Risk of death from motor-vehicle injury in Brazilian steelworkers: a nested case-control study

Association of hearing loss with land transport accidents: a nationwide population-based study

OBJECTIVE

This study aimed to investigate the association of prior hearing loss with land transport accidents using a nationwide population-based dataset.

DESIGN

A case-control study.

STUDY SAMPLE

Data for this study were obtained from Taiwan's National Health Insurance Dataset. We retrieved data on 2066 patients who had received a diagnosis of a land transport accident as cases. We used a propensity score-matched method to select 6198 controls.

RESULTS

A Chi-squared test revealed that there was a significant difference in the prevalence of prior hearing loss between cases and controls (6.8% vs. 5.6%, p = 0.046). The odds ratio (OR) of prior hearing loss for cases was 1.128 (95% confidence interval [CI]: 1.003 ∼ 1.503) compared to controls. After adjusting for demographic variables and comorbidities, the OR of hearing loss for cases was 1.238 (95% CI: 1.008 ∼ 1.522) that of controls.

CONCLUSIONS

Our finding suggests that pre-existing hearing loss may be associated with land transport accidents among adults aged 50 years and older. Further study is needed to elucidate the mechanism(s) through which hearing loss may contribute to land transport accidents and examine how the use of hearing rehabilitation devices, for example, hearing aids impacts the observed associations.

Association of Social Determinants of Health and Road Traffic Deaths: A Systematic Review

OBJECTIVE

This study aims to review systematically the association of social determinants of health (SDH) and road traffic deaths (RTD) within scientific literature.

METHODS

A search strategy was designed and run in EMBASE, PubMed via MEDLINE, Scopus, Web of Science, and Cochrane library. Through title, abstract, and full-text screening, all English original papers (except ecological studies) which studied social determinants of health and fatal injuries were included. Papers which studied association between RTD and the education, income, rural settlement, and marital status were evaluated and the related data was extracted from the full-texts.

RESULTS

Eleven articles out of 7,897 primary results were selected to be included in the study. Among eight papers studied education, seven confirmed a negative association between years of schooling and RTD. Two out of three articles reported no association between income leveland RTD. Among three papers studied rural settlement, two approved a positive relationship between this determinant and RTD. Both articles studied marital status, confirmed an association between this determinant and RTD.

CONCLUSION

A few papers studied association of social determinants of health (SDH) and RTD. There was an inverse relationship between education and RTD. The evidence for such an association between income, rural settlement, and marital state was scarce. Further investigations are recommended through original research.

Evaluating the Risk of Noise-Induced Hearing Loss Using Different Noise Measurement Criteria

Objectives

This article examines whether the Occupational Safety and Health Administration's (OSHA) average noise level (LAVG) or the National Institute of Occupational Safety and Health's (NIOSH) equivalent continuous average (LEQ) noise measurement criteria better predict hearing loss.

Methods

A cohort of construction workers was followed for 10 years (2000-2010), during which time their noise exposures and hearing threshold levels (HTLs) were repeatedly assessed. Linear mixed models were constructed with HTLs as the outcome, either the OSHA (LAVG) or NIOSH (LEQ) measurement criteria as the measure of exposure, and controlling for age, gender, duration of participation, and baseline HTLs (as both a covariate or an additional repeated measure). Model fit was compared between models for HTLs at 0.5, 1, 2, 3, 4, 6, and 8 kHz using the Akaike information criterion (AIC). The 10th, 50th, and 90th percentiles of hearing outcomes predicted by these models were then compared with the hearing outcomes predicted using the ISO 1999:2013 model.

Results

The mixed models using the LEQ were found to have smaller AIC values than the corresponding LAVG models. However, only the 0.5, 3, and 4 kHz models were found to have an AIC difference greater than 2. When comparing the distribution of predicted hearing outcomes between the mixed models and their corresponding ISO outcomes, it was found that LEQ generally produced the smallest difference in predicted hearing outcomes.

Conclusions

Despite the small difference and high correlation between the LEQ and LAVG, the LEQ was consistently found to better predict hearing levels in this cohort and, based on this finding, is recommended for the assessment of noise exposure in populations with similar exposure characteristics.

Seriousness of Traffic Accidents during Work and Commuting

This study examined the seriousness of traffic accidents that happened either on work errands or during commuting. The article was based on three independently gathered data sets, of which two were based on compensation claims to the insurance companies ( N = 2,050 and N = 17,108) and one on the interviews of victims ( N = 328). The traffic accidents at work led to a major injury or death more often than the commuting accidents. On the other hand, the work-related traffic accidents were less serious than the leisure-time traffic accidents. One explanation could be that heavy vehicles used during the working hours protected the drivers of these vehicles.

