Repetitive Strain Injury: Age,Sex and Activity Patterns

Age, sex and activity patterns of 30 females suffering from repetitive strain injury (RSI) were studied by employing a 21 item questionnaire, comprising questions related to the amount of time the subject spent in one week performing work-related, household and leisure activities. The subjects, diagnosed as non-inflammatory RSI, were selected from a large public hospital. The results indicated that RSI is significantly more common in females; that the right hand is affected significantly more often than the left; and that the disease is most prevalent in the 30 year age group. The results also indicated that the homemakers spent significantly more time (p<.05) in household activities than full-time workers. Young age group workers (18–28 yrs.) spent significantly more time (p<.05) in work-related activities than older subjects (29–48 yrs.). Based on these findings, suggestions for further research are offered.     

32例骨科手术神经损伤医疗事故分析

目的分析骨科手术神经损伤的术前病情状况、术后不良后果及神经损伤的直接原因,并探讨防范对策。方法对1999—2009年某市卫生局卫生监督所所存档的32例骨科中神经损伤医疗事故案例进行回顾性分析。结果神经损伤主要因素在于手术操作失误。结论脊椎为最容易发生神经损伤部位;术中操作失误是造成神经损伤主要因素。     

Changing Trends in US Injury Profiles: Revisiting Non-Fatal Occupational Injury Statistics

The purpose of this paper is to review the current trends in non-fatal injury profiles of workers in the United States. It is generally accepted that occupational injury and illness rates are affected by many factors, such as the amount and quality of training, employee turnover rates, work experience, extent of mechanization and automation, job-related parameters, and worker gender. In the last decade, not only have the technologies used in the workplace changed significantly, there has been a greater awareness among employers and employees as to the importance of containing work injuries. Additionally, the extent of outsourcing for labor-intensive jobs has increased dramatically owing to cheaper labor costs in places such as China and Mexico. These changes have affected the manufacturing sector of US industry more than any other sector. How these changes have influenced the injury and illness profiles of the American worker is of considerable interest given the increased attention paid to work-workplace design, injury hazard control, and ergonomics in general. In this paper, we compare the injury and illness profiles of US workers separated by nearly a decade. The trends from early 1990s are compared to those from early 2000s. Data from the Bureau of Labor Statistics were used to compile the injury statistics. The results of our comparison show that while the absolute numbers of work-related injuries and illnesses have declined over the last 10 years, the basic trends associated with different factors remain almost unchanged. The reasons for this decline are discussed in this paper.     

2012-2017年阆中市60岁及以上老年人伤害死亡分析

目的了解阆中市60岁及以上老年人伤害死亡情况、构成特点及其影响因素,为制定防治对策提供科学依据。方法对人口死亡信息登记管理系统中报告的阆中市2012-2017年60岁及以上老年人伤害死亡数据进行描述性统计分析。结果2012-2017年阆中市因伤害死亡2870人,粗死亡率为55.25/10万,其中60岁及以上老年人伤害死亡1317人,平均粗死亡率为143.84/10万,标化率为153.34/10万,占全人群伤害死亡45.89%。男性死亡率(157.98/10万)高于女性(129.39/10万),差异有统计学意义(χ^2=13.029,P<0.01)。意外跌落居老年人伤害死亡原因首位(占30.98%),其次是自杀、机动车辆交通事故、淹死、意外中毒,前5位伤害原因占总伤害死亡的87.93%。结论阆中市60岁及以上老年人伤害死亡率较高,且呈逐年上升趋势。应根据主要伤害死亡的类型、特点制定综合防治措施,降低伤害死亡率。     

2013年浙江省台州市居民伤害死亡原因分析

[目的]了解2013年浙江省台州市居民伤害死亡原因及其分布特点,为伤害预防策略制定提供依据.[方法]对2013年浙江省台州市死亡监测数据采用“死亡医学登记系统(2005版)”(DeathReg 2005)和SPSS 13.0软件进行伤害死亡描述性统计分析. [结果] 2013年浙江省台州市伤害死亡率为63.91/10万,占死亡总数的11.05％,位居第5位.按潜在寿命损失年数(YPLL)进行排位,位居第2位.男性伤害死亡率为75.65/10万(标化死亡率73.44/10万),女性伤害死亡率为51.54/10万(标化死亡率48.43/10万).城市伤害死亡率为65.53/10万,农村为63.32/10万.伤害前5位死因依次为意外跌落、机动车辆交通事故、溺水、自杀、其他意外事故和有害效应.0～1岁组以窒息为主;1～14岁组以溺水为主,占该年龄段伤害死亡的43.05％;15～64岁组以交通事故为主,占该年龄段伤害死亡的33.14％;65～岁组以意外跌落为主,占该年龄段伤害死亡的49.48％. [结论]伤害是浙江省台州市居民的主要死亡原因之一,根据不同年龄阶段伤害死亡的流行特征,急需制定有效的控制策略,开展针对性的综合防制措施.     

