Abstract：
BACKGROUND: In 2014, the Federal Occupational Safety and Health Administration (OSHA) enacted a standard requiring employers to report work-related amputations to OSHA within 24 hours. We studied the characteristics of the injured workers and employer compliance with the regulation in Michigan.
METHODS: Two independent data sets were used to compare work-related amputations from 2016 to 2018: employer reports to OSHA and the Michigan Multi-Source Injury and Illness Surveillance System (MMSIISS). We deterministically linked employer reports to OSHA with the MMSIISS by employee name, employer name, date, and type of amputation.
RESULTS: We identified 1366 work-related amputations from 2016 to 2018; 575 were reported by employers to OSHA and 1153 were reported by hospitals to the MMSIISS. An overlap of 362 workers were reported in both systems, while 213 workers were only reported by employers to OSHA and 791 workers were only reported by hospitals. Employer compliance with the regulation was 42.1%. Employer compliance with reporting was significantly less in: agriculture, forestry, fishing, and hunting (14.6%); construction (27.4%); retail trade (20.7%); arts, entertainment, and recreation (7.7%); accommodation and food services (13.0%); and other services (27.0%). Large employers and unionized employers were significantly more likely (67.9% and 92.7%, respectively) and small employers were significantly less likely (18.2%) to comply with the reporting rule. Enforcement inspections at 327 workplaces resulted in 403 violations; of those, 179 (54.7%) employers had not corrected the amputation hazard before the time of inspection.
CONCLUSIONS: Michigan employers reported less than half of the work-related amputations required by OSHA\'s reporting regulation. Noncompliance was greatest in small employers, and agriculture, forestry, fishing, and hunting; construction; arts, entertainment, and recreation; accommodation and food services; and retail and other service industries. Inspections found that over half of the employers had not corrected the hazard that caused the amputation at the time of the inspection\'s initial opening date; in these cases, abatement of any hazards identified would have occurred after the inspection. Improved compliance in employer reporting of work-related amputations will identify hazards posing a high risk of recurrence of injury to other workers from the same injury source. Greater compliance can also help target safety-related preventive and intervention efforts in industries that might otherwise be overlooked.
METHODS: Two independent data sets were used to compare work-related amputations from 2016 to 2018: employer reports to OSHA and the Michigan Multi-Source Injury and Illness Surveillance System (MMSIISS). We deterministically linked employer reports to OSHA with the MMSIISS by employee name, employer name, date, and type of amputation.
RESULTS: We identified 1366 work-related amputations from 2016 to 2018; 575 were reported by employers to OSHA and 1153 were reported by hospitals to the MMSIISS. An overlap of 362 workers were reported in both systems, while 213 workers were only reported by employers to OSHA and 791 workers were only reported by hospitals. Employer compliance with the regulation was 42.1%. Employer compliance with reporting was significantly less in: agriculture, forestry, fishing, and hunting (14.6%); construction (27.4%); retail trade (20.7%); arts, entertainment, and recreation (7.7%); accommodation and food services (13.0%); and other services (27.0%). Large employers and unionized employers were significantly more likely (67.9% and 92.7%, respectively) and small employers were significantly less likely (18.2%) to comply with the reporting rule. Enforcement inspections at 327 workplaces resulted in 403 violations; of those, 179 (54.7%) employers had not corrected the amputation hazard before the time of inspection.
CONCLUSIONS: Michigan employers reported less than half of the work-related amputations required by OSHA\'s reporting regulation. Noncompliance was greatest in small employers, and agriculture, forestry, fishing, and hunting; construction; arts, entertainment, and recreation; accommodation and food services; and retail and other service industries. Inspections found that over half of the employers had not corrected the hazard that caused the amputation at the time of the inspection\'s initial opening date; in these cases, abatement of any hazards identified would have occurred after the inspection. Improved compliance in employer reporting of work-related amputations will identify hazards posing a high risk of recurrence of injury to other workers from the same injury source. Greater compliance can also help target safety-related preventive and intervention efforts in industries that might otherwise be overlooked.
