eLCOSH : Fatal Occupational Injuries in Massachusetts 1991-1999

Fatal Occupational Injuries in Massachusetts 1991-1999

Massachusetts Department of Public Health

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Massachusetts Department of Public Health

3.1 Fatal Falls to Lower Levels

Workplace falls claimed the lives of 133 Massachusetts workers between 1991-1999 accounting for 21% of all fatal occupational injuries during this period. The average annual fall fatality rate was 0.5 per 100,000 workers, similar to the 1999 fall fatality rate of 0.5 per 100,000 workers for the nation. Fatal workplace falls in Massachusetts occurred in a wide range of circumstances. The great majority (118 fatalities, 89%) were falls to lower levels. Falls from roofs (26), ladders (21), and scaffolds and staging (18) were the most common. This special topic section focuses on fatal falls to lower levels.

Most fatal falls to lower levels occurred in the construction industry division.

Most fatal falls to lower levels (71 fatalities, 60%) occurred in the Construction industry division, an average of 8 fatalities per year (Table 10). The Service industry division had the second highest number of fatal falls to lower levels (13 fatalities).
Within the Construction industry division, the Special Trade Contractors major industry group accounted for 81% (58 fatalities) of fatal fall injuries. Contractors engaged in roofing and sheet metal work, carpentry and floor work, structural steel erection, and masonry work led all other groups in the number of fatalities.
The construction industry division also had a high annual average rate of fatal falls to lower levels (6.6 fatalities per 100,000 workers), more than sixteen times the overall rate for all industry divisions (0.4 fatalities per 100,000 workers).

Table 10. Number and Average Annual Rate of Fatal Falls to Lower Levels in the Construction Industry Division, Massachusetts, 1991-1999

Industry Division	Number of Falls to Lower Levels (1991-99)	Percent	Average Annual Fall Fatality Rate
Construction	71	60	6.6
Special trade contractors - Roofing, siding and sheet metal work - Carpentry work - Structural steel erection - Masonry, stone setting, tile setting and plastering	58 14 11 9 7	49 12 9 8 6
All industry divisions	118	100.0	0.4

A pest control technician died when he fell from the roof of an apartment building. The technician was spraying for spiders in the vents and other parts of the roof when the incident occurred. While spraying along a gutter of a rooftop penthouse, the technician walked off the edge of the roof and fell nine stories to the parking lot below. Emergency medical services were called immediately. The victim was given CPR and transported to a local hospital emergency room where he died.

In order to prevent similar incidents in the future, FACE recommended that employers: 1) should develop and implement a site specific health and safety plan for each site under contract; and 2) employ alternative controls for fall hazards when personal fall arrest systems are not required or appropriate. Building owners should consider installation of guardrails at the perimeter of flat roofs wherever possible (Massachusetts FACE report 97MA038).

Fatal falls in the construction industry division were concentrated in small establishments.

About two-thirds of the fatal falls to lower levels in the construction industry division occurred in small establishments with 10 or fewer employees (Chart 11).
Establishments with fewer than 11 employees are not regularly inspected by OSHA unless a fatality occurs. Therefore, they are likely to have less contact with safety inspectors than large establishments and less knowledge about safety precautions should be taken to prevent fall injuries.

Chart 11. Number of Fatal Falls to Lower Levels in Construction Industry Division by Establishment Size, Massachusetts, 1991-1999 (N = 69)

Roofers and Carpenters had the highest number of fatal falls to lower levels.

Construction occupations accounted for 60% of all falls to lower levels. Roofers and carpenters had the highest number of fatal falls followed by construction laborers, and structural metal workers (Table 11).

Table 11. Number and Percent of Fatal Falls to Lower Levels by Selected Occupations, Massachusetts, 1991-1999

Occupation	No. of Fatal Falls	Total Fatal Injuries	% of Fatal Injuries Due to Falls
Roofers	14	16	88
Carpenters	11	16	59
Construction laborers	7	21	33
Structural metal workers	7	7	100
Brick and stone masons	6	6	100
Painters	6	9	75
All occupations	118	633	19

Falls to lower levels accounted for a high proportion of fatalities (52%, 71 fatalities) among construction workers, whereas only 19% of total fatal injuries in the state were due to falls to lower levels. All of the occupational fatalities among the brick and stone masons and structural metal workers were due to falls.

