Fatores sociodemográficos e clínicos associados à força de preensão manual de idosos condutores de veículos / Sociodemographic and clinical factors associated with handgrip strength in elderly automobile drivers / Factores sociodemográficos y clínicos asociados a la fuerza de prensión de la mano en conductores de vehículos de ancianos

Objetivo: investigar a associação entre força de preensão manual e características sociodemográficas e clínicas de idosos condutores de veículos automotores. Método: estudo transversal, realizado em clínicas de medicina de tráfego na cidade de Curitiba/Paraná, com 421 idosos (≥ 60 anos). Realizou-se análise estatística pelo modelo de Regressão Logística e Teste de Wald, considerando intervalo de confiança de 95% e valores de p <0,05 como significativos. Resultados: oitenta e quatro (20%) idosos apresentaram força de preensão manual reduzida. A força de preensão manual reduzida foi associada à faixa etária (p=0,001) e à hospitalização no último ano (p=0,002). Conclusão: houve associação significativa entre a força de preensão manual de idosos motoristas e as variáveis idade e hospitalização no último ano. Dessa forma, torna-se essencial a inclusão de avaliações específicas, centradas nas variáveis sociodemográficas e clínicas próprias da pessoa idosa, durante o exame de aptidão para dirigir veículos automotores.(AU)

Objective: to investigate the association between handgrip strength and sociodemographic and clinical characteristics of elderly automobile drivers. Method: cross-sectional study, carried out in traffic medicine clinics in the city of Curitiba/Paraná, with 421 elderly people (≥ 60 years old). Statistical analysis was performed using the Logistic Regression model and the Wald Test, considering a 95% confidence interval and p values <0.05 as significant. Results: eighty-four (20%) seniors had reduced handgrip strength. Reduced handgrip strength was associated with age group (p=0.001) and hospitalization in the last year (p=0.002). Conclusion: there was a significant association between the handgrip strength of elderly drivers and the variables age and hospitalization in the last year. Thus, it is essential to include specific assessments, centered on sociodemographic and clinical variables specific to the elderly person, during the aptitude test to drive automobiles.(AU)

Objetivo: investigar la asociación entre la fuerza de prensión de la mano y las características sociodemográficas y clínicas de los ancianos conductores de vehículos automotores. Método: estudio transversal, realizado en clínicas de medicina de tránsito de la ciudad de Curitiba/Paraná, con 421 ancianos (≥ 60 años). El análisis estadístico fue realizado por el modelo de Regresión Logística y Test de Wald, considerando intervalo de confianza de 95% y valores de p <0,05 como significativos. Resultados: 84 (20%) sujetos ancianos presentaron reducción de la fuerza de prensión de la mano. La reducción de la fuerza de prensión de la mano se asoció al grupo de edad (p=0,001) y a la hospitalización en el último año (p=0,002). Conclusión: hubo una asociación significativa entre la fuerza de prensión de la mano de los conductores ancianos y las variables edad y hospitalización en el último año. Así pues, es esencial incluir evaluaciones específicas, centradas en las variables sociodemográficas y clínicas de los ancianos, durante el examen de aptitud para conducir vehículos automotores.(AU)

Analysis of traffic accidents caused by epileptic seizures in 7 patients without definite diagnosis / 中华神经科杂志

Objective:To elucidate the phenomenon that epileptic seizure occurs in patients with epilepsy without definite diagnosis when driving a motor vehicle and its hazards.Methods:From January 2020 to June 2022, 7 epileptic patients who experienced traffic accidents caused by seizures were selected from the First Affiliated Hospital of Soochow University, and their demographic data, traffic accident related data and epilepsy diagnosis and treatment data were summarized and analyzed.Results:A total of 7 adult patients with epilepsy were collected, including 6 males, 4 of whom had been driving for more than 10 years. Among them, 1 patient drove a bus, and the other 6 patients drove private cars. Totally 5/7 of the accidents resulted in personal injury, and 3/7 of the accidents resulted in personal death. In 5 patients, video electroencephalogram showed interictal epileptiform discharges. In 2 patients, the imaging findings suggested the presence of cerebral cortical lesions that may lead to seizures. In terms of the form of seizure, 3 patients′ seizure type was focal to bilateral tonic-clonic, and the other 4 patients were very probable to be focal impaired awareness seizure.Conclusions:Undiagnosed epileptic seizures lead to traffic accidents, endanger patients and public safety, which need to attract attention from both doctors and patients, as well as the whole society.

Prevalence and risk factors of work-related musculoskeletal disorders in upper back of welders in an automobile factory / 环境与职业医学

