Epidemiologic study on work-related eye injuries in Kaohsiung, Taiwan

To describe the epidemiologic features of work-related eye injuries in Kaohsiung, a hospital-based study was performed. Four hundred and eighty-six patients who were treated at emergency service or were admitted to the ophthalmology ward over a 4-year period were reviewed. Among these, 38.9% of eye injuries in the study were work-related. Male workers had a 3.99 higher odds ratio (OR) than females to suffer from eye injuries (95% confidence interval [CI], 1.99-8.04). Most of the work-related eye injuries occurred in subjects who were 30-49 years old (OR, 3.02, and 95% CI, 1.56-5.82, when compared with those aged < or = 29 years). The most common type of eye injury in the occupational exposure group was foreign body injury (31.2%), followed by blunt injuries (20.6%), chemical burn (19.6%), UV light radiation (12.7%), and corneal abrasions (11.6%). On the other hand, in the non-occupational exposure group, the most common types of eye injury were blunt injuries (43.4%), corneal abrasions (28.3%), and foreign body injury (20.2%). Our study found that foreign body injury and blunt injuries were the two highest priority injuries for which prevention strategies should be developed in Kaohsiung city. Furthermore, after advanced examination of types of media that caused eye injuries, we found that being hit by wooden objects around the eye, by flying objects in the eye, and by welding flashes are important risk factors for workers to avoid. In conclusion, most of the occupational eye injuries occurred among male workers aged 30-49 years. Due to the lack of an occupational eye injury surveillance system to monitor the incidence of eye injuries and to undertake risk assessment, preventable occupational eye injuries have not been properly controlled. We hope to provide information for further development of preventive strategies.     

208例布鲁氏菌病高危从业人员感染现况调查

目的 了解职业人群布鲁氏菌病的感染现况和可能的影响因素,为制定布鲁氏菌病防治对策提供科学依据。方法 对羊交易市场内的从业人员开展流行病学调查和血清学检查,探讨布鲁氏菌病感染的影响因素。结果 共调查208例从业人员,以本地中年男性为主,文化程度较低,个人防护不到位,涉及多个高危岗位。检查发现布鲁氏菌感染阳性11例,总感染率为5.29%。影响因素关联性分析结果显示,屠宰是可能的危险因素(OR=4.07, 95%CI: 1.05~15.81),工作中戴手套是可能的保护因素(OR=0.25, 95%CI: 0.07~0.85)。结论 建议开展通俗易懂的宣传教育,引导从业人员做好自身防护,改正不良行为,加强布病防控力度。     

Occupational exposure,attitude to HIV-positive patients and uptake of HIV counselling and testing among health care workers in a tertiary hospital in Nigeria

Health care workers (HCWs) are at risk of occupational exposure to HIV. Their attitude to HIV-positive patients influences patients’ willingness and ability to access quality care. HIV counselling and testing (HCT) services are available to inform HCWs and patients about their status. There is little information about HCT uptake and attitude to HIV-positive patients among HCWs in tertiary health facilities in Nigeria. The aim of this study was to determine occupational exposure and attitude to HIV-positive patients and level of uptake of HCT services among HCWs in a tertiary hospital in Nigeria. A cross-sectional design was utilized. A total of 977 HCWs were surveyed using semi-structured, self-administered questionnaires. Nurses and doctors comprised 78.2% of the respondents. Their mean age was 35?±?8.4 years. Almost half, 47.0%, reported accidental exposure to blood and body fluids (BBFs) in the preceding year. The main predictor of accidental exposure to BBFs in the last year was working in a surgical department, OR?=?1.7, 95% CI (1.1–2.6). HCWs aged <40 years, OR?=?5.5, 95% CI (1.9–15.9), who had worked for >5 years, OR?=?3.6, 95% CI (1.4–9.3) and who work in nursing department, OR?=?6.8, 95% CI (1.7–27.1) were more likely to be exposed to BBFs. Almost half, 52.9%, had accessed HCT services. Predictors for HCT uptake were age <40 years OR?=?1.6, 95% CI (1.1–2.4), having worked for >5 years OR?=?1.5, 95% CI (1.03–2.2) and working in medical department OR?=?1.7, 95% CI (1.1–2.8). Respondents in nursing departments were more likely to require routine HIV test for all patients, OR?=?3.9, 95% CI (2.4–6.2). HCWs in the laboratory departments were more likely to believe that HIV patients should be on separate wards, OR?=?3.6, 95% CI (1.9–7.0). HCWs should be protected and encouraged to access HCT services in order to be effective role models in the prevention of HIV/AIDS.     

