Injury Hazards Research Articles

Inability to Perform the Repeated Chair Stand Task Predicts Fall-Related Injury in Older Primary Care Patients.

The aim of the study was to examine whether the chair stand component of the Short Physical Performance Battery predicts fall-related injury among older adult primary care patients. A 2-yr longitudinal cohort study of 430 Boston-area primary care patients aged ≥65 yrs screened to be at risk for mobility decline was conducted. The three components of the Short Physical Performance Battery (balance time, gait speed, and chair stand time) were measured at baseline. Participants reported incidence of fall-related injuries quarterly for 2 yrs. Complementary log-log discrete time hazard models were constructed to examine the hazard of fall-related injury across Short Physical Performance Battery scores, adjusting for age, sex, race, Digit Symbol Substitution Test score, and fall history. Participants were 68% female and 83% white, with a mean (SD) age of 76.6 (7.0). A total of 137 (32%) reported a fall-related injury during the follow-up period. Overall, inability to perform the chair stand task was a significant predictor of fall-related injury (hazard ratio = 2.11, 95% confidence interval = 1.23-3.62, P = 0.01). Total Short Physical Performance Battery score, gait component score, and balance component score were not predictive of fall-related injury. Inability to perform the repeated chair stand task was associated with increased hazard of an injurious fall for 2 yrs among a cohort of older adult primary care patients.

Injury and infection in dental clinics: Risk factors and prevention.

Needlestick and sharp instrument injuries are common in dental practice and present the risk of direct exposure to blood-borne pathogens, including hepatitis B virus. This cross-sectional study was carried out to determine the risk factors of injury and infection in three types of dental clinic in Riyadh, Saudi Arabia. A total of 274 male and 241 female dentists completed a structured questionnaire on demographic factors, compliance with infection control practices, and past exposure to injury and infection hazards. Dentists with more years of professional experience were significantly less likely to report having had an injury in the past (unadjusted odds ratios (ORs) and 95% confidence intervals (CIs) were 0.48, 0.27-0.87 and 0.38, 0.16-0.89 for dentists with 10-20 years and for those with over 20 years of experience, respectively). Greater compliance with infection control procedures was associated with significantly fewer reports of previous infection (OR 0.31, 95% CI 0.12-0.84). Experience of occupational safety training was not associated with a lower rate of injury or infection. Greater occupational safety knowledge and compliance with infection control management practices contribute to a reduced risk of injury and infection among dentists. More focused and specialized training on infection control and occupational safety is needed for all practicing dentists and dental students.

Risk for Lower Extremity Injury After Concussion: A Matched Cohort Study in Soldiers.

Background Rates of lower extremity musculoskeletal injury are reportedly higher in professional and collegiate athletes following concussions. However, there is a paucity of evidence on this relationship in individuals who are not high-level athletes. Objectives To examine the risk of acute lower extremity musculoskeletal injury in soldiers within 2 years of an incident concussion, compared to matched nonconcussed soldiers. Methods This was a matched-cohort study that used the medical encounter and personnel data of active-duty US Army soldiers from 2005 to 2011. Incident concussions were identified using International Classification of Diseases-Ninth Revision codes in medical encounter data of all soldiers from 2005 to 2009. One nonconcussed soldier in the US Army during the same month was matched by age, sex, rank, length of service, deployment status, and military career field to each concussed soldier. Hazard ratio (HR) and 95% confidence interval (CI) were calculated for the risk of lower extremity injury within 2 years of the incident concussion. Monthly HRs were compared to identify differences in injury rates between the groups, and an HR for the period of greatest difference was also calculated. Results A total of 23 044 individuals (11 522 concussed and 11 522 nonconcussed) were included in the study. Within 2 years of concussion, the hazard of lower extremity injury was 38% greater in concussed compared to nonconcussed soldiers (HR, 1.38; 95% CI: 1.30, 1.46), while the 15-month hazard was 45% greater (HR, 1.45; 95% CI: 1.36, 1.56). Conclusion The rate of lower extremity musculoskeletal injury among this population of physically active adults is higher following concussion, and the risk remains elevated for more than a year following injury. Level of Evidence Prognosis, level 2b. J Orthop Sports Phys Ther 2018;48(7):533-540. Epub 8 May 2018. doi:10.2519/jospt.2018.8053.

