Nonfatal work-related injuries among agricultural machinery operators in northern China: A cross-sectional study

Purpose

To identify the annual prevalence and potential risk factors of nonfatal agricultural machinery injuries among agricultural machinery operators in the northern areas of China.

Methods

A quota sampling method was used to study 1921 agricultural machinery operators in 5 provinces in northern China. Agricultural machinery injuries that occurred between July 1, 2008, and June 30, 2009 were investigated. Data on nonfatal injuries and related factors were obtained by in-person interviews.

Results

The prevalence of agricultural machinery-related injuries among the surveyed operators was 13.1%. Being male, having lower family income and/or poor hearing, being in debt, and feeling stressed were five significant risk factors for injuries. The majority of injuries took place on farmlands (46.6%), roads (26.3%), or in backyards (17.5%). The four most common causes of injuries were being stuck by starting handles that slipped, being slashed or stabbed by sharp objects, being struck by falling objects, and falls from stationary vehicles.

Conclusions

The prevalence of agricultural machinery-related injuries in our study was high. Males, low family income, poor hearing, and stress were associated with high risk of injury occurrence.     

Double gloving and practice attitudes among surgeons

BACKGROUND: Exposure to blood and body fluids while operating places surgeons at risk. Double gloving is a safety measure, which decreases this risk. However, many surgeons do not incorporate this precaution into their personal practice. This study evaluates surgeons' gloving practices and hepatitis status. METHODS: A questionnaire was sent to all consultant surgeons and residents in the surgical specialties in the Capital Health region, University of Alberta. A double mail-out design was used. A second questionnaire, containing information on safety issues, was sent to the general surgeons (consultants and residents) who did not double glove to ascertain whether this information would change their practice. RESULTS: In all, 268 surgeons and residents were sent the original questionnaire; 170 replied (63.4% response rate.) Fifty-seven percent of the respondents do not double glove (none of the urologists double glove versus 87% of orthopedic surgeons). The most common reason sited was a decrease in manual dexterity (46%). Ninety-seven percent of respondents are immunized for hepatitis B with 53% having had their titres recently checked. Thirty-seven general surgeons received the evidence on safety issues but only 9 (23%) of them would change their practice as a result of this information. CONCLUSIONS: The majority of surgeons and residents do not double glove. Even when provided with good evidence of efficacy, few surgeons contemplate adopting safety techniques.     

Thermal burn and electrical injuries among electric utility workers, 1995-2004

This study describes the occurrence of work-related injuries from thermal-, electrical- and chemical-burns among electric utility workers. We describe injury trends by occupation, body part injured, age, sex, and circumstances surrounding the injury. This analysis includes all thermal, electric, and chemical injuries included in the Electric Power Research Institute (EPRI) Occupational Health and Safety Database (OHSD). There were a total of 872 thermal burn and electric shock injuries representing 3.7% of all injuries, but accounting for nearly 13% of all medical claim costs, second only to the medical costs associated with sprain- and strain-related injuries (38% of all injuries). The majority of burns involved less than 1 day off of work. The head, hands, and other upper extremities were the body parts most frequently injured by burns or electric shocks. For this industry, electric-related burns accounted for the largest percentage of burn injuries, 399 injuries (45.8%), followed by thermal/heat burns, 345 injuries (39.6%), and chemical burns, 51 injuries (5.8%). These injuries also represented a disproportionate number of fatalities; of the 24 deaths recorded in the database, contact with electric current or with temperature extremes was the source of seven of the fatalities. High-risk occupations included welders, line workers, electricians, meter readers, mechanics, maintenance workers, and plant and equipment operators.     

Expanded Occupational Safety and Health Administration 300 log as metric for bariatric patient-handling staff injuries

