RESUMEN
BACKGROUND: Previous studies indicate 20% of injuries represent 80% of injury costs in agriculture. To help prevent the most costly injuries, we aimed to identify characteristics and risk factors associated with serious injuries. METHODS: We analyzed insurance records of 93,550 self-employed Finnish farmers. We ranked injury causes by claim cost and used multiple logistic regressions to identify risk factors for (any) injury and serious injury (injuries exceeding claim costs of 2000 euros). RESULTS: A total of 5,507 compensated injuries occurred in 2002 (rate 5.9/100 person-years), and 1,167 or 21% of them (rate 1.25/100 person-years) were serious. The causes/sources resulting in highest average claim costs were motor vehicles; stairs, scaffoldings, and ladders; trailers and wagons; floors, walkways, and steps; other structures and obstacles; augers, mills, and grain handling equipment; horses; combines and harvesting equipment; tractor steps; and uneven and slippery terrain. Older age, male gender, higher income level, greater field size, residing on the farm, Finnish language (vs. Swedish), occupational health service (OHS) membership, and animal production were risk factors for injury. The risk factors for serious injury were similar; however, the effects of age, income level, and the raising of horses were more prominent. Language, residence, ownership status, and OHS membership were not risk factors for serious injury. CONCLUSIONS: Cost-effective prevention efforts should address the following risk factors: older age, male gender, larger income and operation size, livestock production (particularly dairy, swine, and horses), motor vehicle incidents, falls from elevation, and slips, trips and falls.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas/epidemiología , Enfermedades de los Trabajadores Agrícolas/prevención & control , Indemnización para Trabajadores/estadística & datos numéricos , Heridas y Lesiones/epidemiología , Heridas y Lesiones/prevención & control , Adulto , Distribución por Edad , Enfermedades de los Trabajadores Agrícolas/clasificación , Agricultura/estadística & datos numéricos , Femenino , Finlandia/epidemiología , Humanos , Seguro de Salud/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Distribución por Sexo , Índices de Gravedad del Trauma , Recursos Humanos , Heridas y Lesiones/clasificación , Adulto JovenRESUMEN
BACKGROUND: Although the use of smoke alarms is widely recommended, little guidance is available on the types of alarms and batteries that function best. This study examined smoke alarm and battery function 12 months after installation in rural residential households. METHODS: An RCT, involving the installation of either a photoelectric or ionizing smoke alarm with either a lithium or carbon-zinc battery, was conducted in 643 rural Iowa households in July 2003. The functionality of each installed smoke alarm was tested 12 months later. Generalized estimating equations were used to model the effects of alarm type and battery type on alarm function and false alarms 12 months after installation. RESULTS: Of 643 study homes, 98.8% had at least one functioning alarm, and 81.5% had all alarms functioning 12 months after installation. No difference was observed in alarm function between photoelectric alarms and ionizing alarms 12 months after installation (OR=1.30, 95% CI=0.88, 1.92). However, photoelectric alarms had significantly lower odds of false alarms than ionizing alarms. Alarms with lithium batteries had 91% higher odds of functioning than those with carbon-zinc batteries. The main reasons for nonfunctioning included a missing battery (30.7%); a missing alarm (28%); and a disconnected battery (11.3%). CONCLUSIONS: Although lithium batteries and photoelectric alarms are more expensive than their counterparts, the financial investment might be worthwhile in terms of overall performance.