Heavy drinking, alcohol dependence, and injuries at work among young workers in the United States labor force

BACKGROUND: To determine whether heavily drinking and alcohol-dependent workers are at higher risk of occupational injury, we analyzed the nationally representative cohort of people enrolled in the National Longitudinal Survey of Youth since 1979. METHODS: This analysis was restricted to the 8569 respondents in the 1989 annual interview (age 24-32) who were employed during the 6 months before the interview. We studied occupational injuries (excluding sprains or strains) reported within 6 months of the interview in 1989 (cross-sectional analysis) and 1990 (prospective analysis). RESULTS: Among current drinkers, significant two-fold increases in the odds of injury for one or more episodes of heavy drinking were reduced to an odds ratio (OR) of 1.2 (95% confidence interval [CI] = 0.7, 2.1) in the cross-sectional analysis and an OR of 1.6 (CI 1.0, 2.8) in the prospective analysis after adjustment for confounding. No dose-response relationship with the frequency of heavy drinking was found. Alcohol-dependent respondents were not at higher risk of injury in the cross-sectional (OR = 1.1, CI 0.7, 1.8) or prospective (OR = 1.3,CI 0.8, 2.2) analyses after adjustment for confounding. CONCLUSIONS: For young U.S. workers, common occupational injuries (excluding sprains and strains) may not be strongly associated with alcohol dependence. Confounding by other risk factors may explain much of the association between being a heavy drinker and occupational injuries in this population.     

基层妇产科工作人员实施普遍性防护原则和职业暴露的调查分析

目的：了解农村基层妇产科工作人员对普遍性防护原则的知识、态度和行为。方法：采用半结构式问卷对安徽省2个县的县级和乡级卫生机构妇产科所有在岗工作人员进行横断面调查。结果：在137名妇产科工作人员中。59(43％)人没听说过普遍性防护原则。17人(12％)知道污染针头刺伤后有感染艾滋病病毒(HIV)的可能性。72人(53％)认为自己有可能遇到感染了HIV的病人，54(39％)人检查病人时每次都戴手套，82人(60％)检查病人前后每次洗手，59人(43％)曾被针头和其它锐利器具刺伤。43人(31％)曾被病人分泌物溅入眼鼻口中。结论：基层妇产科工作人员对普遍性防护原则的了解程度有限。对职业暴露的危险性认识不足。存在着明显的职业暴露现象。应加强对医务人员的职业防护。控制血源性疾病的医源性传播途径。     

Sex-work harm reduction

Sex work is an extremely dangerous profession. The use of harm-reduction principles can help to safeguard sex workers' lives in the same way that drug users have benefited from drug-use harm reduction. Sex workers are exposed to serious harms: drug use, disease, violence, discrimination, debt, criminalisation, and exploitation (child prostitution, trafficking for sex work, and exploitation of migrants). Successful and promising harm-reduction strategies are available: education, empowerment, prevention, care, occupational health and safety, decriminalisation of sex workers, and human-rights-based approaches. Successful interventions include peer education, training in condom-negotiating skills, safety tips for street-based sex workers, male and female condoms, the prevention-care synergy, occupational health and safety guidelines for brothels, self-help organisations, and community-based child protection networks. Straightforward and achievable steps are available to improve the day-to-day lives of sex workers while they continue to work. Conceptualising and debating sex-work harm reduction as a new paradigm can hasten this process.     

