Work-related injuries and illnesses (WRII) presenting to Illinois hospitals, 2017-2021: The importance of emergency department (ED) data.

OBJECTIVES: Research characterizing work-related injuries and illnesses (WRII) has predominantly focused on inpatients and deaths, despite evidence that 4% of WRII are admitted as inpatients and deaths are less than 0.2% of acute WRII. Our aim is to determine the usefulness of incorporating emergency department (ED) hospital data into current occupational health surveillance systems. METHODS: Data on ED and admitted WRII treated in Illinois hospitals from 2017 to 2021 were analyzed. Demographic characteristics, primary diagnosis, procedures undertaken, and unique patient estimates are described. Multivariable logistic regression models were developed to evaluate predictors of treatment in the ED and multivariable median regression models determined associations of total hospital charges. RESULTS: Between 2017 and 2021 there were 488,033 hospital presentations (95.9% nonadmissions) for WRII in Illinois, equating to a crude annual population rate of 1502.1/100,000. Non-Hispanic Whites (NHW) were disproportionately treated for illnesses, while Hispanic or Latino workers were disproportionately treated for injuries. African-Americans had the highest rate of ED emergent presentations (incident rate ratio [IRR] = 1.3, ref = NHW) and were less likely to be admitted for emergent presentations (IRR = 0.7, ref = NHW). ED presentations were more likely to be female, present with an injury, and at a rural, versus urban, hospital. Radiological investigations compromised the majority of procedures for nonadmitted patients (n = 403,317), and 94.8% were coded for a body region CONCLUSION: Between 2017 and 2021 in Illinois, there were nearly 500,000 hospital visits charged to workers' compensation totaling over US$ four billion. ED data provide additional insights into work-related chronic conditions, health disparities, and the usage of diagnostic and therapeutic procedures for WRII.

Identifying Work-Related Injuries Among Healthcare Workers in Makkah Hospitals, Saudi Arabia: A Cross-Sectional Study in 2024.

Background Work-related injuries (WRIs) are a major occupational health issue among healthcare workers (HCWs) worldwide. HCWs face numerous daily hazards including needlestick injuries, chemical exposures, ergonomic strains, and psychological stressors crucial for their health and healthcare system functionality. In Makkah, Saudi Arabia, healthcare infrastructure advances raise concerns about work-related injuries among HCWs. This study in Makkah hospitals aims to identify, understand, and manage WRIs for improved occupational health guidelines and strategies. Methods This descriptive cross-sectional study on HCWs was conducted at Makkah hospitals using an electronic questionnaire that investigated the demographics, work-related injuries, and occupational hazards. The data collected from the retrieved questionnaires were analyzed using the IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). Results Among 379 enrolled HCWs, 172 (49.3%) were physicians and 89 (19.8%) were nurses; 304 (80.2%) of the total participants knew about occupational safety. The total incidence of WRIs was 67.8%. WRIs were significantly associated with age (P˂0.001), gender (P=0.02), educational level (P˂0.001), profession (P˂0.001), working hours (P˂0.001), and shift time (P˂0.001). Conclusion WRIs were highly prevalent among HCWs with varying rates based on the type of injury and the frequency of injury. WRIs were associated with various factors including age, gender, education, profession, working house, and shift time of the participants.

Surgeons with disabilities, they do exist.

