• 한국안전학회지
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• 제37권3호
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• pp.52-59
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• 2022

Conventionally, all the unsafe acts by human beings in relation to industrial accidents have been regarded as unintentional human errors. Exceptionally, however, in the cases with fatalities, seriously injured workers, and/or losses that evoked social issues, attention was paid to violating related laws and regulations for finding out some people to be prosecuted and given judicial punishments. As Heinrich stated, injury or loss in an accident is quite a random variable, so it can be unfair to utilize it as a criterion for prosecution or punishment. The present study was conducted to comprehend how categorizing intentional violations in unsafe acts might disrupt conventional conclusions about the industrial accident process. It was also intended to seek out the right direction for countermeasures by examining unsafe acts comprehensively rather than limiting the analysis to human errors only. In an analysis of 150 industrial accident cases that caused fatalities and featured relatively clear accident scenarios, the results showed that only 36.0% (54 cases) of the workers recognized the situation they confronted as risky, out of which 29.6% (16 cases) thought of the risk as trivial. In addition, even when the risks were recognized, most workers attempted to solve the hazardous situations in ways that violated rules or regulations. If analyzed with a focus on human errors, accidents can be attributed to personal deviations. However, if considered with an emphasis on safety rules or regulations, the focus will naturally move to the question of whether the workers intentionally violated them or not. As a consequence, failure of managerial efforts may be highlighted. Therefore, it was concluded that management should consider unsafe acts comprehensively, with violations included in principle, during accident investigations and the development of countermeasures to prevent future accidents.

• Journal of Trauma and Injury
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• 제32권4호
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• pp.226-237
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• 2019

Purpose: This study investigated the characteristics of adult patients who had fallen from a height and presented to an emergency room (ER) according to gender and intentionality, with the goal of reducing the harm caused by these injuries. Methods: A retrospective analysis was conducted of fall-from-height patients aged ≥19 years from the in-depth surveillance study of injured patients visiting ERs conducted under the supervision of the Korea Centers for Disease Control and Prevention from 2011 to 2016. Patterns were analyzed according to gender and intentionality. Results: There were 29,838 men (68.5%) and 13,734 women (31.5%), with mean ages of 50.3±15.7 years and 57.2±19.9 years, respectively. The most common height of the fall was ≥1 m to 4 m in men (n=15,863; 53.2%) and <1 m in women (n=7,293; 53.1%). The most common location where the fall occurred was the workplace for men (n=10,500 male; 35.2%) and residential facilities for women (n=7,755; 56.5%). Most falls from height were unintentional (n=41,765; 97.1% vs. n=1,264; 2.9% for intentional falls). Suicide was the most frequent reason for intentional falls, and the age group of 19-30 years predominated in this category (n=377; 29.9%). For intentional falls, the most common interval before presentation to the ER was 0-6 hours (n=370; 29.3%) and the most common height was ≥4 m (n=872; 69.0%). Conclusions: Among men, falls from height most often occurred from ≥1 m to 4 m, at the workplace, and during the course of paid work, whereas among women, they were most common from <1 m, in residential facilities, and during daily activities. Intentional falls most often occurred with the purpose of suicide, in the age group of 19-30 years, with an interval of 0-6 hours until treatment, from ≥4 m, and in residential facilities. Alcohol consumption was more common in intentional falls.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.196-205
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• 2023

Purpose: Surgical stabilization of rib fractures (SSRF) is widely used in patients with flail chests, and several studies have reported the efficacy of SSRF even in multiple rib fractures. However, few reports have discussed the hardware failure (HF) of implanted plates. We aimed to evaluate the clinical characteristics of patients with HF after SSRF and further investigate the related factors. Methods: We retrospectively reviewed the electronic medical records of patients who underwent SSRF for multiple rib fractures at a level I trauma center in Korea between January 2014 and January 2021. We defined HF as the unintentional loosening of screws, dislocation, or breakage of the implanted plates. The baseline characteristics, surgical outcomes, and types of HF were assessed. Results: During the study period, 728 patients underwent SSRF, of whom 80 (10.9%) were diagnosed with HF. The mean age of HF patients was 56.5±13.6 years, and 66 (82.5%) were men. There were 59 cases (73.8%) of screw loosening, 21 (26.3%) of plate breakage, 17 (21.3%) of screw migration, and seven (8.8%) of plate dislocation. Nine patients (11.3%) experienced wound infection, and 35 patients (43.8%) experienced chronic pain. A total of 21 patients (26.3%) underwent reoperation for plate removal. The patients in the reoperation group were significantly younger, had fewer fractures and plates, underwent costal fixation, and had a longer follow-up. There were no significant differences in subjective chest symptoms or lung capacity. Conclusions: HF after SSRF occurred in 10.9% of the cases, and screw loosening was the most common. Further longitudinal studies are needed to identify risk factors for SSRF failure.