Safety

Many injuries and deaths occur yearly in the United States due to preventable errors; however, documented harm is lower in hospitals with Magnet^® designation from the American Nurses Credentialing Center (Silver Spring, MD, USA). This manuscript illustrates insights from Magnet^® and non-Magnet^® nurses and nursing leaders regarding what impacts hospital system health, how those factors are communicated, and how hospital system health impacts patient safety. A qualitative descriptive approach was used with semi-structured interview questions. Within-methods data triangulation was applied to transcribed interviews using thematic analysis, application of the Goodwin statistic, and natural language processing (NLP). Thematic analysis revealed the four main themes of Healthy Systems, Unhealthy Systems, Patient Safety, and Nurse Well-Being. NLP revealed non-Magnet^® leaders and nurses scored highest for anxiety, anger, and sadness, in contrast to Magnet^® participants who had the highest levels of positive emotion. Key findings from the Magnet^® participants revealed that poaching employees and placing people in the wrong positions harm hospital system health and patient safety. The use of within-methods data triangulation illuminated the contextual depth of the participants’ speech, revealing the alarming emotional state that non-Magnet^® nurses and leaders are facing. Healthcare staff’s wellness must be prioritized to cultivate environments that provide safe care. Full article

This article presents a comprehensive statistical evaluation of defect frequency in fire alarm systems under real operating conditions, focusing on risk-based factors. The aim is not to introduce a complete RBI approach but rather to assess defect trends that can inform future RBI-based inspection strategies. The study categorizes and evaluates defects by frequency, particularly examining components such as cable and wire systems, acoustic signal devices, and the impact of detector contamination. These findings establish a foundation for developing tailored risk-based inspection and predictive maintenance strategies. A three-stage explanatory research design was employed, analyzing 4629 inspection reports with findings verified through expert surveys and cross-sample analysis. Results indicate that certain components, including acoustic devices and detectors, exhibit a significant increase in defects after 10 years, especially under challenging environmental conditions. Additionally, while ring bus technology supports less frequent functional testing, cable and wire systems require heightened attention in the early operational years. The study also identifies statistically significant trends and their potential for application to a broader system population, supporting enhanced RBI-based maintenance practices. These insights contribute to refining current maintenance approaches and offer practical recommendations for optimizing inspection routines based on risk factors. The article does not propose a system overhaul but lays essential groundwork for further research and improvement in fire alarm system reliability through targeted, risk-informed practices. Full article

In response to the COVID-19 pandemic, higher education institutions adopted a set of measures to ensure safe face-to-face teaching and to control potential outbreaks. However, the effectiveness of the implemented measures is dependent on the behavior of students, who are generally young, often displaced, living with other colleagues, and constantly seeking physical contact, which makes their behavior outside the institution also of particular relevance to controlling the pandemic. An online questionnaire was developed and applied to characterize the behaviors adopted by students inside and outside the higher education institution, as well as risk perception based on the health belief model (HBM) and unrealistic optimism, with the participation of 620 students from three Portuguese higher education institutions. The adoption of safe behaviors is related to a greater perception of the benefits and of the severity of COVID-19. Unrealistic optimism also has a negative impact on preventive behaviors. The behaviors least adopted by students concerning potential exposure to COVID-19 were disinfecting hands and equipment after use, as well as physical distancing from colleagues. With regard to behaviors adopted outside the institution, it was found that students did not avoid physical contact with colleagues and family members. These findings contribute to our understanding of student behavior during the COVID-19 pandemic, help institutions understand if the applied strategies were effective or not, and denote the need to reinforce or improve the implemented strategies. Full article

This paper focuses on the acceptance of ADASs in the traffic safety and human factor domain. More specifically, it examines the predictive validity of the Unified Model of Driver Acceptance (UMDA) for an ADAS bundle that includes forward collision warning, headway monitoring and warning, and lane-keeping assistance in Belgium and Vietnam, two substantially different geographical, socio-cultural, and macroeconomic settings. All systems in the studied ADAS bundle are located at the Society of Automotive Engineer (SAE)-level 0 of automation. We found moderate acceptance towards such an ADAS bundle in both countries, and respondents held rather positive opinions about system-specific characteristics. In terms of predictive validity, the UMDA scored quite well in both countries, though better in Belgium than in Vietnam. Macroeconomic factors and socio-cultural characteristics could explain these differences between the two countries. Policymakers are encouraged to prioritise initiatives that stimulate the purchase and use of the ADAS, rather than on measures meant to influence the underlying decisional balance. Full article

