Assessment of the relationship between the return to work and the severity of work-related upper limb injuries using the whole person impairment / 中华创伤杂志(英文版)

PURPOSE@#Upper limb disorders are one of the most common and important types of occupational injuries. Besides, identifying the factors influencing return to work following these injuries is essential to reduce the dimensions of the problem. In this study, we investigated the return to work and associated factors following occupational injuries leading to upper limb impairment.@*METHODS@#In this retrospective cohort study, the rate of return to work and associated factors were assessed in 256 workers with work-related upper limb injury referred to a teaching hospital from March 2011 to December 2018. The inclusion criterion was a history of occupational injury resulting in upper limb impairment, and exclusion criteria included the presence of simultaneous impairment in other organs, congenital or non-occupational limb defects as well as patients with incomplete information in their medical records. Individuals' records, including age at the time of injury, gender, date of injury, marital status, education, level of amputation and injury, whole person impairment (WPI) and physiotherapy (prescribed by the physician) were reviewed. The WPI was calculated to assess the extent of the injury. All analyzes were performed by SPSS version 25.0.@*RESULT@#The rate of return to work was 54.3%, in which 51.8% for the same job and 48.2% for a new job. The main factors associated with non-return to work were more days off work (p = 0.001), higher injury severity (p = 0.001), and dominant hand injury (p = 0.034).@*CONCLUSION@#The number of days off work, the WPI, and dominant hand injury are the most important determinant in returning to work. In addition, increased job satisfaction and support from co-workers and employers are work-related factors that can lead to an increased return to work.

Overview of work-related diseases and occupational injury surveillance system in the UK / 环境与职业医学

The UK's work-related diseases and occupational injury surveillance system consists of Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR), Labour Force Survey (LFS), The Health and Occupation Research network in General Practice (THOR-GP), and Reporting to The Health and Occupation Research network by specialist physicians. This article briefly described the scope, content, and methods of each surveillance programme in the UK work-related diseases and occupational injury surveillance system, and summarized their advantages and disadvantages. Among them, employers are required to report to relevant law enforcement authorities by RIDDOR, data are highly accessible but with a concern of serious underreport, and it is the only data source of fatal occupational injuries; LFS, a representative national household sample survey, covering occupational injuries and work-related diseases, is the primary data source of non-fatal occupational injuries and work-related diseases such as stress, anxiety, and depression, but collects non-clinically proven data based on self-perception; general practitioners report clinically confirmed work-related diseases, which is more scientific in attribution and is a good secondary source of work-related diseases; specialist physicians report clinically confirmed cases of higher severity, which is the primary source of data on conditions such as asthma and dermatitis, but may underestimate morbidity. Each surveillance programme of the system has its own characteristics, intersects, and complements each other, which can provide reference for the construction of occupational injury surveillance system in China.

Framework and enlightenment of European Union's Occupational Injury Surveillance System / 环境与职业医学

In order to promote the development of China's occupational injury surveillance system, this paper presented the legal basis, project overview, reporting procedures, definitions and stati statistical scope, data sources and collection standards, statistical data management and analysis points of the European Statistics on Accidents at Work (ESAW), and combined with existing research and related surveillance management system in China, five key points were proposed for constructing China's occupational injury surveillance system: 1) Establish and improve laws and regulations related to occupational injury surveillance; 2) Promote utilization of nation-level data systems; 3) Establish and optimize a sound national occupational injury surveillance system; 4) Provide standardized protocols for data collection and data application of occupational injury statistics; 5) Strengthen supervision and law enforcement targeting industries and enterprises.

Research progress on influencing factors of occupational injury in manufacturing workers / 环境与职业医学

Globally, manufacturing workers are one of the most vulnerable groups to occupational injuries. Occupational injuries can lead to absenteeism, disability or even death, and most of the inflicted workers involve young adults aged 18-40 years, suggesting a safety and health problem that needs close attention. In the working environment of manufacturing industry, there are a variety of occupational injury risk factors, involving individuals, equipment, environment, and management, which should be considered comprehensively. This study found comprehensive research coverage on the influencing factors of occupational injuries in manufacturing industry at individual, environmental, and management levels at home and abroad, and rich research results on the impacts of psychological factors on occupational injuries. However, factors associated with occupational injuries in equipment safety and engineering like man-machine environment need further research. Influencing factors at all levels should be comprehensively considered in the surveillance and intervention of occupational injuries in manufacturing industry to protect health and safety of workers.

