Alcohol consumption and work-related injuries among farmers in Heilongjiang Province, People's Republic of China

BACKGROUND

Alcohol consumption has been found to be associated with work-related injuries among workers around the world, but this association has not well been studied among agricultural workers in China.

METHODS

This population-based survey aimed to study the association between alcohol use and work-related agricultural injury. Farmers in a northeastern province of China were questioned about work-related injury in the past year (May 2007-April 2008), alcohol use, farming practices, and sociodemographic factors. The Chi-square test and logistic regression analyses were used to investigate the role of alcohol drinking in agricultural injuries.

RESULTS

Among 2,050 farmers who completed the survey, the 12-month prevalence of work-related injury was 12.2%. The leading external cause of injury was exposure to mechanical force. The odds of injury among farmers with past month drinking, who drank distilled spirits, and reported intoxication were respectively 1.77 (95% CI = 1.27-2.47), 1.89 (95% CI = 1.35-2.66), 2.12 (95% CI = 1.42-3.11). The odds of injury also significantly increased with greater average amounts of pure alcohol per day, with increased frequency of drinking per week, and with greater reported years of drinking. Each alcohol use variable was associated with injury in logistic regression models while controlling for sex, age, years of farm work, months of farm work in the past 12 months, driving a motor vehicle, and agricultural machinery use.

CONCLUSIONS

We found a significant association between alcohol consumption and work-related injuries among farmers. Our findings stress the need for culturally appropriate interventions which affect alcohol use and prevent injuries among Chinese farmers.

Nonfatal unintentional injuries and related factors among male construction workers in central China

BACKGROUND

Work-related injuries (WRIs) among construction workers have recently emerged as an important public health issue as the construction industry is booming in China. We investigated nonfatal unintentional work-related injuries and risk factors among male construction workers in central China.

METHODS

A purposive sampling method was used in 2008 to select 1,260 male workers from 24 construction sites. WRIs that occurred in the past 12 months and possible risk factors were asked about in face-to-face interviews.

RESULTS

Among 1,260 male construction workers, 189 workers reported WRIs. The annual prevalence of nonfatal WRIs was 15.0 per 100 workers (95% confidence interval (CI): 13.0-17.0). The top three leading causes of injuries were collisions (27.3 per 100 workers), cuts/piercings (17.5 per 100 workers), and falls (15.5 per 100 workers). WRIs were significantly associated with high cigarette pack-year index (PYI > or = 20 vs. nonsmoker: adjusted odds ratio (OR) = 2.50, 95% CI: 1.31-4.76), serious alcohol consumption (> or =30ml/day vs. nondrinker: adjusted OR = 1.73, 95 %CI: 1.12-2.69), not having injury prevention and safety education (adjusted OR = 2.05, 95% CI: 1.22-3.44), and had depressive symptoms (adjusted OR = 2.63, 95% CI: 1.22-5.67).

CONCLUSIONS

Our results suggest that annual prevalence of nonfatal construction injuries is high in central China and serious cigarette smoking, serious alcohol consumption, not having injury prevention and safety education, and depressive symptoms are considered important factors for those injuries.

Pediatric mobility aid-related injuries treated in US emergency departments from 1991 to 2008

OBJECTIVES

Although mobility aids such as crutches, walkers, and wheelchairs are typically beneficial, they can be associated with injury. The objective of this study was to describe the incidence, patterns, and trends of pediatric mobility aid-related injuries to children and adolescents who were aged < or = 19 years and treated in US emergency departments between 1991 and 2008.

METHODS

A retrospective analysis was conducted by using data from the National Electronic Injury Surveillance System database for children and adolescents who were aged < or = 19 years. Sample weights were used to calculate national estimates of mobility aid-related injuries on the basis of 2301 actual cases.

RESULTS

An estimated 63 309 cases of children and adolescents who were aged < or = 19 years were treated in US emergency departments for mobility aid-related injuries. Approximately 70% of mobility aid- related injuries occurred while patients were using wheelchairs. Children who were aged 2 to 10 years were more likely to sustain injuries while using walkers and wheelchairs, injure their heads, and sustain traumatic brain injuries. Children who were aged 11 to 19 years were more likely to sustain injuries while using crutches, injure their lower extremities, and sustain sprains and strains. Injuries involving wheelchairs were more likely to be traumatic brain injuries and result in hospitalization. Injuries involving crutches were more likely to involve misuse and be triggered by stairs or curbs.