INTRODUCTION: Doctors with disability are likely to face major life crises, challenges and distressing emotions from unforeseen circumstances that threaten their physical well-being. We aimed to identify the existence of work-related pain and discomfort that may cause surgeon's disability. Surgeons who were struck with unpredictable disasters leading to disabilities were also reviewed. METHODS: We conducted a 10-year literature review. In addition, citations about surgeons' physical disabilities were complemented with commentaries about disabled surgeons from gray literature. The quantitative citations were quality assessed by MERSQI scores and evidence graded according to GRADE. For the qualitative study part, the severely traumatized surgeons were analysed by means of Cullberg's crisis phases (CCP) and analysed from Tedeschi and Calhoun's post-traumatic growth perspective (PTG). RESULTS: Altogether 3593 citations from PubMed were studied, and 10 citations met inclusion criteria with a total of 11591 participants. We included 6 surgeons subjected to highly traumatic events complicating their medical career. Our quantitative citations' mean MERSQI score was 11.73 (SD .79) and the citations' evidence value completed grade II (moderate quality: 11.26 to 12.00 scores). Work-related musculoskeletal pain and occupational injuries may lead to physical disabilities. The accidentally traumatized surgeons fought through the four CCP phases and reached successfully the PTG stage. CONCLUSIONS: The surgical workforce is at high risk of work-related musculoskeletal morbidity which can progress to chronic pain and disruption of surgeon's career. Surgeons with disabilities faced serious barriers in their career. Institutions and healthcare systems must urgently develop support strategies for surgeons with disabilities.

Pectoralis Major Tendon Rupture in an Occupational Medicine Setting: A Case Report.

Pectoralis major (PM) rupture is a rare injury, commonly misdiagnosed, that affects mostly young male athletes aged 20-40 years. This type of injury is typically associated with weight lifting, especially bench pressing. In an occupational medicine setting, it is extremely rare and not much reported in the literature. We present the case of a 30-year-old trauma technician male who presented with right shoulder and chest pain following a popping sensation while pushing in full momentum a patient on a gurney accidentally set on break mode. PM rupture was suspected clinically. Magnetic resonance imaging confirmed the diagnosis and revealed a complete rupture of the sternal head of PM. Surgical reconstruction was performed to restore the anatomy and functionality of the shoulder girdle.

Use of General Practitioner Services Among Workers with Work-Related Low Back Pain: A Systematic Review.

PURPOSE: Work-related low back pain (WRLBP) is a highly prevalent health problem worldwide leading to work disability and increased healthcare utilisation. General practitioners (GPs) play an important role in the management of WRLBP. Despite this, understanding of GP service use for WRLBP is limited. This systematic review aimed to determine the prevalence, patterns and determinants of GP service use for WRLBP. METHODS: MEDLINE, Embase via Ovid, Scopus and Web of Science were searched for relevant peer-reviewed articles published in English without any restriction on time of publications. Low back pain (LBP) was considered work-related if the study included workers' compensation claim data analysis, participants with accepted workers' compensation claims or reported a connection with work and LBP. The eligibility criteria for GP service use are met if there is any reported consultation with family practitioner, medical doctor or General Practitioner. Two reviewers screened articles and extracted data independently. Narrative synthesis was conducted. RESULTS: Seven eligible studies reported prevalence of GP service use among workers with WRLBP ranging from 11% to 99.3%. Only studies from Australia, Canada and the United States met the eligibility criteria. The prevalence of GP service use was higher in Australia (70%) and Canada (99.3%) compared to the United States (25.3% to 39%). The mean (standard deviation) number of GP visits ranged from 2.6 (1.6) to 9.6 (12.4) over a two-year time interval post-WRLBP onset. Determinants of higher GP service use included prior history of low back pain, more severe injury, prior GP visits and younger age. CONCLUSION: Only seven studies met the eligibility indicating a relative lack of evidence, despite the acknowledged important role that GPs play in the care of workers with low back pain. More research is needed to understand the prevalence, patterns and determinants to support effective service delivery and policy development.

Prevalence and Associated Factors of Work-Related Injury Among Municipal Solid Waste Collectors in Hawassa City, Southern Ethiopia: A Cross-Sectional Study.