Innovation and employee injury risk in automotive disassembly operations

Engineering innovations in car disassembly systems are studied for affects on system operators’ risk of repetitive strain injury (RSI). Objective instrumented measures of injury risk factors with synchronised video-based task analyses were used to examine changes in operators’ RSI risk during two cases of engineering innovation: (1) a shift in industrial model from traditional extracting saleable parts to line-based full material recovery, and (2) the prospective effects of a simulated ‘Lean’-inspired process improvement in the line system. Both cases of innovation showed significantly increased movement speeds and reduced muscular recovery opportunities, implying increased RSI risk. This case study reveals a mechanism by which innovation may increase RSI risks for operators. Managers responsible for engineering innovation should ensure their teams have the tools and mandate necessary to control injury hazards as part of the development and design process. These cases suggest how failure to manage RSI hazards in the innovation process may allow increases of injury risks that can compromise operational performance. This ‘innovation pitfall’ has implications for operator health and organisational sustainability. Alternative pathways are discussed.

Lateral Arthroplasty as an Optimal Treatment for Surgical Management of Unilateral Temporomandibular Joint Ankylosis Type III in Children

Management of temporomandibular joint (TMJ) ankylosis described in the literature showed many surgical techniques. Purpose: The aim of this study was to evaluate the lateral TMJ arthroplasty as a surgical technique for treatment of type III Sawhney’s TMJ ankylosis in children both clinically and radiographically. In that surgical technique the need of a costochondral graft for reconstructive arthroplasty is avoided with its potential complications (as a donor site) and the unpredictable growth pattern. Materials & Methods: Eight children with unilateral type III Sawheny ankylosis (ankylosis on the lateral aspect of the medially displaced condyle) were included in this research. They all underwent lateral TMJ arthroplasty with the aid of panoramic and coronal C.T views. Evaluation was done both clinically and radiographically regarding interincisal distance, lateral TMJ movement, protrusive movements, postoperative pain, patient’s satisfaction and hazards of facial nerve injury. All patients were seen weekly for 4 weeks, at three and six months then at one year. Results: The used surgical technique of lateral arthroplasty had greatly achieved the desired goals of treating TMJ ankylosis during a follow up period of one year. Those achieved goals include restoration of full mandibular function and free movements of the joint with adequate mouth opening and a mean interincisal distance of 35 mm, maintaining acceptable occlusion and ramus height and obviates the need of any autogenous chondro-osseous graft (commonly costochondral) with potential complications of the donor sites. Conclusion: The surgical procedure of lateral arthroplasty is an easy and safe technique. It is considered as an effective treatment modality in treatment of type III TMJ ankylosis especially in children.

Risk factors for first hospitalization due to meniscal lesions - a population-based cohort study with 30\xa0years of follow-up

BackgroundMeniscal lesions are among the most common injuries of the knee, yet limited epidemiologic data is available on their risk factors. We investigated the association of lifestyle factors and physical strenuousness of work on knee injuries with a focus on meniscal lesions.MethodsWe examined a nationally representative sample of persons aged 30 to 59 years, who participated in a comprehensive health examination (the Mini-Finland Health Survey). Subjects without any injury or osteoarthritis in the knee joint at baseline (n = 4713) were subsequently followed via the National Hospital Discharge Register up to 30 years.ResultsDuring the follow-up, 338 knee injuries were identified of which 224 were meniscal lesions. Obesity and regular leisure time physical exercise were associated with an increased risk of first hospitalization due to meniscal lesions (hazard ratio (HR) 1.62 and 95% confidence interval (CI) 1.06–2.48 and 1.53, 95% CI 1.05–2.23, respectively). The types of sports predicting the highest risk of meniscal lesions were ballgames, gymnastics and jogging. Physical strenuousness of work did not predict meniscal lesion. The hazard of other knee injury was increased among those reporting irregular or regular physical exercise at baseline (HR 1.64, 95% CI 1.03–2.64 and 1.88 CI 1.05–2.36, respectively). Smoking or alcohol intake were not associated with knee injuries.ConclusionsBetter safety measures in high-risk sports and weight control would likely improve the prevention of meniscal lesions in populations.

