five of the world s most fatal work safety accidents in the past decade ( 20012010 ) occurred in china ( 1 ) .
work safety accidents has become the first cause of deaths of chinese citizens below 44 yr old ( 2 ) .
work safety accidents pose a great threat to people 's life , especially major accidents , defined as ones that result in at least 10 deaths .
the chinese government has established a surveillance system for monitoring work safety accident since 2001 under state of saws ( 3 ) , which is the only authority system for work safety accidents inquiry in china .
injuries related to transportation , mining , fire , explosion had the majority of occurrence ( 46 ) , and the most accidents occurred in construction on certain geographic regions of china ( 7 , 8) .
previous researches had focused on the characteristics of work safety accidents , while there is very few research analyzing major accidents with mass casualties .
there has no clear answer yet that whether accidents with mass casualties are a simple enlargement of general accidents , or there is inherent mechanism of accident cause and special risk factors or not .
the in - depth research focused on cause mechanism of work accidents with at least 10 fatalities has important theoretical value and practical meaning to improve relevance and effectiveness of accident prevention . to examine the national profile of the extent and type of major accidents in work safety , which causes more than 10 fatalities per accident
, we analyzed data from accident inquiry system on saws website for the period 2003 to 2012 and provide scientific basis for prevention measures and strategies to reduce major work safety accidents and deaths in china .
data from the state saws corresponding to the period 20032012 were used in this analysis .
saws is the competent agency under the state council in charge of the comprehensive supervision and administration of work safety and coalmines of the whole country .
china has made mandatory provisions focusing on the implementation of safety standards , risk forecasting , accident reporting , accident accountability and other aspects through the development of relevant laws and regulations , departmental regulations and safety standards .
the saws is law - based administration to strengthen the comprehensive supervision and administration of work safety and coal mines of the whole country .
the saws collects information from provinces , cities and local data sources , including details regarding fatal accidents with more than three deaths and non - fatal injuries , and associated economic losses .
the information of work safety accidents and coalmine incidents are required to report from enterprise involved to the regional agency and provincial department , and then finally submitted to the saws . after conducting an investigation ,
the saws announces the findings and determines about penalty . in this study , the data covered most industries except the military forces and private enterprises .
additionally , we checked statistical year - book of road traffic accidents and public literature to supplement information and details .
the analysis was conducted using the registered data with more than 10 deaths per incident .
major accidents in transportation involved victim who was the operator , passenger , or a pedestrian stuck in or on the side of the road . after extraction , details including types of the event , year , region , number of deaths and injuries , causes of accidents were transformed into spss v13.0 ( chicago , il , usa ) .
we performed analysis on the frequency of accidents and deaths , the trend , geographic distribution and type of major accidents .
we analyzed the geographic distribution using hierarchical cluster analysis , focused on the frequency of accidents and deaths .
incidence of major accident shows the occurrence probability of any person , and major accident mortality shows the dying probability .
the incidence and mortality of major accident are defined as follows : 
 incidence = number  of  major  accident/  ( total  national  population106)mortality = number  of  death/  ( total  national  population  106 ) 

data from the state saws corresponding to the period 20032012 were used in this analysis .
saws is the competent agency under the state council in charge of the comprehensive supervision and administration of work safety and coalmines of the whole country .
china has made mandatory provisions focusing on the implementation of safety standards , risk forecasting , accident reporting , accident accountability and other aspects through the development of relevant laws and regulations , departmental regulations and safety standards .
the saws is law - based administration to strengthen the comprehensive supervision and administration of work safety and coal mines of the whole country .
the saws collects information from provinces , cities and local data sources , including details regarding fatal accidents with more than three deaths and non - fatal injuries , and associated economic losses .
the information of work safety accidents and coalmine incidents are required to report from enterprise involved to the regional agency and provincial department , and then finally submitted to the saws . after conducting an investigation ,
the saws announces the findings and determines about penalty . in this study , the data covered most industries except the military forces and private enterprises .
additionally , we checked statistical year - book of road traffic accidents and public literature to supplement information and details .
the analysis was conducted using the registered data with more than 10 deaths per incident .
