RESEACH ON THE ACCIDENT AT WORK AND WORK-RELATED HEALTH PROBLEMS, 2013



Similar documents
SCB (9) BV/AKU, Peter Beijron phone: peter.beijron@scb.se Box Stockholm

Definitions 1 and interviewers instructions of the supplementary survey and non-response rate

Health risks at work. Statistisches Bundesamt, Wiesbaden, 2009 Author: Page 1. Destatis, 1 September 2009

How To Fill Out A Health Declaration

Managing Health Hazards at Work.

Application for a Medical Impairment Rating (MIR)

CHIEF COMPLAINT: Please number your symptoms (1 is the most severe) that you have developed since the accident.

Motor Vehicle Accident - New Patient

History Questionnaire

The Power Plate is the innovative, time saving and results driven way to improve your fitness and well being.

Life Insurance Plans Application Forms

ORTHOPAEDIC SPINE PAIN QUESTIONNAIRE

Life Insurance Plan Application form

INCIDENT RATES DEFINITIONS:

PATIENT INFORMATION INSURANCE INFORMATION

Workers Compensation: Making a claim

Patient Case Information (Please Fill Out Forms Completely) (IF PATIENT IS UNDER 18 YEARS OF AGE LEGAL GUARDIAN MUST SIGN ALL PAPERWORK)

Requirements for Medical Clearance: History and Physical exam within 6 months of applying for privileges

Quality Measures for Long-stay Residents Percent of residents whose need for help with daily activities has increased.

Contact your Doctor or Nurse for more information.

New Patient Evaluation

Application for Employment

Pittsfield Family YMCA: Personal Training Services

Rivaroxaban to prevent blood clots for patients who have a lower limb plaster cast. Information for patients Pharmacy

Learn about Diabetes. Your Guide to Diabetes: Type 1 and Type 2. You can learn how to take care of your diabetes.

The McGee Law Firm. 213 Princess Street Wilmington, NC (910)

Alcohol and drug abuse

Completion Test Answer Key. 1. Why are young people more likely to be injured on the job than other groups of workers?

UNDERSTANDING STRESS AND YOUR BODY

NEW STUDENT-ATHLETE MEDICAL HISTORY FORM

Surgery for cervical disc prolapse or cervical osteophyte

Health and Safety Management in Healthcare

NORTHERN EDGE PHYSICAL THERAPY

Lesson 7: Respiratory and Skeletal Systems and Tuberculosis

How To Be Active

NEW PATIENT INFORMATION FORM

DRAFT OUTLINE YOGA IN HOSPICE CARE PRESENTATION Michele Hoffman, E-RYT, CYT April 21, 2015

*Date of injury/auto Accident/Slip and fall: / / Time: : AM PM

Nature of Accident Nature of Injury Body Part Code Table

Like cocaine, heroin is a drug that is illegal in some areas of the world. Heroin is highly addictive.

Acknowledgement of Receipt of Notice of Privacy Practices

Memorial Hospital Sleep Center. Rock Springs, Wyoming Sleep lab Phone: (Mon - Wed 5:00 pm 7:00 am)

STRESS. Health & Wellness The Newsletter About Achieving and Maintaining Optimal Well-being UNDERSTANDING AND YOUR BODY.

Workman s Compensation

Medication Guide Testim (TĔS tim) CIII (testosterone gel)

Stress Management Policy

CHAPTER 9 BODY ORGANIZATION

Medical Massage Client Intake Form Medical Massage Client Intake Form

Danita Thomas Heagy, DC, LLC 4425 US 1 South, Suite 109 St Augustine FL

of INJURY REPORT and APPLICATION for Benefit Occupational Health and Safety Authority PART 1. TO BE FILLED IN BY THE PERSON MAKING THE CLAIM / REPORT

PATIENT INFORMATION SHEET. Last Name: First Name: MI: Home Address: Apt# City: State: Zip Code: Home Phone #: Cell Phone #:

Body Positioning & Lifting Techniques

Health Science / Anatomy Exam 1 Study Guide

MINDING OUR BODIES. Healthy Eating and Physical Activity for Mental Health

TRADIES NATIONAL HEALTH MONTH HEALTH SNAPSHOT

KEY PERSON INSURANCE (Accident & Sickness) PROPOSAL FORM

NEURO-OPHTHALMIC QUESTIONNAIRE NAME: AGE: DATE OF EXAM: CHART #: (Office Use Only)

SPORTS INSURANCE PROPOSAL FORM (All questions must be answered in ink)

