Nonfatal occupational injuries and illnesses among workers treated in hospital emergency departments--United States, 2003

CDC's National Institute for Occupational Safety and Health (NIOSH) collects data on nonfatal occupational injuries and illnesses through the National Electronic Injury Surveillance System (NEISS), an emergency department (ED)-based surveillance system. This report summarizes data for 2003. The overall number and rate of occupational injuries and illnesses did not change substantially during the 5-year period since data were last reported in 1998. In 2003, age-, sex-, and diagnosis-related patterns of injury and illness among workers treated in EDs (ED-treated injuries/illnesses) were similar to those reported in 1998. To achieve substantial decreases in these injuries and illnesses, prevention efforts must focus on effective, targeted workplace-safety interventions for diverse occupations.     

香港建筑业工伤事故住院病人调查分析

目的：了解香港地区建筑业工伤的特征、伤害程度和危险因素。方法：对 在某公立医院住院治疗的122例工伤病人及相同数量无工伤记录的人员（对照）的社会人口学特征、工作场所的安全措施和使用情、吸烟与饮酒情况进行调查。并用简化计分法（AIS）和伤害严重程度计分法＊（ISS）对工伤病人的伤害特征、类型和程度进行编码分析。结果：80％的工伤者身体只有一处受伤。按照：AIS编码，194个受伤身体部位中，49％是体表伤，26％属四肢伤，11％为脊柱伤。高空作业与伤害程度得分（ISS）显著相关。68％受伤者的工伤场所存在安全隐患。未接受正规教育、未接受安全培训和现在吸烟是发生工伤的危险因素。结论：建筑业是香港地区的高危险职业，改善工作场所安全设施和加强工人的安全教育有助于减少或消除建筑业工伤的发生。     

Causes of electrical deaths and injuries among construction workers

BACKGROUND: Contact with electrical current is the fourth leading cause of deaths of construction workers. This study evaluates electrical deaths and injuries to construction workers. METHODS: Two sources of data were analyzed in detail: (1) 1,019 electrical deaths identified by the Bureau of Labor Statistics, Census of Fatal Occupational Injuries (CFOI) for the years 1992-1998; and (2) 61 electrical injuries identified between November 1, 1990 and December 31, 1998 from a George Washington University Emergency Department injury surveillance database. RESULTS: Contact with "live" electrical wiring, equipment, and light fixtures was the main cause of electrical deaths and injuries among electrical workers, followed by contact with overhead power lines. Among non-electrical workers, contact with overhead power lines was the major cause of death. Other causes included contact with energized metal objects, machinery, power tools, and portable lights. Arc flash or blast caused 31% of electrical injuries among construction workers, but less than 2% of electrical deaths. CONCLUSION: Adoption of a lockout/tagout standard for construction, and training for non-electrical workers in basic electrical safety would reduce the risk of electrical deaths and injuries in construction. Further research is needed on ways to prevent electrical deaths and injuries while working "live".     

某院医务人员锐器伤目标性监测

目的了解某院医务人员发生锐器伤的人群分布特征和风险环节,为制定有效防护措施提供依据。方法回顾性调查2014年1-12月该三级甲等医院医务人员上报医院感染管理科的职业暴露情况,分析发生锐器伤者的职业类别、暴露地点及环节、暴露源等情况。结果2014年1-12月共监测医务人员2 643名,发生锐器伤61名,其中护士43名（占70.49%）,医生13名（占21.31%）。医务人员锐器伤职业暴露科室主要为骨科（9名,占14.75%）,致伤锐器主要为输液针（33名,占54.10%）,发生的主要操作环节为拔针（21名,占34.43%）;暴露源主要为乙型肝炎病毒（HBV）,共36例（占59.01%）;34名（占55.74%）锐器伤职业暴露医务人员在操作中均未戴手套。锐器伤职业暴露后进行局部处理者54名（占88.52%）,进行药物治疗（含预防用药）者仅18名（占29.51%）;追踪随访43名（占70.49%）,均未因暴露而发生感染。结论医院应建立完善的锐器伤职业暴露监控体系,加强对发生锐器伤高危人群的培训,强化标准预防,对风险环节进行监控和干预,有效减少医务人员锐器伤的发生。     

Chronic symptoms in construction workers treated for musculoskeletal injuries.