Urban-Rural Disparities in Injury Mortality in China, 2006

Context: Urban-rural disparity is an important issue for injury control in China. Details of the urban-rural disparities in fatal injuries have not been analyzed.
Purpose: To target key injury causes that most contribute to the urban-rural disparity, we decomposed total urban-rural differences in 2006 injury mortality by gender, age, and cause.
Methods: Mortality data came from the Chinese Vital Registration data, covering a sample of about 10% of the total population. The chi-square test was used to test the significance of urban-rural disparities.
Findings: For all ages combined, the injury death rate for males was 60.1/100,000 in rural areas compared with 40.9 in urban areas; for females, the respective rates were 31.5 and 23.6/100,000. The greatest disparity was at age <1 year for both sexes, where the rate from unintentional suffocation in rural areas was more than twice the urban rate. The higher mortality from drowning among males of all ages and among females ages 1-24 and 35+ contributed substantially to the age-specific urban-rural disparities. For both sexes, transportation incidents and suicide were the most important contributors to higher rates among rural residents ages 15+.
Conclusions: Unintentional suffocation, drowning, transportation incidents, and suicide not only are the major causes of injury death, but also play a key role in explaining the urban-rural disparities in fatal injuries. Further research is needed to identify factors leading to higher rural death rates and to explore economical and feasible interventions for reducing injuries and narrowing the urban-rural gap in injury mortality.     

邳州市1990—1999年居民意外伤害死亡原因及趋势分析

目的为探讨邳州市居民意外死亡的水平、原因、分布特征及变动趋势.方法采用2×C表线性回归的显著性检验原理结合流行病学方法,对本地区1990～1999年意外死亡者分布特点,死亡率、减寿率作趋势分析.结果10年间意外伤害死亡率平均为84.81/10万,在全死因中次于呼吸系病、恶性肿瘤、循环系疾病居第4位,而在潜在寿命损失(YPLL)居首位.意外伤害死亡率呈下降趋势(P＜0.01),但标化死亡率(84.96/10万)仍高于全国(65.24/10万)和全国农村(72.10/10万)人群的水平,YPLL下降也有极显著意义,但幅度和速度均超过死亡率下降水平.结论提示意外死亡是当前影响居民健康的重要原因.但对寿命影响程度减少.     

Multimorbidity Patterns and 5-Year Mortality in Institutionalized Older Adults

ObjectivesThe aim was to characterize multimorbidity patterns in a large sample of older individuals living in nursing homes (NHs) and to investigate their association with mortality, also considering the effect of functional status.DesignObservational and retrospective study.Setting and ParticipantsWe analyzed data on 4131 NH residents in Italy, aged 60 years and older, assessed through the interRAI long-term care facility instrument. Entry date was between 2014 and 2018, and participants were followed until 2019.MethodsMultimorbidity patterns were identified through principal component analysis; for the identified components, subjects were stratified in quintiles (Q) with respect to their loading values, with the higher quantiles indicating greater expression of the component's pattern. Their association [hazard ratio (HR) and 95% CI] with mortality was tested in Cox regression models. Analyses were stratified by disability status.ResultsFour patterns of multimorbidity were identified: (1) heart diseases; (2) dementia and sensory impairments; (3) heart, respiratory, and psychiatric diseases; and (4) diabetes, musculoskeletal, and vascular diseases. For the heart diseases pattern [HR Q5 vs Q1 = 1.83 (1.53–2.20)] and the dementia and sensory impairments pattern [HR Q5 vs Q1 = 1.23 (1.06–1.42)], as the specific multimorbidity expression increases, the risk of mortality increases. On stratifying by disability status, the association between the multimorbidity patterns and mortality was not always present.Conclusions and ImplicationsDifferent multimorbidity patterns are differentially associated with mortality in older residents of NHs, confirming that multimorbidity's prognosis is strictly dependent on the underlying disease combinations. This knowledge may be useful to implement personalized preventive and therapeutic care pathways for institutionalized older adults, which respond to individuals’ health needs.     