Introduction: Municipal solid waste collectors are at risk of experiencing work-related health problems due to the waste they handle and the physical effort they put in. Work-related injuries among domestic waste collectors have been the subject of scant research in developing nations. Therefore, it is necessary to describe work-related injuries in these subpopulation groups. Objective: This study aimed to determine the prevalence and associated factors of work-related injury among municipal solid waste collectors in Hawassa city, Southern Ethiopia. Methodology: A cross-sectional study was conducted from January 11 to 30, 2022, with all the registered municipal solid waste collectors (411). Three diploma environmental health professionals assisted in collecting data using a pretested structured interviewer-administered questionnaire; 1 Bachelor of Science environmental health professional served as a supervisor. Statistical Package for the Social Sciences (SPSS) version 20.0 was used to enter, clean, code, and analyze the data. Associations between independent and dependent variables were assessed, and the strength of the associations was presented by using Adjusted Odds Ratio (AOR) and 95% confidence intervals (CI). According to the bivariable analysis, all independent variables associated with a P-value <.25 were entered into a multivariable logistic regression model. Variables in the multivariable regression analysis were considered significant if their P-value was less than 0.05. Results: In this study, the prevalence of work-related injuries within the last 30 days was 12.9% (95% CI: 9.5, 16.3), while the prevalence over the last 12 months was 59.4% (95% CI: 54.7, 64.0). After adjusting for possible confounding factors, age 18 to 24 years [AOR = 1.72;95% CI: (1.07, 2.76)], lack of personal protective equipment (PPE) utilization [AOR = 2.30; 95% CI: (1.44, 3.68)], chewing khat (yes) [AOR = 2.32;95% CI: (1.32, 4.08)], drinking alcohol (yes) [AOR = 1.80; 95% CI: (1.003, 3.24)] and job dissatisfaction [AOR = 2.26, 95% CI: (1.44, 3.54)] were shown to be significantly associated with work-related injury. Conclusion: The prevalence of work-related injuries was high. Age 18 to 24 years, chewing khat, drinking alcohol, lack of PPE utilization, and job dissatisfaction were significantly associated with work-related injury. Based on the findings of this study, we suggest that addressing these risk factors could help to reduce work-related injuries.

Increased patient body mass index is associated with increased surgeon physiologic stress during total hip arthroplasty.

INTRODUCTION: While increased body mass index (BMI) in patients undergoing total hip arthroplasty (THA) increases surgical complexity, there is a paucity of objective studies assessing the impact of patient BMI on the cardiovascular stress experienced by surgeons during THA. The aim of this study was to assess the impact of patient BMI on surgeon cardiovascular strain during THA. METHODS: We prospectively evaluated three fellowship-trained arthroplasty surgeons performing a total of 115 THAs. A smart-vest worn by the surgeons recorded mean heart rate, stress index (correlate of sympathetic activation), respiratory rate, minute ventilation, and energy expenditure throughout the procedures. Patient demographics as well as perioperative data including surgical approach, surgery duration, number of assistants, and the timing of the surgery during the day were collected. Linear regression was utilized to assess the impact of patient characteristics and perioperative data on cardiorespiratory metrics. RESULTS: Average surgeon heart rate, energy expenditure, and stress index during surgery were 98.50 beats/min, 309.49 cal/h, and 14.10, respectively. Higher patient BMI was significantly associated with increased hourly energy expenditure (P = 0.027), mean heart rate (P = 0.037), and stress index (P = 0.027) independent of surgical approach. Respiratory rate and minute ventilation were not associated with patient BMI. The number of assistants and time of surgery during the day did not impact cardiorespiratory strain on the surgeon. CONCLUSION: The physiologic burden on surgeons during primary THA significantly increases as patient BMI increases. This study suggests that healthcare systems should consider adjusting reimbursement models to account for increased surgeon workload due to obesity. Further surgeons should adopt strategies in operative planning and case scheduling to handle this added physical strain. LEVEL OF EVIDENCE: III.

Factors affecting work-related non-fatal injuries among aged workers in South Korea.

