Olaf Jensen, Centre for Maritime Health & Society, Southern Danish University Esbjerg, Denmark

1. Nordic Collaboration on Fishing Safety Workshop in Copenhagen 20-21 Feb 2014Improvement and Harmonisation on Nordic fishermen´sdata on injuries and working time - comparable data to improve safety in fishing by working together Olaf Jensen, Centre for Maritime Health & Society, Southern Danish University Esbjerg, Denmark

2. Contents • Why do weneedinjuryincidence data • Methods – epidemiological measures • Harmonised ”nominator data…” • Harmonised ”denominator data” • ILO proposals international • Proposals for the nordiccollaboration Olaf Jensen ocj@sdu.dk

3. A review based on peer-reviewed scientific publications gave the following information: Studies from Poland, UK, Norway, Iceland, USA inclusive Alaska,Canada and Denmark show more or less similar results There has been about 50 % reduction of the fatal injury rates in fishing since the 1970’ies. Olaf Jensen ocj@sdu.dk

4. The relative risk for fatal injuries in fishing compared with other industries varied from about 25 to 50. There is good evidence that around half of the fatal injuries are related to vessel disasters - and that fatigue and lack of good safety culture are main risk factors for the vessel disasters. Olaf Jensen ocj@sdu.dk

5. National rates cannot be compared due to: different methods for denominator time (different calculation of fishermen´s hours or days of work) different criteria for inclusion of accidents (3 days off, 1 day or other) We need comparablecount of the accidents We need comparable information about the risk time Olaf Jensen ocj@sdu.dk

6. Epidemiology Epidemiology is the study of the determinants, distribution, and frequency of disease and accidents in human populations 6

7. Epidemiology The development of new cases of an accident that occur during a specified period of time in (“at risk”) individuals = INCIDENCE RATES 7

8. Crude incidence rate: Number of fatal accid. in time period = Number at risk of dying in period 8

9. Tools of Measurement • Counts • Proportions • Rates • Ratios

10. Case Counts • Measuring disease or health or health care frequency startswith counting cases • Simplest and most frequently gathered measure in epidemiology 10

11. Counts • Refers to the number of accidents counted i.e. Number of fatal accidents in fishing in Denmark in 2010 = ? • Limited usefulness for comparable purposes without knowing size of the source population 11

12. Rates • Epidemiologic rates contain the following: • Accident number (Numerator) • Person-time (De-numerator) 12

13. Rates - example LocationAccidentsYearPopulation Denmark4 2010 3000 Faroe Islands 3 2010 1000 Annual Rates of Occurrence DK 4/ 3000 = 1,3 per 1000 person-years F 3 /1000 = 3,0 per 1000person-years

14. Ratio • is a fraction between the numerator and denominator • Annual Rates of fatal accidents • DK 4/ 3000 = 1,3 per 1000 person-years • F 3/1000 = 3,0 per 1000 person-years RATIO = 3/1,3 = 2,3 = Relative risk 14

15. Rates are the basic tool for prevention • Why are rates important? • Because they provide complete information to compare rates: • Year by year in the same industry • Between countries • Between industries 15

16. Comparison Ratios can be seriously biased by: 1) Inequal nominator data: X / Y 2) Inequal denominator data: X / Y 3) Inequal reporting degree: 0-99% 4) Difference in validity – classification bias, 16

17. 1) Different inclusion criteria of cases • Lost time injury (LTI-1 Day): A work injury that results in an absence from work for at least one full day or shift any time after the day or shift on which the injury occurred • Lost time injury (LTI-3 Day): A work injury that results in an absence from work for at least 3 full days or shift any time after the day or shift on which the injury occurred • Serious injury: A lost time injury that results in the injured person being disabled for a period of two weeks or more. • Minor injury: A lost time injury that results in the injured person being disabled for a period of less than 2 weeks

18. 2) Different definition of population risk time • 1000 fishermen per year • 1000 Full-time equivalent fishermen per year • 1000 days at sea • 1.000.000 hours work at sea

19. 3) Different reporting degree – seriousness ?

