中国北方少数民族聚居地农村居民饮酒与农业伤害的流行病学研究

目的 了解北方少数民族聚居地农村居民农业伤害的发生情况和饮酒与农业伤害的关系.方法 采用多级抽样的方法选取样本,通过面对面访谈方式收集资料;共抽取2366名达斡尔族聚居地农村居民,收到合格问卷2198份.结果 在2198名达斡尔族聚居地农村居民中,农业伤害发生率为11.8%,男性伤害发生率(13.8%)明显高于女性(9.7%)(P=0.003).年龄、职业、从事农业生产的年限、睡眠困难、从事农业生产时吸烟、驾驶农用机动车、使用农用机械和饮酒是伤害的危险因素(P＜0.01).通过控制混杂因素,饮酒与农业伤害有关,先前饮酒者、目前饮酒者发生伤害的危险性分别是不饮酒者的1.57倍(95%CI:1.05～2.37)和1.80倍(95%CI:1.24～2.62).目前的饮酒率为29.1%(640/2198).随着每周饮酒次数、每次饮纯酒精量、饮酒年限、饮用酒精饮料种类的变化,农业伤害的危险性增加;在早午餐饮酒发生农业伤害的危险性是不饮酒者的2.15倍(95%CI:1.43～3.22),经常醉酒者发生农业伤害的危险性是不饮酒者的2.09倍(95%CI:1.38～3.15).结论 饮酒是农业伤害的主要危险因素.控制饮酒、加强道路安全知识和农用机械使用知识培训,是预防农业伤害的主要措施.     

Horse-Related Injuries Among Agricultural Household Members: Regional Rural Injury Study II (RRIS-II)

ABSTRACT:  Purpose: To determine the incidence, associated consequences, and potential risk factors for horse-related injuries among youth and adults residing in Midwestern agricultural households. Methods : Demographic, injury, and exposure data were collected for 1999 and 2001 among randomly selected agricultural households within a 5-state region. A causal model facilitated survey design, data analysis, and interpretation of results; directed acyclic graphs guided multivariate modeling. Findings : From 7,420 households (84% response of eligible), involving 32,601 persons, 5,045 total injury events were reported; 1,016 were animal-related injuries, of which 215 (21%) were horse-related (rate, 6.7 events per 1,000 persons per year). Seventy-seven percent (77%) required health care; comparing those under age 20 and those 20 and older, 49% and 54%, respectively, lost work time on their operation (28% and 26%, one week or more), as a result of injuries largely associated with horse riding activities (70% and 56%). Multivariate analysis for youths under age 20 indicated: increased risks in North and South Dakota, for >0 hours worked, and for having a history of prior agriculture-related injury; and decreased risks for males. For those 20 and older, increased risks were identified for a prior injury history and less than high school education. Conclusions : Horse-related injuries, primarily associated with riding activities, are a significant problem among agricultural communities, and greatly impact their operations.     

部分省份农业伤害现况及其影响因素

[目的]了解农业伤害的发生率、流行特征及其影响因素,为制订农业伤害干预措施提供科学依据。[方法]2010年2月至2010年8月,采用整群与分层相结合的抽样方法,从全国随机抽取6个省份,再从每个省份中抽取1个村,共调查1623名从事农业劳动的农民,由经过培训的调查员进行问卷调查。[结果]2009年6个省份农业伤害的总发生率为43.9%（95%CI为41.5%~46.3%）,居前5位的分别是刀或锐器伤、扭伤、跌倒或坠落、农业机械伤、烧烫伤。单因素及多因素logistic回归分析结果显示：文化程度、身体状况、心情状态、是否使用防护用品为本次调查农业伤害发生的影响因素。[结论]目前我国农业伤害已经成为危害农村居民健康的重要因素和突出的公共卫生问题,有必要针对农业伤害的危险因素,采取科学的干预措施予以控制。     