Background China's automobile manufacture is a labor-intensive industry, and most of the welding tasks are manual operations. It is often necessary to observe the solder joints during operation, and there are many adverse health outcome-related factors involved in the work process. However, the research on the prevalence and risk factors of work-related musculoskeletal disorders (WMSDs) in the upper back of welders is still insufficient. Objective To explore the prevalence and risk factors of WMSDs in the upper back of welders from an automobile factory. Methods This was a cross-sectional study. A cluster random sampling method was used to select 972 electric welders from an automobile factory as the study subjects. The Musculoskeletal Disorders Questionnaire was used to estimate the prevalence of WMSDs in the upper back in the past year. Results The prevalence rate of WMSDs in the upper back in the welders was 42.2% (410/972). The positive rates of studied occupational risk factors were 72.5% (705/972) for maintaining same posture for a long time, 71.8% (698/972) for bending and twisting for a long time, and 64.7% (629/972) for repetitive trunk movements. The univariate analysis showed that the prevalence rates of WMSDs were significantly different among workers categorized by gender, working age, twisting and/or bending for a long time, working in the same position for a long time, lifting heavy objects in an uncomfortable position, repetitive trunk movements, being unable to exert energy due to discomfort, work involving cold or temperature changes, personnel shortage, no rest between work, working hours per week, and working in an uncomfortable position (P<0.05). The results of multiple logistic regression indicated that female, working in the same position for a long time, working in an uncomfortable position (frequently), lifting heavy objects in an uncomfortable position, and being unable to exert energy due to discomfort were associated with higher risks of reporting WMSDs in the upper back (OR=2.37, 1.46, 1.76, 1.44, and 1.50, respectively, P<0.05); the risk of reporting WMSDs in the upper back increased by 95%, 157%, and 196% for every 10 h increase in weekly working hours (41-50 h, 51-60 h, ≥61 h vs ≤40 h); adequate rest time was associated with a lower risk for WMSDs in the upper back (OR=0.70, 95%CI: 0.49-0.98). Conclusion The prevalence rate of WMSDs in the upper back of welders in the automobile factory is high, and many occupational risk factors are involved. Measures should be taken for intervention and prevention.

Influencing factors and attribution analysis of hand/wrist musculoskeletal disorders among welders in an automobile factory / 环境与职业医学

Background Welders in automobile manufacturers are prone to hand/wrist musculoskeletal disorders (MSDs), which seriously affect workers' physical and mental health. Objective To investigate the factors influencing hand/wrist MSDs of welders in an automobile factory and the population attributable risk percentage (PARP). Methods Five branches of an automobile factory were selected by convenient sampling method, and all qualified welders in the selected branches were enrolled as research participants. The Chinese Musculoskeletal Disorders Questionnaire was used to collect information such as general characteristics of welders, presentation of MSDs in the wrists and hands, and selected ergonomic factors. Log-binomial model in the SAS program was used to calculate the prevalence ratio (PR) of each influencing factor and PARP. Results The prevalence rate of MSDs in the hands/wrists of welders in the automobile factory was 44.1% (345/782). The results of multiple analysis showed that female (PR=1.25, 95%CI: 1.10-1.44), being very tired after work (versus not tired, PR=2.22, 95%CI: 1.16-4.25), twisting wrists (PR=1.44, 95%CI: 1.19-1.74), insufficient operating space (PR=1.22, 95%CI: 1.07-1.40), and holding or pinching objects by hands (PR=1.58, 95%CI: 1.18-2.12) increased the risk of reporting hand/wrist MSDs symptoms. The PARP of major occupational risk factors was: holding or pinching objects by hands, 32.46%; twisting wrists, 21.50%; being very tired after work, 15.28%; and insufficient operating space, 8.18%. Conclusion The prevalence of MSDs symptoms in hands/wrists of welders in this automobile factory is high. Gender, holding or pinching objects by hands, twisting wrists, being very tired after work, and insufficient operating space are the factors affecting hand/wrist MSDs, among which holding or pinching objects by hands and twisting wrists are the priority intervention factors.

Survey on awareness of occupational health knowledge and concept among front-line workers in the automotive manufacturing industry / 中国职业医学

Objective To investigate the awareness of occupational health knowledge and concept of front-line workers in the automobile manufacturing industry. Methods A total of 1 188 front-line workers from 47 automobile manufacturing enterprises in Guangdong Province were selected as the research subjects using the judgment sampling method. The awareness of occupational health knowledge and concept of the workers was investigated using the Personal Questionnaire for National Survey of Occupational Health Literacy for Key Populations. Results The median (25th and 75th percentiles) awareness of occupational health knowledge and concept among the research subjects was 56.00% (44.00%, 64.00%). The awareness was higher among male workers than female workers (P<0.05). The awareness was higher among married workers than workers with other marital status (P<0.05). The awareness of workers with an education level of middle school or below was lower than those in the senior high school and junior college group and bachelor's degree or above group (all P<0.05). The awareness of workers in the group with personal monthly income <5 000 was lower than that in the other two income groups with personal monthly income ≥5 000 (all P<0.05). The awareness of workers in medium and large enterprises was higher than that of workers in small and micro enterprises (all P<0.05). The awareness of workers in foreign-funded enterprises was higher than that in private enterprises and other enterprises (all P<0.05). The awareness of workers with job tenure >5-10 and >10 years was higher than that in workers with job tenure of 1-≤5 years (P<0.05). The awareness for the 25 items of occupational health knowledge and concept among the research subjects ranged from 6.14% to 96.72%, with an average awareness of 54.46% for the 25 items. Conclusion The awareness of occupational health knowledge and concept of front-line workers in automobile manufacturing industry is not high in general, and it is influenced by gender, marriage status, education level, personal monthly income, enterprise nature and scale, and job tenure.

Status and influencing factors of occupational health literacy among workers in automobile manufacturing industry in Beijing City / 中国职业医学

Objective To analyze the current status and influencing factors of occupational health literacy(OHL) among workers in automobile manufacturing industry in Beijing City. Methods A total of 1 639 frontline workers from 15 automobile manufacturing enterprises in Beijing City were selected using stratified cluster sampling method. The National Occupational Health Literacy Monitoring for Key Groups Questionnaire was used to investigate the OHL of the workers. Results The overall awareness of OHL was 60.5% in these 1 639 automobile manufacturing workers. The awareness of OHL in the four dimensions, from high to low, were basic knowledge of occupational health protection, info of healthy working style and behaviors, legal knowledge of occupational health and basic skills of occupational health protection (82.1% vs 73.2% vs 57.5% vs 43.3%, P<0.01). The multivariate logistic regression analysis results showed that gender, marriage status, education level, personal monthly income and enterprise scale were influencing factors of OHL of automobile manufacturing workers (all P<0.05). Conclusion The OHL awareness among workers of automobile manufacturing industry in Beijing City, especially the basic skills of occupational health protection and the legal knowledge of occupational health, needs to be improved. It is essential to focus on promotion and intervention of occupational health in female workers, those with low education levels, low-income levels, and workers in small- and medium-sized enterprises.

