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Unintentional Injury and Safety

I.  Overview

General Considerations

  Causes of Unintentional Injury

Accidental or unintentional injury is a leading cause of death .  Distress, particularly that stemming from life stressors, depression and alcohol abuse, has been shown to increase risk of unintentional injury ("accidents") and intentional injury (violence and suicide).  When individuals are experiencing life stressors, such as relationship, financial or legal problems, they may be more likely to engage in high-risk behavior.  These same individuals may also have impaired sleep, which can lead to unsafe driving or work behavior.  Sleep deprivation, even without associated life stress risk factors, greatly increases the risk of unintentional injury.

These concerns in combination with poor operational risk management  may have a detrimental impact on safety related to duty performance. 

  Leadership Responsibility and Opportunities for Prevention

Commanders should establish a process to identify individuals whose behavior, attitudes or recent mishaps indicate difficulty with functioning safely both on-and-off duty.  Consistently applying ORM methods may likely carry over to become part of the personal safety practices of  members.

The following may help you identify persons who are at risk for unintentional injury.  Such persons may have:

  • Demonstrated failure to use safety devices or personal protective equipment.
  • A history of mental or emotional stress leading to unsafe acts, including aggressive behavior.
  • Involvement in an alcohol or drug related incident.
  • A history of suspended  driving privileges.
  • Involvement in multiple mishaps.

Leaders should remind individuals who appear distressed that their personal safety is a priority.  For example, if they appear depressed and subsequently distracted, they should be encouraged to seek help.  If someone is significantly distressed, temporary duty changes may help. These might include temporary modified work schedule,  or duty restrictions. 

Other recommendations for improving safety in the unit are:

  • Educate supervisors about the link between distress and unintentional injury.
  • Hold people accountable for safety practices at the unit.
  • Ensure personnel are aware of safety risks in their environment and safety measures.

Commanders have many options for managing individuals engaging in high risk behaviors.  Each case must be addressed and action taken on a case-by-case basis.  The following actions are recommended:

  • Immediate supervisors and  sergeants need to inform the unit commander any time an individual’s attitude or behaviors indicate a potential safety problem.
  • Counsel the individual on the behavior or situation causing concern.
  • Do not authorize duty involving operation of a motor vehicle for individuals whose behavior, personal history, attitude or mishap experience indicate an inability to safely function.

  Putting It all Together

Accident prevention is an ongoing process.    Monthly and quarterly review of quality improvement standards, safety programs, incident reports, health promotion activities, and performance reviews of personnel will give commanders and supervisors important information from which they can identify individuals who are at higher risk for having an accident or are having personal problems that affect their work performance.

II.  Relevant Policy

 Emphasis on Safety and Opportunities for Prevention

Leaders should be vigilant for inappropriate risk taking behavior in members, particularly when you are a ware that a member is distressed or experiencing ongoing significant life stressors.  Discuss your concerns and counsel the person when appropriate.  During counseling sessions, an emphasis on the person’s overall well-being can be made with consideration for referral to the chaplain or mental health if indicated.  If reckless behavior occurs at the workplace, and safety becomes a concern, the person may have to be removed from certain duties to ensure his/her safety as well as the safety of coworkers. 

III.  Suggested Resources

  1. Hancock, P. & Desmond, P. (2001).  Human factors in transportation:  Stress, workload and fatigue.  Lawrence Erlbaum Associates.

IV. References

  1. Dobson, A., Brown, W., Ball, J. & Powers, J. (1999).  Women drivers' behavior, socio-demographic characteristics and accidents.  Accident Annual Prevention, 31, 525-535.

     
  2. Holt, P. l. (1981).  Stressful life events preceding road traffic accidents.  Injury, 13, 111-115.

     
  3. Neeleman, J., Wessely, S., & Wadsworth, M. (1998).  Predictors of suicide, accidental death, and premature natural death in a general-population birth cohort.  Lancet, 351, 93-97.

     
  4. Norris, F. H., Matthews, B. A.& Riad, J. K. (2000).  Characterological, situational, and behavioral risk factors for motor vehicle accidents:  A prospective examination. Accidental Annual Prevention, 32, 505-515.

     
  5. Raymond, M.W.& Moser, R. Jr. (1995).  Aviators at risk.  Aviation Space Environmental Medicine, 66, 35-39.

     
  6. Stea, J. Anderson, M. A., Bishop, J. M., & Griffith, L. J. (2002).  Behavioral health force protection:  Optimizing injury prevention by identifying shared risk factors for suicide, unintentional injury, and violence.  Military Medicine, 167, 944-949.