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