Occupational noise annoyance linked to depressive symptoms and suicidal ideation: a result from nationwide survey of Korea

BACKGROUND

Noise, or undesirable sound, is one of the most common environmental stressors, and it can cause various health effects. Beyond the auditory consequences of occupational noise exposure, extra-auditory effects such as psychological problems have also been found. The aim of the current study is to elucidate the association between occupational noise annoyance and psychological symptoms, including symptoms of depression and suicidal ideation.

METHODS

A total of 10,020 participants (5,410 men and 4,610 women) were included in the current analysis, using data from the fourth Korean National Health and Nutrition Examination Survey (KNHANES). Self-report questionnaires were used to assess noise annoyance levels, depressive symptoms, and suicidal ideation. Odds ratios (ORs) and 95% confidence intervals (95% CIs) for psychosocial symptoms were calculated using multiple logistic regression models.

RESULTS

Compared to the no noise annoyance group, ORs (95% CI) of the severe annoyance groups were 1.58 (1.12-2.23) and 1.76 (1.29-2.40) in men and 1.49 (1.05-2.11) and 1.41 (1.01-1.97) in women for depressive symptoms and suicidal ideation, respectively. The ORs (95% CI) for severe noise annoyance in those with less than five hours of sleep were 2.95 (1.46-5.96) and 2.05 (1.01-4.16) in men and women, respectively, compared with those with no noise annoyance and a sleep time of more than five hours.

CONCLUSION

Our study shows that occupational noise annoyance is significantly related to mental health, including depressive symptoms and suicidal ideation after controlling for individual and socio-demographic characteristics even with gender stratification. However, prospective studies with quantified noise exposure assessment were needed to elucidate the causality on the association between noise annoyance and psychological symptoms.

Sociodemographic factors associated with aggressive driving behaviors of 3-wheeler taxi drivers in Sri Lanka

Little is known about the nature and scope of aggressive driving in developing countries. The objective of this study is to specifically examine the sociodemographic factors associated with aggressive driving behavior among 3-wheeler taxi drivers in Sri Lanka. Convenience samples of 3-wheeler taxi drivers from Rathnapura, Ahaliyagoda, Sri Lanka were surveyed from June to August 2006. Analyses included bivariate and multivariate logistic regression. Drivers with less than high school education were 3.5 times more likely to drive aggressively (odds ratio [OR] = 3.46; 95% confidence interval [CI] = 1.08, 11.1). Single drivers were 9 times more likely to run red lights (OR = 8.74; 95% CI = 2.18, 35.0), and being single was a major risk factor for drunk driving (OR = 4.80; 95% CI = 1.23, 18.7). Furthermore, high school completers were 4 times more likely to bribe a policeman (OR = 4.27; 95% CI = 1.23, 14.9) when caught violating the road rules. Aggressive driving and risk-taking behavior are amenable to policy initiatives, and preventive programs targeted at key groups could be used to improve road safety in Sri Lanka. This study demonstrates that aggressive driving behavior is associated with sociodemographic factors, including the level of education, marital status, and other socioeconomic factors. Hence, economic factors should be addressed to find solutions to traffic-related issues. It will be the government's and policy makers' responsibility to try and understand the economic factors behind risky road behavior and bribe-taking behavior prior to legislating or enforcing new laws.

Could driving safety be compromised by noise exposure at work and noise-induced hearing loss?

OBJECTIVE

A study was conducted to verify if there is an association between occupational noise exposure, noise-induced hearing loss and driving safety expanding on previous findings by Picard, et al. (2008) that the two factors did increase accident risk in the workplace.

METHODS

This study was made possible when driving records of all Quebec drivers were made available by the Societe de l'assurance automobile du Quebec (SAAQ is the state monopoly responsible for the provision of motor vehicle insurance and the compensation of victims of traffic accidents). These records were linked with personal records maintained by the Quebec National Institute of Public Health as part of its mission to prevent noise induced hearing loss in the workplace. Individualized information on occupational noise exposure and hearing sensitivity was available for 46,030 male workers employed in noisy industries who also held a valid driver's permit. The observation period is of five years duration, starting with the most recent audiometric examination. The associations between occupational noise exposure levels, hearing status, and personal driving record were examined by log-binomial regression on data adjusted for age and duration of exposure. Daily noise exposures and bilateral average hearing threshold levels at 3, 4, and 6 kHz were used as independent variables while the dependent variables were 1) the number of motor vehicle accidents experienced by participants during the study period and 2) participants' records of registered traffic violations of the highway safety code. The findings are reported as prevalence ratios (PRs) with their 95% confidence intervals (CIs). Attributable numbers of events were computed with the relevant PRs, lesser-noise, exposed workers and those with normal hearing levels making the group of reference.