Joint application of active and passive surveillance of occupational injuries: Based on UK HSE data / 环境与职业医学

Background The United Kingdom (UK) adopts active surveillance and passive surveillance to jointly collect occupational injury data, and builds a relatively complete occupational injury surveillance system, which can provide reference for the construction of China's occupational injury surveillance system. Objective To compare the results of active surveillance and passive surveillance of occupational injuries in the UK, and to explore the joint application value of active and passive surveillance methods in the field of occupational injury prevention and control. Methods The non-fatal occupational injury active surveillance data from Labor Force Survey were used to calculate indicators such as number of reported cases, reporting rate, lost workdays per year, lost workdays per capita, and average lost workdays per case. The fatal passive surveillance data reported by the employers were used to calculate number of reported deaths, reported mortality, and other indicators. Join-point regression was used to estimate the reported trends of fatal and non-fatal occupational injuries from 2004 to 2020, and the annual percentage change (APC) and average annual percentage change (AAPC) were calculated. Results The active surveillance data showed that from 2004 to 2020, the number of reported cases of absenteeism ≥0 d due to occupational injury decreased from 89.7 (95%CI: 85.2, 94.2) per ten thousand to 44.1 (95%CI: 39.1, 49.2) per ten thousand, and the reporting rate of occupational injury decreased from 32100/100000 (95%CI: 3050/100000, 3370/100000) to 1410/100000 (95%CI: 1250/100000, 1570/100000), showing a linear downward trend (both APC and AAPC were −3.88%, P<0.05); the average lost workdays per case in 2019 was 9.1 (95%CI: 6.8, 11.5) d. The passive surveillance data showed that from 2004 to 2020, the number of reported deaths due to occupational injury decreased from 223 to 142, and the reporting rate of occupational injury decreased from 0.78/100000 to 0.44/100000, showing a linear downward trend (both APC and AAPC were −4.59%, P<0.05). Conclusion The reporting rates of fatal and non-fatal occupational injuries in the UK are showing a linear downward trend. The active surveillance method based on Labor Force Survey provides more surveillance indicators for non-fatal occupational injuries, and the passive surveillance method based on employer report has more advantages in assessment of fatal occupational injuries. Jointly applying the two surveillance modalities and the combination of trend analysis indicators, such as AAPC, provide a more comprehensive picture of the epidemiological characteristics of occupational injuries.

Influencing factors of fall injury risks in manufacturing enterprises based on Bayesian networks / 环境与职业医学

Background Falls are one of the most important types of occupational injuries. The incidence of falls is high in manufacturing workers. However, most of the studies on falls in China focus on primary and secondary school students and the elderly, and there are few studies on falls in the occupational population. Objective To evaluate efficiency of Bayesian network model in predicting fall injury risks in manufacturing enterprise staff, and impacts from work content, work environment, enterprise status, and health management on falls and their mutual relationships, and provide a scientific basis for enterprises to carry out fall-associated injury intervention. Methods Data from the European Survey of Enterprises on New and Emerging Risks (ESENER) were used. The survey provided data on work content, working environment, enterprise status, and health management of enterprises in European countries. The outcome indicator, was fall injury risks reported in enterprises. A total of 23 potential impact factors covering work content, working environment, enterprise status, and health management were screened by least absolute shrinkage and selection operator (LASSO) regression, followed by Bayesian network model for structure learning and parameter learning and area under the curve (AUC) for model fitness evaluation, using R and Netica 5.18. Diagnostic inference analysis was also conducted to identify key influencing factors and key influencing chains of fall injury risks based on the change rate of fall injury risks. Results In 5997 enterprises surveyed, 2573 (42.9%) enterprises reported fall injury risks. Ordered by their coefficient estimates from high to low, the 14 variables (mean-squared error=0.20) selected by LASSO regression were: manual handling, repetitive arm movement, poor posture, using desktop computers, and using robots in the category of work content; abnormal temperature and noise in the category of working environment; company size and employee quality in the category of enterprise status; mental health training, regular risk assessment, availability of psychologists, health and safety procedures, and provision of psychological counseling in the category of health management. The fitting result of Bayesian network model for fall injury risks was good (AUC=0.779). The Bayesian network diagnostic inference identified five key influencing factors, including abnormal temperature (change rate=35.9%), poor posture (change rate=27.3%), noise (change rate=23.4%), manual handling (change rate=18.2%), and repetitive arm movement (change rate=5.1%). The key influencing chain was "manual handling - poor posture - repetitive arm movement - fall injury risks" (combined change rate=16.9%). Conclusion The Bayesian network model has a good predictive performance in predicting the risk of falls in manufacturing enterprises. Manufacturing enterprises need to focus on jobs involving manual handling and repetitive arm movement, identify and improve workers' poor posture and mental health problems, and avoid workers working in harsh temperature or noise environment.

