A case-crossover study of transient risk factors for occupational acute hand injury
A case-crossover study of transient risk factors for occupational acute hand injury
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DOI：
10.1136/oem.2002.004028
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发表时间：
2004-04-01
影响因子：
4.9
通讯作者：
Mittleman, MA
中科院分区：
文献类型：
--
作者：
Sorock, GS;Lombardi, DA;Mittleman, MA
背景资料：工人急性手外伤占超过1000000急诊科就诊每年在UnitedStates.Aims：为了确定潜在的短暂的职业性急性hand injuries.Methods的危险因素：受试者被招募从23个职业健康诊所在美国东北部五个州。在一次电话采访中，受试者被要求在急性手部受伤前90分钟内报告7个潜在危险因素的发生情况。每个病例还提供了受伤前一个月的暴露对照信息。自我匹配的功能的研究设计控制稳定的人之间的confers.Results：共1166名受试者进行了采访（891名男性，275名女性），平均年龄（SD）为37.2岁（11.4）。受伤和面谈之间的中位时间间隔为1.3天。63%的受试者有撕裂伤。当使用不符合预期的设备、工具或工件工作时（11.0，95% CI 9.4至12.8），或使用不同的工作方法完成任务时（10.5，95% CI 8.7至12.7），手部受伤的相对风险增加。其他相对风险递减的短暂因素是做一项不寻常的任务，分心和匆忙。戴手套使相对风险降低60%（0.4，95%CI 0.3 - 0.5）。职业类别，工作经验，和安全培训被发现改变几个这些effects.Conclusion：结果表明，这些短暂的，潜在的修改因素在工作中的急性手损伤的病因学的重要性。尝试通过各种策略来改变这些暴露，可能会降低工作中急性手损伤的发生率。
Background: Workers with acute hand injuries account for over 1 000 000 emergency department visits annually in the United States.Aims: To determine potential transient risk factors for occupational acute hand injury.Methods: Subjects were recruited from 23 occupational health clinics in five northeastern states in the USA. In a telephone interview, subjects were asked to report the occurrence of seven potential risk factors within a 90-minute time period before an acute hand injury. Each case also provided control information on exposures during the month before the injury. The self-matched feature of the study design controlled for stable between-person confounders.Results: A total of 1166 subjects were interviewed ( 891 men, 275 women), with a mean age (SD) of 37.2 years (11.4). The median time interval between injury and interview was 1.3 days. Sixty three per cent of subjects had a laceration. The relative risk of a hand injury was increased when working with equipment, tools, or work pieces not performing as expected (11.0, 95% CI 9.4 to 12.8), or when using a different work method to do a task (10.5, 95% CI 8.7 to 12.7). Other transient factors in decreasing order of relative risk were doing an unusual task, being distracted, and being rushed. Wearing gloves reduced the relative risk by 60% (0.4, 95% CI 0.3 to 0.5). Occupational category, job experience, and safety training were found to alter several of these effects.Conclusion: The results suggest the importance of these transient, potentially modifiable factors in the aetiology of acute hand injury at work. Attempts to modify these exposures by various strategies may reduce the incidence of acute hand injury at work.