BACKGROUND: Soft tissue musculoskeletal injuries make up a high proportion of all work-related injuries in construction. Data from Workers' Compensation claims indicate that strains and sprains are the leading compensable injury for construction workers. This study describes the consequences of soft tissue musculoskeletal injuries for construction workers, and assesses the persistence of symptoms after an injury and the impact of that injury on return to work. METHODS: Through an Emergency Department surveillance system [Hunting et al., 1994a], we recorded 176 construction worker visits, from 5/01/93 through 2/28/95, for strains, sprains, joint injury or pain, tendinitis, dislocations, hernias, or other musculoskeletal injuries excluding fractures. Telephone interviews were conducted several months after workers had visited the emergency room for a musculoskeletal injury. RESULTS: Seventy individuals were interviewed about the long-term impacts of 72 incidents that had resulted in work-related musculoskeletal injuries. For 46 (62%) of the 74 diagnoses, problems continued beyond two months. The likelihood of problems continuing more than two months varied considerably by body location of injury. Hispanic workers and older workers were more likely to have continuing symptoms. Eleven of the 45 construction workers with symptoms persisting longer than two months were not employed at the time of the interview. Only 11 of the 45 workers with ongoing symptoms told us that modifications had been made to their jobs to accommodate their symptoms. About one-quarter of these 45 subjects reported substantial effects on home or work life. CONCLUSIONS: Acute musculoskeletal injuries in construction workers frequently result in chronic symptoms, and those with chronic symptoms report substantial effects of the injury on their quality of life. Job accommodations were made in a minority of these injuries. These findings point to the need for heightened efforts for injury prevention in this industry.     

某院医务人员针刺伤调查及防护对策

目的了解医务工作者针刺伤现况并分析原因,以探讨有效的针刺伤防护策略。方法回顾性调查某院2013年1月—2015年12月医院感染管理科登记的针刺伤案例并进行分析。结果共发生164例针刺伤,其中医生71名(43.29%),护士81名(49.39%),其他医务人员12名(7.32%)。2013年发生针刺伤事件47例(28.66%),2014年54例(32.93%),2015年63例(38.41%)。医疗器械为受污染器械的有152例(92.68%),医疗器械污染情况未知的有9例(5.49%),而未受污染的器械仅为3例(1.83%)。164例针刺伤发生地点以手术室最多(67例,占40.85%);针刺伤发生部位以手指的发生率最高(141例,占85.98%);发生针刺伤的原因以粗心、工作繁忙或者未按规范操作为主(115例,占70.12%),医生发生针刺伤的原因以工作经验不足者最多,占52.11%,护士发生针刺伤原因以粗心、工作繁忙或者未按规范操作者最多,占93.83%。结论医务人员针刺伤案例逐年增多,应加强医务人员职业防护意识,加强医院感染管理制度建设,改善医疗环境等措施减少针刺伤的发生。     

Characteristics of working hours and the risk of occupational injuries among hospital employees: a case-crossover study

Objectives:We investigated the association of working hours with occupational injuries in hospital shift work.Methods:Registry data of occupational injuries of hospital employees from 11 towns and 6 hospital districts were linked to daily payroll data to obtain working hours for 37 days preceding the first incidence of the injury (N=18 700). A case-crossover design and associated matched-pair interval analysis were used to compare working hour characteristics for three separate hazard windows among the same subjects. Conditional logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI).Results:We found an elevated risk of an occupational injury for workdays with evening shifts (OR 1.09, 95% CI 1.03–1.14) and workdays following night shifts (OR 1.33, 95% CI 1.17–1.52). After excluding commuting injuries, the risk increased during the evening shifts (OR 1.15, 95% CI 1.09–1.23) and the work days following night shifts (OR 1.44, 95% CI 1.24–1.69), but was no more significant during the morning shifts. Injury risk increased following a week of ≥5 morning shifts or ≥3 evening shifts, but did not increase according to the number of preceding night shifts or quick returns. The length of the work shift (OR 1.22, CI 1.06–1.42) – not the length of the weekly working hours – was associated with an increased risk.Conclusions:The results indicate an increased occupational injury risk during the evening shifts and during work days following night shifts, with the risk increasing according to the number of evening but not night shifts.     