Impacts of poor working conditions, occupational psychology, and enterprise risk factors on occupational injury by path analysis / 环境与职业医学

Background Occupational injuries, which can result in absenteeism, disability, or death, are closely related to poor working conditions. However, the improvement of operating conditions are often time-consuming and require significant economic inputs. Both occupational psychology and enterprise risk factors have been proved to be related to the occurrence of occupational injuries, but their roles in the influence path of adverse working conditions leading to occupational injuries remain unclear. Objective To explore the roles of occupational psychology and enterprise risk factors in the impact of adverse working conditions on occupational injury, so as to provide a scientific basis for enterprises with adverse working conditions to carry out targeted occupational injury intervention programs. Methods The survey data of 5997 manufacturing enterprises were obtained from the European Survey of Enterprises on New and Emerging Risks (ESENER) database. The data on enterprise risk characteristics, occupational injuries, working conditions, and occupational psychological factors were extracted and assigned. Occupational injury differences by enterprise categories were examined by chi-square test. Correlations between interest variables were evaluated by Spearman test. Path analysis with Bootstrap method was conducted using AMOS 26 software, and ratio of chi-square statistic to degree of freedom (χ2/ν), comparative fit index (CFI), Tucker-Lewis index (TLI), and root mean square error of approximation (RMSEA) were used to evaluate the path model candidates. The effect size and its proportion were calculated for variables (occupational psychological factors, enterprise risk factors, and adverse working conditions) included in the final model. Results The M (P25, P75) scores of occupational injuries, adverse working conditions, and occupational psychological factors were 40 (20, 50), 50 (30, 60), and 20 (10, 30), respectively. The enterprises that reported occupational injuries accounted for 25.5% (1550 enterprises) of the total enterprises. Proportions of the enterprises that reported occupational injuries varied significantly by company scale, branch companies, temporary employment, language barriers, and establishment time (P<0.05). The results of Spearman test showed that occupational injuries were positively correlated with working conditions (rs=0.440), occupational psychological factors (rs=0.205), company scale (rs=0.307), temporary employment (rs=0.282), and language barriers (rs=0.158); but negatively correlated with branch companies (rs=−0.180) and establishment time (rs=−0.176) (P<0.05). In the path analysis, the fitness indexes of the final model were χ2/ν=2.85, CFI=0.997, TLI=0.993, and RMSEA=0.018 (90%CI: 0.011, 0.025). The indirect effect size values and constituent ratios of enterprise risk factors and occupational psychological factors in the effect of adverse working conditions on occupational injuries were 0.166 (30.01%) and 0.013 (3.13%) respectively. The indirect effect size value of occupational psychological factors in the effect of enterprise risk factors on occupational injuries and its constituent ratio were 0.022 and 6.85%. Conclusion Enterprises with adverse working conditions may control the risk of occupational injuries by offering better solutions to surmount language barriers and temporary employment, developing occupational psychological intervention and optimization programs such as improving working hours system. At the same time, large enterprises, enterprises without branches, or enterprises with a long history are the focus of occupational injury prevention and control.

Application of lost workdays in surveillance and assessment of non-fatal occupational injuries: Based on European Statistics on Accidents at Work / 环境与职业医学

Background The severity of occupational injury in countries such as the United Kingdom, the United States, and Germany is usually analyzed using lost workdays, but in existing occupational injury surveillance research in China, the application of this index is rare. Objective To evaluate the application value of lost workdays in non-fatal occupational injury surveillance, and provide a reference for the construction of occupational injury surveillance index system. Methods The public data of European Statistics on Accidents at Work (ESAW) from 2010 to 2019 on non-fatal injury accidents in 27 member states of the European Union were used. Non-fatal occupational injury is defined as an injury event during occupational activities or at work resulting a victim's absence from work for ≥4 d. According to the European Statistics on Accidents at Work-Summary methodology, the lost workdays were divided into 8 categories (4-6 d, 7-13 d, 14-20 d, 21-30 d, 31-91 d, 92-182 d, 183 d and above, and unknown). Annual percentage change (APC) and the average annual percentage change (AAPC) were used to evaluate the overall trend changes in the incidence rate of non-fatal occupational injury accidents in different lost workdays from 2010 to 2019, and the non-fatal occupational injury accidents in key industries. The characteristics of the occurrence of non-fatal occupational injuries were analyzed in conjunction with the changes in non-fatal occupational injuries in different lost workdays in the industry. Results From 2010 to 2019, the overall incidence of non-fatal occupational injury accidents in the European Union showed a downward trend, and the AAPC was −1.0% (P<0.05). The accident rates of lost workdays of 4-6 d and 92-182 d showed an upward trend, and the AAPC were 7.9% and 5.8% respectively (P<0.05). The average annual accident rates of non-fatal occupational injuries (≥4 d) in Categories C (manufacturing industry), E (water supply, sewage treatment, waste management and remediation), and F (construction industry) showed a linear downward trend, and the AAPC were −3.0%, −2.5%, and −1.5%, respectively (P<0.05). However, among them, the rate of non-fatal occupational injury accidents with 92-182 d of lost workdays in the manufacturing industry showed a significant upward trend, with an AAPC of 3.7% (P<0.001). Conclusion Using lost workdays combined with APC and AAPC by Join-point linear regression analysis can measure the severity and trend changes of non-fatal occupational injury accidents in different industries and different lost workdays. This indicator has an important practical significance in evaluating the effectiveness of occupational injury prevention and control strategies adopted by countries and enterprises.