Asunto(s)
Incendios/prevención & control , Artículos Domésticos/instrumentación , Población Rural , Diseño de Equipo , Humanos , Oportunidad Relativa , SeguridadRESUMEN
BACKGROUND: The differences in occupational and non-occupational injuries between military men and women have not been documented. This study compares occupational and non-occupational injuries between male and female United States Army soldiers by examining injury hospitalization rates and characteristics. METHODS: The U.S. Army's Total Army Injury and Health Outcomes Database was searched for hospitalizations with ICD-9-CM codes for injury (800-959.9) between 1992 and 2002. Injury rates were calculated using yearly U.S. Army population data and compared using rate ratios. Injury characteristics were compared among categories of the Trauma Code (on duty; off duty; scheduled training, schemes, and exercises), stratified by gender. RESULTS: Included in this analysis were 792 women for an injury hospitalization rate of 11.0 per 1000 individuals (95% confidence interval [CI]=8.5-13.5) and 4879 men for a rate of 15.5 per 1000 individuals (95% CI=14.0-16.9). While women had significantly more injuries during scheduled training, schemes, and exercises than men (p<0.0001), there were few differences in the cause of those injuries. Women had longer average hospital stays compared to men due to these injuries (9.3 days vs 7.4 days, p=0.002), although these injuries were not more severe (average Injury Severity Score=3.5 for men vs average ISS for women=3.5, p=0.79). There was no difference between the genders in the percent of injuries that occurred off duty; however, men were more likely to get injured due to sports and athletics (p=0.001) and due to fighting (p=0.017) while off duty compared to women. CONCLUSIONS: Injury prevention messages for military personnel should focus on reducing risk factors for both on- and off-duty injuries.
Asunto(s)
Accidentes de Trabajo/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Personal Militar , Heridas y Lesiones/epidemiología , Adolescente , Adulto , Estudios Transversales , Bases de Datos Factuales , Femenino , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores Sexuales , Estados Unidos/epidemiologíaRESUMEN
CONTEXT AND PURPOSE: Rural households report high fire-related mortality and injury rates, but few studies have examined the risk factors for fires. This study aims to identify occupant and household characteristics that are associated with residential fires in a rural cohort. METHODS: Of 1,005 households contacted in a single rural county, 691 (68.8%) agreed to participate. One household with missing information on a reported fire was excluded from the analysis. We used logistic regression to examine the independent association of occupant and household characteristics with reported fires, controlling for years lived in the residence. We also examined the association between the occurrence of previous fires and the adoption of safety measures. FINDINGS: A total of 78 (11.3%) households reported a residential fire. Occupant characteristics that were associated with significantly higher odds of reported fires included the presence of an occupant with alcohol problems (OR = 1.82, 95% CI = 1.01-3.28) and being married (OR = 2.11, 95% CI = 1.14-3.91). Rural farm households were associated with significantly higher odds (OR = 1.72, 95% CI = 1.01-2.93) of reporting a fire when compared to residences in towns, after controlling for all other occupant and household characteristics. The presence of a fire extinguisher (OR = 2.00, 95% CI = 1.10-3.64) was the only fire safety measure that had a statistically significant association with reported fire. CONCLUSIONS: Rural farm households report higher incidences of fire when compared to households located in towns. Experiencing a fire is not associated with an increased likelihood of adopting safety measures to prevent injuries once a fire has started.
Asunto(s)
Composición Familiar , Incendios/estadística & datos numéricos , Medición de Riesgo , Población Rural/estadística & datos numéricos , Seguridad , Estudios Transversales , Recolección de Datos , Demografía , Incendios/prevención & control , Humanos , Entrevistas como Asunto , Iowa/epidemiología , Factores de RiesgoRESUMEN
CONTEXT: Crash fatality and injury rates are higher on rural roadways than other roadway types. Although slow-moving farm vehicles and equipment are risk factors on rural roads, little is known about the characteristics of crashes with farm vehicles/equipment. PURPOSE: To describe crashes and injuries for the drivers of farm vehicles/equipment and non-farm vehicles involved in an injury crash. Passengers are not included in this analysis. METHODS: Injury crashes were included that involved a farm vehicle/equipment and at least one non-farm vehicle reported in Iowa Department of Transportation crash data from 1995 to 2004. Odds ratios were calculated through logistic regression to identify increased odds for injury among drivers of non-farm vehicles and farm vehicles/equipment. We examined frequently occurring crash characteristics to identify crash scenarios leading to the highest odds for injury. FINDINGS: Non-farm vehicle drivers were 5.23 times more likely to be injured than farm vehicle/equipment drivers (95% CI = 4.12-6.46). The absence of restraint use was a significant predictor of injury for both farm vehicle/equipment drivers (OR = 2.85; 95% CI = 1.14-7.13) and non-farm vehicle drivers (OR = 2.53; 95% CI = 1.54-4.15). Crash characteristics increasing the odds of injury for non-farm vehicle drivers included speeding, passing the farm vehicle/equipment, driving on a county road, having a frontal impact collision, and crashing in darkness. Ejection was the strongest predictor of injury for the farm vehicle/equipment driver. CONCLUSION: Non-farm vehicle drivers were much more likely to be injured than farm vehicle/equipment drivers, suggesting that farm vehicle/equipment crash prevention should be a priority for all rural road users. Prevention strategies that reduce motor vehicle speed, assist in safe passing, increase seat belt use, and increase conspicuousness of the farm vehicle/equipment are suggested.
