Woodworking Injuries

1.1 Today's Date *

1.2 Gender *

Male
Female

1.3 Handedness *

Left Handed
Right Handd

1,4 Are you able to write with your dominant hand? *

1.5 What is your profession? *

1.6 Do you consider yourself to be a professional woodworker? (earn greater than 50% of income from woodworking *

1.7 As a hobbiest/amateur woodworker - how advanced to you think you are?

Selected Value: 0

0 = Beginner 10 = Expert

1.8 How many years have you been a woodworker? *

Less than 1
1-5
5-10
Greater than 10

1.9 Have you ever sustained a woodworking injury/accident that caused you to seek medical attention? *

1.10 Since you started woodworking - how many times did you have to seek medical attention because of a woodworking injury??

1
2
3
If more than 3 - please complete as 3 and contact us

Injury #1 - Answer questions as relates to your injury

2.1 Date of Injury *

2.2 Please describe injury *

2.3 What type of injury did you sustain? (select one) *

Laceration
Amputation
Blunt trauma (kickback, etc)

2.4 Body Part Injured (select all that apply) *

Head and Neck
Chest
Abdomen
Upper Extremity (Arm elbow, hands, fingers)
Lower Extremity (Hip, thigh, knee, lower leg, foot, toes

2.5 Head & Neck (select all that apply) *

Scalp
Eyebrow
Eyes
Nose
Cheeks
Lips
Mouth
Neck

Check all that apply

2.6 Eyebrow *

Left Eyebrow
Right Eyebrow
Both Eyebrows

2.7 Eyes (select all that apply *

Left Eye
Right Eye
Both Eyes

2.8 Were you wearing eye protection? (i.e. goggles - prescription glasses do not count as eye protection) *

2.9 Cheeks (select one) *

Left
Right
Both

2.10 Lips (select one) *

Upper
Lower
Both

2.11 Neck (select all that apply) *

Left
Right
Front
Back

2.12 Chest (select all that apply) *

Left
Right
Front
Back

2.13 Abdomen (select all that apply) *

Left
Right
Front
Back

2.14 Upper Extremity (select all that apply) *

Left upper arm
Right upper arm
Left elbow
Right elbow
Left forearm
Right forearm
Left hand (top)
Right hand (top)
Left hand (palm)
Right hand (palm)
Fingers

2.15 Fingers (select all that apply) *

Left Thumb - laceration
Left thumb amputation - soft tissue only
Left thumb amputation - with bone
Right Thumb - laceration
Right thumb amputation - soft tissue only
Right thumb amputation - with bone
Left Index - laceration
Left index amputation - soft tissue only
Left index amputation - with bone
Right index - laceration
Right index - amputation - soft tissue only
Right index - amputation - with bone
Left long - laceration
Left long - amputation - soft tissue only
Left long - amputation - with bone
Right long - laceration
Right long - amputation - soft tissue only
Right long - amputation - with bone
Left ring - laceration
Left ring - amputation - soft tissue only
Left ring - amputation - with bone
Right ring - laceration
Right ring - amputation - soft tissue only
Right ring - amputation - with bone
Left little - laceration
Left little - amputation - soft tissue only
Left little - amputation - with bone
Right little - laceration
Right little - amputation - soft tissue only
Right little - amputation - with bone

2.16 Lower Extremity (select all that apply)

Left thigh
Right thigh
Left knee
Right knee
Left lower leg (knee to ankle)
Right lower leg (knee to ankle)
Left ankle
Right ankle
Left foot & Toes
Right foot & Toes

2.17 What type of tool were you using when your injury occurred? (select 1) *

Band Saw
Chop Saw/Power Miter
Drill Press
Jig Saw
Jointer
Lathe
Planer
Skill/Circular Saw
Table Saw - not Saw Stop
Table Saw - Saw Stop
Router (Hand Held)
Router (Table)
Sander (all types)
Scroll Saw
Shaper
Sawz-All
Other - please describe

1 - Please describe the "other" tool *

2.18 Were you using the tool for which it was intended?

2.18a Please describe *

2.19 On a scale of 1-10, how proficient with this tool do you think you were PRIOR to your injury?

Selected Value: 0

1=Amateur 10=Expert

2.20 On a scale of 1-10, how proficient with this tool did you think you were AFTER your injury?

Selected Value: 0

1=Amateur 10=Expert

2.21 At the time of your injury were you doing repetitive work? *

2.22 Do you think you were distracted when the injury took place? *

2.23 Did you follow the manufacturer's recommendation when using this tool? (hold down clamps, goggles, push sticks, blade guard, rifing knife, anti-kickback cauls, etc)? *

2.23a What could you have done differently?