Majority of fatal falls to lower levels in construction occurred from heights of less than 20 feet.

Height information was available for 56 out of 71 fatal falls to lower levels in the construction industry division. Of these 56 fatal falls, 52% (29 fatalities) occurred from heights of 20 feet or less (Chart 12). Eight fatal falls (14%) occurred from heights of 10 feet or lower and another 8 falls occurred from heights of over 30 feet. The heights ranged from 3 feet to 130 feet.

Chart 12. Fatal Falls to Lower Levels in the Construction Industry Division by Height of Fall, Massachusetts, 1991-1999 (N = 56)

Falls to lower levels were the leading event among older workers.

Falls to lower levels accounted for 41% (20 fatalities) of all work-related fatal injuries among workers age 65 years and older. The annual average fatal fall rate for these workers was 2.7 per 100,000, more than six times higher than the average rate for all age groups (Chart 13). This rate would be even higher if hours of work were used as a denominator instead of number of workers employed because older workers are more likely to work part time.¹⁵

A 23-year old ironworker was fatally injured when he fell approximately 20 feet through a roof opening to ice-covered ground. The victim was part of a crew that was building the flat roof on a new building, and he fell through an uncovered opening while he was capping the roof’s expansion joists with its center plate. The victim was not wearing any fall protection.

In order to prevent future similar incidents, FACE recommended that employers: 1) require floor openings to be adequately protected; 2) provide and require use of fall protection equipment; and 3) design, develop and implement a comprehensive safety program that includes, but is not limited to, fall protection (Massachusetts FACE report, 94MA011).

Chart 13. Number and Rate of Fatal Falls to Lower Levels by Age of Workers, Massachusetts, 1991-1999

NOTE: Rates are not presented for age groups with fewer than 5 fatalities. Employment data from the Current Population Survey for 1995 is used to calculate rates.

Preventing Falls to Lower Levels in the Workplace

Surveillance findings underscore falls in construction as a priority for prevention in Massachusetts. Falls in this industry division should not simply be accepted as part of the job. Comprehensive worksite fall prevention programs, including the use of fall protection systems, can reduce the risk of fall injuries in construction. The Occupational Safety and Health Administration has established standards for fall protection in construction workplaces (Subpart M, Fall Protection, 29 CFR 126.500- 1926.503). Employers should develop and implement comprehensive fall protection programs that, at a minimum, meet these OSHA requirements. The National Institute of Occupational Safety and Health (NIOSH) recommends the following elements as a guide for employers and workers in developing fall-protection programs: ¹⁶

Address all aspects of safety and hazards in the planning phase of projects
Train employees in the recognition and avoidance of unsafe conditions and the OSHA regulations applicable to their work environment
Provide appropriate fall protection equipment
Train workers on the proper use of fall protection equipment, enforce its use, and inspect equipment daily
Conduct scheduled and unscheduled safety inspections of the work-site
Address environmental conditions, language differences, alternative methods/equipment to perform assigned tasks, and establish medical and rescue programs
Encourage workers to participate actively in workplace safety

In addition to these general recommendations, NIOSH also recommends specific strategies to prevent falls from ladders, scaffolds, and roofs, common fall hazards both in Massachusetts and across the nation.

