Skyrocketing oil prices have led to onshore drilling technologies in areas that were previously untapped in Western states and North Dakota (ND) has recently become the third-most active drilling state in the country (1), a state of approximately 650,000 people with a major source of the economy tied to a rapidly expanding oil and gas extraction industry (2). It is predicted ND will soon become the second-largest oil-producing state after Texas as it is believed to hold 400 billion barrels of oil and produces 35,000 barrels of oil daily (3)
Figure 1.pdf illustrates the rise in deaths from unintentional injuries in ND (4) and occupational fatalities are a major part of that statistic. ND has the second highest rate of work-related fatalities in the nation after Montana (5). A NIOSH publication in 2007 reported that the oil and gas industry experiences a fatality rate of 32 per 100,000 workers, which is eight times the national average for all workers and ranks as high as coal miners. (5). Furthermore there is a statistically significant correlation between the number of drilling and workover rigs and the annual occupational fatality rate during 1993-2006 (6). ND state statistics show a 148% increase in oil drilling rigs and a 200% increase in the number of barrels produced daily since 2005 (2). The association between rig activity and occupational fatalities is concerning for states that are experiencing an increase oil and gas exploration, because with the rapid increase in activity comes an increased demand for employees and with the influx in employees, in the oil and gas industry comes a greater potential for occupational injuries overall.
Common injuries from working on the oil rigs are caused by getting caught in or struck by equipment, falls, explosions, and motor-vehicle-related incidents such as crashes, rollovers and truck jack knife (5). Highway motor-vehicle crashes accounted for more than 25% of all occupational fatalities nationwide and, thus, have proven to be the most deadly when it comes to the oil and gas industry (6) (5).
Carmell Barth at the North Dakota Department of Vital Records provided with the number of motor-vehicle related deaths in the past decade. Figure 2 below shows the number of deaths related to motor-vehicles in ND from 2000 to 2009. Overall the number of deaths related to motor-vehicle incidents has increased in the past decade. It appears there was a sharp increase around the time of the commencement of the oil and gas boom (2006), although this data does not stratify by location of crash or occupation of driver. Even so, it is apparent the crude number of MVR deaths is increasing.
*Counties of Dunn, McKenzie, Williams, Stark and Ward
†cars, pickups, vans, heavy transport
Transportation between work sites is the biggest exposure to motor-vehicle fatalities in the oil and gas industry but it is unclear whether the incidents are caused by individual-related behaviors (speeding, distracted driving, substance abuse), environmental (harsh road conditions, faulty equipment, demanding work schedules), or a combination of the two factors (5).
Connie Serhienko (7) is the forensic administrator at the NDDoH and upon request she swiftly provided information on the determined causes of deaths in the oil and gas workers within the past year. Figure 3 below displays information regarding incidents of oil field worker deaths.
*Oil field workers are from the counties of Dunn, McKenzie, Williams, Stark and Ward
Overall there were 13 injury deaths in this occupational cohort in the past year alone. Traffic fatalities are the most with 4 deaths, followed by work-related and suicide, then drug overdose and homicide (7). "Work related" was identified as two machine related and one fall, although it's important to remember that although the deaths did not get coded as "worker related," they still may be occupationally related if their job is a risk factor.
New Mexico looked at their high rates of occupational fatalities and found that the high rate of occupational injury fatalities are attributed to rural location, use of motor-vehicles, and alcohol use (8). The counties in ND that produce the majority of oil and gas are rural, the most deadly injuries are related to motor-vehicle collisions, and it is currently unclear what the root cause/s of the problem is/are. This alone is a sound argument for a need for surveillance of occupational injuries in the oil and gas industry, particularly related to fatal motor-vehicle injuries.
The variables (exposures) potentially related to the motor-vehicle related fatalities in the oil and gas industry are related to the type of work being done, personal characteristics of the workers, and the environment in which the work is being performed (physical and sociocultural).
An example of a job posting from an oil company is found in Table 1 below. You can see that the oil and gas industry is targeting laborers who are willing to put in many hours per week, and transportation-related jobs are in high demand.
The nature of the work is laborsome and overtime is encouraged (10). Oftentimes field workers work strenuous hours for days on end which can lead risk factors for injuries. The oil and gas companies have been drilling about 1,000 wells per year, and it takes about seventy-four companies to drill one well. The types of workers in high demand are workers to run the rigs, drivers to carry product and equipment, technical workers and all of the support jobs that spin off from oil and gas (11).
Working long hours is associated with more workplace hazard exposure and less time to be healthy outside of work. For example when there is less time to sleep, recover from work, and spend time with family and other non-work responsibilities, workers can experience fatigue, stress, negative mood, discomfort, pain, and decrements in functioning, not to mention having less time to exercise and prepare nutritious diet (12). Stress is associated with increased alcohol and tobacco use, which poses additional health threats. These negative effects trickle into the worker's social and family life, potentially causing marital and/or child-rearing problems. The economic implications on a community level have the potential to be catastrophic (12). For those workers who are responsible for driving vehicles to transport product and equipment between worksites, these stressors can potentially be life-threatening.
