Does occupation explain gender and other differences in work-related eye injury hospitalization rates?

OBJECTIVE: We sought to determine whether demographic differences in eye injury rates persist after adjusting for occupational exposure. METHODS: On-duty eye injury hospitalizations were linked to occupation among active-duty US Army personnel. RESULTS: Eye injury rates were higher for white soldiers, men, and for younger soldiers, even after adjusting for occupational group and specific job titles using multivariate models. CONCLUSIONS: This finding contrasts with studies of other injuries, suggesting that occupation does not fully account for variations in eye injury risk. Because protective eye-wear can prevent most serious eye injuries, we hypothesize that differences in protective eye-wear use between men and women may contribute to differences in eye injury rates, although follow-up studies are needed to confirm this. Prevention efforts should consider targeting high-risk demographic groups in addition to high-risk occupations.     

Survey of injuries among West End performers

OBJECTIVES: To obtain more information about injuries of West End performers. METHODS: A retrospective survey of 269 performers appearing in 20 West End productions (12 dramas and eight musicals). RESULTS: In current productions, 46% of all performers sustained at least one injury for an average of 0.87 injuries per performer. Lower extremity injuries were the most common for dancers (52.2% of injuries) and actors (43.2%) with neck and back injuries the second most common. Sprains and strains were the most common diagnoses. 61% of performers thought that their injuries were preventable. Most performers consulted nonphysician healthcare providers. Factors significantly influencing the risk of injuries for performers include female sex, a history of previous injuries, missed performances due to previous injuries, more physically demanding roles, and performing on raked (angled) stages. CONCLUSION: West End performers commonly sustain injuries. Although primary prevention of most theatrical injuries is not possible, modification of raked stages may reduce the incidence. This study may be helpful to the growing number of healthcare providers who practice performing arts medicine and may stimulate additional concern and research in the medical and theatrical communities about the performance injuries of professionals, amateurs, and theatrical students worldwide.

 

     

Tractor-related injuries: a population-based study of a five-state region in the Midwest

BACKGROUND: Tractor-related injuries are among the most severe of agricultural injuries. This study identifies the incidence, consequences, and potential risk factors for tractor injuries among 3,765 agricultural households in a five-state region. METHODS: Demographic, injury, and exposure data were collected for two 6-month recall periods in 1999 using computer assisted telephone interviews. A causal model served as a basis for survey design, data analysis, and interpretation of results; associated directed acyclic graphs guided development of multivariate models. RESULTS: The overall injury rate was 9.6 events per 1,000 persons per year. Increased personal risk was observed for males and prior agricultural injury experience. Compared with ages 35-44, decreased risks were identified for those less than 5, 5-9, 10-14, 15-19, and 20-24. CONCLUSIONS: Risk of tractor injury among agricultural household members varied by gender, age, and prior injury experience. .     

The effect of cigarette smoking on musculoskeletal-related disability

BACKGROUND: This study describes cigarette smoking's effect on development of physical disability following initial musculoskeletal-related hospitalization. METHODS: We followed 15,140 US Army personnel hospitalized for common musculoskeletal disorders between 1989-1996 for up to 8 years (1997) to assess risk for long-term physical disability. RESULTS: Trends between increased smoking level and long-term disability were identified for persons with knee injuries, rotator cuff injuries, and intervertebral disc displacement. In proportional hazards models, disability was significantly associated with heavy smoking among all subjects (relative hazard (RH) = 1.21). Both heavy smokers (RH = 1.49) and light to moderate smokers (RH = 1.44) were at greater risk for disability following meniscal injuries. Excess fraction due to smoking among subjects with meniscal injuries who currently smoke was 38%. CONCLUSIONS: Findings suggest an association between smoking and development of disability following meniscal injury. Given the high excess fraction of disability associated with smoking, other studies are needed to confirm this association.     