Asunto(s)
Accidentes de Trabajo , Agricultura , Equipos y Suministros , Heridas y Lesiones/epidemiología , Accidentes de Trabajo/prevención & control , Accidentes de Trabajo/tendencias , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Lactante , Iowa/epidemiología , Masculino , Persona de Mediana Edad , Medición de Riesgo , Población Rural , Heridas y Lesiones/etiologíaRESUMEN
BACKGROUND: Homes in rural areas have a higher fire death rate. Although successful exit from a home fire could greatly reduce fire-related deaths and injuries, little is known about factors associated with behaviors of developing and practicing an escape plan. METHODS: Between July 2003 and June 2004, a baseline survey was administered, in person, to 691 rural households. Information collected included a history of previous home fire, perceived risk of home fire, existing smoke alarms and their working status, and home fire safety practices, as well as home and occupant characteristics. The association of residents' perceived risk of home fire and fire escape plans was assessed. RESULTS: Forty-two percent of rural households reported having a fire escape plan. Of the households with a plan, less than two thirds (56.9%) discussed or practiced the plan. Households with children were more likely to develop and practice a fire escape plan. Households with an elderly or disabled person were less likely to develop or practice the plan. Compared to respondents who perceived low or very low risk of home fire, those who perceived a high or very high risk had 3.5 times greater odds of having a fire escape plan and 5.5 times greater odds of discussion or practicing their plan. CONCLUSIONS: Increasing awareness of the potential risk of home fires may help occupants develop and practice home fire escape plans. In order to reduce fire deaths and injuries, different strategies need to be developed for those households in which the occupants lack the ability to escape.
Asunto(s)
Planificación en Desastres/estadística & datos numéricos , Incendios , Conocimientos, Actitudes y Práctica en Salud , Medición de Riesgo , Población Rural/estadística & datos numéricos , Adolescente , Adulto , Anciano , Niño , Preescolar , Composición Familiar , Encuestas de Atención de la Salud , Vivienda , Humanos , Iowa , Modelos Logísticos , Persona de Mediana Edad , Prevalencia , Equipos de Seguridad/estadística & datos numéricos , Factores SocioeconómicosRESUMEN
BACKGROUND: Therapeutic trauma laparotomy (TTL) is a common emergency procedure after traumatic abdominal injury, but it can lead to complications and even death. We explored the role of the time from emergency department (ED) arrival to surgical intervention as a predictor of complications and mortality from TTL. STUDY DESIGN: This is a retrospective study of 175 patients receiving TTL between July 1997 and October 2003 in a Level I teaching hospital serving a primarily rural population. Mortality after TTL and complications, both general and abdominal, were the main outcomes. Time from ED arrival to operation was the primary exposure. Confounders, including time from injury to ED arrival, age, gender, injury severity, and patient status, were controlled in logistic models. RESULTS: Of the 175 TTL patients, 23 (13.1%) died, 102 (58.3%) had abdominal complications, and 119 (68.0%) had general complications. Controlling for confounders, patients whose operation began more than 1 hour after ED arrival were 11.3 (95% CI=2.2 to 58.8) times more likely to die and 3.1 (95% CI=1.44 to 6.60) times more likely to have complications. CONCLUSIONS: The traumatologist has little control over patient treatment and transfer before ED arrival. After arrival the traumatologist can reduce negative outcomes by reducing the time for patient assessment and start of TTL, when warranted.
