THE OCCURRENCE OF ACCIDENTS: WORKERS

AND

DETERMINANTS CONTROL PORT. STUDY

A CASE IN THE

AMONG

ASSAB

i
B
KITAW

Y
M.D.

DEMISSIE,

Thesis

submitted for

as partial the degree

fulfilment of Master

of of

the Science.

requirements

January Assab,

37,

7988

Ethiopia.

Jimma Institute Post Graduate

of Health Program

Science in Community Medicine.

CERTlFlCA

TE

OF

APPROVAL. Feb.

28, 7988

I hereby, by Kitaw

recommend

that

the

thesis

prepared

under and

my supervision Determinants Port of Med.) of be

Demissie , M. D.

entitled

The Occurrence among workers

Accidents: accepted MASTERS

A Case - Control

study of the

in Assab for the

i
in partial fulfilment requirements MEDICINE degree (Comm.

OF SCIENCE

IN COMMUNITY

-M.SC

Professor
, . \ ) ~

Yves
:' ') 'I

Bergevin
.') \. ,-.~ "

!hesis

:dViSO~.

Recommendation

concurred

in

Head of Department

Committee Final

on

Examination

ACKNOWLEDCEMEN

T.

I have Professor

had

the good

fortune

of receiving on this study. Dr. Berqevin, project He

Yve Bergevin's

collaboration

who is a Director contributed shared

of the MC-CiII ideas his

- Ethiopio

Community of this

health work.

numerous

to the development broad knowledge in conducting and content

generously

from

of Epidemiology, studies and perception

biostatistics, of my needs

practical in regard

experience to the level

of material.

Dr. encoourgement this project.

Cetachew

Tades se ,

Vice Minister

of Health

gave on

and strong

administrative

support

to my work

am very also wish

grateful

to IORC, A to Solomon

for

funding for

the project. his help in

to acknowledge the statistical

Zewdie

analyzing

data.

TABLE OF CONTENTS
GAPTER

PAGE
1

INTRODUCTION LITERATURE 1. General 2. Frequency rates: Accidents REVIEW:

a) Ger~r~~

b) Port Accidents ~. The Cost of Accidents 4. Causation - I. METHODOLOGY: 1. Objective 2. Design a) Preparatory phase of Accidents

15 21 31

49 50 50 50

b) Types of the study c) Population

51
instrument and training 54 55 56 56

d) The research
e) Recruitment
f) Pilot

phase

3. Definitions 4. Collection 5. Handling 6. Analysis of Data of Data of Data

56 57 59

LIST OF FIGURES FIGURES

- V

TABLE OF CONTENTS (CONTD.)

CHAPTER IV. V.
1.

PAGE
62 103 116

RESULTS DISCUSSIONS CONCLUSIONS AND RECOMMENDATIONS ANNEX: Atmex A - Data Entry Format Annex B - ANSI Classification

n.

124 131

Ill.

BIBLIOGRAPHY

143

LIST OF FIGURES (CONTD.)

FIGURES
14. Percentage distribution of accidents by place in Assab Port,1987 15. Distribution of accident by day of the weeks,Assab Port,1987 16. Accident rates by time of the day Time of accidents since the beginning of work,Assab Port,1987 18. Distribution of accidents by their nature,Assab Port,1987 19. Accidents by part of the body affected

PAGE

77

79 81

17.

83

87 88

LIST OF TABLES TABLES Table 1. All factories accident rates per 1,~00 workers employed in India and 2. PAGES

U.K.
in port

14

Comparison of employment accidents operations and other activities

16 21 25

3. 4. 5.

Three years accident rates in Assab Port Financial statistics 1966,1967,1968

Estimates for the national costs of occupational accidents: HMF data 29

q.
7.

Estimates for the national costs of occupational accidents: DHSS data 29

Frequency of exposure among N case control pairs 60 involved, 62 by age involved,A~~ab 62 by sex involved, Assab 66 by ever attended 68

8.

Accident rates by departments Assab Port 1987

9.

Rate of accidents Port,1987

10.

Rate of accidents Port,1987

11.

Rate of accidents

educational status, Assab Port, 1987 12. Rate of accidents worker,Assab 3. by category of worker

Port,1987 by payment method,Assab

68

Rate of accidents Port,1987 Rate of accidents Assab Port,1987

71 by the worker's job title, 74

LIST OF TABLES (CONTD.) TABLES

15. 7.of accidents by their place of occurrence, Assab Port,1987 16. Accidents by the day of the~eek,Assab 1987 17. Rates of accidents by shift of the day,Assab Port,1987 18. 7.of accident time since beginning or work, Assab Port,1987 19. Percentage distribution of accidents by their nature 20. 21. Accidents by part of body affected Percentage distribution their source 22. 23. 24. 25. 26. Accidents by their type Accidents by Major causes Distribution Distribution of hazardous conditions of unsafe acts involved in port 95 96 96 of accidents by 89 90 91 92 93 84 85 82 80 Port, 78 76

