Educational and training issues in occupational first aid: the requisites for the teachers of the workers responsible for first aid

BACKGROUND: The inter-ministerial decree (D.I.) 388/03 (the Italian law on first aid in the workplace) attaches particular importance to the organization of first aid and to the content of the teaching and training of designated workers, specifying teaching objectives, programme and duration of courses. However it provides less details on the requirements and qualifications of the teachers and trainers. OBJECTIVES: To discuss this topic in the light of the guidelines contained in the literature and the existing legislation. METHODS: We used the specific references of literature and legislation concerning first aid training of designated workers. RESULTS: The objectives and the content of the training courses call for a high level of professional competence and approach. Therefore, training of designated workers should be planned and carried out in accordance with the training standards used for the teaching and training of the so-called "lay rescuers". CONCLUSIONS: The need to achieve high training standards for workers responsible for first aid at the workplace is to a large extent justified by the difficulty of the role of employees. This need follows the current tendency in regulations to guarantee adequate and up-dated training also for other agents operating within the system of workplace prevention. In this context the occupational physician plays a significant role in the training programmes for designated workers.     

Pain and pain treatment were associated with traffic accident involvement in a cohort of middle-aged workers

BACKGROUND AND OBJECTIVE: To assess the influence of medical conditions on road traffic accidents among a cohort of middle-aged workers and pensioners. STUDY DESIGN AND SETTING: A longitudinal study of 13,548 participants from a cohort study of French workers. Follow-up data covered the 1989-2000 period. Adjusted hazards ratios (HR(adj)) for serious accidents were computed by Cox's proportional hazards regression with time-dependent covariates adjusted for age, occupation, annual mileage in 2001, alcohol consumption, and number of reported health problems. RESULTS: Men who reported treated dental or gingival problems (HR(adj)=8.57, 95% confidence interval CI=2.70-27.2) and women who reported treated renal colic or kidney stones (HR(adj)=9.71, 95% CI=2.40-39.3) were much more likely to have a serious traffic accident. Treated glaucoma, hiatal hernia or gastric ulcers, and diabetes among women and treated cataract among men were also found to be associated with the risk of serious traffic accidents. CONCLUSIONS: This study raises the hypothesis that pain and pain treatment (singly or in combination) could increase the risk of road traffic accident and confirms that medical conditions traditionally found to be associated with traffic accident involvement of older drivers are also risk factors for middle-aged drivers.     

Recessions are bad for workplace safety

Workplace accidents are an important economic phenomenon. Yet, the pro-cyclical fluctuations in workplace accidents are not well understood. They could be related to fluctuations in effort and working hours, but workplace accidents may also be affected by reporting behavior. Our paper uses unique data on workplace accidents from an Austrian matched worker-firm dataset to study in detail how economic incentives affect workplace accidents. We find that workers who reported an accident in a particular period of time are more likely to be fired later on. And, we find support for the idea that recessions influence the reporting of moderate workplace accidents: if workers think the probability of dismissals at the firm level is high, they are less likely to report a moderate workplace accident.     

我国道路伤害与交通环境因素关系的流行病学分析

目的 探讨交通环境因素对道路伤害的影响,为减少交通事故发生提供依据。方法 采用主成分回归分析法分析我国１９５１～１９９８年机动车数量、公路运输量和公路里程数等因素与人身安全的关系。结果 人身安全与机动车数量、公路货运量、公路客动量和有路面公路里程数呈正相关关系（相关系数分别为０．８７１４、０．９６９１、０．９５１０,Ｐ＝０．０００５）,即道路伤害死亡率（／１０万）随着机动车数量、公路货运量、公路客     

幼儿园安全教育课程设计及实施效果评估

目的通过实施幼儿园儿童安全教育课程，对课程设计及实施效果进行评估。方法设计了在幼儿园中班开展针对烫伤、跌落伤、火灾、急救常识课程，在大班开展车祸、切割伤、跌落伤、触电和中毒的危险环境和危险行为识别、急救常识的健康教育课程。安全教育内容围绕某种意外伤害以主题活动形式，在南京市鼓楼区1所幼儿园于2个学期共进行了8个主题活动。实施效果采取课堂评估和终期评估。结果中班和大班儿童课堂前后评估显示他们的知识掌握明显提高，几乎达100％；中班儿童在安全教育课程后对烫伤、跌落伤、火灾的意外伤害危险因素项目的认知显著提高；大班儿童在车祸、跌落伤、中毒等危险环境和危险行为识别项目的认知都有显著提高。结论本研究设计的幼儿园安全教育课程反应了学龄前儿童对意外伤害的认知能力和思维特点，幼儿园儿童接受良好，评估效果满意，为在幼儿园开设安全教育迈出了第一步。     

