Environmental and Geographic Patterns of Occupational Injuries

NCT07750782 | Active Not Recruiting

• 2 other identifiers: BTL 001-2026work accidents and weather
• Study Type: observational
• Target: 350,000
• Locations: 1 country
• Sites: 1

Brief Summary

This study will determine whether extreme ambient temperatures increase the incidence and severity of occupational injuries in Israel, and we request Helsinki Committee approval to conduct the analysis using de-identified National Insurance and historical meteorological data, with a waiver of informed consent. The project will link the date, time, and geographic location of recognized occupational accidents with corresponding historical temperature and humidity measurements. The study is retrospective, observational, and involves no direct contact with participants, no intervention, and no alteration of medical care or benefit eligibility.

Conditions

Occupational Accidents; Weather

Outcome Measures

Primary Outcomes (1)

• Occurrence of Recognized Occupational Injury During Case Versus Matched Control Periods

  The number of accepted occupational-injury events occurring during predefined case periods will be evaluated in relation to ambient temperature, relative humidity, and wind speed obtained from the nearest representative meteorological station. Each injury period will be compared with control periods matched by geographic-climatic region, calendar year and month, day of the week, and three-hour time interval. The association between environmental exposure and occupational-injury occurrence will be estimated using time-stratified case-crossover analysis with conditional logistic regression.

  At the index injury date and matched control dates, January 1, 2020-December 31, 2024.

Study Arms (7)

Northern valleys and inland north

Occupational injuries occurring in the northern valleys and inland northern region will be assigned to this geographic-climatic division according to the location of the workplace or accident. Meteorological exposure will be determined using data from the nearest representative monitoring station, including Dafna, Tavor Kadoorie, or Nazareth. This region is characterized by inland climatic conditions with substantial seasonal variation in temperature and humidity. Accident occurrence and severity will be evaluated in relation to temperature, relative humidity, wind speed, extreme heat, extreme cold, and other predefined environmental indicators.

Other: Ambient Weather Exposure

Northern Mediterranean coast

Occupational injuries occurring along the northern Mediterranean coastal region will be assigned to this geographic-climatic division according to the location of the workplace or accident. Meteorological exposure will be determined using data from the Haifa Technion monitoring station or the nearest available representative station. This region is characterized by a Mediterranean coastal climate, with relatively high humidity, moderate winter temperatures, warm summers, and frequent sea-breeze effects. Accident occurrence and severity will be evaluated in relation to ambient temperature, relative humidity, wind speed, extreme heat, extreme cold, and other predefined environmental indicators.

Other: Ambient Weather Exposure

Central Mediterranean coast

Occupational injuries occurring within the central Mediterranean coastal region will be assigned to this geographic-climatic division according to the workplace or accident location. Meteorological exposure will be determined using data from the Tel Aviv Coast monitoring station or the nearest available representative station. This region is characterized by a warm Mediterranean climate, relatively high humidity, mild winters, hot summers, and frequent sea-breeze effects. The occurrence and severity of occupational injuries will be evaluated in relation to ambient temperature, relative humidity, wind speed, extreme heat, extreme cold, and other predefined environmental indicators.

Other: Ambient Weather Exposure

Southern Mediterranean coast

Occupational injuries occurring within the southern Mediterranean coastal region will be assigned to this geographic-climatic division according to the workplace or accident location. Meteorological exposure will be determined using data from the Ashqelon Port monitoring station or the nearest available representative station. This region is characterized by a warm coastal Mediterranean climate, relatively high humidity, mild winters, hot summers, and frequent sea-breeze effects. The occurrence and severity of occupational injuries will be evaluated in relation to ambient temperature, relative humidity, wind speed, extreme heat, extreme cold, and other predefined environmental indicators.

Other: Ambient Weather Exposure

Central highlands

Occupational injuries occurring within the central highlands region will be assigned to this geographic-climatic division according to the workplace or accident location. Meteorological exposure will be determined using data from the Jerusalem Centre monitoring station or the nearest available representative station. This region is characterized by higher elevation, lower average humidity than the coastal areas, greater day-night temperature variation, cooler winters, and warm, dry summers. The occurrence and severity of occupational injuries will be evaluated in relation to ambient temperature, relative humidity, wind speed, extreme heat, extreme cold, and other predefined environmental indicators.

Other: Ambient Weather Exposure

Negev desert

Occupational injuries occurring within the Negev desert region will be assigned to this geographic-climatic division according to the workplace or accident location. Meteorological exposure will be determined using data from the Avdat monitoring station or the nearest available representative station. This region is characterized by an arid desert climate, very low relative humidity, intense solar exposure, high daytime temperatures, substantial day-night temperature variation, and limited rainfall. The occurrence and severity of occupational injuries will be evaluated in relation to ambient temperature, relative humidity, wind speed, extreme heat, extreme cold, and other predefined environmental indicators.