Introduction: The objective of this paper is to investigate whether an aging workforce is associated with an increase in work-related non-fatal injuries and to explore the underlying reasons for this potential increase. Methods: Aged workers were defined as those who were at least 55-years-old. Work-related non-fatal injuries were assessed in aged and young workers who were registered with the workers' compensation system from 2017 to 2021 of South Korea. Results: The mean estimated rate of work-related non-fatal injuries of aged workers (0.88/100) was about 2.5-times higher than that of younger workers (0.35/100). Most work-related non-fatal injuries in the older adults were in individuals working in the "construction sector" (36.0%), those with "elementary occupations (unskilled workers)" (45.0%), and those with employment status of "daily worker" (44.0%). "Trip & slip" (28.7%) and "falling" (19.6%) were more frequent types of work-related non-fatal injuries in aged workers relative to young workers. The category of "buildings, structures, and surfaces" was a more frequent cause of work-related non-fatal injuries in aged workers than young workers. Discussion: The incidence of non-fatal work-related injuries is higher among aged workers compared to their younger counterparts. The increased occurrence of aged workers participating in precarious employment and jobs, along with the greater physical vulnerability, is likely the cause of their higher rate of work-related non-fatal injuries.

Worker's Compensation Injury and Illness Care: A Global Round Table.

BACKGROUND: Work-related injuries and diseases have a significant impact on workers and their families, society, and the economy. There is a gap in the literature regarding the structures, content, quality, and outcomes of international occupational health systems serving injured and ill workers. This global round table was an attempt to elucidate, evaluate, and identify areas needing improvement. METHODS: International occupational health professionals were identified via chain/snowball sampling and asked to answer five questions designed to evaluate the structures, processes, and outcomes of the workers' compensation systems in each country. FINDINGS: Areas for improvement identified during this round table included timely access, reducing the impact of liability and eligibility determinations on access to medical care, equitable access to care, and the accuracy of reporting. Canada had successfully utilized a virtual approach to care for the geographically remote worker. CONCLUSIONS: International workers' compensation structures are designed to ensure timely access to quality care and services. Financial incentives optimize the safety of the working environment. There remain areas for improvement. Resources are limited, especially within the public health systems, which may delay care and affect quality. Informal and remote workers often do not have the same access to care. Occupational Health Services (OHS) and national reporting databases exist throughout the world but may not accurately capture data on informal, self-employed, small business, migrant, and remote workers.

Child labour in cocoa growing regions of Ghana and Côte d'Ivoire: an analysis of academic attainment in children engaged in hazardous labour.

This paper examines the relationship between child labour and educational attainment and explores the distinction between harmful and non-harmful agricultural cocoa work. We conduct a secondary analysis of data on 3,338 children who reported attending school in 2018 across cocoa growing regions of Ghana and Côte d'Ivoire. To address differences between harmful and non-harmful child labour, we differentiated work completed by a child by hazardous activity engagement. These groups of child labour were then modelled against educational attainment, defined by a whether or not the child needed to repeat a class. We then conducted mediation analysis to assess whether injury mediates this relationship. Our results show that hazardous child labour increases the odds of repeating a class and work-related injury compared to non-hazardous labour. The effect of hazardous child labour on academic attainment was also found to be mediated by work-related injuries by 14%. Educational attainment is associated with hazardous labour activities and the odds of injury and not the act of participation in agricultural labour alone. Programmes based on strong measures of harmful work will foster better protection for children who are most at risk and may inform global debates around the benefits versus the risks of child labour.

Return-to-Work Experiences in Ontario Policing: Injured But Not Broken.

PURPOSE: Police officers and others working in police services are exposed to challenging and traumatic situations that can result in physical and/or psychological injuries requiring time off work. Safely returning to work post-injury is critical, yet little is known about current return-to-work (RTW) practices in police services. This study examines RTW practices and experiences in police services from the perspective of RTW personnel and workers with physical and/or psychological health conditions. METHODS: We used a purposive sampling approach to recruit sworn and civilian members from several police services in Ontario, Canada. The recruited members had experienced RTW either as a person in a RTW support role or as a worker with a work-related injury/illness. We conducted and transcribed interviews for analysis and used qualitative research methods to identify themes in the data. RESULTS: Five overarching themes emerged. Two pointed to the context and culture of police services and included matters related to RTW processes, injury/illness complexity, the hierarchical nature of police organizations, and a culture of stoicism and stigma. The remaining three themes pointed to the RTW processes of accommodation, communication and trust-building. They included issues related to recovery from injury/illness, meaningful accommodation, timely and clear communication, malingering and trust. CONCLUSIONS: Our findings point to potential areas for improving RTW practices in police services: greater flexibility, more clarity, stricter confidentiality and reduced stigma. More research is needed on RTW practices for managing psychological injuries to help inform policy and practice.

