Use of a national hospitalization register to identify industrial sectors carrying high risk of severe injuries: a three-year cohort study of more than 900,000 Danish men.

BACKGROUND: Data indicates that Denmark has relatively high risks of occupational injuries. We evaluated all injuries resulting in hospitalization by occupation. METHODS: All gainfully employed men younger than 60 in 1990 were divided into 47 industrial groups and followed using the National Inpatient Registry, for hospitalized injuries 1991-1993. Following ICD-8, injuries were grouped into six categories: head, upper extremities, back, trunk, lower extremities and ruptures, sprains and strains. Standardized industrial hospitalization ratios (SHRs) were calculated and Pearson's independence test was performed for each category. RESULTS: Industrial differences were ascertained for each injury category. The highest associated injury category was upper extremity injuries ranging from SHR = 43 (fire services and salvage corps) to SHR = 209 (slaughterhouse industry). Carpentry, joinery, bricklaying and construction work had significantly high SHRs for all injury categories, whereas administrative work was significantly low throughout. CONCLUSIONS: Occupational surveillance systems based on hospitalized injuries can be used to identify high-risk industries, and thereby suggest where to direct prevention efforts.

Reflexivity--a strategy for a patient-centred approach in general practice.

Reflexivity as a strategy in general practice can be used to implement a patient-centred approach in the consultation. General practice has long represented a tradition attempting to integrate both illness and disease. For the GP, it is natural to focus on the patient's whole situation, and the GP's experience with patients is often based on a long-term relationship. Reflexivity implies having a self-conscious account of the production of knowledge as it is being produced. We believe that GPs can gain access to additional knowledge by consciously using reflexivity as a strategy in the consultation. In the present article, we discuss reflexivity in relation to the notions of empathy, personal experience and self-knowledge. By using reflexivity in order to rely on personal experience, the GP can gain access to patients' understanding of their health. Reflexivity can be a valuable concept for the GP in patient-centred medicine and can contribute to bridging the gap between the patient's perspective and the doctor's understanding of the patient's health.