Predictors of occupational low back disability: implications for secondary prevention

Over the past decade, studies have identified a combination of demographic, physical/medical, ergonomic, and psychosocial factors in the development of work disability related to occupational low back pain. Using such data on disability risk factors, investigators have begun to develop risk identification and disability prevention programs. As part of an ongoing effort to develop a secondary prevention program, the present case-control study identified the relative contribution of demographic, physical demand, physical fitness, as well as occupational and individual psychosocial variables to back-related work disability in the US Army. Soldiers (n = 174) diagnosed with a lumbosacral strain and medically discharged from the Army were compared with non-disabled controls (n = 173). Dependent measures were obtained from the US Army Health Risk Appraisal (HRA). For cases, these data pre-dated disability determination by 1 to 3 years. For controls, the HRA was completed during the same time period. Significant predictors of low back disability were: age (odds ratio [OR] = 1.13 per year), lower rank (E2/E3) (OR = 4.08/OR = 3.02), infrequent aerobic exercise (OR = 2.2), higher work stress (OR = 2.71), worries (OR = 2.17), and lower social support (OR = 5.07). The model correctly classified 73.13% of all subjects. These results highlight the importance of considering age, status level in the organization, frequency of aerobic exercise, occupational stress, general worries, and social support for the early detection of soldiers at increased risk for back-related disability. Additionally, the findings support past research indicating the multivariate nature of work disability and emphasize the importance of considering such factors in future secondary prevention efforts.     

Equal opportunities, equal risks? Overuse injuries in female military recruits

BACKGROUND: The rate of female personnel medically discharged from service in the British Army has been rising steadily since 1992 from around 3 per 1,000 per year to over 35 per 1,000 in 1996, although there has been only a minor increase in medical discharges for males over the same period. This paper examines the increasing rate of medical discharge in young female members of the British Army from an aetiological perspective and reviews the literature to identify risk factors that may be relevant. METHODS: Data from published military medical statistical reports were reviewed and the clinical records of a 10 per cent sample of females medically discharged for relevant conditions were examined. RESULTS: The majority of the excess medical discharges had occurred in females under the age of 22 and were due to musculoskeletal disorders and injuries caused by military training. Data from the clinical records showed that 75.5 per cent (37/49) of those medically discharged for these conditions were recruits. Stress fractures and other overuse syndromes accounted for 70.2 per cent of medical discharges among the recruits in the sample. CONCLUSION: Females undertaking strenuous exercise alongside males are at increased risk of injury. Risk factors include smoking, short stature, restricted dietary intake and menstrual disturbance. Equal opportunities legislation has been interpreted to require identical training for males and females, but some segregation of training may be acceptable provided the outcome of training is no less favourable to either gender, and this may reduce the excess risk of injury to females.     

The causes and consequences of injury in students at UK institutes of higher education

BACKGROUND: Injuries are the leading cause of mortality and also an important cause of permanent disability in young people living in developed countries. This study aimed to inform injury prevention programmes by assessing the incidence of injury and disabling injury, and identifying factors predicting injury in students at institutes of higher education, an under-researched group with regard to injury studies. METHODS: Secondary analysis of data obtained from a postal questionnaire survey of 1208 students at three institutions in the UK. RESULTS: Eighteen percent (222/1208) of students reported at least one injury requiring medical attention in the last year. Males and younger students were at greater risk, as were those who reported 'seeking out risky activities because they enjoyed potential danger'. Seventy-nine percent of reported injuries caused some degree of, at least temporary, disability. Four percent of students reported an injury in the last year that interfered with studies, work or other regular daily activities for at least 1 month. Team sports increased the risk of injury by a factor of 2.5 independently of age, gender and risk-taking attitudes. Sport/physical activity injuries were much more likely to be disabling than injuries attributable to other causes. CONCLUSIONS: There is a need for injury prevention programmes among students at institutes of higher education. Programmes need to disseminate the risk of disabling injury, particularly that attributable to participation in sport/physical activity. There is an urgent need for those working on injury prevention to collaborate with those working on other aspects of health promotion to define the net health gain from participation in sport/physical activity and to develop coherent public health messages.     

Is obesity associated with injuries among young people?

Objectives: To look at the relationship between obesity and trauma among young people in the Hainaut Province in Belgium. Design: A cross-sectional study (questionnaire and physical examination) was conduced among a sample of 2363 children of 9- to 17-year-olds (n = 2363) in 1998. Results: In the past 12 months prior to the survey, 37% of the sample had at least one injury requiring treatment (with or without hospitalization), and 5% had a severe injury (with at least one night at the hospital). More than 15% were classified to be obese according to the WHO definition. We observed a significantly higher frequency of injury in obese people, in boys, in subjects playing sport intensively, with members of a sports club and in those reporting more than one physical activity per week. In multivariate analysis for injury, gender, physical activity, playing sport in a club and obesity were significant. For severe injuries, only gender and physical activity remained significant in the multivariate analysis. Conclusion: Our analysis shows that childhood obesity and physical activity increase the occurrence of injuries. However, we did not observe an association between obesity and severe injuries. Obesity as a risk factor for the occurrence of injuries has to be confirmed by other studies, and the understanding of the mechanism for the observed association needs more investigation.     