BackgroundMobilization of morbidly obese patients poses significant physical challenges to healthcare providers. The purpose of this study was to examine the staff injuries associated with the patient handling of the obese, to describe a process for identifying injuries associated with their mobilization, and to report on the need for safer bariatric patient handling.MethodsWe performed our study at a 761-bed, level 1 trauma center affiliated with a U.S. medical school. The hospital's Occupational Safety and Health Administration (OSHA) 300 log was expanded to the “E-OSHA 300 log” to specifically identify injuries the staff attributed to bariatric patient handling. The 2007 E-OSHA 300 log was analyzed to identify and describe the frequency, severity, and nature of bariatric versus nonbariatric patient handling injuries.ResultsThe analyses revealed that during 2007, although patients with a body mass index of ≥35 kg/m² constituted <10% of our patient population, 29.8% of staff injuries related to patient handling were linked to working with a bariatric patient. Bariatric patient handling accounted for 27.9% of all lost workdays and 37.2% of all restricted workdays associated with patient handling. Registered nurses and nursing assistants accounted for 80% of the injuries related to bariatric patient handling. Turning and repositioning the patient in bed accounted for 31% of the injuries incurred. The E-OSHA 300 log narratives revealed that staff injuries associated with obese and nonobese patient handling were usually performed using biomechanics and not equipment.ConclusionManual mobilization of morbidly obese patients increases the risk of caregiver injury. A tracking indicator on the OSHA 300 logs for staff injury linked to a bariatric patient would provide the ability to compare obese and nonobese patient handling injuries. The E-OSHA 300 log provides a method to identify the frequency, severity, and nature of caregiver injury during mobilization of the obese. Understanding the heightened risk of injury associated with manual bariatric patient handling should help healthcare institutions identify deficiencies in their current injury prevention program and focus resources more precisely for safer, systems-based bariatric patient-handling solutions. Effective patient handling systems should also reduce the aura of fear that might be present in some caregivers when mobilizing a bariatric patient.     

Occupational and traffic accidents among veterinary surgeons

A recent large‐scale survey of accidents in German veterinary surgeons was performed. Veterinary work represents a relatively high‐risk occupation involving substantial driving throughout the working week (visiting rural farms, etc.) with high reported rates of driving accidents and of accidents resulting from physical injury through treatment of animals. In this paper the prediction of both driving and other work‐related accidents among veterinary surgeons (N=494) is considered; it is appropriate to consider accident rates for this group separately, as there is evidence that the main predictors of accidents differ between veterinary surgeons and auxiliary veterinary personnel. A series of univariate and multivariate analyses of the data indicate that work‐related accident occurrence is best predicted by work‐related driving distance and risk attitude, with associations also being found with working hours and stress. Driving accident rate is best predicted by risk attitudes, stress and aggression, with associations also being found with age, number of children, work‐related driving distance and safety attitude. Construction of transactional models suggests models in which the effect of work‐related driving distance on driving accident rates is mediated by risk attitude, whilst the effect of working hours on work‐related accidents is mediated by stress. A detailed discussion of the general factors which predict work‐related accidents and specific occupational factors which apply to veterinary workers is also included. Problems associated with the high degree of intercorrelation between individual difference and occupational predictors in the interpretation and modelling of accident data are discussed. The implications for practice are also discussed. Copyright © 2000 John Wiley & Sons, Ltd.     

Behaviour and knowledge skill levels of orthopedic surgeons about radiation safety and fluoroscopy use: A survey analysis

ObjectiveThe aim of this study was to evaluate the behaviour and knowledge skill levels of Turkish orthopedic surgeons about fluoroscopy usage and radiation safety.MethodsThe questionnaire, consisting of nineteen questions, was sent to orthopaedic surgeons and requested by a total of 323 surgeons online. The questions were about personal information, training and behaviours related to radiation and fluoroscopy usage, and the use of protective equipment.ResultsA total of 277 individuals completed the questionnaire. The answers of 180 surgeons whose working duration was more than 1 year and also who participated in at least one fluoroscopy requiring operation per week, were analysed. 22 (12%) participants answered that they were trained on fluoroscopy usage. Sixty people (33.3%) reported that they did not use any protective equipment regularly. The most commonly used protection methods were lead aprons 123 (68.3%). Thyroid protectors were used by 92 participants (52.1%). There was no significant difference between the groups when comparing the use of protective equipment according to the academic title. Only 19 (10.6%) of the surgeons noted that they used dosimeter regularly, and 15 (83.3%) of them reported that they controlled their dosimeters.ConclusionIn this study, Orthopedic surgeons were found not to be adequately trained about use and risks of fluoroscopy and also not to be equipped about methods for preventing radiation damage.     

