Farm-related fatal injury of young and older adults in Australia, 1989-1992

This paper describes the types of, and circumstances surrounding, unintentional farm-related fatal injuries involving young and older adults in Australia. Information was obtained from an inspection of coronial files for the period 1989-1992. Around 14% of all farm-related fatalities in Australia during 1989-1992 were of young adults aged 15-24 years and approximately one-quarter were of older adults aged > or = 55 years. Young adults were commonly fatally injured in motor vehicle incidents and in incidents involving firearms. Tractors were the most common agent involved in fatal incidents involving older adults. Intervention measures to prevent fatalities of older adults in agriculture should focus on the safe use of tractors, while for young adults it appears prevention efforts should centre around safe use of firearms and operation of motor vehicles on the farm. Ways to overcome barriers to the use of injury prevention measures in rural Australia should be further explored.     

ICD-10在医院伤害监测工作中的应用

目的为了使伤害预防专业人员能够掌握与准确地理解ICD-10在伤害领域的使用方法及其应用情况，以便有利于进一步开展各类伤害的发生机制及其预防的研究。方法分析ICD-10与伤害的关系及其在伤害中的作用，结合医院使用IGD-10的情况，确定采用ICD-10的类目分类方法对医院急诊伤害患者进行编码。结果经过实际应用ICD-10对医院急诊伤害患者进行编码，不但能客观评价伤害性质和伤害基本情况，还能客观评价急诊医生工作态度和急诊室的医疗环境，为今后的培训工作总结经验。结论ICD-10是医院伤害监测工作首选的疾病分类方法。     

2008 - 2017年天津市某综合医院法定传染病报告分析

目的 对天津市某综合医院2008 - 2017年10年间传染病特征进行分析,为制定传染病防控措施提供科学依据。方法 提取中国疾病预防控制信息系统2008 - 2017年该院法定报告传染病病例数据,采用描述流行病学方法,利用软件SPSS20.0进行分析。结果 2008 - 2017年共报告传染病18 724例次,无甲类传染病报告,主要为乙类和丙类传染病（占比94.74%）。报告前五位病种为其他感染性腹泻、细菌性痢疾、梅毒、流行性感冒及肺结核。8年来,报疫以肠道传染病为主,血源及性传播传染病与呼吸道传染病占比有所上升。5 - 10月份为传染病高发时间,人群分布以15～49岁年龄组为主,绝大多为天津市本地人口。结论 传染病管理工作任重道远,应根据不同时期的流行特征,针对性地采取有效措施对重点传染病进行监测及防控。     

上海市浦东新区2011-2012年0~6岁婴幼儿伤害情况分析

目的 分析2011-2012年上海市浦东新区0~6岁婴幼儿伤害情况, 为制定相应的伤害预防措施提供科学依据。方法 采用描述性研究方法, 以2011-2012 年上海市浦东新区0~6岁婴幼儿伤害患者为研究对象, 分析患者年龄、性别和伤害类型、原因、发生地点和伤害发生时的活动的关系。结果 共报告1 336 例0~6岁婴幼儿伤害病例, 平均年龄为(3.83±1.61)岁, 男女童比为1.73∶1;婴幼儿伤害患者前3 位的伤害类型依次为挫伤或擦伤(46.48%)、锐器伤或咬伤或开放伤(32.49%)、扭伤/拉伤(10.25%), 主要发生原因依次为跌倒或坠落(54.49%)、刀或锐器伤(19.16%)和钝器伤(12.20%);有64.82%的伤害发生在家中, 36.08%的患者伤害部位是头部, 多在休闲活动时发生伤害(74.93%)。结论 浦东新区婴幼儿伤害主要是在家中休闲活动时跌落受到的伤害(尤其挫伤或擦伤), 因此, 婴幼儿伤害预防的优先领域是家庭内跌落伤预防。     

