Survey of Non-fatal Workplace Injuries to Commercial Fishermen in Dutch Harbor, Alaska, 2007-2008 Paul Anderson, M.D., M.P.H. National Institute for Occupational Safety and Health, Alaska Pacific Regional Office
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Survey of Non-fatal Workplace Injuries to Commercial
Fishermen in Dutch Harbor, Alaska, 2007-2008
Paul Anderson, M.D., M.P.H.National Institute for Occupational Safety
and Health, Alaska Pacific Regional Office
Background
• Commercial fishermen in Alaska• 124 deaths/100,000 workers• 31 times national average• Significant reduction in fatal injuries• Minimal attention to non-fatal injury• Non-fatal injury patterns unknown
Objectives
• Describe non-fatal injuries to commercial fishermen in AK
• Develop preventive strategies• Create plan for AK investigation• Develop model for expansion to U.S.
Dutch Harbor, Alaska
• Unalaska island• Largest volume fishing port in U.S. • Thousands employed• Seasonal• Migrant workers• Solitary medical clinic• Iliuliuk Health Center
Dutch Harbor, Alaska
Methods• Query medical records (2007-2008)
– ICD-9 codes: 800-999– Job Type: Fisherman– Corporate payer
• Onsite medical chart review (N=366)– Demographics – Injury description – Lost time
Injured Fishermen (N = 366)
%Male 99Caucasian 55African American 6Pacific Islander 6Asian 5American Indian 3Filipino 1Other 6
Location of Injury, 2007-2008 (N=366)
%
At Sea 65In Port 17
On Deck 30Freezer 15Factory 4
Injured Workers by Job Type, 2007-2008 (N = 366)
3
6
151
178
0 50 100 150 200
Captain
Engineer
Deckhand
Processors
Injuries by Mechanism, 2007-2008 (N=366)
0
5
10
15
20
25
30
35
Caught In Laceration Strain Struck by Slips/Falls Crush
Deckhands (151)
Processors (178)
Mechanism
Perc
ent
Injuries by Causal Agent, 2007-2008 (N=366)
0
5
10
15
20
25
30
35
40
Box of Fish Deck Deck Equip. Stairs Knife
Deckhands (151)
Processors (178)
Mechanism
Perc
ent
Iliuliuk Clinic Visits for Acute Injury to Fishermen, 2007-2008
0
10
20
30
40
50
60
70
80
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
Inju
ry V
isit
s
A Season
B Season
King Crab Season
Number of Injuries to Fishermen by Type, 2007-2008 (N = 366)
6
7
15
27
30
42
72
72
82
0 20 40 60 80 100
Toxic effects Crushing injury
Unspecified Late complications Superficial injuries
Open wounds Fractures Contusion
Strains & Sprains
Injuries
Strain & Sprain Injuries to Fishermen, 2007-2008 (N = 82)
3
3
10
11
13
18
25
0 5 10 15 20 25 30
Hip & Thigh
Other
Wrist & Hand
Knee & Leg
Ankle & Foot
Shoulder/Upper Arm
Back
Injuries
Fractures Among Fishermen, 2007-2008 (N = 72)
1
8
18
35
0 10 20 30 40
Skull
Neck Trunk
Lower Limb
Upper Limb
Injuries
Upper Limb Fractures Among Fishermen, 2007-2008 (N = 35)
1
1
33
0 5 10 15 20 25 30 35
Humerus
Other
Hand
Injuries
Contusions Among Fishermen, 2007-2008 (N = 72)
2
3
17
20
29
0 5 10 15 20 25 30 35
Eye
Head
Trunk
Lower Limb
Upper Limb
Injuries
Upper Limb Contusions Among Fishermen, 2007-2008 (N = 29)
1
4
24
0 5 10 15 20 25 30
Shoulder
Elbow & Forearm
Hands & Fingers
Injuries
Fisherman Return to Work Status, 2007-2008 (N=366)
0
5
10
15
20
25
30
35
40
45
Today No Restrictions
Today With Restrictions
Off Work See Specialist
Pink Slip Status
Perc
ent
Injuries to Fishermen by Specialist Consulted, (N=85)
2
4
5
8
18
50
0 20 40 60
Surgeon
Neurologist
Ophthalmologist
Clinic Staff
Hand Surgeon
Orthopedist
Days of Restrictions
Perc
ent
Safety Pays
• Estimates cost of injury by type• Uses profit margin (e.g. 3%)• Calculates profit required per injury• 1 Fracture, 3% margin• Direct Costs = $37,911• Indirect Costs = $41, 702• Income required (3%) = $2,653,766
http://www.osha.gov/dcsp/smallbusiness/safetypays/estimator.html
Indirect Costs• Wages not covered by work comp• Costs from work stoppage• Post-incident administrative time• Employee training & replacement costs • Lost productivity
– new hire learning curve– Accommodation of injured employees
• Replacement of damaged material, machinery and property.
Conclusions
• Male, Caucasian, average age 39• Most are deckhands & processors• Injured at sea, delayed presentation• Hand injuries & back strain• Slips & falls on deck • Deck equipment • Handling frozen product
Limitations
• Documentation inconsistent• Underreporting• Worst injuries evacuated
Recommendations
• Continued data analysis• Expanded chart reviews in AK• Field research for hand injury• Job hazard analyses• Surveillance system
Acknowledgements• Tracie Gardner, PhD, Alaska Department of Health• Jennifer Lincoln, PhD, APRO• Sonia Handforth-Kome, Iliuliuk Health Clinic
The findings and conclusions in this report are those of the author(s) and do not necessarily represent the views of NIOSH or the Centers for Disease Control and Prevention.
Fishing Methods
Injuries to Fishermen by Days of Restrictions, 2007-2008 (N=88)
0
5
10
15
20
25
1 2 3 4 5 6 7 8 9 10 12 14 21 30 45 56 90
Days of Restrictions
Perc
ent
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