Incidents under-reported

In residents of Seveso, Italy, a significant rise in the incidence of birth defects, as compared to pre-accident levels, was observed the year after the accident (Bisanti et al. 1980). A variety of birth defects were observed, but the incidence for any particular defect was not elevated. The authors suggest that the rise in birth defects may not be related to 2,3,7,8-TCDD exposure. Prior to 1976, birth defects in Italy were usually under reported the authors note that the reported incidences of birth defects after the accident (23 per 1,000 births) were similar to incidences reported in other western countries. Thus, the increased incidence may be reflective of the increased reporting rather than an increased number of birth defects. In a study which assessed the risk of birth defects for the 6-year period after the Seveso accident, no increases were observed for the risk of total defects (RR of 1.2, 90% Cl of 0.88-1.64 for zones A and B and RR of 0.97, 90% 0=0.83-1.13 for zones A, B, and R), major defects RR of 1.02, 90% 0=0.64-1.61 for zones A and B and RR of 0.83, 90% 0=0.67-1.04 for zones A, B and R), and minor defects RR of 1.44 90% 0=0.92-2.24 for zones A and B and RR of 1.14, 90% 0=0.92-1.42 for zones A, B and R) (Mastroiacovo et al. 1988). The small number of observed birth defects limits the statistical power of this study to detect significant increases in a specific defect. 

Since the literature on this topic largely comprises case reports and retrospective reviews, it is possible that complications may have been under-reported. In addition, there is marked variability in the reported incidence of respiratory complications from series to series, and there is the additional confounding factor that malignant pleural effusion, a condition with a poor short-term survival and significant associated morbidity, is often the... 

Typical concentrations for pesticides in indoor air obtained under defined conditions either directly during or after application and up to 20 years after an incident were reported by Pluschke [108]. Concentrations of various pesticides in the air of nonoccupational indoor environments of different countries and measured under different conditions are compiled in Table 2. Additionally results for chlorpyrifos in air were reviewed by Lemus and Abdelghani [109]. 

Ghaleb and Wong s review (2006) demonstrates that the spontaneous reporting systems tend to yield a lower rate of paediatric medication errors than the other methods. This is due to underestimation and under-reporting. In contrast, observation methods tend to find higher incidences than the other two methods. These published reports confirm that paediatric medication errors are at least as common as errors in adults. A study by Kaushal and colleagues (2001) has shown that potential adverse drug events may be three times more common in children than in adults. 

TBE is an important infectious disease of in many parts of Europe, the former Soviet Union, and Asia, corresponding to the distribution of the ixodid tick reservoir. The annual number of cases (incidence) varies from year to year, but several thousand are reported annually, despite historical under-reporting of this disease. 

Poorly defined feedback can lead to a decrease in safety. As an incentive to reduce the number of accidents in the California construction industry, for example, workers with the best safety records—as measured by fewest reported incidents— were rewarded [126]. The reward created an incentive to withhold information about small accidents and near misses, and they could not therefore be investigated and the causes eliminated. Under-reporting of incidents created the illusion that the system was becoming safer, when instead risk had merely been muted. The inaccurate risk perception by management led to not taking the necessary control actions to reduce risk. Instead, the reporting of accidents should have been rewarded. 

Incident investigation reports received had a variety of titles, although some were identical. They come under these names, which in themselves have significance ... 

The reactor was shut down at the time. There were neither casualties nor contamination. The incident had been reported under reportable incidents procedures and appropriate modifications made. 

The overall incidence ofpriapismis 1.5 per 100000 person-year [1]. Priapism is broadly classified as high-flow and low-flow. Arterial high-flow priapism (HFP) is usually secondary to the laceration of a cavernous artery with unregulated flow into the lacunar spaces. This type of priapism is most of the times not painful because there is no ischemia. HFP is rare and only 200 cases have been reported in the literature. Nonetheless, because it is painless, it is possible that HFP is under reported. The other type is veno-occlusive priapism which is usually caused by corporeal veno-occlusion, and can be very painful due to ischemia. 

We found that 23 % of hospital admissions in eight specialties were associated with patient safety incidents and 11% with adverse events. This is similar to rates found in studies using similar methods in the United Kingdom and internationally. The routine reporting system as implemented in this large hospital missed most patient safety incidents that were identified by case note review and detected only 5% of those incidents that resulted in patient harm. This suggests that the routine reporting system considerably under-reports the scale and severity of patient safety incidents. 

Before Six Sigma," Lanham reports, "frequency and type of incident reports would drive the direction of improvement projects. For example, if we had chosen a direction for this project based on prevalence of incident reports, we would have focused on R.N. medication administration and brainstormed ideas for improvement in this limited area. However, it is well known that events are tremendously under-reported. Our initial... 

Report, report, report Educate employees on the importance of reporting injuries, first aids and near misses. Prepare for an increase in incidents if currently there is under-reporting. It will level off eventually. 

Soft incident reporting (or under reporting) of the lessons that should be shared far and wide along with a lack of memory of these incidents. 

In previous years, the EPA site had a heading for EPA/OSHA Joint Chemical Incident Investigation Reports. A dozen or so were listed under that heading. Now these valuable well-researched documents typically in excess of 50pages are now available via the search engine. It appears that most of the incidents were in the 1995 to 1998 period and can be individually searched with a keyword as the incident location or organization name. 

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