镇江市院前救治的创伤性脑损伤患者特征分析

目的分析镇江市急救中心院前救治的创伤性脑损伤(TBI)患者的特征。 方法采用回顾性分析方法，对镇江市急救中心在2019年1月至2019年12月间收治的212例TBI患者进行描述性分析。其中男性115例(54.2%)，女性97例(45.8%)；年龄0(新生儿)~84岁，平均(30.5±11.5)岁；男∶女＝1.2∶1。分析患者的一般资料、损伤特征和干预措施等。 结果212例TBI患者中最常见的致伤原因是道路交通事故(155例，73.1%)、其次是殴打(26例，12.3%)和跌倒(16例，7.5%)。损伤部位以下肢为最多见(175例，82.5%)，其次是上肢(85例，40.1%)。其中损伤部位≥2处的患者87例(41.0%)。大多数患者为轻度脑外伤(格拉斯哥昏迷评分≥13分；182例，85.8%)。针对创伤患者最常见的干预措施是吸氧(198例，93.4%)，其次止血包扎(179例，84.4%)，夹板固定(129例，60.8%)、输液(79例，37.3%)和用颈托固定(39例，18.4%)。 结论TBI的主要原因是道路交通事故，需要进一步努力做好道路交通安全工作以更好地预防TBI。院前对脑损伤患者的救治手段和方法还需进一步专业化。     

交通运输化学事故中的医学救援特点、措施及建议

通过对事故案例的调查分析，运用分类对比、综合归纳、现况分析等方法，研究了军队医院应对交通运输化学事故的救援特点、措施并提出了几点建议，希望为建立健全我国的化学事故应急救援体系提供参考。     

海宁市道路交通事故原因与疾病负担评价

目的探讨道路交通伤亡事故（简称车祸）原因与疾病负担。方法应用2001年全市车祸现场勘察信息及其相关资料，对车祸的成因、流行特征、人体损伤部位、经济损失情况等进行综合分析研究，并计算平均潜在寿命损失年（YPLL）、潜在工作寿命损失年（WYPLL）和潜在价值寿命损失年（VYPLL）在全死因中的位次。结果2001年海宁市人口车祸发生率188．59／10万、人口死亡率22．48／10万；万车事故发生率151．73、万车死亡率18．10。事故原因分析显示：人的因素占93．1％、其中驾驶员因素占89．4％，主要表现在：不按规定让行、措施不当、疏忽大意、纵向间距不够、违章行驶等；直接经济损失3127万元，平均每宗交通事故2．59万元，车祸导致的人均YPLL、WYPLL、VYPLL位居各类主要死因之首。结论提高驾驶员的综合素质，是预防车祸发生的关键。     

我国老年人伤害死亡率的meta分析

目的 综合评价我国老年人伤害死亡率的情况,为预防老年人伤害提供依据。方法 系统检索中国知网、万方数据库、中国生物医学文献数据库、维普及PubMed数据库,收集2007－2017年发表的与我国老年人伤害死亡率相关的文献,采用meta分析的方法,计算合并的伤害死亡率,分性别、城乡进行亚组分析,并对结果进行敏感性分析和发表偏倚的评价。结果 共纳入符合标准的文献23篇,总样本含量32 591 537人,老年人合并伤害死亡率为：173.93/10万(95%CI：155.20/10万～192.67/10万),男性伤害死亡率(178.92/10万)高于女性(159.08/10万),农村老年人伤害死亡率(244.27/10万)高于城市(164.34/10万),二者差别均有统计学意义(P＜0.001)。结论 我国老年人伤害死亡率处于较高水平,性别、城乡之间存在差异,应采取针对性干预措施,降低老年人伤害死亡率。     

2009年上海市松江区48630例首诊伤害病例流行病学分析

[目的]探讨上海市松江区人群伤害的流行病学特征,为制定针对性的干预措施提供科学依据.[方法]对2009年1月1日至12月31日在松江区3家伤害监测哨点医院就诊并被诊断为伤害的首诊伤害病例(不包括犬伤伤害病例)按全国伤害监测报告卡填报收集并作数据分析.[结果]2009年共报告伤害病例48630例,男女性别比为1.75∶1...     