PAGE

Break-up of expenditure accidents (55 days)

Relation of safety training to accidents Relation of sex to accidents Rel?tjon of

t~e ~~st_oge

y~~r sickness 97

episodes to accidents elation of previous sick days lost to ~ccidents, dose-response

97

LIST OF TABLES (CONTD.) TABLES

31. 32. Relation of literacy status to accidents Relation of educational status to accidents, dose-response 33. 34. 35. Relation of age to accident Relation of age to accident,dose-response Relatio of total work experience port to accidents 36. Relation of work experience to accidents,dose-response 37. Relation of work experience within the same work category in the port to a~cidents 38. Relation of work experience within the same work category in the port to accident, dose-response 102 101 in the port 101 in the 100 99 99 100

PAGE
98

LIST OF ABBREVIATIONS:

1.

ANSI

American National Standard Method of Recording Basic Facts Relating to the Nature and Occurrence of Work Injuries.

2. 3.

IDRC NEC
=

International Not Elsewhere

Development and Research Center Classified.

SUM

M A R Y.

The high incidence awraja of As sob , during of accidents

of accidents
7986-87

related

to the port in the observation

lea to a more detailed

and analysis

in the port of Assab in 7987. are employed in the port of As sob , but or are employed with industrial

Some 6,500 workers of these

570 (8. 8. %) are listed

as " non- industrial", them into contact

on work that is unlikely hazards. The remainder

to bring

5,930 (97.2% L were on the list of the concerned with industrial males, work.

four departments This number females. To describe among workers pairs) study,

principally

was made up of 5725 (96.5%)

and 205 (3.5%)

the occurrence

and determinants

of accidents per case (247 with respect was conducted 9,

in the port of Assab , a one control

matched on the basis of their similarity variables was designed. from October
76,

to the selected

The study

over a 55 days period,

7987.

7987 to December

The total number exposed to the risk

of accidents

that occurred

among workers

of accidents

in the

port of Assab were 247 per 700,000 worked or 2.03 accidents

man-hours ,

(4. 7%) , giving

a rate of 8.2 accidents per 7,000 exposed workers

0.6 accidents
00 employee

per

- months. department rate of accidents construction was produced project

77.8

The real highest the departmet

of Haleb boot eard

with

accident

rate of 75.5 per 700,000 man-hours, or 3.9 per 700 employee

per 7,000

sed workers

- months.

No significant among the worker's apprentice. The accident to its lawest Saturdays. be highest

difference categories

was noted

in the rate of accidents unskilled and

labeled as skilled,

frequency

was highest

on Mondays and fell once more on to

level at mid-week, The frequency in the period rate

with an increase

rate of accidents of the second shift

was observed
(8

p. m to 4 p. m) man-hours,

with an accident 50.4 per

of 70.6 per 700,000 worked at risk, or 2.52

7,000 workers

per 700 employee-months. temperature occurring

This is probably in the second Analysis

due to the peak environmental

shift. of man-days lost showed, 7,577 over a period works total man days of 55 days. to The

be lost due to the 247 accidents average being man-days

lost per accident The rate

out to 6.5,

the range in Assab

from 0 to 97 days. was 0.5,

of seriousness of seriousness

port study be 0.3. Analysis average days.

and the index

was found

to

of the cost of accidents

737.2

showed

37,606 birr , the over the 55 lost expenses indirect

being

birr per accident

to be spent

This cost is only for the medical and man-days the insurance payments and other

and does not include costs. A nalysis

of accidents

by category

of causation to be involved

showed

both

the environmental the accidents.

and human factors In 25.7%

in 57% of factor alone,

it was the environmental alone.

and in 76.6% the human factor

Among the causes causes were: defects

(22.5%),

by

environmental
(35.2%)

factors,

the most frequent methods

in agencies

hazardous

or procedures

and placement

hazards

( 22.4%). the most frequent

(78.4%),

Among the causes were

by the human factors, or surroundings

(78%),

inattention

to footing

improper

use of hands or body parts attire factors of the

(T2.3%J.

and failure

to wear safe personal for the human educational status

The main determinants

identified

from this study worker,

are; age of the worker,

job title of the worker,

experience

of the worker Thus the

in the port of Assob , and work shift risk groups identified

of the worker. of accidents

for the epidemiology : port workers

in the

port of Assab include years, port workers

between

the ages of 78-24 , Port workers and carpenters"., shift. given

with no formal education welders, plumbers,

classified and

as " electricians,

port workers

who are employed of this study,

to work in the second the recommendations

From the findings are:7. 2. 3.

A firm and well defined Employment

policy. Officer in the port. committee in the

of a fulltime Safety

Formation and Organization port.

of a safety

q,

Introduction system

of an effective

investigation port.

and recording

of accidents

in the Assab inspection

5.