宁波市江东区2009年居民伤害流行特征分析

目的了解浙江省宁波市江东区伤害流行病学特征,为伤害防制提供依据。方法在宁波市江东区3家监测哨点医院,采用统一登记表对前来就诊的首诊伤害病例进行登记,采用描述流行病学方法进行分析。结果2009年全年累计伤害病例8 032例,男女性别比为1.74:1,年龄以15~44岁为主,占53.04%,职业以工人、农民工和农/渔业劳动者为主,分别占40.25%,29.06%,11.38%;伤害原因前5位依次为跌伤/坠落占25.57%,交通伤占22.36%,钝器伤(硬物击伤)占17.26%,刺/割伤占16.36%,动物伤占12.82%;伤害以非故意伤害为主,占93.07%;伤害以轻微浅表伤和中等程度伤害为主,占94.67%;伤害发生后以治疗后回家居多,占79.46%;伤害发生居前4位的地点依次为工作场所占9.64%,家中占28.09%,街道/城区占26.58%,城际间公路占10.96%;伤害发生居前2位的的活动是工作时占43.51%,空闲时占43.07%;伤害多发生于5-9月。结论伤害是严重的公共卫生问题,青壮年男性、跌倒、交通伤、钝器伤、动物伤已成为伤害干预的重点领域,应根据监测结果制定防制措施。     

A study on the incidence of nosocomial infections in a large University hospital

The results of a study on the incidence of nosocomial infections in a 1800 bed University hospital are reported. The study, carried out over a 9 months period, included: 1) continuous microbiological surveillance, and 2) a clinical and epidemiological survey. On the basis of the microbiological data collected and analyzed by a computer data system, developed and employed for the control of nosocomial infections, a weekly bed-to-bed survey was carried out by the staff of the Institute of Infectious Diseases. Among 2777 suspected nosocomial infections, as revealed by microbiological monitoring, 701 were confirmed after the bed-to-bed survey. The nosocomial infection rate was 6.75 per 100 discharges. It was higher in the surgical than in the medical wards (7.3 and 6 per 100 discharges, respectively).Nosocomial urinary tract infections were the most frequent (74.2%). The urinary infection rate was higher in the surgical than in the medical wards (5.3 and 4.6 per 100 discharges, respectively). Escherichia coli (19.4%), Pseudomonas aeruginosa (19.3%), Proteus spp. (18.4%) were the pathogens most frequently associated with nosocomial infections. They were followed by Klebsiella pneumoniae (7.8%) and Staphylococcus aureus (6.5%) in frequency.Among the risk factors, involved in nosocomial infections, the importance of catheterization was confirmed: among our patients with nosocomial urinary tract infections; 73.4% and 79.5% — in the medical and surgical wards, respectively -underwent urological instrumentation, mainly catheterization.An analogous and more detailled study is now in progress and will be extended in the next years.Corresponding author.     

清远市农村儿童伤害监测结果分析

目的分析清远市15岁及以下农村儿童伤害的原因,找出伤害发生的规律,评价伤害对该人群造成的危害。方法对清远市农村地区2009—2011年儿童伤害监测资料进行描述性分析。结果 2009—2011年全国伤害监测系统共收集清远市农村儿童伤害病例980例,占清远市伤害总病例的9.27%;不同性别各年龄段均有伤害发生,男童的比例高于女童;一年中农村儿童伤害发生以6—10月份较高;伤害发生地点第1位是学校与公共场所463例(47.29%),其次为家中278例(28.34%),农场(农田)150例(15.27%)占第3位;伤害原因构成中跌落伤害居第1位,动物咬伤、交通事故、锐钝器伤的伤害排位靠前,伤害发生性质中917例(93.59%)是非故意的,59例(6.02%)为故意(暴力、攻击),自残、自杀4例(0.41%);伤害的受伤部位前3位依次为:头部369例(37.64%),上肢214例(21.82%),下肢195例(19.93%);伤害严重程度中轻度伤害有786例(80.21%),中度145例(14.77%),重度38例(3.85%),死亡11例(1.17%)。结论伤害是危害儿童健康的主要危险因素之一,政府和社会应积极采取有效措施来预防和控制农村儿童伤害。     