云浮市化学中毒突发事故危害评估与医学应急救援系统

目的发生化学中毒突发事故时,能够快速、准确、简便、实用的对事故进行危害评估,提出相应的医学应急救援方案,指导相关部门对事故进行救援工作。方法广东省职业病防治院提供系统计算机模块,调查收集云浮市存放、使用危险化学源资料,形成危险化学源概况模块,建立开放的计算机评估平台。结果该系统包括发生事故危害评估及应急方案、预测化学事故危害并制定应急预案、档案管理、职业病危害评价等功能模块,并建立化学品毒性数据库,便于对化学事故危害评估和提供应急救援措施。结论该系统具有较好的科学性、先进性和可行性,可以对云浮市发生的突发化学中毒事故进行定量危害评估,提出相应的医学应急救援预案、毒物应急救援方法措施,为相关部门对突发公共卫生事故现场应急救援的决策提供科学数据。     

Injury mortality in the European Union 1984-1993: An overview

Background: Approximately 190,000 European Union (EU) citizensdie annually as a result of an injury. In response, the EuropeanCommission identified accidents and injuries as a priority areafor action in the field of public health in 1993. In 1984, theWorld Health Organization (WHO) Health for All targets wereset in Europe to reduce unintentional injuries by 25% and reversethe rising trends in suicide by the year 2000. The aim of thisstudy was to examine the trends in mortality due to externallycaused physical injuries between 1984 and 1993 in the 15 countrieswhich are currently members of the EU. Methods: Injury mortalitydata for all countries were obtained from the WHO and nationalgovernment agencies. Age-standardized mortality rates were calculatedfor both unintentional and intentional injuries and examinedover time. Results: Downward trends in age-standardized injurymortality due to unintentional injuries were identified in mostcountries. Marked variations were observed between countries,with low rates in the UK, The Netherlands and Sweden and highrates in Finland, Portugal and France. Age-standardized suiciderates decreased In most countries over the study period, withmarked variations between countries. In general, countries innorthern Europe experienced higher suicide rates than countriesin southern Europe. Mortality rates due to homicide and otherviolent causes were low and relatively stable over the studyperiod. Conclusions: Most countries appear to be on track tomeet the WHO targets for unintentional injury mortality andsuicide mortality. However, disparities between countries remain,for reasons that are unclear. While mortality data were valuablein describing the epidemiology of fatal injury in Europe, agreementon standardized practices of data collection, coding and analysiswould improve the comparability of data between countries.     

上海世博会园区内伤害流行病学特征分析

[目的]了解中国2010年上海世博会（简称“上海世博会”）园区内伤害流行病学特征。[方法]利用“中国2010年上海世界博览会园区内就诊异常情况监测和报告系统”（后称“就诊监测报告系统”）,观察上海世博会园区内伤害病例,对其伤害原因、伤害性质等流行病学特征进行调查分析。[结果]从2010年5月1日至10月31日,伤害监测系统共收集12505例伤害病例。5月份游客伤害发生率最高（月均3．01／万）,在世博局采取健康宣教以及改善园区内设施等一系列干预措施后,游客伤害发生率逐步下降,从5月初的4．50／万降低到最后一周的0．80／万。伤害分别是≥65岁和0～14岁游客的第1和第3位就诊原因。游客的主要伤害原因是跌倒和坠落。但是园区内最主要的伤害性质是挫伤和擦伤。[结论]上海世博会园区内伤害发生特征表明,在大型活动中,及时进行健康干预能有效地降低伤害的发生。     

Injury and illness in the American workplace: A comparison of data sources

Setting priorities for workplace health and safety research depends upon accurate and reliable injury and illness data. All occupational health databases have limitations when used to summarize the national scope of workplace hazards. The comparison of data from multiple sources may produce more credible estimates of the leading occupational injuries and illnesses. The purpose of this paper is to describe the strengths and weaknesses of six data collection systems that record occupational injuries and illnesses on a national level and to compare the leading estimates from these systems for 1990. The six systems are: 1) National Traumatic Occupational Fatalities database, 2) the Bureau of Labor Statistics Census of Fatal Occupational Injuries, 3) The Bureau of Labor Statistics Annual Survey data, 4) a large workers' compensation database, 5) the National Council on Compensation Insurance data, and 6) The National Electronic Injury Surveillance System. Occupational injuries, as defined herein, predominate over illnesses in terms of the number of cases and the overall costs. Databases that provide information on the antecedents of injuries suggest how these injuries may be prevented and warrant more attention and refinement. © 1996 Wiley-Liss, Inc.     

