Risk factors of fatal occupational accidents in Iran

BACKGROUND: Occupational accidents are of most important consequences of globalization in developing countries. Therefore, investigating the causes of occupational accidents for improving the job situation and making operational policy is necessary. So the aim of this study was to investigate factors affecting the fatal occupational accidents and also calculate the years of life lost for dead workers. METHODS: This cross-sectional study was conducted on data related to the 6052 injured workers that was registered in the 2013 registry system of the Ministry of Health and Medical Education of Iran. Variables including sex, education, age, job tenure, injury cause, referred location of injured workers, occupation, shift work, season, accident day, damaged part of the body were chosen as independent variables. The Chi-squared and Fisher exact tests were used for univariate analysis and then exact multiple logistic regression was carried out to identify independent risk factors of fatal occupational accidents. Finally, for dead workers, years of life lost, according to the injury causes was calculated. RESULTS: Among the 6052 accidents reported, 33 deaths were recorded. Chi-square and Fisher exact tests showed that factors including: current job tenure (p = 0.01), damaged parts of the body (p < 0.001) and injury cause (p < 0.001) are associated with the fatal accidents. Also exact multiple logistic regression analysis showed a significant association between electric shocks as a cause of injury (OR = 7.04; 95% CI: 1.01–43.74; p = 0.02) and current job tenure more than 1 year (OR = 0.21; 95% CI: 0.05–0.70; p = 0.005) with the fatal accidents. The total amount of years of life lost based on causes of injuries was estimated 1289.12 years. CONCLUSIONS: In Iran, fatal accident odds in workers with job tenure more than 1 year was less in comparing to the workers with job tenure less and equal to 1 year. Also odd of death for electrical shock was more than other causes of injuries. So it seems that employing of workers who have more than one-year work experience in a specific job and using of appropriate safeguards will be useful for the reducing of fatal occupational accidents.

Diagnostic accuracy of ultrasonography and radiography in detection of pulmonary contusion; a systematic review and meta-analysis

Ultrasonography is currently being used as one of the diagnostic modalities in various medical emergencies for screening of trauma patients. The diagnostic value of this modality in detection of traumatic chest injuries has been evaluated by several studies but its diagnostic accuracy in diagnosis of pulmonary contusion is a matter of discussion. Therefore, the present study aimed to determine the diagnostic accuracy of ultrasonography and radiography in detection of pulmonary contusion through a systematic review and meta-analysis. An extended systematic search was performed by two reviewers in databases of Medline, EMBASE, ISI Web of Knowledge, Scopus, Cochrane Library, and ProQuest. They extracted the data and assessed the quality of the studies. After summarization of data into true positive, false positive, true negative, and false negative meta-analysis was carried out via a mixed-effects binary regression model. Further subgroup analysis was performed due to a significant heterogeneity between the studies. 12 studies were included in this meta-analysis [1681 chest trauma patients, 76% male]. Pooled sensitivity of ultrasonography in detection of pulmonary contusion was 0.92 [95% CI: 0.81-0.96; I2= 95.81, p<0.001] and its pooled specificity was calculated to be 0.89 [95% CI: 0.85-0.93; I2 = 67.29, p<0.001] while these figures for chest radiography were 0.44 [95% CI: 0.32-0.58; I2= 87.52, p<0.001] and 0.98 [95% CI: 0.88-1.0; I2= 95.22, p<0.001], respectively. Subgroup analysis showed that the sources of heterogeneity between the studies were sampling method, operator, frequency of the transducer, and sample size. Ultrasonography was found to be a better screening tool in detection of pulmonary contusion. Moreover, an ultrasonography performed by a radiologist / intensivist with 1-5MHz probe has a higher diagnostic value in identifying pulmonary contusions