Acoustic measures of construction site noise are important for hearing loss prevention and safety. This work examines noise exposure assessment using binaural measurements to pave the way for more accurate noise characterization and hearing loss prevention in loud workplaces. Recordings were made over three days on a construction site, and noise exposure was estimated using state-of-the-art methods (a shoulder-worn dosimeter) and binaural measurements (microphones at each ear). For the binaural assessment, noise exposure was quantified at each ear to identify the higher- and lower-exposure ears, and the assessment incorporated kurtosis, a statistical measure that quantifies impulsiveness of the noise. The impulsiveness of the noise of four construction tools was also assessed. For this set of measurements, traditional hearing loss risk assessment consistently underestimated the noise exposure relative to binaural assessment. Moreover, the binaural measurement method exposed multiple cases of asymmetric noise exposure that are not detectable using the traditional method. Overall, there are clear benefits to assessing risk using binaural measurements and more detailed analysis methods. Full article

Bariatric surgery is an effective long-term treatment for severe obesity, but relapse rates remain high. Digital interventions can enhance patient care, yet research on the intention to use digital discharge management interventions is lacking. This study aims to assess the behavioral intention to use digital discharge management interventions after bariatric surgery and to identify differences in sociodemographic and medical characteristics, as well as potential key drivers and barriers. A cross-sectional study with N = 514 patients was conducted using the Unified Theory of Acceptance and Use of Technology (UTAUT). Mean scores for behavioral intention and predictors were calculated. Group differences were analyzed with independent t-tests and analyses of variance with post hoc tests. Drivers and barriers were assessed through multiple hierarchical regression analysis. The behavioral intention to use digital discharge management interventions was high. Significant predictors included age (β = −0.17, p < 0.001), eHealth literacy (β = 0.10, p = 0.037), internet anxiety (β = −0.15, p = 0.003), and time since bariatric operation (β = −0.13, p = 0.005). The predictors performance expectancy (β = 0.23, p < 0.001), effort expectancy (β = 0.36, p < 0.001), and social influence (β = 0.26, p < 0.001) were significantly positive key factors. These results confirm the need for implementing digital discharge interventions after bariatric surgery, with various drivers and barriers identified for application usage. Full article

Back pain is an occupation-related problem among workforces. This cross-sectional study aimed to identify the prevalence of back pain and the risk factors of occupational back pain among workers in the electronics industry. In total, 354 electronics workers in Thailand participated in the study. Data were collected using the Musculoskeletal Disorders Severity and Frequency Questionnaire, the Job Content Questionnaire, and ergonomics risk assessment via the Rapid Upper Limb Assessment (RULA). Risk factors of back pain were identified by multiple logistic regression analysis, providing adjusted odds ratios (OR_adj) and 95% confidence intervals (95% CI). The study found that most workers were operators (92.09%) and had repetitive work (83.62%). A high ergonomics risk was observed in workers who stood during work (68.49%) and operated machines (71.70%). The 1-month prevalence of developing back pain was 20.62% and the significant factors correlated with back pain were low levels of job control and decision-making (OR_adj = 2.26; 95% CI [1.26, 4.05]), lack of exercise (OR_adj = 8.30; 95% CI [1.35, 24.28]), repetitive work (OR_adj = 2.94; 95% CI [1.19, 7.29]), and high ergonomic risk level (OR_adj = 2.81; 95% CI [1.16, 5.07]). These findings suggest that measures should be implemented by empowering electronics workers to make decisions and control their jobs, as well as promoting health through muscle-stretching exercise, to support back pain prevention. Full article

