Using Fatality Data for Action

Fatal injury surveillance is the ongoing and systematic collection,
analysis, interpretation and dissemination of fatal injury information.
Ideally, a surveillance system produces data that describe the size and
characteristics of the fatality problem, the populations at risk, risk
factors, and trends.  Using this information it is possible to design
interventions to prevent fatal injuries and to evaluate the impact of
the interventions.

For the past year, the MACOSH Committee has been discussing the need to
understand where the fatal injuries are occurring in the various Marine
Industries so that we can understand where we should place our focus to
have the largest impact during our tenure on the committee.

Review of National Surveillance Data

 MACOSH requested a presentation from the Bureau of Labor Statistics
(BLS) to review the injuries and fatalities experienced by the Marine
Cargo Handling and Ship Building and Repair Industry sectors.  In
January 2010, BLS presented fatality data from the Census of Fatal
Occupational Injuries (CFOI).

CFOI includes all work-related injury fatalities that occur in the
United States, including the 200-mile offshore economic zone.  The
census is collected on the state level and includes self-employed,
public and private sector, all industries and volunteer workers. 
Fatalities are coded for industry, occupation, general characteristics. 
See Table 1.

Table 1:  Variables of the Census of Fatal Occupational Injuries

Variable name	Coding System	More Specifics

Industry	North America Industry Classification System (NAICS)	NAICS
336611 and NAICS 488320

Occupation	Standard Occupational Classification (SOC)

	Characteristics	Occupational Injury and Illness Classification System
(OIICS)	Nature of Injury

Part of Body

Event/Exposure

Source of Injury

  

Results

Ship Building and Repair

From 2003-2008 the Ship Building and Repair sector experienced 42
fatalities.  Each year, the industry suffered from 3-12 fatalities with
and average of 7 fatalities a year.  Information was then presented
regarding the manner in which the fatality occurred (Table 2).  Data
from CFOI is first divided into broad categories of Transportation,
Contact with Objects and Equipment, Falls, Harmful Substances and
Environments.  Then these categories are broken down further to get more
specific.  The middle row of Table 2 has more details of what types of
fatalities were experienced.  The leading causes in the table were Falls
from Ship 19%, Other Falls 14%, and being struck by falling objects 14%.

Table 2:  Manner in which the Ship Building and Repairing fatalities
occurred, 2003-2008, n=42.

General Categories of Fatalities	Sub-categories	Number*, Percent of all
fatalities

Transportation	Falls from Ship	8, 19%

	Other transportation	1, 2%

Contact with Objects and Equipment	Struck by falling objects	6, 14%

	Caught in or between	5, 12%

	Other contact w/ objects and equipment	3, 7%

Falls	Falls	6, 14%

Harmful Substances/ Environments	Electrocution	3, 7%

	Drowning	3, 7%

	Other harmful substances/ environments	2, 3%

Other	Other	6, 15%

*The numbers should be checked by BLS to get correct numbers for the
final document.  

Marine Cargo Handling

From 2003-2008 the Marine Cargo Handling industry sector experienced 69
fatalities.  Each year, the industry suffered from 7-16 fatalities with
an average of 12 fatalities a year.  Information can then be broken down
into the manner in which the fatality occurred (Table 3).  Data from
CFOI is first divided into broad categories of Transportation, Contact
with Objects and Equipment, Harmful Substances and Environments.  Then
these categories are broken down further to get more specific.  The
middle row of Table 3 has more details of what types of fatalities were
experienced.  The leading types of fatal events were Worker struck by
vehicle 25%, Stuck by falling objects 19% and Falls on or from ship 12%.
 

Table 3:  Manner in which the Marine Cargo Handling fatalities occurred,
2003-2008, n=69.

General Categories of Fatalities	Sub-categories	Number*, Percent of all
fatalities

Transportation	Worker struck by vehicle	17, 25%

	Fall on or from ship	8, 12%

	Non-highway transportation	6, 9%

	Other transportation	1, 2%

Contact with Objects and Equipment	Struck by falling objects	13, 19%

	Other struck by	7, 10%

	Other contact	6, 9%

Harmful Substances/ Environments

5, 7%

Other

5, 7%

*The numbers should be checked by BLS to get correct numbers for the
final document.

What do the data mean and how can the committee use them?

Although CFOI is a national surveillance system and does not answer all
of the questions we would like, there are some things we can learn from
just these two tables.  