Other: Ambient Weather Exposure

Dead Sea and extreme arid region

Occupational injuries occurring within the Dead Sea and extreme arid region will be assigned to this geographic-climatic division according to the workplace or accident location. Meteorological exposure will be determined using data from the Massada monitoring station or the nearest available representative station. This region is characterized by very low elevation, an extremely hot and arid climate, low annual rainfall, intense solar radiation, prolonged periods of extreme heat, and substantial seasonal temperature variation. The occurrence and severity of occupational injuries will be evaluated in relation to ambient temperature, relative humidity, extreme heat, extreme cold, and other predefined environmental indicators. Wind speed will be analyzed when reliable measurements are available.

Other: Ambient Weather Exposure

Interventions

Ambient Weather Exposure OTHER

Ambient temperature, relative humidity, and wind speed at the occupational-injury location and time will be retrospectively obtained from the nearest representative meteorological monitoring station. Environmental exposures will be analyzed in relation to occupational-injury occurrence and severity.

Central Mediterranean coast; Central highlands; Dead Sea and extreme arid region; Negev desert; Northern Mediterranean coast; Northern valleys and inland north; Southern Mediterranean coast

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

The study population will include adults aged 18 years or older with occupational injuries recognized by the National Insurance Institute between January 1, 2020, and December 31, 2024. Eligible records will be selected from the national occupational-injury administrative database and assigned to one of seven predefined geographic-climatic regions according to the workplace or accident location. Environmental exposure will be determined by linking each injury date, time, and location to the nearest representative meteorological monitoring station. The study will include workplace, occupational-traffic, and commuting injuries meeting the prespecified eligibility criteria.

You may qualify if:

• Individuals aged 18 years or older with an occupational injury recognized by the National Insurance Institute.
• Occupational injury occurring between January 1, 2020, and December 31, 2024.
• Injury occurring at the workplace, during occupational travel, or while commuting to or from work.
• Valid injury date and geographic information sufficient to assign the accident to one of the seven predefined geographic-climatic regions and the nearest representative meteorological station.
• Meteorological measurements available for the injury period and eligible matched control periods.
• For time-specific analyses, a valid recorded accident time permitting linkage to the closest preceding three-hour meteorological observation.

You may not qualify if:

• Occupational diseases, repetitive-exposure conditions, or gradual-onset disorders without a clearly defined accident date.
• Rejected, withdrawn, or unconfirmed occupational-injury claims.
• Missing or invalid accident date or geographic information preventing linkage with meteorological data.
• Accidents occurring outside the predefined geographic-climatic regions or beyond the prespecified maximum distance from an eligible meteorological station.
• Duplicate or administratively repeated records referring to the same occupational-injury event.
• Injury events for which no eligible matched control periods or corresponding meteorological measurements are available.
• Individuals younger than 18 years.

Sponsors & Collaborators

• Sergio Gabriel Susmallian: lead

Study Sites (1)

Israel National Insurance Institute

Rishon LeZiyyon, 7526557, Israel

Location

Related Publications (3)

• Calkins MM, Bonauto D, Hajat A, Lieblich M, Seixas N, Sheppard L, Spector JT. A case-crossover study of heat exposure and injury risk among outdoor construction workers in Washington State. Scand J Work Environ Health. 2019 Nov 1;45(6):588-599. doi: 10.5271/sjweh.3814. Epub 2019 Mar 14.

  PMID: 30869152 BACKGROUND

• Sheng R, Li C, Wang Q, Yang L, Bao J, Wang K, Ma R, Gao C, Lin S, Zhang Y, Bi P, Fu C, Huang C. Does hot weather affect work-related injury? A case-crossover study in Guangzhou, China. Int J Hyg Environ Health. 2018 Apr;221(3):423-428. doi: 10.1016/j.ijheh.2018.01.005. Epub 2018 Jan 11.

  PMID: 29361390 BACKGROUND

• Marinaccio A, Scortichini M, Gariazzo C, Leva A, Bonafede M, De' Donato FK, Stafoggia M, Viegi G, Michelozzi P; BEEP Collaborative Group. Nationwide epidemiological study for estimating the effect of extreme outdoor temperature on occupational injuries in Italy. Environ Int. 2019 Dec;133(Pt A):105176. doi: 10.1016/j.envint.2019.105176. Epub 2019 Oct 22.

  PMID: 31654985 BACKGROUND

Study Officials

• Eytan Ellenberg, M.D.

  Israel National Insurance Institute

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: CASE CROSSOVER
• Time Perspective: CROSS SECTIONAL
• Target Duration: 2 Years
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Medicine doctor

Study Record Dates

• First Submitted: August 2, 2026
• First Posted: August 6, 2026
• Study Start: January 1, 2020
• Primary Completion: December 31, 2024
• Study Completion (Estimated): December 31, 2026
• Last Updated: August 6, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will not share

Locations

IL (1)