Application and comparison of three occupational health risk assessment methods in automobile manufacturing enterprises / 环境与职业医学

Background The complex and diverse occupational disease hazards in automobile manufacturing industry pose high occupational health risks to workers. Objective To explore the methods that can accurately reflect the workplace health risk grade of automobile manufacturing enterprises, and to guide enterprises to practice risk classification management. Methods Comprehensive index method, International Commission on Mining and Metals occupational health risk assessment method (ICMM method), and risk index method were used toassess health risks of occupational disease hazards in major workstations such as welding, polishing, and painting in three automobile manufacturing enterprises in Hunan Province. Kappa consistency test was used to test the grading results of the three assessment methods. The re-examine results and detection rate of contraindications of occupational health examinations in the past three years were used to verify the assessment results. Results The results of comprehensive index method showed that the hazards of each selected workstation in enterprises A and B were evaluated as grade 2-3, among which NO2 in enterprise A was grade 3, and welding fume, NO2, and formaldehyde in enterprise B were all grade 3. The hazards of each selected workstation in enterprise C were grade 3-4, among which NO2 and benzene in were grade 4, and welding fume, manganese and its compounds, grinding wheel dust, and xylene were grade 3. The hazards evaluated by ICMM quantitative method were grade 2 and grade 5, among which manganese and its compounds in enterprise A and welding fume, grinding wheel dust, and benzene series in enterprise C were graded as grade 5. The hazards evaluated by risk index method were grade 1-4, among which manganese and its compounds in enterprises A and B were grade 3, and manganese and its compounds and benzene in enterprise C were grade 4. The Kappa value between comprehensive index method and ICMM method was 0.084 (P>0.05), that between comprehensive index method and risk index method was −0.046 (P>0.05), and that between ICMM method and risk index method was 0.014 (P>0.05), indicating poor consistency. By comparing the results of occupational health surveillance with the results of occupational health risk assessment, one worker was found to have occupational contraindication of manganese exposure and 1 worker was found to have excessive manganese in hair in enterprise A. However, the comprehensive index method graded low risk for manganese and its compounds in enterprise A and the result is conservative. The key workstations identified by ICMM method were consistent with the occupational health examination results, but the assessment grades were all extremely high risk, and the results were too strict. One worker was found to be contraindicated to welding fumes, and 2 polishers were found to have severe mixed pulmonary ventilation dysfunction in enterprise C. Mild and moderate pulmonary ventilation dysfunction was found to be common in welding and polishing workstations in each enterprise. The assessment results of welding fumes and grinding wheel dust by the risk index method were negligible risks, which were inconsistent with the occupational health examination results. Conclusion The comprehensive index method, ICMM method, and risk index method can basically identify workstations with serious occupational hazards, but they have certain limitations and applicability. In general, the evaluation results of the comprehensive index method were generates more consistent with the results with occupational health surveillance than the other two methods, is more comprehensive and objective in consideration, and is more suitable for health risk assessment of automobile manufacturing enterprises.

Handgrip strength in older adults and driving aptitude / Fuerza de prensión manual y aptitud para conducción vehicular de adultos mayores / Força de preensão manual em idosos e a aptidão para condução veicular

ABSTRACT Objective: to analyze handgrip strength as a predictor of the inability to drive in older adults. Method: a cross-sectional study conducted in traffic clinics with 421 older adults in Curitiba-Paraná from January 2015 to December 2018. A sociodemographic and clinical questionnaire, handgrip strength test, and queries from the National Registry of Qualified Drivers form were applied. Results: Reduced handgrip strength was not a predictor of inaptitude for vehicular driving (p=0.649). The predictors of inaptitude were: low education (p=0.011), incomplete elementary education (p=0.027), and cognition (p=0.020). Conclusion: reduced handgrip strength was not shown to predict for loss of driving skills in older adults. Low education level and reduced cognition level are conditions that were shown to be predictors for loss of vehicular driving license.

RESUMEN Objetivo: analizar la fuerza de prensión manual como factor predictivo de inaptitud para la conducción vehicular de adultos mayores. Método: se trata de un estudio transversal llevado a cabo en clínicas de tránsito de Curitiba, Paraná, entre 421 adultos mayores, de enero de 2015 a diciembre de 2018. Se aplicaron los cuestionarios sociodemográfico y clínico, la prueba de fuerza de prensión manual y se consultó el formulario del Registro Nacional de Conductores Habilitados. Resultados: la fuerza de prensión manual reducida no fue un factor predictivo de la incapacidad para conducir (p=0,649). Los predictores de inaptitud fueron: baja educación (p=0,011), estudios primarios incompletos (p=0,027) y cognición (p=0,020). Conclusión: la fuerza de prensión manual reducida no demostró ser predictora de la pérdida de habilidades de conducción vehicular en adultos mayores. El nivel de escolaridad bajo y el nivel cognitivo reducido despuntaron como predictores de la pérdida de habilitación en la conducción vehicular.

