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A E Lincoln

Publications and source records attributed to A E Lincoln.

8 recordsLinked to original sources
PubMed2004

Using narrative text and coded data to develop hazard scenarios for occupational injury interventions.

OBJECTIVE: To determine whether narrative text in safety reports contains sufficient information regarding contributing factors and precipitating mechanisms to prioritize occupational back injury prevention strategies.Design, setting, subjects, and MAIN OUTCOME MEASURES: Nine essential data elements were identified in narratives and coded sections of safety reports for each of 94 cases of back injuries to United States Army truck drivers reported to the United States Army Safety Center between 1987 and 1997. The essential elements of each case were used to reconstruct standardized event sequences. A taxonomy of the event sequences was then developed to identify common hazard scenarios and opportunities for primary interventions. RESULTS: Coded data typically only identified five data elements (broad activity, task, event/exposure, nature of injury, and outcomes) while narratives provided additional elements (contributing factor, precipitating mechanism, primary source) essential for developing our taxonomy. Three hazard scenarios were associated with back injuries among Army truck drivers accounting for 83% of cases: struck by/against events during motor vehicle crashes; falls resulting from slips/trips or loss of balance; and overexertion from lifting activities. CONCLUSIONS: Coded data from safety investigations lacked sufficient information to thoroughly characterize the injury event. However, the combination of existing narrative text (similar to that collected by many injury surveillance systems) and coded data enabled us to develop a more complete taxonomy of injury event characteristics and identify common hazard scenarios. This study demonstrates that narrative text can provide the additional information on contributing factors and precipitating mechanisms needed to target prevention strategies.

Accidental Falls↗
PubMed2001

Clinical tools to facilitate workplace accommodation after treatment for an upper extremity disorder.

Failure to implement work site accommodations for work-related upper extremity disorders (WRUEDs) may be a factor contributing to delayed functional recovery and relapse. The present study describes the use of the 38-item Job Requirements and Physical Demands (JRPD) scale, a self-report measure of ergonomic exposure, and other case management tools to improve accommodation efforts for 101 workers (75 women, 26 men) returning to work after lost time related to a WRUED. Items were categorized into five subscales based on item content: administrative, computer-related, workstation design, environmental, and equipment. Administrative risk factors were elevated among office clerks, whereas postal clerks and letter carriers reported more workstation design risk factors, and letter carriers and electrical/mechanical workers cited more equipment-related risk factors (p < 0.05). All occupational categories rated computer-related risk factors highest. The Integrated Case Management (ICM) approach, which relies on the JRPD scale to guide recommendations, was used with a subgroup of these workers (n = 53), resulting in 1.4 times more workplace accommodations per worker than with a non-ICM approach. Clinical use of the self-reported exposure measure within the overall workplace accommodation process may have been a factor contributing to more frequent accommodation in the ICM group. This study of a subgroup of workers' compensation cases highlights the need for additional investigation of tools to integrate ergonomic approaches within the workplace accommodation process.

Arm Injuries↗
PubMed2001

Case management services for work related upper extremity disorders. Integrating workplace accommodation and problem solving.

A case manager's ability to obtain worksite accommodations and engage workers in active problem solving may improve health and return to work outcomes for clients with work related upper extremity disorders (WRUEDs). This study examines the feasibility of a 2 day training seminar to help nurse case managers identify ergonomic risk factors, provide accommodation, and conduct problem solving skills training with workers' compensation claimants recovering from WRUEDs. Eight procedural steps to this case management approach were identified, translated into a training workshop format, and conveyed to 65 randomly selected case managers. Results indicate moderate to high self ratings of confidence to perform ergonomic assessments (mean = 7.5 of 10) and to provide problem solving skills training (mean = 7.2 of 10) after the seminar. This training format was suitable to experienced case managers and generated a moderate to high level of confidence to use this case management approach.

Arm↗
PubMed2000

Ocular trauma in the United States Army: hospitalization records from 1985 through 1994.

PURPOSE: To determine the incidence of hospitalized ocular injury in the United States Army and evaluate specific types and external causes of these injuries. METHODS: A US Army database that captured all hospital discharge records for Army personnel admitted to military and civilian hospitals was used to determine incident episodes of ocular injury requiring hospitalization from 1985 through 1994. Denominator data were available from the US Army. RESULTS: The average annual incidence of hospitalization for a principal or secondary diagnosis of ocular trauma (total hospitalized ocular injury) was 77.1 per 100,000 persons (95% confidence interval, 75.1-79.2). There was a 38% decline in the rate of total hospitalized ocular injury during this 10-year period. Men had twice the rates of women over all age groups. The highest rate occurred in the 17- to 19-year age group, with rates of 220.7 and 123.4 per 100,000 in men and women, respectively. Whites had a higher rate than blacks and nonwhites-nonblacks. Almost a third of the injuries were contusions of the eye and adnexa. Among men, the leading causes were machinery or tools (21%), fights (18%), transport accidents (18%), and sports and training (11%). Only 7% were related to weaponry or war, and of these, 90% were from nonbattle activities. CONCLUSION: The type and cause of injury suggest that preventive measures may be effective in decreasing the incidence of ocular trauma requiring hospitalization in US Army personnel.

