Occupational fatalities of Hispanic construction workers from 1992 to 2000

BACKGROUND: Hispanic construction employment has dramatically increased, yet published data on occupational risk is lacking. METHODS: Data from the Census of Fatal Occupational Injuries (CFOI) and current population survey (CPS) were examined from 1992 to 2000. Fatality rate, relative risk (RR), and risk index were calculated using CFOI fatality data and CPS data on hours worked, adjusted to full-time-equivalents (FTE). Data between 1996 and 2000 were combined to allow reliable comparisons of age and occupational groups. RR and 95% confidence intervals were calculated. RESULTS: In 2000, Hispanics constituted less than 16% of the construction workforce yet suffered 23.5% of fatal injuries. RRs were: helpers, construction trades, 2.31 (95% CI: 1.41-3.80); roofers 1.77 (95% CI: 1.38-2.28); carpenters 1.39 (95% CI: 1.08-1.79); and construction laborers 1.31 (95% CI: 1.17-1.46). CONCLUSIONS: Hispanic construction workers consistently faced higher RRs, for every year from 1992 to 2000 and for every age group. In 2000, Hispanic construction workers were nearly twice (1.84, 95% CI: 1.60-2.10) as likely to be killed by occupational injuries as their non-Hispanic counterparts.     

Tuberculin reactivity among California Hispanic migrant farm workers

We conducted a cross-sectional study of tuberculin reactivity among residents of two northern California migrant-farm-worker housing centers. Participants completed a brief health questionnaire and were offered tuberculin skin testing with radiologic and medical follow-up. Four hundred and sixty-nine persons (estimated participation rate: 70%) completed questionnaires. All but one were Hispanic. Two hundred and ninety-six (63%) participants completed tuberculin skin testing and 49 (16.6%) showed reactivity (≥10 mm induration at 48–72 hours). Increased prevalence was seen for the 15–39-year age group (vs. persons younger than 15: OR 2.59; 95% CI 0.79–8.47), former smokers (vs. never smokers: OR 3.11; 95 %CI 1.20–8.09), and persons born outside the U.S. (OR 2.09; 95% CI 0.66–6.61). Prophylaxis with isoniazid was recommended for 23 persons; nine (39%) completed therapy. No cases of active tuberculosis were found. Prevalence of tuberculin reactivity in this population is lower than reported among Hispanic farm workers in the eastern and midwestern U.S. Higher prevalence may obtain among California farm workers not included in the study population, including homeless, single, and highly mobile persons. Public-health efforts in this population should focus on ever-smokers, young adults, and persons born outside the U.S. Am. J. Ind. Med. 32:600–605, 1997. © 1997 Wiley-Liss, Inc.     

某院医务人员职业暴露监测

目的了解医务人员发生职业暴露人群的分布特征、危险因素与风险环节。方法对某院所有医务人员2011年1月—2014年6月发生的职业暴露进行风险监控,分别从发生职业暴露者的职业类别,暴露的地点、环节以及方式进行数据统计。结果 286例次职业暴露者中,男性63例(22.03%),女性223例(77.97%);2011年111例次(38.81%),2012年75例次(26.22%),2013年67例次(23.43%),2014年1—6月份33例次(11.54%);对不同人群发生职业暴露者统计数据显示,各年度不同人群发生职业暴露所占百分比相似,由高到低依次为护士(31.97)%、医师(19.90%)、护工(15.79%)、技师(7.64%)、护师(4.17%)和保洁员(2.84%);整理废物、拔针或更换针头、丢弃锐器入利器盒、手术缝合或器械传递、各种穿刺(含抽血)操作时的锐器伤是医务人员发生职业暴露损伤的主要风险环节,其构成比分别为22.38%、19.58%、14.34%、12.94%和11.19%;各年度职业暴露发生地点相似,主要是病房、手术室和注射(治疗)室,其构成比分别为51.40%、19.58%和11.54%。结论医院应建立完善的职业暴露监控与风险管理体系,强化标准预防,加强对职业暴露高危人群的培训,对风险环节及危险因素进行监控和干预,以有效降低医务人员职业暴露发生率。     

Occupational deaths among healthcare workers

Recent experiences with severe acute respiratory syndrome and the US smallpox vaccination program have demonstrated the vulnerability of healthcare workers to occupationally acquired infectious diseases. However, despite acknowledgment of risk, the occupational death rate for healthcare workers is unknown. In contrast, the death rate for other professions with occupational risk, such as police officer or firefighter, has been well defined. With available information from federal sources and calculating the additional number of deaths from infection by using data on prevalence and natural history, we estimate the annual death rate for healthcare workers from occupational events, including infection, is 17-57 per 1 million workers. However, a much more accurate estimate of risk is needed. Such information could inform future interventions, as was seen with the introduction of safer needle products. This information would also heighten public awareness of this often minimized but essential aspect of patient care.     

