1. Rosa L Rodríguez-Acosta Christen Byler
Seat belt use among fatally injured U.S. workers: Analysis of CFOI/FARS matched data.
Rosa L Rodríguez-Acosta
Christen Byler
National Institute for Occupational Safety and Health, Morgantown, WV
Bureau of Labor Statistics,
Washington, DC
44th International Traffic Records Forum
Milwaukee, WI

2. Presentation Outline
Work-related motor vehicle safety at the National Institute for Occupational Safety and Health (NIOSH)
Seat belt use analysis using Census of Fatal Occupational Injuries (CFOI)/Fatality Analysis Reporting System (FARS) matched data
Barriers to seat belt use research project
Questions/Discussion

3. Work-related motor vehicle safety at the National Institute for Occupational Safety and Health (NIOSH)

4. Who we are
The National Institute for Occupational Safety and Health is a federal research entity focused on the study of worker safety and health.

5. Who we are
The NIOSH Center for Motor Vehicle Safety (CMVS) is the only part of the U.S. federal government whose mission includes preventing crashes and resulting injuries for all worker populations, not just a specific worker group.

6. Burden of workplace motor vehicle crashes
Motor vehicle crashes are the leading cause of U.S. work-related deaths
35% of all deaths in 2016
1st or 2nd leading cause of death in every major industry group
Over 25,000 deaths from

7. Work-related MVC fatalities by event type, U.S., 2008-2016
Roadway incident
Number of Deaths
Pedestrian struck-by
Non-roadway incident
Source: Bureau of Labor Statistics, Census of Fatal Occupational Injuries

8. Who’s at risk of a work-related fatal crash?
Truck drivers
Drivers in other high-risk jobs
Light-vehicle drivers
It’s not just truck drivers. Over 60% of workplace crash deaths in 2016 were workers employed in an occupation other than “truck driver.”
Source: Bureau of Labor Statistics, Census of Fatal Occupational Injuries

9. What we do
The NIOSH Center for Motor Vehicle Safety (CMVS) conducts research and develops recommendations to prevent work-related motor vehicle crashes and resulting injuries.
Knowledge
Partnerships
Policy
Communication

10. Strategic Plan

11. Research areas Identifying crash risk factors Evaluating
technology-based
and management interventions
Identifying crash risk factors
Developing/evaluating engineering controls and technology

12. Risk factors for work-related crashes
All of these can be modified with strong employer policies.
Not using a seat belt
Distraction
Fatigue
Shift work and long hours of work
Substances
Unsafe vehicles

13. Intervention Evaluation

14. Engineering Controls and Technology

15. Engineering Controls and Technology
Ambulance crash test methods published by the Society of Automotive Engineers (SAE):
SAE J2917: Crash pulse from frontal impact
SAE J3026: EMS worker seating and restraint integrity
SAE J3027: Patient cot, floor mount, and restraint system
SAE J3043: Ambulance equipment mount devices and systems
SAE J3044: Crash pulse from rear impact
SAE J2956: Crash pulse from side impact
SAE J3057: Modular body (or box style) integrity
SAE J3058: Storage compartment integrity
SAE J3059: Measurement of EMS worker head movement during a crash event
SAE J3102: Floor integrity test to hold patient cot

16. Communication products
Oil & Gas Employer Fact Sheet
Oil & Gas Workers Fact Sheet

17. Rosa L Rodríguez-Acosta Christen Byler
Seat belt use among fatally injured U.S. workers: Analysis of CFOI/FARS matched data.
Rosa L Rodríguez-Acosta
Christen Byler
National Institute for Occupational Safety and Health, Morgantown, WV
Bureau of Labor Statistics,
Washington, DC
The findings and conclusions in this presentation are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health.
This research was conducted with restricted access to Bureau of Labor Statistics (BLS) data. The views expressed are those of the authors and do not reflect the views of the BLS.

18. Background
Adult seat belt use is the single most effective way to save lives and reduce injuries in the event of a motor vehicle crash.
In 2016, for passenger vehicles:*
National estimated seat belt use rate was at 90.1%
Nearly 27.5 million still did not buckle up
48% of fatally-injured occupants were unrestrained
Seat belt use saved an estimated 14,668 lives
*Occupant protection in passenger vehicles: 2016 data (Traffic Safety Facts. Report No. DOT HS ).