CONCLUSIONS

Injuries related to crutches, walkers, and wheelchairs have distinct injury patterns, mechanisms of injury, and trigger factors. Injury patterns between younger and older children were different. Additional research is needed to identify effective injury prevention strategies for the pediatric population.

Improving emergency preparedness capability of rural public health personnel in China

OBJECTIVES

Since the outbreaks of severe acute respiratory syndrome and avian influenza, improving the emergency preparedness capability of rural public health personnel has become a new priority in building the infrastructure needed to address public health emergencies. The Chinese Government has carried out a series of emergency preparedness education and training programmes to improve the emergency preparedness capability of rural public health personnel nationwide. The purpose of this study was to evaluate and develop a participatory emergency preparedness training programme for rural public health personnel.

STUDY DESIGN

The research emphasizes the major components of instructional design, including assessing, designing, delivering and evaluating training. The approach is an integrated system with results from one phase influencing the next, so that a series of steps are followed when developing, implementing and evaluating emergency preparedness training.

METHODS

The 226 participants were rural public health personnel from 84 different rural centres for disease control and prevention in China. The programme was evaluated by anonymous questionnaires and semi-structured interviews held prior to training, immediately post-training and 12-months after training (follow-up).

RESULTS

The emergency preparedness training resulted in positive shifts in knowledge and skills for rural public health personnel. At follow-up, the knowledge and skill scores of participants declined slightly compared with the post-test levels (P>0.05). However, there was a significant increase compared with the pre-test levels (P<0.01). Moreover, more than 90% of participants reported that this training provided a valuable learning experience and reinforced the importance of emergency preparedness.

CONCLUSIONS

The emergency preparedness training programme was effective and feasible in improving the performance of rural public health personnel on emergency response. Further studies are needed to test the efficacy of the training approach for competency improvement.

Disability and employment among U.S. working-age immigrants

BACKGROUND

There is little research which examines disability status and the employment decisions of the US immigrant working-age population.

METHODS

The 2007 American Community Survey data were analyzed to compare disabilities and employment characteristics between immigrant and US-born adults 18-64 years of age. Separate logistic regression models of employment were constructed among persons with disabilities and among persons without disabilities. Each multivariate model included nativity/citizenship, sex, race/ethnicity, age, and education.

RESULTS

In 2007, 40.8% (95% CI: 39.9-41.7) of immigrants with disabilities were employed, while only 34.9% (95% CI: 34.6-35.2) of US-born persons with disabilities were employed. For each type of disability, including difficulty working, immigrants with disabilities were more likely than their US-born counterparts to be employed. The median wage/salary incomes for persons with disabilities, foreign-born and US-born, respectively, were $20,000 and $22,000. In contrast, the median wage/salary incomes of foreign-born persons with mental impairments, self-care limitations, or participation restrictions exceeded those of US-born persons with these same disabilities. Nativity and citizenship had different effects in separate logistic models of employment for persons with disabilities and persons without disabilities. Among persons with disabilities, foreign-born citizens were more likely to be employed than the US-born, OR = 1.40 (95% CI: 1.33-1.48), and non-citizens were also more likely to be employed, OR = 1.74 (95% CI: 1.62-1.87), than US-born persons. Among persons without disabilities, foreign-born non-citizens were less likely to be employed than the US-born, OR = 0.82 (95% CI: 0.82-0.85).

CONCLUSION

Immigrants with disabilities were more frequently employed than US-born persons with disabilities for all types of disabilities.

Immigrants as crime victims: Experiences of personal nonfatal victimization

BACKGROUND

Immigrants to the United States are disproportionately victims of homicide mortality in and outside the workplace. Examining their experiences with nonfatal victimization may be helpful in understanding immigrant vulnerability to violence.

METHODS

We compared the annual prevalence of nonfatal personal victimization experienced by immigrant and US-born adults by sociodemographics, employment, occupation, industry, smoking, alcohol and drug use using data from Wave 1 National Epidemiologic Survey on Alcohol and Related Conditions.

