Risks injuries reduction

Having presented in Appendix 3A the technical details of how the labor market establishes hedonic equilibrium we now fill in the details of the structural equations underlying the matching of workers to jobs by injury risk. We fill out the structure of our numerical simulations by describing the quantitative properties of workers utility functions including the distribution of workers by risk preferences, firms profit functions including the distribution of employers by their costs of injury reduction, and the economic properties of product and input markets. 

It is important to know and understand the desired end result and keep in focus what is to be achieved. In the case of safety, it might be a specific type of injury reduction through improved hazard and risk controls. 

HDetect Financial Risks. In addition to physical injuries, a company may be injured by the perception of injury that result in law suits, drop in stock price, and reduction in sales. A detailed analysis (2) will as.scss vulnerability but it docs not directly address the perception factor. A case in point is TMI-2 which complied with 10 CFRIOO, had no injuries and no deaths, but the company was driven to near-bankruptcy. Similarly with Bhopal and Union Carbide, although there were deaths. ... 

The Chemical Process Industry (CPI) uses various quantitative and qualitative techniques to assess the reliability and risk of process equipment, process systems, and chemical manufacturing operations. These techniques identify the interactions of equipment, systems, and persons that have potentially undesirable consequences. In the case of reliability analyses, the undesirable consequences (e.g., plant shutdown, excessive downtime, or production of off-specification product) are those incidents which reduce system profitability through loss of production and increased maintenance costs. In the case of risk analyses, the primary concerns are human injuries, environmental impacts, and system damage caused by occurrence of fires, explosions, toxic material releases, and related hazards. Quantification of risk in terms of the severity of the consequences and the likelihood of occurrence provides the manager of the system with an important decisionmaking tool. By using the results of a quantitative risk analysis, we are better able to answer such questions as, Which of several candidate systems poses the least risk Are risk reduction modifications necessary and What modifications would be most effective in reducing risk ... 

Policy makers, practitioners, and scholars from a variety of disciplines have recently embraced a new approach to risk reduction in health care—a "systems approach"—without proposing any specific reforms of medical liability law. The Institute of Medicine (IOM) placed its imprimatur on this approach in its recent reports (Kohn et al., 2000 IOM, 2001). In its simplest form, a systems approach to risk reduction in health care posits that an injury to a patient is often the manifestation of a latent error in the system of providing care. In other words, a medical mishap is the proverbial "accident waiting to happen" because the injury-preventing tools currently deployed, including medical liability law, are aimed at finding the individuals at fault rather than the systemic causes of error. Coexistence of a systems approach to error reduction and medical liability law as a conceptual framework for policy makers implies that the latter is likely to evolve in an incremental fashion as the former makes more visible different aspects of the medical error problem. 

Risk is defined as a measure of human injury, environmental damage, or economic loss in terms of both the incident likelihood (probability) and the magnitude of the loss or injury (consequence) (AICHE/CCPS, Guidelines for Chemical Process Quantitative Risk Analysis, 2d ed., American Institute of Chemical Engineers, New York, 2000, pp. 5-6). It is important that both likelihood and consequence be included in risk. For instance, seat belt use is based on a reduction in the consequences of an accident. However, many people argue against seat belts based on probabilities, which is an incorrect application of the risk concept. 

Exercise is not without risks these include sudden cardiac death, hyperthermia, hypothermia, hypoglycaemia, hypo-natraemia, a reduction in the effectiveness of the immune system, overuse injury and interference in the reproductive system in females. Whether severe physical activity affects the reproductive system in males is sometimes discussed but these are no reports in the scientific literature. 

One useful tool of risk assessment is to compare the risk before and after prevention or mitigation to determine the difference in risk. A cost benefit analysis can be completed that determines the cost of the mitigation versus the amount of risk reduction. All costs need to be calculated to determine a cost per year. These costs would include fire damage, injury or fatality, insurance cost increases, loss of profits, etc. The cost of the mitigation, including capital and maintenance costs, needs to be determined. 

Abrupt alcohol withdrawal leads to a characteristic syndrome of motor agitation, anxiety, insomnia, and reduction of seizure threshold. The severity of the syndrome is usually proportionate to the degree and duration of alcohol abuse. However, this can be greatly modified by the use of other sedatives as well as by associated factors (eg, diabetes, injury). In its mildest form, the alcohol withdrawal syndrome of tremor, anxiety, and insomnia occurs 6-8 hours after alcohol consumption is stopped (Figure 23-2). These effects usually abate in 1-2 days. In some patients, more severe withdrawal reactions occur, with patients at risk of hallucinations or generalized seizures during the first 1-3 days of withdrawal. Alcohol withdrawal is one of the most common causes of seizures in adults. Several days later, individuals can develop the syndrome of delirium tremens, which is characterized by total disorientation, hallucinations, and marked abnormalities of vital signs. 

Fertility assessment in test animals has limited sensitivity as a measure of reproductive injury, because, unlike humans, males of most test species produce sperm in excess of the minimum requirements for fertility. In addition, test animals can undergo multiple matings (Amann, 1981 Working, 1988 Chapin Heindel, 1993). In some strains of rats and mice, production of sperm can be reduced by 90% or more without compromising fertility (Aafjes et al., 1980 Meistrich, 1982 Working, 1988) in human males, less severe reduction in sperm production can cause reduced fertility. Thus, measurement of change in sperm count or fertility in laboratory rodents may be insufficient to assess reproductive health risk in humans. Other animal models may be more suitable for assessing fertility (Chapin et al., 1998). However, it should not be assumed that a reduction in sperm count (i.e., <90%) will have no effect on fertility in rodents (Wine et al., 1997). 

Halothane is a volatile general anesthetic that was introduced into the practice of clinical anesthesia in 1956. Shortly after its introduction two forms of hepatic injury were noted to occur in patients who received halothane anesthesia. A subclinical increase in blood concentration of transaminase enzymes is observed in 20% of patients and has been attributed to lipid peroxidation caused by the free radical formed by reductive metabolism of halothane as shown in Figure 16.7 (39/ 40). The second form of toxicity is a potentially fatal hepatitis-like reaction that is characterized by severe hepatocellular necrosis and is thought to be initiated by the oxidative formation of trifluoroacetyl chloride (Figure 16.7). Fatal hepatic necrosis occurs in only 1 of 35/000 patients exposed to halothane/ but the risk of this adverse event is greater in females and is increased with repeat exposure/ obesity/ and advancing age (40). Because the onset of halothane hepatitis is delayed but is more frequent and occurs more rapidly following multiple exposures/ and because these patients usually are febrile and demonstrate eosinophilia/ this reaction is suspected... 

Decision-makers have sometimes found presentations of comparative risk information a useful aid to the public discourse on risk acceptance. We referred in the last section, for example, to OSHA s use of statistics on the risks of job-related accidents to support decisions on risk reduction goals for workplace carcinogens. The agency noted that lifetime risks of death from injuries suffered in what most people perceive to be safe occupations do not go below about 1 per 1000. Data of these types were helpful in explaining why the agency settled on carcinogen risk levels in this range as sufficiently low to provide a safe work environment. 

Reduction of personal injury risks under OSHA N/A Yes N/A Yes N/A... 

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