职业紧张与非致死性职业伤害关系的研究

目的评价职业紧张和非致死性职业伤害的关系。方法采用1:1配比的病例-对照调查设计,以2013年10—12月在中山市6家工伤定点医院收治的151名职业意外伤害工人和151名经年龄、性别、工种匹配且在过去一年无意外伤害的同事为调查对象,运用工作内容问卷(Job Content Questionnaire,JCQ)测量职业紧张。结果两组工人的职业紧张包括自主性维度与工作要求维度与对照组相比差异均有统计学意义(均P0.01)。社会支持方面,上级支持维度得分两组差异有统计学意义(P0.05)。使用多因素COX回归拟合条件logistic回归分析结果显示,工作需求高(OR=1.27,95%CI=1.15~1.42)是职业性意外伤害的危险因素,而工作自主性高(OR=0.82,95%CI=0.74~0.91)及上级支持较高(OR=0.84,95%CI=0.69~1.00)是职业性意外伤害的保护因素。结论职业紧张对非致死性职业伤害的发生存在影响。     

某县农村学龄儿童伤害影响因素的病例对照研究

探讨农村学龄儿童伤害发生的影响因素,为开展伤害预防干预提供依据.方法 随机选取某县农村小学、初中各3所学校,分层整群抽取小学三~五年级、中学七~八年级共2 196名学龄儿童作为研究对象;筛选出1年内发生过伤害的354名学龄儿童作为病例组,按照同班级、同年龄、同性别的原则1∶1选取未发生伤害的学龄儿童作为对照组.采用自拟调查表对儿童基本情况及伤害情况进行调查.结果 过去1年内共有354人发生伤害,伤害人数发生率为16.12%;发生伤害375人次,伤害人次发生率为17.08%.非留守儿童(OR=0.467,95%CI=0.248~0.987)是伤害发生的保护因素,身体状况一般(OR=1.801,95%CI=1.187~2.733)、有伤害史(OR=3.161,95%CI=1.611~6.203)、非独生子女(OR=2.071,95%CI=1.413~3.037)是伤害发生的危险因素.结论 农村学龄儿童伤害发生比较普遍,儿童自身因素对伤害的发生有重要影响.     

企业员工职业应激对健康生产力的影响

目的 分析企业员工职业应激对健康生产力的影响.方法 通过横断面调查的方法获取基本数据,采用多因素logistic逐步回归方法分析职业应激与健康生产力的关系.结果 员工的性别、学历、生活方式(吸烟、饮酒、体育锻炼和参加兴趣小组)、工作要求和社会支持对健康所致总体生产力受损有影响.女性(OR=1.60,95%CI=1.30～1.96)、高学历(以高中及以下为参照,大专OR=1.47,95%CI=1.18～1.83;本科及以上OR=1.98,95%CI=1.60～2.42)、高工作要求(以低工作要求为参照,中等工作要求OR=1.60,95%CI=1.27～2.02;高工作要求OR=1.91,95%CI=1.50～2.42)、低社会支持(以低社会支持为参照,中等社会支持OR=0.65,95%CI=0.53～0.80;高社会支持OR=0.63,95%CI=0.49～0.80)、有不良生活方式[吸烟(OR=1.28,95%CI=1.03～1.60)、饮酒(OR=1.35,95%CI=1.11～1.65)、无规律的体育锻炼(以无体育锻炼为参照,OR=0.65,95%CI=0.54～0.78)和未参加单位的兴趣小组(以不参加为参照,OR=0.72,95%CI=0.57～0.90)]会增大健康生产力受损的风险.结论 员工的职业应激程度影响其生产力;适度降低工作要求、增加社会支持,有利于减少因健康所导致的总体生产力损失.     

