Work-related maritime fatalities

All maritime fatalities investigated by Coroners that occurred in Australia from 1992 to 1998 inclusive have been collated, coded and recorded in the Australian Boating Injury Database: Fatal Injury (ABID:FI). This article focuses on the work-related maritime fatalities recorded in the database. Over the period 1992-1998 there were 74 fatalities involving people who were working for income at the time of the incident: 46 commercial fishermen, 12 seamen involved in the transport of cargo and 16 miscellaneous workers. The fatality rate of commercial fishermen has declined substantially in Australia over recent years. The main contributing factors were: hazardous conditions; an error of judgement; unsafe work practices; and failure to wear a personal flotation device (PFD) in circumstances where, in the opinion of the Coroners, it would have saved life. Hazardous conditions were much more of a factor in fishermen deaths than in other maritime deaths. Most vessels involved had an insufficient number of PFDs for the number of crew on board. The Australian fatal injury database should be updated with the details of recent fatalities in order to further monitor safety performance, causal factors and prevention measures in the maritime industry in Australia. Attention should be focused on reducing alcohol use and increasing PFD availability and usage. In order to continue to improve safety, it is essential that a constructive dialogue is maintained with industry sources, informed by independent research and up-to-date information.     

Developing a tool to measure safe recreational boating practice

To reduce the number of recreational boating injuries and incidents, appropriate educational measures are important to improve boat operator safety practice. A tool (the boating safety scale (BSS)) to measure safe practice was developed and tested among Western Australian recreational boaters. The BSS allowed the identification of factors influencing safety behaviour among recreational boaters. Using a database of registered recreational vessels, a telephone survey was conducted in 2008 among a sample of 1002 boat owners and a response fraction of 47.5% was achieved. The majority of boaters displayed a moderate level of safe boating behaviour based on BSS scores. Not being a member of a boating association and going boating less often in protected waters was associated with a higher level of boating safety behaviour. With further development, the BSS can provide information to assist is designing effective intervention strategies to reduce the number of boating-related fatalities, injuries and incidents.     

Alcohol consumption among recreational boaters: factors for intervention

Recreational boating is a popular leisure time activity in many countries. It is estimated that, in Australia, boating incidents cause more harm than rail and air crashes combined and, in terms of transport, are second only to motor vehicle crashes as a cause of serious injury. The consumption of alcohol among recreational boaters is considered an important risk factor for fatalities and injuries among both operators and passengers. Using a database of all recreational vessels registered in Western Australia (WA), a sample of 500 adult boaters was recruited to participate in a telephone survey. The effects of demographic variables and boating characteristics upon the use of alcohol among recreational boaters on their last trip were explored using logistic regression. The odds of not having a drink were associated, after adjusting for age, with having completed a boating education course and with carrying children less than 12 years on board. The use of alcohol was not found to be prevalent among WA recreational boat owners. Based on these findings, it is recommended that efforts to decrease boating-related incidents, such as through education and legislation measures, be monitored over time to determine the effects of these strategies upon safety behaviours.     

Human error in recreational boating

Each year over 600 people die and more than 4000 are reported injured in recreational boating accidents. As with most other accidents, human error is the major contributor. U.S. Coast Guard reports of 3358 accidents were analyzed to identify errors in each of the boat types by which statistics are compiled: auxiliary (motor) sailboats, cabin motorboats, canoes and kayaks, house boats, personal watercraft, open motorboats, pontoon boats, row boats, sail-only boats. The individual errors were grouped into categories on the basis of similarities in the behavior involved. Those presented here are the categories accounting for at least 5% of all errors when summed across boat types. The most revealing and significant finding is the extent to which the errors vary across types. Since boating is carried out with one or two types of boats for long periods of time, effective accident prevention measures, including safety instruction, need to be geared to individual boat types.     

