公交司机肌肉骨骼损伤风险的工效学分析

通过问卷调查,结合Ovako工作姿势分析系统(OWAS)对城市公共汽车司机患肌肉骨骼损伤性疾病的风险进行了评估和分析。分析结果显示,公共汽车司机的颈部和背部存在较大的损伤风险,车辆进站、出站和转弯过程中不良姿势的比例较高。研究结果分别从主观和客观两个方面评估了城市公共汽车司机的职业负荷和可能的职业伤害,对城市公共汽车司机职业健康的促进和工作环境的改进具有一定的实践指导意义。     

基于OWAS方法的选煤厂工人肌肉骨骼损伤分析

探讨选煤厂拣矸作业中危险姿势对工人肌肉骨骼损伤的影响。通过问卷调查和工作姿势分析系统（OWAS）对工人不良作业姿势重复出现的比例以及身体损伤状况进行评估与分析。结果显示工人背部和颈部出现不良作业姿势的比例、危害和损伤程度较高。这与疲劳自觉症状调查和OWAS系统分析所得出的结果基本一致。采取恰当的轮岗方式,增加座椅以及防护装备可有效降低工人肌肉骨骼的损伤程度,同时会更好的提高工作表现并减少工伤事故的发生。     

消费品说明中警示信息有效性的工效学研究(Ⅰ)——警示信息对消费者危险感受与商品危险性之间关系的影响

该研究采用问卷法，通过对３０种消费品的调查，分析了消费者对消费品说明中警示信息的阅读倾向性，消费者的危险感受、消费者安全使用商品的自信度、遵守警示信息的可能性、主观危险估计和客观危险性这几项因素之间的关系。结果表明：消费者的危险感受与阅读警示信息的倾向性、遵守警告的要求之间存在高度的一致性；且与自信度呈负相关，所以可以通过研究消费者的危险感受来研究警示信息的有效性；消费者的危险感受、主观危险估计常与商品的客观危险性不一致，所以必须采取一些措施来矫正消费者的危险感受，以确保警示信息发挥应有的安全保障作用     

An empirical analysis of farm vehicle crash injury severities on Iowa's public road system

Farm vehicle crashes are a major safety concern for farmers as well as all other users of the public road system in agricultural states. Using data on farm vehicle crashes that occurred on Iowa's public roads between 2004 and 2006, we estimate a multinomial logit model to identify crash-, farm vehicle-, and driver-specific factors that determine farm vehicle crash injury severity outcomes. Estimation findings indicate that there are crash patterns (rear-end manner of collision; single-vehicle crash; farm vehicle crossed the centerline or median) and conditions (obstructed vision and crash in rural area; dry road, dark lighting, speed limit 55 mph or higher, and harvesting season), as well as farm vehicle and driver-contributing characteristics (old farm vehicle, young farm vehicle driver), where targeted intervention can help reduce the severity of crash outcomes. Determining these contributing factors and their effect is the first step to identifying countermeasures and safety strategies in a bid to improve transportation safety for all users on the public road system in Iowa as well as other agricultural states.     

Impact of safety belt use on road accident injury and injury type in Kuwait

The enactment of Kuwait's seat belt law in January 1994 provided an opportunity to examine the impact of seat belt use on road accident fatalities and injury types in this affluent Persian Gulf nation. Via a structured data form, the results of injurious/fatal road accidents for more than 1200 accident victims were gathered from the files of the six major government hospitals which treat most traffic accident victims. Statistical analysis of the data showed that seat belt use has had a positive effect in reducing both road traffic fatalities and multiple injuries in Kuwait. The use of seat belts has also affected the nature of the injuries resulting from road traffic accidents. Non-users of belts experienced higher frequencies of head, face, abdominal and limb injuries. Users of belts, on the other hand, suffered higher frequencies of neck and chest injuries. The interrelationship between the victim, his age, and the type of injuries resulting from road traffic accidents is also investigated.     

Decreased use of cervical spine clearance in blunt trauma: The implication of the injury mechanism and distracting injury

Background

Cervical spine injury (CSI) can be ruled out based on clinical examination and no X-ray is required if patient is awake, alert, and examinable. This is known as a clinical clearance (CC). Clinicians have decreased the use and reliance of CC and relied more upon X-ray, especially now that computerized tomography (CT) is fast and readily available. The objective of this study was to identify clinical factors, in particular, the injury mechanism and the distracting injuries, which may be associated with CSI. The knowledge may help to improve the use of CC.

Methods

We retrospectively reviewed the records of all blunt trauma patients who were awake, alert, and examinable, with a Glasgow Coma Scale of 14-15, and who were admitted to our Level 1 Trauma Center during January 1 to December 31, 2005. We excluded patients who presented with gross neurological deficit or who died within 72 h. From the chart review, we collected the demographics; the injury severity score (ISS); the injury mechanism; the presence of distracting injuries (DI) which were defined as bony fractures (divided into upper body, lower body, or both); and the radiographs obtained. Patients who did not receive CC underwent a 3-view plain film X-ray, with or without CT scan. We then divided the group into those with CSI (Case) and those without (Control). We compared the two group variables and performed a multiple logistic regression analysis to identify clinical factors associated with CSI. Statistical significance was accepted with p-value <0.05.