To adopt a systematic by various factors identified

and follow-up accidents in

system

level of personnel, as a cause of

till all the environmental and

he A ssab port are rectified,

6.

Strong

efforts

in the areas supervision identified resulting

of safety

training

and

education, to the risk

safety

and safety

communication to effectively

groups

are necessary

reduce

the accidents

from the human factors.

CHAPTER

I.

IN TRODUCTlON

Work related hazard.

to the port represents

special industrial

The port is the link between and it involves where

the sea and other routes hazardous conditions dictated operations

or means of transport by the lay-out

of the places

work is to be performed: either

take place in close proximity and in the neighbouring and floating obiect s .

to the water,

on the dock side

warehouses

and sheds

or on boardships

In economic terms, economic sectors enterprise

the port is a meeting

place for various

and it differs

from the classic form of business of management or interests. economic

in that it has none of its unity

Work done there does not reflect agent. tatives handlers) but rather (transit the combined

the operations effort of users suppliers

of a single

or their represenof services (carriers,

agents),

the various

and the port authority

managing

the harbour

as well

as the government.
[unctions tm y

which has administrative,

policing and supervisory

These various ho often language,

in such

enterprises,

which employ different or even speak

personnel

do not know one another have to work together

the same

and perform

their operations

circumstances

that is often

no easy task to safeguard

e saiet y of the workers.

The difficulty is intermittentto perform cargo and

is further gangs

increased made

by

the fact ways

that

the

work

up in different to the

are formed to handle the

a collective

job limited

time needed

in question.

In the one port Some

North-Eastern

part

of Ethiopia, seven in the ocean A ssab

there going port-

is established ships but at a time. of these on work hazards. depart-

which

can accommodate are employed

6500 persons are listed

570 (8.8%) that

as "non-lridustriol", them into were with and contact an the industrial

or are employed with books work. making industrial of the four This 96.5

is unlikely

to bring

The remainder ments principally

5930 (97.23%) concerned

number and 3.5 percent

is made

up of 5725 males

205 females,

respectively.

The safety he port are:

problems

arising

in connection

with

the

work

in

For work persons _ ip , the

c

on boardship the and shore

or floating and the

objects: floating

the object.

transport access to the

between movement

presence

of persons and

on board, unmooring

transport of vessels.

goods

on boardshlp , and

the mooring

For work e dock side, sheds and

on dry

land: and

the

movement

and presence on open by means

of persons ground of

transport warehouses,

storage

of goods

and

trans-shipment

=--:-~r]~ent on boardship

or on landlIB).

Three years safety this section section

ago, the Assab port authority the safety

established

to coordinate is served

and health in the port. in social science. for

only by one BA graduate purpose

He was hired for another the safety and health

and is a part time worker

section.

His job description cord the accident surance

with regard

to safety

and health

is to

which occur in the port and to facilitate payments to the workers. Accidand

and compensation recorded

were being section,

s:

since the establishment been analyzed.

and the degree

of the safety The recording

of severity was

but it had never

cidents

was also inaccurate

ed.

1986 - 87 ,000

the accident

rate in the Assab port was 14.5 (913,412.20) does of super-

worked

hours and close to a million birr payments.

for medical and insurance ;o-~-f-'_~'e indirect

s:

This figure

(hidden) person,

accident

costs such as cost

injured
ing

cost of time lost by foremen cost of time spent department staff

injured

employee,

on the case etc ....

endant

and hospital

same year one worker

985 - 86

died as a result

of an

there

were six deaths

in the Assab

The cost of the accidents together with the mortality and morbidy is a big drain on an already precarious economy and is a major and potentially modifiable health problem in the Awraja.

The above findings forced us to undertake accident investigations in the Assab port.

As there is no reported Ethiopian data on the occurrence, 'eterminants and causation of accedents in the port, the present udy provides information ~tive on the major causes of accidents, the

frequencies of all causes, consequences and cost of treatand cost of accidents in general. It also develops a

useful for the planning of preventive strategies and - ~ implementation in the future. _ e specific objectives are:-

etermine the incidence density of all causes of 'dents in Assab 'Port. escribe the rate of accidents by age, sex, educational
~=~n~,

loacation of accident, day of the week, time of theday, facility attended, experience of work, work category,

~~~~ent,

work site, title of worker and number of illness

(e)

To describe the percentage distribution of accidents by the nature of injury, part of body affected, source of injury, Accident type, major causes and severity.

(d)

To describe the environmental existing in the port.

health and safety methods

(e)

To describe cost of accidents

in general, and

(f)

To plan preventive strategies

for accident in the port.

In addition, several hypothesis of association with the occurrence of accident~ are to be tested.

HI. That the rate of occurrence of accidents is inversely related to the educational status of the worker.

H2. That accidents occur more frequently in the night shift than the day shift.

That the rate of occurrence of accidents is directly related to the number of sickness episodes last one year. in the patient within the

t accidents occur more frequently

in those who does

have safety training that with safety training.

C H APT

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