Eye glance analysis and driving performance during texting while driving: Differential effects of varying driving speed versus text message length. Background and Objective. Texting while driving continues to be a significant public health concern. Eye glances off the roadway are a measure of the visual distraction associated with texting while driving. In the present study, we examined the effects of two ‘real-world’ factors relating to the adverse effects of texting on driving performance and eye glances off the roadway: (1) text message length and (2) driving speed. Methods. Subjects ‘drove’ a fixed-base simulator and read, typed and sent text messages while driving. In study #1, the driving speed was 60 mph and the effects of short (1 word) versus longer (8–10 words) texts were compared. In study #2, the text messages were short only and driving speed was 60 or 80 mph. Driving performance was assessed using the Standard Deviation of Lane Position (SDLP). Video recordings of the drivers’ faces were used to assess eye glances from the road to the phone—and back—during texting. Results. Texting while driving impaired driving performance as measured by SDLP, and both longer text messages and faster drive speeds made driving performance even worse. Analysis of the eye glance data, however, revealed different effects of these two manipulations. Specifically, longer text messages were associated with an increase in the number of eye glances to the phone during a text message episode, an increase in the total time spent with the eyes off the road, and an increase in the single longest eye glance from the road. Moreover, with longer text messages the longest single eye glance away from the road typically occurred at or near the end of the text message episode. In contrast, increasing driving speed to 80 mph did not affect any of these eye glance measures relative to driving at 60 mph. Conclusion and Application. Both text message length and driving speed while texting adversely affect driving performance, but they do so via different mechanisms. These results have implications for how to tailor “don’t text and drive” messaging to better serve the public health. Full article

This study investigates fire separation distances as essential means of passive fire protection in building design. The focus is on the inner corner configuration of building exterior walls, which represents the worst-case scenario for façade fire spread outside of a building. The inner-corner configuration appears to increase the intensity of the radiative heat flux due to reflection and reradiation of heat. Comprehensive approaches for determining fire separation distances around the various façade geometries can be found, but none of them is focused on detailed descriptions of the unprotected area in an inner corner. A medium-scale scenario was chosen and was experimentally validated with a radiant panel for a better understanding of heat flux spread. This paper compares the experiment with analytical and numerical models. The analytical model is based on the Stefan–Boltzmann law and the calculated configuration factor as per Eurocode 1. The numerical model combines radiative and convective components of the heat flux because convection is non-negligible near the heat source. Experimental data confirm the prediction based on the numerical and analytical model and show agreement. The final increase in heat flux due to the corner configuration investigated at the medium scale reaches up to 29%. Full article

The construction sector is known to have the highest risks of occupational accidents. A rationale for this high occurrence of occupational risks can be related to legislative requirements to enforce safe construction practices within this sector. Within the context of excavation works in Turkey, this study investigates the leading risks for any compliance shortfalls and ultimately presents recommendations to mitigate occupational accidents’ occurrences during excavation works in the construction sector. Based on a quantitative methodology, a closed-ended survey consisting of 35 questions and based on legislative requirements was applied to project managers in the construction industry, such as site supervisors, occupational safety experts, auditors, and control personnel. A sample size of 277 responses was found to have stability and validity through a reliability analysis and an exploratory factor analysis, and was used for testing statistical significance via cross-tabulation analysis and chi-square tests. The findings revealed that the major deviation of safety in excavation works from legislative requirements is executing works during adverse weather conditions. Moreover, it was also noteworthy that protective curtains did not surround the excavation sites, and most of the employees encountered ground slippage during excavation work. Therefore, the findings revealed preliminary research that will contribute positively to providing incentives for a focus on and development of relevant security and technical measures. It also provided information to protect the safety and welfare of the workers involved in excavation works. Finally, though these findings may be considered context-specific, this research can be used for comparative purposes for similar studies into the safety practices of excavation works in different countries, where generalized findings can be later derived to inform academia and practice. Full article

