Northeast Center for Occupational Health and Safety in Agriculture, Forestry, and Fishing (NEC), Bassett Medical Center, Cooperstown, New York, USA.
Bassett Medical Center, Bassett Research Institute, Cooperstown, New York, USA.
Am J Ind Med. 2023 Oct;66(10):866-875. doi: 10.1002/ajim.23518. Epub 2023 Jul 24.
Despite dramatic improvements in safety, logging remains one of the most dangerous industries in the United States. The purpose of this study was to explore longitudinal injury trends among Maine logging workers.
Loggers participated in seven quarterly surveys, over the course of 18 months. Categorical and free text data related to traumatic and acute injury, musculoskeletal disorders (MSD), and chronic pain were exported from REDCap into SAS 9.4, Excel, and NVivo, for quantitative and qualitative analysis, respectively. Time to injury was modeled using two different approaches: (1) time to the occurrence of first injury modeled by proportional hazard regression and (2) an intensity model for injury frequency. Two research team members also analyzed qualitative data using a content analysis approach.
During the study, 204 injuries were reported. Of the 154 participants, 93 (60.4%) reported musculoskeletal pain on at least one survey. The majority of injuries were traumatic, including fractures, sprains, and strains. Lack of health insurance was found to be related to increased risk of first injury [HR = 1.41, 95% CI = 0.97-2.04, p = 0.069]. Variables found to be related to injury intensity at the univariate level were: (1) a lack of health insurance [HR = 1.51, 95% CI = 1.04-2.20, p = 0.030], (2) age [HR for 10-year age increase;= 1.12, 95% CI = 0.99-1.27, p = 0.082], and (3) years employed in logging industry [HR for 10-year increase = 1.12, 95% CI = 0.99-1.26, p = 0.052]. Seeking medical attention for injury was not a priority for this cohort, and narratives revealed a trend for self-assessment. A variety of barriers, including finances, prevented loggers from seeking medical attention.
We found that loggers still experience serious, and sometimes disabling, injuries associated with their work. It was unsurprising that many injuries were due to slips, trips, and falls, along with contact with logging equipment and trees/logs. The narratives revealed various obstacles preventing loggers from achieving optimal health. Examples included geographic distance from healthcare, lack of time to access care, and entrenched values that prioritized independence and traditional masculinity. Financial considerations were also consistently cited as a primary barrier to adequate care.
There is a continued need to emphasize occupational health and safety in the logging industry. Implementation of relevant safety programs is key, but it is likely that the benefits of these will not be fully realized until a cultural shift takes place within this industry.
尽管安全状况有了显著改善,但伐木仍是美国最危险的行业之一。本研究旨在探讨缅因州伐木工人的纵向伤害趋势。
伐木工人参加了七次季度调查,历时 18 个月。与创伤和急性损伤、肌肉骨骼疾病 (MSD) 和慢性疼痛相关的分类和自由文本数据从 REDCap 导出到 SAS 9.4、Excel 和 NVivo,分别进行定量和定性分析。使用两种不同的方法对受伤时间进行建模:(1) 使用比例风险回归对首次受伤的发生时间进行建模;(2) 对受伤频率进行强度模型分析。两名研究团队成员还使用内容分析方法对定性数据进行了分析。
在研究期间,报告了 204 起伤害事件。在 154 名参与者中,93 名(60.4%)在至少一项调查中报告了肌肉骨骼疼痛。大多数伤害是创伤性的,包括骨折、扭伤和拉伤。发现缺乏健康保险与首次受伤的风险增加有关[HR=1.41,95%CI=0.97-2.04,p=0.069]。在单变量水平上与伤害强度相关的变量包括:(1)缺乏健康保险[HR=1.51,95%CI=1.04-2.20,p=0.030],(2)年龄[每增加 10 岁的 HR=1.12,95%CI=0.99-1.27,p=0.082],和(3)在伐木行业工作的年数[每增加 10 年的 HR=1.12,95%CI=0.99-1.26,p=0.052]。对于该队列来说,寻求医疗关注并不是优先事项,而叙事则显示出自评趋势。各种障碍,包括财务问题,阻止了伐木工人寻求医疗关注。
我们发现伐木工人仍然会经历与其工作相关的严重且有时致残的伤害。许多伤害是由于滑倒、绊倒和跌倒以及与伐木设备和树木/原木接触造成的,这并不奇怪。叙述揭示了各种阻碍伐木工人获得最佳健康的障碍。例如,地理上远离医疗保健、缺乏时间获得医疗保健以及重视独立和传统男子气概的根深蒂固的价值观。财务考虑因素也一直被认为是获得足够护理的主要障碍。
需要继续强调伐木行业的职业健康和安全。实施相关的安全计划是关键,但只有在该行业发生文化转变后,这些计划的好处才有可能得到充分体现。