Asunto(s)
Traumatismos Abdominales/cirugía , Laparotomía , Complicaciones Posoperatorias/mortalidad , Traumatismos Abdominales/mortalidad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Análisis Multivariante , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Factores de Tiempo , Índices de Gravedad del TraumaRESUMEN
Using the National Health Interview Survey Disability Supplement of 1994 to 1995, we examined the factors associated with employment among Americans with disabilities. Persons with disabilities who were more educated were more likely to be working. Married men were more likely to work than unmarried men (odds ratio [OR], 1.58). Blacks were less likely to work than whites (OR, 0.56). Persons with disabilities related to cardiovascular disease (OR, 0.23), musculoskeletal disease (OR, 0.37), and respiratory disease (OR, 0.23) were less likely to work than other Americans with disabilities. Among persons with psychiatric disorders, there was considerable variety in the propensity to work. Persons with schizophrenia (OR, 0.24) and paranoid delusional disorder (OR, 0.34) were markedly less likely to work; persons with bipolar disorder (OR, 0.60) and major depression (OR, 0.69) were also less likely to work. Lastly, persons with self-reported alcohol abuse (OR, 1.30) were more likely to work, and persons with self-reported drug abuse (OR, 0.93) were not less likely to work, than others in our study population of Americans with disabilities.
Asunto(s)
Personas con Discapacidad/estadística & datos numéricos , Empleo/estadística & datos numéricos , Encuestas Epidemiológicas , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo , Estados UnidosRESUMEN
As American workers age, workers with impairments and functional limitations make up a larger percentage of our workforce. This investigation presents data from the National Health Interview Survey Disability Supplement 1994-1995 (NHIS-D) describing the nature of workplace accommodations in the American workforce and factors associated with the provision of such accommodations. Of a nationally representative sample of workers aged 18 to 69 years with a wide range of impairments, 12% reported receiving workplace accommodations. Males (odds ratio (OR) 0.64: 95% confidence interval (CI) 0.53-0.78) and Southerners (OR 0.57; 95% CI = 0.47-0.70) were less likely than others to receive workplace accommodations. Those with mental health conditions were less likely than others to receive accommodations (OR 0.56; 95% CI = 0.44-0.70). College graduates (OR 1.53; 95% CI = 1.22-1.91), older workers, full time workers (OR 3.99; 95% CI = 2.63-3.87), and the self-employed (OR 1.76; 95% CI = 1.28-2.41) were more likely than others to receive accommodations.
Asunto(s)
Accesibilidad Arquitectónica , Personas con Discapacidad , Ocupaciones , Lugar de Trabajo/organización & administración , Actividades Cotidianas , Adulto , Anciano , Personas con Discapacidad/clasificación , Empleo , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , National Center for Health Statistics, U.S. , Encuestas y Cuestionarios , Estados UnidosRESUMEN
This study compares the prevalence of the health risk factors for chronic disease and injury among farmers with their prevalence among other workers, using data from the Iowa Behavioral Risk Factor Surveillance System. From January 1999 to December 1999, there were 3,620 adults who participated in the survey. This report focuses on the 2,140 subjects who reported they were working. We calculated the percentage with each health risk factor, the adjusted odds ratio (OR) and the associated 95% confidence interval (CI), comparing the prevalence of health risks among farmers and other workers. Most health conditions and risk factors were similar among farmers and other workers. However, we found that farmers had some protective behaviors. They had better oral health (OR = 0.34, 95% CI 0.20-0.57) and were less likely to smoke (OR = 0.14, 95% CI 0.06-0.29) than other workers. In contrast, we found that farmers reported some high-risk behaviors compared to other workers. They were less likely to have smoke detectors at home (OR = 0.39, 95% CI 0.18-0.82), or to have had stool blood screening for colorectal cancer (OR = 0.41, 95% CI 0.1 7-1.00). These results suggest areas for future research to define targeted preventive interventions in farm communities.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas/epidemiología , Adolescente , Adulto , Anciano , Escolaridad , Femenino , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Estado de Salud , Humanos , Seguro de Salud/estadística & datos numéricos , Iowa/epidemiología , Masculino , Estado Civil , Tamizaje Masivo/estadística & datos numéricos , Persona de Mediana Edad , Prevalencia , Valores de Referencia , Factores de Riesgo , Fumar/epidemiología , Quemadura Solar/epidemiología , Enfermedades Dentales/epidemiologíaRESUMEN