Road traffic accidents (RTAs) represent the key sign of the level of road safety. Romania once held the record for road deaths among European Union (EU) countries and as of 2023, it came second place. It is of utmost importance to assess whether measures that restricted human mobility during the coronavirus disease 2019 (COVID-19) pandemic led to a significant reduction in road fatalities. This study assesses the impact of the COVID-19 pandemic on victims of fatal RTAs by analyzing medicolegal autopsies from the Timisoara Institute of Legal Medicine (TILM), Timis County, Romania. Materials and methods: Medicolegal autopsy records of RTA victims from TILM in a 5-year period (2017–2021) were analyzed. Results: 395 cases (10.5%) were represented by victims of fatal RTAs. The reduction in the number of cases in the pandemic period was not statistically significant (p = 0.061) compared to the pre-pandemic period, but the number of victims of RTAs decreased by 17.6%. This highlights the importance of understanding the role of other risk factors in fatal RTAs, since a lesser volume of traffic did not cause a significant decrease in road fatalities. Male victims were predominant, with 18–50 years being the most affected age group. In the pandemic period, the most affected age groups were 31–40 (18.5%), followed closely by 41–50 (17.6%) and 18–30 (16.7%). In the pre-pandemic period, the first place was held by people in the age interval of 61–70 (20.5%), followed by 18–30 (19.2%). Drivers were the most involved type of road user, and a slight increase in the proportion of cyclists (13.9% from 10.5%) and motorcyclists (6.5% from 5.9%) was noted. Conclusions: Our findings show that measures implemented to control the COVID-19 pandemic may have had a positive effect on the reduction of RTAs, as shown by the information based on medicolegal autopsies in Timis County, Romania, but more attention needs to be focused on other risk factors. Further studies need to identify reasons for the small reduction in fatal injuries when the volume of traffic was reduced during mandated national lockdown. Full article

This paper presents the fuzzy real-time safety level (Fuzzy RealTSL) methodology. It aims to address the data uncertainties resulting from a lack of sensors in complex sociotechnical systems and reduce the need for the determination of their safety level in real-time during their operation. To achieve this, the methodology utilizes: (1) safety constraints from STPA (systems theoretic process analysis) analysis and EWaSAP (early-warning-signs analysis process), (2) fuzzy logic as the mathematical backbone to identify the degree of confidence about the occurrence of unsafe system states, (3) a modified centroid point and spread ordering to enable ordering sequences of unsafe system states that can lead to accidents according to how detrimental they are to the system safety. The RealTSL methodology is presented through its step-by-step application to the panel alignment system of a solar park utilizing rotating solar arrays. This paper aims to open a new perspective on the STAMP literature for discussions of uncertainties from a lack of information about the system’s state and to make it easier to measure its safety level. Knowing the safety level of a system in real-time is crucial for the systems in question as it enables proactive risk management and enhances decision-making by providing immediate insights into potential hazards, thus safeguarding against accidents. Full article

The Law enforcement profession is known to impart high stress. Members of Special Weapons and Tactics (SWAT) teams are allocated particularly demanding law enforcement operations and may therefore attain high fitness levels but may accumulate excessive stress. Heart rate variability (HRV), an assessment of time differences between heartbeats, likely indicates holistic load in field settings. To date, though, little research measuring HRV has been conducted involving SWAT units. The purpose of this study was to explore HRV measurements following (1) annual firearms qualification and (2) potential stress exposure with respect to completion time on an anaerobically taxing obstacle course. Officers with greater obstacle course performance were hypothesized to also exhibit greater HRV. HRV was also expected to stratify personnel more effectively than heart rate. Prospective 3-lead ECGs were obtained from a cohort of male SWAT operators (n = 15) with 5.2 ± 4.3 years of experience at three time points throughout one training day. HRV was assessed by time, frequency, and non-linear domains. Differences between baseline and post-training values were significant as assessed by the Wilcoxon signed-ranks test for heart rate, SDRR, LF, HF, and SD2. An enter-method linear regression model predicted post-training HF HRV by obstacle course time; r² = 0.617, F (1,6) = 9.652, p = 0.021. Anaerobic performance may be highly valuable in SWAT units. HRV analysis may also be beneficial in measuring the psychophysiological impact of SWAT activities. Full article

