急性职业性手外伤流行病学研究现状与展望

综述急性职业性手外伤的流行特征、经济负担、手外伤患者回归工作的时间及流行病学研究方法。结果显示：急性职业性手外伤具有明显的年龄、性别及行业分布差异,危险因素具有多样性;经济负担以间接为主;研究方法以描述性研究为主,分析性的研究较少。就目前研究中存在的问题进行分析,并提出以后的研究方向。     

Surveillance for nonfatal work-related injuries in Alaska, 1991–1995

Historically, Alaska has had an occupational fatality rate five times greater than that for the United States. This article reports recent surveillance results for hospitalized nonfatal work-related injuries in Alaska, using the population-based Alaska Trauma Registry (ATR) from 1991 through 1995. The fishing, construction, and logging industries led with the highest number of reported cases in the ATR. Workers in the logging, water transportation, and wood product manufacturing industries had the highest injury rates. Cause, severity, type, and body region of injury were examined for each target industry. For industries with the highest numbers and rates of injuries, in most cases, falls were identified as a common cause of injuries. A fractured bone was the most common type of injury, and the extremities were the most common body region affected. The ATR has proved to be a reliable tool for work-related injury surveillance and will be helpful in planning research priorities and targeting injury prevention efforts. Am. J. Ind. Med. 34:493–498, 1998. © 1998 Wiley-Liss, Inc.     

某钢铁企业职业伤害调查研究

[目的]探讨某钢铁股份公司职业伤害的发生特点、分布、主要原因及发生趋势。[方法]根据对某钢铁股份公司1999年1月至2002年12月间职工人数及发生的职业伤害事故调查资料进行分析。[结果]该公司2002年职业伤害发生率为22．39／万，职业伤害类型以物体打击(24．39％)、灼烫(17．56％)、高处坠落(17．32％)和机械伤害(15．37％)为主。而操作不当(22．20％)和安全意识不强(15．85％)是其主要原因。[结论]职业伤害防制应从提高职工安全意识和技术水平着手，针对不同类型作业场所采取相应的措施。     

Risk factors for injury among construction workers at Denver International Airport

Background The Denver International Airport construction project provided a rare opportunity to identify risk factors for injury on a large construction project for which 769 contractors were hired to complete 2,843 construction contracts. Workers' compensation claims and payroll data for individual contracts were recorded in an administrative database developed by the project's Owner-Controlled Insurance Program. Methods From claims and payroll data linked with employee demographic information, we calculated injury rates per 200,000 person-hours by contract and over contract characteristics of interest. We used Poisson regression models to examine contract-specific risk factors in relation to total injuries, lost-work-time (LWT), and non-LWT injuries. We included contract-specific expected loss rates (ELRs) in the model to control for prevailing risk of work and used logistic regression methods to determine the association between LWT and non-LWT injuries on contracts. Results Injury rates were highest during the first year of construction, at the beginning of contracts, and among older workers. Risk for total and non-LWT injuries was elevated for building construction contracts, contracts for special trades companies (SIC 17), contracts with payrolls over $1 million, and those with overtime payrolls greater than 20%. Risk for LWT injuries only was increased for site development contracts and contracts starting in the first year of construction. Contracts experiencing one or more minor injuries were four times as likely to have at least one major injury (OR &equals: 4.0, 95% CI (2.9, 5.5)). Conclusions Enhancement of DIA's safety infrastructure during the second year of construction appears to have been effective in reducing serious (LWT) injuries. The absence of correlation between injury rates among contracts belonging to the same company suggests that targeting of safety resources at the level of the contract may be an effective approach to injury prevention. Interventions focused on high-risk contracts, including those with considerable overtime work, contracts held by special trades contractors (SIC 17), and contracts belonging to small and mid-sized companies, and on high-risk workers, such as those new to a construction site or new to a contract may reduce injury burden on large construction sites. The joint occurrence of minor and major injuries on a contract level suggests that surveillance of minor injuries may be useful in identifying opportunities for prevention of major injuries. Am. J. Ind. Med. 34:113–120, 1998. © 1998 Wiley-Liss, Inc.     

