CASE CROSSOVER STUDY OF OCCUPATIONAL HAND INJURIES

描述：(改编自《调查员摘要》)职业上 四肢创伤是一种非常常见的问题，但很少有人研究。 文献中已发表的病例对照研究。1996年，有1.4个 上肢职业性创伤急诊科就诊百万人次， 其中80%涉及手指、手或手腕。大约500,000 与工作有关的手指或手撕裂伤在紧急情况下得到治疗 全国各部门。 此外，职业性上肢挫伤占所有创伤的23% 1996年向劳工统计局报告的损失工作日案件。 尽管这些伤害对公共健康很重要，但相对较少的是 已知潜在的可预防的暂时性病因 紧跟在他们之前。新近发展起来的病例交叉方法 非常适合于研究这种瞬时暴露。 在这项申请中，我们建议对1,000人进行病例交叉研究 从22个职业健康中心招募与工作相关的手部损伤患者 在新英格兰地区超过2年的诊所。我们会调查的 工作场所因素与职业性创伤的关系 伸展到手和手指。我们将从以下几个方面评估风险因素 领域：(1)工作设备因素，包括不寻常的性能 设备或工具以及手套的使用；(2)工作惯例，如 执行不寻常的工作任务或者使用不寻常的工作方法； 与工人相关的因素，包括疲劳、感觉不适、匆忙和 分心了。 此外，我们将评估工业部门、具体职业和 工人特征包括性别、年龄、惯用手、工作经验、 作为相对风险修饰物的种族/民族和手部损伤病史 观察到的。在一项使用建议的研究方案的试点研究中，我们 成功电话访问了130名患者(70%符合条件的患者) 手指或手的职业性创伤性损伤。在66%的案例中， 访谈在受伤后1天内进行。以病人为主 代表制造业、建筑业和服务业。在我们的 初步发现，我们观察到患糖尿病的风险增加了5.8倍 手指或手的职业性创伤性损伤(95%CI：3.9至8.6) 当使用与标准工作实践相比不寻常的工作方法时。 成功完成这项研究将确定潜在的可修改 增加职业性手部损伤风险的因素。 这些知识将有助于制定具体的干预措施。 旨在减少这些伤害的发生率。

DESCRIPTION: (Adapted from the Investigator's Abstract) Occupational upper extremity trauma is an extremely common, yet under-studied problem with few published case-control studies in the literature. In 1996 there were 1.4 million emergency department visits for occupational upper extremity trauma, 80% of which involved the fingers, hand or wrist. Approximately 500,000 work-related finger or hand lacerations were treated in emergency departments nationwide. Furthermore, occupational upper extremity truma accounted for 23% of all lost work day cases reported to the Bureau of Labor Statistics in 1996. Despite the public health importance of these injuries, relatively little is known about potentially preventable transient etiologic factors that immediately precede them. The recently developed case-crossover methodology is ideally suited to study such transient exposures. In this application, we propose to conduct a case-crossover study of 1,000 work-related hand injury patients recruited from 22 occupational health clinics in the New England area over a 2 year period. We will investigate the association between workplace factors and occupational traumatic injury to the hand and fingers. We will evaluate risk factors in the following domains: (1) Work equipment factors including unusual performance of equipment or tools and the use of gloves; (2) Work practices such as performing an uncommon work task or using an unusual work method; (3) worker-related factors including fatigue, feeling ill, being rushed, and being distracted. In addition, we will evaluate industrial sector, specific occupation and worker characteristics including gender, age, handedness, job experience, race/ethnicity, and hand injury history as modifiers of the relative risks observed. In a pilot study using the proposed study protocol, we successfully telephone interviewed 130 patients (70% of those eligible) with occupational traumatic injury to the fingers or hand. In 66% of cases, the interview was conducted within 1 day of the injury. Patients primarily represented manufacturing, construction and service industries. Among our preliminary findings, we observed a 5.8 fold increase in risk of occupational traumatic injury to the fingers or hand (95% CI: 3.9 to 8.6) when using an unusual work method compared to standard work practices. Successful completion of this study will identify potentially modifiable factors that increase the risk of occupational hand injury. This knowledge will facilitate the development of specific interventions designed to reduce the incidence of these injuries.