The remediation of contaminated groundwater is a critical component of environmental management. In situ bioremediation (ISB) is a technique used to treat contaminated groundwater by promoting the activity of microorganisms, which transform harmful substances into less toxic or non-toxic forms. The present study investigates social issues regarding the sustainability approach applied to the remediation of contaminated sites by analyzing occupational health and safety (OH&S) impacts on workers involved in the remediation process. Occupational chemical risk is analyzed by comparing two techniques for the remediation of groundwater contaminated by chlorinated aliphatic hydrocarbons (CAHs): the pump-and-treat system and biological barriers. A contaminated Italian site, located near an industrial waste disposal site, was analyzed, applying a quantitative approach for chemical risk assessment. This approach is based on the use of a validated algorithm (SNPA software) and environmental measurement campaigns of chemical agents. This study (as far as the authors know) is the first research carried out in this field and shows that the adoption of bio-barriers for remediation is intrinsically safer in terms of OH&S impacts on workers. Full article

The survey entitled “Field Survey of Alabama Department of Transportation (ALDOT) Transportation Maintenance Technicians (TMTs) Perception of Worker Safety” investigates the safety perceptions and concerns of maintenance workers within ALDOT through a multifaceted analysis approach. The findings reveal critical insights that can significantly enhance ALDOT’s safety practices, training programs, and overall safety culture. Disparities in safety perceptions across different ALDOT’s areas were found, emphasizing the need for ALDOT to tailor its strategies to meet the unique needs of each area, ensuring that safety measures are both relevant and effective. The study emphasizes the importance of implementing targeted interventions focused on high-risk activities and prevalent safety concerns, allowing ALDOT to prioritize resources effectively. Additionally, the research highlights the necessity for continuous improvement by regularly evaluating safety initiatives based on feedback and best practices. This ongoing evaluation ensures that safety measures remain relevant and effective in addressing the evolving needs of TMTs. By integrating these insights into its safety management practices, ALDOT can cultivate a more proactive and resilient work environment that not only addresses immediate safety concerns but also establishes a sustainable culture of safety prioritizing employee well-being. The study provides a roadmap for future improvements in workplace safety and initiates discussions on the implications and recommendations for enhancing ALDOT’s and other transportation agencies’ safety management practices. Full article

Lower back pain is a common occurrence among mine workers due to the nature of their work. Globally, workplace (occupational) and ergonomic risk factors have been reported to influence the prevalence of lower back pain among workers. This study aimed to determine ergonomic risk factors associated with lower back pain and associated risk factors (workplace and ergonomics) among mineworkers in a nickel mine in Zimbabwe. A cross-sectional study design was employed, and participants were randomly selected to complete a questionnaire that included the Dutch Musculoskeletal Questionnaire (DMQ). A total of 420 mine workers were interviewed, with the majority being male (n = 259, 61.7%) and aged between 31 and 44 years old (n = 159, 37.9%). The study found that the prevalence of lower back pain was 41.43% (n = 174). Several risk factors were found to be associated with lower back pain, including working overtime (AOR = 1.13, p < 0.01; 95% CI: 0.07–0.22), performing repetitive tasks (AOR = 8.06, p < 0.01; 95% CI: 4.67–13.93), bending (AOR = 7.77, p < 0.01; 95% CI: 3.97–15.22), and twisting (AOR = 3.32, p < 0.01; 95% CI: 1.83–6.03). Based on these findings, it is recommended that an ergonomic risk assessment and prevention program be implemented, which should include educational awareness about lower back pain and its prevention among mine workers. Full article

Electric power substations, as critical components of modern power grids, are increasingly becoming targets for intentional physical attacks, including vandalism, theft, and sabotage. These threats, coupled with the potential for cyber-attacks and the weaponization of technologies, necessitate robust security measures and comprehensive auditing practices. Despite utilities providers’ focus on understanding grid vulnerability and implementing physical security upgrades, there is a recognized gap in evaluating the effectiveness and long-term usability of these measures. This paper addresses the need for regular security audits to identify vulnerabilities and ensure the overall resilience of substations against evolving threats. The rationale behind this study is to propose a conventional auditing method that includes an auditing framework, checklists, inspections, and post-inspection suggestions. Through the systematic identification and addressing of vulnerabilities via security auditing, the framework aims to significantly enhance the resilience of substations against physical threats. This paper provides a comprehensive guideline for the physical security auditing procedure, which is essential for the reliable operation of the power grid. Full article

