May 2012 Dave Mertz, Deputy Fire Marshal Hanford Fire Department.
Firefighter Injury Research & Safety Trends-Reliability Study (FIRST-RS) Oregon Governor's Fire...
-
Upload
jean-newton -
Category
Documents
-
view
217 -
download
0
Transcript of Firefighter Injury Research & Safety Trends-Reliability Study (FIRST-RS) Oregon Governor's Fire...
Firefighter Injury Research & Safety Trends-Reliability Study (FIRST-RS)
Oregon Governor's Fire Service Policy Council MeetingOffice of State Fire Marshal
4760 Portland Rd NESalem, Oregon 97305
Mt Hood Conference RoomTuesday, October 27, 2015
Jennifer Taylor, PhD, MPH, CPPS - Associate ProfessorDepartment of Environmental and Occupational Health
Dornsife School of Public Health at Drexel University ~ Philadelphia, PA1
Outline• Our mission• Partnerships and Pilots• Benefits of data analysis and linkage• Drexel responsibilities• State partner responsibilities
2
Adapted from Christian et.al JAP 2009, vol 94 (5): 1102-1127
Safety Knowledge
Safety Motivation
SafetyCompliance
HelpingStewardship
Exercising RightsInitiating safety-related
change
Safety Citizenship
Following proceduresUsing protective
equipmentPracticing risk reduction Safety
OutcomesNear Miss
InjuryLODD
Safety Climate
Management commitment
Supervisor supportSafety systems
Job riskWork pressureInternal group
processes
Safety Behaviors
Antecedents to Safety Behaviors
FEMA AFG Grant #: EMW-2011-FP-00069
FEMA AFG Grants #: EMW-2009-FP-00427 EMW-2012-FP-00205
Our Mission
3
Mission Relevance• #1 - Define and advocate the need for a cultural change
within the fire service relating to safety…• #4 – All firefighters must be empowered to stop unsafe
practices• #7 - Create a national research agenda and data collection
system that relates to the initiatives• #9 - Thoroughly investigate all firefighter fatalities, injuries,
and near misses.
4
How Mission is Accomplished• Data Systems Development and Evaluation
– Non-fatal injury– Near-miss– Policy
• Methods– Data Linkage– Narrative text mining– Interviewing and focus groups– Survey development and assessment
• Emerging Topics– EMT Assaults– Women in the Fire Service– Community Use of 911
5
Drexel’s Fire Service Research
2015 IAFF Contract, YFIRES
6
publichealth.drexel.edu/FIRST 7
Partnerships
8
Advisory Council• Congressional Fire Services Institute • Fire Department Safety Officers
Association • Firehouse Magazine • International Association of Arson
Investigators • International Association of Fire
Chiefs • International Association of Fire
Fighters • International Society of Fire Service
Instructors • Liberty Mutual Research Institute
for Safety
• National Fallen Firefighters Foundation
• National Volunteer Fire Council • National Association of State Fire
Marshals • North American Fire Training
Directors • Retired Fire Chief, Alan Brunacini• The Fire Protection Research
Foundation• The Secret List
9
Advisory Board Input• Data that tells a story at the local level • Data collection that does not increase the reporting
burden for firefighters• Data that describe all firefighter injuries • A clear connection between the data collection
system and benefits for the Fire Service
10
Why are we doing this research?
11
Data Systems Development and Evaluation• Studies that “focus on the design and
feasibility of a new database system” – FIRST and FIRST-RS• FEMA AFG grant # EMW-2009-FP-00427 (2010-2013) • FEMA AFG grant # EMW-2012-FP-00205 (2013-2016)
12
Fire Service Deaths and Injuries• Firefighter Fatalities– NFFF– NFPA– NIOSH – USFA
• Firefighter Injuries– No comprehensive national non-fatal injury reporting
system– NFPA Survey – NFIRS by USFA
13
What about other data?Injury discharge rates by body region, 1979-2001
Head and neck
Spine and back
Torso
Extremities
1
10
100
1979 1985 1990 1995 2001
Rate per 10,000 population
Source: National Hospital Discharge Survey. Age-adjusted rates are plotted on a log scale.
14
Non-fatal Firefighter Injury Data Pilots
Philadelphia, PAState of Florida
15
Research & Development Models• Model 1: Department-Level Data Linkage• Model 2: State-Level Data Linkage• Model 3: Industry and Occupation Policy
Initiative
16
Model 1: Fire Department-Level (Philadelphia Model)
• Developing fire department-level systems by linking injury reports to other existing data.
• AIMFIRST_RS: testing this model with new departmental partners– New pilot partners• Portland, OR (in due diligence)• Boston, MA (agreements complete)
17
Model 2: State-Level (Florida Model)• Developing state-level systems by
linking workers’ compensation, and hospital and emergency department encounters, to a statewide registry of firefighters.