What the data tell us…

For the Ship Building and Repairing industry sector note that 33% of the
fatalities are due to falls (19% from the ship and 14% other falls).  So
1/3 of the fatality problem is due to falls.  In addition, another 1/3
or 33% of the fatalities are due to Contact with Objects and Equipment. 
Understanding how these events occur, when, to whom and from what cause
is the next step in understanding how to prevent them.  The Committee
can ask for more data from BLS as well as looking into other data
sources that may not be national, but regional in scope.  The committee
can also learn from scientists working in the area of fall prevention
and doing any research in avoiding contact with objects and equipment. 
What resources or tools exist that can be adapted or modified to the
workers at risk that we are concerned with.

For the Marine Cargo Handling sector note that 25% of the fatalities are
due to being struck by a vehicle and another 9% are from some
non-highway transportation source.  There should be a continued effort
to understand these fatalities.  Like the Ship Building and Repairing
industry sector, many fatalities (38%) are due to Contact with Objects
and Equipment.  Reviewing the source of these injuries may reveal areas
to focus interventions.  

Commercial Fishing as an example

The United States has not had a comprehensive surveillance system for
fatalities in the commercial fishing industry,, until now.  Although the
US Coast Guard does enter information about cases they investigate into
a tracking system and CFOI has limited information about all fishing
fatalities, there was a need for more in depth information to figure out
where the problems are in the fishing industry and what to do about
them.  NIOSH developed the Commercial Fishing Incident Database (CFID)
to collect and analyze data on fatalities in the entire US commercial
fishing industry since 2000.  The purpose of this surveillance system is
to identify high risk fisheries in the US and to identify the risk
factors that contribute to fatal incidents.  

Data for CFID are collected from multiple sources, including the US
Coast Guard, law enforcement agencies, and state-based occupational
fatality surveillance programs.  CFID includes information specific to
each incident including vessel characteristics, environmental factors,
and victim characteristics.  Using data from this new surveillance
system, a descriptive analysis of fatalities for most areas of the
country has been completed.

Each region and fishery of the US examined had different risk factors
for fatalities, for which different prevention efforts must be tailored.
 On the West Coast, there were 66 fatalities during 2000-2007.  These
fatalities resulted from vessel loss (74%) and falls overboard (19%). 
The Dungeness crab fishery had the highest number of fatalities, almost
all due to vessels sinking and capsizing.  In New England, 80 fatalities
occurred during 2000-2007.  In the lobster fishery, 56% of fatalities
were caused by falls overboard.  By contrast, in the scallop fishery,
only 11% were due to falls overboard.

Detailed fatality surveillance can reveal unique risk factors in
different fisheries of a country, and identify the worst problems. 
Interventions should be tailored to various fisheries and should be
based on a sound scientific assessment.  Other industries may be able to
implement surveillance systems similar to CFID to better understand the
safety problems in their unique work settings.

Each year data from CFOI reminds us that fishermen have the highest
occupational fatality rate of any occupation in the country.  Now we
have CFID and NIOSH is working with partners, including fishermen,
across the country on tailored solutions to improve safety regionally. 
These partners are the experts in their industry or fishery.  Particular
pieces of the project, interventions, or the way data are presented are
adjusted to address the needs of the partners.  The data identify the
hazard and together we figure out what to do.

Ideal System to Identify and Mitigate Hazards based on surveillance
data

The use of CFOI statistics provides broad based and reliable data for
tracking these industry sector fatalities.  However, more information is
needed that cannot be found in a national system that is collecting
information for all work-place fatalities.  Systems looking at specific
industries (like CFID for the commercial fishing industry) are necessary
to understand the intervention points.  On-site investigations also
allow for more specific recommendations and better understanding of the
industry hazards.  A working knowledge of the industry is also
important.  Safety experts are invaluable in identifying problems or
emerging problems.  The data also provides a check to see if these
problems truly exist.  There is a role for both processes in our work as
a committee as well.

Figure 1:  An Illustration of how the Census of Fatal Occupational
Injuries, specific surveillance systems, and Industry Safety and Health
Professionals can be used together to understand hazards and
intervention points.

 

How do we move forward?

Based on the most recent 6 years of data,  MACOSH, in conjunction with
the agency should start to learn more about why these fatalities and
hazards associated with falls, contact with objects and equipment, and
being struck by vehicles occur.

Recommendations

Obtain more information from BLS regarding the primary and secondary
source for contact with objects and equipment.

Seek other data sources as well to understand in greater detail what
these patterns of injuries are.

Invite experts who are working in the area of safety research
investigating the causes and intervention points regarding falls,
contact with objects and equipment, and being struck by vehicles in
these industries or similar industries to see what can be applied.  

Understand what the committee can do to offer tools to the industry

Review injury data in a similar way as we have reviewed the fatality
data

