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Prevention Key in Reducing Spinal Injuries

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Construction and transport workers have among the highest rate of traumatic spinal injuries than of any other sector. This new research has sparked a call of action for a stronger focus on workplace injury prevention.

The icare-sponsored research, published in the International Journal of Environmental Research and Public Health, investigated the causes of workplace-related traumatic spinal injuries of 824 people admitted to New South Wales hospitals over a three-year period.

The University of Sydney and University of New South Wales research team found that half of the injured workers were from the construction industry, and a further 31 per cent of admissions were caused by motor vehicle accidents.

“Prevention is by far the best approach and we know that effective regulation is the most cost-effective means of reducing injury”

The study shows the total number of NSW workers with traumatic spinal injuries during the three-year period spent 16 days on average in hospital. They accounted for 13,302 acute-care bed days with a cost of $19.5 million for time off-work and medical costs.

Researchers found there is a clear need for stronger regulation and education in both construction and transport sectors.

“Prevention is by far the best approach and we know that effective regulation is the most cost-effective means of reducing injury,” says co-author Professor Rebecca Ivers, Head, School of Public Health & Community Medicine at UNSW Sydney.

Falls accounted for 78 per cent of all construction worker spinal injuries. These were mainly falls from heights, such as from building structures, scaffolding, or ladders. The remaining 22 per cent were caused by accidents involving occupants of heavy vehicles, being struck by a falling or projected object, coming into contact with a vehicle or machinery on a site, or otherwise unspecified causes.

Lead author, Dr Lisa Sharwood from the University of Sydney Faculty of Medicine and Health, told Jobsite that all of these injuries had been entirely preventable. Machinery coming into contact with workers and causing injuries, for example, is a sign there is something seriously wrong with the safety management system. Falls from ladders or scaffolding strongly suggest a lack of an integrated systems approach without effective prevention policies.

She also pointed out that as many of these traumatic spinal injuries are happening to older workers, not only young people. Therefore, lack of worker experience is likely not the main problem.

Beyond the legal, financial and moral liabilities companies face when there is a serious workplace accident that causes a traumatic spinal injury, she says, the accident has a broader “ripple effect”.

These are not the kinds of injuries where the worker is likely to be back in the same role after a couple of weeks of hospitalisation. There are likely to be long-term effects, which may include a follow-up surgery or treatments, rehabilitation, with potentially permanent impairment or disability.

Moreover, Dr Sharwood says, medical experts have also seen there is a significant correlation between traumatic spinal injury and subsequent mental health issues, including dependence on alcohol or prescription pain relief.

There are also impacts on the worker’s family. They may need to shoulder a high burden of care while managing a reduction in the household income and family maintenance. Where the injury results in loss of functional mobility, such as needing a wheelchair, the injured worker may become house-bound.

For construction companies, however, there is a financial cost beyond the workers’ compensation or possible fines imposed by an authority like Safe Work Australia. Dr Sharwood explains that not only does a company often have to pay the wages of the injured worker following the injury, they also need to pay someone to replace that worker.

Smaller companies can find themselves struggling to cover both salaries, she says. For that reason, they may resort to not hiring a replacement and sharing the injured worker’s tasks among remaining staff, says Dr. Sharwood.

Such behaviour further adds to the challenges for those workers. Potentially, it might result in increasing the likelihood of one of those workers having an accident of some kind, as stress or overwork can be contributing factors.

“The often unseen impact is the significant and ongoing consequence,” Dr Sharwood says.

Dr Sharwood claims that increased local surveillance of safety systems and stricter enforcement of the relevant legislation is needed to reduce the risk of falls and fall-related injuries.

“Work-related traumatic spinal injuries are a current focus of Safe Work Australia policy aiming to reduce serious injury compensation claims by 30 per cent by 2022,” she says. “There is an urgent need for more effective policies, risk management strategies, and countermeasures for prevention.”

“The often unseen impact is the significant and ongoing consequence,” Dr Sharwood says.

Adam Turnbull, owner of South Australian residential construction firm Turnbull Built, is passionate about protecting his workers from any and all injuries. His company partnered with the Neil Sasche Centre for Spinal Cord Research for a recent fundraiser focused on enabling research into leading-edge medical diagnosis and treatment as part of spinal cord injury recovery.

A builder for more than 30 years, Turnbull tells Jobsite that safety is paramount for him.

“I don’t want any injuries on my sites — full stop,” he says.

Working with the Foundation made him more aware of how often he was seeing practices in the industry that were “not the best” in terms of reducing the risk of spinal injury.

On his own sites he takes a risk assessment-based approach, rather than simply achieving compliance with workplace health and safety rules. This means looking at proactive strategies for preventing injuries.

The workplace health and safety code stipulates that where work needs to be carried out at height, scaffolding must be used.

Turnbull says that he uses scaffolding for all work that is on two-storey homes. He also installs temporary stairs between scaffold levels instead of employing the common practice of using ladders between scaffold levels.

“If a worker is climbing a ladder with a bag of tools, they only have one hand on the ladder. I could see that would be a risk,” he explains.

Turnbull also checks each subcontractor’s Safe Work Method Statements thoroughly to ensure they are intending to use practices on his sites that prevent falls—and if a worker does things in a way that is unsafe and contrary to the SWMS, they are reminded of what the proper practice should be.

“I don’t want any injuries on my sites — full stop”

“I expect that they are all going to perform their work in a manner that reduces the risk of falls or injuries,” Turnbull says.

While the main cause of spinal injury are falls from heights, Turnbull is also conscious that improper manual handling practices can also cause spinal injuries. He uses a crane for lifting of all heavy material loads. He also ensures the programming and schedule incorporates deliveries on a just-in-time basis.

“It is all about coordination,” he says.

Training for young workers is one of the best ways to change the industry’s injury record, he says. “If it goes wrong, you’re a long time injured.”

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