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.

Does company compliance with RS-17 influence the characterization of a casual nexus in expert testimony?

Objective: To examine whether company compliance with RS-17 influences the characterization of the casual nexus in physical therapists' expert reports of cumulative trauma disorders in the labor court of Pernambuco, Brazil. Method: The sample was composed of seven physical therapists who provided expert testimony regarding cumulative trauma disorder cases in the labor court of Pernambuco, Brazil. Data collection was performed across two stages. In the first stage, the experts answered a sociodemographic survey and requested the identification numbers of recent cases where expert testimony was provided to characterize the causal nexus. In the second stage, the researchers went to the labor court to collect expert testimony data. These experts indicated that of 75 total cases, 31% (N=23) of the companies fulfilled RS-17, whereas 69% (N=52) did not comply with the law. Results: Among the organizations that complied with legislation, 30% of the analyzed expert testimonies showed a positive causal nexus. However, of the companies that did not comply with RS-17, 71% of the expert testimonies revealed a causal nexus. These results indicate that the breach of the law increases the probability that a causal nexus will be determined by 54.8%. Conclusion: The results showed that failure to comply with RS-17 significantly increases the probability that a causal nexus will be determined in physical therapists' expert testimony of cumulative trauma disorders. .

Twenty-four-hour pattern in French firemen of lag time response to out-of-hospital cardiac arrest and work-related injury.

Circadian cognitive and physical rhythms plus 24 h patterns of accidents and work-related injuries (WRI) have been verified in numerous studies. However, rarely, if ever, have 24 h temporal differences in both work performance and risk of WRI been assessed in the same group of workers. We explored in a homogenous group of French firemen (FM) 24 h patterns of both lag time (LT) response duration to emergency calls for medical help (ECFM) for life-threatening out-of-hospital cardiac arrests (OHCA), used as a non-specific index of work performance, and WRI. Our studies demonstrate rather high amplitude statistically significant 24 h patterns of the two variables. The LT response duration was twice as long ~0500 h (slowest response) than ~1600 h (fastest response). In the same group of FM, the actual number WRI/h was greatest ~1600 h and lowest in the early morning hours. However, the 24 h pattern of the relative risk (RR) of WRIs, i.e., per clock hour number of WRI/(total number of responses to emergency calls x number of FM at risk per response), was very different, the RR being greatest ~0200 h and lowest in the afternoon. The 24 h pattern in LT response duration to ECMH for OHCA and RR of WRI was strongly correlated (r=+0.85, P<0.01), with the nocturnal trough (slowest response) in LT response duration coinciding with the nocturnal peak RR of WRI. These findings indicate the requirement for circadian rhythm-based interventions to improve the nocturnal compromised work performance and elevated risk of WRI of shift-working FM.

Accidentes de trabajo fatales y violencia interpersonal en Brasil, 2000-2010 / Fatal work-related injuries and interpersonal violence in Brazil, 2000-2010

En el presente estudio se estima la mortalidad proporcional por accidentes de trabajo provocados por violencia interpersonal en Brasil, entre 2000 y 2010. Se analizaron los datos del Sistema de Información sobre Mortalidad, basados en los informes estadísticos de defunción del Ministerio de Salud de Brasil, los cuales incluyen un campo para el registro de accidentes de trabajo que debe ser completado en toda defunción por causas externas. Se identificaron 1.368.732 casos de defunciones por causas externas, 31.576 (2,3%) por accidentes de trabajo y solo 226 (0,02%) por accidentes de trabajo con violencia interpersonal. Cerca del 80% de los informes estadísticos de defunción no tenían el campo "accidente de trabajo" completado. La mayor cantidad de casos ocurrió entre hombres (94,3%) de 25-34 años, con nivel de escolaridad medio, ubicados en la región sudeste y noreste, que trabajan principalmente en la producción de bienes y servicios industriales y la actividad agropecuaria. La mayoría de los casos fueron causados por armas de fuego, seguidos por armas blancas, con un aumento relativo de estos últimos en el período estudiado. Los resultados sugieren un gran subregistro de diagnósticos que reconocen la relación con el trabajo. Se hace necesaria una mejor capacitación en el llenado de los informes estadísticos, así como estudios que cuantifiquen el subregistro de accidentes de trabajo y accidentes de trabajo con violencia interpersonal.

In this study, we present estimates of the proportionate mortality of work injuries involving interpersonal violence in Brazil from 2000 to 2010. Data come from the Mortality Information System based on death certificates from the Health Ministry, which in Brazil include a field for recording work-related injuries that must be completed in all deaths due to external causes. There were 1,368,732 deaths due to external causes, 31,576 (2.3%) due to work injuries, and only 226 (0.02%) due to work injuries involving interpersonal violence. Nearly 80% of the death certificates did not include data in the work injury field. Most cases occurred among males (94.3%) 25-34 years of age with less than high school education in the Southeast and Northeast country regions, primarily in the manufacturing and agricultural industries. The majority of cases were caused by firearms, followed by sharp instruments, with a relative increase in this last category during the study period. Findings suggest underrecording of diagnoses that recognize the work-related nature of the death. Better training on death certificate completion and studies to quantify the underrecording of work injuries and work injuries involving interpersonal violence are needed.

