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The MMWR series of publications is published by the Coordinating Center for Health Information and Service, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, Atlanta, GA 30333.

Suggested Citation: Centers for Disease Control and Prevention. [Article title]. MMWR 2008;57: [inclusive page numbers].

Centers for Disease Control and Prevention
Julie L. Gerberding, MD, MPH

Director

Tanja Popovic, MD, PhD Chief Science Officer James W. Stephens, PhD Associate Director for Science

Steven L. Solomon, MD

Director, Coordinating Center for Health Information and Service Jay M. Bernhardt, PhD, MPH

Director, National Center for Health Marketing

Katherine L. Daniel, PhD

Deputy Director, National Center for Health Marketing Editorial and Production Staff

Frederic E. Shaw, MD, JD
Editor, MMWR Series
Teresa F. Rutledge

(Acting) Managing Editor, MMWR Series
Douglas W. Weatherwax
Lead Technical Writer-Editor
Donald G. Meadows, MA
Jude C. Rutledge

Writers-Editors

Peter M. Jenkins

(Acting) Lead Visual Information Specialist Lynda G. Cupell

Malbea A. LaPete

Visual Information Specialists

Quang M. Doan, MBA

Erica R. Shaver

Information Technology Specialists

Editorial Board

William L. Roper, MD, MPH, Chapel Hill, NC, Chairman Virginia A. Caine, MD, Indianapolis, IN

David W. Fleming, MD, Seattle, WA

William E. Halperin, MD, DrPH, MPH, Newark, NJ
Margaret A. Hamburg, MD, Washington, DC

King K. Holmes, MD, PhD, Seattle, WA
Deborah Holtzman, PhD, Atlanta, GA

John K. Iglehart, Bethesda, MD
Dennis G. Maki, MD, Madison, WI
Sue Mallonee, MPH, Oklahoma City, OK
Stanley A. Plotkin, MD, Doylestown, PA
Patricia Quinlisk, MD, MPH, Des Moines, IA
Patrick L. Remington, MD, MPH, Madison, WI
Barbara K. Rimer, DrPH, Chapel Hill, NC
John V. Rullan, MD, MPH, San Juan, PR
Anne Schuchat, MD, Atlanta, GA

Dixie E. Snider, MD, MPH, Atlanta, GA

John W. Ward, MD, Atlanta, GA

Washington. To reduce fatalities among the Pacific Coas commercial fishermen at greatest risk, additional preve tion measures tailored to the Northwest Dungeness fishery should be considered.

A case was defined as a fatal occupational traumatic i jury in the commercial fishing industry during 2000-200 reported from California, Oregon, or Washington. De mination of an occupational fatality used established guide lines for injury at work, which take into account where t injuries occurred (i.e., on or off employer premises an whether the person was being compensated for the activ at the time of the event (3). Data were collected from mu tiple sources in each state, including reports from the U Coast Guard, local law enforcement agencies, and loc media; death certificates; and state-based occupation fatality surveillance programs.

Fatality rates were calculated using estimates of the nam ber of FTE commercial fishermen for each year durin 2000-2006; these estimates considered the number of ve sels participating in a fishery, number of days at sea, an average number of crew members on board each vessa Estimates of the number of FTE fishermen in some sma scale fisheries could not be determined; therefore, fat events from those fisheries were included in the descript statistics but not in the rate calculations.

During 2000-2006, a total of 58 commercial fishin fatalities were reported from Oregon (21 [36%]), Calif nia (20 [34%]), and Washington (17 [29%]) (Figure). T number of fatalities, by year, during 2000-2006 was follows: 2000 (eight), 2001 (seven), 2002 (10), 20 (eight), 2004 (10), 2005 (five), and 2006 (10). All decedents were male; mean age was 39 years. Forty-th (74%) of the fatalities resulted from the loss (i.e., capsiz or sinking) of 23 fishing vessels, 11 (19%) resulted fro persons falling overboard, and four (7%) resulted from oth incidents involving deck injuries or diving injuries.

Among the 43 fatalities that resulted from vessel lo weather conditions were a contributing factor in 34 deat (79%); other contributing factors included large wa (17 [40%]), flooding (16 [37%]), and vessel instabili (11 [26%]) (Table 1). Among the 11 deaths that result from falling overboard, none of the persons wore a person flotation device. Contributing factors in these deat included being alone (six deaths [55%]), slipping or tri ping (six [55%]), gear entanglement (three [27%]), wet slippery deck (three [27%]), and alcohol or drug use by decedent (three [27%]) (Table 1).

