SHARP Project Achievements and Milestones for 2013

Safety & Health Assessment & Research for Prevention (SHARP) — Research for Safe Work

If you’ve been a long time recipient of the SHARP Focus newsletter, you are already aware that SHARP is involved in a variety of research topics that impact many areas of the state and even collaborates with other state research groups.

In this newsletter, we will attempt to give you a taste of SHARP's work by presenting an overview of various projects including a few of the more significant activities and milestones of the past year.

We gathered the projects into four general themes, although they all have aspects that embody multiple themes:

  1. Identifying and tracking high hazard, high cost injuries and illnesses.
  2. Evaluating the effectiveness of prevention and intervention efforts.
  3. Serving as an objective scientific resource.
  4. Delivering Research to Practice.

SHARP Focus #1 – Identifying and tracking high hazard, high cost injuries and illnesses

SHARP identifies and tracks high-hazard, high-cost work-related injuries and illnesses to look for emerging occupational conditions.

Occupational health surveillance projects

Surveillance is not all binoculars and cameras! For SHARP it means looking at lots and lots of data.

  • SHARP works with the Council of State & Territorial Epidemiologists (CSTE) Occupational Health workgroup to track occupational injuries and illnesses – a set of measures known as ‘occupational health indicators’ (OHI) that are compiled yearly. They provide an overview and general assessment of the occupational health status of WA State. SHARP strives to provide the WA OHIs as soon as data becomes available. The WA OHI document is updated regularly throughout the year. Check out the latest version, updated in August 2013, at
  • Do you know what injuries are common in your industry group? SHARP researchers have compiled the WA State Fund compensable claims from 2002-2010 and ranked them by claim count and claims rate to prioritize industries for prevention efforts using a prevention index. The prevention index is the average of the industry’s ranking by number of workers’ compensation compensable claims (how common are the injuries), and that industry’s compensable claims rate (how high is the worker risk).  By prevention index, for “All Injury Types” combined, the top 5 industries for research and prevention were: Foundation, Structure and Building Exterior Contractors; Residential Building Construction; Building Finishing Contractors; General Freight Trucking; and Building Equipment Contractors. Read the full report, which details the top industry groups by 7 common high-cost injuries at:

Below, we will review select surveillance projects. Here’s a link to the complete list of SHARPs Occupational Health Surveillance Projects:

Traumatic fatalities

SHARP’s NIOSH-funded FACE program tracks and investigates work-related fatalities and communicates findings and recommendations with the goal of preventing work-related fatal injuries.

  • In 2013, the Washington State Fatality Assessment and Control Evaluation (FACE) program communicated workplace injury and fatality prevention information in the form of over a dozen case-based alerts, narratives, and reports to employers, workers, and other concerned stakeholders.

For more information on the Washington FACE program click:


SHARP’s asthma surveillance system tracks this emerging disease of high severity and cost to the workers’ compensation system. 

For more information on asthma:

Temporary Workers

SHARP is tracking the discrepancy between temporary workers injury rates and those of their permanently-employed peers. The goal is to compare the magnitude and severity of their injuries to those suffered by permanent workers in similar occupations, to explore the hazards to which they are exposed and to identify the most promising subjects and formats for training programs that could improve the safety of temporary workers. To date this project has:

  • Interviewed 387 injured temporary and permanent workers.
  • Conducted analyses on the relationship between contract status and workers compensation claims outcomes.
  • Presented preliminary results at the annual conference of the Council of State & Territorial Epidemiologists (CSTE).
  • Had a paper on workers’ compensation data collection challenges in the study of the contingent workforce accepted for publication by the American Journal of Industrial Medicine.
Behavioral Risk Factors

The Behavioral Risk Factor Surveillance System (BRFSS) is an annual telephone survey administered by the Centers for Disease Control and Prevention that collects data on emerging public health issues, health conditions, risk factors and behaviors. SHARP collects information from this survey on Washington workers regarding their health and health care, trends in chronic diseases, and health risk factors.