Resumption of oral anticoagulation following traumatic injury and risk of stroke and bleeding in patients with atrial fibrillation: a nationwide cohort study.

We examined the risks of all-cause mortality, stroke, major bleeding, and recurrent traumatic injury associated with resumption of vitamin K antagonists (VKAs) and non-VKAs oral anticoagulants (NOACs) following traumatic injury in atrial fibrillation (AF) patients. This was a Danish nationwide registry-based study (2005-16), including 4541 oral anticoagulant (OAC)-treated AF patients experiencing traumatic injury (defined as traumatic brain injury, hip fracture, or traumatic torso or abdominal injury). Within 90 days following discharge from traumatic injury, 60.6% resumed VKA (median age = 80, CHA2DS2-VASc = 4, HAS-BLED = 2), 16.7% resumed NOAC (median age = 81, CHA2DS2-VASc = 4, HAS-BLED = 2), and 22.7% did not resume OAC treatment (median age = 81, CHA2DS2-VASc = 4, HAS-BLED = 3). Switch from VKA to NOAC occurred among 9.5%. Since 2009, the trend in OAC resumption increased (P-value <0.0001), in particular with NOACs (P-value <0.0001). Follow-up started 90 days after discharge, and time-varying multiple Cox regression analyses were used for comparisons. Compared with non-resumption, VKA and NOAC resumption were associated with lower hazard [95% confidence interval (CI)] of all-cause mortality [hazard ratio (HR) 0.48 (0.42-0.53) and HR 0.55 (0.47-0.66), respectively] and ischaemic stroke [HR 0.56 (0.43-0.72) and HR 0.54 (0.35-0.82), respectively], increased major bleeding hazard [HR 1.30 (1.03-1.64) and HR 1.15 (0.81-1.63), respectively], and similar hazard of recurrent traumatic injury [HR 0.93 (0.73-1.18) and HR 0.87 (0.60-1.27), respectively]. AF patients resuming VKA and NOAC treatment following traumatic injury have lower hazard of all-cause mortality and ischaemic stroke, increased hazard of major bleeding but without additional hazards of recurrent traumatic injury. Withholding OAC following a traumatic injury in AF patients may not be warranted.

Occupational Safety and Health and Healthy Housing: A Review of Opportunities and Challenges.

Occupational safety and health (OSH) risks in construction of healthy housing (HH) have not been examined and collaboration between HH and OSH professionals is inadequate. The World Health Organization is developing international HH guidelines and the International Labour Organization is working to improve OSH in construction globally. We searched for exemplary reports (including gray literature) on construction hazards; preventive measures for occupants and workers; OSH frameworks, laws, and regulations; definitions; and HH. Healthy housing construction typically improves ventilation, moisture and mold, pest control, injury hazards, cleanability, maintenance, accessibility, thermal conditioning, and avoidance of toxic building materials. To date, this work is done without explicit requirements for worker health. Construction is among the most hazardous sectors around the globe, although protective measures are well known, including engineering and administrative controls and provision of personal protective equipment. Residential construction, renovation, repair, and maintenance are fragmented, consisting mostly of small companies without proper OSH training, equipment, and knowledge of HH principles. Residential construction is often undertaken by informal or unauthorized workers, putting them at high risk. Reduced exposure to toxic building materials is an example of a benefit for both workers and occupants if OSH and HH collaboration can be improved. By recognizing that homes under new construction or renovation are both a workplace and a residence, HH and OSH initiatives can apply public health principles to occupants and workers simultaneously. This article publishes key definitions, hazards and interventions common to both fields. A global increase in residential construction and renewed global interest in HH poses both risks and opportunities for primary prevention. Policy and practice interventions can benefit the health of occupants and those who work on their homes. Improvements in legislation, regulation, and international frameworks are needed to maximize OSH and HH collaboration and realize significant cobenefits. Occupational safety and health and HH standards should include requirements to protect both workers and occupants. Because homes can also be workplaces, both workers and housing occupants will receive important cobenefits when OSH and HH standards use proven interventions to protect workers and occupants.