江苏省居民血吸虫病知信行调查及行为影响因素分析

目的了解江苏省居民血吸虫病防治相关知识、态度和行为现状及其影响因素,为制定有效的健康教育与健康促进模式提供科学依据。方法采用与人口规模成比例的整群抽样方法和多阶段抽样方法,对血吸虫病流行区非集体居住的16~69岁常住居民进行问卷调查,统计分析居民血吸虫病知识、态度、行为现况。结果调查对象血吸虫病防治知识总知晓率为95.98%,信念态度正确率为89.06%,行为判断正确率为77.43%,知、信、行正确率逐步下降且有显著差异(χ2=1 282.96,P0.01);渔船民血吸虫病防治知识知晓率为90.98%,但行为判断正确率仅为53.81%(χ2=120.52,P0.01)。非条件Logistic回归分析,随着学历的逐步提高,行为判断正确合格率也随之上升,大专以上学历人员合格率是文盲的6.411倍(OR=6.411,95%CI:4.896~8.395)。渔船民行为判断正确合格率仅为农民的5.1%(OR=0.051,95%CI:0.029~0.091)。结论江苏省居民血防基本知识总知晓率达到了《全国预防控制血吸虫病中长期规划纲要(2004-2015年)》目标要求,但行为正确水平较低。文化程度、职业、居住区域等因素对居民血吸虫病防治健康行为形成均有不同程度影响。需要重点开展有针对性的健康促进活动,促进健康生活方式与行为的形成。     

云南省HIV/AIDS高发区医务人员职业暴露防护现状调查

目的调查艾滋病病毒/艾滋病(HIV/AIDS)高发区医务人员职业暴露防护现状,探讨潜在的危险因素及干预措施,提高职业暴露防护能力。方法对402名医务人员进行问卷调查。内容包括一般资料、医疗护理过程中的防护措施、锐器伤等。结果医务人员对HIV感染者/AIDS病人的诊治和防病知识知晓率达94%,传播途径的知晓率为98%,但自我防护意识淡漠,防护措施、防护设备不到位。结论在医务人员职业暴露防护方面还存在着潜在的危险因素,应进一步加强职业安全教育及培训,完善相关防护措施及防护设备。     

Protection of healthcare workers from bloodborne pathogens

PURPOSE OF REVIEW: For decades, healthcare workers have been known to be at risk from acquiring a variety of bloodborne pathogen infections as a result of occupational exposure. Primary prevention of exposures, as recommended by universal precautions guidelines, remains the cornerstone of protecting healthcare workers. Nonetheless, a substantial number of parenteral exposures continue to occur. Updated developments are summarized here, and recommendations for the protection of healthcare workers from bloodborne pathogens are provided. RECENT FINDINGS: The predominant evidence suggests that total percutaneous injuries have decreased over the last decade. Thoughtful adherence to universal precautions remains the primary means of preventing occupational exposures and thus of reducing occupational risk of infection with bloodborne pathogens. A number of studies have provided additional evidence for the efficacy of safety devices in reducing specific subsets of injuries when combined with education and administrative interventions. Barriers to and positive predictors of universal precautions compliance have been identified. Postexposure prophylaxis remains the second line of defense; several authorities have now recommended three antiretroviral agents in this setting. SUMMARY: In summary, almost two decades of experience with universal/standard precautions has resulted in a decrease in parenteral injuries, but much work remains to be done. Vaccines, effective infection control procedures, safer procedures, and safer devices will all be necessary, along with a better understanding of factors that influence healthcare worker behaviors that result in injury. In addition, a number of issues relating to the postexposure management of occupational exposures with bloodborne pathogens need to be better understood.     

Occupational risk factors for the development of systemic lupus erythematosus

OBJECTIVE: There have been few studies of occupational exposures and systemic lupus erythematosus (SLE). We examined the association between the risk of SLE and occupational exposures (mercury, solvents, and pesticides), specific jobs (ever worked in teaching, healthcare, and cosmetology), and working night or rotating shifts. METHODS: Patients with recently diagnosed SLE (n = 265) were recruited through 4 university based and 30 community based rheumatology practices in North Carolina and South Carolina, USA. Controls (n = 355) were identified through driver's license records and were frequency matched to patients by age, sex, and state. Data collection included an in-person interview with detailed farming and work histories. RESULTS: Associations were seen with self-reported occupational exposure to mercury (OR 3.6, 95% CI 1.3, 10.0), mixing pesticides for agricultural work (OR 7.4, 95% CI 1.4, 40.0), and among dental workers (OR 7.1, 95% CI 2.2, 23.4). Although these associations were fairly strong and statistically significant, the prevalence of these exposures was very low and thus these estimates are based on a small number of exposed cases and controls. Weaker associations were seen between SLE and shift work (OR 1.6, 95% CI 0.99, 2.7) and among healthcare workers with patient contact (OR 1.7, 95% CI 0.99, 2.9). There was no association of SLE with use of solvents or among teachers or cosmetologists. CONCLUSION: This study reveals the potential contribution of occupational exposures to the development of SLE, and highlights some exposures and experiences that should be examined in other studies using more extensive exposure assessment techniques and in experimental studies of autoimmunity.     