Bull-Related Incidents: Their Prevalence and Nature

ABSTRACT

The hazards associated with breeding livestock were well documented in some of the earliest annals of literature. With the exception of horses, bulls have probably caused more livestock- related deaths and injuries to human beings throughout recorded history than any other domesticated animal. A review of the literature might suggest that attacks by bulls were more of a problem in the past than today. However, a bull-related injury surveillance project conducted by the authors documented that bulls continue to contribute to an unacceptable number of serious injuries and deaths. In 2006, following an increase in the number of bull-attack cases identified during ongoing surveillance of agricultural work-related injuries, a search of agricultural injury data was initiated to gain a better perspective of the bull-incidence problem. Approximately 3 years of data, gathered from daily reviews of online sources plus a review of more than 12,000 prior injury reports, were combined, coded, and summarized. A total of 287 cases primarily from the United States were documented and analyzed. Where reported, contributing factors were identified, including age of victim, type of bull, type and condition of handling facility, experience of handler, and time of year. Analysis of the literature and data indicates that (1) the risk of injury associated with hours of exposure to bulls is higher than that of working around cows; (2) the risk of a bull-related fatality, based upon the hours of exposure, appears to be higher than other known hazards, such as tractor operation; (3) victims generally appeared to have had considerable experience with handling bulls; (4) bulls raised from calves on-site appeared more aggressive; and (5) most of the incidents involved the victim being inside the bull holding area. Recommendations are presented for reducing the potential of bull attacks on humans.     

Incidence of farm-work–related acute injury in a defined population

To determine occurrence and sources of farm-work-related injury, we conducted a population-based, prospective study in a large clinic and hospital serving a defined rural area. The population at risk was identified through a unique demographic and medical records linkage system and a special agricultural census. Cases were 510 individuals who sought inpatient or outpatient care from May 1990 through April 1992 from a physician or chiropractor for harm resulting from acute exposure to energy. One per 31 farm residents was treated annually for a farm-work-related injury. Eight percent of these cases were hospitalized. Animals were the most frequent source of injury. Severity did not differ between cases associated with animals, machinery, falls, or chemicals. Thirty-eight percent of farm-work-related injury cases occurred in nonfarm residents. Injury risk was 2.5 times greater among dairy farm residents than among nondairy farm residents, 352.0 vs. 141.0 cases per 10,000 person-years, respectively. Adult male farm residents had 556.9 injuries per 10,000 person-years and 21.3 injuries per million hours of farm work.     

Nail gun injuries in apprentice carpenters: risk factors and control measures

BACKGROUND: Nail guns increase residential construction productivity but their use is associated with risk of injury. METHODS: Active surveillance data from 772 apprentice carpenters were used to document the injury risk associated with the use of nail guns and the potential impact of modifiable risk factors. Using reported work hours and nail gun injuries injury rates per 200,000 hr worked in the past year were calculated. Using estimates of hours of tool use, Poisson regression was used to calculate adjusted rate ratios for injury associated with time in the trade, trigger mechanism on the tools and training prior to injury. RESULTS: Forty-five percent of these apprentices had sustained a nail gun injury; injury rates in the past year based on hours of work were considerably higher than previously recognized. Those with less than 1 year in the trade compared to those with more than 5 years experience (RR = 2.7; 95% CI 1.2, 5.9) and those with no training in tool use (RR = 2.9; 95% CI 1.9, 4.4) were at greatest risk. After adjusting for experience and training, the rate of injury was twice as high with tools with a contact trip trigger compared to those with a sequential trigger (RR = 2.0; 95% CI 1.2, 3.3). CONCLUSIONS: Preventive measures should include change to the safer sequential trigger that prevents unintentional firing and early training in safe tool use. Because of the high prevalence of use of tools with contact trip triggers the greatest number of injuries among these apprentices could be prevented with an engineering solution.     

Agricultural injury in California migrant Hispanic farm workers

BACKGROUND: Agriculture is among the most hazardous industries in the United States. METHODS: A longitudinal study of injury among migrant Hispanic farm workers residing in six Northern California Migrant Family Housing Centers (MHCs) during the 1997 harvest season was conducted. Participants completed an initial interviewer-administered work-and-health questionnaire at the beginning of the harvest season addressing the preceding year; there were three periodic follow-up surveys. RESULTS: There were 1,201 adult farm workers (participation 85.2%) who completed the initial questionnaire. Of these, 837 (69.7%) completed the final follow-up survey. There were 86 agricultural injuries (incidence 9.3/100 full-time equivalent employees (FTEs), 95% CI 7.5-11.5/100 FTE). Increased risk for agricultural injury occurred among women paid piece-rate (RR 4.9, 95% CI 1.8-12.8). Sprains and strains were most common (31%), followed by lacerations (12%). CONCLUSIONS: Agricultural injury experience in this cohort is comparable to that of agricultural workers in other U.S. settings. Increased risk among women paid piece-rate suggests further study and potential policy changes regarding payment regimens. Heterogeneity of injury in this population presents a major prevention challenge. In view of high frequency of strain and sprain injuries, ergonomic interventions deserve further study.     