To prevent falls from ladders:

Select and use the proper type of ladder (get the right size and check the duty rating)
Inspect ladder, prior to using, for structural damage, missing or damaged safety devices, substances that could cause slips or falls, and paint or stickers that could hide defects
Tag and remove defective ladders from the work-site
Wear approved fall protection equipment, if applicable
Use ladders only on solid, stable and level surfaces unless secured to prevent accidental displacement
Use ladders only as recommended by manufacturer (do not use ladder in a horizontal position as a scaffold, do not have more than one person on the ladder at a time, do not overload, do not work from the top rungs of an extension ladder or the top of a step ladder)
Maintain ladders regularly (change shoes and lubricate metal bearings, locks and pulleys)
Train workers on safe use and make sure that they understand and follow safe use of ladders

To prevent falls from scaffolds:

Select and use the proper type of scaffold for the job
Provide access ladder to scaffolds
Use scaffold grade lumber for all platforms
Install guardrails and toe-boards on all open sides and ends of platforms more than 10 feet above the ground
Make sure that the footing or anchorage for scaffolds is sound, rigid, and capable of carrying four times the maximum intended load, including its own weight
Inspect the scaffolding after erection and before first use
Inspect the scaffolds routinely for consideration of footing (anchorage), parts of the scaffolds, and slippery conditions
Train workers on the safe way to use scaffoldings

To prevent falls from roofs and buildings:

Install guarding and/or fall protection on all roof openings
Put warning signs on all roof openings
Make cutting the roof openings a last action on the roof
Provide fall protection measures along unguarded roof perimeters and balconies
Install a cover (for roof and floor openings) capable of supporting the maximum intended load

Innovative efforts are needed to reach employers and workers in small construction businesses. The Massachusetts Department of Public Health has developed a series of educational brochures on prevention of falls in residential construction, and distributes these through building permit offices in cities and towns throughout the Commonwealth. These materials are available in English, Spanish, Portuguese and Haitian Creole from the Occupational Health Surveillance Program upon request.

A 49-year-old male inventory control clerk died when he fell approximately 12 feet from a high-lift order-picker truck while applying barcode labels in a warehouse freezer. The order picker truck was not positioned next to the desired location due to boxes in the aisle. He fell as he stepped from the raised order picker truck onto a stacked box of product in an attempt to reach the next higher shelf. He was wearing a body harness and lanyard that was not secured to an anchor point on the order picker truck.

In order to prevent future similar incidents, FACE recommended that employers should: 1) adopt a mandatory tie-off/no unhook policy for employees using order picker trucks; 2) ensure that aisle ways are maintained free from obstructions that would interfere with lift truck access to storage shelves; 3) strictly enforce the safety precautions outlined in comprehensive safety programs; and 4) regularly review and update the programs and training. In addition, high lift order picker truck manufacturers should consider equipping trucks with devices that will activate audible or visible alarms if the operator unhooks fall protection while the lift is raised (Massachusetts FACE Report, 99MA058).

3.2 Work-related Homicide

Homicide was the third leading fatal occupational event in Massachusetts between 1991-1999. During this period, 82 workers (13%) died as a result of homicides at work. The average annual occupational homicide rate was 0.3 per 100,000 workers.

Work-related homicides were concentrated in a small number of industries and occupations.

As shown in Chart 14, more than one-third (37%) of the victims of work-related homicide in Massachusetts were employed in the Wholesale and Retail Trade industry division. The Service and Transportation and Public Utilities divisions followed, accounting for 27% and 20% of workrelated homicides, respectively. These three industry divisions combined accounted for 84% (68 homicides) of all work-related homicides.
Occupations with high number of homicides were sales supervisors and proprietors (13 homicides), police and detectives (12 homicides), and taxi drivers and chauffeurs (11 homicides). These three occupations, combined, accounted for 44% of all homicides at work.
Exchange of money and direct customer service are risk factors for workplace homicide. For example, national data indicate that taxi and livery drivers were 60 times more likely than other workers to be victims of work-related homicide.¹⁷

Chart 14. Workplace Homicide by Industry Division, Massachusetts, 1991-1999

The risk of workplace homicide was higher for men than women; however, homicide accounted for a higher proportion of work-related fatalities among women than men.

The average annual occupational homicide rate for male workers (0.5 per 100,000 workers) was five times the female homicide rate of 0.1 per 100,000 workers. This difference was much greater than the difference between the overall homicide rates for men and women in the community (2.8 per 100,000 for males vs 1.2 per 100,000 for females).¹⁸
Although men were more likely to die as a result of homicide on the job than women, homicides accounted for 27% of all fatal occupational injuries among female workers and only 12% of all occupational fatalities among men.