Because of the rural location of the oil fields and low population density, there is a lack of experienced oil and gas workers in North Dakota. Furthermore, there is a perception that oil field workers are "traditional" and the oil companies' ability to attract and retain talent in the oilfield may very well be hampered by their "stodgy image" (13).
The oil and gas industry employed an estimated 12,750 workers in 2009, and because the number of wells being drilled is increasing, the number of workers is also expected to increase. (11). The worker population in North Dakota is interesting and poses unique challenges for changing the culture of health and safety in the workplace. The oil and gas industry, in particular, faces challenges specific to ND in recruiting employees; these challenges include low population base, low unemployment, high labor force participation, and expanding economy in most other sectors (14). Furthermore, they have an aging population, and many young workers move out of state after high school and college (out-migration) (14). In an effort to maximize productivity, the industry has to tap into the resources available, which are lacking.
Because of the growing population rapidly there are issues of overcrowding which has law enforcement officials expressing concern about the increase in violence, substance abuse, and mental health issues related to in the communities where oil and gas exploration is occurring (15). Moreover, it has been hypothesized that the influx of workers to rural or isolated communities can bring about stresses to the local people and may increase crime, social diseases and psychological outcomes. Surveillance of psychosocial conditions is not mainstream and complex data would be needed to look at this issue further in ND (16).
Researchers in involved in the Mountains and Plains Educational Research Center performed a comprehensive literature review looking at health impacts of the oil and gas industry in Garfield County, Colorado, which has similar worker demographics as the worker in the ND oil and gas industry (17). They found several studies suggesting psychosocial issues that may be associated with industrial activity moving into populated areas. They have concerns about possible increases in domestic violence, rape, assault, child abuse, suicide, homicide and crime (18; 19; 20; 21; 22; 23; 24) . Some of these injury problems are already being experienced, as shown in Figure 3.pdf. The influx of oil and gas industry activity potentially creates psychosocial problems in the workers and those problems can potentially lead to injuries on the job. Stress, substance abuse, and fatigue while driving between worksites may be psychosocial factors associated with increased motor-vehicle related fatalities. In addition to the social environment, the physical environment also plays a significant role in motor-vehicle related incidents.
ND is known for extreme weather condition, which can be severe: blizzards, floods, droughts, tornadoes, hail storms, thunderstorms, high winds, severe cold spells, and extreme heat are not uncommon (25). Furthermore, the infrastructure is not able to sustainably withstand the high volume of truck traffic is involved with the oil and gas industry (26).When harsh weather conditions, psychosocial issues, and increased driving in a weak infrastructure are combined, the potential for injuries increases dramatically. When fatalities occur on the road, especially at work, it is necessary to document driver impairment, road conditions, vehicle safety features, and other environmental conditions related to the incident. It would also be interesting to look at the association of time of day and day of week, as well as when the individual last had a day off work. These data might help determine underlying causes of motor-vehicle related crashes, which could help change the safety culture in the industry overall. Also important to consider is the location of the incident in terms of emergency response and training of first responders.
The National Institute of Occupational Safety and Health (NIOSH) is in the process of creating a research agenda to address the increasing burden on oil and gas workers. Table2.pdf outlines the five strategic goals of the National Oil and Gas Industry Research Agenda for 2020. The overarching goals address reducing fatalities by half from occupational-related and motor-vehicle-related causes in this industry (9).
Occupational motor-vehicle fatality rates is an agenda item by itself, which is appropriate since it is the most common cause of fatalities in occupational fatalities, and the oil and gas industry is no exception. This exemplifies the relative significance of this injury problem in this industry. Cost effectiveness of health and safety programs in occupational settings is often a good way to promote policy change industry-wide. The next section will discuss the estimated costs of motor-vehicle related fatalities in the oil and gas industry.
Table3.pdf defines the types of measureable costs that are related to motor-vehicle related fatalities. There potential unquantifiable costs to families of victims and society that are not described in this table, but are extremely important to consider when conceptualizing the costs related to a death.
Table 4.pdf describes the cost components used to estimate costs of motor-vehicle related fatalities which can be used by government and industry officials, and policy advocates to calculate the overall cost of the problem in their communities. It is not surprising that deaths cost more than nonfatal injuries and property damage, and that incapacitating injuries are more costly than non-incapacitating injuries.
The average comprehensive cost of motor-vehicle related fatalities is estimated to be $4.3 million per injured person. This information was put out by the National Safety Council in 2011 and is not industry-specific. Based on these estimates, ND will have lost $17.2 million from the four traffic-related fatalities in the oil and gas industry workers from 2010 to 2011. As the oil and gas industry grows in North Dakota and other states, the potential costs to the injury problem have the potential to be devastating.
Limiting factors to reducing motor-vehicle related fatalities in ND oil and gas workers both simple and complex. The problem is that the industry is growing faster than the data can measure it. Much of the evidence is anecdotal from interviews with law enforcement , Petroleum industry leaders, and health department officials (3) (7) (15).