RESUMO Objetivo: analisar a força de preensão manual como preditora de inaptidão para condução veicular de idosos. Método: estudo transversal realizado em clínicas de trânsito com 421 idosos em Curitiba-Paraná de janeiro de 2015 a dezembro de 2018. Aplicaram-se questionários sociodemográfico e clínico, teste de força preensão manual e consultas ao formulário de Registro Nacional de Condutores Habilitados. Resultados: A força de preensão manual reduzida não se mostrou preditora de inaptidão para a direção veicular (p=0,649). Os preditores de inaptidão foram: baixa escolaridade (p=0,011), ensino primário incompleto (p=0,027) e cognição (p=0,020). Conclusão: a força de preensão manual reduzida não se mostrou preditora para perda da habilitação na condução veicular de idosos. O baixo nível de escolaridade, o nível de cognição reduzida, são condições que se mostraram preditoras para a perda da habilitação na condução veicular.

Influencing factors and population attributable risk percent of low back pain in automobile assemblers / 中国职业医学

Objective: To investigate the influencing factors and population attributable risk percent (PAR%) of low back pain in automobile assemblers. Methods: A total of 634 assemblers from 11 automobile manufacturers in Shiyan City, Hubei Province were chosen as research subjects using judgment sampling method. The prevalence of low back pain in the past one year was investigated using Musculoskeletal Disorders Questionnaire. PAR% was used to analyze the contribution of influencing factors to low back pain. Results: The annual prevalence of low back pain was 68.8%. The results of multivariate logistics regression showed that length of service>15 years, high school or secondary college education or above, standing most of the time, sitting most of the time, the proportion of cumulative time of poor posture in work shift time ≥1/8, and bending for insufficient height of working space were the risk factors for low back pain (all P<0.05). The PAR% of the proportion of cumulative time of poor posture in work shift time ≥1/8 was 43.0%, 37.8% for standing most of the time, and 12.8% for bending for insufficient height of working space. Conclusion: The annual prevalence of low back pain was higher in automobile assemblers. The influencing factors included individual factors and occupational factors. The proportion of cumulative time of poor posture in work shift time ≥1/8, standing most of the time and bending for insufficient height of working space should be taken as the priority intervention factors to reduce the prevalence of low back pain among assemblers in this enterprise.

Perfil epidemiológico de pacientes vítimas de trauma torácico em um hospital de urgência e trauma / Epidemiological profile of patients victims of thoracic trauma in an emergency and trauma hospital

O trauma é responsável por significativos impactos na sociedade. De acordo com dados da Organização Mundial de Saúde (OMS), mais de nove pessoas morrem por minuto, vítimas de trauma. Entre os principais tipos de trauma, o torácico representa na atualidade cerca de 25% dos mortos em politraumatizados, constituindo um problema complexo, tendo em vista os elevados índices de mortalidade e sequelas incapacitantes permanentes. Objetivo: Descrever o perfil epidemiológico dos pacientes atendidos em um hospital de urgências da região centro-oeste, vítimas de trauma torácico. Método: Estudo quantitativo, de caráter transversal e retrospectivo, realizado a partir de coleta de dados efetuada em prontuário eletrônico no período de março a maio de 2022. Resultados: Identificou-se 73 pacientes vítimas de trauma torácico, com maior acometimento de pessoas do sexo masculino, com idade entre 26 e 35 anos. Como causa mais frequente, se destacaram os acidentes motociclísticos, resultando principalmente em lesões do tipo hemopneumotórax. Conclusão: o perfil epidemiológico dos pacientes vítimas de trauma torácico foi representado com maior frequência pelo sexo masculino, com idade entre 26 a 35 anos, causados predominantemente por acidentes motociclísticos, resultando na maioria das vezes em lesões do tipo hemopneumotórax

Trauma is responsible for significant impacts on society. According to data from the World Health Organization (WHO), more than nine people die per minute victims of trauma. Among the main types of trauma, thoracic trauma currently represents about 25% of polytrauma deaths, constituting a complex problem, in view of the high rates of mortality and sequelae permanent disabling. Objective: To describe the epidemiological profile of patients treated at an emergency hospital in the Midwest region, victims of thoracic trauma. Method: Quantitative, cross-sectional and retrospective study carried out from data collection of electronic medical records in the period from March to May of 2022. Results: We identified 73 patients who were victims of chest trauma with higher affecting males aged between 26 and 35 years. As the most frequent cause motorcycle accidents stood out, resulting mainly in lesions of the hemopneumothorax type. Conclusion: the profile epidemiology of patients victims of thoracic trauma was represented with greater frequency by males, aged between 26 and 35 years, caused predominantly by motorcycle accidents, often resulting in hemopneumothorax lesions

Lower extremities task of pressing an "accelerator" or a "brake": association with traffic accidents in older drivers - a preliminary study / A tarefa das extremidades inferiores de pressionar um "acelerador" ou um "freio": associação com acidentes de trânsito em motoristas mais velhos - um estudo preliminar

ABSTRACT Traffic accidents by older drivers are a social urgent problem. The National Police Agency (NPA) in Japan has institutionalized the Cognitive Function Test (NPA test) for renewal of a driver's license for older adults. However, driving ability cannot be simply evaluated by usual cognitive tests on the desk. Objective: It is important to add an on-road test, but if not possible, we can use simulators. Before doing simulators, it is important to use the right foot to control the accelerator and brake pedals. We applied the Posner paradigm (visual attention test) for lower extremities. Methods: The participants were older adults. They and their families had anxiety about their driving. The 66 participants (44 men and 22 women) were divided into groups with and without experience of a traffic accident, and the following tests were examined: General cognitive and executive function tests, the NPA test, and an original Lower Extremity Reaction Test. Each participant was asked to press the "brake" or "accelerator" pedal by the right foot as quickly as possible in response to a traffic situation shown on the screen. Results: Compared to participants with favorable reactions to the Lower Extremity Reaction Test, those with poor reaction time tended to have more traffic accidents (OR=6.82), rather than the result of the NPA test. Conclusions: The results suggest that the probability of having a traffic accident can be better evaluated using the Lower Extremity Reaction Test.