A 68-year old merchant was shot to death in a late-morning hold-up attempt at his neighborhood grocery store. According to newspaper reports, a gunman ordered several customers to the floor but was stopped by the proprietor after walking around the store counter. The grocer, who was working alone, was shot in the ensuing struggle. He had reportedly been trying to sell the store after several earlier robberies (Massachusetts CFOI report, 1994).

A disproportionate number of black, Hispanic, and foreign-born workers were victims of workplace homicide.

Homicide was the leading fatal event among black and Hispanic workers, accounting for 45% (14 fatalities) and 31% (10 fatalities) of all fatal occupational injuries among black and Hispanic workers, respectively. In contrast, only 11% of the occupational fatalities among white workers were the result of homicide. This finding is consistent with national data.
Between 1991 and 1999, black and Hispanic workers were victims of 17% and 12% of all workplace homicides respectively, while they constituted only 4% and 3% of the state’s labor force. In contrast, white workers, who constituted 93% of the labor force, were victims of 76% of workplace homicides.
Twenty-five percent (28 fatalities) of the work-related fatalities among foreign-born workers in Massachusetts were due to homicides, whereas homicides accounted for only 10% of the occupational fatalities among workers born in the U.S.
A high risk of workplace homicide among black, Hispanic and foreign-born workers at the national level was explained in large part by their concentration in occupations with high homicide rates such as taxicab drivers and managers and proprietors of small business establishments.¹⁹
Self-employed workers, including those working for a family business, accounted for 23% of the homicides at work, whereas they comprised only 7% of all employed workers during 1999.

Patterns of workplace homicide differ from patterns of homicide in general

Homicide in the workplace is characterized by unique patterns that set it apart from homicide in general. For instance, robbery was the precipitating circumstance in 49% of work-related homicides where motives were known in Massachusetts over the nine-year period. In contrast, a 1995 report by the Massachusetts Department of Public Health (MDPH) identifies robbery or other felony as responsible for less than one-fifth of all homicides in Massachusetts between 1978 and 1993.
The MDPH report also points out that 45% of homicide victims in general were related to or acquainted with their assailants, a higher percentage than the 26% of workers who were fatally injured by someone they knew (Chart 15).
Homicide in the workplace is also more likely to result from shooting than homicide in general. In
Massachusetts, 68 percent of workers who died as a result of homicide between 1991 and 1999 were fatally injured by shooting, while shootings were responsible for approximately 54 percent of Massachusetts homicides overall in 2000.20 Such differences between workplace and community homicides have been found to exist to an even greater degree at the national level.

A lawyer was shot and fatally injured by his client’s husband. He had gone to the residence of the client. While the lawyer was in her house, the client’s husband shot and killed the victim, his wife, and himself (Massachusetts CFOI report, 1995).

An off-duty police officer was killed when a perpetrator who was accused of child molestation stabbed him. The officer was consoling the family of the molested child when the assailant showed up with a knife and mace to attack the child’s family. The officer tried to fend off the assailant and was stabbed in the ensuing struggle. He died later from the stab wound he suffered (Massachusetts CFOI report, 1997).

Chart 15. Workplace Homicide by Circumstance Massachusetts, 1991-1999 (N = 51)

Preventing Violence in the Workplace

Workplace violence cannot be considered independently from violence in the community at large. Efforts to prevent violence in the community should contribute to reduction of injuries due to violence at work. At the same time, it is important to recognize that specific efforts can and should be made to address violence in the workplace. As discussed, patterns of workplace homicides are distinct from patterns of homicide in the community in general and point to unique opportunities for violence prevention. While specific approaches will vary depending by the type of workplace, there are steps that most workplaces can take to address risk factors that have been identified. These risk factors include: ²¹