天长市2000-2004年居民损伤中毒死亡原因分析

目的了解天长市居民损伤中毒死亡水平及对居民健康危害程度,为制定损伤中毒死亡的预防决策提供科学依据。方法对本市2000—2004年居民死亡资料按《国际疾病分类(ICD-9)》编码,录入微机,使用DeathReg软件生成报表进行分析。结果我市5年来居民损伤中毒总死亡人数为1553人,男性死亡率为62.03/10万,女性死亡率为41.22/10万;死因顺位为机动车事故占首位(27.50%),第2位为自杀(22.41%),第3位为淹死(21.12%),我市损伤中毒死亡随时间推移呈增高趋势。结论损伤中毒死亡已对本市居民健康构成了严重的危害,应根据不同年龄段的人群,制定不同的预防措施。     

Traumatic Brain Injury in Older Adults: Characteristics,Outcomes, and Considerations. Results From the American Association for the Surgery of Trauma Geriatric Traumatic Brain Injury (GERI-TBI) Multicenter Trial

ObjectivesDescribe the epidemiology of a large cohort of older adults with isolated traumatic brain injury (TBI) and identify predictors of mortality, palliative interventions, and discharge to preinjury residence in those presenting with moderate/severe TBI.DesignProspective observational study of geriatric patients with TBI enrolled across 45 trauma centers.Setting and ParticipantsInclusion criteria were age ≥40 years, and computed tomography (CT)-verified TBI. Exclusion criteria were any other body region abbreviated injury scale score >2 and presentation at enrolling center >24 hours after injury.MethodsThe analysis was restricted to individuals aged ≥65 and stratified into 3 age groups: young-old (65–74), middle-old (75–84), and oldest-old (≥85). Demographic, clinical, and injury data were collected. Predictors of mortality, palliative interventions, and discharge to preinjury residence in the moderate/severe TBI group were identified using Classification and Regression Tree and Generalized Linear Mixed Models.ResultsOf the 3081 subjects enrolled in the study, 2028 were ≥65 years old. Overall, 339 (16.7%) presented with a moderate/severe TBI and experienced a 64% mortality rate. A Glasgow Coma Scale (GCS) score <9 was the main predictor of mortality, CT worsening (odds ratio [OR] = 1.7, P < .04), cerebral edema (OR = 2.4, P < .04), GCS <9, and age ≥75 (OR = 2.1, P = .007) were predictors for palliative interventions, and an injury severity score ≤24 (OR = 0.087, P = .002) was associated with increased likelihood of discharge to preinjury residence in the moderate/severe TBI group.Conclusion and ImplicationsIn this prospective study of a large cohort of older adults with isolated TBI, comparisons across the older age groups with moderate/severe TBI revealed that survival and favorable discharge disposition were influenced more by severity of injury rather than age itself. Indicating that chronological age alone maybe insufficient to accurately predict outcomes, and increased representation of older adults in TBI research to develop better diagnostic and prognostic tools is warranted.     

Work accident victims: a comparison between non-standard and standard workers in Belgium

Background: The fast growth of non-standard employment in developed countries highlights the importance of studying the influence of contract type on worker’s safety and health.

Objective: The main purpose of our study is to investigate whether non-standard workers are more injured than standard workers or not. Additionally, other risk factors for occupational accidents are investigated.

Methods: Data from the Belgian surveys on work ability in 2009 and 2011 are used. During their annual occupational health examination, workers were asked to fill in a self-administered questionnaire. In total, 1886 complete responses are collected and analyzed using logistic regression.

Results: Temporary workers did not have higher injury rates than permanent workers [OR 0.5, 95% confidence interval 0.2–1.2]. Low-educated, less-experienced workers and those exposed to dangerous conditions are more frequent victims of occupational accidents.

Conclusion: The present data do not support the hypothesis that non-standard workers have more injuries than standard workers. Our results about occupational accidents derived from a non-representative sample of the Belgian workforce and cannot be generalized due to the heterogeneity in job organization and labor regulations between countries. Further research is needed to extend our findings and to seek other factors that may be associated with work accidents.