广州市天河区居民意外伤害流行病学特征分析

目的　探讨广州市天河区居民意外伤害的流行病学特征及影响因素 ,为开展伤害预防干预提供依据。方法　采用分层整群抽样方法 ,以问卷方式调查广州市天河区居民过去一年的意外伤害发生情况。结果　共调查天河区居民 2 85 3人 ,意外伤害发生率为 13.99% ,男、女分别为2 2 .0 8%和 17.19% ,男性高于女性 (P <0 .0 0 1) ,伤害次数发生率为 19.6 3%。跌倒 /坠落、扭伤和碰撞 /挤压伤是最常见类型 ,最常见的伤害地点是家里 /宿舍、学校 /幼儿园和道路。 2 .32 %的受伤居民需住院治疗 ,35 .89%的受伤居民需医院门诊处理。伤害的危险因素有中小学生、0～ 14岁儿童少年、文化程度为初中及以下、15～ 39岁青壮年、自评 (或家长自评 )性格外向者及家庭人均年收入 5 0 0 0～ 19999元的人群等。结论　意外伤害严重影响天河区居民的健康 ,给家庭和社会造成经济损失。预防重点是针对不同人群进行健康安全教育 ,尤其是培训家长和教师 ,提高其安全知识水平 ,以减少儿童青少年意外伤害的发生。     

Fatal occupational injuries among self-employed workers in North Carolina

BACKGROUND: Research suggests that rates of occupational injury and death may be higher among self-employed workers than in the wage and salaried population. This analysis was conducted to describe the demographic and occupational characteristics, as well as injuries, activities, and occupations of self-employed workers who are fatally injured on the job. METHODS: Characteristics of workers by type of employment were compared using data from the North Carolina Office of the Chief Medical Examiner, 1978-1994. Age-, activity-, and industry-specific fatality rates in self-employed workers (N=395) were contrasted to those privately employed (N=1,654). RESULTS: Highest fatal injury rates among the self-employed occurred in agriculture, retail, and transportation industries. Homicide deaths occurred more frequently among self-employed workers; deaths resulting from unintentional injuries occurred more frequently among non-self-employed workers. CONCLUSIONS: Elevated occupational fatality death rates among self-employed workers, especially in retail and transportation industries, provide justification for addressing work-related conditions of self-employed workers in North Carolina.     

Risk factors for occupational injuries among older workers: an analysis of the health and retirement study.

OBJECTIVES: This study examined risk factors for occupational injury among older workers. METHODS: We analyzed data on 6854 employed nonfarmers from the Health and Retirement Study (HRS), a population-based sample of Americans 51 through 61 years old. RESULTS: Occupational injuries were associated with the following: the occupations of mechanics and repairers (odds ratio [OR] = 2.27), service personnel (OR = 1.68), and laborers (OR = 2.18); jobs requiring heavy lifting (OR = 2.75); workers' impaired hearing (OR = 1.60) and impaired vision (OR = 1.53); and jobs requiring good vision (OR = 1.43). Self-employment was associated with fewer injuries (OR = 0.47). CONCLUSIONS: These results emphasize the importance of a good match between job demands and worker capabilities.     

某院医务人员血源性职业暴露的流行病学研究

目的掌握某院医务人员血源性职业暴露的流行病学特征。方法采用随机偶遇的方法对该院374名临床医务人员进行回顾性问卷调查。结果医务人员职业暴露后处理内容和处理流程正确率分别为54.81%（205/374）、89.84%（336/374）。 共发生血源性职业暴露174例、533例次,暴露率为46.52%(174/374)。不同科室、岗位医务人员职业暴露率比较,差异有统计学意义(P＜0.05);外科、儿科和内科的医务人员暴露率较高,分别为64.46%（78/121）、60.00%（18/30）和40.00%（50/125）;护士和医生暴露率较高,分别为51.52%（102/198）、47.27%（52/110）。医务人员血源性暴露时间主要集中在上午和晚上,穿刺、采血或处理物品为主要的暴露环节,暴露地点主要是病房和手术或换药室。结论该院医务人员血源性职业暴露率较高,应加强医院高危科室、人员和操作的血源性职业暴露防控措施的落实。     