Examination of factors determining fault in two-vehicle motorcycle crashes

Motorcycle crashes frequently involve a combination of high-risk behaviors by the motorcyclist or the other crash-involved driver. Such behaviors may include riding or driving without appropriate licensure or while under the influence of alcohol, as well as deciding not to use a safety device such as a helmet or safety belt. Given that these factors frequently occur in combination with one another, it is difficult to untangle the specific effects of individual factors leading up to the crash outcome. This study assesses how various rider-, driver-, and other crash-specific factors contribute to at-fault status in two-vehicle motorcycle crashes, as well as how these same factors affect the propensity for other high-risk behaviors. Furthermore, the interrelationships among fault status and these other behaviors are also examined using a multivariate probit model. This model is developed using police-reported crash data for the years 2006–2010 from the State of Ohio. The results show that younger motorcyclists are more likely to be at-fault in the event of a collision, as are riders who are under the influence of alcohol, riding without insurance, or not wearing a helmet. Similarly, motorcyclists were less likely to be at-fault when the other driver was of younger age or was driving under the influence of alcohol, without insurance, or not wearing their safety belt. Crash-involved parties who engaged in one high-risk behavior were more likely to engage in other such behaviors, as well, and this finding was consistent for both motorcyclists and drivers. The results of this study suggest that educational and enforcement strategies aimed at addressing any one of these behaviors are likely to have tangential impacts on the other behaviors, as well.     

DWI enforcement programs: why are they not more effective?

Enforcement-oriented countermeasure programs to prevent alcohol-related fatal crashes in the United States have not been more effective because they have been based on a number of misconceptions. It is widely believed that (a) 50% of all traffic deaths involve alcohol, (b) alcohol-related fatal crashes are part of a continuum beginning with the minor fender bender, (c) one-third of all fatal crashes are caused by problem drinkers, (d) all problem drinkers, heavy drinkers in general and youth who drink are high-risk drivers and (e), that those arrested for DWI are of the same population as those involved in alcohol-related fatal crashes. It is further believed that mass arrests for DWI would reduce the number of alcohol-related fatal crashes.A review of the literature reveals that the proportion of all fatal crashes involving alcohol in some causal fashion is closer to 30% than to 50%, that relatively few alcoholics are high-risk drivers and that it is not alcohol alone that leads to crash involvement but alcohol in combination with such characteristics or conditions as alienation, hostility, aggression, and/or transient traumatic experiences.Mass arrests for DWI have not been effective in preventing alcohol-related deaths. The frequency of impaired driving episodes is believed to be of such magnitude and the relative likelihood of involvement in an alcohol-related fatal crash is so low that current DWI enforcement programs are regarded as inefficient means to prevent alcohol-related deaths. Recommendations to define the problem more clearly are presented.It is concluded that, if fatal crashes are the problem of concern (as opposed to the use of alcohol), the focus of research must be turned from drinking (per se) to the behavior, characteristics or conditions that precede or accompany fatal crashes, only some of which are triggered or exacerbated by alcohol. This approach would not only focus attention on the estimated 30% of all fatal crashes that involve alcohol, but on the other 70% as well.     

Risk factors for fatal crashes in rural Australia

This paper presents findings from the rural and remote road safety study, conducted in Queensland, Australia, from March 2004 till June 2007, and compares fatal crashes and non-fatal but serious crashes in respect of their environmental, vehicle and operator factors. During the study period there were 613 non-fatal crashes resulting in 684 hospitalised casualties and 119 fatal crashes resulting in 130 fatalities. Additional information from police sources was available on 103 fatal and 309 non-fatal serious crashes. Over three quarters of both fatal and hospitalised casualties were male and the median age in both groups was 34 years. Fatal crashes were more likely to involve speed, alcohol and violations of road rules and fatal crash victims were 2½ times more likely to be unrestrained inside the vehicle than non-fatal casualties, consistent with current international evidence. After controlling for human factors, vehicle and road conditions made a minimal contribution to the seriousness of the crash outcome. Targeted interventions to prevent fatalities on rural and remote roads should focus on reducing speed and drink driving and promoting seatbelt wearing.     

Epidemiology of accidental drowning in Denmark 1989–1993

Three hundred and forty-nine cases of accidental drowning or cooling in water occurring in Denmark from 1989 to 1993 have been studied. The incidence was highest in 0–4-year-old children, in middle-aged men, and in old people. A third of the children drowned in private pools. A quarter of all fatalities occurred during leisure boating. At least half of those that drowned in this way did not wear a life-jacket and could have been saved if they had been wearing one. Between a third and a half of the adult drownings were related to alcohol intake, and a large number of inebriated men fell into harbour basins and other water bodies. A few final remarks are made on the prospects for preventing accidental drowning in children, elderly people and adult males.     