RESULTS

Adjusting for age confirmed that experienced workers had fewer traffic accidents. The data show that occupational noise exposure and hearing loss have the same effect on driving safety record than that reported on the risk of accident in noisy industrial settings. Specifically, the risk of traffic accident (PR = 1.07 (CI 95% [1.01; 1.15]) is significantly associated with the daily occupational noise exposures >or= 100 dBA. For participants having a bilateral average hearing loss ranging from 16 to 30 dB, the PR of traffic accident is 1.06 (CI 95% [1.01; 1.11]) and reaches 1.31 (CI 95% [1.2; 1.42]) when the hearing loss exceeds of 50 dB. A reduction in the number of speeding violations occurred among workers occupationally exposed to noise levels >or= 90 dBA and those with noise-induced hearing loss >or=16 dB. By contrast, the same individuals had an increase in other violations of the Highway safety code. This suggests that noise-exposed workers might be less vigilant to other traffic hazards.

CONCLUSION

Daily occupational noise exposures >or= 100 dBA and noise-induced hearing losses-even when just barely noticeable-may interfere with the safe operation of motor vehicles.

Hearing loss as a risk factor for agricultural injuries

BACKGROUND

Previous studies suggested that hearing impairment based on self-report might increase the risk of agricultural injuries. However, self-reported hearing measures may be subject to inaccuracy and subjective perception. We assessed the association of agricultural injuries with hearing loss and other hearing characteristics using measured hearing.

METHODS

Study subjects were 150 farmers who participated in the Iowa Certified Safe Farm study. Injury information was collected by telephone interviews at 2-5 month intervals from September 1999 to October 2002. Hearing levels were measured annually using the pure tone audiometry from 1998 to 2002. Adjusted rate ratios of injuries were calculated using the multivariate Poisson regression model.

RESULTS

Hearing loss in the better ear (RR = 1.62), hearing asymmetry (RR = 1.67), and fair/poor self-reported hearing (RR = 1.96) were significantly associated with the risk of agricultural injuries. It is notable that self-reported hearing might be a stronger predictor of injuries than pure tone audiometry (PTA). Exposure to noise elevated the risk of injuries in those farmers with hearing loss or hearing asymmetry. The occasional use of hearing protection was significantly associated with agricultural injuries.

CONCLUSIONS

This study adds substantial evidence that hearing loss acts as a risk for agricultural injuries. Prevention of hearing loss and noise exposure may be important in reducing the burden of agricultural injuries.

The joint effect of noise exposure and job complexity on distress and injury risk among men and women: the cardiovascular occupational risk factors determination in Israel study

We sought to explore the possibility that exposure to noise at work might interact with job complexity and gender to affect the incidence of occupational injury among industrial employees. In this study, we examined 4084 men and 1643 women from 21 industrial plants while controlling for a number of potent confounding variables, among them active safety hazards. Logistic regression results showed that the predictor variables interacted and that the highest injury risk (odds ratio = 2.72) was observed in women in high noise and high job complexity, compared with the referents scoring low on these predictors. The comparable injury risk in men was only 1.3. Parallel results were observed for three noise stress indicators: workload, noise annoyance and postwork irritability. We conclude that the joint exposure to noise and high job complexity is disruptive, resulting in higher distress and occupational injury risk, particularly among women.

Motor vehicle driver injury and marital status: a cohort study with prospective and retrospective driver injuries

OBJECTIVE

To investigate the association of marital status with risk of motor vehicle driver injury.

DESIGN

A cohort study with prospective and retrospective outcomes.

SETTING

New Zealand.

PARTICIPANTS

A total of 10,525 adults (a volunteer sample of a multi-industry workforce, n = 8008; and a random sample of urban electoral rolls, n = 2517). EXPOSURE VARIABLE: Self reported marital status, assessed from a questionnaire administered in 1992-93 (baseline).

MAIN OUTCOME MEASURE

Motor vehicle driver injury resulting in admission of the driver to hospital and/or the driver's death, during the period 1988-98; hospitalisation and mortality data were obtained by record linkage to national health databases.

RESULTS

During 108 741 person-years of follow up, 139 driver injury cases occurred (85 before baseline, 54 after). After adjustment for age, sex, and study cohort, never married participants had twice the risk of driver injury (hazard ratio [HR] 2.06, 95% confidence interval [CI] 1.35 to 3.16) as married participants (HR 1.00). The relative risk for never married participants was slightly higher (HR 2.29), though less precise (95% CI 1.39 to 3.76), after further adjustment for alcohol intake, driving exposure, area of residence, body mass index, and occupational status.

CONCLUSIONS

After taking age, sex, and other variables into account, never married people had a substantially higher risk of driver injury than married people. While requiring corroboration, these findings imply that it may be appropriate for driver injury countermeasures to be targeted to never married people.

Motor vehicle driver injury and socioeconomic status: a cohort study with prospective and retrospective driver injuries

STUDY OBJECTIVE

To investigate the association between motor vehicle driver injury and socioeconomic status.