Job stress as a risk factor for absences among manual workers: a 12-month follow-up study

This study was conducted to evaluate the impact of job stress on absence from work caused by illnesses and accidents through a prospective research design. A total of 2,349 manual workers were included in this analysis. In the first survey, job stress was determined using the Korean Occupational Stress Scale-Short Form. In the second survey, information on absence due to accidents or illnesses during the past one year was obtained through a questionnaire. The relationship was analyzed using a logistic regression model with multiple imputation. After adjusting for confounding variables for males, absence due to accidents was statistically associated with high job demand, insufficient job control, inadequate social support, and organizational injustice. In addition, high job demands and organizational injustice were related to increased absence due to illnesses in both genders. A lack of reward was associated with increased absence due to illnesses among female workers. We found that job stress was associated with a higher risk of absence caused by accidents or illnesses of manual workers.     

Occupational risk among orchard workers: a descriptive study

Orchard workers are exposed to an array of occupational health and safety hazards that result in injury, illness, and, in some cases, death. The purpose of this qualitative study was to identify and explore factors that contribute to occupational risks related to orchard work. Twenty-five Hispanic orchard workers were interviewed. They reported that the most common type of accident was falls, usually from a ladder; and the most common injuries were strains and sprains. Three broad categories of factors that contributed to the occurrence of such injuries were Knowledge, Attitudes and Behaviors; Work-Related Factors; and Factors External to Work.     

口腔医院护工锐器伤现况调查

摘要:目的　了解口腔医院护工锐器伤的发生情况,为制定口腔医院护工锐器伤规范化防护措施提供理论依据。方法　采用卫生部设计的《医务人员锐器伤筛查表》,对某院55名护工人员对过去1个月中锐器损伤的发生情况进行问卷调查。结果　护工锐器伤发生率为21.8%（12/55）,发生密度为 0.47次/（人.月）;年限≤1年的护工锐器伤发生率最高,为61.1%;接受过培训的护工锐器损伤发生率（18.5%）明显低于未培训的护士（39.3%）。结论　口腔医院护工是锐器伤发生的高危人群,通过针对性预防和干预,可有效地降低锐器伤发生率。     

Reported needlestick and sharp injuries among health care workers in a Greek general hospital

Between July 1990 and June 1996, 284 exposures to infectious material were reported by 247 health care workers (HCWs) at AHEPA University Hospital, Thessaloniki, Greece, representing an overall rate of 2.4% reported injuries per 100 HCWs/year. Nurses reported the highest rates of incidents (3.0%) and in all but one working group women exhibited higher injury rates per year than male HCWs. Young workers (21-30 years old) were primarily affected in incidents (P < 0.001). Needles were the most common implement causing injury (60.6%) and resheathing of used needles as well as garbage collection were common causes of injury. None of the HCWs seroconverted in exposures where immune status to blood-borne pathogens was estimated. Efforts by the infection control committee need to be more intense, in order to increase the rate of reported staff injuries. This will facilitate identification of unsafe practices and provide more adequate preventive measures.     

某基层医院医务人员锐器伤现状调查

目的了解某院不同科室医务人员锐器伤发生现状,为制定预防措施提供依据。方法2011年7月,对该院重症监护室（ICU）、急诊科、外科、内科、手术室、供应室工作满4年的340名医务人员进行回顾性问卷调查。结果共发放问卷340份,收回有效问卷332份,有效率97.65%。医务人员锐器伤发生率为38.25%（127/332）,其中医生为30.00%（30/100）,护士为41.81%（97/232）,护士锐器伤发生率显著高于医生（χ2=4.13,P＜0.05）。不同科室医务人员锐器伤发生率不同,差异有统计学意义（χ2=49.29,P＜0.01),其中急诊科医务人员锐器伤发生率最高（73.08%）。结论医务人员发生锐器刺伤的概率较高,应强化职业安全防范意识,规范操作行为,最大限度地减少职业伤害,实现暴露后零感染目标。     

Prevalence and prevention of needlestick injuries among health care workers in a German university hospital