RESUMO Os acidentes de trânsito por motoristas idosos são um problema social urgente. A Agência Nacional de Polícia (National Police Agency - NPA) no Japão institucionalizou o Teste de Função Cognitiva (teste NPA) para renovação de carteira de motorista para idosos. No entanto, a capacidade de dirigir não pode ser avaliada simplesmente por testes cognitivos usuais escritos. Objetivo: É importante adicionar um teste em estrada, mas se não for possível, simuladores podem ser utilizados. Antes de fazer simulações, é importante usar o pé direito para controlar os pedais do acelerador e do freio. Aplicamos o paradigma de Posner (teste de atenção visual) para extremidades inferiores. Métodos: Os participantes eram idosos. Eles e suas famílias tinham ansiedade sobre a condução de veículos. Os 66 participantes (44 homens e 22 mulheres) foram divididos em grupos com e sem experiência de acidente de trânsito, e foram examinados os seguintes testes: testes cognitivos gerais e funções executivas, o teste NPA, e um Teste de Reação de Extremidade Inferior original. Cada participante foi solicitado a pressionar o pedal de "freio" ou "acelerador" com o pé direito o mais rápido possível em resposta a uma situação de trânsito mostrada na tela. Resultados: Comparados aos participantes com reações favoráveis ao Teste de Reação de Extremidade Inferior, aqueles com tempo de reação ruim tenderam a ter mais acidentes de trânsito (OR=6,82) do que o resultado do teste NPA. Conclusões: s resultados sugerem que a probabilidade de ocorrência de um acidente de trânsito pode ser melhor avaliada por meio do Teste de Reação da Extremidade Inferior.

Revisión sistemática de estudios sobre intervenciones que promueven la salud en conductores profesionales

Resumen: Introducción: Los trabajadores que se dedican al rubro de conducción están expuestos a factores que dificultan su quehacer laboral, tales como: problemas asociados a la temperatura, ruidos y vibraciones, ventilación insuficiente e ineficiente, atascos y relacionamientos interpersonales con los pasajeros. Objetivo: Identificar, en el estado del arte disponible, qué intervenciones promueven la salud de los conductores profesionales. Material y método: Revisión sistemática, siguiendo las recomendaciones de Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA), orientada por la pregunta: ¿qué intervenciones promueven la salud de los conductores profesionales? Resultados: La búsqueda arrojó 1303 artículos, de los cuales se incluyeron 11; las intervenciones identificadas se asociaron a dispositivos portátiles y mensajería de salud móvil, entrevistas motivacionales, documentos interactivos, exposición a entornos naturales, programas intensivos, asesoramiento, cambios a nivel de políticas, cambios ambientales y de sistemas. Conclusión: Se identificaron intervenciones que incluyeron a la tecnología, entrevistas, el ambiente y control estratégico. Se recomienda la implementación de las intervenciones identificadas, pues se torna perentorio el abordaje de la salud de los conductores profesionales, considerando las características descritas en el presente estudio.

Resumo: Introdução: Os trabalhadores envolvidos na condução estão expostos a fatores que dificultam o seu trabalho, tais como: problemas associados à temperatura, ruído e vibrações, ventilação insuficiente e ineficiente, engarrafamentos e relações interpessoais com os passageiros. Objetivo: Identificar, a partir do estado da arte disponível, quais as intervenções que promovem a saúde dos condutores profissionais. Método: Revisão sistemática, seguindo as recomendações dos itens Preferred Reporting Items for Systematic Reviews e Meta-Analyses (PRISMA), orientada pela pergunta: Quais intervenções promovem a saúde dos condutores profissionais? Resultados: A pesquisa produziu 1303 artigos, dos quais 11 foram incluídos; as intervenções identificadas foram associadas a dispositivos portáteis e mensagens de saúde móveis, entrevistas motivacionais, documentos interativos, exposição a ambientes naturais, programas intensivos, aconselhamento, mudanças a nível político, mudanças ambientais e de sistemas. Conclusão: Foram identificadas intervenções que incluíram tecnologia, entrevistas, ambiente e controle estratégico; recomenda-se a implementação das intervenções identificadas, pois é imperativo abordar a saúde dos condutores profissionais, considerando as características descritas no presente estudo.

Abstract: Introduction: Workers engaged in the driving field are exposed to factors that hinder their work tasks, such as: problems associated with temperature, noise and vibrations, insufficient and inefficient ventilation, traffic jams and interpersonal relationships with passengers. Objective: To identify, in the available state of the art, which interventions promote the health of professional drivers. Method: Systematic review, following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), guided by the question: what interventions promote the health of professional drivers? Results: The search yielded 1303 articles, of which 11 were included; the interventions identified were associated with handheld devices and mobile health messaging, motivational interviewing, interactive documents, exposure to natural environments, intensive programs, counseling, policy-level changes, environmental and systems changes. Conclusion: Interventions were identified that included technology, interviews, the environment and strategic control; the implementation of the identified interventions is recommended, since it is urgent to address the health of professional drivers, considering the characteristics described in this study.

