve the measurement of policy effectiveness.

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Pre-Existing Mental Disorder, Clinical Profile, Inpatient Services, And Costs in People Hospitalised Following Traumatic Spinal Injury: A Population Record-Linkage Study

International Journal for Population Data Science ◽

10.23889/ijpds.v5i5.1589 ◽

2020 ◽

Vol 5 (5) ◽

Author(s):

Lisa Nicole Sharwood ◽

Taneal Wiseman ◽

Emma Tseris ◽

Kate Curtis ◽

Bharat Vaikuntam ◽

...

Keyword(s):

Mental Illness ◽

Substance Use ◽

Mental Disorders ◽

Mental Disorder ◽

Dual Diagnosis ◽

Record Linkage ◽

Injury Severity ◽

Spinal Injury ◽

Linkage Study ◽

Icd 10

IntroductionRisk of traumatic injury is increased in individuals with mental illness, substance use disorder and dual diagnosis (mental disorders); these conditions will pre-exist among individuals hospitalised with acute traumatic spinal injury (TSI). Although early intervention can improve outcomes for people who experience mental disorders or TSI, the incidence, management, and cost of this often complex comorbid health profile is not sufficiently understood. Objectives and ApproachIn a whole-population cohort of patients hospitalised with acute TSI, we aimed to describe the prevalence of pre-existing mental disorders, and compare differences in injury epidemiology, costs and inpatient allied health service access. Record-linkage study of all hospitalised cases of TSI between June 2013 and June 2016 in New South Wales, Australia. TSI was defined by specific ICD-10-AM codes. Mental disorder status was considered as pre-existing where specific ICD-10-AM codes were recorded in incident admissions. Results13,489 individuals sustained acute TSI during this study. 13.11%, 6.06%, and 1.82% had pre-existing mental illness, substance use disorder, and dual diagnosis, respectively. Individuals with mental disorder were older (p<0.001), more likely to have had a fall or self-harmed (p<0.001), experienced almost twice the length of stay and inpatient complications, and increased injury severity compared to individuals without mental disorder (p<0.001). Conclusion / ImplicationsIndividuals hospitalised for TSI with pre-existing mental disorder have greater likelihood of increased injury severity and more complex, costly acute care admissions compared to individuals without mental disorder. Care pathway optimisation including prevention of hospital acquired complications for people with pre-existing mental disorders hospitalised for TSI is warranted.

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SELF-COMPACTING CONCRETE USE FOR CONSTRUCTION WORK ENVIRONMENT SUSTAINABILITY

Journal of Civil Engineering and Management ◽

10.3846/13923730.2012.723399 ◽

2012 ◽

Vol 18 (5) ◽

pp. 724-734 ◽

Cited By ~ 1

Author(s):

Romuald Rwamamara ◽

Peter Simonsson

Keyword(s):

Work Environment ◽

Construction Industry ◽

Musculoskeletal Injury ◽

Construction Work ◽

Casting Method ◽

Self Compacting Concrete ◽

Work Activity ◽

Work Related ◽

Work Tasks ◽

Concrete Casting

Many of those working on construction sites are exposed to demanding work loads; construction workers lift and carry heavy materials and work in awkward postures. Occupational injuries and accidents due to poor ergonomics are more common in the construction industry and many times lead to human tragedies, disrupt construction processes and adversely affect the cost, productivity, and the reputation of the construction industry. In Sweden, it is reported that concrete workers have the highest relative work-related musculoskeletal injury frequency. Therefore, the use of ergonomic production methods to prevent this can have a significant human, social and financial impact. Research introduced here presents a case study of comparative analyses of ergonomic situations for concrete workers performing concrete casting processes. Three different ergonomic risk assessment methods were used to assess the physical strain, hand-arm vibration and noise affects risks involved in concrete casting work tasks. The combination of technical and managerial factors results in a system where workers are as efficient and safe as possible during their work tasks, and thus, makes the construction work environment sustainable. The aim of our research is to find practical methods to evaluate and compare two different concrete casting methods from an ergonomic perspective. The focus is on the production of cast-in-place concrete bridge constructions where the traditional concrete casting method is compared with the SCC (Self-Compacting concrete) casting method. To be able to identify work-related musculoskeletal injury risks due to concrete casting work tasks, QEC (Quick Exposure Check for musculoskeletal risks), PLIBEL (Checklist for identification for Ergonomics Hazards) and ErgoSAM (Ergonomic production technology method) methods were used. Ergonomic risks analysis methods QEC, PLIBEL and ErgoSAM have all shown capabilities to evaluate construction work activities and thus determine whether a construction work activity constitutes a musculoskeletal risk to the worker or not before any ergonomic intervention is introduced. As a result the present ergonomic risks emanating from work methods used in the traditional concrete placing can be significantly reduced with the use of self-compacting concrete (SCC) that eliminates awkward work postures, noise and hand arm vibration, thereby reducing if not eliminating musculoskeletal injuries among concrete workers during their concrete casting work tasks.