Trauma fellowship impact on trends and complications of operatively treated clavicle fractures in recently trained orthopedic surgeons

PurposeThe purpose of this study was to evaluate whether fellowship training affected trends and complications of operative clavicle fracture treatment in newly trained orthopedic surgeons.MethodsThe American Board of Orthopedic Surgery (ABOS) database was utilized to identify cases of open treatment of clavicle fractures submitted by ABOS Part-II Board Certification candidates. From 2005 to 2017, 3148 candidates performed at least one open clavicle fracture treatment. Overall, 6919 cases were included; 3516 of these had over 6 weeks of follow-up. Candidates were divided by fellowship type into 5 groups: Trauma, Sports Medicine, Hand and Upper Extremity or Shoulder, multiple, and other or no fellowship(s). Group differences were analyzed with ANOVA and Bonferroni post hoc analysis. Complications, reoperations, nonunion rates, and readmissions between groups were evaluated with Chi-squared test and logistic regression analyses.ResultsCase volume during the study period was significantly higher after 2007. Trauma candidates performed significantly more operations for clavicle fracture per candidate while candidates with other or no fellowship(s) performed significantly fewer operations per candidate. Patients treated by Trauma candidates were significantly older, had significantly fewer early surgical complications and significantly more early medical complications. Nonunion rates were not significantly different between groups.ConclusionCandidates treated clavicle fractures surgically more often in 2007 and beyond. Trauma candidates treated older patients, had fewer early surgical complications, and had more medical complications. Reoperation, readmission and nonunion rates were not significantly different between groups.     

Pattern of multiligament knee injuries and their outcomes in a single stage reconstruction: Experience at a tertiary orthopedic care centre

IntroductionMulti-ligamentous knee injuries (MLKI) are rare orthopedic injuries with diverse approaches to its management protocol. The purpose of this study was to determine the epidemiology of MLKI in our centre and its outcome in single stage reconstruction.Methods60 patients who were surgically treated for MLKI between 2014 and 2018 were included in this study, data was collected pre and postoperatively and their Lysholm and IKDC scores were used to evaluate the outcomes.ResultsA male predominance was noted in the present study. Road traffic accidents (RTA) were the most common mode of injury (66.7%). ACL & MCL combination constituted the most common injury pattern (36.7%). 41.7% of our patients were treated within 3 weeks from injury and 58.3% were treated 3 weeks after injury and there was no statistically significant difference in their outcomes with a p value > 0.05 for their post op Lysholm scores and post op IKDC scores. Overall, there was a statistically significant difference in outcomes post surgery with regards to pre-operative and post-operative Lysholm and IKDC scores in our patients with a p value < 0.0001, substantiating the need for surgical management of MLKI. With a mean post-operative Lysholm score of 89.11 and mean post operative IKDC score of 85.25, this study showed functionally good results in the patients treated in a single sitting. 28 of 60 patients could get back to their sports activities after atleast 6 months of rehabilitation.ConclusionMLKI are relatively uncommon injuries eluding a large scale prospective clinical studies and consensus regarding its management. In the present study, a male predominance was noted, high velocity injuries like RTA was the most common mechanism of injury. A combination of ACL & MCL accounted for the most common pattern of injury. We could also conclude that surgical management yields good results irrespective of the time since injury i.e. either early (<3 weeks) or delayed (>3 weeks) surgery. Single stage surgical management of MLKI produce considerably better outcomes compared to staged management. It was also found that surgical management of MLKI with reconstruction could help patients to return to their pre operative level of sports activities with a proper rehabilitation protocol.     

Prevalence of injuries among high school students in Eastern and Western parts of Cairo,Egypt

BackgroundInjury is the leading cause of death and long term disability and a significant contributor to healthcare costs among children worldwide especially those aged 15–19 years.ObjectivesTo determine the prevalence of injuries among secondary school students in Cairo, Egypt and to explore the associated risk factors for sustaining injury.MethodologyA Cross-sectional study was conducted on secondary school students in eastern and western part of Cairo; self-administered questionnaire was used for assessing injuries sustained in previous 12 months and the associated risk factors for injury.ResultsThe overall prevalence of injuries was 68.5%. Unintentional injuries were the most common injuries falls (50%) and burns (38.6%). Significant factors associated with sustaining injury were truancy, smoking, alcohol use, quarreling behavior, carrying weapon, threatened by weapon and verbal bullying.ConclusionThis study showed a high prevalence of injuries among high school students in Egypt which necessitates raising public awareness about the magnitude and burden of injuries among adolescents.     

Examination to assess the clinical examination and documentation of spine pathology among orthopedic residents

Background Context

The Accreditation Council for Graduate Medical Education (ACGME) guidelines requires residency programs to teach and evaluate residents in six overarching “core competencies” and document progress through educational milestones. To assess the progress of orthopedic interns' skills in performing a history, physical examination, and documentation of the encounter for a standardized patient with spinal stenosis, an objective structured clinical examination (OSCE) was conducted for 13 orthopedic intern residents, following a 1-month boot camp that included communications skills and curriculum in history and physical examination. Interns were objectively scored based on their performance of the physical examination, communication skills, completeness and accuracy of their electronic medical record (EMR), and their diagnostic conclusions gleaned from the patient encounter.

