"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).