广州市中学生运动伤害心理应激因素配对病例对照分析

目的探讨中学生心理应激因素对运动伤害发生的影响,为预防和减少中学生运动伤害提供依据。方法随机抽取广州市5所初中和5所高中的学生进行运动伤害筛查,按性别、年龄、班级1∶1配对原则,通过样本量计算选择267对运动伤害病例和对照,采用单因素和多因素条件Logistic回归分析。结果运动时感觉疲倦(OR=6.77,95%CI=3.56～13.89)、运动时感觉焦虑(OR=5.34,95%CI=3.02～11.97)、过去1 a有过伤害史(OR=3.18,95%CI=1.01～7.98)、遭到体育老师的严厉批评(OR=2.73,95%CI=1.23～7.05)以及感觉运动场地恶劣(OR=1.45,95%CI=0.61～3.26)是中学生运动伤害发生的危险因素。结论不良的心理应激可能让中学生运动伤害发生率升高,应注意调整学生运动时的心理状态以及改善教师批评学生的态度与方式。     

滨州市农村小学生意外伤害与社会支持的关系

目的 探讨农村小学生意外伤害的流行特征及其与社会支持的关系。方法 采用两阶段抽样方法抽取滨州市乡镇小学生592名进行问卷调查,建立多因素二分类logistic回归模型分析意外伤害与社会支持的关系。结果 在调查592名农村小学生中意外伤害的发生率为63.2%。农村小学生意外伤害的发生地点主要在家中占64.8%,发生部位以下肢为主占42.8%,严重程度中致残占1.3%。意外伤害的类型主要以跌伤(49.4%)、动物咬伤(12.4%)、碰击伤(11.7%)为主。在控制了其他变量影响后,小学生意外伤害与社会支持的得分仍存在负相关关系(aOR=0.956,95%CI=0.940~0.972)。结论 社会支持高的农村小学生意外伤害的发生率较低,基于社会支持的干预可能对预防小学生意外伤害有一定作用。     

社会心理因素与高血压关系的病例对照研究

目的 :探讨社会心理因素与高血压的相关关系。方法 :以 94名门诊及住院确诊高血压患者为病例组 ,筛选整群抽样的 5 87名无病患职工组成对照组 ,进行病例对照研究 ,调查其社会经济和人口学特征 ,并以相关量表测量其社会心理因素 ,采用非条件 L ogistic回归进行统计分析。结果 :年龄 (OR=1.82 9,P<0 .0 5 )、心理健康状况不良 (OR=2 .737,P<0 .0 5 )和负性生活事件刺激量 (OR=4 .811,P<0 .0 5 )是高血压发生的危险因素 ,而文化程度较高 (OR=0 .196 ,P<0 .0 5 )和家庭月收入较高 (OR=0 .5 4 1,P<0 .0 5 )是其保护因素。结论 :社会心理因素在高血压的发生中起着一定的作用 ,在高血压的防治工作中应当引起重视     

公交司机肌肉骨骼疾患及其危险因素调查

目的调查公交司机肌肉骨骼疾患现况及其危险因素。方法采用横断面研究设计和自填式问卷调查方法对昆明公交集团下属的3个车队公交司机进行整群调查,调查内容主要包括肌肉骨骼系统疾患、职业特征和职业性社会心理因素,采用两分类logistic回归分析探讨影响公交司机肌肉骨骼疾患的危险因素。结果公交司机肌肉骨骼疾患年患病率位于前2位的分别是腰部疼痛(62.6%)和颈部疼痛(62.2%)。两分类logistic回归分析中,控制了混杂因素,工作自主性是公交司机腰部疼痛的保护因素(OR=0.970,95%CI:0.941~0.999);工作生理性要求是公交司机腰部疼痛的危险因素(OR=1.212,95%CI:1.045~1.406)。轮班类型和工作自主性是公交司机颈部疼痛的保护因素,OR值分别是0.431(95%CI:0.249~0.748)和0.958(95%CI:0.928~0.989);工龄和每天平均工作时间是公交司机颈部疼痛的危险因素,OR值分别是1.035(95%CI:1.003~1.069)和1.198(95%CI:1.016~1.411)。结论公交司机的肌肉骨骼疾患与其职业特征和职业性社会心理因素有关。     