Objective Health care workers (HCWs) are exposed to bloodborne pathogens, especially hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) through job-related risk factors like needlestick, stab, scratch, cut, or other bloody injuries. Needlestick injuries can be prevented by safer devices. Methods The purpose of this study was to investigate the frequency and causes of needlestick injuries in a German university hospital. Data were obtained by an anonymous, self-reporting questionnaire. We calculated the share of reported needlestick injuries, which could have been prevented by using safety devices. Results 31.4% (n = 226) of participant HCWs had sustained at least one needlestick injury in the last 12 months. A wide variation in the number of reported needlestick injuries was evident across disciplines, ranging from 46.9% (n = 91/194) among medical staff in surgery and 18.7% (n = 53/283) among HCWs in pediatrics. Of all occupational groups, physicians have the highest risk to experience needlestick injuries (55.1%—n = 129/234). Evaluating the kind of activity under which the needlestick injury occurred, on average 34% (n = 191/561) of all needlestick injuries could have been avoided by the use of safety devices. Taking all medical disciplines and procedures into consideration, safety devices are available for 35.1% (n = 197/561) of needlestick injuries sustained. However, there was a significant difference across various medical disciplines in the share of needlestick injuries which might have been avoidable: Pediatrics (83.7%), gynecology (83.7%), anesthesia (59.3%), dermatology (33.3%), and surgery (11.9%). In our study, only 13.2% (n = 74/561) of needlestick injuries could have been prevented by organizational measures. Conclusion There is a high rate of needlestick injuries in the daily routine of a hospital. The rate of such injuries depends on the medical discipline. Implementation of safety devices will lead to an improvement in medical staff’s health and safety.     

Increased risk of asthma among Finnish construction workers

AIM: To determine the risk of asthma among 7891 Finnish construction workers in the Pirkanmaa Region of southern Finland. METHOD: Retrospective cohort study of hospital records of the Tampere University Hospital. A population of Pirkanmaa paper mill workers (n=2686) and the Pirkanmaa working age population (n=252,500) served as reference populations. RESULTS: There were 147 new cases of asthma among the construction workers in 1991-1995. The annual rate was 37 per 10,000 workers and the odds ratio was 2.1 [95% confidence interval (CI)=1.2-3.6] for the women and 1.8 (95% CI=1.5-2.2) for the men when compared with the general working age population. In general, the risk of asthma among the paper mill workers did not differ from the risk of asthma among the general working age population. The construction workers had an increased risk for asthma, although the number of reported cases of occupational asthma was lower for the construction workers than for the paper mill workers or for the working population. CONCLUSION: Construction work, especially dusty tasks, was associated with an elevated risk of asthma. Thus the effect of exposure to irritant agents may have a role in the development of asthma among construction workers. For the most part, these cases of asthma do not meet the criteria for occupational asthma because the specified causal agent can not be defined. The aetiologic agents and mechanisms of asthma in construction work should be clarified for preventive measures.     

某医院内科临床护士针刺伤的危险因素调查与预防措施

目的 探讨临床内科护士针刺伤发生的危险因素及防范措施.方法 采取自行设计的调查问卷,对某教学医院100名内科临床护士进行回顾性调查.结果 针刺伤多发生在护理人员操作中(47.0％),工作量大、紧张繁忙是护士发生针刺伤的主要原因.工作年限越长,发生针刺伤的概率越小,工作年限与针刺伤的发生有很大关系(x2=14.790,P＜0.01).结论 需加强对护士职业安全防护教育,规范操作流程,加强硬件建设,减少护理人员职业伤害.     

Self-reported immunity and opinions on vaccination of hospital personnel among paediatric healthcare workers in Denmark