摘要：
背景：2014年，联邦职业安全与健康管理局（OSHA）颁布了一项标准，要求雇主在24小时内向OSHA报告与工作相关的截肢手术。我们研究了密歇根州受伤工人的特征和雇主遵守法规的情况。
方法：使用两个独立的数据集比较了2016年至2018年与工作相关的截肢：雇主向OSHA和密歇根州多源伤害和疾病监测系统（MMSIISS）的报告。我们通过员工姓名将雇主报告与OSHA与MMSIISS确定性地联系起来，雇主姓名,date,截肢的类型。
结果：我们确定了2016年至2018年的1366例与工作相关的截肢；雇主向OSHA报告了575例，医院向MMSIISS报告了1153例。据报告，两个系统中有362名工人重叠，雇主仅向OSHA报告了213名工人，医院仅报告了791名工人。雇主符合规定的比例为42.1%。雇主对报告的遵守程度明显低于：农业，林业,钓鱼,和狩猎(14.6%);建筑业(27.4%);零售业(20.7%);艺术,娱乐,及康乐(7.7%);住宿及食物服务(13.0%);及其他服务(27.0%)。大型雇主和加入工会的雇主的可能性要高得多（分别为67.9％和92.7％，分别）和小型雇主遵守报告规则的可能性大大降低（18.2％）。327个工作场所的执法检查导致403起违规行为；其中，179名(54.7%)雇主在检查前没有纠正截肢危险。
结论：密歇根州的雇主报告了OSHA报告法规要求的与工作相关的截肢的不到一半。不遵守规定在小雇主中是最大的，农业,林业,钓鱼,狩猎；建筑；艺术，娱乐,和娱乐；住宿和食品服务；以及零售和其他服务业。检查发现，超过一半的雇主在检查的初始开放日期时没有纠正造成截肢的危险；在这些情况下，检查后，应消除已确定的任何危险。提高雇主报告与工作有关的截肢的合规性将识别出危险，这些危险对来自同一伤害源的其他工人造成伤害的高风险。更高的合规性还可以帮助针对可能被忽视的行业中与安全相关的预防和干预工作。
方法：使用两个独立的数据集比较了2016年至2018年与工作相关的截肢：雇主向OSHA和密歇根州多源伤害和疾病监测系统（MMSIISS）的报告。我们通过员工姓名将雇主报告与OSHA与MMSIISS确定性地联系起来，雇主姓名,date,截肢的类型。
结果：我们确定了2016年至2018年的1366例与工作相关的截肢；雇主向OSHA报告了575例，医院向MMSIISS报告了1153例。据报告，两个系统中有362名工人重叠，雇主仅向OSHA报告了213名工人，医院仅报告了791名工人。雇主符合规定的比例为42.1%。雇主对报告的遵守程度明显低于：农业，林业,钓鱼,和狩猎(14.6%);建筑业(27.4%);零售业(20.7%);艺术,娱乐,及康乐(7.7%);住宿及食物服务(13.0%);及其他服务(27.0%)。大型雇主和加入工会的雇主的可能性要高得多（分别为67.9％和92.7％，分别）和小型雇主遵守报告规则的可能性大大降低（18.2％）。327个工作场所的执法检查导致403起违规行为；其中，179名(54.7%)雇主在检查前没有纠正截肢危险。
结论：密歇根州的雇主报告了OSHA报告法规要求的与工作相关的截肢的不到一半。不遵守规定在小雇主中是最大的，农业,林业,钓鱼,狩猎；建筑；艺术，娱乐,和娱乐；住宿和食品服务；以及零售和其他服务业。检查发现，超过一半的雇主在检查的初始开放日期时没有纠正造成截肢的危险；在这些情况下，检查后，应消除已确定的任何危险。提高雇主报告与工作有关的截肢的合规性将识别出危险，这些危险对来自同一伤害源的其他工人造成伤害的高风险。更高的合规性还可以帮助针对可能被忽视的行业中与安全相关的预防和干预工作。