Adolescent↗
PubMed2000

Interventions for the primary prevention of work-related carpal tunnel syndrome.

OBJECTIVE: To evaluate interventions for the primary prevention of work-related carpal tunnel syndrome (CTS). SELECTION CRITERIA: Studies had to include an engineering, administrative, personal, or multiple component intervention applied to a working or working-age population. All study designs that included comparison data were considered. Outcome measures included the incidence, symptoms, or risk factors for CTS, or a work-related musculoskeletal disorder of the upper extremity that included CTS in the definition. RESULTS: Twenty-four studies met our inclusion criteria. Engineering interventions included alternative keyboards, computer mouse designs and wrist supports, keyboard support systems, and tool redesign. Personal interventions included ergonomics training, splint wearing, electromyographic biofeedback, and on-the-job exercise programs. Multiple component interventions (e.g., ergonomic programs) included workstation redesign, establishment of an ergonomics task force, job rotation, ergonomics training, and restricted duty provisions. Multiple component programs were associated with reduced incidence rates of CTS, but the results are inconclusive because they did not adequately control for potential confounders. Several engineering interventions positively influenced risk factors associated with CTS, but the evaluations did not measure disease incidence. None of the personal interventions alone was associated with significant changes in symptoms or risk factors. All of the studies had important methodologic limitations that may affect the validity of the results. CONCLUSIONS: While results from several studies suggest that multiple component ergonomics programs, alternative keyboard supports, and mouse and tool redesign may be beneficial, none of the studies conclusively demonstrates that the interventions would result in the primary prevention of carpal tunnel syndrome in a working population. Given the societal impact of CTS, the growing number of commercial remedies, and their lack of demonstrated effec- tiveness, the need for more rigorous and long-term evaluation of interventions is clear. Fund- ing for intervention research should prioritize randomized controlled trials that include: (1) adequate sample size, (2) adjustment for relevant confounding variables, (3) isolation of speci- fic program elements, and (4) measurement of long-term primary outcomes such as the inci- dence of CTS, and secondary outcomes such as employment status and cost.

Carpal Tunnel Syndrome↗
PubMed2000

Sports and physical training injury hospitalizations in the army.

INTRODUCTION: Injuries are the leading health problem in the military services. Sports and physical training activities are an area in which a substantial number of injuries can occur. Although athletic injuries are not often investigated in military populations, the Armed Forces database provides a unique opportunity to investigate sports injuries. METHODS: An Army database of all hospital admissions for active duty Army personnel in the 1989-1994 period was used to study injuries resulting from sports and Army physical training. RESULTS: For the 6-year time period reviewed, there were 13,861 hospital admissions for injuries resulting from sports or Army physical training: 94% (13,020) of these admissions were men and 6% (841) were women. The rates of sports injuries were 38 and 18 per 10,000 person-years for men and women, respectively. Sports injuries accounted for an average of 29,435 lost duty days each year: Men lost an average of 13 days per injury and women lost an average of 11 days per injury. Acute musculoskeletal injuries in the categories of fractures, sprains/strains, and dislocations accounted for 82% of all injuries. The knee was the most often injured body area in both genders, with the anterior cruciate ligament (ACL) identified as the most frequently injured body part overall. The top seven injuries were virtually identical for men and women, with only slight variations in order. Although the rates of all hospitalized sports injuries were higher for men than women, women had a higher proportion of ACL injuries from basketball and softball, ankle fractures from softball and head injuries from basketball. For men, football and basketball contributed to the highest rates of injuries. The highest injury rates for women were from Army physical training and basketball. For both men and women, Army physical training was the leading cause of lumbosacral strains. CONCLUSIONS: Sports and Army physical training injuries account for a significant amount of lost duty time and impact military readiness.

Adolescent↗
PubMedDate not supplied

Using multiple information sources to identify opportunities for ergonomic interventions in automotive parts distribution: a case study.

An essential activity in any ergonomics program is determining specific work locations and activities where physical demands place workers at increased risk of sustaining an overexertion injury. To do this, safety and health professionals rely on a variety of information sources to identify and prioritize opportunities for ergonomic interventions. As part of a 4-year project to reduce overexertion injuries in the service parts division of a major auto maker, a study was performed in 19 parts distribution centers to evaluate the contributions of the following information sources in identifying specific high-risk work locations and activities: (1) archival medical/injury records, (2) identification of "problem tasks" by plant-based ergonomic committees, (3) facility walk-throughs by experienced ergonomists, and (4) detailed ergonomic job analyses. Archival records were not particularly useful in identifying high-risk activities because essential exposure information (e.g., task, work location) was not documented. Walk-throughs and detailed ergonomic analyses were partially effective in identifying high-risk activities; however, in some cases the observation time was too short to observe peak exposures. Ergonomic committees were generally effective in identifying specific high-risk tasks and work locations. Rankings of "problem tasks" from multiple sites identified consensus division-wide ergonomic concerns. Detailed ergonomic job analyses confirmed that these tasks had high exposure to ergonomic risk factors. This study demonstrated potential pitfalls in relying on a single information source to identify work locations and activities that place workers at increased risk of overexertion injury.

Automobiles↗