Contact with the public
Exchange of money
Delivery of passengers, goods, or services
Having a mobile workplace (i.e. taxicab, police cruiser)
Working with unstable persons in health care, social services, or criminal justice settings
Working alone or in small numbers
Working late at night or during early morning hours
Guarding valuable property or possessions
Working in high-crime areas
Working in community-based settings

The National Institute for Occupational Safety and Health has recommended that workplace violence prevention programs should include:

1) Management commitment

Management should develop and publicize a written “zero tolerance for violence” policy. A written program should include a policy statement, a system of record keeping, and a program of responsibilities and actions in the event of violence. Implementation of the program should entail mechanisms for reporting threats or violent acts, identification of procedures for dealing with violence, and enforcement of the non-violence policy.

Three immigrant taxi drivers were killed during robberies in separate incidents. One incident occurred during daytime while the other two occurred during evening and early morning hours. The cab of one of the victims did not have a safety partition. Another victim was using his own car as a cab to drive shoppers from a neighborhood supermarket to their residences (Massachusetts CFOI report, 1997).

2) Work-site analysis

Identification and analysis of potential problem areas is a necessary prelude to implementing effective control measures. Part of this process involves studying the history of violence in the community and workplace to better understand the scope and nature of potential violence. A comprehensive physical inspection of the work-site to document areas where controls are in order is also necessary.

3) Environmental controls

Controls will vary with the work setting. Measures may include: enhanced lighting at strategic outside locations and enhanced street visibility; installation of security devices such as alarms, mirrors and video cameras; and design of entrances and exits to deter access by unauthorized persons and eliminate hiding places. In retail and other establishments where money is exchanged, the installation of bulletproof glass can provide workers with physical protection, while using drop safes and posting signs about limited cash availability may also serve as deterrents. In other settings where the public or clients may pose a threat, additional controls may include the provision of separate and locked bathroom facilities for staff, the installation of panic buttons and alarms, and the use of card key access systems.

4) Administrative controls

Staffing patterns are among the foremost violence prevention administrative measures. Increasing the number of staff on site is only one possible control. Particular activities may carry increased risk, such as transporting patients or storing money. Increased staffing policies should be implemented for such activities. Using trained security guards is another way of improving workplace security. Employee training and education on hazard recognition, safe work practices, and conflict resolution is another form of administrative control. Instructing employees in restaurants or bars on how to deal with customers who leave without paying or cause problems and making clear that employees should not physically engage customers are examples of such practices.

Preventing violence against taxi drivers

Taxi and livery drivers face an increased risk of workplace violence both in Massachusetts and nationally. The Occupational Safety and Health Administration recommends the following protective measures to prevent violence-related injury to taxi drivers and speed response time to those who need help. They include:²²

Automatic vehicle location or global positioning system (GPS) to locate drivers in distress
Caller ID to help trace location of fares
First-aid kits in every car for use in emergencies
In-car surveillance cameras
Partitions or shields between the driver and passenger
Protocol with police—owners and police to track high-crime locations
Radios to communicate in emergencies (e.g., with an “open mike switch”)
Safety training for drivers
Silent alarms
Use of credit/debit cards (“cash-less” fare systems) to discourage robberies

A plain-clothes police officer was shot and killed by an assailant. The officer was responding to a domestic disturbance call from residents and saw one of the men involved in the disturbance leaving the scene. As he followed the assailant, the assailant shot and wounded him several times. He later died of gun shot injuries (Massachusetts CFOI report, 1999).

3.3 Commercial Fishing

Fishing claimed the lives of more workers in Massachusetts during 1991-1999 than any other single occupation. During this period, 57 Massachusetts fishers were fatally injured on the job. All victims were men, 24 were self-employed, 43 were white, and 15 were foreign-born. It was not possible to compute a state-specific fatality rate for the fishing industry because adequate data on the number of workers in this industry in Massachusetts were not available. However, commercial fishing has been found to be the most dangerous industry in the country. Nationally, between 1992-1996, an average of 76 fishers were fatally injured on the job each year, and the fatal occupational injury rate was 140 fatalities per 100,000 fishers, more than 28 times the average rate for all industries.²³ During the same period, Massachusetts was second only to Alaska in the number of fishers fatally injured at work.