肿瘤科护士死亡焦虑现状及影响因素分析

目的 了解肿瘤科护士死亡焦虑现状及影响因素,为针对性干预提供参考。方法 采用一般资料调查表、死亡焦虑量表、自尊量表及死亡应对能力量表对河北省7所医院的441名肿瘤科护士进行调查。结果 肿瘤科护士死亡焦虑总分为7.66±1.91;死亡焦虑与自尊及死亡应对能力呈负相关（均P＜0.05）。多因素分析结果显示,薪资、参加死亡教育、自尊及死亡应对能力是死亡焦虑的主要影响因素（均P<0.05）,可解释总变异的59.0%。结论 肿瘤科护士死亡焦虑处于较高水平,受多种因素的影响;医院管理者应予以重视,并制订和落实针对性干预方案以缓解肿瘤科护士死亡焦虑情绪。     

肿瘤科护士伦理行为现状及影响因素分析

目的 了解肿瘤科护士伦理行为现状,分析其影响因素,为制定针对性干预措施提供参考。方法 便利抽取郑州市3所三级甲等医院肿瘤科护士552人,采用一般资料调查表、护士伦理行为量表、拉什顿道德复原力量表、医院伦理氛围量表进行调查。结果 肿瘤科护士伦理行为得分为(75.85±10.75)分。多元线性回归分析结果显示,工作年限、道德韧性、医院伦理氛围是肿瘤科护士伦理行为的主要影响因素(均P<0.05),共解释总变异的50.0%。结论 肿瘤科护士伦理行为处于中等偏上水平。护理管理者可通过提升肿瘤科护士道德韧性水平,营造良好的医院伦理氛围,从而改善肿瘤科护士伦理行为。     

肿瘤科护士应对死亡工作自我能力现状及影响因素分析

目的 了解肿瘤科护士应对死亡工作自我能力现状并分析其影响因素。方法 选取356名肿瘤科护士为研究对象,采用一般资料调查表、死亡工作自我能力量表、生命意义感量表、职业倦怠量表进行问卷调查。结果 肿瘤科护士应对死亡工作自我能力得分为(57.83±8.75)分,情绪应对自我能力得分率最低。多元逐步回归分析显示,生命意义感、个人成就、葬礼经历、参与死亡/濒死患者照顾是否造成影响、死亡相关课程培训是其主要影响因素(均P<0.05)。结论 肿瘤科护士应对死亡工作自我能力处于中等水平,影响因素较多,护理管理者需明确护士应对死亡工作中的需求,积极开展应对患者死亡工作相关培训。     

肿瘤科护士安宁疗护核心能力及影响因素分析

目的 调查肿瘤科护士安宁疗护核心能力现状,分析其影响因素,为制订针对性的干预措施提高肿瘤科护士的安宁疗护核心能力提供参考.方法 采用肿瘤科护士安宁疗护核心能力问卷对辽宁省11所医院的613名肿瘤科护士进行调查.结果 肿瘤科护士安宁疗护核心能力总分为123.30±27.09分,条目均分为3.08,其中教育、协作与专业发展...     

死亡应对量表的汉化及信效度检验

目的 引进并翻译死亡应对量表并在肿瘤科护士中检验其信效度.方法 按照Brislin翻译模式对英文版量表进行直译和回译,采用专家咨询及预试验对中文版量表进行初步检验;选取全国5所三级甲等肿瘤专科医院的446名肿瘤科护士进行信效度验证.结果 中文版量表包括6个因子共28个条目,S-CVI为0.987,I-CVI为0.832...     

Control of burn wound infections by pefloxacin and its silver derivative

As might be anticipated, strains of Pseudomonas aeruginosa resistant to silver sulfadiazine have appeared. We have found an analogue of nalidixic acid (pefloxacin) which, along with its silver derivative, is highly effective against these resistant strains. In vitro the minimal inhibitory concentrations are 10 to 20 times lower than that of silver sulfadiazine against bacteria. In burned mice and rats infected with silver sulfadiazine resistant pseudomonas strains, mortality in groups receiving topical therapy with pefloxacin and silver pefloxacin is about 10 per cent compared to 80 per cent with silver sulfadiazine (100 per cent in untreated controls). There is little systemic absorption of pefloxacin and no absorption of silver from topical treatment. In addition, silver pefloxacin exhibits higher antifungal activity in vitro.