Breath alcohol test in construction sites in the Province of Belluno: a campaign in favour of health promotion and surveillance and against drinking

BACKGROUND AND OBJECTIVES: Health impairment due to alcohol use and abuse is well known, in terms of relationship with traffic accidents and work accidents. In Italy almost 10 per cent of accidents at work involve intoxicated people injuring themselves and innocent victims. Alcohol abuse is a factor involved in determining severe accidents in the construction industry and epidemiological studies demonstrated a relationship between an elevated alcohol use and severity of accidents. Since in the Province of Belluno alcohol consumption may be elevated also at work, the two Occupational Health Units (SPISAL) in the province organized a campaign of information and surveillance against alcohol consumption at work in the construction industry. This report shows the campaign results, mainly in terms of breath alcohol tests performed in construction workers. DISCUSSION AND CONCLUSIONS: After an extensive information campaign we inspected 50 sites, where 105 construction companies were at work, and tested 294 workers by breath alcohol test. No-one refused the test. Only 2.7% construction workers were positive for the breath alcohol test, and the levels were not elevated. This study shows that the construction workers in Belluno Province are responsible drinkers and are well aware of the policy of prohibition of alcohol consumption at work.     

2004～2006年威海市暴雪期间交通伤害特征分析

[目的]了解暴雪期间交通事故伤害发生特点,为制定灾害干预策略提供科学依据。[方法]对2004～2006年威海市12月份的交通伤害发生情况进行分析。[结果]3年的12月,2005年交通事故发生率(1.24次/万辆)最低,但致死率最高(42.35%)。1日内事故好发时段在17:00～、6:00～8:00,2006年在20:00多1个高峰。事故发生率与事故伤亡率2005年环翠区最高,2006年荣成市最高;2004年4市(区)相近。2004和2006年伤亡人员年龄集中在30～45岁,职业集中在工人与农民,交通方式以骑乘摩托车占第1位,为40.80%、37.17%。2005年伤亡人员的年龄、职业、交通方式较2004与2006年相对分散,交通方式为骑乘摩托车和步行并列第1,占30.59%,第3位是骑自行车,3者占77.65%。3年的伤亡人员的性别以男性为主,占75.22%～80.00%,且主要肇事人群均以机动车驾驶人为主,占92.55%～96.16%。[结论]晴朗天气以预防交通事故的发生为主,雪天以预防交通事故的死亡为主;提高机动车驾驶人的综合驾驶素质,开展全民性的交通伤害现状、伤害预防知识宣传,加强雪天交通伤害的急救措施,提高救治水平,降低交通伤害致死率是冬季预防交通伤害的关键。     

Professional driving and safety, a target for occupational medicine

BACKGROUND: Road traffic injuries constitute one of the main causes of death and disability in Italy and in the European Union. Occupational medicine should pay special attention to the field of road transport because every year a large number of road accidents occur with fatal outcomes. Via health surveillance the occupational physician can play an important role in the prevention of such events. OBJECTIVES: The aim of the article is to summarize the results of the most recent studies on the main risk factors for road transport safety and discuss possible strategies of health surveillance, according to the recent indications of the European Agency for Safety and Health at Work, Bilbao. METHODS: A review of the literature was made. RESULTS AND CONCLUSIONS: The scientific literature provides a large amount of interesting information on the most important risk factors for road accidents, such as drinking and drug abuse, sleepiness and other medical conditions, or excessive speed. The presence of numerous and varied hazards for road transport safety requires, as suggested by the Bilbao Agency, the adoption of occupational health measures, including risk assessment, health education, technical and environmental prevention, health surveillance and clinical interventions (diagnosis and rehabilitation of occupational accidents). Moreover, the paper stresses the need to strengthen collaboration between occupational health physicians and other medical specialists.     

