Injury Epidemiology and the Aging Workforce

Transcription

1 Injury Epidemiology and the Aging Workforce ASSE Lunch & Learn - March 12, 2012 Ken Scott, MPH (kenneth.scott@ucdenver.edu) Mountain & Plains ERC Outreach Director

2 Who Does Injury Epidemiology? Injury Epidemiologists Safety Professionals Risk Managers HR Professionals Physicians Economists Actuaries

3 Take Home Points Epidemiology used to be about infectious diseases, but now it s about much, much more Epidemiologists compare groups of people to figure out: Who is getting sick and injured The numbers and rates of people experiencing illness and injury The causes of illness and injury Strategies to prevent illness and injury Epidemiology surveys and epidemiology studies can be of practical use to safety professionals

4 A SHORT HISTORY

5 The Bills of Mortality In 1592, during the Plague, England began collecting records of Burials and Christenings through a system of parishes The results were published as the Bills of Mortality every week and every year John Graunt, a haberdasherturned-politician arranged the data into tables in order to: have a view of the whole together, in order to the more ready comparing of one Year, Season, Parish or other Division of the City with another...

6 Table of Casualties The Years of our Lord Aged Cancer, Gangrene and Fistula Wolf 8 Executed Killed by Several Accidents Plague Consumption and Cough Murdered

7 Cholera Epidemic of 1854

8 The Epidemiology Triangle Host Agent Environment

9 The Epidemiology Triangle Host Risk Factors: Age Socioeconomic Status Prevention Strategies: Vaccination Education

10 The Epidemiology Triangle Risk Factors: Subtypes O1 & O139 Virulence Persistence in water Agent

11 The Epidemiology Triangle Risk Factors: Food contamination Untreated water Lack of plumbing Natural disasters Prevention Strategies: Waste management Pest control Clean water Environment

12 Risk Factor Cause Risk factor: some characteristic of the host, agent or environment that is associated with an increased risk of disease Cause: one link in a chain of events without which some outcome would not have occurred

13 Leading Causes of Death in Pneumonia 2. Tuberculosis 3. Diarrhea, enteritis and ulceration of the intestines 4. Diseases of the heart 5. Intracranial lesions of vascular origin 6. Nephritis 7. All accidents 8. Cancer and other malignant tumors 9. Senility 10. Diphtheria National Office of Vital Statistics, December 1947

14 Leading Causes of Death in Heart disease 2. Cancer 3. Stroke 4. Accidents 5. Certain diseases of early infancy 6. Influenza and pneumonia 7. Tuberculosis 8. General arteriosclerosis 9. Chronic and unspecified nephritis 10. Diabetes mellitus National Office of Vital Statistics, December 1957

15 Dr. William Haddon, Jr. Born May 24, 1926 Died March 4, 1985 First federal highway safety chief Used methods from infectious disease epidemiology to study injuries

16 The Epidemiology Triangle Host? Agent Environment

17 The Epidemiology Triangle Mechanical Thermal Chemical Electrical Radiant Energy Host Environment

18 The Epidemiology Triangle Host Energy Environment

19 The Haddon Matrix Host Vehicle Environment Pre-Crash Crash Post-Crash

20 The Haddon Matrix Host Vehicle Environment Pre-Crash Vision testing Brake check Well lit roads Crash Wearing seat belt Air bags Guard rails Post-Crash Poor fitness Automatic fuel shut off Emergency response systems

21 Tools for Assessing the Burden SURVEYS

22 The Point of Surveys To take a sample of individuals and make generalizable statements about bigger groups Example: The number of people living on Earth? Billion People

23 Common Surveys in OSH Survey of Occupational Illnesses and Injuries (SOII) National Occupational Mortality Study (NOMS) Workers Compensation Data?... Census of Fatal Occupational Injuries (CFOI)?...