Injury in Australian veterinarians

BACKGROUND: There are a number of risk factors for traumatic injury in veterinary practice but there is little information on the prevalence of injuries or the factors associated with injury in this profession. AIMS: To identify the prevalence of injuries sustained by veterinarians and the groups most at risk for different types of injury. METHODS: Cross-sectional survey of Australian veterinarians. Subjects were asked whether they had ever had a significant work-related injury, a less serious acute work injury in the last 12 months, a work-related chronic musculoskeletal problem or dog or cat bites. The prevalence of injuries by gender, practice type and decade of graduation were reported and multivariate logistic regression was used to examine the risk of each type of injury. RESULTS: Of 2800 veterinarians, over half (51%) reported a significant work-related injury during their career while 26% of practitioners reported having at least one injury in the previous 12 months. Chronic work-related musculoskeletal problems were reported by 49% of respondents. Dog and cat bites were also very common. After adjusting for graduation year and university, males were more likely than females to have experienced cat or dog bites or have a chronic or significant injury, and large animal veterinarians were most likely to have chronic or significant injuries. CONCLUSIONS: A high injury prevalence was found among Australian veterinarians with large animal practitioners at highest risk. This is the largest study of Australian veterinarians to have been reported and has shown that injuries are common and serious in the profession.     

A survey of injuries among Broadway performers.

To obtain more information about injuries of Broadway performers, 313 performers appearing in 23 Broadway companies were surveyed. The percentage of performers injured was 55.5%, with a mean of 1.08 injuries performer. Lower extremity injuries were the most common. Sixty-two percent of performers believed that their injuries were preventable. As this study reports factors that significantly increase the risk of injury for dancers and actors, it may help to heighten concern with reducing the incidence of injuries to professional performers, theatrical students, and nonprofessionals worldwide.     

Relationships between depressive symptoms and self-reported unintentional injuries: the cross-sectional population-based FIN-D2D survey

ABSTRACT: BACKGROUND: There is a lack of knowledge on the influence of different levels of physical activity (PA) on unintentional injuries among those with depressive symptoms (DS). The aim of this study was to evaluate the relationship between PA categories and unintentional injuries among participants with and without DS based on a cross-sectional population-based FIN-D2D survey conducted in 2007. METHODS: Out of 4500, 2682 participants (60 %) aged 45-74 years attended in this study. The unintentional injuries over the past year were captured in a questionnaire. DS were determined with the Beck Depression Inventory (equal or higher than 10 points) and PA with the International Physical Activity Questionnaire. The statistical significance between DS and unintentional injury categories was evaluated by using t-test, chi-square test, or permutation test, analysis of covariance, or regression models. The factors related to unintentional injuries were estimated by univariate and multivariate logistic regression models. RESULTS: The proportion of subjects with unintentional injuries was higher among those with DS (17%) compared to those without DS (10%) (age- and gender-adjusted p=0.023). The median (range) number of activity-loss days after injury was 22 (0-365) in participants with DS and 7 (0-120) in participants without DS (p=0.009). The percentage of subjects with unintentional injuries was not significantly different between PA categories in participants with DS and without DS A stepwise multivariate logistic regression analysis showed that DS, functional ability, and musculoskeletal diseases were related to unintentional injuries. CONCLUSIONS: PA level was not related to unintentional injuries, whereas those with DS had a higher prevalence of unintentional injuries and prolonged activity-loss after injury. These results underline the importance of injury prevention, especially among those who have DS and additional risk factors.     

海军军事训练伤研究进展

对军事训练伤、骨骼肌肉损伤和骨骼肌肉疾患三个概念进行区分和鉴别,全面总结军事训练伤的危险因素(个体因素、体能素质和活动量、行为习惯、训练组织管理、环境心理等)和目前主要的干预策略(健康宣教、训练组织、心理辅导、医务督导和营养供给);提出未来军事训练伤的研究方向和重点:明确军事训练伤的概念,增强训练伤研究方法科学性,加强训练伤研究内容系统性,提升训练伤防治研究的内涵.     