News Reports and Their Role in Child Agricultural Injury Prevention

Objectives: The news media can be important sources of health information. News reports of child agricultural injuries were examined to assess what was reported and to evaluate potential implications for health communication and surveillance efforts. Methods: A content analysis was conducted of a convenience sample of 113 US news reports from 2012 to 2014 involving agricultural injuries to children less than 18 years of age. The data collection instrument included basic elements of injury surveillance, as well as variables related to injury causation and prevention. Results: Law enforcement personnel were the main source of information on the injury event (79%). Severity, age, sex, injury mechanism, and source were reported more than 90% of the time. However, few news reports mentioned use or lack of protective equipment (12%) or a prevention message (6%). Recommended prevention messages from the research team included keeping young children out of the farm worksite (38%) and following guidelines for age-appropriate work and recreational activities (31%). Conclusions: This study shows that news reports provide a valuable and relatively inexpensive addition to other childhood agricultural injury data sources. They highlight current serious events and have potential to be an effective communication tool with respect to education, prevention, and framing the public’s perception of injury risk. An important next step may be to partner with law enforcement to develop three to five prevention messages that can be shared with reporters to educate readers on risks and steps that can be taken to prevent similar injuries on farms and ranches.     

中国五岁以下儿童非致死性伤害发生率及影响因素研究

目的 了解中国5岁以下儿童非致死性伤害的发生率及相关影响因素.方法 数据来自于第四次国家卫生服务调查,其中5岁以下儿童10 819名,为本次研究对象.伤害相关内容:是否发生伤害以及发生次数、原因、地点、严重程度.采用两水平Poisson回归分析社会经济学变量与非致死性伤害发生次数的关联性.结果 最近12个月内5岁以下儿童非致死性伤害发生率为16.0%o.＜1岁组儿童非致死性伤害前3位原因是:跌倒、动物咬伤、烧伤/烫伤,发生率分别为3.9%o、1.8%o和1.8%o;1～4岁组儿童是:动物咬伤、跌倒、烧伤/烫伤,发生率分别为6.5‰、6.0‰和2.9‰.两年龄组儿童分别有83.0%和69.0%的最近一次伤害发生在家里.＜1岁组无残疾发生,1～4岁组伤害致残疾率为1.0%.控制其他变量后,1～4岁组中男童非致死性伤害风险是女童的1.57倍(P＜0.05);民族、家庭人均收入和地区等变量差异无统计学意义(P＞0.05);＜1岁组在全部社会经济学变量上的统计检验结果均无统计学意义(P＞0.05).结论 中国5岁以下儿童最近12个月非致死性伤害发生率为16.0%o;动物咬伤、跌倒、烧伤/烫伤是非致死性伤害的前三位原因;家庭内是非致死性伤害最常见地点;1～4岁男童非致死性伤害发生率明显高于女童.

Abstract：

Objective To determine the incidence of non-fatal injuries and related influencing factors among children under 5 years old in China. Methods Data involving 10 819 children under 5 years old was from the Fourth National Health Service Survey of China. Injury-related indicators include: history of ever having had an injury, its frequency, cause, location and severity of the injury.A two-level Poissun regression was used to examine the significance of related socio-economic variables. Results The overall incidence rate of nonfatal injuries among children under 5 years old was 16.0 per 1000 population in the prior 12 months. The first three leading causes of non-fatal injuries were falls,animal bite, fire/bum among children under 1 year old,with the rates as 3.9, 1.8 and 1.8 per 1000 population, respectively. For children aged I to 4 years old, the first three leading causes were animal bite, fall, fire/burn with rates as 6.5,6.0 and 2.9 per 1000 population, respectively. 83.0% and 69.0% of last injuries occurred at home for the above said two age groups. No disability was found among children younger than 1 year old who suffered from a nonfatal injury while for the 1-4 age group, the disability accounted for 1.0% of injury-induced outcomes. After adjusting other variables,boys had 1.57 times the risk of injury compared with girls in the 1-4 age group (P＜0.05). The differences on the effects regarding ethmicity,per capita household income, and place were insignificant (P＞0.05). None of the socio-economic variables was found that significantly related to the non-fatal injury risk among children under 1 year old (P＞0.05). Conclusion The incidence of nonfatal injuries among children under 5 years old was 16.0 per 1000 population in the prior 12 months. The three leading causes of injuries were animal bite, falls, fire/bum respectively. Home was the most common place that non-fatal injuries occurred. Boys had a higher risk of injury compared with girls among children aged 1 to 4 years old and the difference was significant.     