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None of the 43 persons whose deaths resulted from vesloss were able to enter a functional life raft. In 12 (28%) the fatalities, no life raft was aboard the vessel; however, en of those deaths were among fishermen aboard skiffs t were too small to carry a life raft. Other life raft comations included malfunctioning (12 [28%]) and inabilto reach a raft (9 [21%]) (Table 2).

Three (13%) of the 23 vessels that were lost had a curdecal from a U.S. Coast Guard voluntary dockside safety mination. Three vessels had expired decals (i.e., >2 years e the examination), and 12 vessels did not have a decal might have never participated in the safety examinaprogram. Four vessels were skiffs and were not included. he examination program; decal status was unknown for vessel. Among fatalities in these 23 vessel losses, three sons died despite successfully donning an immersion

Unknown

* N = 43.

None of the fishermen who died were able to enter a functional life raft.

$ Includes seven deaths of fishermen aboard four skiffs that were too small to carry a life raft.

suit*; 31 persons did not use an immersion suit, and immersion suit use was unknown for the other nine persons. Information regarding how many of the vessels had immersion suits aboard was not available.

The highest number of fatalities (23 [40%]) was reported from the shellfish fishery (including 17 from the Northwest Dungeness crab fleet), followed by salmon and other pelagic fisheries (15 [26%]) and the groundfish fishery (10 [17%]). Type of fishery was not identified for 10 fatalities.

One person who drowned wore the immersion suit improperly; another person wore the suit properly but died from head trauma after striking his head on rocks; the third person wore the suit properly but drowned, with no indication of head trauma.

The average annual number of FTE fishermen in the three states was 2,706. This number included annual averages of 828 in the shellfish fisheries (including 524 in the Northwest Dungeness crab fleet), 1,084 in the salmon and other pelagic fisheries, and 794 in the groundfish fisheries. The average annual fatality rate for all fisheries in the threestate area during 2000-2006 was 238 deaths per 100,000 FTE fishermen. The shellfish fishery had the highest average annual fatality rate (362 deaths per 100,000 FTE fishermen); within that fishery, the rate for the Northwest Dungeness crab fleet was higher still (463 deaths per 100,000 FTE fishermen). The salmon and other pelagic fisheries had a fatality rate of 132 deaths per 100,000 FTE fishermen, and the groundfish fisheries had a rate of 72 deaths per 100,000 FTE fishermen.

Reported by: J Lincoln PhD, D Lucas, MS, Alaska Pacific Regional Office, National Institute for Occupational Safety and Health, CDC. Editorial Note: Commercial fishing has long been associated with high fatality rates; however, this report is the first to identify the most hazardous Pacific Coast fisheries outside of Alaska. The findings reveal that, during 20002006, the average annual fatality rate for commercial fishing deaths reported from California, Oregon, and Washington was approximately double the national fishing fatality rate of 115 deaths per 100,000 workers (1) and also double the Alaska rate of 107 per 100,000 FTE fishermen during the same period (CDC, unpublished data, 2008).

The analysis indicates that the Pacific Coast fishery with the greatest hazard, during 2000-2006, was the Northwest Dungeness crab fishery. Although Alaska's Bering Sea crab fishery has been described as the most dangerous fishery, data from this analysis indicate that the Northwest Dungeness crab fleet had a greater number of fatalities and a higher fatality rate during 2000-2006. During that period, the number of fatalities in the Bering Sea crab fishery was 11, and the fatality rate was 305 deaths per 100,000 FTE fishermen (CDC, unpublished data, 2008). By comparison, the number of deaths in the Northwest Dungeness crab fishery during 2000–2006 was 17, with a fatality rate of 463 deaths per 100,000 FTE fishermen. The Bering Sea rate represents a 60% reduction from the rate of 768 deaths per 100,000 FTE fishermen recorded during 1990– 1999 (CDC, unpublished data, 2008).

Concern over the high fatality rates in Alaska during the 1990s led to institution of various safety measures. For example, in 1999, a preseason dockside enforcement program that ensures vessels are not overloaded with crab pots and that primary safety equipment is present and

maintained was developed and implemented by the U Coast Guard in Alaska (4). A similar program, tailored the Dungeness crab fleet, might reduce deaths in the Nor west Dungeness crab fishery.

The U.S. Coast Guard has primary jurisdiction over safety of the U.S. commercial fishing fleet, enforcing reg lations of the U.S. Commercial Fishing Industry Vesse Safety Act of 1988 (CFIVSA) with at-sea boardings, du ing which officers check for illegal fishing activities, il drugs, and safety violations. CFIVSA regulations focus pr. marily on saving lives after the loss of a vessel and not preventing vessels from capsizing or sinking, falls overboar or injuries on deck. CFIVSA regulations require that con mercial fishing vessels carry various equipment (e.g.. rafts, radio beacons, and immersion suits) depending. the size of the vessel and the area in which it operates.