Guidelines for health surveillance of health care workers exposed to biological risks set up by the Italian Society for Occupational Health and Industrial Hygiene: application in health facilities of the Regional Health Administration--District No. 7, Ancona

BACKGROUND: Evidence Based Medicine and the need to achieve better management of health budgets call for verification and, if necessary, revision of the criteria used in Occupational Health, in order to ensure appropriate measures as regards protection of health at the workplace. In December 2003, the Marche Region initiated a process of reform of the regional health service, which will be completed in two years, and will provide a new regional health organization that will improve the quality and appropriateness of health services available to the population. The reform also involves the Occupational Health Services responsible for prevention activities for 20,000 health care workers employed in regional public health facilities. The need was strongly felt to set up a network that would meet the health needs of health care workers, by adopting a common language among occupational health physicians, by eliminating reported criticism, which is due not only to lack of communication between different structures and profiles, but also to the different methods of approach, evaluation and management of occupational risks. OBJECTIVES AND METHODS: From a historical point of view, the health sector has the biggest as regards prevention of biological risk. Therefore, with a view to harmonizing actions and approach among occupational health physicians in the evaluation of this risk, the publication by the Italian Society for Occupational of Health and Industrial Hygiene of Guidelines for health surveillance of health care workers exposed to biological risks, produced by the working group under the leadership of Prof. Lorenzo Alessio, was considered to offer an interesting opportunity to verify the reproducibility of methods and the quality of results, as applied to health facilities under the Regional Health Administration in Ancona (District No. 7). RESULTS AND CONCLUSION: The Guidelines fully confirmed the need to plan activities, starting from analysis of epidemiological and occupational data, thus assuring good results both in terms of efficacy and efficiency of the health surveillance programme used. This method also assures a high level of appropriateness of medical measures as regards the "safety" target, at the same time avoiding waste and poor management of human and economic resources, which were till now caused by differences in methods used in assessment of biological risk.     

Organization of workplace first aid in health care facilities

BACKGROUND: Laws D.Lgs. 626/94 and D.I. 388/03 attach particular importance to the organization of first aid in the workplace. Like every other enterprise, also hospitals and health care facilities have the obligation, as foreseen by the relevant legislation, to organize and manage first aid in the workplace. OBJECTIVES: To discuss the topic in the light of the guidelines contained in the literature. METHODS: We used the references contained in the relevant literature and in the regulations concerning organization of first aid in health care facilities. RESULTS: The regulations require the general manager of health care facilities to organize the primary intervention in case of emergencies in all health care facilities (health care or administrative, territorial and hospitals). CONCLUSIONS: In health care facilities the particular occupational risks, the general access of the public and the presence of patients who are already assumed to have altered states of health, should be the reason for particular care in guaranteeing the best possible management of a health emergency in the shortest time possible.     

2015—2019年宁波市海曙区道路交通伤害住院病例流行病学特征分析

[目的]分析宁波市海曙区道路交通伤害所致住院病例的流行病学特征,为相关部门采取有效防控措施提供依据.[方法]通过《宁波市住院伤害监测报告卡》收集海曙区2015—2019年报告的道路交通伤害所致住院病例,分析其流行病学特征和住院费用的影响因素.[结果]2015—2019年共报告道路交通伤害住院病例8 543例,其中男女性...     

Road safety practices among commercial motorcyclists in a rural town in Nigeria: implications for health education

This cross-sectional, community-based study was carried out among commercial motorcyclists in Igboora. All the commercial motor parks in Igboora were visited and all the commercial motorcyclists who consented to participate in the study were interviewed. Information on the respondents' socio-demographic characteristics, and the practice of road safety measures was collected using an interviewer administered questionnaire. A total of 299 motorcyclists were interviewed. All (100%) of them were males. The mean age of the respondents was 27.4 +/- 7.4 years. One hundred eighty-two (60.7%) of the motorcyclists had the correct knowledge of the purpose of Highway Code. Only 70 (23.3%) could recognize more than half of the currently used road safety codes and 47 (15.7%) obey these road safety codes more than half of the time they see it. Only 183 (61.2%) of them had a driving license and 72 (24.1%) were able to produce these licenses on demand. All (100%) of the respondents did not use any protective helmet. Those who have longer years of working experience, higher level of education and higher knowledge of the safety codes practice it more regularly (r = 0.198, p = 0.001, chi2= 9.31, p = 0.025, and r = 0.28, p = 0.001 respectively). One hundred thirty-six (45.5%) have been involved in at least one accident in the preceding year. The overall incidence of road traffic accident was 2.16 per 1,000. There was however on statistically significant association between the practice of road safety codes and the occurrence of road traffic accidents (chi2= 0.176, p = 0.916). The study shows that the practice of road safety measures was low in this rural Nigerian community and was not associated with the incidence of road traffic accidents. Introducing road safety education particularly targeted at educating the motorcyclists on the importance and practice of road safety measures would lead to an increase in the practice of the safety measures and hopefully a reduction in the incidence of road traffic accidents.     