A prospective population based study of childhood injuries: the Velestino town study

BACKGROUND: Unintentional injuries in childhood constitute a significant public health problem. Our purpose is to estimate the incidence of identifiable unintentional childhood injuries of any type and severity, and to document risk factors of non-transient nature. METHODS: We have undertaken a prospective population-based investigation in a Greek town with a population of 748 children (0-14 years old). All identifiable injuries have been monitored during a twelve-month period through information provided by the health care outlets or educational institutions as well as the police station and the regional hospital. RESULTS: The overall incidence was 28.2 per 100 person-years (95% confidence interval from 24.4 to 32.0), whereas the incidence of injuries with Hopkins Injury Severity Score equal to or higher than four was 6.3 with 95% confidence interval 4.5 to 8.1. The incidence of total injuries was higher among boys than among girls (p<0.01) and the gender difference was particularly evident among older children. Almost half of the injuries were due to falls and more than 20% were due to cutting. Children of younger and less educated parents have higher risk for injury and children from families with more injuries were more likely to be injured themselves. There was no evidence that somatometric characteristics were associated with injury risk. CONCLUSION: The incidence of unintentional childhood injuries is high and represents a considerable health burden. Family related variables are important risk factors for childhood injuries, whereas somatometric characteristics play a minimal role. Key points: Incidence and risk factors of all injuries in a population-based study among children. About 28 per 100 children got injured over a period of one year. There is evidence that younger paternal age and lower education may be associated with increased injury risk. Family related variables seem to be important risk factors for childhood injuries, whereas somatometric characteristics play minimal role.     

Fall-related injuries among agricultural household members: Regional Rural Injury Study II (RRIS-II)

OBJECTIVE: The objective of this study was to identify the magnitude and consequences of and potential risk factors for fall-related injuries among agricultural operation households. METHODS: Demographic, injury, and exposure data were collected through 1999 from 3765 households in a five-state region. A causal model facilitated survey design, data analyses, and interpretation of results; directed acyclic graphs guided multivariate modeling. RESULTS: The 16,538 participants experienced 766 fall-related injury events (48.3 per 1000 persons). Consequences included lost agricultural and other work time. Increased risks involved residence in states other than Minnesota, male gender, and injury history. Decreased risks were among those less than 35 years of age and those who worked 40 hours or less per week. CONCLUSIONS: Fall-related injury is a major problem for the agricultural population. This effort serves as a basis for further in-depth research.     

Pain, medication, and injury in older farmers

BACKGROUND: Agricultural work continues to be a dangerous occupation. Older farmers experience high risks for work-related injury. The purpose of this research was to determine if there is a relationship between medication use and injury among older male farmers in Alberta. METHODS: Using probabilistic linkage between an Alberta Agriculture government registry of farm operators and the Alberta Health Plan registry file, older farmers (aged 66 and older) were identified. Farm related injuries were identified using an E-code search of both hospitalization and emergency department separations for a 3-year period. Cases were matched to controls on age, geographic health region, and index injury date at a ratio of 1:5. Co-morbidity and medication use for each of the cases and controls were derived from population based health system utilization files. Conditional logistic regression was used to determine which medications were related to injury. RESULTS: Overall, a total of 282 farm related injuries were suffered by the linked group. Controlling for co-morbidity, farmers who had stopped taking narcotic pain killers (OR = 9.37 [95% CI:4.95, 17.72]) and non-steroidal anti-inflammatories (OR = 2.40 [95% CI:1.43, 4.03]) 30 days prior to the date of injury were at risk of injury. Those farmers taking sedatives up until the date of injury were also at risk (OR = 3.01 [95 CI:1.39, 6.52]). In addition, those suffering from incontinence/urinary tract disorders (OR = 2.95 [95% CI:1.30, 6.71]), and prior injury (OR = 1.42 [95% CI:1.04, 1.95]) were also at greater risk of injury. CONCLUSIONS: The relationship of medication use and injury in this population is different from those observed in studies of falls in older persons. We hypothesize that distraction from either pain or co-morbidity may play an important role in the etiology of injuries suffered in this active older working population. Further investigations in this area are required to confirm these findings.     