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Work-related traffic crashes: A record linkage study

Accident Analysis & Prevention ◽

10.1016/j.aap.2005.06.014 ◽

2006 ◽

Vol 38 (1) ◽

pp. 14-21 ◽

Cited By ~ 38

Author(s):

Soufiane Boufous ◽

Ann Williamson

Keyword(s):

Record Linkage ◽

Linkage Study ◽

Traffic Crashes ◽

Work Related

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Epidemiology of spinal injury patients admitted to the department of orthopaedics, King George Medical University

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20194829 ◽

2019 ◽

Vol 5 (6) ◽

pp. 1196

Author(s):

Satyendra Kumar ◽

Vikas Verma ◽

Vineet Sharma ◽

Shailendra Singh

Keyword(s):

Spinal Injury ◽

Body Height ◽

Spinal Injuries ◽

Common Mechanism ◽

Mechanism Of Injury ◽

Associated Injuries ◽

Female Ratio ◽

Modifiable Factors ◽

Medical University ◽

Epidemiological Characteristics

Background: Socioeconomic structure, policies and cultural traditions play important roles in the determining the epidemiological characteristics of spinal injury patients. An understanding of epidemiology of spinal injuries is essential for planning and implementation of preventive measures as well as clinical services. The objective of this study is to describe the epidemiology of spinal injury patients admitted to the Department of Orthopaedics, King George Medical University (KGMU).Methods: Age, sex, time since injury to admission, site of injury, mechanism of injury, stability of injury, vertebral level, collision type, visibility, type of road, associated injuries, complications and outcome at the end of hospital stay was recorded.Results: Mean age of the 149 enrolled patients was 33.62±13.47 years. Male to female ratio was 2.63. More than fifty percent (52.3%) patients were admitted more than 48 hrs after injury. Most of the patients sustained injury in the house (59.1%). Falls were the most common mechanism of injury (79.2%). 54.23% of the falls were less than body height. Stable injuries (51%) were more common than unstable injuries. 21.48% patients had multiple levels of injury. 1st lumbar vertebra was the most common vertebra injured (20.88%). Ninty six (64.42%) patients had associated injuries. Most common complication were pulmonary (16.10%).Conclusions: Traumatic spinal injuries predominantly involve young males. Household falls are the most common cause of traumatic spinal injuries. There is a need to determine the modifiable factors that contribute to household falls. There is a significant association between falls and complete injuries.

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Pre-existing mental disorder, clinical profile, inpatient services and costs in people hospitalised following traumatic spinal injury: a whole population record linkage study

Injury Prevention ◽

10.1136/injuryprev-2019-043567 ◽

2020 ◽

pp. injuryprev-2019-043567

Author(s):

Lisa Nicole Sharwood ◽

Taneal Wiseman ◽

Emma Tseris ◽

Kate Curtis ◽

Bharat Vaikuntam ◽

...

Keyword(s):