Are Workplace Psychosocial Factors Associated With Work-Related Injury in the US Workforce?: National Health Interview Survey, 2010.

Psychosocial hazards in the workplace may adversely impact occupational and general health, including injury risk. Among 16,417 adult workers in the 2010 National Health Interview Survey Occupational Health Supplement, weighted prevalence estimates were calculated for work-related injuries (WRI) and any injuries. The association between injury and psychosocial occupational hazards (job insecurity, work-family imbalance, hostile work environment) was assessed adjusting for sociodemographic and occupational factors. WRI prevalence was 0.65% (n = 99); any injury prevalence was 2.46% (n = 427). In multivariable models job insecurity, work-family imbalance, and hostile work environment were each positively associated with WRI prevalence (odds ratio [OR]: 1.60, 95% CI: 0.97-2.65; OR: 1.69, 95% CI 0.96-2.89; and 2.01, 95% CI 0.94-4.33, respectively). Stressful working conditions may contribute to injuries. There is need for ongoing surveillance of occupational psychosocial risk factors and further study of their relationship with injury.

An Integrative Review of the Hands-Free Technique in the OR

Sharps injury rates are proportionally higher in perioperative areas than in other practice settings. The hands-free technique (HFT) has been shown to decrease the hazards of sharps injuries when passing sharps during surgery. We reviewed and synthesized research studies regarding compliance with the HFT and factors facilitating its use using a key word search of online databases and a secondary search of references. We reviewed English language studies published since 2001 regarding HFT compliance rates or related factors using the Johns Hopkins Nursing Evidence-Based Practice Model and Guidelines. We found 14 articles reporting a wide range of HFT compliance rates (ie, 5% to 84%), which identified that a number of organizational factors and health care workers’ perceptions of infection risks influenced the use of the HFT.

The Development of Robotic Technology in Cardiac and Vascular Interventions.

Robotic technology has been used in cardiovascular medicine for over a decade, and over that period its use has been expanded to interventional cardiology and percutaneous coronary and peripheral vascular interventions. The safety and feasibility of robotically assisted interventions has been demonstrated in multiple studies ranging from simple to complex coronary lesions, and in the treatment of iliofemoral and infrapopliteal disease. These studies have shown a reduction in operator exposure to harmful ionizing radiation, and the use of robotics has the intuitive benefit of alleviating the occupational hazard of operator orthopedic injuries. In addition to the interventional operator benefits, robotically assisted intervention has the potential to also be beneficial for patients by allowing more accurate lesion length measurement, stent placement, and patient radiation exposure; however, more investigation is required to elucidate these benefits fully.

Reducing Safety Hazards in the Home through the Use of an Evidence-Based Parenting Program

Unintentional child injury is a significant public health concern and leading cause of death among children. Though the majority of unintentional injuries are preventable, few interventions target child injury hazards. Since many unintentional injuries occur in the home, home visiting may be an effective method for modifying unsafe home environments. In this paper, we examined whether a behavioral parenting program conducted in the home would reduce home safety hazards among families who were in the child welfare system or at risk for child maltreatment. Paired t-tests were used to analyze the change in number of safety hazards, as measured by the Home Accident Prevention Inventory-Revised, across four types of rooms. Significant reductions in home hazards were demonstrated across room type after program participation. Results suggest that families at risk for child maltreatment can have significant reductions in home safety hazards following program participation.