Trend and prediction of fatality due to occupational injuries in China / 环境与职业医学

Background Occupational injury is one of the important causes of death among the working population and a worldwide hot topic, but there are few relevant studies on the trend and prediction of occupational injury attributable deaths in China. Objective To analyze the trend of occupational injury attributable deaths in China from 2000 to 2019, predict the deaths of occupational injuries in China from 2020 to 2024 by contructing a gray GM(1,1) model, and provid a reference for surveillance and assessment of occupational injuries. Methods Mortality, crude mortality rates, and standardized mortality rates of occupational injuries in China by year, sex, and age groups were calculated using data of the Global Burden of Disease (GBD) 2019 study. Join-point model was used to analyze possible trend of standardized mortality rate from 2000 to 2019, and calculate annual percentage change (APC) and average annual percentage change (AAPC). After a gray model GM(1,1) was established, the accuracy of the model was evaluated by posterior error ratio (C) and small error probability (P) and rated as Level 1 (good, C≤0.35 and P≥0.95) or Level 2 (qualified, 0.35<C≤0.50 and 0.80≤P<0.95). Then the gray model was further used to predict the number of deaths and standardized mortality rates of occupational injuries in China from 2020 to 2024. Results From 2000 to 2019, the deaths due to occupational injuries in China showed a downward trend, the number of deaths decreased from 111557 to 61780, the crude mortality rate decreased from 8.58/100000 to 4.34/100000, the standardized mortality rate decreased from 7.67/100000 to 3.65/100000, and the AAPC of standardized mortality rate was −4.0% (P<0.05); the number of male deaths decreased from 87760 to 49192, and the male standardized mortality rate decreased from 11.78/100000 to 5.68/100000; the number of female deaths decreased from 23797 to 12588, and the female standardized mortality rate decreased from 3.34/100000 to 1.55/100000; the AAPCs of male and female standardized mortality rate were −3.9% and −4.1% respectively. The accuracy of the established gray model for deaths (C=0.09, P=1) was rated as Level 1, and that for standardized mortality rate (C=0.41, P=0.9) was rated as level 2, which allowed for prediction extrapolation. The model showed that from 2020 to 2024, the number of occupational injury attributable deaths would be 76039, 73849, 71721, 69655, and 67649, and the standardized mortality rate would be 4.23/100000, 4.07/100000, 3.92/100000, 3.77/100000, and 3.62/100000, respectively. Conclusion From 2000 to 2019, the standardized mortality rate of occupational injuries in China showed a downward trend, and it is predicted that the standardized mortality rate from 2020 to 2024 will still show a downward trend, but the number of deaths will remain high, so it is necessary to continue to strengthen prevention and control of occupational injuries.

Disease burden of deaths attributable to occupational injuries in China from 1990 to 2019 / 环境与职业医学

Background Occupational injuries are one of the leading causes of death or disability in occupational populations. According to the World Health Organization and the International Labour Organization, occupational injuries were the occupational contributor responsible for the largest loss of disability-adjusted life years (DALY) globally in 2016. Objective To analyze the burden of deaths attributed to occupational injuries in Chinese population from 1990 to 2019, and provide a reference for further construction of occupational injury surveillance system. Methods Using the results and data of the Global Burden of Disease 2019 (GBD 2019), this study estimated the burden of deaths attributable to occupational injuries by year, sex, and age groups, and the indicators included deaths, years of life lost (YLL), mortality, and YLL rates. Age-standardized rates of deaths and YLL rates were calculated using a world standard population presented by GBD 2019. Annualized rate of change (ARC) was use to evaluate changes in the indicators over time. All results were presented as point estimates with 95% uncertainty intervals (95%UI). Results In 2019, the deaths attributable to occupational injuries among women in China accounted for 33.16% of that among world's women, their YLL accounted for 31.88%, and the two indicators among Chinese men accounted for 17.98% and 17.09%, respectively. Compared with 1990, the standardized mortality rate and the standardized YLL rate attributable to occupational injuries in China in 2019 decreased, among which the ARCs of the standardized mortality rate in the whole population, men, and women were −0.68 (95%UI: −0.78, −0.51), −0.68 (95%UI: −0.80, −0.47), and −0.68 (95%UI: −0.82, −0.46), respectively. The ARCs of the standardized YLL rate in the whole population, men, and women were −0.68 (95%UI: −0.78, −0.51), −0.67 (95%UI: −0.80, −0.48), and −0.68 (95%UI: −0.81, −0.44), respectively. Absolute values of the ARCs of the standardized mortality rate and the standardized YLL rate attributable to occupational injuries from 1990 to 2010 were higher than those from 2010 to 2019. The ARCs of the standardized YLL rate for road injuries, falls, and drowning from 1990 to 2010 were −0.55 (95%UI: −0.67, −0.36), −0.57 (95%UI: −0.73, −0.38), −0.77 (95%UI: −0.84, −0.63), and the ARCs from 2010 to 2019 were −0.27 (95%UI: −0.46, −0.02), −0.07 (95%UI: −0.34, −0.26), −0.06 (95%UI: −0.32, −0.29), respectively. In 2019, the standardized mortality rate attributable to occupational injuries among Chinese men was 5.68/100000 (95%UI: 3.89/100000, 8.23/100000), and the standardized YLL rate was 286.27/100000 (95%UI: 197.58/100000, 411.38/100000); the standardized mortality rate attributable to occupational injuries among Chinese women was 1.55/100000 (95%UI: 0.99/100000, 2.36/100000), and the standardized YLL rate was 80.85/100000 (95%UI: 51.61/100000, 122.07/100000). Conclusion From 1990 to 2019, the burden of deaths attributable to occupational injuries in China is declined, but the rate of decline is slowed down in the last decade. The burden of deaths attributable to occupational injuries among women in China still accounts for a high proportion of the global burden among women. The burden of deaths attributable to occupational injuries among Chinese men is higher than that among Chinese women.