A cross-sectional study of pulmonary function test in traffic policemen of Gangtok, East Sikkim, North East India

Background: Vehicular or automobile emission constitutes a significant health injury to traffic policemen posted at thenumerous traffic junctions. Aim and Objectives: Evaluating the spirometric lung function test parameters of traffic policemen posted in Gangtok town and to compare and measure the findings with general police personnel and also to study the effect of exposure to long-term automobile pollution. Materials and Methods: In this study, after matching for anthropometric variables such as weight, height, and body mass index, 40 traffic policemen were taken as case and 40 general duty policemen were taken as control groups. The exclusion criteria were duly screened, and only those subject who fulfilled the inclusion criteria were included after which the spirometric pulmonary function tests (PFT) ‘s evaluation was done. The indices measured in the study included (1) Forced vital capacity (FVC) (2) Forced expiratory volume in 1 s (FEV1) (3) FEV1/FVC ratio (4) Peak expiratory flow rate (PEFR) (5) Forced mid expiratory flow (FEF 25–75%). Spirometric indices of the subjects and controls were statistically analyzed using the student’s t test and p value computed against the degree of freedom. Results: The traffic policemen showed decline in various PFT indices as compared to controls in terms of FVC(L), FEV1 (L), FEV1/FVC, FEF 25–75%, PEFR, although it was not statistically significant. Conclusion: The traffic policemen working in Gangtok town had decreased PFT, although it was not statistically significant in this study. Even then, we strongly recommend for the adoption and practice of various preventive measure from vehicular pollution and conduction of further studies on larger samples.

Verbal Learning as a predictor of risks of accidents in elderly drivers / Aprendizado verbal como preditor de risco de acidentes em idosos

ABSTRACT Background: Age-related cognitive decline impacts cognitive abilities essential for driving. Objective: We aimed to measure main cognitive functions associated with a high number of traffic violations in different driving settings. Methods: Thirty-four elderly individuals, aged between 65 and 90 years, were evaluated with a driving simulator in four different settings (Intersection, Overtaking, Rain, and Malfunction tasks) and underwent a battery of cognitive tests, including memory, attention, visuospatial, and cognitive screening tests. Individuals were divided into two groups: High-risk driving (HR, top 20% of penalty points) and normal-risk driving (NR). Non-parametric group comparison and regression analysis were performed. Results: The HR group showed higher total driving penalty score compared to the NR group (median=29, range= 9-44 vs. median=61, range= 47-97, p<0.001). The HR group showed higher penalty scores in the Intersection task (p<0.001) and the Overtaking and Rain tasks (p<0.05 both). The verbal learning score was significantly lower in the HR group (median=33, range=12-57) compared with the NR group (median=38, range=23-57, p<0.05), and it was observed that this score had the best predictive value for worse driving performance in the regression model. General cognitive screening tests (Mini-Mental State Examination and Addenbrooke's Cognitive Evaluation) were similar between the groups (p>0.05), with a small effect size (Cohen's d=0.3 both). Conclusion: The verbal learning score may be a better predictor of driving risk than cognitive screening tests. High-risk drivers also showed significantly higher traffic driving penalty scores in the Intersection, Overtaking, and Rain tests.

RESUMO Antecedentes: O declínio cognitivo relacionado à idade impacta as habilidades cognitivas essenciais para direção. Objetivos: Nosso objetivo foi medir as funções cognitivas associadas ao alto número de violações de trânsito em diferentes contextos de direção. Métodos: Trinta e quatro idosos entre 65 e 90 anos foram avaliados em simulador de direção em quatro diferentes contextos (Travessia, Ultrapassagem, Chuva e Mal-funcionamento) e realizaram uma série de testes cognitivos, incluindo memória, atenção, visuoespacial e rastreamento. Indivíduos foram então divididos em dois grupos: Alto Risco de condução (HR, top 20% de pontos de penalidades de condução), e Risco Normal (NR). Comparações não-paramétricas e análise de regressão foram realizadas. Resultados: O grupo HR mostrou aumento no escore total de penalidades de condução quando comparado com o grupo NR (mediana=29, limites=9-44 vs. mediana=61, limites=47-97, p<0.001). O grupo HR mostrou maiores escores de penalidade na tarefa de Travessia (p<0.001), Ultrapassagem e Chuva (p<0.05 ambos). O escore de aprendizado verbal foi significativamente menor no grupo HR (mediana=33, limite=12-57) comparado com o grupo NR (mediana=38, limite=23-57, p<0.05), e foi observado que este escore foi o melhor preditor de pior performance de condução no modelo de regressão. Testes de rastreio cognitivo (Mini-exame do estado mental e Avaliação Cognitiva de Addenbroke) foram similar entre os grupos (p>0.05), com pequena magnitude de efeito (Cohen's d=0.3). Conclusões: O escore de aprendizado verbal pode ser o melhor preditor de risco de condução do que os testes de rastreio cognitivos. Motoristas de alto risco também mostraram maior escores de penalidade de trânsito nos testes de Travessia, Ultrapassagem e Chuva.