19. Background
Estimated self-reported seat belt use among employed US adults*:
Prevalence of not always using a seat belt higher, 23.6%, in states with secondary seat belt laws vs. 10.4% in states with primary laws
Seat belt use among employed adults varies by industry
NIOSH survey of long-haul truck drivers+: 14% did not use a seat belt on every trip
*Boal et. al., 2016; +Chen et. al., 2015

20. Methods: Data Sources Census of Fatal Occupational Injuries (CFOI)
Federal/State cooperative program conducted by the Bureau of Labor Statistics.
Produces comprehensive, accurate, and timely annual counts of all fatal work injuries in the U.S.
Cases confirmed using multiple source documents including:
Death certificates
Reports from:
Occupational Safety and Health Administration (OSHA)
Coroner/Medical examiner
Police
Workers’ compensation
Media

21. Methods: Data Sources
Census of Fatal Occupational Injuries (CFOI) – cont.
Collects data on:
Employment: industry, occupation, and, ownership
Demographic characteristics
Injury case characteristics
Analyzed the subset of motor vehicle occupant fatalities resulting from roadway incidents involving a motorized land vehicle
“those occurring on that part of public highway, street, or road normally used for travel … where at least one vehicle was in regular operation…”

22. Methods: Data Sources Fatality Analysis Reporting System (FARS)
Census of police-reported traffic crashes involving a motor vehicle travelling on traffic way open to the public, and resulting in the
death of a motorist or non-motorist within 30 days of crash
Hierarchical data system: crash-, vehicle-, and person-level data.
At-work determination based on “injury-at-work” item in death certificate.

23. Methods: CFOI/FARS Matched Dataset
Published methods manuscript

24. Methods: CFOI/FARS Matched Dataset, 2011-2014
Source files
Matched cases
Data set
CFOI Highway
All Fatal FARS
All Matches N
4,512
98,464
4,060
Description
All CFOI records for which event = roadway incident involving motorized land vehicle
All FARS person-level records for fatally-injured persons*
CFOI Highway merged with All Fatal FARS
* Excludes pedestrians.
90% of CFOI roadway cases were also in All Fatal FARS (4,060/4,512)
Only 60% of matched cases were identified as at work in FARS (2,442/4,060)
Data were generated with restricted access to the CFOI Research file.

25. Results: CFOI/FARS matched dataset
Fatal Work-related Motor Vehicle Incidents,
CFOI/FARS Matched Data
Crashes
Vehicles
Fatalities
Drivers
3,822
3,879
4,060
3,581
Data were generated with restricted access to the CFOI Research file.

26. Methods: Data Analysis
Generated person-level descriptive analysis by seat belt use
Demographic characteristics (CFOI)
Age
Gender
Race
Seating position (FARS)
Ejection (FARS)
Vehicle body type (FARS)
Occupational characteristics (CFOI)
Industry

27. Results: Seat belt use status among all fatally injured workers
Seat belt used n %
Yes
1,749 43 No
1,467 36
Unknown
610 15
Not applicable*
234 6
Total
4,060
100
Seat belt used n %
Yes
1,749 54 No
1,467 46
Total
3,216
100
* Some examples include: in a motorcycle, or operating equipment
Data were generated with restricted access to the CFOI Research file.

28. Demographic characteristicsn %
Age group*
16-24
266 8
25-34
501 16
35-44
635 20
45-54
801 25
55-64
661 21
65+
348 11
Gender
Male
2,951 92
Female
265
Race/ethnicity
White
2,329 72
Black
360
Hispanic
434 13
Other^ 93 3
* Data missing for 4 workers
^ Other category includes: American Indian, Alaska Native, Asian and Pacific Islander
Data were generated with restricted access to the CFOI Research file.

29. Seat belt use by age group (N=3,216)
Data were generated with restricted access to the CFOI Research file.

30. Seat belt use by race/ethnicity
By race/ethnicity we observed the highest proportion of restrained workers among Hispanics with 58% and highest proportion of unrestrained workers in the other category, 52%.
% restrained % unrestrained
White 54 46
Black 55 45
Hispanic 58 42
Other 48 52
(American Indian, Alaska Native, Asian, and Pacific Islander)
All 54 46
Data were generated with restricted access to the CFOI Research file.

31. Seat belt use by seating position
Restrained
Unrestrained
Total n %
Driver
1,615 56
1,279 44
2,894
Front seat passenger
107 53 94 47
201
Back seat passenger 22 25 65 75 87
Enclosed passenger or cargo area -  - 23
100
Unknown 3 38 5 63 8
1,747 54
1,466 46
3,213
Data were generated with restricted access to the CFOI Research file.

32. Seat belt use by vehicle body type
Restrained
Unrestrained n %
Passenger cars
292 65
160 35
Light trucks and vans
Utility vehicles 75 46 89 54
Vans
156 52
142 48
Pick-up trucks
267 50
263
Other light trucks 7 33 14 67
Large trucks
Medium trucks
154 53
135 47
Heavy trucks
773 58
565 42
Buses 15 39 23 61
Farm and construction equipment 6 10 57 90
Other vehicles 5
100
Unknown body type 8
Total
1,745
1,461
Data were generated with restricted access to the CFOI Research file.