Seasonal variations in injury rates during US Army Basic Combat Training

OBJECTIVES: Previous literature suggests that injury rates during physical activity may be higher in the summer than in the fall or winter, possibly due to the greater amount or intensity of physical activity in the summer. This study examined seasonal differences in injury incidence during US Army Basic Combat Training, where physical activity was similar at all times of the year. METHODS: Four independent groups of subjects (total n = 1543 men and 1025 women) were investigated, two training in the summer and two training in the fall. Injury data were obtained from a retrospective review of the subjects' medical records at the conclusion of the 8 week training program. RESULTS: For men, the corrected relative risk of suffering an injury or a time loss injury in the summer was, respectively, 2.0 [95% confidence interval (CI) = 1.7-2.4] and 2.5 (95% CI = 1.9-3.0) times higher than in the fall. For women, the corrected relative risk of suffering an injury or time-loss injury in the summer was, respectively, 1.4 (95% CI = 1.3-1.6) and 1.7 (95% CI = 1.5-2.0) times higher than in the fall. These risks were essentially unchanged after adjustment for subject physical characteristics (age, stature, body mass, body mass index) and physical fitness (push-ups, sit-ups and 2 mile run), indicating that the summer season was an injury risk factor independent of these variables. Linear correlations (r-values) between maximal daily temperature and injury incidence ranged from 0.92 to 0.97, indicating a strong relationship between these two variables. CONCLUSIONS: These data suggest that injury incidence among physically active individuals is higher in the summer than in the fall and that environmental temperature may provide a partial explanation for this finding.     

Occupational and geographic risk factors for hepatitis B among US Army enlisted personnel during 1980

Hepatitis B hospitalization rates for US Army enlisted personnel were determined by occupation and geographic area for 1980. The only group in the US Army currently recommended to receive hepatitis B vaccine is medical personnel regularly exposed to blood. Other groups of Army personnel, specifically those working in areas of high hepatitis B endemicity, have been thought to be at higher risk. Therefore, this work was undertaken to document hospitalization rates for all personnel using occupational blood exposure criteria as well as geographic area of assignment as risk factors for hepatitis B. The hospitalization rates underestimate true rates of hepatitis B incidence by a wide margin, and therefore were not used to calculate specific costs and specific benefits for a new vaccination strategy. In spite of this limitation, these data were useful for calculating relative risk, attributable risk, and amount of vaccine preventable disease. The risk of hospitalization for blood-exposed employees was consistently higher than that for non-blood-exposed personnel. The magnitude of the relative risk for blood exposure may be as high as 3.8 times or as low as 1.2 times, depending on which occupational comparison group is used. The relative risk of hospitalization in South Korea vs. the United States was 3.1 (p less than 0.0001), that for Europe vs. the United States, 2.1 (p less than 0.0001). Of all occupational and geographic risk comparisons, assignment to South Korea carried the highest attributable risk: 225 per 100,000. The amount of vaccine preventable disease in personnel assigned to South Korea was similar to that in occupationally blood-exposed employees (5.5 vs. 5.2 hospitalized cases per 1,000 vaccinees) after prorating exposure to risk based on average number of days of exposure to risk over three years. These data support the argument that geographic factors are as important as occupational blood exposure in defining risk of hepatitis B hospitalization among the US Army enlisted personnel.     

Social influences and low leisure-time physical activity in young Danish adults.

BACKGROUND: Many youths and adults maintain a sedentary life style and a better understanding of the factors which influence physical activity is needed. This study analyses the association between social factors and low leisure-time physical activity in young adults. METHODS: Three hundred and seventeen children aged 6-18 years participated in a health survey in 1979 and again 13 years later. In this cohort the influence of family factors during childhood on the subsequent risk of low leisure-time activity was analysed using multiple logistic regression. RESULTS: Young women were significantly less physically active during leisure time if over 25 years of age, poorly educated and smokers. In multivariate analysis, childhood smoking was the only variable significantly related to low leisure-time physical activity (OR = 5.6 and 95% CI: 1.4-23.6) in young women. In young men, low leisure-time physical activity was associated with parental work activity. Men whose parents had reported high physical activity during work at the examination in 1976-1978 were less often physically inactive during leisure time (OR = 0.2 and 95% CI: 0.1-0.6) at the follow-up in 1992. CONCLUSIONS: Young smoking girls seem to be a key group in the prevention of both smoking and a sedentary life style.     