Analysis of noise hazard characteristics in automobile sand casting industry / 公共卫生与预防医学

Objective To study the characteristics of noise hazards in automobile sand casting industry and understand the impact of noise on the health of automobile foundry workers, and to provide scientific data support for the control of noise hazards. Methods An automobile sand casting enterprise was selected as the research object. The post noise intensity test results from 2010 to 2019, the noise spectrum test results of each post in 2019, and the prevalence of occupational noise deafness in the 10 years from 2010 to 2019 were analyzed and sorted out. Using chi-square test and t-test the noise hazard characteristics and noise intensity changes were statistically analyzed. Results 1. The noise LEX.8h exceeding standard rate of foundry enterprises in the 10 years from 2010 to 2019 was not statistically significant（χ2=6.76, P=0.66), and the mean value of noise LEX.8h fluctuated horizontally in the 10 years, which was basically stable between 80 - 90 dB (A). 2. The mean value of noise intensity of sand falling, sand preparation, cleaning and shot blasting in the first five years was significantly different compared to that in the last five years. There was no statistically significant difference in other posts. 3. Among all posts in the foundry sand casting industry, the noise spectrum of core-making and cleaning posts was mainly medium and high frequency, while the noise spectrum of other posts was mainly medium and low frequency. 4, Cases of occupational noise deafness were mainly concentrated in cleaning and polishing workers, melting chemical workers, inspectors and other types of workers. Conclusions The noise hazards in the automobile foundry sand casting industry are mainly concentrated on the posts of molding, and sand falling, and the noise intensity and the over standard rate remain high in the past 10 years. The noise of each post is mainly medium and low frequency, and the noise of a few individual posts is mainly medium and high frequency. In recent years, due to the automatic renewal of equipment, the noise intensity of some posts such as sand dropping, sand mixing, cleaning and shot blasting has decreased, but the overall noise exceeding standard rate has basically not changed, and the noise hazard is still serious. The noise hazard of foundry sand casting enterprises is difficult to be controlled, and the risk of hearing loss of foundry workers is still high.

Assessment of Readiness for Mobility Transition：Development of the Japanese Version of the ARMT and Verification of Linguistic Validity / The Japanese Journal of Rehabilitation Medicine

Purpose：The Assessment of readiness for mobility transition (ARMT) is a self-administered questionnaire that assesses individuals' emotional and attitudinal readiness when they need to change their means of mobility, such as driving due to old age. This study aimed to examine the linguistic validity of the Japanese version of the ARMT (ARMT-J).Methods：The translation was carried out for the “Basic Guidelines for Scale Translation.” Three occupational therapists in Japan conducted forward translation and adjustment, and a translation company conducted back translation. In addition, the original authors reviewed the back translation and the cognitive debriefing. The cognitive debriefing was conducted with five older people living in the community.Results：Disagreements were identified on five items in the forward translation and three in the review of back translation. In particular, item 11,“ retirement community,” is not widely used in Japan and the Japanese translation differed among translators. A “retirement community” is defined as a residential area or building for the older people in other countries. The three occupational therapists who performed the translation discussed with the original author and changed the Japanese translation to “housing for the elderly.” In addition, a supplementary document was added to the translation, stating that it includes the meaning of “the need to change one's living area when one changes their means of transportation due to aging.Conclusion：In this study, we examined the linguistic validity of the ARMT-J and developed a Japanese translation that we believe is appropriate.

Epidemiological characteristics of noise-induced hearing loss among workers in five automobile manufacturing enterprises in Zhejiang Province / 环境与职业医学

Background Noise is the most common occupational hazard in the automobile manufacturing industry with the most workers exposed. Automobile manufacturing industry is a high-risk industry for noise-induced hearing loss. Objective To understand the epidemiological characteristics of noise-induced hearing loss among workers in automobile manufacturing industry and explore related influencing factors. Methods A questionnaire survey, individual noise recording, and pure tone audiometry were conducted among workers (n=656) exposed to noise from five automobile manufacturing enterprises. The data on age, sex, exposure duration, noise intensity, kurtosis, and hearing loss were obtained. The positive rates of high-frequency noise-induced hearing loss (HFNIHL) and speech-frequency noise-induced hearing loss (SFNIHL) were calculated, and each factor was compared between workers with and without HFNIHL. Chi-square test and analysis of trend were conducted among different groups of age, sex, exposure duration, A-weighted equivalent continuous sound pressure level normalized to a nominal 8-hour working day (LAeq,8h), and kurtosis. Logistic regression analysis was conducted to analyze the factors influencing the positive rates of HFNIHL and SFNIHL. Results The exposure rates of non-Gaussian noise was 73.6%. The positive rates of HFNIHL and SFNIHL were 32.6% (214 workers) and 6.7% (44 workers), respectively. The HFNIHL workers showed older age, higher proportion of male, longer exposure duration, higher noise intensity (LAeq,8 h), and increased kurtosis than those without HFNIHL (P<0.05). The positive rates of HFNIHL increased with the increase of age, exposure duration, LAeq,8 h, and kurtosis (\begin{document}$ {\chi

Relationship between occupational stress, job burnout, and depressive symptoms among workers in an automobile manufacturing enterprise in Guangzhou / 环境与职业医学