Adolescent Riding Behavior During the COVID-19 Pandemic in Urban Area,Indonesia: A Cross-sectional Study

BackgroundAccording to police reported crash, in 2020 there have been 510 road traffic accidents among adolescents aged 16–25 years. The problem is that although restrictions on social activities have been implemented, 9.80% of accidents have caused deaths in Semarang City. There were many factors that influence the occurrence of road traffic accidents; one of those is the poor knowledge about safe riding behavior. The aim of this study is to determine the factors that contribute to the occurrence of road traffic accidents in adolescents during the pandemic.MethodsThis was a cross-sectional study, collected data using an online questionnaire distributed to adolescents aged 15–20 years in Semarang City, Indonesia. It was distributed during February-April 2021. The data included participant''s demographic information, riding behavior, and knowledge about safe riding. We analyzed using chi-square and logistic regression to determine the most influential factors.ResultsThe sample included 725 participants with a mean age of 17.4 years (SD=0.97); 260 (35.9%) males. We have found that gender was associated with the incidence of road traffic accidents (AOR=1.455, 95% CI [1.048–2.020], P=0.025) after adjusting for experience road safety education, vehicle type, and knowledge of safe riding.ConclusionIt is necessary to carry out Road Safety Education efforts to male students during the pandemic to reduce the incidence of traffic accidents.     

Fitness for work in health care workers: state of the art and possible operational recommendations for its formulation and management in relationship to alcohol and drug addiction

Both chronic and acute alcohol or drug consumption have severe health consequences, alter the subject's cognitive functions and work performance and increase the risk of work-related accidents, for the worker and for third parties (e.g., co-workers and other people subject to negative impact of worker's actions). Limited scientific evidence has suggested that some working conditions present in the health care sector (e.g., high levels of responsibility, competitiveness, burnout, shiftwork, work-related stress) may favour alcohol and drug abuse. The aim of the present report is to describe the problem of alcohol and drug consumption among health care professionals and to evaluate the problem of related fitness for work. The magnitude of this problem remains unclear; recent estimates have reported alcohol abuse and addiction problems in 1-14% and psychotropic, illicit and non-illicit, substance abuse in 6-15% of health care workers. The prevalence of tranquilizer and sedative/hypnotic drug use is high, particularly among physicians. However, it remains unclear whether the incidence of workplace accidents and injuries is higher among drug abusers, and whether the statutory introduction of prevention programmes has led to actual control of this problem in the workplace. Italian legislation identifies the occupational physician as a key figure to prevent psychotropic substance abuse in some work activities, but some difficulties in its application remain. Legislators should issue simple norms that clearly define the responsibilities and skills of each actor involved in safeguarding workplace health and safety, as well as clearly outlining workplace monitoring procedures.     

Causes and effects of road traffic accidents in Saudi Arabia

In Saudi Arabia the motor vehicle is the main means of transportation. Between 1971 and 1997; 564,762 people died or were injured in road traffic accidents, a figure equivalent to 3.5% of the total population in Saudi Arabia. During this period 66,914 people have died on the roads in Saudi Arabia due to road accidents, amounting to one person killed and four injured every hour. Over 65% of accidents occur because of vehicles travelling at excess speed and/or drivers disobeying traffic signals. Of deaths in Ministry of Health hospitals, 81% are due to road traffic accidents and 20% of their beds are occupied by traffic accidents victims. Also, 79.2% of patients admitted to Riyadh Armed Forces Hospital with spinal injuries has sustained their injuries as a result of a motor vehicle accident. We recommend compulsory use of safety seat belts in vehicles and the setting up of a new database to collect, store and analyse information relating to the road traffic accidents.     

Effects of working permanent night shifts and two shifts on cognitive and psychomotor performance

Objectives: The study aimed to clarify whether cognitive and psychomotor performance, which are important for occupational and traffic safety, are impaired by working permanent night shifts (NSs) compared with early–late two shifts (TSs) and whether age and chronobiological type influences the relationship between shift and performance. Methods: The study included 44 male automobile workers, 20 working TSs and 24 working NSs. Chronobiological type was determined by questionnaire (D-MEQ). Each subject was tested at the beginning and end of the shift for alertness [by a visual analogue scale (VAS)]; feeling of well-being (Basler); concentration and accuracy (d2); reaction speed, orientation and reaction to stress (Vienna System). Results: TS workers were more frequently morning types whereas the NS workers were more frequently evening types. In the performance tests, the TS and NS workers did not differ at shift start or shift end. Over the course of the shift, concentration and accuracy improved in both groups, as did reaction to stress. Chronobiological type alone or in combination with shift type had no effect on performance. Conclusions: The results of this study indicate that—if chosen voluntarily—working NSs has no immediate negative effects on cognitive and psychomotor performance when compared with working TSs. There was no indication of an increased risk of accidents after working NSs. The unequal distribution of the circadian types in the shift groups may indicate selection.     