2.24 At what part of your workday did this injury occur? *

Beginning
Middle
End

2.25 Were you using a push stick or push blocks when your injury occurred?

No
Yes
Not applicable

2.26 Was a blade guard installed?

No
Yes
I removed it!

2.27 Was a riving knife installed? *

No
Yes
I removed it because I was making a dadoo
I removed it (rip or cross cut)

2.28 Treatment (select one) *

I was treated in the Emergency Room and sent home the same day
I was treated in the Operating Room and sent home the same day
I was treated in the Operating Room and stayed over night
I stayed over night but did not require a surgical procedure

2.28a Procedure *

2.29 How many days did you stay in the hospital? *

1
2
3
4
5
greater than 5

3.30 Did you or will you require therapy? (Physical, Occupational or Hand)

2.31 Did you lose your job or have to change your position?

2.32 Please rate your level of your temporary disability (0=none 10=unable to work

Selected Value: 0

2.33 Was your injury cover by

No insurance
Private Insurance
Worker's Compensation

2.34 Did you loose income? *

No
Yes - Temporary loss
Yes - Permanent loss

2.35 How long will you be out of work? *

Returned to work immediately
Less than 1 week
2 weeks
3 weeks
1 month
2-4 months
4-6 months
6 months - 1 year
I am disabled and will not be able to work again
Unknown at this time

Injury #2 - Answer questions as relates to your SECOND injury only

3.1 Date of Injury *

3.2 Please describe injury *

3.3 What type of injury did you sustain? (select one) *

Laceration
Amputation
Blunt trauma (kickback, etc)

3.4 Body Part Injured (select all that apply) *

Head and Neck
Chest
Abdomen
Upper Extremity (Arm elbow, hands, fingers)
Lower Extremity (Hip, thigh, knee, lower leg, foot, toes

3.5 Head & Neck (select all that apply) *

Scalp
Eyebrow
Eyes
Nose
Cheeks
Lips
Mouth
Neck

3.6 Eyebrow *

Left Eyebrow
Right Eyebrow
Both Eyebrows

3.7 Eyes (select all that apply *

Left Eye
Right Eye
Both Eyes

3.8 Were you wearing eye protection? (i.e. goggles - prescription glasses do not count as eye protection) *

3.9 Cheeks (select one) *

Left
Right
Both

3.10 Lips (select one) *

Upper
Lower
Both

3.11 Neck (select all that apply) (copy) *

Left
Right
Front
Back

3.12 Chest (select all that apply) *

Left
Right
Front
Back

3.13 Abdomen (select all that apply) *

Left
Right
Front
Back

3.14 Upper Extremity (select all that apply) (copy) *

Left upper arm
Right upper arm
Left elbow
Right elbow
Left forearm
Right forearm
Left hand (top)
Right hand (top)
Left hand (palm)
Right hand (palm)
Fingers

3.15 Fingers (select all that apply) *

Left Thumb - laceration
Left thumb amputation - soft tissue only
Left thumb amputation - with bone
Right Thumb - laceration
Right thumb amputation - soft tissue only
Right thumb amputation - with bone
Left Index - laceration
Left index amputation - soft tissue only
Left index amputation - with bone
Right index - laceration
Right index - amputation - soft tissue only
Right index - amputation - with bone
Left long - laceration
Left long - amputation - soft tissue only
Left long - amputation - with bone
Right long - laceration
Right long - amputation - soft tissue only
Right long - amputation - with bone
Left ring - laceration
Left ring - amputation - soft tissue only
Left ring - amputation - with bone
Right ring - laceration
Right ring - amputation - soft tissue only
Right ring - amputation - with bone
Left little - laceration
Left little - amputation - soft tissue only
Left little - amputation - with bone
Right little - laceration
Right little - amputation - soft tissue only
Right little - amputation - with bone

