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目的探讨职业性手外伤的急性危险因素及其强度。方法采用病例-交叉研究方法,以急性伤害危险因素病例交叉调查问卷对180名职业性手外伤患者进行调查,采集患者伤害发生前30 min(危险期)和伤害发生前1周内(对照期)12种急性危险因素的接触情况,计算各危险因素的人时发病率比(IRR)和95%可信区间(CI)。结果与对照期比较,危险期接触机器故障、更换操作方法、突然不愉快、未佩戴防护用品、更换锋利刀具、使用不熟悉工具、使用不熟悉机器、更换工作岗位、临时加班、临时赶工和突然身体不舒服等11个危险因素与职业性手外伤发生的关联均有统计学意义(IRR的95%CI不包含1.00),其中突然不愉快、更换操作方法和机器故障的IRR较高(分别为108.11、56.41和30.59),95%CI分别为(55.10~211.11)、(23.61~134.81)和(17.84~52.48);危险期接触使用锋利边角料危险因素与职业性手外伤发生的关联无统计学意义(IRR为1.08,其95%CI包含1.00)。结论病例-交叉设计能够有效地识别职业性手外伤的危险期危险因素。采取措施改变急性危险因素有利于降低职业性手外伤的发生。
Objective To explore the acute risk factors and intensity of occupational hand injuries. Methods A case-crossover study was conducted to investigate 180 cases of occupational hand trauma patients by cross-sectional questionnaire of risk factors of acute injury. Patients were collected 30 minutes before the injury and 1 week before the injury (control period) Exposure to 12 acute risk factors, the human-person morbidity ratio (IRR) and the 95% confidence interval (CI) for each risk factor were calculated. The results compared with the control period, the risk of exposure to machine failure, the replacement of operating methods, suddenly unhappy, did not wear protective equipment, replace sharp knives, use unfamiliar tools, use unfamiliar with the machine, job change, temporary overtime, temporary rush and sudden body The association of 11 risk factors with occupational hand injuries was not statistically significant (95% CI of IRR did not include 1.00), of which sudden unpleasantness, high IRR for changing procedures and machine failures (108.11, 56.41, and 30.59). The 95% CI was (55.10 ~ 211.11), (23.61 ~ 134.81) and (17.84 ~ 52.48) respectively. There was no significant correlation between the risk factors of occupational hand injuries and the risks of exposure to sharp scrap materials during the dangerous period Is 1.08, 95% CI contains 1.00). Conclusions Case-crossover design can effectively identify risk factors for occupational hand injuries at risk. Take measures to change acute risk factors will help reduce the incidence of occupational hand injuries.