山东省威海市居民伤害负担的现况

目的了解威海市居民伤害发生现状及其所造成的损失。方法采用分层整群随机抽样方法,对8600户居民家庭前一年发生伤害的情况及其经济负担进行回顾性问卷调查。结果共有390人418人次遭遇过伤害,伤害发生率总体为19.12‰。主要的伤害类型分别是交通事故、碰撞伤和跌落伤。所有伤害的患者人均卧床休息天数为24.77d,人均休工休学天数为55.98d,人均日常活动受限制天数为33.27d,人均住院天数为8.47d,人均门诊医疗费用为2343元,人均住院医疗费用为2709元。全市因伤害导致的经济损失约3.185亿元。结论伤害给居民的健康造成较大威胁,并导致了严重的社会和家庭经济负担,应采取针对性措施预防控制伤害的发生。     

Agricultural Injury in California Hispanic Farm Workers: MICASA Follow-up Survey

ABSTRACT

The authors report here results from the first follow-up survey of the Mexican Immigration to California: Agricultural Safety and Acculturation (MICASA) cohort of community-dwelling immigrant Hispanic farm workers in California's Central Valley. Among 560 participants the authors observed cumulative 1-year injury incidence of 6.6% (all injuries) and 4.3% (agricultural injuries). Increased prospective injury risk was associated with males, US birth, years lived in the United States, family income, and poor self-rated health. Agricultural injuries were associated most frequently with being struck by an object, falls, and cutting instruments, whereas over two thirds of nonagricultural injuries involved motor vehicles. Prevention should focus on safe handling of tools and materials, falls, and motor vehicle safety.     

造纸工人健康状况与工作能力的调查研究

[目的]调查造纸行业生产工人健康状况与工作能力,为提高工人的身心健康和工作能力提供依据。[方法]分层随机选择一线工人1309名,用工作能力指数和职业紧张量表评价其工作能力和职业紧张相关因素;以480名非一线工人为对照组。[结果]研究组意外伤害及呼吸、心理、消化和神经感觉系统疾患的年患病率高于对照组（P〈0．05）;工作能力平均得分低于对照组（P〈0．01）,工作能力单项得分也低于对照组（P〈0．01）;工作能力单项分析,除现阶段工作能力主观评价外,其余各项得分低于对照组（P〈0．05）;工作能力与健康状况有关（P〈0．01）;多元回归分析显示,工人的工作能力与职业任务冲突、工作环境和心理、躯体紧张反应呈负相关（P〈0．05）。[结论]造纸行业一线工人的健康状况不容忽视,改善工作环境,促进身心健康,对于提高工作能力有重要意义。     

Rates and Predictors of Suicidal Ideation During the First Year After Traumatic Brain Injury