Effect of different questionnaire formats on reporting of occupational exposures

During an exposure monitoring study, 78 saw maintenance tradesmen were randomly assigned to be interviewed about their exposures using one of two questionnaire formats: open-ended and partly prompted questions about five categories of materials; and detailed prompting about 75 agents. The more open-ended questionnaire elicited fewer exposure responses overall, but more responses about agents not included on the detailed questionnaire. Composite materials and trade name products were more frequently cited as exposures than individual metals or compounds. Validity of responses was ascertained using air measurements (individual metals) or observations of the employees (composite materials). Sums of sensitivities and specificities were very low (near 1.0) for most of the metals for both types of questionnaire. For composite materials, validity improved substantially. Sensitivities with the partly prompted format (0.44–0.85) were always lower than with detailed prompting (0.80–1.00). Specificities were usually, but not always, higher with partial prompting (0.66–0.92) than with detailed prompting (0.18–0.86). Selection of questionnaire format for an epidemiologic study would depend on the likely prevalence of exposure in controls and the effects of trade-offs in sensitivity and specificity.     

暴力性伤害住院病人的流行特征分析

目的 揭示某地区暴力性伤害住院病人的流行特征，为暴力性伤害的预防和控制提供线索。方法 收集武汉市某医院病案科病案数据库1996～2000年由于损伤和中毒而住院的病人资料。根据E编码(ICD-9-CM)从中抽出暴力性伤害住院病人，并进行描述性分析。结果暴力性伤害主要发生在19～45岁的青壮年人群(86．43％)；伤害的主要类型为切割和穿刺器具加害，占36．21％；其次是钝器或投掷物体打击、非武装的斗殴或争吵分别占22．82％、24．62％。受伤的主要部位是头部(34．32％)和胸腹部(20．13％)。约41．33％的患者需手术治疗。暴力性伤害住院患者的病死率为1．71％。结论 暴力性伤害是一个日益严重的公共卫生问题，是导致住院和死亡的重要原因。     

绍兴市社区居民伤害现况和疾病负担调查

目的　调查绍兴市居民伤害的发生现况和疾病负担。方法　采取随机分层整群抽样入户调查的方法 ,选择城区、郊区、平原和山区 4类不同地区 116 4 0名社区居民 ,对其伤害发生情况进行回顾性调查。结果　 8种伤害的总发生率为 12 .5 4 % ,标化率为 12 .5 1% ,居发生率前三位的伤害依次为跌伤、钝 /锐器伤和车祸。不同年龄组的伤害发生率差异有显著性 (χ2 =15 8.92 ,P <0 .0 1)。男性高于女性 (χ2 =13.0 1,P <0 .0 1) ;不同地区居民的伤害发生率差异有显著性(χ2 =75 .37,P <0 .0 1) ,依次为郊区 15 .95 %、平原 14 .0 7%、城市 10 .16 %、山区 9.6 1%。平均每例伤者休息 9.11d ,医疗费用 6 2 1.6 2元。结论　绍兴市居民伤害发生率较高 ,并导致较重的疾病负担 ,应加强伤害的预防和控制工作。     

Agricultural injuries among older Kentucky farmers: The farm family health and hazard surveillance study

This population-based study reports the cumulative incidence of agricultural injuries during a 1-year period in a sample of 998 farmers aged 55 years and older living in Kentucky. A total of 98 farm-related injuries were reported among 88 older farmers for a crude injury rate of 9.03 injured farmers per 100 farmers (95% confidence interval (CI) = 7.03–11.03) over a 1-year period. The leading external causes of farm injury were falls (24.9%), machinery (22.5%), wood-cutting (14.6%), and animal-related events (14.3%). Farmers working on farms with beef cattle (alone) (odds ratio = 1.90; 95% CI = 1.02–3.55) or farms with beef cattle and tobacco (odds ratio = 2.15; 95% CI = 1.00–4.59) had a statistically significant increased risk for a farm-related injury. Farmers reporting a prior injury that limited their ability to farm were at increased risk for a farm-related injury. Approaches to using farm injury surveillance data for injury control programs in the state are discussed. Am. J. Ind. Med. 33:341–353, 1998. © 1998 Wiley-Liss, Inc.     