某三级综合医院医务人员职业暴露调查

目的了解某三级综合医院医务人员职业暴露情况,分析职业暴露发生原因及预防对策。方法对某院2010年1月—2013年12月134例发生职业暴露的医务人员进行调查。结果暴露人群中,护士所占比率最高(59.70%),其次是医生(19.40%)、医技人员(9.70%)。职业暴露主要原因为锐器管理不规范(占46.27%,62例),其次为操作意外(占42.54%,57例)、防护措施不足所致(占11.19%,15例);暴露方式以锐器伤为主(占94.78%,127例),黏膜接触暴露占5.22%(7例),暴露源不明确者占42.54%,暴露源明确者占57.46%,其中乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、梅毒螺旋体(TP)、人类免疫缺陷病毒(HIV)分别占35.82%、12.69%、3.73%、2.24%;HBV、HCV合并感染占2.24%(3例);HIV、HBV、HCV、TP合并感染占0.74%(1例)。职业暴露后正确处理率为95.52%。结论护士是职业暴露高危群体,做好职业防护,并规范锐器管理,可以减少医务人员职业暴露发生。     

农民工职业紧张与工作满意度关系

目的 初步探讨农民工职业紧张与工作满意度关系:心理资本的中介作用。方法 整群随机抽取安徽建筑工地、民营企业899名农民工,运用付出-回报失衡问卷、工作满意度问卷和心理资本问卷进行测量。结果 889名农民工工作满意度平均得分为(65.04±10.91)分,心理资本4个维度平均得分自我效能为(22.1±5.34)分,希望(23.7±4.67)分,韧性(23.5±3.61)分,乐观(22.6±2.69)分;外在付出与工作满意度呈负相关(r=-0.150,P<0.001),回报、内在投入和心理资本均与工作满意度呈正相关(均P<0.001),职业紧张在工作满意度的解释增量为30.6%,心理资本的中介作用对工作满意度解释增量为22.5%。结论 农民工工作满意度一般,外在付出、回报、内在投入对于工作满意度有良好的预测作用,心理资本在回报、内在投入与工作满意度的关系中起中介作用。     

Occupational injury among cooks and food service workers in the healthcare sector

BACKGROUND: Incidence of occupational injury is anticipated to be high among cooks and food service workers (CFSWs) because of the nature of their work and the types of raw and finished materials that they handle. METHOD: Incidents of occupational injury, resulting in lost time or medical care over a period of 1 year in two health regions were extracted from a standardized operational database and with person years obtained from payroll data, detailed analysis was conducted using Poisson regression modeling. RESULTS: Among the CFSWs the annual injury rate was 38.1 per 100 person years. The risk of contusions [RR, 95% CI 9.66 (1.04, 89.72)], burns [1.79 (1.39, 2.31)], and irritations or allergies [3.84 (2.05, 7.18)] was found to be significantly higher in acute care facilities compared to long-term care facilities. Lower risk was found among older workers for irritations or allergies. Female CFSWs, compared to their male counterparts, were respectively 8 and 20 times more likely to report irritations or allergies and contusions. In respect to outcome, almost all irritations or allergies required medical visits. For MSI incidents, about 67.4% resulted in time-loss from work. CONCLUSIONS: Prevention policies should be developed to reduce the hazards present in the workplace to promote safer work practices for cooks and food service workers.     

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.     

中国医务人员职业暴露与防护工作的调查分析

目的了解医务人员职业暴露与防护工作现状,为制定职业暴露防护措施提供依据。方法采用分层抽样方法于2016年4月6日—5月6日向全国13个省份158所不同级别医院发放调查问卷进行调查,分别调查各所医院开展职业暴露监测首年、2010年及2015年的职业暴露与防护管理及监测情况。结果81.65%（129/158）的医院医务人员职业暴露管理工作由医院感染管理部门负责;98.73%（156/158）的医院制定了相关规章制度;77.22%（122/158）的医院存在医务人员职业暴露漏报现象。共发生职业暴露事件11 116例,调查首年发生1 542例,2010年发生2 474例,2015年发生7 100例。锐器伤在各类职业暴露类型中占96.76%;职业暴露人员职业分布中,护理人员占53.90%;职业暴露人员科室来源主要为普通病房、手术室、重症监护病房等;引起医务人员职业暴露器具主要为注射器、头皮钢针、手术缝针等;静脉注射、针头丢入利器盒、手术缝针等是引起医务人员职业暴露的高危操作;在职业暴露源阳性分布中,以乙型肝炎病毒（HBV）为主,占58.69%。结论我国医务人员面临职业暴露的风险大,危害重,形势严峻,应通过政府立法、推广应用安全器具、规范医务人员操作行为、正确使用个人防护用品、强化医务人员教育与培训、建立健全职业暴露报告、评估和随访机制等措施,以切实减少职业暴露的发生。     

