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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per 100,000 workers (1) and also double the Alaska rate of 107 per 100,000 FTE fishermen during the same period (CDC, unpublished data, 2008).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fatalities in the Bering Sea crab fishery was 11, and the fatality rate was 305 deaths per 100,000 FTE fishermen (CDC, unpublished data, 2008).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rate represents a 60% reduction from the rate of 768 deaths per 100,000 FTE fishermen recorded during 1990– 1999 (CDC, unpublished data, 2008).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 i 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 less Safety Act of 1988 (CFIVSA)* with at-sea boardings, di ing which officers check for illegal fishing activities, illi drugs, and safety violations. CFIVSA regulations focus pri marily on saving lives after the loss of a vessel and no: preventing vessels from capsizing or sinking, falls overboa. or injuries on deck. CFIVSA regulations require that w. mercial fishing vessels carry various equipment (e.g.is 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. CFIT: requirements for life rafts and immersion suits likely ce tributed to a survival rate of 94% among commercial fis ermen aboard vessels that sank or capsized durir, 1997–1999 in Alaska; this rate was up from 73% in 19 (2). CDC determined that, during 1992–2004, survis of vessel sinkings in Alaska were approximately seven tir. more likely to have worn an immersion suit than deceder: in these events and 15 times more likely to have used a .. raft (CDC, unpublished data, 2008). To improve surv chances among Pacific Coast fishermen, added emphu 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 thr limitations. First, unlike the methodology used in it study, national fatality rates for commercial fishermen 2. not calculated based on FTE fishermen but are calcular using annual average estimates of employed civilians d > 16 years and deaths from the Census of Fatal Occus tional Injuries. Therefore, the national rates might not directly comparable to the rates calculated in this study California, Oregon, and Washington. Second, fatality ra for the three states do not include the number of fatalice or FTE fishermen in certain small-scale fisheries who deaths occurred. Finally, certain information (e.g., type fishery or immersion suit usage) was not available for fatal events. The U.S. Coast Guard is working with cu to improve data-collection instruments so that investig ing Coast Guard officers can produce more complete reports

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

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Vafety improvements in the Alaska commercial fishing "dustry during the 1990s did not occur because of a single

ervention. Several interventions were implemented, in

ding requirements for emergency gear, development of - 1ds-on safety training, and tailored safety interventions - dressing specific hazards for particular fishing fleets. The tidings in this report suggest that safety interventions in vuld be tailored to specific groups of vessels and empha

should be placed on the Northwest Dungeness crab fleet, h targeted preseason safety inspections and safety and tbility 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 - l'his 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 abor Statistics; 2008. Available at http://www.bls.gov/iifloshcfoil.htm.

CDC. Surveillance and prevention of occupational injuries in Alaska: a S-lecade of progress, 1990–1999. Cincinnati, OH: US Department of 1 Health and Human Services, CDC, National Institute for Occupa

ional Safety and Health; 2002. NIOSH publication no. 2002-115. Available 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, 1.000. Cincinnati, OH: US Department of Health and Human Ser

ices, CDC, National Institute for Occupational Safety and Health. NIOSH publication no. 2003-102.

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 fatali

ong 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

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ties among

Fatalities Among Oil and Gas

Extraction Workers United States, 2003-2006 Oil and gas extraction (i.e., removing oil and natural gas im the ground) is a growing industry in the United States, tc-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

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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TABLE 1. Number and rate* of fatal injuries among oil and gas extraction workers and average number of drilling and workover rigs,t by year — United States, 1993–2006$ No. of No. of