The Keokuk County Rural Health Study (KCRHS) was designed as a 20-year, prospective cohort study focusing on chronic disease and injury in an agricultural southeastern Iowa county. The goals of the KCRHS are to prospectively describe, measure, and analyze prevalent rural and agriculturally related adverse health outcomes and their respective risk factors and to provide the basis for future community-based intervention programs to reduce disease and injury incidence. Methods of data collection included in-person interviews, medical screenings, and environmental assessments of homes and farms. All households studied were rural; comparisons were made among farm, rural nonfarm, and town households, between men and women, and between smokers and nonsmokers. The present paper reports selected adult baseline data from Round 1 of this study. Residents of farm households were somewhat younger and better educated than residents of rural nonfarm and town households; smoked less; were more likely to have ridden an all-terrain vehicle; and were more likely to report firearms in the home. Eighty-nine percent of the men and 66% of the women engaged in farming or did so in the past. Men more often reported hearing loss, were more often overweight and obese, more often reported an injury, less often reported asthma, and less often saw a medical practitioner. Women reported poorer emotional health and higher rates of depression symptoms. The KCRHS has identified several modifiable health outcomes and risk factors as candidates for further analysis and targets for community-based prevention and intervention programs.
Asunto(s)
Enfermedad Crónica/epidemiología , Estado de Salud , Salud Rural/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Heridas y Lesiones/epidemiología , Adolescente , Adulto , Anciano , Agricultura , Consumo de Bebidas Alcohólicas/epidemiología , Actitud Frente a la Salud , Estudios de Cohortes , Femenino , Humanos , Iowa/epidemiología , Estudios Longitudinales , Masculino , Salud Mental/estadística & datos numéricos , Persona de Mediana Edad , Exposición Profesional/efectos adversos , Estudios Prospectivos , Características de la Residencia/estadística & datos numéricos , Enfermedades Respiratorias/epidemiología , Factores de Riesgo , Fumar/epidemiologíaRESUMEN
CONTEXT: Although farmers are at risk for injuries from contact with large livestock, few previous studies have examined risk factors for animal-related injuries. PURPOSE: This case-control study, nested in the Agricultural Health Study, aimed to assess risk factors for animal-related injury among Iowa large-livestock farmers. METHODS: A screener questionnaire sent to 6999 farmers identified 116 farmers with large livestock who had an animal-related injury requiring medical advice/treatment in the previous year. Several possible risk factors for injury were assessed by comparing these farmers with 342 farmers who had livestock but were not injured in the previous year. FINDINGS: A multiple logistic regression analysis showed significant associations between animal-related injury and the use of a hearing aid (odds ratio [OR] = 5.4 [95% CI, 1.6 to 18.0]), doctor-diagnosed arthritis or rheumatism (OR = 3.0 [95% CI, 1.7 to 5.2]), education beyond high school (OR = 1.8 [95% CI, 1.1 to 2.8]), and a younger age. Farmers engaged in off-farm work were less likely to sustain animal-related injuries (OR = 0.4 [95% CI, 0.2 to 0.8]). CONCLUSIONS: This is the first study to show associations between animal-related injury and a younger age, hearing difficulties, and doctor-diagnosed arthritis. Hearing loss and arthritis, which are more common among farmers than among other workers, may be particularly important risk factors to address in future preventive studies.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas/epidemiología , Crianza de Animales Domésticos , Animales Domésticos , Heridas y Lesiones/epidemiología , Adulto , Animales , Estudios de Casos y Controles , Humanos , Iowa/epidemiología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de RiesgoRESUMEN
Farm machinery is a major cause of injury morbidity and mortality among farmers. This case-control study assessed risk factors for machinery-related injuries among Iowa farmers. A screener questionnaire sent to 6,999 farmers in 1998 identified 205 farmers who had machinery-related injuries requiring medical advice/treatment in the previous year. Possible risk factors for injury were assessed among these farmers compared with 473 farmers with no injury in the previous year. A multiple logistic regression analysis showed significant associations between machinery-related injury and hours per week spent on farmwork (OR = 2.02; 95% CI 1.38-2.94), fewer years of farming experience (OR = 1.79; 95% CI 1.14-2.79), wearing a hearing aid (OR = 4.37; 95% CI 1.55-12.25), and a high CAGE score suggesting problem drinking (OR = 2.49; 95% CI 1.00-6.19). This is the first study to show associations between machinery-related injury and hearing impairment, problem drinking, and fewer years of farming experience. These findings may be useful for future interventions to decrease injuries related to farm machinery.