BackgroundDenmark has no general recommendations for vaccination of healthcare workers (HCWs). We explored the self-reported immunity to varicella, measles, mumps, and rubella, reasons for receiving the influenza vaccine or not, and opinions on vaccination of HCWs against varicella, MMR, pertussis, diphtheria, and influenza among staff from departments with a high risk of exposure to infectious agents.MethodsFrom May 2019 to August 2019, a structured questionnaire was distributed to clinical and non-clinical HCWs at a tertiary and a general paediatric department in Denmark. Self-reported immunity was defined as either previous infection or vaccination against the disease.ResultsOf 619 employed HCWs, 555 (90%) were included. A large proportion were unsure of or denied previous vaccination or infection with measles (20.1%), mumps (30.2%), rubella (21.4%), varicella (12.1%), pertussis (44.1%), and diphtheria (32.1%). Non-clinical personnel and employees born in 1974–1983 had the lowest level of self-reported immunity. Mandatory vaccination of non-immune HCWs was approved by 54–68.9% of participants, and any kind of vaccination (mandatory or as an offer at hospitals) was approved of up to 95.3% of all participants depending on the disease. During the season 2018/19, 214 (38.6%) HCWs received the influenza vaccine, including 20.3% of non-clinical staff, 34.8% of nurses and 56.5% of doctors (P < 0.001). Reasons for lack of vaccine uptake were mainly employees considering themselves rarely sick, the vaccine was not regarded as necessary, forgetfulness or lack of time. Only 37.8% was in favour of mandatory influenza vaccination.ConclusionsA large proportion of paediatric HCWs were not aware of their immune status against important vaccine-preventable diseases. >90% supported vaccination of HCWs, with two out of three supporting mandatory MMR, pertussis and diphtheria vaccination. Better information and an official immunisation policy of non-immune HCWs in Denmark is warranted.     

某大型综合医院医护人员针刺及其他锐器损伤情况

目的 了解医院医护人员针刺及其他锐器损伤情况,为进一步开展干预研究提供线索,并为干预措施效果评价提供基线数据.方法 采用白填式调查问卷对某大型综合医院1201名临床一线医护人员在2009年1月1日至2009年12月31日期间所发生的针刺及其他锐器损伤状况进行回顾性调查.结果 医护人员在过去1年中发生针刺及其他锐器损伤共4302人次,针刺及其他锐器损伤年人均发生次数为3.58人次,损伤发生率为78.85％.发生针刺及其他锐器损伤的高风险人群为妇产科、外科、重症监护室和急诊科医护人员,其接触发生率和年人均发生次数分别为94.67％和4.51人次、93.09％和4.46人次、85.44％和3.08人次、76.62％和4.55人次,引起医护人员针刺及其他锐器损伤的主要医疗操作是掰安瓿、输液结束拔针、整理用毕的锐器和手术中(缝合或切开),其接触发生率分别为46.96％ 、30.97％ 、25.73％和14.49％.医护人员针刺及其他锐器损伤主要是由安瓿瓶、头皮针、皮下注射针、缝合针和手术刀片引起,其损伤发生率分别为47.04％、37.22％、31.31％ 、17.65％和7.08％.结论 医护人员仍然面临较大的针刺及其他锐器损伤风险,不同工种、不同科室医护人员在不同医疗操作及医疗操作的不同阶段、使用不同医疗锐器、使用锐器的用途不同发生职业接触的风险不同,应积极采取有针对性的综合性预防控制措施,全面贯彻落实GBZ/T 213-2008《血源性病原体职业接触防护导则》.     

Client-related work tasks and meaning of work: results from a longitudinal study among eldercare workers in Denmark

Purpose

To investigate the association between the perception of client-related work tasks and the experience of meaning of work among eldercare workers in the Danish eldercare sector.

Methods

We used baseline and follow-up questionnaire data from 3,985 female eldercare workers. The eldercare workers’ perception of the client-related work tasks was measured by six items. Meaning of work was measured by a three-item scale. General linear modelling was used to investigate the association between the client-related work tasks at baseline and experience of meaning of work at follow-up adjusted for job title, type of workplace, and age.

Results

When care workers experience to have time to be flexible in the care provision and to be able to talk and socialize with the elderly, they are significantly more likely to experience meaning of work at follow-up than care workers who occasionally or rarely have this experience. Care workers who frequently experience to have to end a visit prematurely are significantly less likely to experience meaning of work at follow-up than care workers who rarely experience this. Experiences of having time to perform other than pre-planned tasks and to have insufficient time have little impact on experience of meaning of work at follow-up.

Conclusion

This study indicates that to enhance the experience of meaning of work among eldercare workers, improvements of the relational aspects of care work, i.e. the possibilities to talk, socialize, and involve the elderly in the care provision, should be considered.