Objectives. We examined rates of suicidal ideation (SI) after traumatic brain injury (TBI) and investigated whether demographic characteristics, preinjury psychiatric history, or injury-related factors predicted SI during the first year after injury.Methods. We followed a cohort of 559 adult patients who were admitted to Harborview Medical Center in Seattle, Washington, with a complicated mild to severe TBI between June 2001 and March 2005. Participants completed structured telephone interviews during months 1 through 6, 8, 10, and 12 after injury. We assessed SI using item 9 of the Patient Health Questionnaire (PHQ-9).Results. Twenty-five percent of the sample reported SI during 1 or more assessment points. The strongest predictor of SI was the first PHQ-8 score (i.e., PHQ-9 with item 9 excluded) after injury. Other significant multivariate predictors included a history of a prior suicide attempt, a history of bipolar disorder, and having less than a high school education.Conclusions. Rates of SI among individuals who have sustained a TBI exceed those found among the general population. Increased knowledge of risk factors for SI may assist health care providers in identifying patients who may be vulnerable to SI after TBI.Suicide is a major public health problem among the 1.7 million people who sustain traumatic brain injury (TBI) each year in the United States.1 People with a history of TBI in both civilian and military populations are 1.55 to 4.05 times more likely to die by suicide than the general population.2–5 In a study of Australian outpatients with a history of TBI, the majority of whom had no preinjury history of suicide attempts, suicide attempts were reported by 17.4% (30 of 172) of the sample over a 5-year period.6 Nearly half of the individuals who attempted suicide had made multiple attempts.6,7 The Centers for Disease Control and Prevention recently called for investigations of individual-level risk and protective factors for self-directed violence among people with TBI as an important component of improving long-term outcomes.8Rates of suicidal ideation (SI) after TBI have been found to exceed 20% in some studies6,9–14; however, in a recent systematic review of SI and behavior after TBI, Bahraini et al. highlighted the paucity of research in this area.15 They concluded that additional research is needed to determine the prevalence of SI and behavior after brain injury, as well as to ascertain patient-level factors that may be associated with increased suicide risk. Studies examining whether injury severity predicts post-TBI suicidality have yielded inconclusive findings.6,13,16,17 In perhaps the most thorough study on this topic to date, Tsaousides et al.12 surveyed 356 community-dwelling adults with a self-reported history of TBI and found that preinjury substance abuse was the only correlate of current SI. Risk factors for SI after TBI have been underinvestigated. Research in this area has been limited by reliance on retrospective reporting and self-reported history of TBI,12,18–20 with only a few studies including objective indicators of TBI severity.6 Most studies have involved cross-sectional designs and have included participants whose time since injury varied from several months to many years.12,21 Finally, because most existing studies have included relatively small, potentially biased samples21 recruited from outpatient clinics or TBI survivor programs,6,7,12 they may not be representative of the population of people who sustain TBI.Given these gaps in the existing literature, our objectives were (1) to investigate rates of SI during the first year after complicated mild to severe TBI in a representative sample of adults who had been admitted to a level I trauma center and (2) to investigate whether demographic characteristics, preinjury psychiatric history, or injury-related factors predicted SI.     

System Failure: Work Organization and Injury Outcomes among Latino Forest Workers

ABSTRACT

Objectives: Forestry services is a hazardous industry with high job-related injury, illness, and fatality rates. The Northwest workforce is largely Spanish-speaking, Latino, and immigrant, working in poor conditions with insufficient attention paid to safety and health. Institutional racism fundamentally shapes the structural vulnerability of Latino immigrant workers. Given this context, we sought to understand how workplace organizational factors and safety climate affect job-related injuries in this industry.

Methods: We developed 23 case studies from personal interviews after selecting from an initial participant survey pool of 99 Latino forest workers in southern Oregon who had been injured at work in the previous 2 years. Workers were recruited through snowball sampling and door-to-door canvassing. Questions spanned work conditions, tasks, employer safety practices, injury experience, medical treatment, and workers’ compensation benefits.

Results: Workers reported broken bones, chainsaw lacerations, back pain, heat and pesticide illnesses, and other occupational injuries. One-third of the cases fell into a Systems Functional category in which they reported their injuries to their supervisors and received medical treatment and workers’ compensation benefits. The remaining two-thirds experienced System Failures with difficulties in receiving medical treatment and/or workers’ compensation benefits, employer direction to not report, being fired, or seeking alternative home remedies.

Conclusion: Workers employed by companies with more indicators of safety climate were more likely to obtain adequate treatment for their injuries and fully recover. Workers for whom interpretation at medical exams was provided by someone unaffiliated with their employers also reported better treatment and recovery outcomes.     

小型肉类加工厂卫生防护距离的研究

作者对小型肉类加工厂周围环境中空气氨和耗氧量进行了调查。根据实测结果,结合大气扩散模式,分析了污染范围。通过实测、居民询问和扩散模式计算得到结果的综合判断,认为年产能力1500吨的肉类加工厂卫生防护距离以100m为宜。     

小型肉类加工厂卫生防护距离的研究

作者对小型肉类加工厂周围环境中空气氨和耗氧量进行了调查。根据实测结果,结合大气扩散模式,分析了污染范围。通过实测、居民询问和扩散模式计算得到结果的综合判断,认为年产能力1500吨的肉类加工厂卫生防护距离以100m 为宜。     