major accidents in transportation involved victim who was the operator , passenger , or a pedestrian stuck in or on the side of the road .
after extraction , details including types of the event , year , region , number of deaths and injuries , causes of accidents were transformed into spss v13.0 ( chicago , il , usa ) .
we performed analysis on the frequency of accidents and deaths , the trend , geographic distribution and type of major accidents .
we analyzed the geographic distribution using hierarchical cluster analysis , focused on the frequency of accidents and deaths .
incidence of major accident shows the occurrence probability of any person , and major accident mortality shows the dying probability .
the incidence and mortality of major accident are defined as follows : 
 incidence = number  of  major  accident/  ( total  national  population106)mortality = number  of  death/  ( total  national  population  106 ) 

we found a dramatic decline in both numbers of accidents and deaths since 2006 . the number of accidents and deaths dropped by 52.0% and 66.6% from the peak year ( 2005 ) to 2012 , respectively . in the 10-yr period from 2003 to 2012
, there were 866 major accidents in work safety in china , resulting in 16795 deaths and 9183 injuries .
the incidence of major accident and the mean mortality rate were 1.93 and 1.34 per one million populations annual . in recent years , both the major accident mortality rate and incidence of major accident have declined ( fig .
1 ) . mortality rate and incidence of major accidents in work safety in china , by year , 20032012 fig .
the deeper the color in the region , the higher number of accidents and deaths occurred . using hierarchical cluster analysis , we found that the regions reporting the highest number of injuries and deaths were hunan ( 62/936 ) , guizhou ( 69/1101 ) , henan ( 54/1302 ) , shanxi ( 79/2045 ) , with a total of 264 incidents and 5384 deaths , both accounting for 30% nation - wide .
geographic distribution of major work safety accidents in china , 20032012 ( number of incidents / number of deaths ) transportation - related accident was responsible for the highest frequency of deaths from 2003 to 2012 ( n=437 ) .
table 1 shows that transportation and mining caused more injuries and deaths during the dates evaluated . the number of injuries declined in the last years , as did the number of injuries caused by all types of industries .
however , we have not noticed such a tendency in manufacturing , construction and service . furthermore , mining declined in percentage of injuries , while percentage of transportation - related accident increased .
type of industry - related accident in china by year , 20032012 mining contributed to the highest number of deaths ( n=7646 ) . from 2003 to 2012 , there were 309 mining - related accidents , each of which caused 24.7 fatalities .
as indicated in table 2 , more than 80% of major work safety accident - related deaths occurred in mining and transportation , and both of them declined in recent years .
number of deaths by industry in china by year , 20032012 table 3 displays the number of deaths per accident by industry by year .
the average number of death per accident in service and mining shows a decline in recent years , while we have not found the similar trend in manufacturing , construction and transportation .
coal mine - related and road traffic - related accidents were dominant and nearly accounted for four - fifths of all types of major accidents .
the evaluation of all types of accidents has revealed that tailing dam related accident was the most severe in terms of number of fatalities per incident , causing 105 deaths per incident .
number of deaths per accident by industry in china by year , 20032012 aviation - related and railway - related accidents caused 49.5 and 43.3 deaths per incident , respectively ( table 4 ) .
the most lethal type of major work safety accident , with the highest death injury ratio was tailing dam accident .
machinery , collapse , electric shock accident and coalmine accident were specifically higher in death injury ratio , while aviation accident and railway accident were specifically higher in the number of deaths per incident ( fig .
3 ) . number of deaths and frequency by type of accidents in china , 20032012 death per incident and death injury ratio in different types of accident
we found a dramatic decline in both numbers of accidents and deaths since 2006 . the number of accidents and deaths dropped by 52.0% and 66.6% from the peak year ( 2005 ) to 2012 , respectively . in the 10-yr period from 2003 to 2012
, there were 866 major accidents in work safety in china , resulting in 16795 deaths and 9183 injuries .
the incidence of major accident and the mean mortality rate were 1.93 and 1.34 per one million populations annual . in recent years , both the major accident mortality rate and incidence of major accident have declined ( fig .