Most Massachusetts fishers died as a result of sinking or capsizing of water vehicles.

Sinking or capsizing of water vehicles were the leading events accounting for 60% (34 fatalities) of fishing fatalities (Chart 16). Thirteen workers fell overboard from fishing vessels and 10 died from other injuries such as being struck by a tow-line, inhalation of substance in enclosed, restricted or confined space, being caught in a rotating fishing vessel engine, and falling on boats.

Chart 16. Fishing Fatalities by Event/Exposure Massachusetts, 1991-99 N = 57

Out of the 34 fatalities due to sinking or capsized fishing vessels, 88% (30 fatalities) were due to ten multiple-fatality incidents with 2 to 6 lives lost at one time. Vessel size information was available for 5 fishing vessels that sunk or capsized, and their size ranged from 40 feet to 112 feet.

Sinking or capsizing of water vehicles claimed more lives of Shellfisher than finfisher.

Of the total 57 fatalities, 27 victims were shellfishers and 26 were finfishers. Information on specific industry was not available for 4 fatalities. Nationally, more shellfishers (188 fatalities) than finfishers (138 fatalities) died between 1992 and 1997.²⁴

Two fishers were fatally injured when their fishing vessel sank. They were part of a five-man crew on a quahog clam boat. The other three members were rescued by another fishing vessel. The weather condition was rainy with strong wind, high seas, low visibility, and cold water temperature. The bodies of the victims were found washed up on shore two days later (Massachusetts CFOI report, 1999).

Events involving sinking or capsizing water vehicles claimed more lives of finfishers than shellfishers in Massachusetts. Two-thirds (77%, 20 fatalities) of finfishers who were fatally injured on the job died when their fishing boats sank or capsized, whereas less than half (48%, 13 fatalities) of the fatalities among shellfishers were the result of similar events.
Fall overboard events were more common among shellfishers than finfishers. One-third (33%, 9 fatalities) of the fatalities among shellfishers and about one-tenth (3 fatalities, 12%) of the fatalities among finfishers were the results of a fall overboard.

Most fishing fatalities occurred during fall and winter seasons.

In Massachusetts, most fishing fatalities occurred during fall and winter seasons (Chart 17). Six in 10 of all fishing fatalities and two-thirds (68%) of the fatalities due to capsized fishing boats occurred in the months between October and March.

Chart 17. Work-related Fishing Fatalities by Time of the Year, Massachusetts, 1991-1999 (N = 57)

Preventing work-related fatalities among commercial fishers

Capsizing or sinking vessels accounted for the majority of fatalities among commercial fishers in Massachusetts. A NIOSH working group on Commercial Fishing in Alaska identified vessel stability and hull integrity, licensing and training of operators and crew, management regimes, and avoidance of most harsh sea and weather conditions as critical issues to be addressed to prevent fatalities due to capsizing and sinking fishing vessels. The working group recommended the following measures²⁵:

Two fishers were fatally injured when their fishing trawler sank. One of them died of hypothermia and drowning and the other could not be found and was presumed dead. According to reports from the Coast Guard, the vessel did not meet several of the voluntary standards set for small commercial fishing vessels. The life raft was found to have been stowed improperly in the wheelhouse. The Emergency Positioning Indicating Radio Beacon (EPIRB), an electronic device meant to float to the surface and give off a signal during an emergency, had also been improperly stowed. In addition, the vessel did not carry immersion suits that protect workers from exposure to cold water (Massachusetts CFOI report, 1991).