No. of Year fatalities! workers**

Rate

rigs 2006 123

385,803

31.9

3,221 2005 98 338,234

29.0

2,735 2004

306,863

31.9

2,427 2003 85 292,846

29.0

2,161 2002

308,000

23.1

1,840 2001 98 353,000

27.8

2,367 2000 83 313,000

26.5

1,974 1999 50 329,000

15.2

1,460 1998 76 373,000

20.4

1,915 1997 85 369,000

23.0

2,365 1996 82 302,000

27.2

2,113 1995 77 336,000

22.9

2,000 1994 99 387,000

25.6

2,072 1993 94 371,000

25.3

2,146 SOURCES: US Department of Labor, Bureau of Labor Statistics, Census of Fatal Occupational Injuries (2003–2006). US Department of Labor, Bureau of Labor Statistics, Current Population Survey (1993–2002). US Department of Labor, Bureau of Labor Statistics, Quarterly Census of Employment and Wages (2003–2006). Baker Hughes, Inc., Rig Counts (1993–2006). * Per 100,000 workers. Workover rigs restore or increase production of an existing well, whereas

drilling rigs drill new wells. § Data for 2006 are preliminary. The industry definition used by the U.S. Department of Labor changed

in 2003. ** Numbers of workers for 1993–2002 are from the Current Population

Survey and are reported in thousands. Numbers of workers for 2003– 2006 are from the Quarterly Census of Employment and Wages. Data sources differ because the industry definition used by the U.S. Department of Labor changed in 2003.

TABLE 2. Number of fatal injuries among oil and gas extractic workers, by type of injury event - United States, 2003–2008

No. of fata Injury event

injuries Highway crash

110 Struck by object Explosion

36 Fall to lower level

30 Fire

27 Caught or compressed in moving machinery or tools

26 Electric current

20 Aircraft crash

18 Other

49 Total

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

71

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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).

The 110 fatal highway motor-vehicle incidents in th industry were divided among noncollision (42 (389 collision between vehicles (40 (36%]), and other evers (28 (26%]) (Table 3). Three out of four highway fatalite (82 (75%]) involved light trucks (e.g., pickups delivery trucks) (55 (50%]) or semi-tractor trailers (25%]). A total of 39 (35%) workers in highway fatalick were not wearing seatbelts; another 13 (12%) workers we ejected upon impact and likely were not wearing seatbel:

A total of 88 (22%) workers died after being strucks tools and equipment (most of which were dropped from height), and another 26 (6%) were caught or comprescu 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 w? had fatal injuries had worked for their employer for les than 1 year (112 (28%]). Reported by: NA Mode, MS, GA Conway, MD, Alaska Pacific Regis 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 com relation might be a result of several factors, including increase in the proportion of inexperienced workers, longe working hours, and the use of all available rigs (includin older equipment with fewer safeguards). Current petroleum prices suggest that increased oil and gas extraction activy will continue. Therefore, unless changes are made to in crease worker safety, the high fatality rates described in da report are likely to continue.

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

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

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*-ther study and targeted interventions. Vehicles used in

L and gas extraction are exempt from certain U.S. partment of Transportation hours-of-service regulations. uck drivers and workers in pickup trucks often travel

tween oil and gas wells located on rural highways, which cen lack firm road shoulders, rumble strips, and, occanally, pavement. Workers often are on 8- or 12-hour

fts, working 7-14 days in a row. Fatigue has been idenled as an important risk factor in motor-vehicle crashes 1; therefore, a targeted program that addresses fatigue u hong workers in this 24-hour industry might reduce tor-vehicle crashes and fatalities. Persons also can reduce ving fatalities by always wearing seatbelts while operat} or riding in motor vehicles. Many of the hazards associated with using heavy tools d equipment in this industry were documented in the 70s (10), and being struck by these items remains the cond most common event leading to an occupational ality. The use of mechanized tools to move and manipu

heavy pipe can remove workers from potentially injuus environments. These types of controls are becoming ore common on land-based drilling rigs and are consisit with good safety practices because they control a workated hazard at the source. The findings in this report are subject to at least three uitations. First, fatality rates were calculated using an

ployment estimate that is different from the standard Tployment estimates used by CFOI to calculate occupa

nal fatality rates. Comparisons of the fatality rates in s report to other CFOI occupational fatality rates should

interpreted with caution. Second, the data do not proV

e detailed information on the worker population at risk 3., the proportion of new workers), which would allow

vre detailed analyses of risk factors. Finally, because clas- cation of worker fatalities into industry subsectors is

limited by the information available, misclassification might have occurred.