RESULTS

The prevalence of victimization among immigrants was comparable to that among US-born adults [3.84% (95% CI: 3.18-4.63) vs. 4.10% (95% CI: 3.77-4.44)]. Lower percentages of victimization experienced by immigrants were seen among the unmarried, those age 30-44 years, and among residents of central city areas as compared to those groups among the US-born. For immigrants entering the US as youth, the victimization prevalence declines with greater years of residency in US. Multivariate logistic regression models suggest that, the odds of victimization was significantly associated with age, family income, marital status, central city residency, smoking, and drug use while employment status was not a significant factor. Immigrant workers with farming/forestry occupations might face a higher risk of being victims of violence than their US-born counterparts.

CONCLUSIONS

The prevalence of victimization among immigrants was comparable to that among US-born adults. Employment status and industry/occupation overall were not significant risk factors for becoming victims of violence.

The impact of a standard enforcement safety belt law on fatalities and hospital charges in Ohio

INTRODUCTION

The purpose of this study was to analyze linked crash and hospital data to determine the effect that enactment of a standard enforcement safety belt law in Ohio would have on hospital charges and direct medical costs due to motor-vehicle crashes, focusing on the impact to the state's Medicaid system.

METHOD

The linkage and analysis was conducted as part of the Ohio Crash Outcome Data Evaluation System (CODES) program. Current safety belt usage in Ohio stands at 82% with its secondary enforcement safety belt law.

RESULTS

Assuming an increase in usage to 92% through standard enforcement, over $15.3 million in medical costs to Medicaid for injuries that occur in a single year could be prevented over a 10-year period. Cumulative savings could reach more than $91.2 million during the 10-year period. In addition, 161 fatalities could have been prevented in one year had all unbelted occupants who sustained a fatal injury instead chosen to wear their safety belt. SUMMARY AND IMPACT ON INDUSTRY: Clearly, substantial progress can be made in reducing the number of deaths and injuries, as well as medical costs associated with motor-vehicle crashes, by strengthening safety belt laws and increasing safety belt usage in Ohio.

[Epidemiological study on alcohol consumption and agricultural profession-related injuries among minority residents from the northern parts of China]

OBJECTIVE

To understand the incidence rates of agricultural profession-related injuries and the relationship to alcohol consumption.

METHODS

A multistage sample of 2366 villagers was selected from Minority Nationality Villages, Heilongjiang province. Face-to-face interviews were conducted by trained interviewers during May 2008. 2198 (92.9%) of the eligible questionnaires were available.

RESULTS

Incidence rate of agricultural profession-related injury rate was 11.8% (260/2198) from May 2007 to April 2008. Higher proportions of injuries were seen for males, 30 - 49 year olds, farmers and among those people working on farms for 10 years or more, smoking during farm work, with sleeping disorder, using motor vehicles, and those using agricultural machinery. Rate of alcohol drinking was 29.1% (640/2198) in the month prior to the investigation. Results from logistic regression models showed that alcohol consumption patterns and other alcohol-related behavior were examined in separate logistic models because of collinearity by controlling the variables that were associated with agricultural profession-related injury including sex, age, years of farm work, driving a motor vehicle, and agricultural machinery use etc. In each model, the reference group was those villagers who did not drink in the past month. The odds of injury among villagers with history of past month drinking, who drank distilled spirits, and alcohol drinking at breakfast and lunch were 1.80 (95%CI: 1.24 - 2.62), 2.09 (95%CI: 1.38 - 3.15), 2.15(95%CI: 1.43 - 3.22) respectively. The odds of agricultural injury also significantly increased with greater average amounts of pure alcohol per day, with increased frequency of drinking per week, and reported years of drinking.

CONCLUSION

Intervention efforts should include increasing awareness about alcohol drinking as a major risk factor causing agricultural injuries as well as controlling alcohol drinking, improving knowledge about driving motor vehicle and using agricultural machinery.

Urban and rural variation in walking patterns and pedestrian crashes

OBJECTIVE

To examine the urban and rural variation in walking patterns and pedestrian crashes.

DESIGN

The rates of pedestrians being struck by motor vehicles was estimated according to miles walked and resident years.

SETTING

New York State, USA during 2001 through 2002.

PARTICIPANTS

35 732 pedestrians struck by vehicles.

MAIN OUTCOME MEASURES

The adjusted rate ratio (aRR) of pedestrian-vehicle crash and pedestrian injury based on resident years and miles walked according to urban and rural areas.