口腔医院护工锐器伤现况调查

摘要:目的　了解口腔医院护工锐器伤的发生情况,为制定口腔医院护工锐器伤规范化防护措施提供理论依据。方法　采用卫生部设计的《医务人员锐器伤筛查表》,对某院55名护工人员对过去1个月中锐器损伤的发生情况进行问卷调查。结果　护工锐器伤发生率为21.8%（12/55）,发生密度为 0.47次/（人.月）;年限≤1年的护工锐器伤发生率最高,为61.1%;接受过培训的护工锐器损伤发生率（18.5%）明显低于未培训的护士（39.3%）。结论　口腔医院护工是锐器伤发生的高危人群,通过针对性预防和干预,可有效地降低锐器伤发生率。     

Risk factors for falls among Iowa farmers: a case-control study nested in the Agricultural Health Study

BACKGROUND: Farmers are at increased risk for fall-related injury compared with other occupations. Little is known about risk factors for non-fatal falls on the farm. This case-control study, nested within the Agricultural Health Study, aimed to assess risk factors for work-related falls among Iowa farmers. METHODS: A screener questionnaire sent to 6,999 farmers in 1998 identified 79 farmers who reported a fall-related farm injury that required medical advice or treatment in the previous year. Multivariable logistic regression analysis was used to assess several possible risk factors for injury among these farmers compared with 473 farmers with no injury in the previous year. RESULTS: There were significant associations between fall-related farm injury and age between 40 and 64 years (OR = 2.21; 95% CI = 1.20-4.07), doctor-diagnosed arthritis/rheumatism (OR = 2.05; 95% CI = 1.11-3.79), difficulty hearing normal conversation (even with a hearing aid, in the case of those who used one) (OR = 1.82; 95% CI = 1.07-3.08), and taking medications regularly (OR = 1.80; 95% CI = 1.02-3.18). CONCLUSIONS: Aging and health impairments, such as arthritis and hearing difficulties, are risk factors for which accommodations and preventive strategies can be devised to prevent fall-related injuries on the farm.     

Agricultural injury

BACKGROUND: Agriculture is one of the most hazardous industries in the US. METHODS: We reviewed MEDLINE and NIOSHTIC to identify English-language studies addressing occupational injury among agricultural populations, focusing on North America. Additional references were identified from the reference lists of identified studies and from contacts with experts in the field. RESULTS: U.S. data indicate up to approximately 780 deaths and 140,000 cases of nonfatal disabling injuries in 1998. Risk of agricultural injuries is approximately 5-10/100 persons per year, but is higher in certain risk groups, such as males and cattle workers. Falls, machinery, and animals are among the most common causes. Unique features of the agricultural workplace and exposed population combine to increase risk and hinder accurate measurement. These features include a wide range of activities, hazards, and dispersed work places in agriculture; a seasonal hired work force that often has brief tenure, poor English skills, and a distrust of officialdom; and a history of exemption regarding occupational health and safety regulations. CONCLUSIONS: Research in agricultural injury should include epidemiologic study of risk factors and evaluation of interventions. Although only limited data are available documenting efficacy of specific preventive approaches, prevention should focus on engineering controls, regulatory approaches, and education.     