DESIGN

Cohort study with prospective and retrospective outcomes.

SETTING

New Zealand.

PARTICIPANTS

10 525 adults (volunteer sample of a multi-industry workforce, n=8008; and a random sample of urban electoral rolls, n=2517).

OUTCOME MEASURE

Motor vehicle driver injury resulting in admission of the driver to hospital or the driver's death, or both, during the period 1988-98; hospitalisation and mortality data were obtained by record linkage to national health databases.

MAIN RESULTS

After adjustment for age and sex, driver injury risk was inversely associated with both occupational status (p for linear trend <0.0001) and educational level (p for linear trend =0.007). Participants in the lowest approximate quartile of occupational status were four times as likely (HR 4.17, 95% CI 2.31 to 7.55) to have experienced a driver injury during follow up as participants in the highest approximate quartile. Participants who had been to secondary school for less than two years were twice as likely (HR 2.26, 95% CI 1.34 to 3.81) to have experienced a driver injury as those who had been to university or polytechnic. There was little evidence that driver injury risk was associated with neighbourhood income (p for linear trend =0.12) CONCLUSIONS: Occupational status and educational level seem to be important determinants of driver injury risk. Driver injury countermeasures should be targeted to people in low status occupations, as well as to people with comparatively little formal education.

Noise pollution: non-auditory effects on health

Noise is a prominent feature of the environment including noise from transport, industry and neighbours. Exposure to transport noise disturbs sleep in the laboratory, but not generally in field studies where adaptation occurs. Noise interferes in complex task performance, modifies social behaviour and causes annoyance. Studies of occupational and environmental noise exposure suggest an association with hypertension, whereas community studies show only weak relationships between noise and cardiovascular disease. Aircraft and road traffic noise exposure are associated with psychological symptoms but not with clinically defined psychiatric disorder. In both industrial studies and community studies, noise exposure is related to raised catecholamine secretion. In children, chronic aircraft noise exposure impairs reading comprehension and long-term memory and may be associated with raised blood pressure. Further research is needed examining coping strategies and the possible health consequences of adaptation to noise.

Do accidents happen accidentally? A study of trauma registry and periodical examination database

BACKGROUND

Health profile of trauma victims might affect accident involvement. Information linking medical data to accident epidemiology is lacking. This study aims to identify health factors that increase risk of accident involvement.

METHODS

The Israeli Defense Forces maintains two databases: records of periodical health examination of military personnel and a trauma registry including emergency department referrals of personnel resulting from injury. We identified 5,578 subjects who were examined in the Periodical Health Examination Center and were victims of trauma. We analyzed relation between injuries and various health parameters.

RESULTS

Results shows cigarette smoking is more frequent among the population involved in trauma (40% in motor vehicle crash, 37% in fall injury, and 31% in blunt contusion compared with 28% in Periodical Health Examination Center population not involved in trauma, p < 0.05). Odds ratio of smokers involvement in motor vehicle crash is 1.82 (95% confidence interval, 1.25-2.67, p < 0.005). Younger age is relatively more frequent among trauma victims.

CONCLUSION

We conclude that cigarette smokers and younger subjects might be at greater risk of being involved in accidental injuries.

Non-fatal work related injuries in a cohort of Brazilian steelworkers

OBJECTIVES

Workers in the steel industry are exposed to various severe hazards. This study investigated risk factors for non-fatal injury occurring in the workplace and during travel to and from work in steelworkers in Brazil.

METHODS

Non-fatal work related injuries during employment from January 1977 to September 1992 were analysed in a cohort of 21 732 male workers in the steel plant of USIMINAS, Brazil.

RESULTS

There were 14 972 non-fatal injuries during follow up, with 10 891 injuries in the workplace and 4081 during travel to and from work (travel to work injury). The rate of injury in the workplace was 5.6/100 person-years and that of travel to work injury was 2.1/100 person-years. The most common injuries were to hands, arms, and eyes, with 90% of the eye injuries caused by a foreign body. Both rates of workplace and travel to work injury increased significantly with the number of injuries previously experienced, and decreased with number of years in employment and calendar period. The rates of travel to work injury also seemed to decrease with age, but age was not an independent predictor of workplace injury when we controlled for duration of employment. The rate of workplace injury was increased eightfold for workers who had experienced more than six previous injuries compared with those with no previous workplace injuries after adjusting for duration of employment and calendar period. Labourers were most at risk of workplace injury, with about eight injuries per 100 person-years. Travel to work injury was most common among support workers, with nearly half of the travel to work injuries affecting the eyes.

CONCLUSION

The rate of injury was high in these steelworks, both for workplace and travel to work injuries. Characteristics of the work areas and the employees can identify high risk groups; protective measures, safety, health training, and injury programmes should concentrate particularly on these groups. Prevention of eye injury needs special attention in steelworks.