RESULTS

Compared with rural areas, the aRR for a pedestrian-vehicle collision, based on resident years, was 2.0 (95% CI 1.7 to 2.3) in small urban areas, 1.8 (95% CI 1.5 to 2.3) in mid-size urban areas, and 4.2 (95% CI 3.6 to 4.8) in the large urban area. The aRR based on miles walked was 2.3 (95% CI 1.6 to 3.2) in small urban areas, 2.0 (95% CI 1.4 to 2.9) in mid-size urban areas, and 1.9 (95% CI 1.4 to 2.7) in the large area. The aRR for a fatal pedestrian injury, based on miles walked, was 2.1 (95% CI 1.3 to 3.6) in small urban areas, 1.9 (95% CI 1.3 to 2.9) in mid-size urban areas, and 0.9 (95% CI 0.6 to 1.3) in the large urban area.

CONCLUSIONS

The rate of pedestrian crashes and injuries in small and mid-size urban areas was twice that in rural areas, whether based on resident years or miles walked. The high rate of pedestrian crashes in the large urban area based on resident years could be partly explained by the fact that residents in such areas walk about twice as much as residents in rural areas. The rate of fatal pedestrian injury based on miles walked was similar in the large urban area and rural areas.

Injuries associated with bathtubs and showers among children in the United States

OBJECTIVE

The goal was to describe the epidemiological features of injuries associated with bathtubs and showers, especially those related to slips, trips, and falls, among US children.

METHODS

A retrospective study was performed by using nationally representative data from the US Consumer Product Safety Commission National Electronic Injury Surveillance System from 1990 through 2007 for children <or=18 years of age.

RESULTS

There were an estimated 791 200 bathtub- and shower-related injuries among children <or=18 years of age who were treated in US emergency departments in 1990-2007, with an average of 43 600 cases per year or approximately 5.9 injuries per 10 000 US children per year. The largest number of injuries involved children 2 years of age; children <or=4 years accounted for 54.3% of injuries. The most common diagnosis was laceration (59.5%). The most common mechanism of injury was a slip, trip, or fall, accounting for 81.0% of cases or 4.6 injuries per 10 000 US children per year. The most frequently injured body part was the face (48.0%), followed by the head/neck (15.0%). The majority (71.3%) of injuries occurred in a bathtub. Of the cases with a known place of injury, 97.1% occurred at home. An estimated 2.8% of patients were admitted, transferred to another hospital, or held for observation.

CONCLUSIONS

This is the first study on bathtub- and shower-related injuries using nationally representative data. Slips, trips, and falls in bathtubs and showers are a common cause of injury among children, especially children <or=4 years of age. The incidence of these injuries may be decreased by increasing the coefficient of friction of bathtub and shower surfaces.

Farm work-related injury among middle school students in rural China

Farm work-related injuries are considered an important issue facing rural area adolescents. However, little research has been done in developing countries, including China. This study evaluated agricultural work-related injuries among Chinese middle school adolescents, focusing on the potential association between farm work hours, sleep patterns, school-related stress, and farm work-related injuries. This cross-sectional study surveyed 1,551 middle school students in Hunan Province who reported working on farms. The surveys assessed their involvement in farm work, sleep patterns, school activities, and farm work-related injuries during a three-month recall period. The cumulative incidence of farm work-related injury was 15.6% among the 1187 students who reported working on a farm. Average days per month farming, number of pesticide applications per month, sleep disturbances, and school-related stress were significantly associated with farm work-related injuries (p < 0.05). Multivariable logistic regression analysis revealed that after adjusting for possible confounding effects of age, gender, and farm work days per month, sleep disturbance (less than 7 hours of sleep: OR = 2.36, 95% CI = 1.07-5.22; awakening at night and having trouble falling back to sleep: OR = 2.70, 95% CI = 1.36-5.37; having nightmares: OR = 2.24, 95% CI = 1.18-4.24) and school-related stress (difficult homework: OR = 2.45, 95% CI = 1.21-4.99; extra homework assigned often by parents: OR = 3.62, 95% CI = 1.88-6.97; and scolded/chastised by parents for poor school performance: OR = 2.53, 95% CI = 1.75-3.65) were statistically significant risk factors for farm work-related injuries (p < 0.05).