医务人员血源性病原体职业暴露调查

目的了解医务人员发生血源性病原体职业暴露的特点和危险因素,探讨防治对策。方法采用回顾性调查方法,运用《医务人员血源性职业暴露登记表》对某院2013年1月1日—2015年12月31日发生的血源性病原体职业暴露事件进行调查分析。结果共发生血液/体液职业暴露246例。职业暴露人群以在职护士为主(95例,占38.62%);职业暴露发生地点主要为病房(148例,60.16%);职业暴露方式以锐器伤为主(219例,占89.02%);医务人员发生职业暴露时的操作环节主要为手术意外(69例,占28.05%);暴露源主要为乙型肝炎病毒(HBV),共123例(占50.00%);暴露医务人员经局部处理和预防用药后,无1例发生感染。结论医疗机构应加强医务人员血源性病原体职业暴露相关培训,提高防护意识,规范操作行为,改善工作环境,最大限度地减少职业暴露的发生。     

Illnesses and injuries reported by Latino poultry workers in western North Carolina

BACKGROUND: Poultry processing is the largest sector of the meat products industry. Many workers are immigrants; few data exist on their illness and injury rates and the impact of workplace safety environment. METHODS: Survey interviews were conducted with a representative sample of 200 Latino poultry workers employed by three different companies in western North Carolina; topics included symptoms, work-related illnesses and injuries, and plant safety climate. RESULTS: Most respondents were <35 years of age and had been in the US <10 years. Frequency of self-reported symptoms was high, particularly for musculoskeletal symptoms. Despite symptoms, workers reported not missing work or seeking medical care. Occupational injuries and illnesses and symptoms varied by company. Between-company differences in injury and illness rates were consistent with perceived safety and company provision of personal protective equipment. CONCLUSIONS: Symptoms reported exceeded rates reported by other community, clinical, and occupational samples. Findings suggest policy changes and research are needed to reduce the high rates of occupational illnesses and injuries in this vulnerable population.     

某院医务人员血源性职业暴露的流行病学研究

目的掌握某院医务人员血源性职业暴露的流行病学特征。方法采用随机偶遇的方法对该院374名临床医务人员进行回顾性问卷调查。结果医务人员职业暴露后处理内容和处理流程正确率分别为54.81%（205/374）、89.84%（336/374）。 共发生血源性职业暴露174例、533例次,暴露率为46.52%(174/374)。不同科室、岗位医务人员职业暴露率比较,差异有统计学意义(P＜0.05);外科、儿科和内科的医务人员暴露率较高,分别为64.46%（78/121）、60.00%（18/30）和40.00%（50/125）;护士和医生暴露率较高,分别为51.52%（102/198）、47.27%（52/110）。医务人员血源性暴露时间主要集中在上午和晚上,穿刺、采血或处理物品为主要的暴露环节,暴露地点主要是病房和手术或换药室。结论该院医务人员血源性职业暴露率较高,应加强医院高危科室、人员和操作的血源性职业暴露防控措施的落实。     

211例医务人员锐器伤监测结果分析

目的分析医务人员锐器伤发生情况,为持续改进锐器伤安全管理工作提出建议。方法回顾性分析某院2006年8月—2015年7月上报的《锐器伤登记表》,分析统计相关资料。结果共上报211例锐器伤,主要人群为护士(118例,55.92%)和医生(83例,39.34%);工龄主要为5年及以下者(117例,55.45%);发生地点主要为外科病房(67例,31.75%)、内科病房(65例,30.81%)及门急诊(33例,15.64%);致伤物主要为注射器针头(91例,43.13%)、缝合针(34例,16.11%)和头皮针/输液器针头(27例,12.80%);主要致伤操作为各种注射(40例,18.95%)、静脉输液(38例,18.00%)、手术缝合/剪断(36例,17.06%)。主要致伤环节为操作中(治疗、检查、手术),共109例(51.66%)。血源性病原体污染的器械中,HBV污染95例(76.61%),HCV污染25例(20.16%),HIV污染4例(3.23%)。无血源性病原体感染病例发生。211例医务人员接种乙肝疫苗者155例(73.46%)。结论应重点针对工作时间≤5年的护士和医生,外科病房、内科病房及门急诊的医务人员,注射、静脉输液、缝合/剪断等操作时做好锐器伤防护工作。医院相关部门完善上报流程,加强追踪。     