广州市中小学生运动伤害危险因素的配对病例对照分析

目的 探讨中小学生运动伤害的危险因素.方法 按性别、年龄、班级1:1配对原则,通过样本量计算选择349对运动伤害病例和对照,采用单因素和多因素条件logistic回归分析.结果中小学生发生运动伤害的危险因素是:鞋底磨损大(OR=7.20,95%CI:2.37～21.84)、疲倦(OR=14.34,95%CI:2.29～89.66)、带病时参加运动的频率高(OR=1.96,95%CI:1.29～3.06)和既往伤害史(OR=2.11,95%CI:1.41～3.96).运动伤害的保护因素:体育训练时有老师指导动作(OR=0.46,95%CI:0.26～0.79)、运动时做防护措施(OR=0.36,95%CI:0.20～0.64)和运动前热身运动的频率高(OR=0.31,95%CI:0.14～0.67).结论 中小学生运动伤害与个人因素、家庭因素和社会因素有关;应提高学生和老师的安全运动意识,减少运动伤害危险行为的发生.     

生育经历、生活满意度对“80后”已婚育职业群体二孩生育计划的影响

目的同步观察生育经历、生活满意度对二孩生育计划的影响,为研究社会心理因素对生育意愿和生育行为的影响机制提供新思路。方法采用横断面现况研究设计、整群抽样方法分别对银川市5家事业单位和5家企业单位中出生日期在1980年1月1日至1990年1月1日的所有在职人员进行调查,获得有效问卷1426份,本次对其中已婚并生育一孩的599人进行分析。结果 37. 01%的"80后"已婚育职业群体有生育二胎打算;多分类Logistic回归分析结果显示,一胎生育经历与生育预期越符合的"80后"已婚育职业群体越倾向于要二胎(OR=2.525, 95%CI:1.584～4.026);生活满意度越高的"80后"已婚育职业群体越倾向于要二胎(OR=0.951,95%CI:0.911～0.992);性别(OR=0.395, 95%CI:0.244～0.639)、文化程度(OR=2.366, 95%CI:1. 353～4. 136)、月收入(OR=0.444, 95%CI:0.229～0. 859)也对其二孩生育计划有影响。结论 "80后"已婚育职业群体做出生育二胎抉择不仅会受到基本人口学、一胎生育经历等客观因素的影响,也会受生活满意度等社会心理因素的影响。     

湘西地区大学生伤害行为及其影响因素分析

目的了解湘西地区大学生伤害行为现状并探讨其影响因素,为制定干预措施及实施健康教育提供参考依据。方法采用随机整群抽样方法对湘西地区在校大学生的伤害行为进行问卷调查,不同特征大学生伤害行为的比较采用X~2检验,影响因素采用Logistic回归分析。结果共调查647名大学生,步行违规、骑车违章、非安全游泳行为报告率分别为1. 2%、12. 5%和10. 0%,其中骑车违章、非安全游泳行为报告率男生均高于女生(P均0.05)。打架行为报告率为6.8%,男生高于女生(P0.01);自杀意念、常心情不愉快、常孤独报告率分别为:9.3%、11.6%和7. 7%,年级之间均存在显著差异(P均0.05)。骑车违章行为的危险因素有男生(OR=1.829, 95%CI:1.132～2.954)、自杀意念(OR=2.496, 95%CI:1.294～4. 816);抑郁行为的危险因素有城镇(OR=1.742, 95%CI:1.082～2.806)、常孤独(OR=3. 385, 95%CI:1.740～6. 584)、自杀意念(OR=2.414, 95%CI:1.294～4. 816)。结论湘西地区大学生伤害行为问题普遍存在,学校应针对不同特征大学生的突出问题采取相应的干预措施,预防大学生伤害行为的发生。     

Associations of Work Stress,Supervisor Unfairness,and Supervisor Inability to Speak Spanish with Occupational Injury among Latino Farmworkers