Applicability of feature selection combined with Boosting algorithm in severity prediction of non-fatal occupational injuries in miners / 环境与职业医学

Background Identification and analysis of influencing factors of occupational injury is an important research content of feature selection. In recent years, with the rise of machine learning algorithms, feature selection combined with Boosting algorithm provides a new analysis idea to construct occupational injury prediction models. Objective To evaluate applicability of Boosting algorithm-based model in predicting severity of miners' non-fatal occupational injuries, and provide a basis for rationally predicting the severity level of miners' non-fatal occupational injuries. Methods The publicly available data of the US Mine Safety and Health Administration (MSHA) from 2001 to 2021 on metal miners' non-fatal occupational injuries were used, and the outcome variables were lost working days < 105 d (minor injury) and ≥ 105 d (serious injury). Four different feature sets were screened out by four feature selection methods including least absolute shrinkage and selection operator (Lasso) regression, stepwise regression, single factor + Lasso regression, and single factor + stepwise regression. Logistic regression, gradient boosting decision tree (GBDT), and extreme gradient boosting (XGBoost) were selected to construct prediction models by training with the four feature sets. A total of 12 prediction models of severity of miners' non-fatal occupational injuries were built and their area under the curve (AUC), sensitivity, specificity, and Youden index were calculated for model evaluation. Results According to the results of four feature selection methods, age, time of accident occurrence, total length of service, cause of injury, activities that triggered injury occurrence, body part of injury, nature of injury, and outcome of injury were identified as influencing factors of non-fatal occupational injury severity in miners. Feature set 4 was the optimal set screened out by single factor+stepwise regression and the GBDT model presented the best predictive performance in predicting the severity of non-fatal occupational injuries. The associated specificity, sensitivity, and Youden index were 0.7530, 0.9490, and 0.7020, respectively. The AUC values of logistic regression, GBDT, and XGBoost models trained by feature set 4 were 0.8526 (95%CI: 0.8387, 0.8750), 0.8640 (95%CI: 0.8474, 0.8806), and 0.8603 (95%CI: 0.8439, 0.8773), respectively, higher than the AUC values trained by feature set 2 [0.8487 (95%CI: 0.8203, 0.8669), 0.8110 (95%CI: 0.8012, 0.8344), and 0.8439 (95%CI: 0.8245, 0.8561), respectively] . The AUC values of GBDT and XGBoost models trained by feature set 4 were higher than that of logistic regression model. Conclusion The performance of the prediction models constructed by predictors screened out by two feature selection methods is better than those by single feature selection methods. At the same time, under the condition of optimal feature set, the performance of model prediction based on Boosting is better than that of traditional logistic regression model.

Carrying out occupational injury surveillance and assessment, and protecting workers’ occupational health / 环境与职业医学

Occupational injuries cause a large number of personal injuries, illnesses, or deaths, resulting in a huge burden of disease, and has become an important global occupational safety and health problem. Developed countries in Europe and the United States have provided strong support for occupational injury prevention and control by establishing continuous and stable occupational injury surveillance systems. The occupational injury problem has not attracted enough attention and concern in China, with few relevant research reports, and the current occupational injury surveillance system is far from perfection. From the perspective of protecting workers' occupational health, this paper analyzed and compared the classification and scope of occupational injuries at home and abroad, as well as the status quo of occupational injury surveillance and assessment, and proposed to set up an occupational injury surveillance system with multiple surveillance methods and multiple data sources that complement with each other, so as to strengthen the continuity of surveillance activities, consistency of data formats, and comparability of assessment indicators. Step by step, we can set up a surveillance system covering the whole process of surveillance, assessment, intervention, and evaluation of intervention effects.