社区卫生服务机构艾滋病防治工作人员的艾滋病知识和歧视态度及相关影响因素的研究

目的了解社区卫生服务机构艾滋病防治工作人员,对艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（简称HIV/AIDS病人）的歧视情况及影响因素。方法采用自填式调查问卷,对8个城市40家社区卫生服务机构361名工作人员进行调查。调查内容包括工作人员的一般情况、对HIV/AIDS病人的态度和开展艾防工作意愿等。结果 292人（80.9%）表示能像对待其他患者一样对待HIV/AIDS病人,或者可以为他们提供医疗卫生服务,没有歧视。多因素Logistic回归分析显示,近一年接受培训的天数（3-6天、7-14天和15天以上）、支持社区开展艾滋病防治工作的工作人员对HIV/AIDS病人歧视有显著性差异,比值比（OR）[95%可信区间（CI）]分别为3.96（1.10,14.25）、4.93（1.27,19.19）、10.33（1.86,57.42）、0.25（0.12,0.52）。结论社区卫生服务机构工作人员对HIV/AIDS病人依然存在歧视,当地卫生行政部门和疾控机构需要加强对社区医生的艾滋病防治知识、技能和职业暴露预防的培训,同时要提高其工作待遇,稳定基层防艾队伍。     

北京市两所三甲医院医务人员血液和体液职业暴露及HIV相关防护知识调查

目的了解北京市两所三甲医院医务人员的血(体)液艾滋病病毒(HIV)职业暴露情况,防护知识、态度情况,培训情况及培训意愿。方法采用方便抽样的方法,对两所医院的392名医务人员采取自填式问卷调查。结果有81.2%(311/383)的医务人员被锐器刺伤过,有62.7%(240/383)被病人的血(体)液溅到过黏膜或破损皮肤。近一年内暴露密度中位数为1.0次/人年;相关防护知识的知晓率在51.4%～95.4%之间。42.3%(166/392)的医务人员接受过HIV职业暴露防护培训,94.6%(368/389)表示希望得到HIV职业暴露防护培训。结论医务人员HIV相关暴露普遍存在,防护知识缺乏,相关部门应加大培训力度,为医务人员创造良好的防护环境。     

A descriptive analysis of Canadian youth treated in emergency departments for work-related injuries

Because labour laws and regulations protect minors by preventing them from working, this population is often excluded from labour data. However, work is common among Canadian youth. Young teens, and especially pre-teens, have informal employment arrangements such as odd jobs, yard work, babysitting and deliveries. Work injuries occurring in these informal employment arrangements are surprisingly frequent and not usually captured by traditional occupational health and safety data sources (e.g. workers' compensation claims). We analyzed data from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) and found 999 youths (5 to 17 years) who had suffered a work-related injury between 1995 and 1998. They were concentrated in two main areas: clerical/service and manual labour. Work-related injuries increased with age. Approximately one third of the youth experienced open wounds and 5.5 percent had animal bites. Collisions with someone or something were common, as were falls. Others or animals were frequently involved. For the majority of cases, the direct cause of injury corresponds to one of ten categories. Injuries and circumstances varied by occupation. Even informal work arrangements (e.g. delivering newspapers) contained hazards and these varied by workplace. The injuries of young workers have implications for future research, prevention efforts, health services policy and legislative and regulatory efforts.     