The involvement of cold water in recreational boating fatalities—I2: causal analysis

Part 1 of this paper describes an intensive analysis of the recreational boating fatality history. The purpose of this analysis is to quantify the significance of hypothermia and other cold-related mechanisms as risks to recreational boaters. It is shown that approx. 16% of boating fatalities involve cold-related causes. Part II of this paper addresses a demographic analysis of the identified cold-related fatalities.     

Epidemiology of personal watercraft-related injury on Arkansas waterways, 1994-1997: identifying priorities for prevention

Personal watercraft (PWC) use has increased rapidly in the past ten years. Consequences of the increased use are collisions and injuries. This study was conducted to determine the etiology and the characteristics surrounding PWC collisions and injury associated with the use of these popular water recreational vehicles and determine countermeasures. Methods included obtaining boating accident reports limited to PWCs from the Arkansas Game and Fish Commission for the years 1994 through 1997. Results show that there were 126 incidents involving 141 vessels and over $156,000 (US) in property damage. Almost two-fifths of PWC users were injured, mainly head trauma and fractures to the lower limbs. There were five reported fatalities. Study suggests that PWC collisions and injury are increasing. With increased use and popularity, this trend will continue unless sustained efforts in prevention are established. Changes in policy, education and manufacturing standards need to be considered and initiated to provide for safe PWC operation and boating environment.     

Development of a standardized boating sobriety test

A sobriety test capable of being administered on boats was developed as an aid in establishing probable cause to request a breath sample of recreational boat operators suspected of being over the legal alcohol limit. In a laboratory phase some 12 candidate measures suitable for use in a boating environment were assessed for their relationship to blood alcohol levels through administration to 32 subjects tested at blood alcohol concentrations (BACs) of 0.00, 0.06 and 0.12%. Four measures showing significant relationships to BAC were then administered by marine police to a sample of 60 recreational boaters found to have BACs ranging from 0.0 to 0.20%. Three measures still showing significant relationships to alcohol were horizontal gaze Nystagmus given in a seated position, reciting the alphabet from A to Z, and clapping hands alternately with palm and back of hand, while counting. Correlation of the measures with BAC, and the ability to distinguish boaters over and under a 0.10% limit were similar to those found over the same BAC range with the standardized field sobriety test (SFST) for motor vehicle operators. Where there is not sufficient cause to request a boat operator to proceed to shore for testing, a standardized boating sobriety test (SBST) making use of the three measures appears to be a suitable replacement for the SFST.     

Drinking locations of drink-drivers: A comparative analysis of accident and nonaccident cases

This study utilizes data collected by the Perth (Australia) Traffic Police on the last drinking location of persons arrested for drink-driving either as a consequence of their being involved in a road traffic accident or as a result of failing a roadside breath test. A comparison of these data has found that significantly more persons involved in traffic accidents had been drinking at unlicensed locations, that is at private residences or in public places such as parks, than at licensed premises. It was also found that accident cases were more likely to involve males under 25 years; for those involved to have, on average, significantly higher blood alcohol levels than was the case for nonaccident drink-driving cases; and for most accidents to occur late at night and early morning. The significance of these findings were confirmed by logistic regression. A surprise incidental finding was that considerably more women had been arrested for drinkdriving than had been previously reported in other studies, both in Australia and overseas.     

Killer crashes: Fatal road traffic accidents in the UK

Road traffic accidents are responsible for over 3000 deaths per year in the UK, according to Department for Transport (2004a) figures. Although progress is being made in a number of areas, vehicle occupant fatalities have not been falling in line with casualty reduction targets for the year 2010. A sample of 1185 fatal vehicle occupant cases was considered, from ten UK police forces, from the years 1994-2005 inclusive. The main findings were: (1) over 65% of the accidents examined involved driving at excessive speed, a driver in excess of the legal alcohol limit, or the failure to wear a seat belt by a fatality, or some combination of these. (2) Young drivers have the great majority of their accidents by losing control on bends or curves, typically at night in rural areas and/or while driving for ‘leisure’ purposes. These accidents show high levels of speeding, alcohol involvement and recklessness. (3) Older drivers had fewer accidents, but those fatalities they were involved in tended to involve misjudgement and perceptual errors in ‘right of way’ collisions, typically in the daytime on rural rather than urban roads. Blameworthy right of way errors were notably high for drivers aged over 65 years, as a proportion of total fatal accidents in that age group.     