3.16 Lower Extremity (select all that apply)

Left thigh
Right thigh
Left knee
Right knee
Left lower leg (knee to ankle)
Right lower leg (knee to ankle)
Left ankle
Right ankle
Left foot & Toes
Right foot & Toes

3.17 What type of tool were you using when your injury occurred? (select 1) *

Band Saw
Chop Saw/Power Miter
Drill Press
Jig Saw
Jointer
Lathe
Planer
Skill/Circular Saw
Table Saw - not Saw Stop
Table Saw - Saw Stop
Router (Hand Held)
Router (Table)
Sander (all types)
Scroll Saw
Shaper
Sawz-All
Other - please describe

3.18 Were you using the tool for which it was intended?

3.18a Please describe *

3.19 On a scale of 1-10, how proficient with this tool do you think you were PRIOR to your injury?

Selected Value: 0

1=Amateur 10=Expert

3.20 On a scale of 1-10, how proficient with this tool did you think you were AFTER your injury?

Selected Value: 0

1=Amateur 10=Expert

3.21 At the time of your injury were you doing repetitive work? *

3.22 Do you think you were distracted when the injury took place? *

3.23 Did you follow the manufacturer's recommendation when using this tool? (hold down clamps, goggles, push sticks, blade guard, rifing knife, anti-kickback cauls, etc)? *

3.23a What could you have done differently?

3.24 At what part of your workday did this injury occur? *

Beginning
Middle
End

3.25 Were you using a push stick or push blocks when your injury occurred?

No
Yes
Not applicable

3.26 Was a blade guard installed?

No
Yes
I removed it!

3.27 Was a riving knife installed? *

No
Yes
I removed it because I was making a dadoo
I removed it (rip or cross cut)

3.28 Treatment (select one) *

I was treated in the Emergency Room and sent home the same day
I was treated in the Operating Room and sent home the same day
I was treated in the Operating Room and stayed over night
I stay over night but did not require a surgical procedure

3.28a Procedure *

3.29 How many days did you stay in the hospital? *

1
2
3
4
5
greater than 5

3.30 Did you or will you require therapy? (Physical, Occupational or Hand)

3.31 Did you lose your job or have to change your position?

3.32 Please rate your level of disability (0=none 10=unable to work

Selected Value: 0

3.33 Was your injury cover by

No insurance
Private Insurance
Worker's Compensation

3.34 Did you loose income? *

No
Yes - Temporary loss
Yes - Permanent loss

3.35 How long will you be out of work?

Returned to work immediately
Less than 1 week
2 weeks
3 weeks
1 month
2-4 months
4-6 months
6 months - 1 year
I am disabled and will not be able to work again
Unknown at this time

Injury #3 - Answer questions as relates to your THIRD injury only

4.1 Date of Injury *

4.2 Please describe injury) *

4.3 What type of injury did you sustain? (select one) *

Laceration
Amputation
Blunt trauma (kickback, etc)

4.4 Body Part Injured (select all that apply) *

Head and Neck
Chest
Abdomen
Upper Extremity (Arm elbow, hands, fingers)
Lower Extremity (Hip, thigh, knee, lower leg, foot, toes

4.5 Head & Neck (select all that apply) *

Scalp
Eyebrow
Eyes
Nose
Cheeks
Lips
Mouth
Neck

4.6 Eyebrow (select all that apply)) *

Left Eyebrow
Right Eyebrow
Both Eyebrows

4.7 Eyes (select all that apply (copy) *

Left Eye
Right Eye
Both Eyes

4.8 Were you wearing eye protection? (i.e. goggles - prescription glasses do not count as eye protection) (copy) *

4.9 Cheeks (select one) *

Left
Right
Both

4.10 Lips (select one) *

Upper
Lower
Both

4.11 Neck (select all that apply) *

Left
Right
Front
Back

4.12 Chest (select all that apply) *

Left
Right
Front
Back

4.13 Abdomen (select all that apply) *

Left
Right
Front
Back

4.14 Upper Extremity (select all that apply) *

Left upper arm
Right upper arm
Left elbow
Right elbow
Left forearm
Right forearm
Left hand (top)
Right hand (top)
Left hand (palm)
Right hand (palm)
Fingers