• AIMFIRST_RS: testing this model with new state partners, including technological data transfer innovation– New pilot partner
• State of Oregon
18
Data Sources from Florida• Fire College Department of Insurance and
Continuing Education– FC-DICE
• Workers’ Compensation– Medical– Lost-time
• Agency for Health Care Administration– AHCA (hospital data)
19
FC-DICE• Source population• Basic demographic data• Denominator data– Important for calculating prevalence and
proportions
• Longitudinal data– Important for calculating incidence and risk
• Rank, training, fire department/station20
Workers’ Compensation• Medical Claims– Line-item list of medical procedures and costs– Confirms that injuries are work-related
• Lost Time Claims– Severity of injury– Indemnity data for total cost of injuries
21
AHCA• Four data sources:– Emergency Department Discharge– Inpatient Discharge– Ambulatory– Rehabilitation
• Detailed information on cause and nature of injury
22
Linkage of Data
FC-DICE
Workers Comp AHCASSN
SSNNameDOB Inpatient
Ambulance
Rehab
ED
Med Claims
Lost Time Claims
Provider
Hospital
Drug
Dental
ID Control Number
Inj Date NameDOB
E-Codes
Work-RelatedCost of Injuries
SSNDate of Injury
23
Benefits of data analysis and linkage
24
Descriptive StatisticsTotal
Total 2372 (100%)Race
White 1514 (63.9%)Black 700 (29.5%)Hispanic 142 (6%)Asian or Pacific Islander 3 (0.1%)American Indian or Alaskan Native 10 (0.4%)
SexMale 2082 (87.8%)Female 290 (12.2%)
RankNon-Officer 1926 (81.2%)Lieutenant 337 (14.2%)Captain 109 (4.6%)
Light DutyYes 833 (35.1%)No 1539 (64.9%)
Injury occurred on a runYes 1479 (62.4%)No 893 (37.6%) 25
Cause of InjuryStrain or Injury By 645 (27.2%)Burn or Scald-Heat or Cold Exposures-Con 486 (20.5%)Fall, Slip, or Trip Injury 402 (16.9%)Struck or Injured By 313 (13.2%)Miscellaneous Causes 140 (5.9%)Motor Vehicle 115 (4.8%)Cut, Puncture, Scrape Injured By 106 (4.5%)Caught In, Under, or Between 71 (3%)Striking Against or Stepping On 55 (2.3%)Foreign Matter (Body) in Eye(s) 39 (1.6%)
AgeMean (std) 45.26 (0.203)
Median (IQR)43.97 (37.42-
51.88)Age at Injury
Mean (std) 40.41 (0.197)
Median (IQR)39.29 (32.46-
46.72)Years of Experience
Mean (std) 15.47 (0.181)
Median (IQR) 13.14 (7.96-19.87)Years of Experience at Injury
Mean (std) 11.25 (0.183)Median (IQR) 8.56 (3.79-15.91)
26
PFD Injury Burden
• Strains, fall/slip/trips, and burns…– 74% of all injuries – 85% of total cost ($22 million) between the years
2005 and 2013. – Burns had highest lost time claim payout • $4.8 million (36%) of lost time claim expenditures
– Strain injuries had highest medical claim costs• $4 million (38%) all claims.
PFD Safety Office
COP Risk Mgmt
(Workers’ Comp)
27
A Deep Dive into InjuryEx. Philadelphia Fire Department
• Females reported increased odds of assault injuries compared to males (OR=6.25, 95% CI 3.8-10.2).
• This relationship was entirely mediated through occupation (AOR=1.64, 95% CI 0.94-2.85).
• Paramedics had significantly higher odds for assault injuries than firefighters (OR 14.4, 95% CI: 9.2-22.2, p<0.001).
PFD Human Resources
DemographicsPFD Safety
Office
COP Risk Mgmt
(Workers’ Comp)
28
Florida Descriptive Statistics Cohort: 2005-2009
• Data from 42,981 Firefighters Linked from FCDICE to hospitalizations– 88% career; 12% volunteer– 93% males, 7% females
• Mean age of 42 (18-79)– Career mean age 43 (18-79)– Volunteer mean age 36 (18-79)
• Mean years of experience 14.9 Years (0-59)– Career mean work experience 16.2 years (0-
59)– Volunteer mean work experience 5.48 years
(0-57)• 14,375 (34%) identified as having had an
injury between 2005-2009
29
Florida: Years of Experience
FCDICEWorkers’
Comp
30
Florida: Years of Experience
31
Recommended Core Variables
32
Drexel responsibilities• Secure Funding• Contact data stewards and stakeholders• Initiate legal agreements• Secure IRB and FEMA Research Compliance
Approvals• Provide secure, encrypted data environments
at rest and in motion• Share analysis with stakeholders– Customize as needed
33
State Partner Responsibilities• Identify and Convene
Stakeholders & Data Stewards– State Fire Marshal– State Workers’ Compensation
Contact– State Fire College or
Firefighter Registry holder– State Hospital Authority who
contains hospital discharge records
– IT Contact– Legal Counsel– Any other Fire Service leaders
• Timely response to Drexel data needs• In-person• Remote
• Data Stewards available for technical support
• Provide representative to FIRST Advisory Board
• Joint presentations
34
Questions
Jennifer Taylor, PhD, MPH, CPPSAssociate Professor
Principal [email protected]
267-359-6060
Fireman’s Hall Museum, Philadelphia
Shannon Widman MPH, Project Manager
Non-fatal Injury [email protected]
267-359-6180
publichealth.drexel.edu/FIRST
35