Little is known about how psychosocial work factors such as work stress, supervisor fairness, and language barriers affect risk of occupational injury among Latino farmworkers. This study attempts to address these questions. Surveys were administered via interviews to 225 Latino thoroughbred farmworkers. Multivariable logistic regression analyses were performed to calculate odds ratios (OR) and 95% confidence intervals (CI) of occupational injury in the past year in relation to occupational characteristics. Work stress (OR 6.70, 95% CI 1.84–24.31), supervisor unfairness (OR 3.34, 95% CI 1.14–9.73), longer tenure at farm (OR 2.67, 95% CI 1.13–6.34), and supervisor inability to speak Spanish (OR 2.29, 95% CI 1.05–5.00) were significantly associated with increased odds of occupational injury. Due to the associations between work stress, supervisor unfairness, supervisor inability to speak Spanish and injury, supervisor training to improve Spanish language ability and equitable management practices is merited. Future research is needed to understand the antecedents of work stress for Latino farmworkers.     

Association of occupational stress and social support with health-related behaviors among chinese offshore oil workers

To explore the relationship of occupational stress and social support with health-related behaviors of smoking, alcohol usage and physical inactivity, a cross-sectional survey was conducted among 561 offshore oil installation workers of a Chinese state-owned oil company. They were investigated with a self-administered questionnaire about socio-demographic characteristics, occupational stress, social support and health-related behaviors. Logistic regression analysis was used to study the association between occupational stress, social support and health-related behaviors and adjusted for age, educational level, marital status, duration of offshore work and job title. Of 561 workers, 218 (38.9%) were current smokers, 124 (22.1%) current drinkers, and 354 (63.1%) physically inactive in their leisure time. Further multivariate logistic regression analysis indicated that: (1) Current smoking was significantly negatively related with perceived stress from "Safety" (OR=0.74; 95% CI=0.58-0.94) and lack of supervisors' instrumental support (OR=0.34; 95% CI=0.18-0.65); (2) Current drinking was significantly positively related to perceived stress from "Interface between job and family/social life" (OR=1.32; 95% CI=1.02-1.70) and "Organizational structure" (OR=1.35; 95% CI=1.06-1.74), but was significantly negatively related to poor emotional support from friends (OR=0.54; 95% CI=0.62-0.96); (3) Physical inactivity after work was significantly positively associated with perceived stress from "Safety" (OR=1.44; 95% CI=1.16-1.79) and lack of instrumental support from both supervisors (OR=1.74; 95% CI=1.16-2.65) and friends (OR=1.68; 95% CI=1.06-2.42). The findings suggest that psychosocial factors of occupational stress and social support at offshore oil work might affect workers' health-related behaviors in different ways.     

Mortality from injuries and other causes in a cohort of 21,800 Brazilian steel workers.

OBJECTIVES: Injury is the leading cause of death in the male working population of Brazil. An important fraction of these deaths are work related. Very few cohort studies of steel workers, and none from developing countries, have reported on mortality from injuries. This paper analyses mortality from work and non-work related injuries among Brazilian steel workers. METHODS: Deaths during employment from 1 January 1977 to 30 November 1992 were analysed in a cohort of 21,816 male steel workers. Mortality rates specific for age and calendar year among the workers were compared with those of the male population of the state where the plant is located. Work related injuries were analysed by comparing the mortality rates for different subgroups of the cohort. RESULTS: The number of deaths (391) was less than half that expected based on death rates of the general population. Over 60% (242) of deaths were due to injuries. Mortality from most causes was substantially below that in the general population, but that from unintentional injury, was 50% above that of the general population. Standardised mortality ratios (SMRs) were highest for the youngest and the oldest employees and for labourers and clerical workers. Mortality from motor vehicle injury was twice that expected from population rates (SMR = 209, 95% confidence interval (95% CI) 176-244). There was a 67% fall in the age adjusted mortality from occupational injuries in the study period. CONCLUSION: The healthy worker effect in this cohort was greater than that commonly found in studies of occupational groups in developed countries, probably because of a greater socioeconomic gap between employed and unemployed populations in Brazil, and unequal distribution of health care resources. Mortality was especially high for motor vehicle injuries. The fall in mortality from occupational injuries during the study period was probably due to improvement in safety standards, increased automation, and better medical care. There is a need to investigate risk factors for unintentional injuries among steel workers, especially those due to motor vehicle injuries. Prevention of occupational and nonoccupational injuries should be a main priority in Brazil.     

