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PubMed · 11760703

Incident analysis.

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2001. Incident analysis.. https://pubmed.ncbi.nlm.nih.gov/11760703/

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Factors contributing to construction injury at Denver International Airport.

BACKGROUND: Detailed information about factors contributing to construction injury is important to support design of safety programs directed at particular risks. METHODS: We linked over 4,000 injury reports, including text describing injury events, with an administrative workers' compensation (WC) database, and, using Haddon's matrix as a framework, classified factors contributing to injury during construction of Denver International Airport (DIA). RESULTS: Patterns of contributing factors varied according to injury mechanism and type of work: environmental factors contributed more than any other factor to slip/trip injuries, and building materials contributed to more than 40% of injuries to workers in carpentry, concrete construction, glass installation, and roofing. Rates at which factors contributed to injury also varied among types of work: environmental factors contributed at relatively high rates to injuries in glass installation, metal/steel installation and iron/steel erection >or= 2 stories, and victim factors contributed at high rates to conduit construction and metal/steel installation injuries. WC payment rates for different factors varied widely, ranging from $0.53/$100 payroll to $3.08/$100. DISCUSSION: This approach allows systematic analysis of classes of injuries, contributing factors, types of work, and other variables to assist in setting prevention priorities.

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Concentration-dependent TCDD elimination kinetics in humans: toxicokinetic modeling for moderately to highly exposed adults from Seveso, Italy, and Vienna, Austria, and impact on dose estimates for the NIOSH cohort.

Serial measurements of serum lipid 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) concentrations in 36 adults from Seveso, Italy, and three patients from Vienna, Austria, with initial serum lipid TCDD concentrations ranging from 130 to 144,000 ppt, were modeled using a modified version of a previously published toxicokinetic model for the distribution and elimination of dioxins. The original model structure accounted for a concentration-dependent increase in overall elimination rate for TCDD due to nonlinear distribution of TCDD to the liver (secondary to induction of the binding protein CYP1A2), from which elimination takes place via a first-order process. The original model structure was modified to include elimination due to lipid partitioning of TCDD from circulation into the large intestine, based on published human data. We optimized the fit of the modified model to the data by varying the hepatic elimination rate parameter for each of the 39 people. The model fits indicate that there is significant interindividual variability of TCDD elimination efficiency in humans and also demonstrate faster elimination in men compared to women, and in younger vs. older persons. The data and model results indicate that, for males, the mean apparent half-life for TCDD (as reflected in changes in predicted serum lipid TCDD level) ranges from less than 3 years at serum lipid levels above 10,000 ppt to over 10 years at serum lipid levels below 50 ppt. Application of the model to serum sampling data from the cohort of US herbicide-manufacturing workers assembled by the National Institute of Occupational Safety and Health (NIOSH) indicates that previous estimates of peak serum lipid TCDD concentrations in dioxin-exposed manufacturing workers, based on first-order back-extrapolations with half-lives of 7-9 years, may have underestimated the maximum concentrations in these workers and other occupational cohorts by several-fold to an order of magnitude or more. Such dose estimates, based on a single sampling point decades after last exposure, are highly variable and dependent on a variety of assumptions and factors that cannot be fully determined, including interindividual variations in elimination efficiency. Dose estimates for these cohorts should be re-evaluated in light of the demonstration of concentration-dependent elimination kinetics for TCDD, and the large degree of uncertainty in back-calculated dose estimates should be explicitly incorporated in quantitative estimates of TCDD's carcinogenic potency based on such data.

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Victims twice over: perceptions and experiences of injured workers.

The authors discuss the qualitative component of a participatory research project conducted in Toronto, Ontario, between 1999 and 2001. Injured workers, who were trained as peer researchers, conducted one-time, semistructured interviews with other injured workers (N = 17) and helped with inductive coding and analyzing the interview transcripts. The qualitative research group consisted of seven peer researchers, four academic researchers, and a community legal worker. The group recruited interviewees by advertising on bulletin boards and in newsletters and newspapers, and selected a diverse group of interviewees who had encountered problems with the return-to-work process. Interviewees believed that the process victimizes them and renders them powerless and dependent on others. Furthermore, they considered that health professionals and bureaucrats impede their rehabilitation. The authors suggest that injured workers should be included in the decision-making process of rehabilitation and rebuilding their lives.

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