1 ) . mortality rate and incidence of major accidents in work safety in china , by year , 20032012
fig . 2 shows major work safety accidents and deaths in relation to their geographic distribution . the deeper the color in the region , the higher number of accidents and deaths occurred . using hierarchical cluster analysis
, we found that the regions reporting the highest number of injuries and deaths were hunan ( 62/936 ) , guizhou ( 69/1101 ) , henan ( 54/1302 ) , shanxi ( 79/2045 ) , with a total of 264 incidents and 5384 deaths , both accounting for 30% nation - wide .
geographic distribution of major work safety accidents in china , 20032012 ( number of incidents / number of deaths )
transportation - related accident was responsible for the highest frequency of deaths from 2003 to 2012 ( n=437 ) .
table 1 shows that transportation and mining caused more injuries and deaths during the dates evaluated . the number of injuries declined in the last years , as did the number of injuries caused by all types of industries .
however , we have not noticed such a tendency in manufacturing , construction and service . furthermore , mining declined in percentage of injuries , while percentage of transportation - related accident increased .
type of industry - related accident in china by year , 20032012 mining contributed to the highest number of deaths ( n=7646 ) . from 2003 to 2012 , there were 309 mining - related accidents , each of which caused 24.7 fatalities .
as indicated in table 2 , more than 80% of major work safety accident - related deaths occurred in mining and transportation , and both of them declined in recent years .
the average number of death per accident in service and mining shows a decline in recent years , while we have not found the similar trend in manufacturing , construction and transportation .
coal mine - related and road traffic - related accidents were dominant and nearly accounted for four - fifths of all types of major accidents .
the evaluation of all types of accidents has revealed that tailing dam related accident was the most severe in terms of number of fatalities per incident , causing 105 deaths per incident .
number of deaths per accident by industry in china by year , 20032012 aviation - related and railway - related accidents caused 49.5 and 43.3 deaths per incident , respectively ( table 4 ) .
the most lethal type of major work safety accident , with the highest death injury ratio was tailing dam accident .
machinery , collapse , electric shock accident and coalmine accident were specifically higher in death injury ratio , while aviation accident and railway accident were specifically higher in the number of deaths per incident ( fig .
3 ) . number of deaths and frequency by type of accidents in china , 20032012 death per incident and death injury ratio in different types of accident
economic development is related to the incidence of accident . in developing countries such as china ,
increases in the growth rate of economic may have caused work safety accident rate to rise ( 9 ) . in china , both major work safety accidents and deaths
appear to have decreased since 2006 , while the growth rate of gdp shows an increase steadily ( varying in the range of 7.8% to 14.2% ) ( 10 ) .
efforts in regulations and surveillance , safety initiatives and innovations in safety controls by chinese government can attribute to the decline . to improve the whole country s work safety ,
chinese government has issued a series of supervision regulations especially for fatal serious work safety accidents , such as fire regulation , transportation regulation , coal mine and non - coal mine regulations , and the 11 five - year plan for national economic and social development of the people s republic of china ( 11 ) . as part of this move
, chinese government has also strengthened the penalties for fatal major work safety . as the formulation and implementation of the regulations , provinces have made great improvements in preventing serious and major accidents .
the number of accidents and deaths show a sharp drop in ten years , which are broadly consistent with other published studies ( 1217 ) .
while there has been a decline in the frequency of accidents and deaths in recent years , the mortality rate was still relatively high . according to zhang et al .
( 12 ) , the risk of death was 6.1 per million populations in work safety in whole country , which was higher than other countries ( 18 ) . using hierarchical cluster analysis
, we recognized that provinces of hunan , guizhou , henan , shanxi reported the highest number of major accidents and deaths , while provinces of shanghai , qinghai , hainan , ningxia , beijing , tianjin reported the least , which is consistent with the regional distribution of work safety accidents in whole country ( 12 ) .
after detailed analyzing , we found that hunan , guizhou , henan and shanxi had more than 55 major accidents , resulting in more than 900 deaths . among these accidents , mining and transportation contributed to the majority , accounting for more than 89% of all .
these statistics may relate to the differences in natural environment , working conditions , the level of economic development and economic patterns .
this percentage is comparable with the other published studies of work safety accidents in china ( 19 , 20 ) .