33. Seat belt use by industry
Industry
% restrained
% unrestrained
Agriculture, forestry, fishing, and hunting 27 73
Mining 56 44
Utilities 68 32
Construction 48 52
Manufacturing 69 31
Wholesale trade 62 38
Retail trade 64 36
Transportation and warehousing 57 43
Professional and business services
Administrative and waste management 49 51
Education and Health 65 35
Arts, leisure and accommodations 59 41
Other except Public Admin 55 45
Public Administration 54 46
Data were generated with restricted access to the CFOI Research file.

34. Conclusions
Proportion of fatally-injured workers in passenger vehicles* who were restrained higher than general population.
High proportion of unrestrained younger workers warrants tailored interventions from employers.
Low levels of restraint use in fatal crashes reinforces the need for employer policies requiring all occupants to be belted regardless of seating position and state seat belt law.
Low restraint use in agriculture, construction and waste management industries may be indicative of use of vehicles that lack proper seating.
* includes: passenger cars, pick-up trucks, vans and SUVs

35. Conclusions
Employers can help workers who drive as part of their job stay safe by:
Committing to driver safety programs at the highest level of leadership.
Establishing and enforcing driver safety policies, including requiring everyone in the vehicle to buckle up.
Involving workers in decisions about how to put seat belt programs in place.
Promoting seat belt use in all training and safety meetings.

36. Strengths
Analysis shows the value of matched CFOI/FARS data to advance knowledge and understanding of seat belt use among fatally injured workers.
Analysis identified higher risk worker groups that may lead to development of more focused prevention recommendations.

37. Limitations
Seat belt use in non-fatal work-related crashes remains unknown.
Observational data on seat belt use available for large trucks but not for workers who drive light vehicles.
Did not take into account type of seat belt law.
Did not examine if vehicles used in industries with low seat belt use were equipped with proper seating and seat belts.

38. Next Steps Examine seat belt use by state law type.
Perform additional analysis examining vehicles used in industries with low seat belt use.
Complete drafting manuscripts for publication in peer reviewed journals:
Overall results
Seat belt use analysis
Industry-specific analysis
Oil and Gas Extraction industry
Conduct analysis specific to construction industry.
Match two additional years of data ( ).

39. Barriers to seat belt use research project Seat belt use by workers who drive as part of their job: What’s not clicking?

40. Why do this now?
Project responds to research priorities in the Oil and Gas Extraction (OGE) Industry:
Oil and Gas Extraction operators
Drilling contractors
Well servicing companies
Workers in the OGE industry have a high motor vehicle fatality rate.
Workers employed in small establishments and from well-servicing companies are at greatest risk of dying in a motor vehicle crash.
Limited research done to date to examine seat belt use behavior among workers.
Findings will guide new interventions and strategies to increase seat belt use among workers.
Well-servicing companies- In charge of maintenance procedures on an oil or gas well after the well has been completed and production begun. They are in charge of maintaining or enhancing well productivity, or assessing/monitoring the performance of the well or reservoir. Slickline, coiled tubing, snubbing and workover rigs or rod units are routinely used in well service activities.
Well Servicing are various operations conducted on a well that can range from well workover to completion. These operations are handled by well services, a petroleum department that handles all the maintenance and repair issues related to a well. The well may experience certain issues after it has been drilled and operated. Therefore, these issues are addressed to the well services department, which analyzes the current needs of the well and accordingly offers the well servicing operations.

41. About the project
Four year internally funded project with start date of October 2018
To be conducted at six U.S. oil and gas sites
Involves the use of qualitative research methods
Information gained through this project will help researchers understand what prevents workers from using seat belts at all times and guide recommendations for employers and workers.

42. About the project
Goal: To increase seat belt use among workers employed in OGE industries.
Aim: Identify barriers to seat belt use and factors preventing OGE workers from using their seat belts, by obtaining data from workers and their managers on: knowledge, attitudes, behaviors, and motor vehicle safety policies and practices.

43. Methods Sites Data collection
Three U.S. geographical areas Two sites in each area One large and one small well-servicing company
Data collection
Focus groups with manager at each site to obtain data on policies, practices, and enforcement.
Individual interviews with up to 10 workers per site to:
obtain data on knowledge, attitudes, behaviors and practices
examine factors in and outside the workplace that influence decisions about belt use

44. Methods Data analysis Data will be: Main themes identified
transcribed combining notes from the interviewer focus group facilitator, the note taker, and, if available, recordings
analyzed using several phases of coding to separate, sort, and synthesize the information in order to identify patterns and respective themes
Main themes identified
examine results from interviews and focus groups separately, and,
compare main themes that emerged among workers and managers

45. Products Scientific and trade publications
Presentations to companies’ safety management and at scientific conferences.
Communication products tailored towards both the workers and managers.

46. Questions? Comments? Rosa L Rodriguez-Acosta, Ph.D.
National Institute for Occupational Safety and Health
The findings and conclusions in this presentation are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health.
This research was conducted with restricted access to Bureau of Labor Statistics (BLS) data. The views expressed are those of the authors and do not reflect the views of the BLS.