1. Flight Attendant Nonfatal Injuries and Illnesses Flight Attendant Nonfatal Injuries and Illnesses 20 th International Aircraft Cabin Safety Symposium Universal City, Los Angeles, California February 10-13, 2003 Dinkar Mokadam, OSHA Specialist Air Safety, Health and Security Department Association of Flight Attendants, AFL-CIO Copyright Photodisc 1996

2. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 2 Overview Background –Sample Incident Reports –FSF Report –BLS –Definitions Reardon Study, 1988 AFA Study, 1994 to 2000 Conclusions Further Study

3. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 3 Background Sample Incident Reports –On December 22, 1996 … 737-400 … encountered severe turbulence while cruising in visual meteorological flight conditions at Flight Level 350, approximately 30 miles east of Yakutat, Alaska … the three flight attendants aboard were injured … One flight attendant received minor injuries, two flight attendants received serious injuries [fractured pelvis and elbow; fractured vertebrae in back] and were hospitalized –On November 18, 1999 … 767-223 … experienced a rapid decompression during climb … 2 of the 10 flight attendants, and 4 of the 111 passengers reported having sustained minor injuries and several were transported to a local hospital for examination –On August 12, 2000 … EMB-120ER twin turboprop airplane … experienced an uncommanded disconnect of the autopilot while descending … the flight attendant … landed on the galley floor, on her right ankle and leg

4. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 4 Background Sample Incident Reports –JANUARY 4, 1998 … FA … INJURED HER BACK WHILE RETURNING THE FIRST CLASS LIQUOR CART TO ITS GALLEY POSITION –FLIGHT ATTENDANT … 18 MAY [1998] … DURING THE AIRCRAFT DESCENT … LEFT EAR STARTED TO BE VERY PAINFUL AND BECAME BLOCKED. THE PAIN WAS STILL VERY SEVERE AFTER LANDING AND FA VISITED THE AIRPORT MEDICAL CENTER. DOCTOR DIAGNOSED AEROTITIS AND RECOMMENDED FA NOT TO FLY FOR THREE DAYS –8/29/98, F/A STATES WHILE BOARDING SHE REACHED UP TO CLOSE A FULL BIN, SHE HAD TO LEAN PULL & PUSH UP. F/A FURTHER STATES SHE SUDDENDLY FELT A SHARP PAIN GOING THROUGH HER NECK ON LEFT SIDE

5. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 5 Background Flight Safety Foundation Report –Cabin Crew Safety, July-August 2002 –“Study of Airline’s Flight Attendants Finds More Than Half of Injuries Affect Muscles and Bones in Back, Neck, Shoulders” –“A report on the Canadian study says that the primary risk factors were the handling of passenger baggage, the design of the galley, the design and maintenance of service trolleys, and flight attendant seating” –“About 58 percent of the injuries to … flight attendants were musculoskeletal injuries involving the back, neck or shoulders.” –To access the report, register at www.flightsafety.org

6. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 6 Background Bureau of Labor Statistics –Statistics available at www.bls.gov and on requestwww.bls.gov –Survey of Occupational Injuries and Illnesses: employer reports collected annually from ~ 176,000 private industry establishments, processed by State agencies cooperating with BLS –Employer logs conform with definitions and recordkeeping guidelines set by OSHA –Survey estimates of numbers of cases and median lost days are based on scientifically selected samples

7. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 7 Background Definitions –Lost workday cases involving days away from work (not counting the day of injury or onset of illness), or a combination of days away from work and days of restricted work activity* –BLS industry incidence rate = (Number of injuries and illnesses x 200,000) / Employee hours worked –Flight attendant incidence rate = Number of injuries and illnesses / FA employment (note this understates FA incidence rate, since on average flight attendants work only ~ 1000 hrs/year) *Handbook of Methods (chapter 9); Bureau of Labor Statistics 1997 Apr; http://www.bls.gov/opub/hom/pdf/homch9.pdf

8. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 8 Background Flight Attendant Demographic Codes –Injury/Illness statistics Standard Industrial Classification industry group 451 (Air Transportation, Scheduled, And Air Courier) 1990 U.S. Census occupational code 463 (Public Transportation Attendants) –Employment statistics 1999+: Standard Occup. Classification code 39-6031 1992 – 1998: Occup. Employment Survey code 68026 (1994 and 1998 data are most accurate)

9. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 9 Background BLS Injury and Illness Classification System –Event or exposure: manner in which the injury or illness was inflicted or produced –Nature of injury or illness: principal physical characteristic of the worker's injury or illness –Source of injury or illness: object, substance, bodily motion, or work environment that directly produced or inflicted the injury/illness –Part of the body directly affected by the injury or illness

10. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 10 Reardon Study, 1988 Reardon Study –Occupational safety and health among pilots and flight attendants; Reardon J; Monthly Labor Review 1992 Apr; 115(4):18-24; http://www.bls.gov/opub/mlr/1992/04/art3full.pdf http://www.bls.gov/opub/mlr/1992/04/art3full.pdf –An early application of BLS Supplemental Data –Discovered that the lost workday injury/illness rate for airline workers was almost twice the overall private sector rate

11. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 11 Reardon Study, 1988 Reardon Study –Events or exposures 33% from overexertion (45% of these were pulling/pushing, 36% lifting) 15% from being struck by or against objects 9% from falls –Natures of injuries/illnesses Sprains/strains accounted for 46% of total cases for flight attendants Air pressure changes accounted for 18% of cases Contusions/bruises accounted for 10% of cases

12. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 12 Reardon Study, 1988 Reardon Study –Sources of injuries/illnesses 32% from vehicles (hand carts, aircraft, motor vehicles) 20% from air pressure changes 16% from boxes/barrels/containers –Parts of Body affected 29% head and neck 29% trunk 14% lower extremities 13% upper extremities 12% multiple body parts

13. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 13 AFA Study, 1994 to 2000 Summary Tables and Graphs –1998 Incidence rates and median days away from work tabulated by Event, Nature, Source, and Part of Body –1994 and 1998 Incidence rate comparisons, Flight Attendants vs. Scheduled Air Transportation, the Construction industry and all Private industry –1994 – 2000 Charts of percent contributions by Event, Nature, Source, and Part of Body –1994 and 1998 Incidence rate comparison charts, by Event, Nature, Source, and Part of Body, Flight Attendants vs. the Construction industry and all Private industry

14. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 14 AFA Study, 1994 to 2000 1998 BLS Lost Workday Data (link)link –Events/Exposures Reaction and overexertion (37% of cases) Struck by or against objects (19%) Air pressure changes (15%) For 1998, being struck by unspecified object and overexertion in lifting resulted in the highest number of median lost workdays (Note: median lost workdays data show large year to year fluctuations)

15. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 15 AFA Study, 1994 to 2000 1998 BLS Lost Workday Data (link)link –Natures Traumatic injuries and disorders (86%) Sprains/strains/tears (40%) Bruises/contusions (14%) Air pressure (11%) For 1998, unspecified traumatic injuries and fractures resulted in the highest number of median lost workdays

16. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 16 AFA Study, 1994 to 2000 1998 BLS Lost Workday Data (link)link –Sources Cart/dolly/handtruck (19%) Air pressure (15%) Containers (14%) Bodily motion or position (11%) For 1998, injuries caused by containers (bottles, cans, pots/pans, luggage) resulted in the highest number of median lost workdays

17. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 17 AFA Study, 1994 to 2000 1998 BLS Lost Workday Data (link)link –Parts of Body Back and spine (21%) Lower extremities (17%) Ears (15%) Wrists/hands/fingers (13%) For 1998, elbow, hand/finger, shoulder and knee injuries resulted in the highest number of median lost workdays

18. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 18 AFA Study, 1994 to 2000

19. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 19 AFA Study, 1994 to 2000

20. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 20 AFA Study, 1994 to 2000

21. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 21 AFA Study, 1994 to 2000

22. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 22 AFA Study, 1994 to 2000

23. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 23 AFA Study, 1994 to 2000

24. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 24 AFA Study, 1994 to 2000

25. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 25 AFA Study, 1994 to 2000

26. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 26 AFA Study, 1994 to 2000

27. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 27 AFA Study, 1994 to 2000

28. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 28 AFA Study, 1994 to 2000

29. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 29 AFA Study, 1994 to 2000

30. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 30 AFA Study, 1994 to 2000

31. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 31 Conclusions Rates per hours worked of occupational injuries and illnesses among commercial air transport workers are historically several times that for workers in all private industry sectors, and even significantly greater than rates that occur in the construction industry For the years 1994 and 1998, flight attendant injury and illness incidence rates were similar to the rates for all commercial air transport workers, and were significantly higher and have decreased at a much slower pace than the corresponding rates for workers in all private industry and the construction industry

32. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 32 Conclusions For Injuries/Illnesses with Lost Workdays –Overexertion and contact with objects are the most significant exposures –Approximately 90% of cases are traumatic in nature, including sprains/strains/tears, effects of air pressure, and bruises/contusions –Among a wide variety of sources, bodily motion, contact with vehicles and containers, and air pressure are major contributors –All body parts are affected, but injuries/illnesses to the trunk, head/neck, and extremities predominate

33. 20 th International Aircraft Cabin Safety Symposium Dinkar Mokadam Universal City, Los Angeles, California, February 10-13, 2003Association of Flight Attendants 33 Further Study Cross tabulate incidents by Event, Nature, Source, and POB, and also by age, gender and length of service Develop index to prioritize incident severity for targeted interventions (one possibility: number of cases x median lost workdays, averaged over multiple years) Compare OSHA log data from individual airlines to BLS industry statistics