Mental Illness ◽

Substance Use ◽

Mental Disorders ◽

Mental Disorder ◽

Dual Diagnosis ◽

Record Linkage ◽

Injury Severity ◽

Spinal Injury ◽

Linkage Study ◽

Icd 10

BackgroundRisk of traumatic injury is increased in individuals with mental illness, substance use disorder and dual diagnosis (mental disorders); these conditions will pre-exist among individuals hospitalised with acute traumatic spinal injury (TSI). Although early intervention can improve outcomes for people who experience mental disorders or TSI, the incidence, management and cost of this often complex comorbid health profile is not sufficiently understood. In a whole population cohort of patients hospitalised with acute TSI, we aimed to describe the prevalence of pre-existing mental disorders and compare differences in injury epidemiology, costs and inpatient allied health service access.MethodsRecord linkage study of all hospitalised cases of TSI between June 2013 and June 2016 in New South Wales, Australia. TSI was defined by specific International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes. Mental disorder status was considered as pre-existing where specific ICD-10-AM codes were recorded in incident admissions.Results13 489 individuals sustained acute TSI during this study. 13.11%, 6.06% and 1.82% had pre-existing mental illness, substance use disorder and dual diagnosis, respectively. Individuals with mental disorder were older (p<0.001), more likely to have had a fall or self-harmed (p<0.001), experienced almost twice the length of stay and inpatient complications, and increased injury severity compared with individuals without mental disorder (p<0.001).ConclusionIndividuals hospitalised for TSI with pre-existing mental disorder have greater likelihood of increased injury severity and more complex, costly acute care admissions compared with individuals without mental disorder. Care pathway optimisation including prevention of hospital-acquired complications for people with pre-existing mental disorders hospitalised for TSI is warranted.

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The Nature and Cost of Readmissions after Work-Related Traumatic Spinal Injuries in New South Wales, Australia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16091509 ◽

2019 ◽

Vol 16 (9) ◽

pp. 1509

Author(s):

Lisa N. Sharwood ◽

Holger Möller ◽

Jesse T. Young ◽

Bharat Vaikuntam ◽

Rebecca Q. Ivers ◽

...

Keyword(s):

Health Service ◽

Spinal Injury ◽

New South ◽

New South Wales ◽

Spinal Injuries ◽

Unplanned Readmission ◽

Post Discharge ◽

Major Work ◽

Work Related ◽

South Wales

This study aimed to measure the subsequent health and health service cost burden of a cohort of workers hospitalised after sustaining work-related traumatic spinal injuries (TSI) across New South Wales, Australia. A record-linkage study (June 2013–June 2016) of hospitalised cases of work-related spinal injury (ICD10-AM code U73.0 or workers compensation) was conducted. Of the 824 individuals injured during this time, 740 had sufficient follow-up data to analyse readmissions ≤90 days post-acute hospital discharge. Individuals with TSI were predominantly male (86.2%), mean age 46.6 years. Around 8% (n = 61) experienced 119 unplanned readmission episodes within 28 days from discharge, over half with the primary diagnosis being for care involving rehabilitation. Other readmissions involved device complications/infections (7.5%), genitourinary or respiratory infections (10%) or mental health needs (4.3%). The mean ± SD readmission cost was $6946 ± $14,532 per patient. Unplanned readmissions shortly post-discharge for TSI indicate unresolved issues within acute-care, or poor support services organisation in discharge planning. This study offers evidence of unmet needs after acute TSI and can assist trauma care-coordinators’ comprehensive assessments of these patients prior to discharge. Improved quantification of the ongoing personal and health service after work-related injury is a vital part of the information needed to improve recovery after major work-related trauma.

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Job Validation Studies and Physical Agility Testing: Is the Vendor Telling You What They Think You Want or Are You Telling Them What You Need?

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2016.novdec02 ◽

2016 ◽

Vol 21 (6) ◽

pp. 5-11

Author(s):

E. Randolph Soo Hoo ◽

Stephen L. Demeter

Keyword(s):

Equal Employment Opportunity Commission ◽

Job Analysis ◽

Specific Work ◽

Test Protocol ◽

Systematic Method ◽

Technical Standards ◽

Work Related ◽

Physical Abilities ◽

Specific Factors ◽

Key Terms

Abstract Referring agents may ask independent medical evaluators if the examinee can return to work in either a normal or a restricted capacity; similarly, employers may ask external parties to conduct this type of assessment before a hire or after an injury. Functional capacity evaluations (FCEs) are used to measure agility and strength, but they have limitations and use technical jargon or concepts that can be confusing. This article clarifies key terms and concepts related to FCEs. The basic approach to a job analysis is to collect information about the job using a variety of methods, analyze the data, and summarize the data to determine specific factors required for the job. No single, optimal job analysis or validation method is applicable to every work situation or company, but the Equal Employment Opportunity Commission offers technical standards for each type of validity study. FCEs are a systematic method of measuring an individual's ability to perform various activities, and results are matched to descriptions of specific work-related tasks. Results of physical abilities/agilities tests are reported as “matching” or “not matching” job demands or “pass” or “fail” meeting job criteria. Individuals who fail an employment physical agility test often challenge the results on the basis that the test was poorly conducted, that the test protocol was not reflective of the job, or that levels for successful completion were inappropriate.

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