If you try to find out how many people in the Netherlands sustain head and/or facial injuries in their work every year, you will not find any figures. Work-related head injury is not a category in the otherwise informative Monitor occupational accidents 2021. Although such accidents should often be reported, this is not always the case.
Much more data is available in countries with statutory accident insurance. An interesting Finnish study into work-related head injuries was recently published (Heimonen et al. 2023). The aim of this study is to study the risks and factors leading to work-related head injuries in different economic sectors. This may provide tools for prevention.
Preventing work-related head injuries
Definition of industrial accident
An “occupational accident” or “accident at work” is an accident that occurs during the exercise of a profession or during the performance of activities in the context of a profession. It could be an accident leading to physical or mental injury and missing three dates or more. It could be an accident with injury, illness or death. Thus the definition of the EWAS (European Statistics on Accidents At Work) from 2013. In 2018 it went into effect 6% of all occupational accidents in the European Union to head injuries. But at the 24% of fatal industrial accidents involve head injuries. There is also often permanent disability after head injuries.
In Finland, a country with a working population of approximately 2,5 million, the number of head injuries has been more or less constant in recent years with approximately 16.000 cases per year (2010-2017 data). The researchers want to investigate this further in order to find tools for prevention. In various industrial sectors, the occurrence of head injuries and the causes that led to their occurrence have been examined.
This study was carried out in a register of accident insurance (a national system of statutory insurance). Data from 20 industrial sectors were analyzed using the ESAW classification codes. The register has information about various ESAW variables that describe the situation in which the occupational accidents took place. To outline the risk profile per sector, the annual accident density calculated: the annual incidence of head injury per 1000 insurance years.
There is also information about the body parts that have been injured (such as head, neck, back, chest, organs, arms, hands, legs and feet). The study of head injuries included the code numbers 11. head, brain, cranial nerves and blood vessels; 12. face; 13. eyes; 14 ears; 15. teeth; 18 head, multiple spots affected; and 19 main, no other designation.
Between 2010 and 2017, 37.986 work-related head injuries were registered. After excluding accidents in commuting (2669) and leisure time (2418), 32.898 occupational accidents with head injuries were included in the study. More than two-thirds (69,6%) of the cases involved men.
Over the years, the annual accident densities show a highly varied risk profile across the 20 sectors. Some industries, such as the construction industry, has a consistent high risk profile for head injury. The incidence per 1000 insurance years was 15,7% the highest. In other high-risk industries such as mining, the profile varies more from year to year. In other sectors, the risk profile is consistently low, such as information and communication.
Among work-related head injuries, injuries of the eyes (49,6%) are most common, followed by brain, cranial nerves and blood vessels (21%) and face (18%). Eye injuries were most common in construction (70,4%) and manufacturing companies (66,2%), while in health care and social work it was much lower (25,3%). In the healthcare sector, brain, cranial nerve and blood vessel injuries were more common (32,5%), as were facial injuries (29%). These were less common in construction and industry.
The most common specific activities (ESAW codes) associated with work-related occupational accidents are movement, working with objects and working with hand tools. In construction, the greatest risk of head injury came from working with hand tools with a relative risk of RR = 2,23 (95% CI 2,14–2,32). In the manufacturing industry, it concerns operating machinery with an RR = 3,32 (95% CI 3,01–3,66) and working with hand tools with an RR = 1,99 (95% CI 1,91 –2,07).
In health care and social work, these causes hardly occur and are more concerned with movement (RR = 1,85 with 95% CI 1,78–1,92), presence (RR = 2,65 with 95% CI 2,40 –2,91) and other activities not specified (RR = 2,80, 95% CI 2,30–3,40).
Concerning the type of accident, collisions with moving parts and being struck by falling objects are the most common, followed by contact with hazardous substances and collision with stationary objects. But in health care and social work, it mainly concerns contact with hazardous substances (in the nose, mouth or inhalation) with an RR = 13,48, 95% CI 10,29–17,66) and biting, kicking, hitting with an RR = 8,40 (95% CI 7,79–9,07) relative to other sectors.
The most common cause of industrial accidents in construction and industry leading to head injuries are unexpected events such as flooding, tipping over, leaks, evaporation, etc. In health care and social work, shock, fear, violence, aggression, threat (nine times higher than in construction and industry). Electrical problems, explosion and fire are also more common in these sectors (four times).
There is a particularly high incidence of work-related head injuries in the construction and manufacturing industries. But health care and social work are also struggling with this, where violence is an important risk factor. Attention to the specific circumstances of the injury is important for prevention, for example information about the gender distribution, the nature of the work and the workplace.
Heimonen, A., Nousiainen, K., Lassila, H. et al. Work-related head injury and industry sectors in Finland: causes and circumstances. Int Arch Occup Environment Health (2023). https://doi.org/10.1007/s00420-022-01950-9