某钢铁企业1958～2001年工伤死亡事故原因分析

[目的]了解钢铁企业工伤死亡事故发生的规律,探讨事故发生原因,为企业安全管理提供依据。[方法]本文对某钢铁企业1958~2001年发生的352起工伤死亡事故进行分析,主要涉及工亡事故类型、死者人口学特征、事故发生时间分布特点及原因。[结果]车辆伤害、高处坠落、机械伤害和起重伤害是主要的事故类型,分别占24.72%、11.65%、11.08%和10.23%;最常见的多人死亡事故是爆炸与火灾、坍塌。1958~1961年度工亡事故发生起数最多,占31.53%;5月、7月、8月和12月是事故高发月;事故易于在白班期间发生,且有向11:48集中的趋势(P<0.05)。违反劳动纪律、操作违规/失误是导致事故的首要因素,占63.64%。[结论]工亡事故是由多种因素综合导致,应该针对事故危险因素采取安全防护措施。     

金属制造业非致死性职业伤害流行特征分析

目的了解金属制造业非致死性职业伤害流行特征，为有效控制职业伤害的发生提供科学依据。方法采用随机整群抽样方法，抽取7家金属制造工厂中的2487名工人进行问卷调查，分析非致死性职业伤害发生特征和影响因素。结果调查人群非致死性职业伤害的年发生率为15．08％；事故类型以机器伤害（16．80％）、物体打击（13．60％）和热／火烫（11．47％）为主；伤害部位主要为手指／脚趾（78．16％）。多因素L0gistic回归分析显示，个性维度中的N分较高（情绪稳定性差）、年龄小、文化程度及技术等级低、采用计件／计时方式计算工资等因素。可使职业伤害发生的危险性升高。结论职业伤害已成为重要的公共卫生问题。应引起社会的广泛关注。     

上海市康桥镇金属制造业职业伤害流行现况及影响因素分析

目的了解金属加工企业职工意外伤害发生现况及其影响因素,为开展意外伤害干预提供资料。方法采用随机整群抽样方法,抽取康桥镇5家企业共1921名职工,对其过去一年中发生职业意外伤害情况进行问卷调查。结果康桥镇金属加工企业职业伤害发生率为6．9％,男性高于女性,男性职工职业伤害随着年龄的增长而降低。在187例伤害事件中．主要伤害原因为锐物穿刺伤,构成比为47．1％;主要受伤部位为手指,构成比为43.3％。职业伤害的主要影响因素有年龄、性别、文化程度以及单位安全管理措施等。结论职业伤害在康桥镇金属制造企业流行情况比较普遍,需要加以干预。     

Global,regional and national burden of disease attributable to 19 selected occupational risk factors for 183 countries, 2000–2016: A systematic analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury

ObjectivesWe provide a brief introduction to the objectives, data, methods and results of the World Health Organization (WHO)/International Labor Organization (ILO) Joint Estimates of the Work-related Burden of Disease and Injury (WHO/ILO Joint Estimates), which estimated the burden attributable to 19 selected occupational risk factors.MethodsThe WHO/ILO Joint Estimates were produced within the global Comparative Risk Assessment framework, which attributes the burden of one specific health outcome (ie, disease/injury) to a specific occupational risk factor. For 39 established occupational risk factor-health outcome pairs, estimates are produced using population attributable fractions (PAF) from recent burden of disease estimates. For two additional pairs, PAF are calculated from new databases of exposure and risk ratios produced in WHO/ILO systematic reviews. Attributable disease burdens were estimated by applying the PAF to total disease burdens.ResultsGlobally in 2016, it is estimated that 1.88 [95% uncertainty range (UR) 1.84–1.92] million deaths and 89.72 (95% UR 88.61–90.83) million disability-adjusted life years were attributable to the 19 selected occupational risk factors and their health outcomes. A disproportionately large work-related burden of disease is observed in the WHO African Region (for disability-adjusted life years), South-East Asia Region, and Western Pacific Region (for deaths), males and older age groups.ConclusionsThe WHO/ILO Joint Estimates can be used for global monitoring of exposure to occupational risk factors and work-related burden of disease and to identify, plan, cost, implement and evaluate policies, programs and actions to prevent exposure to occupational risk factors and their associated burden.     