Accident / Injury Report

Injury / Incident Investigation

X. Capsules; pills; Stimulants; increased energy powder; rock alertness; extreme anxiety; temporary mental illness

Mortgage Protection Plan/Level Term Plan With/Without Critical Illness Cover

Denver Spine Surgeons David Wong, MD, Sanjay Jatana, MD, Gary Ghiselli, MD

Arthritis

Tai Chi Nation guide to Qigong - Part 1

Grade. Lesson 12. Substance Abuse Prevention: Tobacco and Marijuana

Fourth Grade The Human Body: The Respiratory System Assessment

SPINE PATIENT HISTORY FORM

JAMES PETROS, M.D., INC. PHONE: (408) FAX: (408)

Aquatic Exercises: Upper Body Strengthening

Physiotherapy for COPD. Chronic Obstructive Pulmonary Disease (COPD) Healthcare you can Trust. Pulmonary Rehabilitation

AXIRON (AXE-e-RON) CIII

Patient Information Form Pain Management Center at Phoebe

Getting the occupational safety basics organised

Living with a lung condition:

UK MANAGING AGENTS ACCIDENT AND INCIDENTS GUIDANCE

PLEASE FILL IN THE FORM AS COMPLETELY AS POSSIBLE. NOTIFY OUR STAFF IF YOU HAVE ANY QUESTIONS; THEY WILL BE GLAD TO HELP YOU. Patient s Name: Date:

Preventing Overuse Injuries at Work

Patient Name: Patient X Date of Birth: April 15, 1954 Age: 54 Start Date: May 20, 2008

1960 Ogden St. Suite 120, Denver, CO 80218,

PATIENT REGISTRATION FORM

Bonnie Dunton RN COHC OHN DuPont NA Region IHS Consultant

[Project name] Standard Operating Procedures. Body Mechanics

1MFBTF GJMM PVU GPSNT BOE GBY 'PSNT XJMM CF TJHOFE BU ZPVS BQQPJOUNFOU

*2PHT* REHAB SERVICES PATIENT HISTORY QUESTIONNAIRE

Transcription:

0.07.0 RESEACH ON THE ACCIDENT AT WORK AND WORK-RELATED HEALTH PROBLEMS, 0 ACCIDENTS AT WORK WHICH HAVE BEEN ENCOUNTERED IN THE LAST MONTHS Colon Codes Questions Filter number AWNUMBR Q COL. 97 In the months before the reference week, have you had any accident at work or in the course of work, resulting in injuries? Accident outside working hours and accidents during the journey from home to work or from work to home are excluded. Accidents during a journey in the course of work are included. For Q= and For Q= Worked in reference week (WSTATOR=,) OR has worked at any time in last months (LFSQ9a,b< year). (For example; slips, falls at work,accidents occured in the course of work within the premises of company etc.) For Q= (LFSQ9=) AWNUMBR Q 9 Has leaved from job more than months, has not worked during the past months How many accidents resulting in injury did you have during the last months? Q= Q8A and Q= Q8A Q= COL. 97 AWROAD Q COL. 98 One Two Three Four Five and more Which type of most recent accident at work or in the course of work, have you had resulting in injuries? Q= ise AWJOB Q COL. 99 A road trafiic accident Other accidents out of road traffic accident Which job you were doing when this accident occured? Main current job Additional current job Last job (for persons not in employment) Job one year ago Job other than above mentined jobs Q= ise If the persons not employed, Q<> and Q<> If the persons worked in reference week Q<> (Q= LFSQ9= ) (LFSQ= Q<> )

0.07.0 Q COL. 00-0 due to this most recent accident? (Q= LFSQ9=) Ask this Q Q= and (LFSQ9a,b< year ) Q= Q Q= Q7 QA COL. 00-0 in the reference week due to this most recent accident? (Q= ve (LFSQ8= and LFSQ9=)) QA= Q QA= Q7 (Q= LFSQ9=) Q COL. 00-0 Q7 COL. 00-0 7 8 Do you expect to start working again? Thinking of the months since (reference week minus one year), how many days did you return to work after the most recent accident? (except the day of accident) Did not need to stay away from work because of this accident, continued to work (or less than day) Within the - days Within the - days Within the -9 days At least month but less than months(0-89 At least month but less than months (90-79 At least month but less than 9 months (80-9 At least 9 month but less than months (70- Q= or Q= Pass Q8 Ask this Question IF Q= and ((LFSQ= or LFSQ7=) OR (LFSQ8= and LFSQ9<>) OR (S<> or SA<>))