Asunto(s)
Accidentes de Trabajo/estadística & datos numéricos , Enfermedades de los Trabajadores Agrícolas/epidemiología , Seguridad de Equipos , Heridas y Lesiones/epidemiología , Estudios de Casos y Controles , Humanos , Entrevistas como Asunto , Iowa/epidemiología , Estudios Prospectivos , Factores de Riesgo , Encuestas y Cuestionarios , Heridas y Lesiones/clasificaciónRESUMEN
Although nonfatal burn injuries vastly outnumber fatal injuries, their epidemiology is not well defined. We sought to determine the epidemiology of nonfatal burn injuries in a largely rural region of a midwestern state to target intervention efforts at populations and injury mechanisms at risk. Data were retrospectively collected on a population-based sample of medically treated burn injuries in 10 counties in southern Iowa from 1997 to 1999 using International Classification of Diseases, 9th Revision, Clinical Modification codes (ICD-9-CM, Ncode 940-949) to identify burn-related emergency room visits from computerized lists. A total of 1430 emergency room visits were identified, with 1382 records available for review. Injuries were grouped into etiology subcategories to better delineate common mechanisms and determine methods of prevention. Scald and hot-object contact and flame-related injuries were the leading causes of burn injury. Scald and contact injuries were subdivided into three major sets of scenarios, scald and contact injuries related to household food preparation and consumption, work-related scald and contact injuries. and injuries resulting from contact with nonfood and nonbeverage-related household objects. Children ages 0 to 4 had the highest population-based scald and hot-object contact injury rate of all age groups, with an average annual incidence rate of 35.9 per 10,000. Injuries in this age group were most commonly related to household objects (34.7%) followed by food preparation (25.3%). Children and young adults ages 5 to 24 were also the most likely to be injured by flame and fire-related causes secondary to open fires. Nonfatal burn injuries typically afflict children and young adults in definable patterns, suggesting intervention strategies. Future studies need to better delineate the contributing factors associated with these injuries to refine the intervention strategies.
Asunto(s)
Quemaduras/epidemiología , Quemaduras/etiología , Asunción de Riesgos , Adolescente , Adulto , Distribución por Edad , Anciano , Quemaduras/prevención & control , Niño , Preescolar , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Humanos , Incidencia , Lactante , Iowa/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Población Rural/estadística & datos numéricosRESUMEN
This study identifies factors associated with mode of transport to rural hospitals. We evaluated 11,541 trauma patient visits that came by ground ambulance or private vehicle to the Emergency Department of one of six northwest Iowa rural hospitals. We performed univariate analyses and logistic regression analyses to identify factors associated with mode of transport for each severity level (fatal, major and minor). For major/fatal injuries, we found that those aged 65 years and over were 3.6 (95% CI = 2.7-4.9) times more likely to use ambulances than those under 15. Motor vehicle traffic injuries and hip fractures were also associated with ambulance usage, while arm fractures and farm-related injuries were not. We conclude that for major/fatal injuries, older persons, those injured from high velocity causes, and those with hip fractures are more likely to use an ambulance. Emergency Medical Services may improve the community's ambulance utilization by providing public education (e.g., proper use of 911 and injury severity recognition), and by collaborating with dispatch, the local community and health care providers. Further study of the community's and individuals' decision-making factors determining mode of transportation is needed.