Comparative analysis of work-related injury appraisal of 13 cases of occupational brucellosis / 环境与职业医学

Background According to the Classification and Catalogue of Occupational Diseases, brucellosis is one of the notifiable occupational infectious diseases, which occurs from time to time in the occupational population. Objective To compare the work-related injury appraisal process and results of 13 cases of brucellosis at both provincial and municipal levels, analyze and summarize the bias in the practical work of labor capacity identification for occupational diseases such as brucellosis by appraisal management departments and experts, and propose suggestions for optimizing appraisal work. Methods A comparative study was conducted on the objective examination results and labor capacity appraisal conclusions based on the occupational contact history, clinical diagnosis, occupational disease diagnosis staging, and labor capacity appraisal of 13 patients with brucellosis. The reasons for the inconsistency between the initial appraisal conclusion by institutions at the municipal level and the final appraisal conclusion by institutions at the provincial level were compared and analyzed. Results All of the 13 patients with brucellosis applied for municipal-level labor capacity identification after being identified as work-related injuries, 11 of which did not receive a disability level, and 2 were rated as level 10 disability. Four of those who did not receive the disability rate applied for provincial-level labor capacity identification. As a result, 2 cases were maintained original appraisal conclusions, while the other 2 changed the conclusions to level 9 disability and level 10 disability respectively. It was the first time in Shijiangzhuang municipal-level primary labor capacity appraisal and Hebei provincial-level labor capacity re-appraisal that the work-related injury caused by occupational brucellosis was rated as level 9 disability or level 10 disability. Hence, the lessons learned from this comparative analysis are that the degree of target organ damage and (or) organ dysfunction are the direct basis for work-related injury appraisal; an objective and scientific labor capacity identification for occupational brucellosis should base on the each case of disability evaluation, identify the relevant target organ damage and the degree of dysfunction, and rate the disability level after a comprehensive appraisal. Conclusion This analysis would be a guidance to the identification of labor capacity for occupational brucellosis in Hebei Province and the whole country. There is a hysteresis issue in the occupational disease provisions in the national standard GB/T 16180—2014 Standard for identify work ability—Gradation of disability caused by work-related injuries and occupatiaonal diseases. In current situation, appraisal experts should not only search for clauses that directly correspond to the occupational diseases and injuries, but also target conditions not covered in the clauses and conduct assessment based on the characteristics of occupational diseases, with scientific, accurate, and flexible application of the clauses in the standard and appendix, so as to make fair, just, and professional appraisal conclusions.

Analysis of work-related injury medical expenses and influencing factors in Kunshan City from 2016 to 2021 / 中国职业医学