Australian trampoline injury patterns and trends

Objectives: To examine national trampoline injury patterns and trends in the context of improved product safety standards and trampoline design modifications. Method: Review of National Hospital Morbidity data. Results: There were an average 1,737 trampoline injuries reported nationally each year from 2002 to 2011. Both injury frequency and rate grew. Statistically significant rate increases were observed among all age groups, although both are highest among children aged 5–9 years. From 2008/09 there is a possible decreasing trend among the 5–9 age group. Falls predominate and 81% of falls result in fracture. Non‐fall injuries increased annually as a proportion of all hospitalised injury although they did not comprise more than 2.4% in any one year. Conclusions: History provides no evidence of an observable effect of voluntary Australian Standards for trampoline safety on population rates for trampoline injury. The major design modification – netted enclosures – could contribute to the risk of injury by leading parents to falsely believe that a netted enclosure eradicates the risk of injury.     

A Comparison of Nonfatal Unintentional Injuries in the United States Among U.S.-Born and Foreign-Born Persons

The objective of this research was to compare the risk of nonfatal unintentional injuries between foreign-born and U.S.-born persons. Cross-sectional, nationally representative data were used from the 2000–2003 National Health Interview Survey to compare the risk of injury between 62,267 foreign-born and 322,200 U.S.-born persons. Nonfatal unintentional injuries occurring during the three months prior to the interview were compared by age, gender, education, poverty status, region of residence, family size, and health insurance coverage status. There were a total of 7,654 injured persons with U.S.-born persons having a weighted injury prevalence of 2.3% (95% confidence interval [CI]: 2.2, 2.4) and foreign-born persons having a weighted injury prevalence of 1.2% (95% CI: 1.0, 1.3). With the U.S.-born population as the reference and while controlling for sociodemographic characteristics, the odds ratio of injury risk was 0.54 (95% CI: 0.48, 0.62) for the foreign-born population. Transportation-related injuries occurred more frequently among foreign-born persons than among U.S.-born persons (23.7%, 95% CI: 19.7, 28.3 vs. 15.0%, 95% CI: 14.0, 16.2, respectively). This research is the first step in determining the morbidity from unintentional injuries among the foreign-born population in the U.S.     

Gender differences in work-related injury/illness: analysis of workers compensation claims

BACKGROUND: Risk of work-related injuries/illnesses among females has not been well documented. This study compares compensable work-related injuries/illnesses between females and males across all major industrial sectors and occupations using a state-managed Workers Compensation database. METHODS: Incidence rates were calculated by dividing the number of compensable injuries/illnesses among West Virginia Workers Compensation claimants by the total number of female and male workers in each specific industry class (based on SIC codes). Gender-specific denominators for occupations were estimated using 1990 U.S. Census data. RESULTS: The overall injury/illness rate was significantly lower in females than males (5. 5 vs. 11.5 per 100 employees), a trend that extended to all major industrial classes with the exception of service and agricultural sectors. The distribution of types of injury/illness varied by gender, occupation, and industry with significantly higher risk of carpal tunnel syndrome, burn, sprain, and fracture in females compared to males. CONCLUSIONS: Female workers have a greater risk of specific injury/illness compared to males in various industries. Further research will be needed to understand the role of differential job-tasks within each occupation in explaining the risk difference.     

Hearing loss as a risk factor for agricultural injuries

BACKGROUND: Previous studies suggested that hearing impairment based on self-report might increase the risk of agricultural injuries. However, self-reported hearing measures may be subject to inaccuracy and subjective perception. We assessed the association of agricultural injuries with hearing loss and other hearing characteristics using measured hearing. METHODS: Study subjects were 150 farmers who participated in the Iowa Certified Safe Farm study. Injury information was collected by telephone interviews at 2-5 month intervals from September 1999 to October 2002. Hearing levels were measured annually using the pure tone audiometry from 1998 to 2002. Adjusted rate ratios of injuries were calculated using the multivariate Poisson regression model. RESULTS: Hearing loss in the better ear (RR = 1.62), hearing asymmetry (RR = 1.67), and fair/poor self-reported hearing (RR = 1.96) were significantly associated with the risk of agricultural injuries. It is notable that self-reported hearing might be a stronger predictor of injuries than pure tone audiometry (PTA). Exposure to noise elevated the risk of injuries in those farmers with hearing loss or hearing asymmetry. The occasional use of hearing protection was significantly associated with agricultural injuries. CONCLUSIONS: This study adds substantial evidence that hearing loss acts as a risk for agricultural injuries. Prevention of hearing loss and noise exposure may be important in reducing the burden of agricultural injuries.