Epidemiologic study of occupational injuries among foreign and native workers in Taiwan

This study was designed to compare the risk of occupational injuries in foreign workers compared to native workers in Taiwan. The cohort of foreign workers under study was constructed by records of legally registered workers migrated from foreign countries to Taiwan from July 1, 1991 to December 31, 1993. The native Taiwanese workers for comparison were labor-insured workers working in the same industries as foreign workers in 1992. The number of occupational injuries in the first year of employment were obtained by matching the cohort of foreign workers with the labor insurance payment records by name, birth date and passport number. The 1-year incidence rate of occupational injuries in the first year of employment was calculated and a standardized morbidity ratio (SMR) was used for comparison with adjustment for age distribution and to accommodate the small sample size of foreign workers. The risk to occupational injuries among total (SMR = 0.86) and male (SMR = 0.58) foreign workers was not higher: indeed, it was even lower, than that among native workers in Taiwan. However, the risk to female migrant workers, especially in the construction industry, was significantly higher than that of female Taiwanese workers (SMR = 1.60). Stratified by industry, the incidence was high in the fabricated metal products manufacturing industry and in machinery and equipment manufacturing industry for male foreign workers, while a high incidence for the female foreign workers occurred in construction industry and rubber products manufacturing industry. The risk of occupational injuries was greater for foreign workers who had been in Taiwan for only a short time. Most fo the injuries occurred within the first 6 months of employment. Eighty-four out of the 394 occupational injuries among foreign workers resulted in disabilities. None of the accidents was fatal, but most of the disabilities were severe. The most common disabling injuries were cut or crushed fingers. The finding of a similar distribution of occupational injuries among foreign and native workers indicates that control measures are needed to reduce occupational injuries for all foreign and native workers in Taiwan. Am. J. Ind. Med. 31:623–630, 1997. © 1997 Wiley-Liss, Inc.     

全球医护人员针刺伤的疾病经济负担文献研究

目的了解全球针刺伤疾病经济负担,以获得相关证据,引起有关部门对针刺伤防护的重视。方法在PubMed、ScienceDirect、EBSCOhost、Cochrane中国知网和万方数据库中检索1990年—2016年5月有关针刺伤疾病经济负担的相关研究,应用世界银行通货膨胀率和2015年货币汇率将各研究针刺伤成本转换成2015年12月美元表示,并进行合并比较分析。结果共纳入7篇文献,3篇美国研究,瑞典、韩国、比利时、中国台湾地区研究各1篇。中国大陆的研究均只集中在针刺伤发生率的报道,未见有成本研究。2篇未明确研究人群,其余5篇的研究人群均为在医疗机构中所有工作人员。成本分析方法:7篇文献中3篇为一手数据分析,4篇为模型推算得出。成本研究范围:4篇研究测算了直接成本,2篇研究分别测算直接成本和间接成本,1篇只测算了直接成本和间接成本总和。每次针刺伤总成本(直接成本+间接成本)为747~2 173美元,直接成本为167~617美元,间接成本为322~455美元。结论全球范围内针刺伤经济负担沉重,但仍被低估;中国针刺伤发生频繁,但关注不足,经济负担研究缺乏,有关部门应重视针刺伤防护及追踪处理流程。     

An occupational focus on falls with serious injury among older women in Australia

Falls prevention and recovery programs have been developed on a predominantly medical model of understanding falls risk. In this cross-sectional study, data from 12 900 community-dwelling women participating in the Australian Longitudinal Study on Women's Health were analysed using multiple stepwise regression to identify if factors related to occupational functioning were independently associated with participants who self-reported serious falls ( n =  655) in the previous year. Four variables were significantly associated with reports of serious falls: poor physical health summary scores (SF-36); higher scores on a life events scale; higher scores on a 'feeling dejected' subscale; and taking medications for 'nerves'. These variables are directly connected with occupational functioning, and were significantly associated with serious falls despite medical falls risk factors being included in the regression model. Results indicate a need to address the occupational background of participants in the design and delivery of both falls injury prevention and falls recovery programs, especially for community-dwelling women.