Incidence and pattern of unintentional injuries and resulting disability among children under 5 years of age: results of the National Health Survey of Pakistan

National estimates of injuries for children under 5 years based on population representative surveys are not readily available globally and have not been reported for developing countries. This study estimated the annual incidence, pattern and distribution of unintentional injuries according to age, gender, socio‐economic status, urban/rural residence and disability caused among children aged under 5 years in Pakistan. The National Health Survey of Pakistan (NHSP 1990–94) is a nationally representative survey of households to assess the health profile of the country. A two‐stage stratified design was used to select 3223 children under 5 years of age for interview and examination. Data were used for boys and girls in urban and rural areas over the preceding year. A community development index was developed to assess the relationship between socio‐economic status and injuries. Weighted estimates were computed adjusting for complex survey design using surveyfreq and surveylogistic option of SAS 9.1 software. Post hoc power calculations were made for each variable keeping the design effect at 3.0. The overall annual incidence of unintentional injuries was 47.8 [95% CI 36.6, 59.0] per 1000 per year; 50.2 [95% CI 37.0, 63.4] and 45.2 [95% CI 29.4, 61.0] per 1000 per year among boys and girls under 5 years of age respectively. An estimated 1.1 million unintentional injuries occur in Pakistan annually among these children. Injury rates increase with age among the under‐5s. Urban and rural injuries were 56.1 [95% CI 33.5, 78.7] and 44.1 [95% CI 31.1, 57.1] per 1000 per year respectively. The children living in least developed communities had almost 3 times higher risks of injuries than most developed communities. The annual incidence of types of injuries were: falls 28.7 [95% CI 19.5, 37.9], cuts/bruises 9.7 [95% CI 5.3, 14.1] and burns 6.6 [95% CI 3.0, 10.2] per 1000 per year. Falls were the most common type of injury (60%) followed by cuts/bruises (21%) and burns (14%). The majority of injuries occur at home (85%), with just 10% due to road traffic. Road traffic injuries and injuries to the female child were more likely to result in disability. There is a high burden of unintentional injuries and disability among children under 5 in Pakistan. These results are useful for planning further research and for prioritising prevention programmes nationally and in other developing countries with similar situation.     

Occupational injuries among workers with diabetes: the National Health Interview Survey, 1997-2005

OBJECTIVE:: To assess associations between diabetes and occupational injury. METHODS:: Data from the 1997 to 2005 National Health Interview Survey comprised a sample of 195,284 adult workers. Multivariate logistic regression analysis assessed associations between diabetes and occupational injuries, adjusting for age, sex, race, and education. Additional logistic regression analysis examined the effect of medical therapy and duration of diabetes with occupational injury. RESULTS:: There was no significant association between diabetes and occupational injury (adjusted OR = 1.18; 95% CI = 0.86 to 1.61). Subgroups of diabetics who reported no current diabetes therapy (OR = 1.87; 95% CI = 1.01 to 3.47) or duration of diabetes longer than 12 years (OR = 1.83; 95% CI = 1.05 to 3.18) were at increased risk for occupational injury. CONCLUSION:: The finding of no overall increased risk for occupational injury among workers with diabetes provides nationally representative results that may be useful to policymakers. Increased risk for occupational injury among untreated diabetics or those with long duration of disease may lead to focused efforts to prevent occupational injuries.     