Occupational health and safety challenges in China--focusing on township-village enterprises

China has experienced dramatic industrialization, urbanization, and economic growth over the last 3 decades. The rapid transformation and dramatic prosperity of industries in rural areas have, in turn, created tremendous challenges for occupational health and safety (OHS). This article was prepared to address occupational health and safety issues in township- and village-owned enterprises (TVEs) from several aspects, including working conditions and workplace hazards, major recognized OHS problems, implications of TVE industries to environmental health, and migrant workers. Among the major recognized OHS problems, pneumoconiosis, chemical poisoning, and workplace accidents, especially in small-scale coal mines, are highlighted. It is suggested that the national polices and regulations that specifically target TVEs are indispensable and a more powerful administrative structure should be established to ensure that the pertinent polices, regulations, and OHS standards can be enforced widely and effectively in practice.     

广州市部分人群交通伤害意识定性研究

目的　了解广州市不同人群交通安全的知、信、行,为开展交通伤害干预、减少交通伤害的发生提供科学依据。方法　2 0 0 3年12月至2 0 0 4年1月在广州市随机选取小学生家长、清洁公司的外省籍工人、违章非机动车驾驶员进行人群访谈,并进行违章行人的现场拍摄,对访谈资料和拍摄资料进行定性分析。结果　被调查者普遍认为交通安全教育严重不足,对交通伤害认识不够,缺乏交通安全知识,大部分人有违反交通规则的行为。小学生家长普遍认为交通管理混乱、道路的交通标志不完善、机动车驾驶员不遵守交通规则、学生没有系统学习交通安全知识等,而为学生的交通安全担忧;工人认为走在路上感到不安全,抽查交通标志的辨认正确率为4 5 % ;违章非机动车驾驶员知道自己的违章行为,但对其持无所谓态度;不少错误的观念导致他们违反交通法规的行为。行人违章行为主要有行人过马路不走人行横道和不遵守交通信号灯、翻越马路中心护栏、马路上嬉戏、家长接学生放学占道一半。结论　广州市居民交通安全意识淡薄和不良交通行为非常严重,必须加大力度开展宣传教育,使居民自觉遵守交通规则,防范交通伤害的发生     

Notion de responsabilité dans la prévention des accidents chez les piétons les plus exposés: enfants et personnes âgées

A study has been carried out on the Swiss road accidents statistics involving pedestrians. The most exposed road users (young and aged pedestrians) are the ones best protected by traffic law. However, data suggest that these pedestrians are more frequently declared responsible for the accidents in which they are involved. Arising from this contradiction, both the notion of responsibility and the way the prevention of these accidents is conceived should be queried.     

Impact of retirement on risky driving behavior and attitudes towards road safety among a large cohort of French drivers (the GAZEL cohort)

OBJECTIVES: This study investigated changes in driving behavior and attitudes towards road safety, following retirement, in a large cohort of road users. METHODS: In 2001, 14 226 participants of the GAZEL cohort in France reported their attitudes towards road safety and driving behavior using a self-administered driving behavior and road safety questionnaire. In 2004, 82% of the group (N=11 706) responded to the same questionnaire. Two complementary logistic regression analyses were performed to assess the association of (i) retirement with change in safe driving behavior and attitudes towards road safety between 2001 and 2004 and (ii) time since retirement with risky driving behavior and negative attitudes towards road safety in 2001. RESULTS: Among the participants who were active in 2001 (N=3927), those retiring between 2001 and 2004 (66%) were more likely to have discontinued sleepy driving [adjusted odds ratio (aOR) 2.12, P<0.001] and phone use while driving (aOR 1.74, P=0.006) than those who remained professionally active. The second analysis showed that the likelihood of sleepy driving and phone use while driving decreased soon after retirement, whereas that of speedy driving decreased over a longer interval. Retirement had no influence on driving while intoxicated or attitudes towards road safety. CONCLUSIONS: The results suggest that any professional activity may account for some risky road behavior. As work-related road traffic accidents are responsible for one out of every four road casualties in France, the monitoring and prevention of sleepy driving and phoning while driving among workers should be further considered.