Cargas e desgastes de trabalho vivenciados entre trabalhadores de saúde em um hospital de ensino / Descripción de cargas de trabajo y el desgaste experimentado entre trabajadores de salud en un hospital universitario / Description of workloads and fatigue experienced among health workers in a teaching hospital

Estudo exploratório, de caráter descritivo e de abordagem quantitativa, alicerçado nas categorias "processo de trabalho", "cargas de trabalho" e "desgaste" em um hospital de ensino em Curitiba, região sul do Brasil. Neste artigo, são caracterizadas as cargas e os desgastes vivenciados em um hospital universitário, captados pelo estudo prévio intitulado "Sistema de monitoramento da saúde do trabalhador de enfermagem" (SIMOSTE). Os resultados demonstram que o gênero feminino foi o mais acometido (85,9%); os profissionais mais afetados foram os auxiliares de enfermagem (53,1%). O maior número de afastamentos ocorreu por doenças do sistema osteoarticular (25,2%) e, dentre as cargas apresentadas, as mais expressivas foram as mecânicas e fisiológicas, com 33,06%, cada. Estes resultados poderão subsidiar estratégias de intervenção nas políticas direcionadas à saúde do trabalhador, para assegurar uma melhor qualidade de vida a este profissional e, por consequência, promover melhorias na qualidade da assistência prestada ao usuário.

Estudio exploratorio, descriptivo y cuantitativo, basado en el proceso de trabajo, las cargas de trabajo y el desgaste en un hospital universitario en Curitiba, sur de Brasil. En este artículo se caracteriza la carga y el estrés experimentado en un hospital universitario, planteada por un estudio previo titulado "Sistema de vigilancia de la salud de los trabajadores de enfermería". Los resultados muestran que las mujeres (85,9%) y los auxiliares de enfermería eran los profesionales más afectados (53,1%). El mayor número de ausencia del trabajo se debieron a enfermedades del sistema musculoesquelético (25,2%) y entre los cargos presentados, los más significativos fueron el mecánico y el fisiológico con el 33,06% cada uno. Estos resultados pueden apoyar las estrategias de intervención en las políticas dirigidas a la salud de los trabajadores, para garantizar una mejor calidad de vida a este trabajo y promover mejoras en la calidad de la atención prestada al usuario.

This is an exploratory, descriptive and quantitative study, based on the following categories: work process, workloads and fatigue in a teaching hospital in Curitiba in the southern region of Brazil. The article characterizes the load and stress experienced in a university hospital, based on a previous study entitled "System for monitoring the health of nursing workers" (SIMOSTE). The results show that females were the most affected (85.9%) and the most affected professionals were nursing assistants (53.1%). The highest number of sick leaves was due to diseases of the osteoarticular system (25.2%) and the most significant loads were mechanical and physiological with 33.06% each. These results may support intervention strategies in the policies directed toward the workers' health to ensure a better quality of life and consequently improve the quality of care provided to the user.

Corneal metallic foreign bodies among Jordanian soldiers

To review the spectrum of metallic foreign bodies among Jordanian soldiers and the efficacy of treatment. A retrospective review was conducted at Prince Rashid Bin Al-Hassan Hospital between August 2011 and March 2012. File and photographs review of 55 patients who attended the ophthalmology clinic and found to have corneal metallic foreign body were included in this study. The following data were extracted and analyzed: age, gender, past ocular history, mechanism and time of injury and whether any eye protective measures were taken for those who were exposed to trauma during work, time to receive treatment, method of corneal foreign body removal, number of foreign bodies, location, depth of foreign body in the cornea, whether the eye was patched or not after removal of corneal foreign body, associated ocular injury, presence of Bell's phenomenon, complications, and duration of absence from work. All patients were males and the age ranged between 17 and 55 years [mean 31.3 years]. Eighty- two percent of eye trauma occurred during work and all of them did not use any protective measure during their work activity. The mid third of the cornea was involved in 39% of patients followed by the paracentral zone in 27%. Corneal foreign bodies were removed by 27 gauge needle in 68% of patients. Eye patch was not used in 48% of patients after removal of foreign body. The most common associated finding was corneal rust in 63% of cases. Absence from work ranged between two to nine days. Corneal foreign bodies are potentially sight threatening that occurs mostly as a result of occupational accidents in male workers who do not comply with the use of eye protection. Educational and safety programs and patient counselling on proper eye protection are essential and must be implemented in the work places to prevent serious eye injuries and work loss.