A classification scheme for aggregating u.s. census occupation and industry codes

The use of occupation as a surrogate for workplace exposures when more specific information is unavailable is common yet is particularly challenging in studies involving many diverse occupations. A classification scheme that aggregates workers based on similar job tasks and potential exposures was developed for use in a Canadian study, and its adaptation for a similar U.S. study is described. The 56 occupational categories and 1980 U.S. census occupation and industry codes used to create each are presented. The scheme was developed using the distribution of occupations and industries in two limited study populations, and no exposure measurements were taken in its preparation. However, the aggregation of jobs with similar exposures has practical utility in the analysis of a large number of specific occupations, each with a small number of workers. As a result, the scheme presented can provide a starting point for researchers facing this task in the analysis of case-control occupational data.     

某有色金属企业1980～1999年职业伤害的流行病学研究

目的 掌握有色金属企业职业伤害分布特征，探索职业伤害发生规律和影响职业伤害发生的因素，为最大限度地控制和减少职业伤害提供科学依据。方法 用回顾性流行病学调查方法，调查某有色金属企业1980～1999年职业伤害发生情况和分布规律。结果 某有色金属企业1980～1999年发生职业伤害3831例。矿山3000例，工厂831例；男性3592例，女性239例；轻伤3630例，重伤104例，死亡57例。职业伤害在时间分布上有季节性特征。昼时分布有明显的集中趋势，高发于中班，圆形分布检验差异有显著性。人群分布以20～30岁年龄为高发人群，构成占40％以上，以20～25岁为最高点。工龄分布以1～10年工龄者为高发，最高点在1～5年工龄段。轻伤和重伤的年龄差别有统计学意义(Z=-2.184，P=0．029)，职业伤害程度与年龄呈正相关(r=0．041，P=0.011)。职业伤害主要分布在打眼、出矿、钳工、起重、支柱五大工种，易受伤部位是手、脚、头、四肢、五官，易受伤类型是物击、车辆、高坠。结论 某有色金属企业职业伤害发生率逐年下降，综合干预收到了效果，职业伤害是可以预防和控制的。     

Injuries among domestic waste collectors

Detailed information on occupational injuries and the precise number of injuries among waste collectors is missing. In this study, risk circumstances associated with injuries among waste collectors were analyzed and described. The study was carried out in a single company with 667 employees in 1993. For each injury, information was collected on date, time, type, and severity of the injury, injury circumstances, department of employment, external or internal registration, sex, year of birth and employment, type of employment, and a registration of where the injury happened. A total of 17% of the employees experienced injury. The number of injuries decreased with increasing seniority and age. Most injuries occurred outside the company area. More injuries occurred on Mondays and Thursdays, and there were peaks in the injury rate in May and September. Most often injured was the back, followed by the knees, hands, and feet. The job as a waste collector was associated with a high risk of experiencing an occupational injury and the number of injuries decreased with increasing seniority and nonsignificantly with increasing age. Moreover, a seasonal and weekly variation was observed. Am. J. Ind. Med. 33:182–189, 1998. © 1998 Wiley-Liss, Inc.     

Laceration injuries among workers at meat packing plants

BACKGROUND: Employees in meat packing experience one of the highest occupational laceration injury rates in the US. METHOD: A retrospective study was conducted using OSHA 200 injury and illness logs and First Reports of Injury from two large US meat packing plants from 1998 to 2000. The total workers observed during the study period ranged between 2,449 and 2,682 per year. RESULTS: Laceration injury incidence rates in Plant 1 were 14.0 injuries per 200,000 person hours (per 100 workers per year) in 1998, 11.5 in 1999, and 8.3 in 2000, whereas in Plant 2 the overall incidence rate was 3.7 in 1998, 4.8 in 1999, and 3.0 in 2000. Laceration injury rates in Plant 2 were close to the expected OSHA recordable laceration injury rate in 1999 (3.0 per 100 workers per year), but Plant 1 was considerably higher. Plant 1 had a kill support department, and removed animal hides whereas Plant 2 did not. Handheld non-powered tools were the most common contact objects whereas the slaughter department had the highest number of injuries. Finger injuries from a handheld non-powered tool were the most frequent. CONCLUSIONS: Findings confirm the high rate of injury from laceration in this industry and indicate hazard varies across time into shift, task being performed, and type of tool being used.     