Background The operation mode of automobile manufacturing industry (AMI) makes workers have different degrees of occupational stress and burnout, which may lead to negative emotions and depressive symptoms. Objective To study the relationship between occupational stress, job burnout, and depressive symptoms in AMI workers. Methods In this study, 1300 workers from a Guangzhou AMI company were selected as subjects by cluster random sampling method. Occupational stress, job burnout, and depressive symptoms of the workers were assessed by using the Effort-Reward Imbalance (ERI) questionnaire, the Maslach Burnout Inventory general survey questionnaire, and the Patient Health Questionnaire-9, respectively. Hierarchical regression was used to analyze the effects of occupational stress and job burnout on depressive symptoms in AMI workers. Mediating effect model was used to analyze the mediating effect of job burnout on the relationship between occupational stress and depressive symptoms. Results There were 1300 questionnaires distributed, 1228 valid questionnaires collected, with a 94.5% recovery rate. The ERI ratio of 1228 AMI workers was 1.06±0.72, and the positive rate of occupational stress was 37.3% (458/1228). The score of job burnout was 2.18±1.37, and the positive rate of job burnout was 62.6% (769/1228). The score of depressive symptoms was 10.27±6.42, and the positive rate of depressive symptoms was 47.1% (578/1228). The dimensional scores of effort and over-commitment in occupational stress as well as emotional exhaustion and depersonalization in job burnout of AMI workers were positively correlated with the depressive symptom scores (rs=0.415, 0.571, 0.573, 0.593, P＜0.05). The dimensional scores of reward and personal achievement were negatively correlated (rs=−0.454, −0.339, P＜0.05). The percentages of variance in depressive symptoms score explained by occupational stress and job burnout were 26.7% and 16.6%, respectively. Job burnout had a partial mediating effect between the three dimensions of occupational stress and depressive symptoms, and the mediating effect values were −0.2832 (95%CI: −0.3250– −0.2434), 0.3553 (95%CI: 0.3071–0.4041), and 0.4193 (95%CI: 0.3681–0.4725), respectively. Conclusion AMI workers' occupational stress affects job burnout, but also indirectly affects depressive symptoms. Job burnout partially mediates the association between occupational stress and depressive symptoms. Reducing occupational stress and burnout levels of AMI workers may alleviate depressive symptoms.

Effects of using hand-held vibration tool on work-related musculoskeletal disorders in automobile factory workers / 中国职业医学

@#Objective - To analyze the effect of using vibration tools on the prevalence of work related musculoskeletal disorders （ ） Methods ， - WMSDs in automobile factory workers. By judgment sampling method front line workers with more than one year of working experience in an automobile factory were selected as the research subjects. Musculoskeletal Disorders Questionnaire was used for investigation. The workers were divided into the control group and the vibration tool group. The propensity score ∶ ， matching method was used to balance the confounding factors of the two groups of workers by 1 1 and 568 people were Results included in each group. The prevalence of WMSDs was compared between the two groups after matching. After ， ， ， ， ， ， matching the prevalence of WMSDs in the shoulder elbow hand/wrist upper back waist hip/buttock and knee of workers in ， （ P ） the vibration tool group was higher than that in the control group and the differences were statistically significant all <0.05 .， The prevalence of WMSDs in different body parts of workers in the vibration tool group ranking from high to low was waist ， ， ， ， ， ， ， ， ， ， neck shoulder hand/wrist upper back knee ankle/foot elbow and hip/buttock with the rate of 74.3% 61.3% 54.2% ， ， ， ， ， （P ） Conclusions 54.0% 50.9% 39.4% 35.2% 31.0% and 27.1% respectively <0.01 . The use of vibration tools can ， ， ， ， ， increase the risk of WMSDs in shoulder elbow hand/wrist upper back waist hip/buttock and knee of automobile factory workers. Corresponding measures should be taken to reduce vibration intensity and reduce contact time to protect workers'

Prevalence of occupational musculoskeletal disorders among workers inheavy-duty automobile parts factories in Beijing Municipality / 预防医学

Objective@#To investigate the prevalence and risk factors of occupational musculoskeletal disorders among workers in heavy-duty automobile parts factories in Beijing Municipality, so as to provide insights into development of effective interventions for occupational musculoskeletal disorders.@*Methods@#The workers in three heavy-duty automobile truck parts factories in Beijing Municipality were recruited using the convenient sampling method during the period from May 2019 to October 2020. Subjects' demographic characteristics, type of job and prevalence of occupational musculoskeletal disorders at various sites were collected using self-designed electronic questionnaires, and the factors affecting the development of occupational musculoskeletal disorders were identified using a multivariable logistic regression model.@*Results@#A total of 264 workers were enrolled, including 260 males (98.48%) and 4 females (1.52%). The participants had a mean age of (31.71±6.13) years, and mean duration of (7.51±5.25) years at current position, and mechanical technician was the major type of work (129 workers, 48.86%). The prevalence of occupational musculoskeletal disorders was 70.08% among the participants, and high prevalence of occupational musculoskeletal disorders was found in the lower back/waist (41.28%), shoulder (40.15%), neck (39.02%) and upper back (33.33%). Multivariable logistic regression analysis identified females (OR=1.280, 95%CI: 1.021-1.602) and head-down posture at work (OR=2.644, 95%CI: 1.034-6.763) as risk factors for occupational musculoskeletal disorders at neck; females (OR=1.633, 95%CI: 1.624-2.117), sheet metal workers, mechanical technicians and painters (OR: 5.811-10.452, 95%CI: 1.205-54.027), working in an uncomfortable posture (OR：1.376-7.749, 95%CI: 1.034-27.270) and frequent working overtime (OR=2.081, 95%CI: 1.192-4.137) as risk factors for occupational musculoskeletal disorders at shoulder; and sheet metal workers, mechanical technicians and painters (OR: 8.760-11.948, 95%CI: 1.630-66.927), working in an uncomfortable posture (OR：4.067-12.185, 95%CI: 1.332-47.523) and frequent working overtime (OR=2.201, 95%CI: 1.142-4.244) as risk factors for occupational musculoskeletal disorders at waist/back.@*Conclusions@#The prevalence of occupational musculoskeletal disorders is high among workers in heavy-duty automobile parts factories, which mainly occur at shoulder, neck, waist and back. Type of work, working posture and working duration are main factors affecting the development of occupational musculoskeletal disorders.