Effect of occupational aluminum exposure on the visuospatialconstruction ability / 预防医学

Objective@#To examine the correlation between visuospatial construction ability and occupational aluminum exposure among aluminum workers, so as to provide the evidence for early protection of occupational injury among aluminum workers.@*Methods@#A total of 442 workers in an aluminum factory in Shanxi Province were selected using a cluster sampling method, and participants' demographic features and occupational history were collected. The blood aluminum concentration was measured using inductively coupled plasma mass spectrometry (ICP-MS), and the visuospatial construction ability was evaluated with the Cube Copying Test (CCT) of the Chinese version of the Montreal Cognitive Assessment (MoCA). The correlation between the visuospatial construction ability and blood aluminum concentration was examined using a multivariable logistic regression model.@*Results@#A total of 442 aluminum workers were enrolled, and all participants were male, with a mean age of (43.40±7.31) years, labor service duration of (23.64±8.35) years and a mean blood aluminum concentration of 33.87 µg/L. Of all participants, there were 206 workers with impaired visuospatial construction ability (46.61%), including 127 workers with blood aluminum concentrations of >33.87 µg/L (61.65%); 190 workers with educational duration of 6 to 9 years (92.23%), 118 electrolytic aluminum workers (57.28%), 114 workers with work shifts (55.34%), and 123 workers with a very good sleep quality (59.71%). Multivariable logistic regression analysis revealed that blood aluminum concentrations of >33.87 µg/L (OR=2.490, 95%CI: 1.531-4.052), educational duration of 6 years or more (OR: 0.075-0.246, 95%CI: 0.015-0.622), work type as a non-electrolytic aluminum worker (OR=0.838, 95%CI: 0.425-0.987), work shift (OR=1.179, 95%CI: 1.078-1.435) and a very good sleep quality (OR=0.104, 95%CI: 0.012-0.896) significantly correlated with impaired visuospatial construction ability among aluminum worker.@*Conclusion@#Impaired visuospatial construction ability correlates with occupational aluminum exposure among aluminum workers.

Enfermedades, lesiones y accidentes en trabajadores de la construcción en Uruguay, período 2014-2018 / Illnesses, injuries and accidents among construction workers in Uruguay, 2014-2018

El presente trabajo se realizó en el marco de las actividades de investigación y extensión del Departamento de Salud Ocupacional de la Facultad de Medicina Universidad de la República, por iniciativa de los trabajadores del sindicato único de la construcción y afines. El objetivo fue conocer el perfil de salud y enfermedad de los trabajadores del sector con el propósito de generar acciones que promuevan la salud laboral del colectivo involucrado. La investigación realizada es de carácter descriptivo a partir de fuentes secundarias. De los resultados se destacaron las enfermedades del aparato osteomioarticular, lesiones por traumatismos o envenenamiento y patologías del aparato respiratorio como principales causas de ausentismo de origen médico. La patología osteomioarticular fue la primera causa de incapacidad total y también es la primera causa de incapacidad para la tarea en el periodo estudiado. La tasa de incidencia acumulada de los accidentes en el año 2014 fue de 81,8 por 1.000 trabajadores cotizantes de la construcción, presentando una caída sostenida hasta el 2018 que alcanzó el valor de 60,2 por 1.000 trabajadores cotizantes. El tipo de accidente más frecuente observado en el periodo fueron las lesiones a esfuerzo excesivo. Con respecto a los accidentes mortales existe una caída marcada entre los años 2014 al 2016 con un ascenso progresivo en 2018. De la investigación surge como necesidad mejorar el reconocimiento de la patología profesional en el sector, profundizar las acciones en seguridad y salud con énfasis en aspectos ergonómicos de la carga física(AU)

This study was carried out under the framework of the research and outreach activities of the Department of Occupational Health of the School of Medicine of the University of the Republic, as an initiative of the workers of its single union of construction and related industries. The objective was to describe the health and disease profile of workers in the sector in order to generate actions to promote their occupational health. The study was descriptive and consisted of a secondary analysis of existing data. Musculoskeletal disorders, traumatic injuries, poisonings and respiratory illnesses were the main cause of sickness absence. Musculoskeletal disorders were the main cause of both work-related and total disability. The cumulative incidence rate of injuries in 2014 was 81.8 per 1000 dues-paying construction workers, and subsequently declined until 2018, to an incidence of 62.2 per 1000 dues-paying workers. Overexertion was the most common mechanism of injury. With respect to fatal accidents, there was a arked decline between 2014 and 2016, followed by a progressive increasein 2018. This study underscores the need to improve the recognition of occupational illness and injury in the construction and related industries sector, and to add depth to safety and health interventions, with an emphasis on ergonomic aspects of physical loads(AU)

Efecto de las lesiones condrales asintomáticas en la recuperación del paciente laboral tras una lesión traumática de rodilla / Effect of asymptomatic chodral on the recovery of the working patient after a traumatic injury of the knee