A requirement for periodic stability reassessment and inspection of all vessels
Minimum specifications for watertight components and bulkheads sufficient to keep vessels afloat
Assessing thoroughly the current licensing and training requirements for skippers and crew and correcting deficiencies
Establishing adequate watchkeeping and staffing requirements for all vessels
Examining all existing and proposed management regimes from a health and safety perspective

A considerable number of fishers also die from falling overboard. Personal Flotation Devices (PFD) can increase the chance of survival. A study by NIOSH indicates that 63% of fishers who fell overboard while wearing PFDs have survived, while only 12% of those who did not wear PFDs survived.²⁶

The availability of PFDs in a readily accessible area to all crewmembers is necessary. The choice and proper use of PFDs during routine work on deck can save the lives of fishers who fall overboard and risk drowning or hypothermia.

NIOSH recommends the following to prevent overboard falling and related fatalities:

Use safety lines when possible
Install or extend guardrails where possible
Keep decks as clean and clear as possible to prevent slipping or tripping
Ensure that vessels are equipped with at least one Personal Floatation Device (PFD) or immersion suit for each person on board
Have a rescue system in place for a quick retrieval from the water
Always wear a PFD while on the deck of a commercial fishing vessel.

A lobsterman died after falling off his boat. He was alone in his boat when he went to check his traps. Hours later, another fisherman found him beneath his boat. He died later from the injuries he suffered (Massachusetts CFOI report, 1996).

Two fishers were fatally injured in two separate incidents when their clothes became entangled in the rotating propulsion shafts of the fishing vessels they were working aboard.

Victim # 1 was attempting to gain access to the bilge pump. He removed the deck cover, which exposed approximately 2 feet of the 2½-inch diameter rotating propulsion shaft and flanged coupling. While reaching underneath the propulsion shaft to clear away debris from the bilge pump the victim's shirt became entangled in the rotating shaft, pulling him into the bilge.

Victim # 2 was owner of a fishing vessel and was assisting his son in solving a problem with the vessel's propulsion system. Prior to checking the transmission and propulsion shaft, the victim had removed the wooden deck cover exposing approximately 1½ feet of the 1½ inch diameter rotating propulsion shaft and flanged coupling. The engine shut down after a clanging sound was heard. The son turned around and found his father entangled in the propulsion shaft.

In order to prevent similar future incidents, the FACE program recommended that fishers should: 1) disengage the transmission before attempting to work on or near the transmission and propulsion shaft; and 2) guard moving machine parts, such as propulsion shafts, to avoid contact (Massachusetts FACE reports, 99MA068 and 99MA072).

15 Ruser, J. Denominator Choice in the Calculation of Workplace Fatality Rates. Fatal Workplace Injuries in 1996: A Collection of Data and Analysis, U.S. Department of Labor, Bureau of Labor Statistics, June 1998.

16 U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Worker Deaths by Falls: A Summary of Surveillance Findings and Investigative Case Reports, November 2000.

17 U.S. Department of Labor, Occupational Safety and Health Administration, Risk Factors and Protective Measures for Taxi and Livery Drivers. May 2000.

18 Massachusetts Department of Public Health, Bureau of Health Statistics, Research and Evaluation, Research & Epidemiology, Massachusetts Deaths, 2000.

19 Castillo, D. and Jenkins, L. Industries and Occupations at High Risk for Work-Related Homicide, Journal of Medicine, Volume 36(4), February 1994.

20 MDPH, Bureau of Health Statistics, Research and Evaluation, Research and Epidemiology, Massachusetts Deaths, 2000.

21 U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Violence in the Workplace, 1996.

22 U.S. Department of Labor, Occupational Safety and Health Administration, Risk Factors and Protective Measures for Taxi and Livery Drivers. May 2000.

23 Drudi, D. Fishing for a Living is Dangerous Work, Fatal Workplace Injuries in 1996: A Collection of Data and Analysis, BLS, June 1998.

24 Drudi, D. Persons Overboard/Sunk Vessels: Fishing Jobs Continue to Take Deadly Toll, BLS, Issues in Labor Statistics, June 1998.

25 NIOSH, Current Intelligence Bulletin 58, Commercial Fishing Fatalities in Alaska: Risk Factors and Prevention Strategies, September 1997.

26 Center for Diseases Control and Prevention, NIOSH, Preventing Drownings of Commercial Fishermen, Alert, April 1994.

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