Driver risk factors for sleep-related crashes

A population-based case-control study was carried out to examine driver risk factors for sleep-related motor vehicle crashes. Cases included 312 drivers involved in recent North Carolina crashes and identified on police reports as asleep at the time of the crash and 155 drivers identified as fatigued. Controls were 529 drivers also involved in recent crashes but not identified as asleep or fatigued, and 407 drivers not involved in recent crashes. All drivers were contacted for brief telephone interviews. Results showed that drivers in sleep-related crashes were more likely to work multiple jobs, night shifts, or other unusual work schedules. They averaged fewer hours sleep per night, reported poorer quality sleep, were less likely to feel they got enough sleep, were sleepier during the day, drove more often late at night, and had more prior instances of drowsy driving. Compared to drivers in non-sleep-related crashes, they had been driving for longer times, been awake more hours, slept fewer hours the night before, and were more likely to have used soporific medications. Knowledge of specific risk factors for sleep-related crashes is an important first step in reducing the thousands of deaths and injuries each year in the US attributed to drowsy driving.     

Characteristics of fatal motorcycle crashes into roadside safety barriers in Australia and New Zealand

This paper reports on the findings of a retrospective case series study of fatal motorcyclist–roadside barrier collisions. Cases were retrieved from the National Coroners Information System (NCIS), the coronial case files of Australian jurisdictions, and the Crash Analysis System (CAS) of the New Zealand Transport Agency. Seventy seven (77) motorcycle fatalities involving a roadside barrier in Australia and New Zealand were examined. The fatalities usually involved a single vehicle crash and young men. The roadside barriers predominantly involved were steel W-beams, typically on a bend in the horizontal alignment of the road. A majority of fatalities occurred on a weekend, during daylight hours, on clear days with dry road surface conditions indicating predominantly recreational riding. Speeding and driving with a blood alcohol level higher than the legal limit contributed to a significant number of these fatalities.     

Britain's most hazardous occupation: Commercial fishing

The main objectives of this study were to investigate the causes and circumstances of all fatal work-related accidents in the UK fishing industry from 1996 to 2005, to compare fatal accident rates with those in all other British occupations and industries and in the general British workforce, and to establish long term trends in the fatal accident rate in UK fishing since 1919.Of 160 deaths from work-related accidents in the UK fishing industry from 1996 to 2005, 86 arose from incidents involving fishing vessels and 74 were from personal accidents, with a fatal accident rate of 102 per 100,000 fishermen-years. After fishermen, the next most hazardous occupations were dockers and stevedores (28 per 100,000), refuse and salvage workers (25), agricultural machinery drivers (18), steel erectors, road construction workers (both 15), roofers (13) and scaffolders (12). The fatal accident rate among fishermen was 115 times greater than in the general British workforce, while there has been little reduction in the fatal accident rate in the UK fishing industry in the last 60 years.This study shows that commercial fishing is by far the most hazardous occupation in Britain. Prevention of fatal accidents should focus on increased use of personal flotation devices, reductions in lone fishing and the use of unstable, unseaworthy and badly maintained fishing vessels.     

Comparison of factors influencing emergency department visits and hospitalization among drivers in work and nonwork-related motor vehicle crashes in Utah, 1999-2005