Asunto(s)
Transporte de Pacientes/métodos , Adolescente , Adulto , Anciano , Ambulancias , Automóviles , Distribución de Chi-Cuadrado , Niño , Preescolar , Femenino , Hospitales Rurales , Humanos , Lactante , Recién Nacido , Puntaje de Gravedad del Traumatismo , Iowa , Modelos Logísticos , Masculino , Persona de Mediana Edad , Salud Rural , Centros TraumatológicosRESUMEN
BACKGROUND: This randomized trial presents findings from the longest follow-up study of smoke alarm and battery function to date. PURPOSE: The purpose of this study is to examine differences in long-term function of smoke alarm and battery combinations. METHODS: A total of 691 households in an ongoing cohort study were randomly allocated into smoke alarm groups of ionizing and photoelectric and battery groups of zinc and lithium. Smoke alarm function was measured in 633 (91.6%) households from January 2007 through February 2008, 42 months following original smoke alarm/battery installation. Data analyses were conducted in 2009. RESULTS: After 3.5 years, 81.9% of the 1898 smoke alarms were functional. Ionizing alarms with zinc batteries were the least likely to function (72.7%). In comparison, photoelectric alarms with lithium batteries were 2.9 times (95% CI=1.8, 4.5) more likely to function; ionizing alarms with lithium batteries were 2.0 times (95% CI=1.3, 3.1) more likely to function; and photoelectric alarms with zinc batteries were 1.7 times (95% CI=1.1, 2.5) more likely to function. Functionality was strongly tied to number of reports of nuisance alarms, which was higher for ionizing than photoelectric alarms. CONCLUSIONS: Photoelectric smoke alarms and lithium batteries are the most likely to function long after smoke alarm installation, and may be worthwhile investments despite their increased cost.
Asunto(s)
Incendios/prevención & control , Artículos Domésticos/instrumentación , Diseño de Equipo , Estudios de Seguimiento , Humanos , Litio/química , Población Rural , Seguridad , Factores de Tiempo , Zinc/químicaRESUMEN
The Keokuk County Rural Health Study (KCRHS) is a population-based, prospective study of health status and environmental exposures of a large stratified random sample of residents in one rural Iowa county. The study focuses on injury and respiratory disease and monitors health care delivery, geriatric health, mental health, and other health outcomes, as well as behavioral risk factors for disease and injury. Injury and disease prevalence is investigated in relation to occupational, agricultural, and other environmental exposures. The KCRHS enrolled 1004 families in Round 1 (1994 to 1998) and 1002 families in Round 2 (1999 to 2004). Participants range in age from newborn to 98 years of age and are about equally divided between males and females. The families live in farm, rural nonfarm, and town households, representing men, women, and children, the elderly, farmers, and nonfarmers. The KCRHS is currently in Round 3 (2006-2011). Although the sample is stratified by residence type, the entire county is, by definition, rural, because the largest town has fewer than 2500 residents. Using the Keokuk County Rural Health Study as an example, this paper describes the methodological challenges faced in conducting a large rural prospective population-based cohort study. Some of these challenges are inherent in any large cohort study; others are unique to rural cohort studies. Topics considered include planning the study, developing the protocol, sampling, recruiting and tracking subjects, data collection and management, sustaining funding, relating to the community, and sharing data.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas , Agricultura , Diseño de Investigaciones Epidemiológicas , Estudios Prospectivos , Población Rural , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades de los Trabajadores Agrícolas/epidemiología , Enfermedades de los Trabajadores Agrícolas/etiología , Niño , Preescolar , Estudios de Cohortes , Recolección de Datos/métodos , Exposición a Riesgos Ambientales , Estado de Salud , Humanos , Lactante , Recién Nacido , Iowa , Masculino , Persona de Mediana Edad , Salud Rural , Adulto JovenRESUMEN
This was a 3-year retrospective cohort study of traumatic injuries in a midwestern pork meatpacking plant. Based on n = 5410 workers, this was a diverse workforce: Caucasian (56.6%), Hispanic (38.9%), African American (2.7%), Asian (1.1%) and Native American (0.8%). There were n = 1655 employees with traumatic injuries during this period. At 6 months of employment, the probability of injury was 33% in the harvest workers who were responsible for slaughter operations. The overall incidence injury rate was 22.76 per 100 full-time employees per year. Women experienced a higher incidence for injury than men. The risk ratio (RR) for traumatic injury was significantly lower in Hispanic workers compared to Caucasians (RR = 0.54, 95% CI = 0.49-0.60) and nonsignificantly higher in African American and Native American workers after adjusting for age, gender, work section assignment, and experience (RR = 1.33, 95% CI = 1.21-1.47). These findings suggest that either Hispanics are very safe employees or they underreport injuries. We make the case for the latter in the discussion.