Occupational transmission of hepatitis C in healthcare workers and factors associated with seroconversion: UK surveillance data

The study aims were to describe a case series of occupationally acquired hepatitis C (HCV) infections in UK healthcare workers and examine factors associated with transmission using exposure data reported to the Health Protection Agency between July 1997 and December 2007. Fifteen reported cases of documented HCV seroconversion occurred after percutaneous exposure, the majority from hollow-bore needles used in the source patient's vein or artery and contaminated with blood or blood-stained fluid. The seroconversion rate was 2.2% (14/626). In multivariable analysis of healthcare workers with percutaneous exposure to blood or blood-stained fluid, we demonstrate that blood sampling procedures (odds ratio [OR], 5.75; 95% CI, 1.33-24.91; P = 0.01) and depth of injury (OR for deep vs superficial injury, 21.99; 95% CI, 2.02-239.61; P = 0.02) are independently associated with a greater risk of HCV seroconversion. This is the first UK study of occupationally acquired HCV in healthcare workers. It has reinforced our knowledge of risk factors for HCV transmission. Most of these exposures and transmissions were preventable. Healthcare employers should provide regular education on the risks of occupational exposure and prevention through standard infection control procedures. They should ensure the availability of effective prevention measures and facilitate prompt reporting and adequate follow-up of exposures.     

A case control etiologic study of sarcoidosis: environmental and occupational risk factors

Past research suggests that environmental factors may be associated with sarcoidosis risk. We conducted a case control study to test a priori hypotheses that environmental and occupational exposures are associated with sarcoidosis. Ten centers recruited 706 newly diagnosed patients with sarcoidosis and an equal number of age-, race-, and sex-matched control subjects. Interviewers administered questionnaires containing questions regarding occupational and nonoccupational exposures that we assessed in univariable and multivariable analyses. We observed positive associations between sarcoidosis and specific occupations (e.g., agricultural employment, odds ratio [OR] 1.46, confidence interval [CI] 1.13-1.89), exposures (e.g., insecticides at work, OR 1.52, CI 1.14-2.04, and work environments with mold/mildew exposures [environments with possible exposures to microbial bioaerosols], OR 1.61, CI 1.13-2.31). A history of ever smoking cigarettes was less frequent among cases than control subjects (OR 0.62, CI 0.50-0.77). In multivariable modeling, we observed elevated ORs for work in areas with musty odors (OR 1.62, CI 1.24-2.11) and with occupational exposure to insecticides (OR 1.61, CI 1.13-2.28), and a decreased OR related to ever smoking cigarettes (OR 0.65, CI 0.51-0.82). The study did not identify a single, predominant cause of sarcoidosis. We identified several exposures associated with sarcoidosis risk, including insecticides, agricultural employment, and microbial bioaerosols.     

Predicting the onset of forearm pain: a prospective study across 12 occupational groups

OBJECTIVE: To determine, among workers free of forearm pain, the role of mechanical and psychosocial factors in predicting future onset. METHODS: A prospective cohort study was conducted among 782 newly employed workers from 12 occupational groups. At baseline, a cohort of 782 workers free of forearm pain was identified and measurement was made about physical and psychosocial aspects of their job and working environment. Subjects were recontacted after 1 year to determine new onsets of forearm pain. A sample of those reporting new onset forearm pain underwent a structured examination of the upper limb. RESULTS: One year after baseline, 666 (85%) subjects were followed up. The overall prevalence of new onset forearm pain was 8.3% (n = 55). The strongest mechanical risk factor was frequent repetitive movements of the arm or wrist (odds ratio [OR] 2.9, 95% confidence interval [95% CI] 1.6-5.2). The strongest psychosocial risk factors were work considered monotonous at least half of the time (OR 3.0, 95% CI 1.6-5.7) or work with little autonomy (OR 2.6, 95% CI 1.1-6.1). Three specific independent risk factors (monotonous work, repetitive wrist movement, working with hands above shoulder level) could distinguish groups of subjects at substantially different risks of onset. CONCLUSIONS: Along with repetitive movements of the arms and wrists, mechanical postural factors and psychosocial factors also are important risk factors for onset of forearm pain. Our study emphasizes the multifactorial nature of risks for onset of forearm pain, and provides leads as to possible mechanisms for prevention.     

