Trends in injury morbidity in China, 1993-2013: A longitudinal analysis of population-based survey data

The epidemiology of employee injuries in a monitoring sentinel unit of a coastal area in China:A nine-year retrospective analysis of clinical data

The epidemiology of injury among subgroups of minors, older adults, students, and athletes has previously been investigated; however, studies investigating employee-related injuries are limited. We aimed to retrospectively analyze the epidemiological characteristics and dynamic change trends of injury among employees over a nine-year period in a coastal area in China to provide a reference for formulating injury prevention and control measures among employees. All 14,168 employee injury cases registered in a hospital injury monitoring system were analyzed from January 2013 to December 2021. The male-to-female sex ratio of the employee injury cases was 3.52:1. The floating-to-registered residence population ratio was 2.05:1. March, May, July, and September-October were peak months for employee injuries. Within the day, the injury cases of employees reached five peaks at 0800, 1000, 1500, 1800, and 2000 h. The highest five causes of injury were falling, blunt injuries, motor vehicle accidents, sharps injuries, and non-motor vehicle accidents. The highest five injury types were fracture; concussion or contusion of the brain; injury from a sharp instrument, bite, or open wound; contusion or abrasion; and sprain or strain. The main locations of the injuries were roads and streets, industrial and building sites, and homes. Vulnerable body regions included the upper limbs, lower limbs, head, trunk, and multiple regions. The independent predictors of all outcomes were census register classification; age; injury causes, locations and types; vulnerable body regions; and injury severity; on multivariate logistic regression analysis (P < 0.05). The average durations of missed work in the different injury outcome groups due to injuries among employees were 50.21, 42.57, 44.57, and 38.20 days, respectively. The average number of missed work days due to injuries was 49.77 days, with an increasing annual trend (F = 79.872, P < 0.01). The average hospitalization cost for employee injuries was ¥16250.37, with a decreasing annual trend (F = 4.621, P < 0.01). The average length of hospitalization was 15.22 days, with a decreasing annual trend (F = 76.657, P < 0.01), and the average number of days of missed work due to injuries was 49.77 days, with an increasing annual trend (F = 79.872, P < 0.01). The correlation coefficients showed a significant positive correlation between the average length of hospitalization and average hospitalization expenses, with an increasing trend from 2014 to 2021 (P < 0.05). Most employee injuries occurred in the male and floating populations. Targeted intervention measures should be implemented according to the epidemiological characteristics of injuries in relation to different populations, sexes, and ages to prevent and control injuries.

Epidemiological characteristics and distribution of pediatric supracondylar fractures in South China: a retrospective analysis of 760 cases

To evaluate demographic characteristics and distribution of pediatric supracondylar fractures (SCFs) at a tertiary hospital in South China. A retrospective observational study was conducted on children aged 15 years or younger with a diagnosis of SCFs during the period from January 2016 to December 2018. Patients' medical records and radiographs were retrospectively analyzed for age at the time of injury, sex, site and mechanism of traumatic injury. A total of 760 patients with 761 SCFs were reviewed (453 males, 59.6%, and 307 females, 40.4%). There were 748 extension-type fractures (98.3%) and 13 flexion-type fractures (1.7%). Associated injuries were identified in 30/760 (3.9%) patients: associated fracture ( n  = 15; 2%), nerve injury ( n  = 12; 1.6%), open fracture ( n  = 2; 0.2%) and compartment syndrome ( n  = 1; 0.1%). Age at the time of fracture has a bimodal pattern with a first peak around the age of 1 year and a second peak around the age of 4-5 years. The fractures occurred mostly around 11 a.m. and between 4 and 9 p.m. in the evening. Most fractures occurred at home (50.7%), and falling down (62.2%) was the most frequent mechanism of injury. SCFs occurred most frequently in children aged 1 and 4-5 years, and during daylight hours. In about 96% of cases, these were isolated injuries, and falling down was found to be the most frequent traumatic mechanism. Based on our findings, targeted educational efforts and interventions can be set up in order to prevent the occurrence of SCFs in South China. Level of evidence: III.