Exploring the Distribution and Determinants of a Change in Recovery Expectations Following Traumatic Injury to Victorian Workers

Purpose To examine the frequency, distribution and determinants of a change in recovery expectations following non-life threatening acute orthopaedic trauma to Victorian workers. It is proposed that interventions to modify recovery expectations may reduce the burden associated with injury. However, it is not known whether recovery expectations change over time or the factors that are associated with change. Methods A prospective inception cohort study was carried out in which participants were recruited following presentation to hospital for treatment of their injury and followed for 6 months post-injury. Baseline data was obtained by survey and medical record review. Binary logistic regression was used to examine factors associated with a change in recovery expectations between week 2 and week 12 post-injury. Results The cohort comprised injured workers (n = 145) who had sustained nonlife threatening acute orthopaedic trauma. Factors associated with an improvement in recovery expectations or recovery timeframe included more years of education and higher social functioning. Participants whose injury involved a perception of responsibility by a third party were 7.18 (95 % CI 1.86–27.68) times more likely to change their recovery expectations to more negative expectations and less likely to change to an earlier recovery timeframe. Participants with more severe injuries were more likely to change their recovery timeframe to a longer timeframe. Conclusion Change in recovery expectations provide some information on injured workers who may benefit from targeted interventions to improve or maintain recovery expectations. The post-injury time-point at which recovery expectations are measured is important if recovery expectations are to inform long-term outcomes.     

Correlation of Return to Work Outcomes and Hand Impairment Measures Among Workers with Traumatic Hand Injury

Introduction Hand impairment is a common and serious occupational injury among workers because it can affect the outcome to return to work (RTW) and even cause permanent dysfunction. The hand measures can directly describe the primary hand function and limitation. This study investigated the correlation of RTW and the overall hand impairment measures in the workers with traumatic hand injury. Methods Ninety-six subjects with occupational hand injury were recruited in this study to answer the RTW questionnaire and received the hand evaluation and motion analysis for their affected hands. RTW outcomes assessed whether the subjects successfully returned to work, either from a job change or salary reduction, and the length of the time it took for them to return to work (TRTW). The hand impairment measures included the hand impairment ratio, total active motion loss, motion area loss, grasp power loss, lateral-pinch power loss, and palmar-pinch power loss. Results A stepwise regression indicated that grasp power loss was a significant predictor for the length of TRTW. The motion area loss was firstly adopted to show statistically significance with RTW outcomes. Besides, the hand impairment ratio was also found to have mild positive correlation with TRTW significantly. Conclusions This study presented the subtle correlation of RTW outcomes and hand impairment measures. Both the strength loss and the motion area loss of the hand showed the significant correlation with RTW outcomes. The findings can point to some practical focuses in occupational rehabilitation for the workers with hand trauma.     

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.     

职业性手外伤的描述性流行病学研究

目的 了解职业性手外伤的构成、分布特征及其影响因素。方法 对自1997年4月－1998年3月在上海市华山医院就诊的1130例急诊职业性手外伤患者进行问卷调查,并随机对其中58例患者进行随访。结果 患者平均年龄为31．3岁,男女性别比为5．4：1;20－50岁的青壮年占83．3％,来自工业性企业患者占60％,开放性外伤占所有职业性手外伤的93．6％;手指损伤占所有病例的79．7％。51．1％的患者为中、重度手外伤,其中机器致伤的占49．9％。结论 职业性手外伤主要发生在青壮年男性和工业性企业中;机器损伤是导致中、重度职业性手外伤最常见的原因,应成为职业性手外伤预防的重点。     

四川工人伤害监测结果分析

目的探讨四川省工人职业伤害发生的流行特征,为制定防制策略提供依据。方法将2006-01-01/2008-12-31到成都市青羊区和攀枝花市米易县监测医院就诊且被诊断为伤害的首诊工人患者作为调查对象,分析其伤害发生的特征。结果在调查的2309例病例中,伤害主要发生在25~44岁年龄组,男女性别比11.28∶1,文化程度主要集中在初中文化,主要发生在工业和建筑场所,其次为公路/街道。身体各个部位均可能受到伤害,主要是非故意伤害。伤害发生原因前3位依次是钝器伤,跌倒/坠落,机动车车祸。结论工人伤害已成为重要的公共卫生问题,工人伤害发生有其自身的特点,因此应根据工人伤害的发生规律开展预防控制,从加强安全教育、改进设备和改善工作环境等方面综合考虑。     