Although each company has the ultimate responsibility for the safety of its employees, drilling operations involve many companies working together in an environment with complex machinery and complex levels of supervision. Well operators have significant influence over how work is conducted and authority to establish a culture and process of safety at a site. Improved safety for oil and gas extraction workers requires a dedicated and collaborative effort from all parts of the industry. CDC is supporting this type of effort through 1) development of new worksite selfassessment, training, and communication products that emphasize seatbelt use and fall protection and 2) the activities of the National Occupational Research Agenda Oil and Gas Extraction Sub Council." References 1. US Department of Labor, Bureau of Labor Statistics. Quarterly Cen

sus of Employment and Wages. Washington, DC: US Department of Labor, Bureau of Labor Statistics; 2008. Available at http://data.bls.gov/

labjava/outside.jsp?survey=en. 2. Baker Hughes, Inc. Rig counts. Available at http://

investor.shareholder.com/bhi/rig_counts/rc_index.cfm. 3. US Department of Labor, Bureau of Labor Statistics. All charts,

Census of Fatal Occupational Injuries, 2004. Washington, DC: US Department of Labor, Bureau of Labor Statistics; 2006. Available at

http://www.bls.gov/iif/oshwc/cfoi/cfch0003.pdf. 4. US Department of Labor, Bureau of Labor Statistics. Injuries, ill

nesses, and fatalities: Census of Fatal Occupational Injuries (CFOI)— current and revised data. Washington, DC: US Department of Labor, Bureau of Labor Statistics; 2008. Available at http://www.bls.gov/iif/

oshcfoil.htm. 5. US Department of Labor, Bureau of Labor Statistics. Technical note.

Washington, DC: US Department of Labor, Bureau of Labor Statis

tics; 2007. Available at http://www.bls.gov/news.release/cfoi.tn.htm. 6. CDC. The oil and gas extraction industry: recent fatal injury data and

areas for action [Abstract]. In: NORA Symposium 2006, Research Makes a Difference. Washington, DC: US Department of Health and Human Services, CDC, National Institute for Occupational Safety and Health; 2006. Available at http://www.cdc.gov/niosh/nora/symp06/

pdfs/norasymposium 2006book.pdf. 7. Curlee CK, Broulliard SJ, Marshall ML, Knode TL, Smith SL.

Upstream onshore oil and gas fatalities: a review of OSHA's database and strategic direction for reducing fatal incidents. Galveston, TX: Society of Petroleum Engineers, Inc.; 2005. Available at http://

www.spe.org/elibrary/servlet/spepreview?id=SPE-94416-MS. 8. US Department of Labor, Bureau of Labor Statistics. All charts,

Census of Fatal Occupational Injuries, 2006. Washington, DC: US Department of Labor, Bureau of Labor Statistics; 2008. Available at

http://www.bls.gov/iif/oshwc/cfoi/cfch0005.pdf. 9. MacLean AW, Davies DR, Thiele K. The hazards and prevention of

driving while sleepy. Sleep Med Rev 2003;7:507–21. 10. CDC. Comprehensive safety recommendations for land-based oil and

gas well drilling. Morgantown, WV: US Department of Health and Human Services, CDC, National Institute for Occupational Safety and Health; 1983. NIOSH publication no. 83-127. Available at http:// www.cdc.gov/niosh/83-127.html.

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Additional information available at http://www.cdc.gov/niosh/nora/councils/ mining/oilgas.

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cheese; none reported consuming unpasteurized milk, pasteurized cheese, or homemade cheese 7 days before en set of illness.