Maternal Pre-Pregnancy Nutritional Status and Physical Activity Levels and a Sports Injury Reported in Children: A Seven-Year Follow-Up Study

Objective: Our aim was to analyze dose–response associations between maternal pre-pregnancy body mass index and physical activity levels with childhood sports injury rates. Methods: Participants included pre-pregnant mothers (n = 4811) and their children at the age of 7 years (n = 3311). Maternal anthropometry (height, weight, and body mass index), time spent in physical activity, and education level were recorded. All sports injuries were defined as injuries reported in the past year by the children at the age of 7 years. Results: Children whose mothers were overweight/obese in the pre-pregnancy period were 2.04 (OR = 2.04, 95% CI = 1.12–3.71) times more likely to report a sports injury at the age of 7 years. Underweight mothers exhibited a 74% decrease in the odds of their children reporting a sports injury at follow-up (OR = 0.26, 95% CI = 0.10–0.68). Finally, an increase in maternal physical activity across the last three quartiles was associated with a lower odds of sports injuries. Conclusions: The risk of reporting a sports injury was greater for children whose mothers were overweight/obese in the pre-pregnancy period. However, there was a lower risk with both maternal underweight status and increasing minutes of physical activity.     

Risk groups for sports injuries among adolescents--representative German national data

Background Physical activity during childhood and adolescence is of major importance with regard to an individual's engagement with sports in later life. Apart from the physical trauma, sports injuries often have negative effects on the motivation to remain physically active. This study evaluates data to gain detailed knowledge on 1‐year incidence and risk groups with the aim of providing information for the development of preventive measures. Methods Our data analysis is based on a net sample from a national study in Germany including 7697 children and adolescents aged 11 to 17 years. Within the statistical analyses, we developed weighting factors and calculated group differences as well as regression models for sports injury incidence. Results A total of 7.7% of the children and adolescents reported a sport injury during the last 12 months. Bivariate analyses showed significant associations between sports injuries and several social and lifestyle‐related covariates. After adjustment for participation in leisure time physical activity, age, non‐migrant status and residence in a large city remained positively associated with the incidence of sports injuries. Conclusions In comparison with other results for developed countries, the incidence seems rather high. It remains to be clarified whether this is because of our use of more accurate population‐based data. The results suggest that while developing preventive measures, the interaction between preferences for high‐risk sports and physical as well as psychological development has to be considered.     

Occurrence and Risk Factors of Unintentional Injuries among 12- to 18-Year-Old Finns – A Survey of 8219 Adolescents

The aim of this study was to evaluate the incidence, nature, and risk factors of unintentional injuries among 12-, 14-, 16- and 18-year-old Finnish adolescents. Of the 8219 respondents (response rate 75%) 5.5% reported an injury that had required medical attention during the past month. The total number of injuries was 506 and the incidence of injuries 62 per 1000 person-months. Boys had a slightly higher injury occurrence rate than girls (OR: 1.33; 95% CI: 1.13-1.59). The most common injuries were sprains (27%), fractures (26%) and wounds (16%) of the upper and lower limbs. In multivariate logistic regression analysis the strongest risk factors of injury were: having experienced violence during past month (OR: 3.6; 95% CI: 2.8-4.6), daily leisure time exercise in sports club (OR: 3.3; 95% CI: 2.3-4.6), having several somatic health complaints weekly (OR: 2.2; 95% CI: 1.7-2.9) and having chronic disease (OR: 2.0; 95% CI: 1.5-2.6). In conclusion, injuries were an important cause of morbidity among our 12-18-year-old adolescents. Adolescents' school success and their parents' education, occupation and employment status were not associated with injuries. The finding that several health and health behaviour variables are important risk factors for injuries challenges the researchers and the society to identify and treat the risk factors that can be modified to reduce the number of adolescent injuries.     

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.     

Occupational needlestick injuries in a metropolitan police force

OBJECTIVES: Police officers are at risk of bloodborne diseases through needlestick injuries but few studies have addressed this problem. The purpose of this study was to assess the risk of needlestick injuries in law enforcement officers and to determine predictors of injuries and reporting rates. DESIGN: An anonymous, voluntary questionnaire was distributed to 1738 active-duty, metropolitan police officers. The survey included the number of needlestick injuries ever experienced, how often these were reported, activities at the time of injury and attitudes toward injuries. RESULTS: Of the 803 respondents (46.2% of survey population), 29.7% had at least one needlestick injury, and 27.7% of this group had two or more. Risk factors included evening shifts, pat-down searches, patrol duties, male gender and less experience. Only 39.2% sought medical attention for these injuries. CONCLUSIONS: Needlestick injuries occur with considerable frequency in this group of law enforcement personnel, suggesting an increased risk of becoming infected with bloodborne pathogens, including hepatitis B, hepatitis C and HIV.