20. 3) Different reporting degree – Type of ship??

21. 3) Different reporting degree – area on the globe

22. 4) Definitions and concepts - misunderstandings • Duration rate: The average number of workdays lost per injury • Injury index: The number of workdays lost per million hours worked • Serious injury frequency rate: The number of serious injuries per million hours worked • The calculated risk: The number of fatal accidents per 1000 man-labour-years • The frequency rate of new cases: • Days lost per new case:

23. 5) Different definitions - lack of comparability • Sound case definitionsbasedon diagnosis, defects, pathology • Definition of the population at risk(number of fisheremenregistered, full-time equivalentnumber of fishermen etc)

24. ILO recommendations 1998 and 2012

25. ILO Definition The frequency rate of new cases of occupationalinjury= Incidence rate = Numberof new cases of occupationalinjuryduringthe reference period Total number of hoursworked by workers in the referencegroup during the referenceperiod

26. ILO recommendations –sources of data • 25. In compilingstatistics of occupational injuries, varioussources of information shouldbeusedin order to provide as full a picture as possible of the situation at a given point in time and to give an estimate of any under-reportingwhichmayoccur. • For example, considerationcouldbegiven to periodicallysupplementing the information available from systems for the notificationof compensationof occupational injuries by adding brief modules of questions to existingsurveyquestionnaires, such as thoseused for establishment surveys for employment and wages, and for labourforce surveys.

27. ILO recommendations –sources of data • 26. Where data from differentsourcesareusedtogether, attemptsshouldbe made to ensurethatthe concepts, definitions, coverage and classificationsused by the differentsourcesareconsistent. • To this end, it wouldbeuseful to establish a coordinatingcommittee at the national level, comprisingrepresentatives of government, other producers of statistics on occupational injuries, and employers’ and workers’ organizations. In addition, effortsshouldbe made to harmonizethe statisticscompiled from differentsources and by differentbodies.

28. The nordic collaboration proposal: • A permanent national coordinatingcommitteein each of the Nordic countries with representativesof government, other producers of statistics on occupational injuries, and employers’ and workers’ organizations, epidemiological researchers and occupationalhealth services. • A permanent nordiccollaborationcommitteeto provide technicaland epidemiological guidance on the how to use and harmonize data from differentsourcesbased on the ILO resolution:

29. The nordic collaboration proposal: A permanent nordiccollaboration of the national groups for improving and harmonising data on fishing injuries and the populations at risk:

30. The nordic collaboration proposal: • To use and harmonizevalid data among the Nordic countries from differentsourcesbased on: • Insurance data (inavailable in DK - legal change?) • Martime Authorities data • Occupational Health Service data • National statisticson mortality and discharge register • Research: • 1. Population register cohorts – validity check of routine data • 2. Repeatedhouseholdsurveyswith estimation of under-reporting and of costs of occupational injuries.

31. The nordic collaboration proposal: The nordicfishinginjurycollaborationgroupelaborates a 5 yearworking plan on how to harmonise and utilise, analyse and disseminate data (injury and population at risk) from differentsourcesstep by step: 2014-15: Data from the insurances 2015-16: Data from the maritime authorities 2016-17: Data from householdsurveys 2017-18: Data from hospitals and death registers

32. Nordic research collaboration proposal: • Faro Islands Establishment of a nordiccollaboration research strategy with a 5 yearworking plan: validation of register data and to validate and use data thatyetcannotbeincluded in a regularsurveillance.

33. Nordic collaboration in the …future:  • Faro Islands Establisment of a nordictraining and education forum by sharingtrainingmaterial etc.

34. Olaf Jensen ocj@sdu.dk

35. Thank you very much for your attention Olaf Jensen ocj@sdu.dk