Lipscomb Hester J, Schoenfisch Ashley L, Cameron Wilfrid, Kucera Kristen L, Adams Darrin, Silverstein Barbara A
Division of Occupational Medicine, Duke University Medical Center, Durham, North Carolina.
Am J Ind Med. 2014 Jan;57(1):69-77. doi: 10.1002/ajim.22234. Epub 2013 Aug 22.
Falls from height (FFH) continue to cause significant morbidity and mortality across the construction industry.
By linking data on work hours with workers' compensation records, rates of work-related injuries resulting from FFH and associated days away from work were evaluated among a large cohort (n = 24,830) of union carpenters in Washington State from 1989 to 2008. Using Poisson regression we assessed rates of FFH over the 20-year period while adjusting for temporal trend in other work-related injuries. Patterns of paid lost days (PLDs) were assessed with negative binomial regression.
Crude rates of FFH decreased 82% over the 20-year period. Reductions were more modest and without demonstrable change since 1996 when adjusting for the temporal reduction in other injuries. Younger workers had higher injury rates; older workers lost more days following falls. Rates of PLDs associated with falls decreased over time, but there was not a consistent decline in mean lost days per fall.
These patterns are consistent with decreased FFH for several years surrounding state (1991) and then federal (1994) fall standards; the decline during this time period exceeded those seen in injury rates overall in this cohort. While crude rates of FFH have continued to decline, the decline is not as substantial as that seen for other types of injuries. This could reflect a variety of things including more global efforts designed to control risk (site planning, safety accountability) and changes in reporting practices.
高处坠落事故在整个建筑行业中持续导致严重的发病和死亡情况。
通过将工作时长数据与工人赔偿记录相联系，对华盛顿州1989年至2008年期间一大群（n = 24,830）工会木匠中因高处坠落导致的与工作相关的伤害率及相关缺勤天数进行了评估。我们使用泊松回归评估了20年期间的高处坠落率，同时对其他与工作相关伤害的时间趋势进行了调整。使用负二项回归评估了带薪缺勤天数的模式。
在20年期间，高处坠落的粗发生率下降了82%。自1996年以来，在对其他伤害的时间性减少进行调整后，下降幅度更为适度且没有明显变化。年轻工人的伤害率更高；年长工人坠落后缺勤天数更多。与坠落相关的带薪缺勤天数随着时间的推移而减少，但每次坠落的平均缺勤天数并没有持续下降。
这些模式与在州（1991年）和随后联邦（1994年）的坠落标准出台后的几年里高处坠落率下降相一致；在此期间的下降幅度超过了该队列中总体伤害率的下降幅度。虽然高处坠落的粗发生率持续下降，但下降幅度不如其他类型伤害那么大。这可能反映了多种情况，包括旨在控制风险的更全面努力（现场规划、安全问责制）以及报告做法的变化。