The field of ergonomics has been significantly shaped by the advent of evolving technologies linked to new industrial paradigms, often referred to as Industry 4.0 (I4.0) and, more recently, Industry 5.0 (I5.0). Consequently, several studies have reviewed the integration of advanced technologies for improved ergonomics in different industry sectors. However, studies often evaluate specific technologies, such as extended reality (XR), wearables, artificial intelligence (AI), and collaborative robot (cobot), and their advantages and problems. In this sense, there is a lack of research exploring the state of the art of I4.0 and I5.0 virtual and digital technologies in evaluating work-related biomechanical risks. Addressing this research gap, this study presents a comprehensive review of 24 commercial tools and 10 academic studies focusing on work-related biomechanical risk assessment using digital and virtual technologies. The analysis reveals that AI and digital human modelling (DHM) are the most commonly utilised technologies in commercial tools, followed by motion capture (MoCap) and virtual reality (VR). Discrepancies were found between commercial tools and academic studies. However, the study acknowledges limitations, including potential biases in sample selection and search methodology. Future research directions include enhancing transparency in commercial tool validation processes, examining the broader impact of emerging technologies on ergonomics, and considering human-centred design principles in technology integration. These findings contribute to a deeper understanding of the evolving landscape of biomechanical risk assessment. Full article

In the Industry 4.0 scenario, human–robot collaboration (HRC) plays a key role in factories to reduce costs, increase production, and help aged and/or sick workers maintain their job. The approaches of the ISO 11228 series commonly used for biomechanical risk assessments cannot be applied in Industry 4.0, as they do not involve interactions between workers and HRC technologies. The use of wearable sensor networks and software for biomechanical risk assessments could help us develop a more reliable idea about the effectiveness of collaborative robots (coBots) in reducing the biomechanical load for workers. The aim of the present study was to investigate some biomechanical parameters with the 3D Static Strength Prediction Program (3DSSPP) software v.7.1.3, on workers executing a practical manual material-handling task, by comparing a dual-arm coBot-assisted scenario with a no-coBot scenario. In this study, we calculated the mean and the standard deviation (SD) values from eleven participants for some 3DSSPP parameters. We considered the following parameters: the percentage of maximum voluntary contraction (%MVC), the maximum allowed static exertion time (MaxST), the low-back spine compression forces at the L4/L5 level (L4Ort), and the strength percent capable value (SPC). The advantages of introducing the coBot, according to our statistics, concerned trunk flexion (SPC from 85.8% without coBot to 95.2%; %MVC from 63.5% without coBot to 43.4%; MaxST from 33.9 s without coBot to 86.2 s), left shoulder abdo-adduction (%MVC from 46.1% without coBot to 32.6%; MaxST from 32.7 s without coBot to 65 s), and right shoulder abdo-adduction (%MVC from 43.9% without coBot to 30.0%; MaxST from 37.2 s without coBot to 70.7 s) in Phase 1, and right shoulder humeral rotation (%MVC from 68.4% without coBot to 7.4%; MaxST from 873.0 s without coBot to 125.2 s), right shoulder abdo-adduction (%MVC from 31.0% without coBot to 18.3%; MaxST from 60.3 s without coBot to 183.6 s), and right wrist flexion/extension rotation (%MVC from 50.2% without coBot to 3.0%; MaxST from 58.8 s without coBot to 1200.0 s) in Phase 2. Moreover, Phase 3, which consisted of another manual handling task, would be removed by using a coBot. In summary, using a coBot in this industrial scenario would reduce the biomechanical risk for workers, particularly for the trunk, both shoulders, and the right wrist. Finally, the 3DSSPP software could be an easy, fast, and costless tool for biomechanical risk assessments in an Industry 4.0 scenario where ISO 11228 series cannot be applied; it could be used by occupational medicine physicians and health and safety technicians, and could also help employers to justify a long-term investment. Full article