ObjectiveTo understand the influencing factors of work-related injury medical expenses in Kunshan City. Methods The work-related injury data of Kunshan City from 2016 to 2021 were collected from the “Jiangsu Human Resources and Social Security Integration Handling Platform” of Kunshan Municipal Human Resources and Social Security Bureau, and the influencing factors of work-related injury medical expenses were analyzed using quantile regression. Results The median (interquartile range) of per capita work-related injury medical expenses in Kunshan City from 2016 to 2021 was 1 025.6(7 199.1) yuan. The result of 0.50 quantile regression analysis showed that the work-related injury medical expenses of male workers were higher than that of female workers (P<0.01), the work-related injury medical expenses of workers aged 46 and above were higher than those aged 16-<26 (P<0.01), the work-related injury medical expenses of veteran workers were lower than those of new workers (P<0.01), the work-related injury medical expenses of workers in the third, fourth, fifth, and sixth major risk industries were higher than that in the first major risk industry (all P<0.05), the work-related injury medical expenses on lower limb, head and neck, trunk, and multiple injured areas were lower than upper limb injuries (all P<0.01), the work-related injury medical expenses of workers with death, grades 5 to 6, grades 7 to 10, failure to reach grade, and ungraded injuries were lower than those of workers with grades 1 to 4 injuries (all P<0.01), the medical expenses for work-related injuries such as scalds, burns, and scorch were higher than cuts, abrasions, and stabs injuries (P<0.01). Conclusion The influencing factors of the workers' medical expenses for work-related injuries are age, gender, and injured body part. It is necessary to further strengthen the prevention of work-related injuries for males, new workers, workers in the third to sixth major risk industries, and those aged 46 and above. Meanwhile, it is needed to prevent workers from suffering scalds, burns, scorch injuries, upper limb injuries, and high disability grades injuries, to reduce the economic burden on workers and the society.

Analysis of the current situation of work-related injuries in Kunshan City from 2016 to 2021 / 中国职业医学

ObjectiveTo analyze the current situation and characteristics of work-related injuries in Kunshan City. Methods Data on work-related injuries in Kunshan City from January 2016 to December 2021 was collected from the integrated management platform of Jiangsu Human Resources and Social Security Bureau. The situations and characteristics of work-related injuries were analyzed. Results A total of 46 358 work-related injuries occurred in Kunshan City from 2016 to 2021, with the incidence of 0.57% to 0.67%. The incidence showed a decreasing trend year by year (P<0.05). The work-related injuries leading to level 10 disability in workers accounted for 44.45%. The incidence of work-related injuries was highest in the sixth major risk industry category, accounted for 0.79%. The incidence of work-related injuries was the highest in July and August, both accounted for 0.60‰. The incidence of work-related injuries was the highest in the traditional manufacturing area of all regions, accounted for 0.65%. The incidence of work-related injuries was higher in males than in females (0.56% vs 0.23%, P<0.01). The incidence of work-related injuries of workers aged ≥46 years was 0.74%, which was higher than those in the other three age groups <46 years old (all P<0.008). Workers with 11 to <16 and 16 to <21 years of social insurance had relatively higher incidence of work-related injuries, accounted for 0.84% and 1.00%, respectively (both P<0.003). The incidence of work-related injuries was lower in urban workers than in rural workers (0.43% vs 0.44%, P<0.01). Work-related wrist and hand injuries had the highest incidence among all body parts, accounted for 44.67%. Contusions, crush injuries, and compression injuries were the most common types of injuries, accounted for 56.18%. Conclusion The incidence of work-related injuries in Kunshan City is lower than the national average. The incidence of work-related injuries is related to the category of risk industry, region, gender, age, years of social insurance and household registration type. Hierarchical classification should be implemented to prevent work-related injuries.

Self-Esteem Trajectories After Occupational Injuries and Diseases and Their Relation to Changes in Subjective Health: Result From the Panel Study of Workers' Compensation Insurance (PSWCI).