Work-related floors as injury hazards \u2013 a nationwide pilot project analyzing floors in theatres and education establishments in Germany

BackgroundAn adequate dance floor is said to prevent injuries. On the basis of scientific research, numerous recommendations regarding an adequate dance floor have been developed. Up to the present, however, studies have still been lacking into how far these recommendations have already been implemented in theatres with regular dance productions and/or in-house dance ensembles. The aim of this study is to analyze a nationwide survey on dance floors of theatres and education establishments in Germany.MethodsA questionnaire-based survey on existence and type of floors in the various dance-related working areas was carried out at theatres and education establishments institutions (n = 86 institutions (n = 76 theatres, n = 10 education establishments). References as to region, size of dance ensembles and dance styles performed were created.ResultsOf all education establishments, 75.3% were equipped with a sprung sub-floor in the ballet studios. In contrast, sprung sub-floors were only found in 29.7% of the working areas, the stage AND ballet studios in theatres. The percentage of theatres providing sprung sub-floors in all rooms used by dancers is even lower. Considering all dance-related work areas, larger ensembles (>30 dancers) were offered better conditions regarding floors than smaller ensembles (p > 0.001). No significant tendencies were found regarding regions or dance styles.ConclusionRecommendations concerning an appropriate dance floor have only partly been realized. Besides secured finances for reinstallation, further education of responsible officials and artists is essential. However, accrediting dance as own genre in theatres is the indispensable prerequisite.

The Relationship Between BMI and Work-Related Musculoskeletal (MSK) Injury Rates is Modified by Job-Associated Level of MSK Injury Risk.

The aim of this study was to examine the relationship between body mass index (BMI) and occupational musculoskeletal (MSK) injury rates, and the statistical interaction between BMI and occupational exposure to MSK hazards (measured by level of MSK injury risk based on job category). Using 17 years of data from 38,214 university and health system employees, multivariate Poisson regression modeled the interaction between BMI and MSK injury risk on injury rates. A significant interaction between BMI and MSK injury risk was observed. Although the effect of BMI was strongest for 'low' MSK injury risk occupations, absolute MSK injury rates for 'mid'/'high' MSK injury risk occupations remained larger. To address the occupational MSK injury burden, initiatives focused on optimal measures of workers' BMI are important but should not be prioritized over (or used in lieu of) interventions targeting job-specific MSK injury hazards.

Animal Injury, Zoonotic Disease, and Other Occupational Hazards of Rural Livestock Keepers in Uganda

Animal Injury, Zoonotic Disease, and Other Occupational Hazards of Rural Livestock Keepers in Uganda

Child Home Injury Hazards: Observations from Palestine

Background: Unintentional injuries are a growing global public health problem that causes mortality, morbidity and disability among children. These injuries are most common among under-fives and form a significant burden on healthcare systems, particularly in low and middle income countries. Home environment is a key element in injury prevention that should be investigated. In Palestine there is a paucity of research in this area. Objective: To investigate potential safety hazards within homes and the mothers' interventions to reduce potential risks among their under-five years children in Ramallah district. Design: Qualitative, case study approach was used. Setting: This case study research investigated three types of residential setting (camp, rural and urban) in the Ramallah District of Palestine. Methods: Twelve mothers (four in each setting) were purposively selected to participate in this study through observing their home environments, and asking them for clarification around these observations. The derived data were analyzed using the content analysis.

Domestic unintentional injury of 1 to 5-year-old children in a rural area of West Bengal, India: a community-based study

Background: Childhood unintentional injury, a major public health problem in India, is largely preventable. The aim of this study was to determine the burden and determinants of unintentional injury of 12 to 59 months old child at household level.Method: A community based cross-sectional study was conducted at Singur block, Hooghly district, West Bengal, India among randomly chosen children using a predesigned and pretested interviewer administered questionnaire and a checklist for assessing household level injury hazard during the period of November 2015 to February 2016. Parental supervisory behaviour was assessed using PSAPQ questionnaire. Multivariable logistic regression was performed using SPSS 19.0 software.Result: A total of 163 were involved in the study. Over one-third (37.4%) of the children underwent any type of injury during last 3-month time period, predominant body part being upper limb. Parental supervisory behaviour [AOR-2.6, (95% CI-1.2-4.9)] and household level injury hazard (AOR-1.55, 95% CI- 1.3-1.7)] were found to be significant predictors of unintentional injury.Conclusion: Unintentional injury among children is prevalent in West Bengal in India. Dissemination of injury prevention information with special focus on household modification and increased parental supervision are effective strategies to prevent unintentional injury.