This information was used to:

  • Assess the prevalence of obesity by occupation among Washington workers. Link to Obesity Prevalence by Occupation in Washington State, Behavioral Risk Factor Surveillance System:
  • Present the study findings at American Public Health Association, Council of State and Territorial Epidemiologists, and BRFSS scientific meetings.
  • Serve as technical committee members for Washington BRFSS.
  • Collaborate with other states and NIOSH on addressing workers health using the BRFSS data.


SHARP Focus #2 – Evaluating the effectiveness of prevention and intervention efforts

SHARP conducts research to evaluate the effectiveness of prevention/intervention efforts to reduce occupational injuries and illnesses.  In the past we have evaluated interventions to reduce back injuries due to resident handling, and agency initiatives to reduce claims rates in residential framing.

Evaluation of DOSH Enforcement and Consultation Activities

  • In 2013, SHARP continued its annual evaluation of the effectiveness of DOSH consultation and enforcement programs in reducing workers’ compensation claims. The results of that work appear in 2013 CNE REPORT.
  • SHARP’s peer-reviewed analysis of DOSH enforcement and consultation activities from 1999 to 2008, which was published in the American Journal of Industrial Medicine received the Scientific Research Award from the Occupational Health Section of the American Public Health Association at its annual conference in November 2013. Link:

For more information about this study:


SHARP Focus #3 – Serving as an objective scientific resource

SHARP serves as an objective scientific resource for employers, workers, health care providers and agency management.  SHARP uses industry-wide studies and worksite visits to develop resource materials that have been used by employers, employees, agency staff and practitioners to improve workplace health and safety.

Collaborating with the trucking industry to prevent injuries

Changing the status quo requires collaboration at all levels for success. Injury prevention takes more than a change of rhetoric; it requires changing the culture of hazard acceptance. Published studies show that the trucking industry has higher rates and costs of injuries than most other industries.

SHARP and trucking industry leaders worked together over the past several years to challenge the culture of accepting risk to get the job done.  Industry, labor and the team of SHARP researchers from the Trucking Injury Reduction Emphasis (TIRES) project came together to work towards a common goal – to make trucking safer. This past year we tackled topics such as:

  • Run-over/crush prevention
  • Safer tire chaining techniques
  • Safety gear and tools
  • Finding, fixing and reporting hazards
  • Lifting
  • Safe ladder climbing
  • Preventing fatalities

Learn more by visiting Sign up to receive new materials as they are published at:
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Follow us on Twitter @TruckSafe.

Evaluating the accuracy of the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses

Two of the most common sources of Washington’s occupational injury and illness data are the Bureau of Labor Statistics (BLS) Survey of Occupational Injuries and Illnesses (SOII) – an employer-based report of injuries and illnesses – and workers’ compensation data – a worker and health care provider-based report of injuries and illnesses. Each source has limitations. Through a comparison of BLS injury and illness data to WC claims data, we aim to identify methods to more accurately assess the true burden of occupational injuries and illnesses.

  • A peer-reviewed publication was published in American Journal of Industrial Medicine called: Injury classification agreement in linked Bureau of Labor Statistics and workers’ compensation data. SHARP researchers found that accounting for classification differences may improve case ascertainment within individual data sources and help align injury and illness estimates derived from different data sources. Link to abstract:
  • SHARP researchers completed 642 interviews with company injury and illness record-keepers to explore recordkeeping practices that may explain differences between sources of occupational injury and illness data.


Identifying High Risk Workplaces for Work-Related Musculoskeletal Disorders (WMSDs)

Strains and sprains are examples of WMSDs that occur frequently in the workplace. While there have been different national and state estimates of the magnitude of WMSDs, there has been very little work on working population estimates of exposures to risk factors or hazards for WMSDs.  SHARP determined that developing and testing a WMSD hazard assessment tool that can be easily used in the workplace could help employers prevent injuries.

With this in mind, the SHARP Program has undertaken an ambitious 5-year WMSD surveillance project across several industries in Washington State.  The overall goal of this project is to develop and test a surveillance system for WMSDs of the hand/wrist, back, shoulder and knee.  This surveillance system will allow better characterization of WMSDs and risk factor exposures patterns and ultimately, will be used to develop a relatively quick WMSD hazard assessment tool that will integrate physical risk factors, safety climate/culture, equipment, tasks and persons.  This tool can be utilized to guide actions to prevent WMSDs in the future.