There is an overall lack of existing data to describe the problem. Incidence data is available, however denomninator data is challenging to quantify. Although ND is one of the few states with a state-based workers' compensation system, occupational health surveillance data is minimal because of a lack of resources, and lack of hospital discharge data.
It seems as though there lack of safety programs and policies in this industry, and that ND has a unique aging and "traditional" population that may not comply as readily with programs even if they do exists. The ND oil and gas industry targets a recruitment pool of potentially vulnerable populations (migrant, recent high school graduates, and older workers) and there appears to be limited (but growing) collaboration between oil and gas industry and government and safety officials, such as NDDoH. Laslty, as with many occupational health and safety issues, there appears to be a lack of a safety 'culture' among workers, within companies, and in the industry as a whole. This leads to a lack of implementation, enforecement, and compliance with new and current safety programs and policies.
The epidemiologic approach to preventing motor-vehicle related injuries in this industry will need to look at individual, equipment, and environmental factors that are unique to North Dakota oil and gas workers in an effort to prevent and control related fatalities. Based on the Epidemiological model of injury prevention the agent is the energy exposure to the individual that causes a fatal injury; the host is the fatal injury; the environments are physical and sociocultural; and the vehicle is what transmits the agent to the host (motor vehicle). In order to prevent a fatal motor-vehicle incident the 'vehicle' must be interfered with to prevent energy transfer from agent to host. The 'vehicle' involves the design components of the motor vehicle.
The HADDON MATRIX.pdfillustrates examples of human, equipment, and environmental components of motor-vehicle fatalities that could be part of the epidemiologic approach to prevention.
"The successes of modern public health measures are substantially the result of a shift from an individual- to a community-centered emphasis" (28). Whether doing a risk-based, or a cultural shift approach, the first step relies on data to identify problem areas and understanding the safety issues in the company/region/industry. The next step is engaging the workers and management, asking them their opinions about what programs they would actually use, if implemented. After that, continued surveillance is necessary in order to evalate effectiveness and adapt the program as needed. (5).
Accurate industry-specific motor-vehicle related death rates per 100,000 workers at risk would give us incidence measures, and we can compare to other states and the nation over the past 10 years to get an idea of pre-and post oil "boom" measures. If industry-specific data are not available, then county-level data can be obtained and can be compared between oil and gas counties versus non-oil and gas counties. Information on industry-specific deaths and county-level motor-vehicle related deaths was obtained from ND government officials and was presented previously in this paper (Table3.pdf & Figure 2.pdf, respectively), although denominator data are yet to be obtained to calculate incidence rates.
Another source of data would be medical chart reviews and autopsy reports. This can provide detailed information about the exposures at the time of the incident. For example, if a worker was under the influence of alcohol or drugs at the time of the incident, this would have been measured at autopsy and will play a role in how we determine the causes of injury. Also road conditions and seasonal effects should be looked at to give rise temporal trends. These types of data sources are necessary to tailor motor-vehicle related injury prevention and control programs to the workers. We also need to collect data on how much training the workers have, such as driving training, and safety training. Some of this can be asked crossectionally, whereas other information can be gathered from training logs and records of attendance.
In 2006 Schlumberger safety specialists presented a risk-based driving improvement plan that had been implemented in Qatar. Researchers identified the root causes of driving incidents and worked with businesses to create a tailored plan involving a combination of training and incentives for improvement. The safety program included motor-vehicle safety-specific measureable action items to allow the company to evaluate the effectiveness of the program (5). One way to implement safety programs is to target the highest risk individuals (i.e. those who are commonly operating motor vehicles). A more sustainable way to address the safety issues is to shift the overall health and safety culture in a company. This requires buy-in from everyone, including higher up officials, managers, and incombent workers (5).
Preventing and treating motor vehicle fatalities in oil and gas industry workers is a multi-dimensional task that needs systems thinking to prove successful. Strategies to address the motor vehicle related fatality rate in ND oil and gas industry workers are outlined below in Haddon 10 strategies.pdf(28; 29).
ND has a unique worker population and poses unique challenges for occupational health and safety programs in the oil and gas industry. Despite the challenges faced, it is possible to take lessons learned from other states that are demographically similar, such as certain counties in Colorado, Montana, and Wyoming who have had similar changes in their worker population, and who have experienced high rates of occupational fatalities in this industry. It is imperative to establish and maintain working partnerships between oil and gas industry and health and safety stakeholders and to build an infrastructure conducive to preventing and controlling fatalities in the workplace.
Oil and gas companies need to prioritize the health and safety of their workers in order to retain workers, expand the industry and improve perception of the industry. Targeted programs and policies are necessary to maximize participation and meet the 'bottom line' of both oil and gas organizations that have an interest in promoting health and safety. Surveillance of injuries must be consistent, complete and accurate in order to identify problem areas related to this worker population.
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