The dangers of dairy farming: the injury experience of 600 workers followed for two years.

In order to better understand the work-related injuries sustained on central New York dairy farms, we undertook a two-year population-based study of 600 farmers and farm workers on 201 dairy farms. During the observation period, 1984-1986, 151 persons had 200 injuries, giving an injury rate of 16.6%/year (166 injuries/1,000 workers/year). Men were injured more often than women (p less than or equal to 0.01). Injured workers were older (p less than or equal to 0.01), worked more hours (p less than or equal to 0.001), and had heavier workloads than noninjured workers (p less than or equal to 0.001). The growing and harvest seasons had the most injuries; winter the fewest. More than 2/3 of the injuries occurred in the afternoon. Owners/operators, often the most experienced, knowledgeable people on the farms, were most often hurt. Those working more than 60 hours/week, with greater than 30 acres under tillage/worker, had a relative risk of 2.76 compared with all other workers. The attributable risk for this group was 51%. There were two fatalities, both involved owner/operators. Our findings suggest that previous studies may have underestimated the risks faced by farmers. Dairy farming in central New York is very dangerous work. Those who own and operate these dairy farms are most often hurt and killed. Analysis of events on individual farms will be reported separately.     

Agricultural injuries among a population-based sample of farm operators in Alabama

A population-based study of the occurrence of agricultural injuries during the previous year was conducted in a simple random sample of 1,000 farm operators in Alabama in 1991. The participation rate was 86.2%. The cumulative 1-year incidence was 9.9% (95% CI = 7.7–12.1), based on the number of injuries, and 7.8% (95% CI = 5.8–9.8), based on the number of farmers injured. Limbs were the body parts most frequently injured: fingers (10.7%), hands or wrists (10.7%), and legs (8.9%). The leading external causes were machinery (28.6%), falls (23.2%), and animals (12.5%). There was a higher injury frequency at the end of the week, with a Saturday peak. Seasonal pattern of injury displayed a bimodal curve, one peak in spring, and a higher peak in early fall in September. The most risky farm types were forestry and dairy. The factors predictive of increased injury risk in multiple logistic regression included younger age, farm ownership, greater percent of working time spent on farming, more alcohol consumed, and prior residual injury. The results provide some indications for formulating agricultural injury control programs and for future research. © 1994 Wiley-Liss, Inc.     

Use of employer administrative databases to identify systematic causes of injury in aluminum manufacturing

BACKGROUND: Employer administrative files are an underutilized source of data in epidemiologic studies of occupational injuries. METHODS: Personnel files, occupational health surveillance data, industrial hygiene data, and a real-time incident and injury management system from a large multi-site aluminum manufacturer were linked deterministically. An ecological-level measure of physical job demand was also linked. This method successfully created a database containing over 100 variables for 9,101 hourly employees from eight geographically dispersed U.S. plants. RESULTS: Between 2002 and 2004, there were 3,563 traumatic injuries to 2,495 employees. The most common injuries were sprain/strains (32%), contusions (24%), and lacerations (14%). A multivariable logistic regression model revealed that physical job demand was the strongest predictor of injury risk, in a dose dependent fashion. Other strong predictors of injury included female gender, young age, short company tenure and short time on current job. CONCLUSIONS: Employer administrative files are a useful source of data, as they permit the exploration of risk factors and potential confounders that are not included in many population-based surveys. The ability to link employer administrative files with injury surveillance data is a valuable analysis strategy for comprehensively studying workplace injuries, identifying salient risk factors, and targeting workforce populations disproportionately affected.