based on counts and proportions of accidents , transportation and mining that mostly produce casualties were still high - risk industrial safety accident types in china . in transportation section
data analysis revealed that one major road traffic accident occurred every 10 days on average in china , while the average number of deaths in aviation was 49.5 .
this may be an important reason why fewer aviation accidents caused more widespread concern in the international community .
road transportation regulations of people 's republic of china was issued at the end of 2004 ( 21 ) , and efforts were made to better disseminate the regulation , safety procedures , and tips to operators to increase drivers awareness of risk and to improve emergency response capabilities . to reduce traffic accidents , some prevention strategies including driver training , working conditions , weather conditions , hours - of - service regulations , and safety culture should be better considered ( 2225 ) . in mining section , coalmine accidents contributed to the majority .
literature reported that coal - mine accidents in china occurred ten times more frequently than that in india ( 1 ) , and the death rate per million tons was 6.66 during the past 24 yr , which was ninety - four times more larger than in america ( 0.07 ) ( 26 ) .
the distribution and exploitation of mineral resources are an important factor for the significant difference between china and america .
fortunately , with the provisions on the prevention of coal mine accidents at the end of 2005 ( 27 ) and the closure of half of the operating mines in 2006 , the death rate per million tons showed a rapid decline since 2006 ( 26 ) , and the number of mining accidents and deaths including major mining accidents declined .
however , several safety concerns still persist in some mines , such as ignoring safety professionals , lack of emergency rescue measures and employee professional safety training .
some effective interventions are needed to mitigate the worst health and safety performance in china .
this study used death per incident and death injury ratio as a surrogate measure to describe the severity of major accidents and the urgency of emergency rescue .
the declines in the number of death per service and mining accident indicated improvement on the special intervention .
however , obstacles exist in transportation , construction and manufacturing intervention . as show in fig .
4 , the occurrence of tailing dam accident associated with major casualties and economic losses , and it will cause high case - fatality once occurred . like tailing dam incident , collapse ,
therefore , full risk assessment and prevention measures are the primary intervention to prevent these accidents .
aviation and railway accidents were recognized to result in relatively higher case - fatality and higher number of occupational injuries .
we discussed the major work safety accidents nationwide and the severity and emergency rescue urgency of accident using a scatter plot by death per accident and death injury ratio , the improvement compared with the similar studies ( 7 , 12 ) .
additionally , we searched the published literature and statistical yearbook to supplement the detailed information .
the information registered in the saws system were not comprehensive , such as the cause of per incident , thus we could not do further analyze .
ten years work safety data indicate that the frequency of incidents and number of deaths of major work safety accidents were declined .
ethical issues ( including plagiarism , informed consent , misconduct , data fabrication and/or falsification , double publication and /or submission , redundancy , etc ) have been completely observed by the authors .
 background : this study provides a national profile of major work safety accidents in china , which cause more than 10 fatalities per accident , intended to provide scientific basis for prevention measures and strategies to reduce major work safety accidents and deaths.methods:data from 20032012 census of major work safety accidents were collected from state administration of work safety system ( saws ) . 
 published literature and statistical yearbook were also included to implement information . 
 we analyzed the frequency of accidents and deaths , trend , geographic distribution and injury types . 
 additionally , we discussed the severity and urgency of emergency rescue by types of accidents.results:a total of 877 major work safety accidents were reported , resulting in 16,795 deaths and 9,183 injuries . 
 the numbers of accidents and deaths , mortality rate and incidence of major accidents have declined in recent years . 
 the mortality rate and incidence was 0.71 and 1.20 per 106 populations in 2012 , respectively . 
 transportation and mining contributed to the highest number of major accidents and deaths . 
 major aviation and railway accidents caused more casualties per incident , while collapse , machinery , electrical shock accidents and tailing dam accidents were the most severe situation that resulted in bigger proportion of death.conclusion:ten years major work safety accident data indicate that the frequency of accidents and number of eaths was declined and several safety concerns persist in some segments . 
Introduction
Materials and Methods
Source of Data
Data Analysis
Results
Injuries Distribution by Year
Injuries Distribution by Geographic Region
Injuries by Industry
Severity of injury
Discussion
Conclusion
Ethical considerations