Resumen: El objetivo principal del estudio fue analizar la asociación entre la presencia de lesiones cartilaginosas asintomáticas en pacientes con lesiones traumáticas de rodilla y su tiempo de baja y gasto mutual. Los objetivos secundarios fueron describir la prevalencia y epidemiología de estas lesiones y analizar si se asocian con la presencia de obesidad y un peor resultado final. Material y métodos: Revisión retrospectiva de una cohorte de todos los pacientes a los que se les realizó una artroscopía de rodilla tras una lesión traumática en un centro mutual en el año 2018. Se recogieron datos demográficos, diagnóstico, patología condral concomitante, tratamiento, clínica al alta, tiempo total de baja y el gasto derivado de ésta. Resultados: Fueron analizados 123 pacientes con una media de edad de 47 años, no se encontraron diferencias entre sexos ni respecto a la obesidad entre los grupos con y sin lesión condral. Las lesiones cartilaginosas fueron diagnosticadas en más de un tercio de los pacientes valorados (35.25%), la mayoría entre 48 y 53 años. La presencia de patología condral no fue un condicionante que aumentara los días de baja o el gasto total (p > 0.05). En pacientes con meniscectomía, la lesión condral aumenta el tiempo de baja (p = 0.03). Los tratamientos enfocados en la lesión condral no produjeron diferencias en cuanto a la duración de la baja ni en el gasto. Conclusión: El manejo de una lesión condral concomitante a nivel de la rodilla sigue presentando controversia. Podría implicar un factor de mal pronóstico de recuperación en pacientes con meniscopatía y las terapias actuales no han mostrado un beneficio claro en estos pacientes del entorno laboral.

Abstract: The objective of this study was to investigate the prevalence and epidemiology of knee cartilage lesions in the work environment, and to assess whether they increase the patient's work leave and thus also cost. We also analyzed the prevalence of concomitant pathology and how it affected recovery and final outcome. Material and methods: Monocentric retrospective cohort of patients with occupational injuries who underwent knee arthroscopy during 2018. Demographic data, diagnosis, concomitant chondral pathology, treatment, symptoms and signs at discharge, work leave and total cost were collected. Results: 123 patients were analyzed, with a mean age of 47 years. No differences were found between sexes or with respect to obesity. Asymptomatic chondral lesions were found in 35.25% of the patients, primarily the older ones (48-53 years). The presence of cartilaginous pathology did not increase days of work leave or total cost (p > 0.05). In patients with meniscopathy in whom meniscectomy is performed, the chondral lesion increased the number of days of work leave (p = 0.03). There were no differences in the number of days of work leave nor total cost for different treatments of chondral pathology. Conclusion: The management of a concomitant chondral knee lesion is still controversial. These lesions might convey poorer functional prognosis in patients with meniscopathy. Current therapies have not shown a clear benefit in work injuries.

Effect of professional certification on employees' return-to-work rate after occupational injuries in Korea: focusing on vulnerable groups

BACKGROUND@#One effective way to improve return-to-work (RTW) performance may be to convince the employer that the worker has the necessary skills. The aim of this paper is to investigate the effect of having a professional certification among workers injured in occupational injuries on their return to work.@*METHODS@#The Panel Study of Workers' Compensation Insurance (PSWCI) targets workers who completed medical care in 2012 after an occupational injury. The study population (n = 2000) was stratified by gender, age, region, disability grade, and rehabilitation service use. A total of 1458 workers were finally selected for this study. The effect of having a certification on RTW status was calculated with an odds ratio and 95% confidence intervals using binomial and multinomial logistic regression analyses. In the binomial logistic regression analysis, the RTW group was made up as a combination of the return to original work and the reemployment groups.@*RESULTS@#The ORs of RTW among those with a certification compared to those without certification were 1.38 (1.16-1.65) in Model 1, 1.25 (1.05-1.50) in Model 2, and 1.22 (1.01-1.47) in Model 3. Among female workers with a certification, the OR of RTW was 4.60 (2.68-7.91), that of return to original work was 3.21 (1.74-5.91), and that of reemployment was 5.85 (3.34-10.27). Among daily workers with a certification, the OR of RTW was 1.32 (1.03-1.69) and that of reemployment was 1.37 (1.07-1.76).@*CONCLUSION@#In conclusion, injured workers with a certification generally had a higher RTW rate. In particular, the RTW rate was higher among female workers and daily workers with a certification than among those without.

