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20 th International Aircraft Cabin Safety Symposium Universal City, Los Angeles, California February 10-13, 2003. Copyright Photodisc 1996. Flight Attendant Nonfatal Injuries and Illnesses. Dinkar Mokadam, OSHA Specialist Air Safety, Health and Security Department

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flight attendant nonfatal injuries and illnesses

20th International Aircraft Cabin Safety Symposium

Universal City, Los Angeles, California

February 10-13, 2003

Copyright Photodisc 1996

Flight Attendant

Nonfatal Injuries and Illnesses

Dinkar Mokadam, OSHA Specialist

Air Safety, Health and Security Department

Association of Flight Attendants, AFL-CIO

overview
Overview
  • Background
    • Sample Incident Reports
    • FSF Report
    • BLS
    • Definitions
  • Reardon Study, 1988
  • AFA Study, 1994 to 2000
  • Conclusions
  • Further Study
background
Background
  • Sample Incident Reports
    • On December 22, 1996 … 737-400 … encountered severe turbulence while cruising in visual meteorological flight conditions at Flight Level 350, approximately 30 miles east of Yakutat, Alaska … the three flight attendants aboard were injured … One flight attendant received minor injuries, two flight attendants received serious injuries [fractured pelvis and elbow; fractured vertebrae in back] and were hospitalized
    • On November 18, 1999 … 767-223 … experienced a rapid decompression during climb … 2 of the 10 flight attendants, and 4 of the 111 passengers reported having sustained minor injuries and several were transported to a local hospital for examination
    • On August 12, 2000 … EMB-120ER twin turboprop airplane … experienced an uncommanded disconnect of the autopilot while descending … the flight attendant … landed on the galley floor, on her right ankle and leg
background4
Background
  • Sample Incident Reports
    • JANUARY 4, 1998 … FA … INJURED HER BACK WHILE RETURNING THE FIRST CLASS LIQUOR CART TO ITS GALLEY POSITION
    • FLIGHT ATTENDANT … 18 MAY [1998] … DURING THE AIRCRAFT DESCENT … LEFT EAR STARTED TO BE VERY PAINFUL AND BECAME BLOCKED. THE PAIN WAS STILL VERY SEVERE AFTER LANDING AND FA VISITED THE AIRPORT MEDICAL CENTER. DOCTOR DIAGNOSED AEROTITIS AND RECOMMENDED FA NOT TO FLY FOR THREE DAYS
    • 8/29/98, F/A STATES WHILE BOARDING SHE REACHED UP TO CLOSE A FULL BIN, SHE HAD TO LEAN PULL & PUSH UP. F/A FURTHER STATES SHE SUDDENDLY FELT A SHARP PAIN GOING THROUGH HER NECK ON LEFT SIDE
background5
Background
  • Flight Safety Foundation Report
    • Cabin Crew Safety, July-August 2002
    • “Study of Airline’s Flight Attendants Finds More Than Half of Injuries Affect Muscles and Bones in Back, Neck, Shoulders”
    • “A report on the Canadian study says that the primary risk factors were the handling of passenger baggage, the design of the galley, the design and maintenance of service trolleys, and flight attendant seating”
    • “About 58 percent of the injuries to … flight attendants were musculoskeletal injuries involving the back, neck or shoulders.”
    • To access the report, register at www.flightsafety.org
background6
Background
  • Bureau of Labor Statistics
    • Statistics available at www.bls.gov and on request
    • Survey of Occupational Injuries and Illnesses: employer reports collected annually from ~ 176,000 private industry establishments, processed by State agencies cooperating with BLS
    • Employer logs conform with definitions and recordkeeping guidelines set by OSHA
    • Survey estimates of numbers of cases and median lost days are based on scientifically selected samples
background7
Background
  • Definitions
    • Lost workday cases involving days away from work (not counting the day of injury or onset of illness), or a combination of days away from work and days of restricted work activity*
    • BLS industry incidence rate = (Number of injuries and illnesses x 200,000) / Employee hours worked
    • Flight attendant incidence rate = Number of injuries and illnesses / FA employment (note this understates FA incidence rate, since on average flight attendants work only ~ 1000 hrs/year)

*Handbook of Methods (chapter 9); Bureau of Labor Statistics1997 Apr; http://www.bls.gov/opub/hom/pdf/homch9.pdf