Occupational injury at Gangsaw machine A rare occurrence.

Since last few decades, occupational injuries have been a major cause of morbidity and mortality among people working in factories, especially those working with unprotected rotating machines. Women are specifically prone to such injuries because of their long unprotected hairs being trapped in moving parts of the machines. Long hairs can get entangled in moving machinery resulting in complete or partial avulsion of scalp. A large scalp avulsion injury may lead to severe bleeding and may cause trauma to forehead, eyebrows and per auricular tissue, which may further bring fatal results aesthetically and functionally. Severe deformities as a result of this trauma may lead to severe psychological trauma, disabling the patient to lead a normal social life. Here, we are presenting a case report of a patient who had an occupational injury causing scalp avulsion with cervical spine injury at gang saw machine.

[Epidemiology of work-related accidents in Kerman coal mines during 1991-2006]

There are annually millions of work-related accidents leading to either loss of life or disability. Coal mine workers, due to the nature of their work, are at a higher risk of work accidents. With regard to the importance of health statue of skilled workers and prevention of work-related injuries, in this study work-related injuries in Kerman Coal Mines during 1991-2006 were analyzed. In this descriptive study, the recorded and approved data of accidents occurred during 1991-2006 were collected from the documents of Kerman coal mines office and Safety indices [frequency, severity and frequency-severity of accidents] were extracted and analyzed. There were a total of 3642 accidents during 16 years and an average of 228 accidents per year. From all accidents, 51 cases had resulted in death of which most cases were related to the years 1992, 1994, 1996, 1997 [each year one case]. Mean frequency percent, severity and frequency-severity were 31.3 +/- 25.9, 473.8 +/- 11275.1 and 9.3 +/- 12.4 respectively. according to the results of chart control, accident frequency percent except for the years 2002 and 1994 which were respectively a little more and less than the expected rates, in the other years was in the expected range. Severity and frequency-severity of accidents during the 16-year period were in the expected range. In whole, safety indices during the 16 years were stable and in the expected range. In other words, there has been no change for the improvement of safety conditions. Therefore, in order to achieve the required standards and to provide more safety for coal mines workers, it is required that all related organization take efficient coordinated measures

La invisibilidad de las condiciones laborales y de salud de niños del mercado Felipe Angeles / Invisibility of working conditions and children's health in the Felipe Angeles market

Objetivo Identificar las condiciones de trabajo y salud de los menores que trabajan en el mercado Felipe Ángeles de la Ciudad de Guadalajara. Metodología Se realizó un estudio descriptivo a 198 menores de 18 años de edad que desempeñaban alguna actividad laboral en dicho mercado. Se aplicó una encuesta que incluía variables sociodemográficas de los menores, de condiciones del trabajo y de salud. Resultados Los menores de que laboran en este mercado son principalmente hombres (89,9 %) con edades de entre 6 a 17 años, residentes de Guadalajara, 71 % asiste a la escuela. El 83 % de los niños iniciaron sus actividades laborales en el mercado entre los 7 y 10 años y 75 % de ellos llevan 1 año o más trabajando. La jornada laboral va de lunes a domingo en el 50 % de los casos. Los riesgos a la salud percibidos y presentados por los menores son lesiones durante la jornada laboral tales como abrasión, contusión, fracturas, atropellamiento; y las relacionadas con el aspecto psicosocial como son ser víctimas de robo o ser sujetos vulnerables para iniciarse en la drogadicción. Conclusiones Las condiciones de trabajo y salud en que laboran los menores no son adecuadas para su edad y afectan su desarrollo físico y psicosocial, ya que el sitio donde trabajan tiene deficiencias en la estructura arquitectónica, les impide la realización de actividades propias de su edad y los somete a riesgos laborales para los que no existe prevención.

Objective Identifying the work environment and health of children working in the Felipe Angeles market in Guadalajara. Methodology This was a descriptive study which included 198 children working in the aforementioned market. A questionnaire was used which asked about the sociodemographic variables, the work environment and the health of such children. Results The children working in the market were predominantly male (89.9 %), aged 6 to 17 years old, residing in Guadalajara; 71 % were attending school. 83 % of the children had started working in the market between 7 to 10 years old and 75 % had worked there for 1 year or more. Workdays lasted all week, without rest in 50 % of the cases. The children perceived health risks as concerning abrasion, contusion, fractures, being run over and other psychosocial types related to becoming the victims of theft or becoming addicts. Conclusions The children's work environment and health were not suitable for their age and affected their physical and psychosocial state as the site had deficient architecture making it impossible to carry out activities appropriate for their age and provoked workplace risk for which there was no prevention.