The agricultural health study: Factors affecting completion and return of self-administered questionnaires in a large prospective cohort study of pesticide applicators

Response rates were examined in a prospective epidemiologic study of individuals, mostly farmers, from Iowa and North Carolina seeking a pesticide applicator license during the period from 1994 through 1996. In the first year of enrollment 16,535 farmers (representing 77% of eligible farmer applicators) enrolled in the study by completing a 17-page questionnaire administered at a pesticide training session; 47% of the enrolled farmers completed and returned a much longer take-home questionnaire. The characteristics of farmers who completed only the enrollment questionnaire were quite similar to those of farmers who also completed and returned the take-home questionnaire. The most notable difference was the increased age of responders. Thus, the study population might have slightly higher cumulative farm exposures and slightly lower current farm exposures than the base population of all farmer applicators. The lack of evidence for substantial selection bias is reassuring for the Agricultural Health Study, and provides a measure of reassurance for other studies depending on the voluntary completion of self-administered questionnaires. Am. J. Ind. Med. 31:233–242, 1997. (This article is a US Government work and, as such, is in the public domain of the United States of America.) © 1997 Wiley-Liss, Inc.     

湖北省伤害流行现状及防治策略

目的 了解湖北省伤害流行特点和规律，提出相应的防治对策。方法 运用描述流行病学方法，对湖北省伤害流行的报告资料和文献资料进行分析。结果 ①学龄前儿童伤害发生率高达30％或以上，男孩明显高于女孩，城市高于农村。伤害类型以碰伤、摔伤或扭伤居首位，其次为锐器刺伤或切割伤。②农村0～14岁儿童伤害死亡率为81．8／10万，前三位死因是溺水、机械窒息和交通事故。0～14岁伤害死亡的女童82．2％发生于5岁以下。③全人群约1／10的死亡是伤害所致，伤害死亡的高发年龄为15～54岁。④全人群伤害死亡主要原因是自杀、交通事故和溺水。结论 伤害的预防与控制是一项长期、复杂社会系统工程，需要各部门齐抓共管。     

北京市牛街社区老年人群伤害发生现状研究

目的 了解北京市牛街地区老年人群各种伤害的流行情况，即伤害的种类、三间分布特点、原因及后果。方法 以居委会为单位，采取随机整群抽样的方法，自行设计问卷对牛街地区三个社区卫生服务站的符合入选条件的大于60岁的老年人进行人户调查。结果 伤害的发生率为13．55％；死亡率为43．57／10万；男女之比为1：1．78；春秋季节高发，白天多见，上午占58．09％；前三位受伤地点为卧室／客厅、马路、卫生间／浴室，共占66．90％；前三种伤害依次为跌倒、钝器僦器伤和烧烫伤，占86．19％(按人次)。跌倒是首位伤害，发生率为10．46％，占伤害总数的77．17％。结论 北京市牛街社区老年人群伤害发生率、死亡率居国内中等水平。跌倒是首位伤害，其对个人、家庭、社会的影响严重，已经构成危害北京市城市社区老年人生存与健康的重要公共卫生问题。当前，应首先致力于高发伤害——跌倒的预防与干预。     

江苏省城市和农村儿童伤害状况比较

目的 通过比较江苏省城市和农村儿童伤害状况，寻找城市和农村儿童伤害发生的特点及其影响因素。方法 在江苏省的1个大城市和1个中小城市各抽取1个区，苏南和苏北农村各抽取1个县，共4个地区。每个地区抽取4个街道或乡为监测点，对监测点的0-14岁儿童受伤害状况采用平时登记和定期调查相结合的方法监测1年。结果 儿童伤害发生率南京为24．2％，徐州为22．5％，太仓为16．6％，建湖为8．8％。城市和苏南农村第一位伤害原因是跌落伤；苏北农村第一位伤害原因是割/刺伤。城市和农村伤害发生率最高的均是小学生。城市小学生、初中生和幼儿园儿童的伤害发生率明显高于农村；农村散居儿童的伤害发生率高于城市。城市和农村儿童去医院就诊率高的伤害主要是动物致伤、交通伤、中毒、烧烫伤和故意伤害。结论 儿童伤害发生率城市高于农村，大城市高于中小城市，苏南农村高于苏北农村。     