Of particular concern in this study are the results sho-ing a lack of use of life rafts and immersion suits. CFIVS requirements for life rafts and immersion suits likely cer tributed to a survival rate of 94% among commercial fis ermen aboard vessels that sank or capsized during 1997-1999 in Alaska; this rate was up from 73% in 194 (2). CDC determined that, during 1992-2004, surviv of vessel sinkings in Alaska were approximately seven tim more likely to have worn an immersion suit than deceder in these events and 15 times more likely to have used a l raft (CDC, unpublished data, 2008). To improve surviva chances among Pacific Coast fishermen, added emphas should be placed on formal marine safety training in deployment and use of life rafts and immersion suits.

The findings in this report are subject to at least thre limitations. First, unlike the methodology used in th study, national fatality rates for commercial fishermen not calculated based on FTE fishermen but are calculate using annual average estimates of employed civilians aga ≥16 years and deaths from the Census of Fatal Occup tional Injuries. Therefore, the national rates might not directly comparable to the rates calculated in this study California, Oregon, and Washington. Second, fatality rat for the three states do not include the number of fataliti or FTE fishermen in certain small-scale fisheries whe deaths occurred. Finally, certain information (e.g., type d fishery or immersion suit usage) was not available for a fatal events. The U.S. Coast Guard is working with CD to improve data-collection instruments so that investigat ing Coast Guard officers can produce more complete reports

Requirements for commercial fishing industry vessels. 46 CFR part 28.

Safety improvements in the Alaska commercial fishing lustry during the 1990s did not occur because of a single ervention. Several interventions were implemented, inding requirements for emergency gear, development of nds-on safety training, and tailored safety interventions dressing specific hazards for particular fishing fleets. The dings in this report suggest that safety interventions ould be tailored to specific groups of vessels and emphashould be placed on the Northwest Dungeness crab fleet, h targeted preseason safety inspections and safety and bility training. Other areas of emphasis should include proved weather reporting, training in the deployment d use of life rafts, and increased training in the use of mersion suits and personal flotation devices.

Acknowledgments

This report is based, in part, on contributions by U.S. Coast Guard sonnel from Districts 11, 13, and 17 and staff members with the egon and Washington Fatality Assessment and Control Evaluation

grams.

ferences

JS Department of Labor, Bureau of Labor Statistics. Injuries, illnesses, nd fatalities: Census of Fatal Occupational Injuries (CFOI)—current nd revised data. Washington, DC: US Department of Labor, Bureau of Labor Statistics; 2008. Available at http://www.bls.gov/iif/oshcfoil.htm. CDC. Surveillance and prevention of occupational injuries in Alaska: a lecade of progress, 1990–1999. Cincinnati, OH: US Department of Health and Human Services, CDC, National Institute for Occupaional Safety and Health; 2002. NIOSH publication no. 2002-115. wailable at http://www.cdc.gov/niosh/docs/2002-115/pdfs/200215.pdf.

CDC. Fatal injuries to civilian workers in the United States, 1980– 995. Cincinnati, OH: US Department of Health and Human Serices, CDC, National Institute for Occupational Safety and Health; 2001. NIOSH publication no. 2001-129. Available at http:// www.cdc.gov/niosh/docs/2001-129/2001129pd.html.

Medlicott. Using dockside enforcement to compel compliance and mprove safety. In: Proceedings of the International Fishing Industry afety and Health Conference. Woods Hole, MA: October 23-25, 2000. Cincinnati, OH: US Department of Health and Human Serices, CDC, National Institute for Occupational Safety and Health. NIOSH publication no. 2003-102.

Fatalities Among Oil and Gas
Extraction Workers —
United States, 2003-2006

Dil and gas extraction (i.e., removing oil and natural gas m the ground) is a growing industry in the United States, ploying approximately 380,000 workers in 2006 (1). recent years, activity in this industry has increased subntially, from an average of 800 actively drilling rigs in United States during the 1990s to approximately 1,300

during 2003-2006 (2). In August 2005, the U.S. Department of Labor's Bureau of Labor Statistics (BLS) asked CDC to investigate a 15% increase in fatalities among oil and gas extraction workers (from 85 fatalities in 2003 to 98 in 2004) (3). CDC analyzed data from the BLS Census of Fatal Occupational Injuries (CFOI) for the period 2003– 2006. This report describes the results of that analysis, which indicated that increases in oil and gas extraction activity were correlated with an increase in the rate of fatal occupational injuries in this industry, with an annual fatality rate of 30.5 per 100,000 workers (404 fatalities) during 2003-2006, approximately seven times the rate for all workers (4.0 per 100,000 workers) (4). Nearly half of all fatal injuries among these workers were attributed to highway motor-vehicle crashes and workers being struck by machinery or equipment. Employers should work with existing industry groups and federal, state, and local government agencies to promote seatbelt use. In addition, researchers and public health officials should collaborate with industry groups to establish engineering and process controls that remove workers from potentially dangerous machinery while drilling and servicing oil and gas wells.

