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28-06-2011 | Article

Work-related fatal brain trauma highest among construction and agriculture industries


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MedWire News: The incidence of work-related fatal traumatic brain injury (TBI) is highest among the construction industry and the agriculture, forestry, and fishing industries, show findings from a US epidemiological study.

"While TBI is an important topic for public health researchers, there has been a lack of attention paid to the investigation of brain injuries occurring in the workplace. Describing the magnitude of the problem, identifying at-risk sociodemographic and occupational subgroups, and documenting trends are vital first steps when developing prevention strategies," said lead study author Hope Tiesman (National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA).

Tiesman and team therefore performed a cross-sectional analysis of the Census of Fatal Occupational Injury to identify TBIs occurring during 2003-2008. Fatality rates were calculated using denominators derived from the Current Population Survey, and were compared among industries, cause of death, and demographics.

A total of 7294 occupational TBI fatalities were identified during the study period, corresponding to an annual fatality rate of 0.8 per 100,000 workers per year. TBIs accounted for 22% of all work-related injury fatalities during this time, which increased to 46% when restricted to work-related fall deaths.

The majority (80%) of TBIs were intracranial injuries, with men 15 fold more likely to experience an occupational fatal TBI than women. As age increased, so did the occupational TBI fatality rate, with individuals aged over 65 years showing the highest rate, at 2.5 per 100,000 per year compared with 0.6-1.1 per 100,000 for those aged 15-64 years.

The leading cause of occupational TBI mortality was motor vehicle-related (31%), followed by falls (29%), assaults and violent acts (20%), and contact with objects/equipment (18%). When stratifying the cause of TBI according to age, the team found that falls accounted for 35-42% of TBI deaths in workers aged 55 years and over, while motor vehicles accounted for the largest percentage (29-36%) in workers aged 15-54 years.

Construction, transportation, and agriculture/forestry/fishing industries recorded 47% of all TBI fatalities. Indeed, the agriculture, forestry, fishing, and hunting industry had the highest fatality rate among all major industries, at 5.7 per 100,000 per year. However, the logging sub-industry had the highest occupational TBI fatality rate of all major or minor industries, at 29.7 per 100,000 per year.

Cause of injury differed by industry, with contact with objects and equipment the leading cause of TBI death in the mining (37%) and agriculture (47%) industries. Falls were the leading cause of death in the construction industry, at 57%.

Over the study period, occupational TBI fatality rates declined by a significant 23%, from 0.93 to 0.71 per 100,000.

Writing in the American Journal of Preventive Medicine, the authors note that impact of occupational TBI may have been underestimated, given that the current study did not provide data on the scope of nonfatal TBIs occurring in the workplace.

"With limited resources available for occupational safety and health programs, the identification and targeting of high-risk populations, including older workers, should be a priority for industry," said Tiesman.

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Ingrid Grasmo