0.07.0 WORK RELATED HEALTH PROBLEMS WHICH HAVE BEEN SUFFERED FROM, DURING THE LAST MONTHS WHPNUMBR Q8 COL. 0 Apart from the accident, within the months since (reference week minus one year) have you suffered from any physical or mental health problem that was/were (is/are) related on current/previous work? Worked in reference week (WSTATOR=,) OR had worked in the past Q8= pass Q9 Q8= pass Q WHPNUMBR Q8A COL. 0 Within the months since (reference week minus one year) have you suffered from any physical or mental health problem that was/were (is/are) related on current/previous work? (persons who had not have any accident at work resulting injuries) Worked in reference week (WSTATOR=,) OR had worked in the past If Q8A= pass Q9 Q8A= pass Q WHPNUMBR Q9 COL. 0 How many different physical or mental health problem(s) have you had in the last months that was/were (is/are) related on current/previous work? Q8= or Q8A= One Two Three Four Five and more WHPTYPEP How would you describe THE MOST Q8= or Q8A=

0.07.0 Q0 COL. 0-0 SERIOUS physical or mental health problem(s) that was/were (is/are) related on current/previous work? WHPLIMAB Q COL. 0 WHPJOB Q COL. 0 Bone, joint or muscle problem which mainly affects neck, shoulders, arms or Bone, joint or muscle problem which mainly affects hips, legs or feet Bone, joint or muscle problem which mainly affects Breathing or lung Skin problem Hearing problem 7 Stress, depression or anxiety 8 Headache and/or eyestrain 9 Heart disease or attack, or other problems in the circulatory system 0 Infectious disease (virus, bacteria or other type of infection) Stomach, liver, kidney or digestive problem Other types of complaint (Specify) Would you say this health problem effect your daily life either at work or outside work?, considerably, to some extent Which job that caused or made worse the health problem one you have suffered? Main current job Additional current job Last job Job one year ago Job other than above mentined jobs Q8= or Q8A= Q8= or Q8A= If the persons not employed, Q<> and Q<> If the persons worked in reference week Q<> (LFSQ= Q<> ) Q COL. 07-08 due to this health problem? (Q8= or Q8A=) and (LFSQ9= ) ask Q= pass Q Q= pass Q QA COL. 07-08 in the reference week due to this health problem? (Q8= or Q8A=) and (LFSQ8= and LFSQ9=) ask Do you expect to start working again? QA= pass Q QA= pass Q Q= or QA= ask

0.07.0 Q COL. 07-08 Q COL. 07-08 Thinking of the months since (reference week minus one year), for how long were you off work because of your most serious health problem in this period? Q= or Q= pass Q (If not employed THE END) (Q8= or Q8A=) and Q COL. 09 Did not need to stay away from work because of this health problem, continued to work (or less than day) At least one day but less than four days ((LFSQ= or LFSQ7=) OR (LFSQ8= and LFSQ9<>) OR (Q= At least four days but less than two weeks or QA=)) and At least two weeks but less than one month (LFSQ9a,b< year ) 7 8 At least month but less than three months(0-89 At least months but less than months (90-79 At least months but less than 9 months (80-9 At least 9 months but less than months (70- ask THE RISK FACTORS AT WORK THAT COULD AFFECT PHYSICAL HEALTH OR MENTAL WELL-BEING difficult work postures or work movements that could affect your physical health? Q7 COL. 09 Q8 COL. 09 Q9 COL. 09 Q0 Would you say that at work you are handling of heavy loads that could affect your physical health? noise or strong vibration that could affect your physical health? chemicals, dust, fumes, smoke or gases that could affect your physical health? Q= don t ask ( THE END) Ask employed persons in the reference week (WSTATOR=,)

0.07.0 COL. 09 activities involving strong visual concentration that could affect your physical health? Q COL. 09 risk of accident that could affect your physical health? Q COL. 09 Q COL. 0 Which of these factors you consider to be the GREATEST risk to your physical health? to difficult work postures or work movements handling of heavy loads to noise or strong vibration to chemicals, dust, fumes, smoke or gases to activities involving strong visual concentration to risk of accident severe time pressure or overload of work that could affect your mental well-being? (Q= and Q7= and Q8= and Q9= and Q0= and Q=) don t ask Q In, one of the choices is YES don t ask Q Q COL. 0 Q COL. 0 violence or threat of voilence that could affect your mental well-being? harressment or bullying that could affect your mental well-being? Ask employed persons in the reference week (WSTATOR=,) Q COL. 0 Which of these factors you consider to be the GREATEST risk to your mental well-being? to severe time pressure or overload of work to violence or threat of voilence to harressment or bullying (Q = and Q= and Q=) don t ask Q In, one of the choices is YES don t ask Q