Occupational injury proneness in Indian women: A survey in fish processing industries

A cross sectional survey was initiated to understand the frequency of occupational injury occurrence and the associated factors in the fish processing industries of western India involving 185 randomly selected women subjects. All the subjects were interviewed with the help of an interviewer-administered questionnaire to collect information regarding their personal, occupational and work related morbidity details (including details of occupational injuries). Logistic regression method was used to analyze the data in order to obtain the contribution of individual factors on occupational injuries. This study has shown that work related morbidity like blanching of hand (OR; 2.30, 95%CI; 1.12–4.74) and nature of job like grading (OR; 3.99, 95%CI; 1.41–11.27) and packing (OR; 5.68, 95%CI; 1.65–19.57) had a significant impact on injury causation. This study eventually concludes that apart from nature of job of fish processing workers occupational hazards prevailing in the work environment contribute significantly to the occurrence of work related injuries and prevention of such occupational hazards may help in protecting workers from occupational injuries also.     

Medical Expenditures Associated with Nonfatal Occupational Injuries among Immigrant and U.S.-born Workers

ABSTRACT: BACKGROUND: No national study has investigated whether immigrant workers are less likely than U.S.-workers to seek medical treatment after occupational injuries and whether the payment source differs between two groups. METHODS: Using the 2004-2009 Medical Expenditure Panel Survey (MEPS) data, we estimated the annual incidence rate of nonfatal occupational injuries per 100 workers. Logistic regression models were fitted to test whether injured immigrant workers were less likely than U.S.-born workers to seek professional medical treatment after occupational injuries. We also estimated the average mean medical expenditures per injured worker during the 2 year MEPS reference period using linear regression analysis, adjusting for gender, age, race, marital status, education, poverty level, and insurance. Types of service and sources of payment were compared between U.S.-born and immigrant workers. RESULTS: A total of 1,909 injured U.S.-born workers reported 2,176 occupational injury events and 508 injured immigrant workers reported 560 occupational injury events. The annual nonfatal incidence rate per 100 workers was 4.0% (95% CI: 3.8%-4.3%) for U.S.-born workers and 3.0% (95% CI: 2.6%-3.3%) for immigrant workers. Medical treatment was sought after 77.3% (95% CI: 75.1%-79.4%) of the occupational injuries suffered by U.S.-born workers and 75.6% (95% CI: 69.8%-80.7%) of the occupational injuries suffered by immigrant workers. The average medical expenditure per injured worker in the 2 year MEPS reference period was $2357 for the U.S.-born workers and $2,351 for immigrant workers (in 2009 U.S. dollars, P=0.99). Workers' compensation paid 57.0% (95% CI: 49.4%-63.6%) of the total expenditures for U.S.-born workers and 43.2% (95% CI: 33.0%-53.7%) for immigrant workers. U.S.-born workers paid 6.7% (95% CI: 5.5%-8.3%) and immigrant workers paid 7.1% (95% CI: 5.2%-9.6%) out-of-pocket. CONCLUSIONS: Immigrant workers had a statistically significant lower incidence rate of nonfatal occupational injuries than U.S.-born workers. There was no significant difference in seeking medical treatment and in the mean expenditures per injured worker between the two groups. The proportion of total expenditures paid by workers' compensation was smaller (marginally significant) for immigrant workers than for U.S.-born workers.     