当涂县医务人员艾滋病职业暴露知识与针刺伤状况调查

目的了解当涂县医务人员对艾滋病职业暴露知识的知晓情况和医护过程中锐器刺伤暴露情况。方法采用整群抽样方法选择当涂县1家县级医院和13家乡镇卫生院及25家村卫生室,于2010年11月~2011年1月对其中的307名医务人员进行问卷调查。结果 307名医务人员艾滋病职业暴露相关知识总体知晓率为52.4%,其中对发生HIV职业暴露后的报告单位知晓率为90.9%;不同医院级别、职业和科室以及是否曾参加过相关培训的医务人员之间掌握艾滋病职业暴露相关知识的程度不同(均有P<0.05);57.3%的调查对象承认在最近1年医疗护理过程中有曾经被针具利器刺破皮肤的经历,不同职业、职称和科室医务人员之间针刺伤发生率不同(均有P<0.05)。结论当涂县医务人员对艾滋病职业暴露相关知识知晓程度较低,发生锐器刺伤等职业暴露率较高,有必要加强培训,提高医务人员艾滋病职业暴露相关知识和自我防护能力。     

深圳市南山区中小学生伤害发生情况及其影响因素分析

目的 了解深圳市南山区中小学生伤害发生情况及其影响因素,为预防中小学生伤害提供依据.方法 采用随机整群抽样方法,以深圳市南山区8所小学、8所初中和4所高中的所有学生为研究对象,调查过去12个月内伤害的发生情况,共收回合格问卷为3169份,采用SPSS 22.0进行统计分析.结果 深圳市南山区中小学生伤害发生率为7.79...     

Epidemiologic study of occupational injuries among foreign and native workers in Taiwan

This study was designed to compare the risk of occupational injuries in foreign workers compared to native workers in Taiwan. The cohort of foreign workers under study was constructed by records of legally registered workers migrated from foreign countries to Taiwan from July 1, 1991 to December 31, 1993. The native Taiwanese workers for comparison were labor-insured workers working in the same industries as foreign workers in 1992. The number of occupational injuries in the first year of employment were obtained by matching the cohort of foreign workers with the labor insurance payment records by name, birth date and passport number. The 1-year incidence rate of occupational injuries in the first year of employment was calculated and a standardized morbidity ratio (SMR) was used for comparison with adjustment for age distribution and to accommodate the small sample size of foreign workers. The risk to occupational injuries among total (SMR = 0.86) and male (SMR = 0.58) foreign workers was not higher: indeed, it was even lower, than that among native workers in Taiwan. However, the risk to female migrant workers, especially in the construction industry, was significantly higher than that of female Taiwanese workers (SMR = 1.60). Stratified by industry, the incidence was high in the fabricated metal products manufacturing industry and in machinery and equipment manufacturing industry for male foreign workers, while a high incidence for the female foreign workers occurred in construction industry and rubber products manufacturing industry. The risk of occupational injuries was greater for foreign workers who had been in Taiwan for only a short time. Most fo the injuries occurred within the first 6 months of employment. Eighty-four out of the 394 occupational injuries among foreign workers resulted in disabilities. None of the accidents was fatal, but most of the disabilities were severe. The most common disabling injuries were cut or crushed fingers. The finding of a similar distribution of occupational injuries among foreign and native workers indicates that control measures are needed to reduce occupational injuries for all foreign and native workers in Taiwan. Am. J. Ind. Med. 31:623–630, 1997. © 1997 Wiley-Liss, Inc.     

Individual,occupational, and workplace correlates of occupational health and safety vulnerability in a sample of Canadian workers

Objective

To describe OH&S vulnerability across a diverse sample of Canadian workers.

Methods

A survey was administered to 1,835 workers employed more than 15 hrs/week in workplaces with at least five employees. Adjusted logistic models were fitted for three specific and one overall measure of workplace vulnerability developed based on hazard exposure and access to protective OH&S policies and procedures, awareness of employment rights and responsibilities, and workplace empowerment.

Results

More than one third of the sample experienced some OH&S vulnerability. The type and magnitude of vulnerability varied by labor market sub‐group. Younger workers and those in smaller workplaces experienced significantly higher odds of multiple types of vulnerability. Temporary workers reported elevated odds of overall, awareness‐ and empowerment‐related vulnerability, while respondents born outside of Canada had significantly higher odds of awareness vulnerability.