This study identified contributing factors in the occurrence of motor vehicle crashes (MVCs) and the severity of crashes according to work-related status in Utah. Analyses were based on probabilistically linked data involving police crash reports and hospital inpatient and emergency department (ED) records for the years1999–2005. Of 643,647 drivers involved in crashes, 73,437 (11.4%) went to the emergency department (ED) and 4989 (0.8%) were hospitalized. Of the drivers in crashes visiting the ED, 2330 (3.2%) were working at the time of the crash and of drivers in crashes who were hospitalized, 235 (4.7%) were working at the time of the crash. There was no significant difference between those working versus not working at the time of the crash in safety belt use (82% [53,947/66,188] for ED cases and 60% [2,489/4,176] for hospitalized cases) or fatigue (4% [2,697/70,536] for ED cases and 9% [450/4,824] for hospitalized cases) among drivers in crashes, but there was a significant difference with respect to alcohol drinking between workers versus nonworkers (ED: 1% [31/2,237] vs. 5% [3,455/68,299], P < 0.001; hospitalized: 3% [7/228] vs. 15% [673/4,596], P < 0.001). Of those attending the ED because of a crash, workers were significantly more likely to have broken bones, bleeding wounds, or to die. Of those hospitalized because of a crash, workers were significantly less likely to have caused the crash (65% [145/223] vs. 73% [3,315/4,566], P < 0.001). Yet although those drivers who were working at the time of the crash compared with those not working were less likely to have alcohol involved or to have caused the crash, there remains room for improvement among workers with respect to these factors, as well as safety belt use and fatigue.     

The effects of drink-driving checkpoints on crashes—A meta-analysis

A meta-analysis has been conducted on the effects on crashes of DUI-checkpoints (DUI, driving under the influence). The results indicate that crashes involving alcohol are reduced by 17% at a minimum and that all crashes, independent of alcohol involvement, are reduced by about 10–15%. In a moderator analysis the effects of a number of factors that may affect the effectiveness of DUI-checkpoints were investigated by means of subgroup analyses and meta-regression. Those moderator variables that were found to be most relevant, are the time period studied, country, and study design. DUI-checkpoints were found to be most effective during the first half year. Australian checkpoints were found to be more effective than checkpoints in other countries. Smaller crash reductions were found in studies that have applied a control group than in other studies. Testing all drivers who are stopped at a checkpoint may improve the effectiveness of DUI-checkpoints. The results do not indicate that DUI-checkpoints have greater effects on more severe crashes or that the use of paid publicity improves the effectiveness. Most likely there are further factors that affect the effectiveness of DUI-checkpoints that could not be investigated in the present analysis.     

Effect of the helmet act for motorcyclists in Thailand

OBJECTIVES: This study investigated the effect of the helmet act for motorcyclists on increasing helmet use and reducing motorcycle-related deaths and severe injuries in Thailand. METHODS: Data were derived from a trauma registry at the Khon Kaen Regional Hospital in the northeast Thailand. Helmet use and outcome in motorcycle crashes were compared 2 years before (1994-1995) and after (1996-1997) enforcement of the helmet act. During the study period, there were 12002 injured motorcyclists including 129 death cases in the municipality of Khon Kaen Province who were brought to the regional hospital. RESULTS: After enforcement of the helmet act, helmet-wearers increased five-fold while head injuries decreased by 41.4% and deaths by 20.8%. Those who had head or neck injuries or died were less likely wearing a helmet. Compliance of helmet use was lower at night. Fatality of injured motorcyclists did not significantly decrease in the post-act period and among helmet-wearers. CONCLUSION: Enforcement of the helmet act increased helmet-wearers among motorcyclists but helmet use did not significantly reduce deaths among injured motorcyclists. Motorcyclists should be instructed to properly and consistently wear a helmet for their safety.     

A review of research on the protection afforded to occupants of cars by seat belts which provide upper torso restraint

The paper presents a critical review and summary of research on the protection afforded to car occupants by seat belts which provide upper torso restraint. The nature and causes of the injuries which occur even when seat belts are worn are then considered, and methods of reducing injuries still further are suggested.

Summaries are given of 8 selected European and American papers on seat belts in accidents. The estimated reductions in serious injuries varied from 45 to 70%, and reasons are suggested for the occurrence of these differences. Evidence of the reduction in deaths, as opposed to serious injuries, when seat belts are worn is scanty, but Australian experience of the results of compulsory seat belt wearing suggest that the wearing of seat belts with upper torso restraint reduces deaths of car occupants by at least 40%.

In non-fatal accidents to belted occupants, head, chest and leg injuries give rise to the largest numbers of severe injuries (AIS >3). In fatalities to belted occupants, however, while head injury retains its premier position, abdominal injury is at least as important as chest injury.

Modifications to the design of lap and diagonal seat belts are suggested, (a) to restrict loads on the abdomen and chest to levels which will not result in serious injury, and (b) to reduce forward movement of the head so as to lessen the risk of head injury.