外来民工子弟学校儿童非故意伤害危险因素的病例对照研究

  目的  探讨外来民工子弟学校儿童非故意伤害的危险因素。  方法  采用1:1匹配的病例对照研究,以同班级、同性别和年龄相差不超过两岁为原则,对外来民工子弟学校发生非故意伤害的的332例儿童进行1:1的匹配。调查以问卷为基础,采用EpiData 3.1软件建立数据库,SPSS 23.0软件进行单因素、多因素条件Logistic回归模型分析。  结果  多因素Logistic回归分析模型结果表明,看护人在儿童考试前施加压力、看护人的性格为外向型和中间型、看护人的文化程度为文盲和小学、儿童的神经症行为是外来民工子弟学校儿童发生非故意伤害的危险因素。其调整后的比值比（odd ratio,OR）和95%的置信区间（confidence interval,CI）分别为2.086（95%CI:1.263~3.444）、2.074（95%CI:1.275~3.372）、1.796（95%CI:1.158~2.784）、1.867（95%CI:1.280~2.722）、2.458（95%CI:1.169~5.168）、1.466（95%CI:1.012~2.124）。  结论  外来民工子弟学校儿童非故意伤害与其看护人以及儿童自身的危险行为有关,应及时采取有效措施降低非故意伤害的发生。     

The global burden due to occupational injury

BACKGROUND: Occupational injuries are a public health problem, estimated to kill more than 300,000 workers worldwide every year and to cause many more cases of disability. We estimate the global burden of fatal and non-fatal unintentional occupational injuries for the year 2000. METHODS: The economically active population (EAP) of about 2.9 billion workers was used as a surrogate of the population at risk for occupational injuries. Occupational unintentional injury fatality rates for insured workers, by country, were used to estimate WHO regional rates. These were applied to regional EAP to estimate the number of deaths. In addition to mortality, the disability-adjusted life years (DALYs) lost, which measure both morbidity and mortality, were calculated for 14 WHO regions. RESULTS: Worldwide, hazardous conditions in the workplace were responsible for a minimum of 312,000 fatal unintentional occupational injuries. Together, fatal and non-fatal occupational injuries resulted in about 10.5 million DALYs; that is, about 3.5 years of healthy life are lost per 1,000 workers every year globally. Occupational risk factors are responsible for 8.8% of the global burden of mortality due to unintentional injuries and 8.1% of DALYs due to this outcome. CONCLUSIONS: Occupational injuries constitute a substantial global burden. However, our findings greatly underestimate the impact of occupational risk factors leading to injuries in the overall burden of disease. Our estimates could not include intentional injuries at work, or commuting injuries, due to lack of global data. Additional factors contributing to grave underestimation of occupational injuries include limited insurance coverage of workers and substantial under-reporting of fatal injuries in record-keeping systems globally. About 113,000 deaths were probably missed in our analyses due to under-reporting alone. It is clear that known prevention strategies need to be implemented widely to diminish the avoidable burden of injuries in the workplace.     

Predictors of first nonfatal occupational injury following employment in a Brazilian steelworks

OBJECTIVES: This study investigated the influence of sociodemographic and occupational factors on the risk of 1st injury among Brazilian steelworkers. METHODS: Workers 1st employed between 1 January 1977 and 31 December 1985 and still employed on 1 December 1983 were followed from the date of hire until 30 October 1992. Occupational injuries were ascertained from a database. Kaplan-Meier curves for time to 1st injury were calculated for the total cohort and for different subgroups. A multivariate analysis of risk factors for 1st injury was carried out using the Cox proportional hazards regression model. RESULTS: Forty-one percent of the workers had > or = 1 occupational injuries, and 39% of 1st injuries occurred in the 1st year of employment. Lacerations, contusions, penetration by foreign bodies, bums, sprains, and fractures constituted the main diagnostic groups. Injuries to the hands, eyes, feet, arms, and legs dominated. Over 5% of the injured workers were on temporary disability leave (cumulative total 10,660 days). The probability for an occupational injury was 16% for the 1st year, rising to 25% in the 2nd year. The risk of nonfatal injury was highest for laborers [hazard ratio (HR) 1.76, 95% confidence interval (95% CI) 1.35-2.29] and employees in the steel mill (HR 1.40, 95% CI 1.21-1.63), and inversely related to worker age and educational level. The risk of injury decreased significantly with calendar period of employment. CONCLUSIONS: Substantial reductions in nonfatal injuries may reflect changes in work organization, increased automation, and improved safety standards. Knowledge of predictors of work-related injury may contribute to injury prevention strategies, especially among newly employed workers.