BACKGROUND: Occupational injuries and diseases are life events that significantly impact an individuals' identity. In this study, we examined the trajectories of self-esteem among victims of occupational injury and disease and their relation to health. METHODS: The Panel Study of Workers' Compensation Insurance conducted annual follow-ups on workers who had experienced occupational injury or disease. A total of 2,000 participants, who had completed medical care, were followed from 2013 to 2017. Growth mixture modeling was utilized to identify latent classes in the self-esteem trajectory. Additionally, logistic regressions were conducted to explore the association between trajectory membership, baseline predictors, and outcomes. RESULTS: Three distinct trajectory classes were identified. Total 65.8% of the samples (n = 1,316) followed an increasing self-esteem trajectory, while 31.1% (n = 623) exhibited a constant trajectory, and 3.1% (n = 61) showed a decreasing trajectory. Individuals with an increasing trajectory were more likely to have a higher educational attainment (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.20-2.88), an absence of a moderate-to-severe disability rating (OR, 0.49; 95% CI, 0.25-0.96), no difficulty in daily living activities (OR, 0.81; 95% CI, 0.75-0.88), and were economically active (re-employed: OR, 2.46; 95% CI, 1.52-3.98; returned to original work: OR, 4.46; 9% CI, 2.65-7.50). Those with a decreasing self-esteem trajectory exhibited an increased risk of poor subjective health (OR, 1.89; 95% CI, 0.85-4.85 in 2013 to OR, 3.17; 95% CI, 1.04-13.81 in 2017), whereas individuals with an increasing trajectory showed a decreased risk (OR, 0.54; 95% CI, 0.43-0.68 in 2013 to OR, 0.44; 95% CI, 0.33-0.57 in 2017). CONCLUSION: Our findings emphasize the diversity of psychological responses to occupational injury or disease. Policymakers should implement interventions to enhance the self-esteem of victims.

Traumatic hemorrhage of the thyroid as a work-related injury: a case report and review of the literature.

Traumatic hemorrhage of the thyroid gland resulting from blunt injury to the neck is a very rare event. Particular neck positions can expose the thyroid to trauma, especially in motor vehicle collisions, falls, direct blows, or sport activities. Preexisting conditions such as goiters, adenomas, and cysts can increase the risk of bleeding, reducing the force required to rupture the gland and make the thyroid more prone to injury. The authors report the case of a 53-year-old man who was involved in a fire while working on maintenance of a liquid petroleum gas (LPG)-powered car. He subsequently presented to the emergency department with painful swelling of his right anterior neck with a palpable mass. CT scan showed a right thyroid hemorrhagic cyst. The worker reported that he had jumped into the car trunk to extinguish the fire and covered the gas tank nozzle with his own body to prevent dispersal of the accelerant. In this case, the medico-legal evaluation was useful to delineate between natural and traumatic causes of the injury. Medico-legal assessment is key in understanding the dynamics involved in work-related events to identify any legal responsibilities of the worker or the employer.

Pathophysiology of Work-Related Neuropathies.

Work-related injuries are common. The cost of these injuries is around USD 176 billion to USD 350 billion a year. A significant number of work-related injuries involve nerve damage or dysfunction. Injuries may heal with full recovery of function, but those involving nerve damage may result in significant loss of function or very prolonged recovery. While many factors can predispose a person to suffer nerve damage, in most cases, it is a multifactorial issue that involves both intrinsic and extrinsic factors. This makes preventing work-related injuries hard. To date, no evidence-based guidelines are available to clinicians to evaluate work-related nerve dysfunction. While the symptoms range from poor endurance to cramping to clear loss of motor and sensory functions, not all nerves are equally vulnerable. The common risk factors for nerve damage are a superficial location, a long course, an acute change in trajectory along the course, and coursing through tight spaces. The pathophysiology of acute nerve injury is well known, but that of chronic nerve injury is much less well understood. The two most common mechanisms of nerve injury are stretching and compression. Chronic mild to moderate compression is the most common mechanism of nerve injury and it elicits a characteristic response from Schwann cells, which is different from the one when nerve is acutely injured. It is important to gain a better understanding of work-related nerve dysfunction, both from health and from regulatory standpoints. Currently, management depends upon etiology of nerve damage, recovery is often poor if nerves are badly damaged or treatment is not instituted early. This article reviews the current pathophysiology of chronic nerve injury. Chronic nerve injury animal models have contributed a lot to our understanding but it is still not complete. Better understanding of chronic nerve injury pathology will result in identification of novel and more effective targets for pharmacological interventions.

Behind the flexibility: insufficient occupational injury protection of gig workers in China.