Surveillance Project Activities are:

  • Analysis and reporting of workers’ compensation findings of WMSDs of the neck, back, shoulder, elbow/forearm, hand/wrist and knee.
  • Interviewing 280 injured workers with WC claims involving lost work time in order to learn about the context in which their WMSD occurred.  These interviews focus on perceived WMSD risk factor exposure and safety culture.
  • Conducting 8 paired site visits to companies with high and low WMSD injury rates in each of the following industries: agriculture, healthcare, construction, wholesale, manufacturing and services (for a total of 48 pairs, 96 companies).  WMSD risk factor evaluations are performed to identify potential difference in risk factor exposure.

To better understand the factors that contribute to exposures and safety climate/culture, SHARP researchers are conducting interviews of both management and worker representatives at 288 companies (576 interviews total) in the agriculture, healthcare, construction, wholesale, manufacturing and services industries. 

Accomplishments to date:

  • Completed site visits to companies in 2 industries, healthcare and manufacturing (32 site visits)
  • Completed over 61% of the injured worker interviews (173 of 280 interviews)
  • Completed over 22% of the management and labor interviews (130 of 576 interviews)

For more information on WMSDs click:


Young Workers

The young worker project aims to increase the awareness of workplace safety among young workers (ages 24 or younger) in Washington State. Traumatic workplace injuries are identified, used and disseminated as prevention materials for young workers, their families and employers in an effort to educate people about the hazards and personal impacts of work-related injuries.

  • SHARP researchers review the L&I  workers’ compensation system for traumatic injuries among young workers (24-year-old and younger) in Washington State, targeted  injury types include amputation, burns, head injuries and motor vehicle collisions.
  • Selected injured young workers are contacted for interviews about their how their injuries occurred. Here’s an example of the materials SHARP researchers developed after working with a young amputee who wanted to prevent other workers from being injured.  Link here:

All the young worker injury alerts can be found at:


SHARP Focus #4 – Delivering Research to Practice

The presence of a multidisciplinary group of scientific researchers within L&I’s management structure allows rapid access, accountable and real-time expert statistical analysis necessary for departmental decisions.  It also allows the agency to take advantage of federal funds for Research to Practice initiatives that develop practical tools to make Washington a safer place to work and live. 

Workplace Violence

SHARP researchers continued work under NIOSH grant-funded workplace violence project titled: “Developing an Intervention to Reduce Workplace Violence in Healthcare Settings.”

This work includes:
SHARP researchers presented Linking Workplace Psychological Aggression to Employee Work, Safety & Health: The Moderating Role of Family-Supportive Supervisory Behaviors at the Work, Stress, and Health Conference in Los Angeles, CA.

Release of a research report: Addressing Workplace Violence: Developing a Collaborative Intervention with a Participatory Action Research Approach.  Click to link:
SHARP researchers partnered with a local hospital to pilot a training intervention. The pilot tested the training of supervisors of direct care staff to get their reactions and improvement feedback. This collaboration included:

  • SHARP researchers and a Western State Hospital team designed a 1 hour computer-based training (CBT) and delivered this training to 8 supervisors at Western State Hospital.
  • SHARP researchers and the Western State Intervention Development Team created a 2 hour face-to-face training with 8 supervisors to follow up on the CBT with discussion of the content key issues, role playing, and skill development practice with scenarios drawn from the prior qualitative research. This training component was delivered one day after participants took the CBT course.
  • Future work will center on a formal evaluation study using a quasi-experimental design with control and experimental groups to test the effectiveness of the training intervention. We hope to expand this evaluation to include employees in similar work-environments in the social services sector. The eventual goal of this research is to have an evidence-based intervention that is applicable to all supervisors and their teams.

For more information on SHARPs work on workplace violence prevention in psychiatric settings:


Hazardous Chemicals

SHARP has profiled two small businesses which have found alternatives to using methylene chloride, a chemical associated with fatal inhalation, during bathtub refinishing. 

For more on SHARP’s work to prevent injuries and illnesses from Hazardous Chemicals:


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