2015-2017年湖南省伤害监测点医院门/急诊居民伤害流行特征

目的  分析湖南省居民伤害发生的原因以及流行病学特征,为制定湖南省居民伤害干预措施提供科学依据。 方法  采用Excel 2007软件和SPSS 18.0软件进行伤害监测数据的整理和分析。 结果  三年共收集有效病例107 754例,男女性别比为1.65：1。伤害发生原因前三位分别是跌倒坠落（36.0%）、机动车车祸（20.6%）以及刀锐器伤（11.8%）。伤害发生地点主要是公路（30.9%）和家中（28.3%）。伤害发生时的活动前三位分别是休闲活动（24.7%）、驾车（17.6%）与工作（16.4%）。伤害发生意图以非故意（93.2%）为主,伤害发生程度主要为轻度伤害（74.3%）。 结论  2015-2017年湖南省伤害监测点哨点医院门/急诊居民伤害人数呈逐年增加的趋势,男性高于女性,应重点加强对跌倒坠落和机动车车祸开展系统研究和实施干预措施。     

The Deployment Health Surveillance Program: vision and challenges of health surveillance for Australian military cohorts

The Australian Government has supported the establishment of a Deployment Health Surveillance Program for the Australian Defence Force. Although some health screening mechanisms already exist for Australian Defence Force personnel, until now health data have been used largely for clinical management at an individual level and have not been aggregated to identify trends in health and risk factors in the shorter or longer term. We identify challenges for and potential benefits of health surveillance in the military context, describe features of the Program and progress to date. Retrospective and cross‐sectional projects based on deployments to the Near North Area of Influence since 1997 are under way. A planned prospective model of health surveillance for those deploying to the Middle East promises more timely attention to any emerging health problems for military personnel and veterans.     

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.     

深圳市中小学生道路交通伤害流行病学分析

目的了解深圳市中小学生道路交通伤害特点,为预防和控制中小学生道路交通伤害提供参考依据。方法采取分层整群抽样的方法,抽取深圳市21所中、小学校全体在校生27 175名,利用《广东省中小学生交通伤害调查问卷》进行调查。结果2007年深圳市中小学生道路交通伤害的发生率为5.1%,男生略高于女生(P<0.01);小学生、初中生伤害的发生率均高于高中生(P<0.05)。交通伤害的发生以骑车上学最高,占6.2%;发生地点主要在人行道占29.4%;住宅区道路占18.1%。受伤部位以四肢为主,达61.8%。伤害性质以擦伤、扭伤为主,占61.3%。受伤害的学生中有15.0%出现功能障碍。结论深圳市中小学生交通伤害以小学和初中为主,骑乘自行车引发的交通伤害最多,肇事车辆以脚踏车为主,但小型机动车造成的伤害程度较重。     

Modeling an irritant gas plume for epidemiologic study

Plume dispersion modeling systems are often used in assessing human exposures to chemical hazards for epidemiologic study. We modeled the 2005 Graniteville, South Carolina, 54,915 kg railcar chlorine release using both the Areal Locations of Hazardous Atmospheres and Hazard Prediction and Assessment Capability (HPAC) plume modeling systems. We estimated the release rate by an engineering analysis combining semi-quantitative observations and fundamental physical principles. The use of regional meteorological conditions was validated by comparing concentration estimates generated by two source-location weather data-sets. The HPAC model estimated a chlorine plume with 20 ppm outdoor concentrations up to 7 km downwind and 0.25 km upwind/downgrade. A comparative analysis of our two models showed that HPAC was the best candidate for use as a model system on which epidemiologic studies could be based after further model validation. Further validation studies are needed before individual exposure estimates can be reliable and the chlorine plume more definitively modeled.     