Objective: Occupational injury protection is essential to safeguard the basic rights of workers. This article focuses on a group of gig workers who have emerged on a large scale in recent years in China and aims to explore their status of occupational injury protection. Methods: Based on the theory of technology-institution innovation interaction, we adopted the institution analysis to assess the work-related injury protection of gig workers. The comparative study was used to evaluate three cases of occupational injury protection in China for gig workers. Results: Institutional innovation failed to respond to technological innovation and provided insufficient occupational injury protection for gig workers. The work-related injury insurance was inaccessible to gig workers due to they were not treated as employees in China. The work-related injury insurance was not available to gig workers. Although some practices were explored, shortcomings remain. Conclusions: Behind the flexibility of gig work is insufficient occupational injury protection. According to the theory of technology-institution innovation interaction, we believe the reform of work-related injury insurance is increasingly essential for improving the situation of gig workers. This research contributes to expanding understanding of gig workers' situation and may offer a reference to other countries on protecting gig workers against occupational injuries.

Estimated trends in hospitalizations due to occupational injuries in Korea based on the Korean National Hospital Discharge In-depth Injury Survey (2006-2019).

OBJECTIVES: In recent years, occupational injuries have sparked a huge social and political debate. Thus, in this study, we focused on the characteristics and trends of occupational injuries requiring hospitalization in Korea. METHODS: The Korea National Hospital Discharge In-depth Injury Survey was designed to estimate the annual number and characteristics of all injury-related hospitalizations in Korea. The annual number of hospitalizations due to occupational injuries and the age-standardized rates (ASRs) were estimated from 2006 to 2019. The annual percentage change (APC) and average annual percentage change (AAPC) of ASRs and their 95% confidence intervals (CIs) were calculated using joinpoint regression. All analyses were stratified by gender. RESULTS: In men, the APC of the ASRs of all-cause occupational injuries was -3.1% (95% CI, -4.5 to -1.7) in 2006-2015. However, a non-significant upward trend was observed after 2015 (APC, 3.3%; 95% CI, -1.6 to 8.5). In women, the APC of all-cause occupational injuries was -8.6% (95% CI, -12.1 to -5.1) in 2006-2012. However, a non-significant upward trend was observed after 2012 (APC, 2.1%; 95% CI, -0.9 to 5.2). A recent upward trend in stabbing injuries was observed after 2012 (APC, 4.7%; 95% CI, -1.8 to 11.8) in women. A non-significant overall increasing trend was also observed for occupational injuries caused by exposure to extreme temperatures (AAPC, 3.7%; 95% CI, -1.1 to 8.7) in women. CONCLUSIONS: A recent upward trend in all-cause injury hospitalizations and hospitalizations caused by stabbing injuries was observed. Therefore, active policy interventions are required to prevent occupational injuries.

The Epidemiology of Work-Related Injuries in Saudi Arabia Between 2016 and 2021.

Background Workplace safety has increased in many developed nations, but work-related injuries (WRIs) are on the rise. Globally, approximately 2.9 million fatal work-related injuries and diseases occurred in 2021, up from 1.1 million in 1999. Method This work employs a cross-sectional study using the open data published by the General Organization for Social Insurance (GOSI) on an annual basis for the years 2016 to 2021. The data from one year in each category were compared with a reference year by using the index value method and simple linear regression. Additionally, the researchers calculated the injury-to-worker ratio for each year. Aim The aim of this study is to assess the trending epidemiology of work-related injuries in Saudi Arabia from 2016 to 2021 among insured workers and compare this trend to previous studies. Result A total of 1,009 work-related deaths wererecorded over the study period, averaging 168 per year. In comparison with non-Saudi workers, the Saudi workers' shares of injuries rose from 5.3% in 2016 to 10% in 2021. Injuries in the construction sector comprised 42%-48% of all injuries, followed by the commerce sector. In 2021, the highest percentage of injuries involved service occupations (47.5%), followed by the engineering sector. Between 2016 and 2018, the most common injury cause was falls (28.5% in 2018), and from 2020 to 2021, exposure to inanimate mechanical forces caused the most injuries (46%). Conclusion The study revealed that the trend of work-related injuries had decreased during the study period, consistent with the results of similar previous studies.