Etiological causes and epidemiological characteristics of patients with occupational corneal foreign bodies: A prospective study in a hospital-based setting in India

Purpose: Corneal foreign bodies (CFBs) due to occupational exposure have been largely ignored in Indian literature, especially nonmetal workers. Our study looks at a broad range of occupations and settings that contribute to CFB in our local Indian population. The study objective was to determine the occupations, level of education and demographics of patients presenting with CFB acquired during occupational work. Methods: Prospective hospital-based study at a tertiary eye hospital in Gurgaon, Haryana, India, within duration of 9 months. Patients presenting with CFB were asked a set of questions relating to their occupation, level of education, understanding of the potential complications of CFB, and demographics. Results: A total of 83 patients were included in the study. CFB were attributed only to males. 66% of patients were in the age group of 14--29 years. 30% of patients were in the age group 30--44 years and 4% of patients were between 45 and 60 years old. The metal work industry was responsible for 47% of presentations. The construction industry was responsible for 27% of presentations. Electricians and carpenters combined were responsible for 10% of presentations and 17% of presentations occurred in other sectors. Conclusion: CFB occur across a number of occupations in the construction industry, not just metallic workers. Among a population that is generally poorly educated and have nominal understanding of the impact that CFB can have on vision, occupational hazard education is necessary to address this problem.

Musculoskeletal Occupational Injuries in Orthopaedic Surgeons and Residents

@#Introduction: Orthopaedic surgeons are significantly predisposed to musculoskeletal injury, and these injuries can have negative effects on surgeon function and patient outcomes. While this phenomenon has been studied in the non-Asian population of surgeons, no study has been carried out in the local or regional Asian setting. The aim of this study was to determine the prevalence, characteristics and associations of occupational injuries in orthopaedic surgeons and residents, and to assess its functional impact. Materials and Methods: The Nordic Musculoskeletal Questionnaire was sent out to all orthopaedic consultants and residents at two institutions in Singapore, via an email link to an online survey. Separately, further questions on symptom description, severity and treatment were surveyed. Additional information like age, gender, height and weight were obtained as well. Results: A total of 87.5% respondents have at least one injury. Neck symptoms (66.1%) were the most prevalent, and back symptoms had the highest median severity score (4.5/10). The 74.1% of these injuries were reported as directly attributable to work. Age was found to be associated with an increase in the total number of anatomical areas affected (p = 0.016). A seated operating position was associated with more severe back pain (p = 0.040). Conclusion: There is a high prevalence of occupational injuries sustained in our population of orthopaedic surgeons. Neck symptoms, followed by back and wrist symptoms, were the predominant symptoms in our population. Targeted ergonomic interventions may be considered to prevent specific musculoskeletal injuries in our population of orthopaedic surgeons.

The harm and protective measures of facial occupational exposure of dental medical and nursing personnel / 口腔疾病防治

@#There are many kinds of medical facial protective equipment with different functions. However, due to the lack of recognition of the hazards of facial occupational exposure, an incomplete understanding of the functions and effects of protective equipment and a lack of awareness, the proportion of staff that wear protective equipment in the Department of Stomatology is low. In this paper, the harmful and protective effects of face occupational exposure of dental staff were reviewed. A literature review showed that with the increasing prevalence of infection with AIDS, hepatitis B, hepatitis C and multidrug resistant bacteria in recent years, the occupational infection rate of medical staff in the Department of Stomatology has increased. The noise generated during oral treatment and the light from photosensitive curing lamps and treatment or surgical lasers can also cause occupational damage to hearing and vision. Face protection measures lack comprehensive functioning, and there is a lack of products that can be easily worn, indicating that the functions of face protection products need to be improved and strengthened. To minimize occupational infection and injury, we should not only improve the existing protective equipment but also improve personal protection awareness through advertising and education and comprehensively explore effective measures to improve occupational safety to ultimately achieve safe and high-quality medical services.

An organization based cross-sectional study of occupational injuries among bridge construction workers in an urban area of Mumbai

Background: Occupational injuries are matter of consideration and purport to be raising cost directly like in illnesses and accidents, loss of employment, disability and loss of productivity and subsequently to families and Society. However, there is paucity of studies to elucidate the state of affairs in most of the part of India. The Present study dictates the prevalence of injury and associated factors among Bridge Construction workers in urban area of Mumbai. Objectives are (1) to study prevalence of injury among bridge construction workers, (2) to identify the factors related to such occupational injuries. Methods: A cross-sectional study was conducted among bridge construction workers in urban area of Mumbai from August 2017 to December 2017. Sample size was 150 by convenient method sampling which were selected randomly.Results: The prevalence of injury among Bridge making was 25.7% in past 3 months. Factors like not using protective devices, smoking, tobacco chewing, lack of sleep, work experience were factors associated with suffering.Conclusions: In the study dictating construction workers health and safety in an urban area of Mumbai, where higher prevalence of injury (25.7%) reported in bridge workers in an urban area of Mumbai. If intense mediation are not established then work absenteeism, drooping of work output, occupation related ailments, disabilities and casualties would remain in existence a major problem among construction workers .Therefore programmes to alleviation the load exhibited by construction related injuries should focus on work safety training, monitoring of health and substance abuse in work area.