Changes in Six-Month Prevalence of Circulatory System Diseases among People Aged 20 Years and Older between 2013 and 2018 in Hunan, China

Recent changes in population-based prevalence for circulatory system diseases (CSDs) remain unreported either nationally or locally for China. Data were from the two-round health service household interview survey of Hunan Province, China, in 2013 and 2018. A Rao–Scott chi-square test was performed to examine prevalence differences across socio-demographic variables. The overall age-standardized prevalence of CSDs increased substantially between 2013 and 2018 for inhabitants aged 20 years and older (14.25% vs. 21.25%; adjusted odds ratio (OR) = 1.59, 95% CI: 1.24–2.04). Hypertensive disease was the most prevalent type of CSD, accounting for 87.24% and 83.83% of all CSDs in 2013 and in 2018, respectively. After controlling for other socio-demographic factors, the prevalence of CSDs was significantly higher in 2018 (adjusted OR = 1.40), urban residents (adjusted OR = 1.43), females (adjusted OR = 1.12) and older age groups (adjusted OR = 5.36 for 50–59 years, 9.51 for 60–69 years, 15.19 for 70–79 years, and 12.90 for 80 years and older) than in 2013, rural residents, males and the youngest age group (20–49 years). The recent increase in the overall age-standardized CSD prevalence and the large prevalence disparities across urban/rural residents, sex and age groups merit the attention of policymakers and researchers. Further prevention efforts are needed to curb the increasing tendency and to reduce the prevalence of disparities across socio-demographic groups.

Road traffic injury mortality and morbidity by country development status, 2011-2017

PURPOSE

This research examined road traffic injury mortality and morbidity disparities across of country development status, and discussed the possibility of reducing country disparities by various actions to accelerate the pace of achieving Sustainable Development Goals target 3.6 - to halve the number of global deaths and injuries from road traffic accidents by 2020.

METHODS

Data for road traffic mortality, morbidity, and socio-demographic index (SDI) were extracted by country from the estimates of the Global Burden of Disease study, and the implementation of the three types of national actions (legislation, prioritized vehicle safety standards, and trauma-related post-crash care service) were extracted from the Global Status Report on Road Safety by World Health Organization. We fitted joinpoint regression analysis to identify and quantify the significant rate changes from 2011 to 2017.

RESULTS

Age-adjusted road traffic mortality decreased substantially for all the five SDI categories from 2011 to 2017 (by 7.52%-16.08%). Age-adjusted road traffic mortality decreased significantly as SDI increased in the study time period, while age-adjusted morbidity generally increased as SDI increased. Subgroup analysis by road user yielded similar results, but with two major differences during the study period of 2011 to 2017: (1) pedestrians in the high SDI countries experienced the lowest mortality (1.68-1.90 per 100,000 population) and morbidity (110.45-112.72 per 100,000 population for incidence and 487.48-491.24 per 100,000 population for prevalence), and (2) motor vehicle occupants in the high SDI countries had the lowest mortality (4.07-4.50 per 100,000 population) but the highest morbidity (428.74-467.78 per 100,000 population for incidence and 1025.70-1116.60 per 100,000 population for prevalence). Implementation of the three types of national actions remained nearly unchanged in all five SDI categories from 2011 to 2017 and was consistently stronger in the higher SDI countries than in the lower SDI countries. Lower income nations comprise the heaviest burden of global road traffic injuries and deaths.

CONCLUSION

Global road traffic deaths would decrease substantially if the large mortality disparities across country development status were reduced through full implementation of proven national actions including legislation and law enforcement, prioritized vehicle safety standards and trauma-related post-crash care services.

Unintentional falls mortality in China, 2006-2016

BACKGROUND

To examine trends in unintentional falls mortality from 2006 to 2016 in China by location (urban/rural), sex, age group and mechanism.

METHODS

Mortality data were retrieved from the National Disease Surveillance Points system (DSPs) of China, a nationally representative data source. Percent change in mortality between 2006 and 2016 was calculated as "mortality rate ratio - 1" based on a negative binomial regression model.

RESULTS

The crude unintentional falls mortality was 9.55 per 100 000 population in 2016. From 2006 to 2016, the age-adjusted unintentional falls mortality increased by 5% (95% confidence interval (CI) = 1%-9%), rising from 7.65 to 8.03 per 100 000 population. Males, rural residents and older age groups consistently had higher falls mortality rates than females, urban residents and younger age groups. Falls on the same level from slipping, tripping and stumbling (W01) was the most common mechanisms of falls mortality, accounting for 29% of total mortality.

CONCLUSIONS

Unintentional falls continued to be a major cause of death in China from 2006 to 2016. Empirically-supported interventions should be implemented to reduce unintentional falls mortality.