社区肺结核患者的知识态度及行为调查分析

目的通过对社区肺结核病患者相关知识态度及行为进行基线调查,并分析相关的影响因素,为开展肺结核病防制提供基础资料。 方法随机抽取会宁县会师镇社区卫生服务中心已建立治疗档案的肺结核病患者,由经专门培训的医生,采取面对面访谈的方式进行调查,对调查资料进行非参数检验,单因素及多因素logistic回归分析。 结果肺结核病KAP总得分及格率53.6%,知识得分及格率59.8%,态度得分及格率62.9%,行为得分及格率52.6%;多因素logistic回归分析提示,知识得分与调查对象年龄和文化程度有关;态度得分与知识得分相关;行为得分与态度得分和家人关心程度有关。肺结核病相关知识的获得主要来源是医疗单位（67.7%）,其次是电视（58.6%）; 结论基线调查显示肺结核患者的知识,态度和行为水平不高,揭示有必要针对社区肺结核病患者的健康需求开展综合防制为主的健康促进活动。干预重点可以放在较低文化层次人群,体力劳动者和有结核病家族史的人群。     

Risk factors for knee osteoarthritis in Japanese women: heavy weight, previous joint injuries, and occupational activities

OBJECTIVE: Risk of knee osteoarthritis (OA) associated with constitutional factors, history of joint injuries, and occupational factors was assessed in a case-control study among women in Japan. Results were contrasted with a comparable study in Britain. METHODS: The study covered 3 health districts in Japan. Cases were women aged >/= 45 years old, diagnosed with knee OA by orthopedic physicians utilizing radiography. No cases displayed established causes of secondary OA. Controls selected randomly from the general population were individually matched to each case for age, sex, and residential district. Subjects were interviewed using structured questionnaires to determine medical history, including history of joint injury, physical activity, socioeconomic factors, and occupation. Height and weight were measured. RESULTS: Interviews were obtained from 101 female cases and controls. The highest third of heaviest body weight in the past [high (> 62.0 kg) vs low (< 55 kg) odds ratio = 4.42, 95% confidence interval 1.17-16.64], previous injury to the knee (OR 7.11, 95% CI 2.40-21.09), sedentary work during initial employment (OR 0.35, 95% CI 0.15-0.84), and total working years (OR 1.05, 95% CI 1.01-1.08) represented independent factors associated with knee OA, after controlling for other potential risk factors. CONCLUSION: Heavy weight in the past appears to represent a risk factor for knee OA among women in Japan, as reported in Britain. Constitutional factors may represent important determinants for knee OA, regardless of race. Previous injury to the knee and occupational factors are also associated with knee OA in both Britain and Japan, although characteristic activities for work vary.     

西安市大学生结核病防治“知信行”现状及结构方程模型分析

目的 了解西安市非医学专业大学生结核病防治“知信行(KAP)”现状,并根据KAP理论构建结构方程模型,分析基本信息、个人史、知识、态度和行为间的相互作用机制,为高校结核病综合防治提供对策和建议。方法 采用分层整群抽样的方法于2016年12月至2017年3月从西安市62所非医学高等院校中抽取4所院校的851名大学生进行问卷调查,问卷包括中国疾病预防控制中心设计的全国公众结核病防治知识信念行为调查问卷(内容为结核病防治相关知识、态度、行为等条目)和自行设计的一般情况调查问卷(内容为学生基本信息及个人史的相关条目)。共回收有效问卷808份,有效率为94.9%;对学生KAP现状进行描述性分析,使用Amos 21.0软件分析被调查者的基本信息、个人史、结核病防治知识、结核病防治态度、结核病防治行为之间的关系。结果 大学生结核病防治知识得分较低,正性态度和正性行为持有率分别为70.8%(1715/2424)、37.1%(600/1616)。构建的大学生结核病防治KAP结构方程模型拟合良好,部分拟合指标如下:适配度指数(GFI)为0.97,调整后适配度指数(AGFI)为0.95,比较适配度指数(CFI)为0.95。结构方程模型表明:学生个人史、结核病防治知识、结核病防治态度对行为均有正向作用;其中,知识对行为的总效应值最大,为0.74,其中直接效应值为0.69 [临界比(CR)=8.38,P=0.003],通过态度产生影响的间接效应值为0.05(P=0.003);个人史对行为产生的间接效应值分别为0.45(P=0.001);态度对行为影响的直接效应值最小,为0.16(CR=2.79,P=0.007)。结论 西安市大学生结核病防治知识有待提高。结核病防治知识、个人史、态度均会影响结核病防治行为,结核病防治态度对结核病防治行为的影响较小。应注重提高学生对结核病的认知,注重KAP同步发展。