background8
Background
  • Flight Attendant Demographic Codes
    • Injury/Illness statistics
      • Standard Industrial Classification industry group 451 (Air Transportation, Scheduled, And Air Courier)
      • 1990 U.S. Census occupational code 463(Public Transportation Attendants)
    • Employment statistics
      • 1999+: Standard Occup. Classification code 39-6031
      • 1992 – 1998: Occup. Employment Survey code 68026 (1994 and 1998 data are most accurate)
background9
Background
  • BLS Injury and Illness Classification System
    • Event or exposure: manner in which the injury or illness was inflicted or produced
    • Nature of injury or illness: principal physical characteristic of the worker's injury or illness
    • Source of injury or illness: object, substance, bodily motion, or work environment that directly produced or inflicted the injury/illness
    • Part of the body directly affected by the injury or illness
reardon study 1988
Reardon Study, 1988
  • Reardon Study
    • Occupational safety and health among pilots and flight attendants;Reardon J; Monthly Labor Review 1992 Apr; 115(4):18-24;http://www.bls.gov/opub/mlr/1992/04/art3full.pdf
    • An early application of BLS Supplemental Data
    • Discovered that the lost workday injury/illness rate for airline workers was almost twice the overall private sector rate
reardon study 198811
Reardon Study, 1988
  • Reardon Study
    • Events or exposures
      • 33% from overexertion (45% of these were pulling/pushing, 36% lifting)
      • 15% from being struck by or against objects
      • 9% from falls
    • Natures of injuries/illnesses
      • Sprains/strains accounted for 46% of total cases for flight attendants
      • Air pressure changes accounted for 18% of cases
      • Contusions/bruises accounted for 10% of cases
reardon study 198812
Reardon Study, 1988
  • Reardon Study
    • Sources of injuries/illnesses
      • 32% from vehicles (hand carts, aircraft, motor vehicles)
      • 20% from air pressure changes
      • 16% from boxes/barrels/containers
    • Parts of Body affected
      • 29% head and neck
      • 29% trunk
      • 14% lower extremities
      • 13% upper extremities
      • 12% multiple body parts
afa study 1994 to 2000
AFA Study, 1994 to 2000
  • Summary Tables and Graphs
    • 1998 Incidence rates and median days away from work tabulated by Event, Nature, Source, and Part of Body
    • 1994 and 1998 Incidence rate comparisons, Flight Attendants vs. Scheduled Air Transportation, the Construction industry and all Private industry
    • 1994 – 2000 Charts of percent contributions by Event, Nature, Source, and Part of Body
    • 1994 and 1998 Incidence rate comparison charts, by Event, Nature, Source, and Part of Body, Flight Attendants vs. the Construction industry and all Private industry
afa study 1994 to 200014
AFA Study, 1994 to 2000
  • 1998 BLS Lost Workday Data (link)
    • Events/Exposures
      • Reaction and overexertion (37% of cases)
      • Struck by or against objects (19%)
      • Air pressure changes (15%)
      • For 1998, being struck by unspecified object and overexertion in lifting resulted in the highest number of median lost workdays (Note: median lost workdays data show large year to year fluctuations)
afa study 1994 to 200015
AFA Study, 1994 to 2000
  • 1998 BLS Lost Workday Data (link)
    • Natures
      • Traumatic injuries and disorders (86%)
      • Sprains/strains/tears (40%)
      • Bruises/contusions (14%)
      • Air pressure (11%)
      • For 1998, unspecified traumatic injuries and fractures resulted in the highest number of median lost workdays
afa study 1994 to 200016
AFA Study, 1994 to 2000
  • 1998 BLS Lost Workday Data (link)
    • Sources
      • Cart/dolly/handtruck (19%)
      • Air pressure (15%)
      • Containers (14%)
      • Bodily motion or position (11%)
      • For 1998, injuries caused by containers (bottles, cans, pots/pans, luggage) resulted in the highest number of median lost workdays
afa study 1994 to 200017
AFA Study, 1994 to 2000
  • 1998 BLS Lost Workday Data (link)
    • Parts of Body
      • Back and spine (21%)
      • Lower extremities (17%)
      • Ears (15%)
      • Wrists/hands/fingers (13%)
      • For 1998, elbow, hand/finger, shoulder and knee injuries resulted in the highest number of median lost workdays
conclusions
Conclusions
  • Rates per hours worked of occupational injuries and illnesses among commercial air transport workers are historically several times that for workers in all private industry sectors, and even significantly greater than rates that occur in the construction industry
  • For the years 1994 and 1998, flight attendant injury and illness incidence rates were similar to the rates for all commercial air transport workers, and were significantly higher and have decreased at a much slower pace than the corresponding rates for workers in all private industry and the construction industry
conclusions32
Conclusions
  • For Injuries/Illnesses with Lost Workdays
    • Overexertion and contact with objects are the most significant exposures
    • Approximately 90% of cases are traumatic in nature, including sprains/strains/tears, effects of air pressure, and bruises/contusions
    • Among a wide variety of sources, bodily motion, contact with vehicles and containers, and air pressure are major contributors
    • All body parts are affected, but injuries/illnesses to the trunk, head/neck, and extremities predominate
further study
Further Study
  • Cross tabulate incidents by Event, Nature, Source, and POB, and also by age, gender and length of service
  • Develop index to prioritize incident severity for targeted interventions (one possibility: number of cases x median lost workdays, averaged over multiple years)
  • Compare OSHA log data from individual airlines to BLS industry statistics