24 Case Study 1 Question: How many work-related fatalities occurred in Colorado during 2011? Answer: 87 Survey: The Census of Fatal Occupational Injuries Organization: BLS and CDPHE Data Sources: Death certificates, workers compensation claims, NIOSH FACE Investigations, OSHA Reports, Traffic Accident Reports, Newspaper Clippings Where to Find It:

25 Case Study 2 Question: How many people go to the emergency room with a nail gun injury in a given year? Answer: ~37,000 ED Visits Survey: National Electronic Injury Surveillance System Data Sources: Hospital Emergency Departments Where to Find It: Research--Statistics/NEISS-Injury- Data/

26 Tools for Determining Cause and Effect STUDIES

27 Exposure? Outcome Hazards Benzene Repetitive motion Silica Asbestos Interventions Slip-resistant-shoes N-95 Respirator Outcomes Leukemia Carpal tunnel syndrome Silicosis Mesothelioma Slip, trip and fall injury Influenza

28 Studies Studies compare two groups of people People with injury and people without injury People who were exposed to a hazard and people who were unexposed People who were given a drug and people who were given a placebo Various study designs are used to make the comparisons valid Case-control studies Cohort studies Randomized control trials (RCTs) We use (a lot of ) statistics to understand the similarities and differences between the two groups

29 Case Study 3 Question: Do back belts prevent back injuries? Answer: Probably not Study Title: A Prospective Study of Back Belts for Prevention of Back Pain and Injury Type of Study: Cohort study Data Sources: Data collected from 160 new retail merchandise stores in 30 states over two years Where to Find It: The Journal of the American Medical Association (JAMA 12/6/2000)

30 Case Study 4 Question: Is body armor a costeffective way to keep police officers safe? Answer: Probably so ($100/officer, 2x cost) Study Title: The Life-Saving Effectiveness of Body Armor for Police Officers Type of Study: Data Sources: FBI database Law Enforcement Officers Killed and Assaulted (LEOKA) Where to Find It: The Journal of Occupational and Environmental Hygiene (7/14/2010)

31 Case Study 5 Question: Do OSHA inspections actually prevent work-related injuries and illnesses? Answer: Probably so Study Title: Randomized Government Safety Inspections Reduce Worker Injuries with No Detectable Job Loss Type of Study: Randomized control trial Data Sources: Workers compensation data, employment data, company survival and compensation data Where to Find It: Science (5/18/2012)

32 THE AGING WORKFORCE

33 Aging & Host Factors What host factors change with age? Vision Balance Reaction time Job Income Family demands Health Experience

34 All Occ Injuries and Illnesses Rates and Median Days Absent from Work Rate per 10,000 fulltime equivalents Median days absent from work Source: MMWR, April 29 th, 2011 Nonfatal Occupational Injuries and Illnesses Among Older Workers United States, 2009

35

36 Aging Workforce Haddon Matrix Pre-Event Host Agent Environment Event Post-Event

37 Perspective Not everything that counts can be measured. Not everything that can be measured counts.

38 Take Home Points Epidemiology used to be about infectious diseases, but now it s about much, much more Epidemiologists compare groups of people to figure out: Who is getting sick and injured The numbers and rates of people experiencing illness and injury The causes of illness and injury Strategies to prevent illness and injury Epidemiology surveys and epidemiology studies can be of practical use to safety professionals

39 Suggested Reading The Ghost Map Steven Johnson While You Were Sleeping David Hemenway

40 Lee Newman, MD, MA ERC Director Steve Reynolds, PhD Ag Center Director ERC Deputy Director

41 18 NIOSH Education and Research Centers «

42 Our Region Colorado Wyoming New Mexico Montana «North Dakota South Dakota Arizona

43 What Is a Center, Anyway? $ 4 Graduate Degree Programs Industrial Hygiene Health Physics Occupational Health Psychology Residency Program Occupational and Environmental Medicine Core Values Interdisciplinary Collaboration Diversity Research to Practice Outreach Program Ergonomics Continuing Education Program Pilot Grants Program

44 ASSE, AIHA & the Mountain & Plains ERC: Present Collaborations ASSE & AIHA Have Representatives on our two advisory boards Annual Fall Technical Conference Sponsorship Development and promotion of the CIH Online Review Course Introducing students from CSU and CU to the EH&S Profession Panel at 1:30 pm Internship opportunities? Future ASSE members?

45 ASSE, AIHA & the Mountain & Plains ERC: Future Collaborations Development & promotion of a CSP Online Review course? Informal Poll Mentorship program? Student chapter of ASSE? Partnering on an epidemiological study?