Sexual Function in Men with Traumatic Brain Injury

Traumatic brain injury has been linked with higher incidence of sexual problems. As there have been few published reports regarding sexual functioning in men with traumatic brain injury in Latin America, this study sought to compare sexual measures in men with traumatic brain injury with healthy controls. The hypotheses that males with TBI would experience significantly lower indices of sexual functioning compared to unaffected individuals and that increased age and injury severity would predict lower sexual functioning among participants with TBI were tested. Seventy-one Spanish-speaking Colombian men with a history of moderate to severe TBI who were at least 6 months post-injury, and 71 healthy controls participated by completing the Sexual Desire Inventory, International Index of Erectile Function, Index of Premature Ejaculation, Sexual Quality of Life Questionnaire, Index of Sexual Satisfaction. SPSS 22 was used to analyze the results. When compared to matched controls, males with TBI had significantly lower overall and dyadic sexual desire, sexual satisfaction and sexual quality of life. Erectile functioning, ejaculation control, satisfaction with ejaculation control were reported to by lower in the TBI group than in the control group. Almost 44% of participants with TBI had moderate to severe erectile dysfunction, whereas nearly 10% of the control group had the same.     

井下煤矿工人和地面煤矿工人心理健康水平调查比较

目的:调查比较井下作业煤矿工人和地面作业煤矿工人心理健康状况水平。方法:用症状自评量表(SCL-90)对283名井下煤矿工人和219名地面煤矿工人的心理健康水平进行问卷调查。结果:煤矿工人SCL-90总分、总阳性项目数、阳性症状均分、躯体化、人际关系、抑郁等各因子分均高于国内常模,并有极显著性差异。井下矿工SCL-90总分、阳性项目数和躯体化、人际关系、焦虑、恐怖因子均分均高于地面矿工,并有显著性差异。结论:煤矿工人的总体心理健康水平低于国内常模,井下煤矿工人的心理问题较地面作业煤矿工人更为明显,应加强心理健康综合性干预。     

农民工职业伤害影响因素的病例对照研究

[目的]研究农民工职业伤害及其影响因素。[方法]2005年3～10月期间,采用统一调查问卷对437名农民工进行调查,其中最近3年里发生非致死性职业伤害的农民工217人作为研究组,未曾发生过职业伤害的农民工220人作为对照组。调查内容包括一般情况和职业伤害情况等。采用单因素和Logistic回归分析方法,分析不同因素对农民工职业伤害的影响。[结果]单因素分析显示：研究组和对照组的文化程度、工作胜任程度、每周工作时间、收入满意程度和健康满意程度差异有统计学意义（P＆lt;0.05）。Logistic回归分析显示：文化程度较低、每周工作时间较长、工作胜任程度较低者的职业伤害危险性增高。[结论]农民工职业伤害的发生与个人背景因素有关,应保护农民工中的高危人群,以减少职业伤害发生。     

接尘工人工作能力研究

目的了解接尘工人工作能力的变化规律。方法用"工作能力指数测量问卷"对213例健康不接尘工人(对照组)、307例接尘工人的工作能力进行测量。结果 WAI均值无论是对照组、接尘组还是尘肺组均随着年龄的增长而下降,不同性别间差异无统计学意义。对照、接尘和尘肺组间差异有统计学意义(P<0.01),其中接尘组显著低于对照组,尘肺组又显著低于接尘组,进一步分析发现接尘组中的石棉组和煤尘组的WAI低于对照组(P<0.01),而矽尘组与对照组间差异无统计学意义。结论早在尘肺发生前,接尘工人的工作能力已显著下降。应该尽早采取措施,保护接尘工人的工作能力和身体健康。     