Injuries due to assaults on psychiatric hospital employees in Washington state

In order to estimate rates and identify risk factors for assaults on employees of a state psychiatric hospital, we examined workers' compensation claims, hospital-recorded incident reports, and data collected in a survey of ward staff. Results revealed 13.8 workers' compensation claims due to assault per 100 employees per year. Assaults were responsible for 60% of total claims. Incident reports revealed 35 injuries due to assault per 100 employees per year. Survey data revealed 415 injuries due to assault per 100 employees per year. Of the respondents, 73% reported at least a minor injury during the past year. Assault management training in the past year was associated with less severe injuries. Working in isolation, the occupation of mental health technician, and working on the geriatric-medical hospital unit were associated with more severe injuries during the past year. Assaults on staff in psychiatric hospitals represent a significant and underrecognized occupational hazard. Am. J. Ind. Med. 31:92–99 © 1997 Wiley-Liss, Inc.     

河南省2007-2011年流行性腮腺炎流行病学特征分析

目的 了解河南省2007-2011年流行性腮腺炎流行病学特征,为进一步防控流行性腮腺炎提供参考依据。 方法 对2007年1月1日-2011年12月31日河南省疾病监测系统报告的流行性腮腺炎病例资料进行回顾描述性流行病学分析。 结果 5年间共报告流行性腮腺炎81 235例,死亡1例,年平均发病率为17.26/10⁵,男女发病率性别比为1.93∶1;平均每年4-6月及11月-次年1月是流行性腮腺炎的高发时间,病例主要集中在2~15岁儿童(93.58%),病例数最多的职业为学生 (57.27%)。 结论 河南省流行性腮腺炎发病率仍处较高水平,应进一步完善儿童免疫规划,提高疫苗接种率,加强流行性腮腺炎的监测工作。     

Occupational sentinel health events: an up-dated list for physician recognition and public health surveillance

An occupational sentinel health event (SHE[O]) is a disease, disability, or untimely death, which is occupationally related and whose occurrence may: 1) provide the impetus for epidemiologic or industrial hygiene studies; or 2) serve as a warning signal that materials substitution, engineering control, personal protection, or medical care may be required. Following survey of scientific literature, a list of 50 disease conditions linked to the workplace was presented in 1983; these were codable within the framework of the International Classification of Diseases system (ICD-9). Three criteria were used for inclusion: documentation of associated agent(s), of involved industries, and of involved occupations. The up-dated list contains 64 diseases or conditions and a bibliography of literature citations. The list is useful for the practicing physician in occupational disease recognition, for occupational morbidity and mortality surveillance, and as a periodically up-dated database of occupationally related diseases.     

医院伤害监测的常见问题及其原因分析

目的探讨我国医院伤害监测过程中存在的主要问题及其原因,旨在全国范围内更有效地开展医院伤害监测,从而更全面、准确地为我国伤害预防工作提供基础资料和科学依据。方法以与伤害监测相关人员的面对面访谈和电话访谈相结合的方式,探讨目前医院伤害监测中存在的主要问题及其解决办法。结果访谈结果显示,目前我国医院开展伤害监测过程中主要存在漏报、信息准确性、资料完整性、质量评估标准等方面的问题,不同地域和医院的伤害监测质量主要影响因素不同。结论基于上述问题和原因,建议设置高效运转的报告流程,建立健全相关监测制度,提高医护人员填报的积极性,从而提高伤害监测质量,为我国的伤害预防提供科学依据。     

某医院急诊室伤害监测的漏报影响因素

目的为了更好地了解医院伤害监测漏报的影响因素,以便采取针对性措施,降低漏报率,提高伤害监测质量。方法通过对比某伤害监测医院急诊室的伤害监测资料和急诊日志,应用单因素χ^2检验与多因素Logistic逐步回归方法分析监测漏报的影响因素。结果不同月份的漏报情况不同,与10月份相比,11月、12月都更容易漏报,OR值分别为1．196和1．135;不同时间段漏报不同,与12：01～18：00相比,其余时间段均容易漏报,0：01～6：00时间段最容易漏报（OR=1．493）,其次为6：01～12：00时间段（OR=1．433）、18：01～0：00时间段（OR=1．171）;不同伤害类型的漏报情况不同,与外伤相比,中毒更容易漏报,OR=4．003。结论对于不同月份、时间段、伤害类型中的易漏报因素,应该采取相应的措施以减少漏报,提高伤害监测质量。