Results

Of the 985 patients evaluated, only 179 (18%) received CC. The remaining did not receive CC and went on to have radiographs. Of these, 76 were diagnosed CSI (Case). On a univariate analysis, the ISS, a motor vehicle collision (MVC) with rollover; MVC with rollover and ejection, the absence of DI, and a lower-body DI were significantly associated with CSI. However, on a multivariate analysis, only an MVC with rollover (odds ratio [OR], 2.326; 95% confidence interval [CI], 1.36-3.97) and a lower-body distracting injury (OR, 0.20; 95% CI, 0.07-0.55) were significantly associated with CSI.

Conclusion

The injury mechanism of MVC with rollover may prevent clinicians from utilizing CC, while the presence of a lower-body DI should not. A future and prospective study is needed to better understand the role of the injury mechanism and the distracting injury in relation to CSI.     

Effects of osteoporosis on AIS 3+ injury risk in motor-vehicle crashes

Older occupants in motor-vehicle crashes are more likely to experience injury than younger occupants. One possible reason for this is that increasing age is associated with increased prevalence of osteoporosis, which decreases bone strength.Crash-injury data were used with Bayes’ Theorem to estimate the conditional probability of AIS 3+ skeletal injury given that an occupant is osteoporotic for the injury to the head, spine, thorax, lower extremities, and upper extremities. This requires the conditional probabilities of osteoporosis given AIS 3+ injury for each of the body regions, which were determined from analysis of the Crash Injury Research and Engineering Network database. It also requires information on probability of osteoporosis in the crash-involved population and the probabilities of AIS 3+ skeletal injury to different body regions in crashes. The latter probabilities were obtained from the National Automotive Sampling System-Crashworthiness Data System (NASS-CDS) database. The former was obtained by modeling the probability of osteoporosis in the US populations using data from the 2006 National Health Examination Nutrition Survey and applying this model to the estimate of the crash-involved population in NASS-CDS. To attempt to account for the effects of age on injury outcome that are independent of osteoporosis, only data from occupants who were 60 years of age or older were used in all analyses.Results indicate that the only body region that experiences a statistically significant change in fracture injury risk with osteoporosis is the spine, for which osteoporosis increases the risk of AIS 3+ fracture by 3.28 times, or from 0.41% to 1.34% (p < 0.0001). This finding suggests that the increase in AIS 3+ injury risk with age for non-spine injuries is likely influenced by factors other than osteoporosis.     

A computational simulation study of the influence of helmet wearing on head injury risk in adult cyclists

Evidence for the effectiveness of cycle helmets has relied either on simplified experiments or complex statistical analysis of patient cohorts or populations. This study directly assesses the effectiveness of cycle helmets over a range of accident scenarios, from basic loss of control to vehicle impact, using computational modelling.     

Management of acute kidney injury in neurotrauma

Fortunately, the incidence of acute kidney injury (AKI) in neurotrauma is low and decreasing. Whereas the majority of AKI occurs in older patients with pre-existing chronic kidney disease, neurotrauma typically occurs in children and young adults with normal renal function. The development of outreach trauma teams has improved initial resuscitation, reducing both volume responsive and volume unresponsive cases of AKI. Most cases occur in the setting of multiple organ trauma with muscle injury, or patients who subsequently develop multiple organ failure. Once AKI has developed and renal replacement therapy is required, continuous modalities of renal replacement therapy offer an advantage to the patient with compromised cerebral perfusion and intracranial hypertension, by reducing the rate of change in serum urea, compared with standard intermittent therapies of hemodialysis and hemofiltration, thus minimizing abrupt changes in serum osmolality. Continuous hemodialysis and hemofiltration are better suited to maintain a normal or high serum sodium and thermal losses through the extracorporeal circuit, than peritoneal dialysis. Dialyzers should preferably be minimally bioincompatible and of a small surface area. In patients at risk of intracranial hemorrhage and those with invasive intracranial monitoring, systemic anticoagulants should either be avoided or regional anticoagulants should be used.     

Patterns and trends in injuries due to chemicals based on OSHA occupational injury and illness statistics

The Occupational Safety and Health Administration (OSHA) and the Bureau of Labor Statistics (BLS) provide the Survey of Occupational Illness and Injury (SOII) statistics from 1992 to 2006, which is often used to measure the rate of injuries and illness in industry. The present system of gathering and classifying this data was implemented in 1992 with minor changes in 2002. It is hoped that using these statistics to measure safety progress and determine patterns of injury will guide further improvements in chemical safety. Recognizing such factors as what chemicals most frequently cause injury can help to focus safety efforts regarding that chemical. Factors such as what part of the body is most commonly affected by particular chemicals can lead to improved personnel protection practices. This paper provides a detailed analysis of injuries due to chemicals using OSHA's SOII data, which offers valuable insight into measures that should be taken to reduce injuries due to chemicals.