4.15 Fingers (select all that apply) *

Left Thumb - laceration
Left thumb amputation - soft tissue only
Left thumb amputation - with bone
Right Thumb - laceration
Right thumb amputation - soft tissue only
Right thumb amputation - with bone
Left Index - laceration
Left index amputation - soft tissue only
Left index amputation - with bone
Right index - laceration
Right index - amputation - soft tissue only
Right index - amputation - with bone
Left long - laceration
Left long - amputation - soft tissue only
Left long - amputation - with bone
Right long - laceration
Right long - amputation - soft tissue only
Right long - amputation - with bone
Left ring - laceration
Left ring - amputation - soft tissue only
Left ring - amputation - with bone
Right ring - laceration
Right ring - amputation - soft tissue only
Right ring - amputation - with bone
Left little - laceration
Left little - amputation - soft tissue only
Left little - amputation - with bone
Right little - laceration
Right little - amputation - soft tissue only
Right little - amputation - with bone

4.16 Lower Extremity (select all that apply)

Left thigh
Right thigh
Left knee
Right knee
Left lower leg (knee to ankle)
Right lower leg (knee to ankle)
Left ankle
Right ankle
Left foot & Toes
Right foot & Toes

4.17 What type of tool were you using when your injury occurred? (select 1) *

Band Saw
Chop Saw/Power Miter
Drill Press
Jig Saw
Jointer
Lathe
Planer
Skill/Circular Saw
Table Saw - not Saw Stop
Table Saw - Saw Stop
Router (Hand Held)
Router (Table)
Sander (all types)
Scroll Saw
Shaper
Sawz-All
Other - please describe

4.18 Were you using the tool for which it was intended?

4.18a Please describe (copy) *

4.19 On a scale of 1-10, how proficient with this tool do you think you were PRIOR to your injury?

Selected Value: 0

1=Amateur 10=Expert

4.20 On a scale of 1-10, how proficient with this tool did you think you were AFTER your injury?

Selected Value: 0

1=Amateur 10=Expert

4.21 At the time of your injury were you doing repetitive work? (copy) *

4.22 Do you think you were distracted when the injury took place? (copy) *

4.23 Did you follow the manufacturer's recommendation when using this tool? (hold down clamps, goggles, push sticks, blade guard, rifing knife, anti-kickback cauls, etc)? (copy) *

4.23a What could you have done differently? (copy)

4.24 At what part of your workday did this injury occur? *

Beginning
Middle
End

4.25 Were you using a push stick or push blocks when your injury occurred?

No
Yes
Not applicable

4.26 Was a blade guard installed?

No
Yes
I removed it!

4.27 Was a riving knife installed? *

No
Yes
I removed it because I was making a dadoo
I removed it (rip or cross cut)

4.28 Treatment (select one) *

I was treated in the Emergency Room and sent home the same day
I was treated in the Operating Room and sent home the same day
I was treated in the Operating Room and stayed over night
I stay over night but did not require a surgical procedure

4.28a Procedure *

4.29 How many days did you stay in the hospital? *

1
2
3
4
5
greater than 5

4.30 Did you or will you require therapy? (Physical, Occupational or Hand)

4.31 Did you lose your job or have to change your position?

4.32 Please rate your level of disability (0=none 10=unable to work

Selected Value: 0

4.33 Was your injury cover by (select 1)

No insurance
Private Insurance
Worker's Compensation

4.34 Did you loose income? (select 1) *

No
Yes - Temporary loss
Yes - Permanent loss

4.35 How long will you be out of work?

Returned to work immediately
Less than 1 week
2 weeks
3 weeks
1 month
2-4 months
4-6 months
6 months - 1 year
I am disabled and will not be able to work again
Unknown at this time

May we contact you should we require additional information (your name will be kept confidential)?

Name *

First

Last

Email *

Phone

Comments about the Survey

We are not receiving funding from any source. These next two questions are purely informational.

Do you own a Saw Stop?

No
Yes
Thinking about purchasing one

When did you purchase your Saw Stop?

Prior to Injury
After Injury
N/A

Thank you for taking the time to complete the survey. After the data have been analyzed, we will be sending you a copy of our results if you have provided us with your e-mail. Elliot B. Duboys, MD, FACS

Phone