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Accidentes de Trabajo/estadística & datos numéricos , Emigrantes e Inmigrantes/estadística & datos numéricos , Etnicidad/estadística & datos numéricos , Embalaje de Alimentos , Heridas y Lesiones/patología , Adolescente , Adulto , Distribución por Edad , Estudios de Cohortes , Femenino , Embalaje de Alimentos/métodos , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Distribución por Sexo , Índices de Gravedad del Trauma , Heridas y Lesiones/etnología , Adulto JovenRESUMEN
OBJECTIVE: To assess associations between diabetes and occupational injury. METHODS: Data from the 1997 to 2005 National Health Interview Survey comprised a sample of 195,284 adult workers. Multivariate logistic regression analysis assessed associations between diabetes and occupational injuries, adjusting for age, sex, race, and education. Additional logistic regression analysis examined the effect of medical therapy and duration of diabetes with occupational injury. RESULTS: There was no significant association between diabetes and occupational injury (adjusted OR = 1.18; 95% CI = 0.86 to 1.61). Subgroups of diabetics who reported no current diabetes therapy (OR = 1.87; 95% CI = 1.01 to 3.47) or duration of diabetes longer than 12 years (OR = 1.83; 95% CI = 1.05 to 3.18) were at increased risk for occupational injury. CONCLUSION: The finding of no overall increased risk for occupational injury among workers with diabetes provides nationally representative results that may be useful to policymakers. Increased risk for occupational injury among untreated diabetics or those with long duration of disease may lead to focused efforts to prevent occupational injuries.
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Accidentes de Trabajo/estadística & datos numéricos , Diabetes Mellitus/epidemiología , Encuestas Epidemiológicas , Heridas y Lesiones/epidemiología , Adulto , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Estados Unidos/epidemiologíaRESUMEN
Farmers are at risk for work-related eye injuries, some of which can be very serious. This study describes the farm activities that were related to eye injury in a group of 36 Iowa farmers in the Agricultural Health Study who sustained 40 farmwork-related eye injuries requiring medical advice or treatment. Farm activities of grinding or cutting metal accounted for 11 (27.5%) of the eye injuries, welding for 3 (7.5%), and drilling for 2 (5%). The other 24 eye injuries were related to diverse farm activities. One injury was caused by an animal. Only one injury was caused by a chemical exposure. Foreign body in the eye was the most frequent type of eye injury overall, accounting for 32 (80%) of the eye injuries. Of those, 20 were metallic foreign bodies. Although none of the injuries required hospitalization, 10 eye injuries (25%) resulted in the farmer missing 1 to 5 days of work. At least three injuries occurred while farmers were wearing safety glasses/goggles. These results suggest that farmers are at risk for eye injury from activities such as grinding and cutting metal, welding, and drilling and from other diverse activities on the farm for which eye hazards may not have been anticipated. In addition, these findings have implications for use of appropriate eye protection during all farm activities.