A fatal injury was considered occupational and was included in CFOI if the event leading to the injury occurred while the employee was working, either on or off the employer's premises (5). CFOI cases are identified, verified, and profiled using multiple source documents; these data sources include death certificates, workers' compensation records, and reports to federal and state agencies. The industry of the worker was based on the North American Industrial Classification System.* Oil and gas extraction workers are coded in the mining sector: 211 (oil and gas extraction), 213111 (drilling oil and gas wells), and 213112 (support activities for oil and gas operations). These include employees of operators that own or lease oil and gas wells, drilling contractors, and service companies that provide additional support. In addition to analyzing the variables collected by CFOI, CDC coded seatbelt use on the basis of information available in the injury narratives. Annual fatality rates were calculated using the BLS Quarterly Census of Employment and Wages estimate of workers.

During 2003-2006, a total of 404 occupational fatalities among oil and gas extraction workers occurred in the United States, resulting in an average annual fatality rate of 30.5 per 100,000 workers (Table 1). A statistically significant correlation was observed between the number of drill

*A standardized system developed jointly by the United States, Canada, and Mexico to provide comparability in statistics on business activity throughout North America.

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ing and workover rigs and the annual occupational fatality rate during 1993-2006 (Pearson correlation coefficient r = 0.80; p<0.01). Two types of events accounted for nearly half of all fatal injuries among oil and gas extraction workers in the United States during 2003-2006: highway motor-vehicle crashes (27%) and workers being struck by tools or equipment (22%). Other events included explosions (9%), falls to lower levels (7%), and fires (7%) (Table 2). The highest numbers of oil and gas extraction occupational fatalities occurred in Texas (153 [38%]), Louisiana (49 [12%]), Oklahoma (43 [11%]), Wyoming (32 [8%]), and New Mexico (22 [5%]). Among the states where most of the fatalities occurred, New Mexico (45.2 per 100,000) and Wyoming (58.5 per 100,000) had the highest average annual fatality rates, compared with Oklahoma (33.3 per 100,000), Louisiana (29.2 per 100,000), and Texas (25.3 per 100,000).

* Workover rigs restore or increase production of an existing well, whereas drilling rigs drill new wells.

SOURCE: US Department of Labor, Bureau of Labor Statistics, Census of Fatal Occupational Injuries (2003-2006). * Data for 2006 are preliminary.

The 110 fatal highway motor-vehicle incidents in th industry were divided among noncollision (42 [38%) collision between vehicles (40 [36%]), and other ever (28 [26%]) (Table 3). Three out of four highway fatalit (82 [75%]) involved light trucks (e.g., pickups ar delivery trucks) (55 [50%]) or semi-tractor trailers [25%]). A total of 39 (35%) workers in highway fatalite were not wearing seatbelts; another 13 (12%) workers we ejected upon impact and likely were not wearing seatbelts

A total of 88 (22%) workers died after being struck tools and equipment (most of which were dropped from a height), and another 26 (6%) were caught or compress in moving machinery or tools. Approximately one fourt of all fatalities (116 [29%]) in this industry occurre among employees of companies with fewer than 1 employees, and approximately one fourth of all workers wi had fatal injuries had worked for their employer for k than 1 year (112 [28%]).

Reported by: NA Mode, MS, GA Conway, MD, Alaska Pacific Regi Office, National Institute for Occupational Safety and Health, CDC Editorial Note: Since 1993, when CFOI data became ava able, both the number and rate of occupational fatalit among oil and gas extraction workers have varied wi increases and decreases in drilling activity (6,7). This co relation might be a result of several factors, including a increase in the proportion of inexperienced workers, long working hours, and the use of all available rigs (includin older equipment with fewer safeguards). Current petroleu prices suggest that increased oil and gas extraction activ will continue. Therefore, unless changes are made to i crease worker safety, the high fatality rates described in th report are likely to continue.

Although highway crashes are the most common fa event in U.S. industries overall (8), certain aspects of his way crashes in oil and gas extraction create the need f

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