Employees Problems in Utilizing ESI Benefits- As Special Reference to Erode District of Tamilnadu

Employees State Insurance Scheme of India is a multidimensional social security system tailored to provide socio economic protection to working population and their dependants covered under the scheme. Besides, full medical care for self and dependents, that is admissible from day one of insurable employment, The insured persons are also entitled to a variety of cash benefits in times of physical distress due to sickness, temporary or permanent disablement etc., resulting in loss of earning capacity, the confinement in respect of insured women, dependants of insured persons who die in industrial accidents or because of employment injury or occupational hazard are entitled to a monthly pension called the dependents benefit. This study also analysis employee’s problems in utilizing ESI Benefit in Erode District of Tamilnadu.

Heat injury risk assessment for single-cropping rice in the middle and lower reaches of the Yangtze River under climate change

Under global warming, the risk of heat injury for crops increases, which leads to increasing instability in agricultural production. In this study, based on phenological observation data and yield data during 1981-2011 and daily meteorological data during 1961-2011 in the middle and lower reaches of the Yangtze River (MLRYR), the risk of heat injury for single-cropping rice in this area and its response to climate change were assessed and analyzed. The risk was decomposed into such elements as hazard, exposure, vulnerability, and disaster prevention/mitigation capacity, in accordance with natural disaster risk assessment theory and the formation mechanisms of agrometeorological disasters. First, a hazard assessment model was established to identify spatiotemporal variations of the heat injury in the MLRYR during 1961-2011, and the relationship between heat injury hazard and air temperature was analyzed to identify the response of hazard to climate change. It was found that the heat injury hazard of single-cropping rice was positively correlated with the mean and maximum temperatures during the rice heading period of 20 days, with the hazard increasing sharply when the mean temperature exceeded 26.5°C and the maximum temperature exceeded 31°C. Then, exposure, vulnerability, and disaster prevention/mitigation capacity were also quantitatively examined. The results show that vulnerability and hazard were the two most important factors in the heat injury risk assessment for single-cropping rice at most stations in the MLRYR. The risk assessment considering only the first three natural elements produced high-risk values (> 0.46) mainly in the northeast of the study area. By adding the regional capability in disaster prevention/mitigation into account, the risk assessment produced high-risk values in a much smaller area in the northeast but some-what larger areas in the southwest of the study domain. In general, the risk of heat injury differed greatly within the MLRYR. Particular rice varieties should be adopted for specific regions, according to the local risk features quantified by this study. Under the warming climate, the risk of heat injury for single-cropping rice is likely to continue to increase.

Avaliação dos indicadores de acidentes de trabalho como proposta de intervenções ergonômicas em um abatedouro de frangos

A indústria frigorífica faz do Brasil um dos principais produtores e exportadores mundiais de carne. Nesta perspectiva, este setor mantem-se na busca constante pela competitividade, sendo que as atividades nas indústrias são intensificadas para alcançar maior produtividade, resultando em doenças ocupacionais e riscos de acidentes. Para propor medidas que contribuam na redução de acidentes de trabalho em abatedouros de frangos, esta pesquisa tem como objetivo avaliar os indicadores de acidentes e propor demandas de intervenções ergonômicas com base nos indicadores de acidentes que ocorreram nos anos de 2012, 2013 e 2014 em um abatedouro de frangos localizado na região de São José – S.C. O estudo trata de uma pesquisa de campo com análise documental e utilização do método indutivo. Os dados foram avaliados quantitativamente utilizando-se de planilhas eletrônicas e gráficos. Os resultados apontam que do total de 161 acidentes avaliados, os com cortes foram os que apresentaram o maior número de casos. O agente causador que mais gerou acidentes foi o uso de facas e a parte do corpo mais atingida nos acidentes foi os membros superiores. Os resultados apontam que o abatedouro apresenta demandas de intervenções ergonômicas para adequação das condições de trabalho com enfoque na redução de acidentes de trabalho.