The National Institute for Occupational Safety and Health (NIOSH) established its Alaska Field Station in Anchorage in 1991 after identifying Alaska as the highest-risk state for traumatic worker fatalities. Since then, the Field Station, working in collaboration with other agencies, organizations, and individuals, has established a program for occupational injury surveillance in Alaska and formed interagency working groups to address the risk factors leading to occupational death and injury in the state. Collaborative efforts have contributed to reducing crash rates and mortality in Alaska's rapidly expanding helicopter logging industry and have played an important supportive role in the substantial progress made in reducing the mortality rate in Alaska's commercial fishing industry (historically Alaska's and America's most dangerous industry). Alaska experienced a 46% overall decline in work-related acute traumatic injury deaths from 1991 to 1998, a 64% decline in commercial fishing deaths, and a very sharp decline in helicopter logging-related deaths. Extending this regional approach to other parts of the country and applying these strategies to the entire spectrum of occupational injury and disease hazards could have a broad effect on reducing occupational injuries.
BACKGROUND: Between 1990 and 1998, aviation accidents in Alaska caused 100 occupational pilot deaths (equivalent to 430/100,000 pilots/ year, approximately 86 times the overall U.S. worker fatality rate). Although Alaskan geography and climate increase aviation risks, many accidents were attributed to pilot error. While most accidents occurred during takeoff/landing, most fatalities resulted from Controlled Flight Into Terrain (CFIT). The purpose of this study was to examine risk factors for CFIT. METHODS: Using National Transportation Safety Board airplane accident data we identified CFIT from flight phase and event description fields, and calculated odds ratios for CFIT/non-CFIT accidents for visual conditions, aircraft features, and pilot experience. RESULTS: Between 1991 and 1998, 351 single aircraft commuter and air taxi accidents occurred in Alaska; 59 (17%) were CFIT. Of 140 total fatalities, 82 (59%) occurred in 30 CFIT accidents. There was a twelve-fold risk for death in CFIT vs. non-CFIT accidents (OR = 12.42, 95% CI = 8.19-18.88). Accidents while flying Visual Flight Rules (VFR) into poor visibility were more likely CFIT than non-CFIT (Odds ratio = 46.06, Confidence Interval = 19.32-112.46), and caused 37% of all deaths. Additionally, flights in Instrument Meteorological Conditions (IMC) were 47 times more likely to be CFIT than non-CFIT. No risk for CFIT was shown for flight hours, number of engines, passenger presence, or pilot age. All CFIT were attributed to pilot error, often for continuing VFR into poor visibility. CONCLUSION: CFIT caused most aviation deaths. Further research into human factors contributing to CFIT is needed. Implementation of global-positioning, ground-proximity/avoidance technology, might reduce CFIT incidence.
Approximately 20% of rural Alaskan homes lack in-home piped water; residents haul water to their homes. The limited quantity of water impacts the ability to meet basic hygiene needs. We assessed rates of infections impacted by water quality (waterborne, e.g. gastrointestinal infections) and quantity (water-washed, e.g. skin and respiratory infections) in communities transitioning to in-home piped water. Residents of four communities consented to a review of medical records 3 years before and after their community received piped water. We selected health encounters with ICD-9CM codes for respiratory, skin and gastrointestinal infections. We calculated annual illness episodes for each infection category after adjusting for age. We obtained 5,477 person-years of observation from 1032 individuals. There were 9,840 illness episodes with at least one ICD-9CM code of interest; 8,155 (83%) respiratory, 1,666 (17%) skin, 241 (2%) gastrointestinal. Water use increased from an average 1.5 gallons/capita/day (g/c/d) to 25.7 g/c/d. There were significant (P-value
Alaska Field Station, Division of Safety Research, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 4230 University Drive, Suite 310, Anchorage, Alaska 99508, USA.
BACKGROUND: Commercial fishing in Alaska accounts for an occupational fatality rate that is 28 times the rate for all U.S. workers. Most deaths are attributed to vessel sinking or capsizing. However, many deaths and most non-fatal injuries are not related to vessel loss. This paper describes injuries that occur on the dock or on the fishing vessel. METHODS: Data from fishing fatalities and non-fatal injuries between 1991-1998 were analyzed using the Alaska Occupational Injury Surveillance System and the Alaska Trauma Registry. RESULTS: There were 60 workplace deaths unrelated to vessel loss; most from falls overboard, others from trauma caused by equipment on deck. There were 574 hospitalized injuries, often from falls on deck, entanglement in machinery, or being struck by an object. SUMMARY: Fishing boats are hazardous working environments. Further efforts are required to prevent falls overboard and on deck, and to redesign or install safety features on fishing machinery and equipment.