Upper limb repetitive strain injuries in Manitoba

A review of workers' compensation board (WCB) claims in Manitoba, Canada identified an estimated 382 upper limb repetitive strain injury (RSI) claims or 9.3% of all upper limb WCB claims accepted in 1991. Tendonitis and carpal tunnel syndrome (CTS) were the most frequent diagnoses (27.5% and 19.3%, respectively). Rates of RSI were not significantly different by gender and age. RSI claimants had been experiencing symptoms for an average of 8 months prior to filing a compensation claim. While clerical occupations accounted for 13.6% of all upper limb RSI claims, the rates for RSIs in these occupations were low (0.67/1,000 workers), in contrast to occupations with the highest RSI rates: food, beverage, and related processing occupations (14.68/1,000 workers) and fabricating, assembling, and repairing of metal products (9.32/1,000). The highest risk industries were meat and poultry processing-related (23.48/1,000) and the manufacturing of airplanes (9.06/1,000). RSI claims were significantly more costly ($5,569 vs. $2,480, p <0.0001) and required more time loss (71.4 vs. 33.6 d. p <0.0001) than similar musculoskeletal non-RSI claims. Similarly, RSI claimants were less likely to return to the same job (67.3% vs. 81.0%, p <0.0001) than non-RSI claimants. It was concluded that the cost and severity of RSI claims militate for intensified preventive measures. © 1996 Wiley-Liss, Inc.     

Needlestick Injuries in Agriculture Workers and Prevention Programs

There are a variety of biologics, vaccines, antibiotics, and hormones used in animal agriculture. Depending upon the procedure or pharmaceutical used, accidental injections or product exposures can result in mild to severe injuries. Needlestick injury (NSI) prevention, research, and education for veterinarians and agriculture workers is limited. The objective of this study was to collect and review published case reports and case series/surveys on human needlestick exposure to veterinary biologics and to summarize needlestick prevention strategies for agricultural workers/veterinarians. A search was conducted of PubMed and Centre for Agriculture Bioscience International (CABI) databases. References were reviewed to identify additional articles. NSI among agricultural workers were primarily included in this review. Thirty articles were applicable to exposures in agricultural settings. Relevant literature consisted of case reports, survey/case series articles, prevention documents, and background articles. Fifty-nine case patients were identified. Most of these cases were associated with exposures to specific vaccines or veterinary products. Injury location was identified from 36 individuals: 24 (67%) NSI to the hands, 10 (28%) injuries to the legs, and 2 to other body locations. Of the 59 cases, 20 (34%) involved oil-adjuvant vaccines. Evidence of hospitalization was recorded for 30 case patients. The length of hospitalization was available from 11 case patients. Median length of hospitalization was 3 days (range: 1–4). Surgical intervention was reported in 25 case patients. Outcome information was available on 30 case patients. Fifteen made a complete recovery within 2 weeks of treatment, 14 had residual sequelae attributed to the injury, and there was 1 reported death. Of the 13 survey/case series articles: 2 focused on oil-adjuvant products, 1 on Brucellosis RB-51 vaccine, 3 on tilmicosin, 1 on Salmonella enteritidis vaccine, 1 on high-pressure injection, and 5 were nonspecific. NSI in agriculture workers and veterinarians can result in significant bodily injury and loss of work. There is a need for varied and comprehensive educational programs for agricultural workers and veterinarians to prevent NSI on livestock operations.     

长期夜班作业人员尿常规检测分析

目的探讨长期夜班作业对人体健康的影响,为夜班作业人员健康保护提供依据。方法对某公司2 231名倒夜班作业人员和1 790名未曾倒夜班作业人员的尿蛋白、尿糖、尿胆红素与酮体指标进行分析。结果与未曾倒夜班作业人员比较,长期夜班作业人员胆红素异常率高,差异有显著性（P〈0.05）;46~55岁组尿蛋白异常率与尿糖异常率差异均有显著性（P〈0.01）;酮体异常率差异没有显著性（P〉0.05）。结论长期夜班对作业人员健康是有影响的,定期尿常规检查有利于早期发现一些轻度泌尿系统疾病,进行及时治疗,以保护他们的身体健康。