Conclusion

Knowing how labor market sub‐groups experience different types of vulnerability can inform better‐tailored primary prevention interventions. Am. J. Ind. Med. 59:119–128, 2016. © 2015 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.     

Methodologic issues in the use of workers' compensation databases for the study of work injuries with days away from work. I. Sensitivity of case ascertainment

BACKGROUND: Case ascertainment costs vary substantially between primary and secondary data sources. This review summarizes information on the sensitivity of state administrative databases in workers' compensation systems for the ascertainment of days-away-from-work (DAFW) work injuries for use in modeling studies. METHODS: Review of the literature supplemented by data from governmental or organizational reports or produced for this report. RESULTS: Employers currently appear to provide workers' compensation insurance coverage for 98.9% of wage and salary workers. Wage and salary jobs account for approximately 90% of jobs in the United States. In industries such as manufacturing, the fraction of covered jobs is probably closer to 98%. In Minnesota, the number of DAFW cases ascertained by the Bureau of Labor Statistics' annual survey of occupational injuries and illnesses is approximately 92-97% concordant with the number of wage compensation claims for injuries producing DAFW over the period 1992-2000, once adjustments are made to permit direct comparisons of the numbers. The workers' compensation databases provide information for more than 95% of the total DAFW resulting from work injuries. Covariate estimates are unaffected by this less than 5% loss because effects appear dependent on time from injury. CONCLUSIONS: Statewide workers' compensation administrative databases can have substantial utility for epidemiologic study of work injuries with DAFW because of their size, using high sensitivity for case ascertainment as the evaluative criterion.     

辽宁省儿童青少年伤害现况调查

目的了解辽宁省儿童青少年伤害发生现况，为预防工作的开展提供依据。方法采用多级抽样方法，对辽宁省6个市／县3644名0～18岁者过去1a中伤害情发生情况进行回顾性调查。结果伤害总发生率为17．07％，农村显著高于城市（OR=1．61，95％CI为1．32～1．96），男性显著高于女性（OR=1．84，95％CI为1．54～2．20），6～岁组发生率最高（22．98％），0～岁组发生率最低（0．81％）。伤害类型前5位依次为跌倒、锐器割刺伤、运动伤、撞击挤压伤和非机动车交通事故，伤害损伤性质前5位为开放性伤、浅表伤、扭伤劳损、骨折和烧烫伤，7～9月为伤害的高发季节。结论辽宁省每年约有1／6儿童青少年发生伤害，应开展有针对性的伤害防控工作。     

某大型综合医院医护人员针刺及其他锐器损伤情况

目的 了解医院医护人员针刺及其他锐器损伤情况,为进一步开展干预研究提供线索,并为干预措施效果评价提供基线数据.方法 采用白填式调查问卷对某大型综合医院1201名临床一线医护人员在2009年1月1日至2009年12月31日期间所发生的针刺及其他锐器损伤状况进行回顾性调查.结果 医护人员在过去1年中发生针刺及其他锐器损伤共4302人次,针刺及其他锐器损伤年人均发生次数为3.58人次,损伤发生率为78.85％.发生针刺及其他锐器损伤的高风险人群为妇产科、外科、重症监护室和急诊科医护人员,其接触发生率和年人均发生次数分别为94.67％和4.51人次、93.09％和4.46人次、85.44％和3.08人次、76.62％和4.55人次,引起医护人员针刺及其他锐器损伤的主要医疗操作是掰安瓿、输液结束拔针、整理用毕的锐器和手术中(缝合或切开),其接触发生率分别为46.96％ 、30.97％ 、25.73％和14.49％.医护人员针刺及其他锐器损伤主要是由安瓿瓶、头皮针、皮下注射针、缝合针和手术刀片引起,其损伤发生率分别为47.04％、37.22％、31.31％ 、17.65％和7.08％.结论 医护人员仍然面临较大的针刺及其他锐器损伤风险,不同工种、不同科室医护人员在不同医疗操作及医疗操作的不同阶段、使用不同医疗锐器、使用锐器的用途不同发生职业接触的风险不同,应积极采取有针对性的综合性预防控制措施,全面贯彻落实GBZ/T 213-2008《血源性病原体职业接触防护导则》.