Outbreak of Multidrug-Resistant

Salmonella enterica serotype Newport Infections Associated with

Consumption of Unpasteurized Mexican-Style Aged Cheese Illinois, March 2006-April 2007 During March 2006-April 2007, an outbreak of Salmonella enterica serotype Newport infections occurred predominantly among Hispanics in northeastern Illinois. Samples from 85 patients, one sample of Mexican-style aged cheese (cotija) from a local Hispanic grocery store (grocery store A), and milk from a bulk tank on a local dairy farm tested positive for S. Newport and had indistinguishable pulsed-field gel electrophoresis (PFGE) patterns. This report summarizes the investigation into S. Newport infections associated with this outbreak. The findings emphasize the need for regulatory authorities to ensure that dairy products, including Mexican-style cheese, are manufactured and distributed by inspected sources and highlight the need for culturally targeted education of consumers and grocerystore operators regarding risks associated with consuming unpasteurized dairy products.

On October 9, 2006, public health officials in Kane County, Illinois, notified the Illinois Department of Public Health (IDPH) of 13 cases of S. Newport infection among Hispanic residents since March 2, 2006. S. Newport is a rare serotype in Kane County; during 2001-2005, five or fewer infections were reported annually. The Kane County Department of Health conducted the initial investigation and contacted IDPH for assistance in determining the source of infection and developing measures to prevent future illness.

By March 1, 2007, local health departments had identified 67 patients who had illnesses compatible with S. Newport infection. Among these, 46 (69%) reported shopping at local Hispanic grocery stores. Three stores with the highest reported shopping frequency (including grocery store A) and the patients' home addresses were mapped using geographic information system software; clustering of cases near the stores was apparent. A hypothesis-generating questionnaire was developed and included questions regarding consumption of various foods, including Mexican-style cheese, unpasteurized milk, and unpasteurized and homemade cheese. The questionnaire was administered beginning March 2, 2007, to patients with onset of illness within the preceding 3 months. Thirteen patients with an onset during December 30, 2006-February 26, 2007, completed the questionnaire. Ten (77%) reported eating Mexican-style

Case Definition and Case Finding

A case was defined as diarrheal illness (three or more lous stools within 24 hours) with onset beginning on or at March 2, 2006, and an isolate of S. Newport with a PEG: match by at least one enzyme (xbal) in an Illinois residen: A memorandum was sent to all local health departmen on November 28 to inform them of the outbreak and er courage prompt reporting to IDPH. Additional cases wa identified by performing PFGE on all S. Newport isol. cultures reported to IDPH. Local Illinois health depe: ments contacted all identified patients to obtain inform. tion regarding demographic characteristics, date of iline onset, clinical presentation, and household contact Patients were asked to report food-consumption and grocer shopping history for the 3 days (one incubation periks } before illness onset by use of a standardized Illinois salm nellosis case report form.

Eighty-five culture-confirmed cases were identified amon residents of nine counties in northeastern Illinois, w:dates of illness onset during March 2, 2006-April 25, 2017 (Figure). Patients ranged in age from 9 days to 85 vez (median: 34 years). Forty-five (53%) were male. Sevenry six (96%) of 79 patients who reported ethnicity were H panic, and Spanish was the primary language for 40 (58of 51 patients who reported a primary language. Ame. patients who reported clinical symptoms, 53 (72%) of reported fever, and 43 (59%) of 73 reported bloody dia rhea. Thirty-six (44%) of 82 patients were hospitalize No deaths were reported. Five patient stool isolates w2" selected randomly and sent to CDC for antibiotic susce. tibility testing. All five isolates were resistant to eight biotics: amoxicillin/clavulanic acid, ampicillin, cefoxit: ceftiofur, chloramphenicol, streptomycin, sulfamethoxazo: and tetracycline. This resistance pattern is consistent wil S. Newport multidrug-resistant phenotype Ampi (Newport-MDRAmpC) (1).

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Case-Control Study

After investigators found improperly labeled cotija chex in grocery store A, a case-control study was initiated oa March 21, 2007. Case-patients with the most recent onsi of illness were contacted first. Controls were selected through a reverse telephone directory and matched by ethnicity, and city of residence. Twelve case-patients with onset of illness from November 1, 2006–March 2, 2009

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