Health-related quality of life in Chinese workers: a systematic review and meta-analysis.

BACKGROUND: Studies of health-related quality of life among workers have generated varying results. The purpose of this study was to conduct a systematic review to synthesize the scores of health-related quality of life measured by the World Health Organization Quality of Life questionnaire among Chinese workers and compare the results across gender, age, occupation and region. METHODS: Six databases including China National Knowledge Infrastructure, WanFang Data, China Science and Technology Journal Database, PubMed, Web of science and Scopus were searched for relevant publications in both English and Chinese from their inception to February 2021. Inclusion and exclusion criteria were established, and study and participant characters as well as health-related quality of life scores were extracted from included publications. Study quality was assessed by using the Crombie tool. The meta-analysis including individual publications used random-effects models. Subgroups analyses by gender, age, occupation and region were also conducted to explore the source of heterogeneity. RESULTS: One hundred thirty-nine out of 1437 potential publications were included. The pooled mean scores of health-related quality of life were 14.1 for the physical domain (95%CI: 13.9-14.3), 13.7 for the psychological domain (95%CI: 13.5-13.8), 14.0 for the social relationship domain (95%CI: 13.8-14.2), 12.3 for the environment domain (95%CI: 12.1-12.5). No significant statistical difference was found between the different subgroups. Publication bias was present in the independence domain and the pooled scores were corrected to 15.0 (95%CI: 14.6-15.5) using the trim and fill method. Sensitivity analysis suggested that the results of the meta-analysis were stable. Region might be a source of heterogeneity. Workers in northeast China reported higher scores in the social relationship domain, and those in the central region reported lower scores in the environmental domain. CONCLUSIONS: Chinese workers reported lower scores in four health-related quality of life domains than the general population. Region might be a potential influencing factor for workers' scores different, which needs further study. The pooled scores can served as benchmarks for workplace health promotion programes in Chinese workers and global occupational health studies.

Hotspots of road traffic crashes in a redeveloping area of Shanghai.

To identify high-risk locations (hotspots) of road traffic crashes (RTC) in a redeveloping area of Shanghai, for formulating relevant countermeasures in similar areas. After geocoding the crash locations on electronic map, assessment of spatial clustering of accidents and hotspots spatial densities was conducted following Moran's I method, the kernel density estimation, the Ripley's K-function and the network-based kernel density estimation (NKDE). A total of 21,679 RTC incidents resulting in 24,147 victims were recorded from 2010 to 2012. RTCs tended to occur among male (81.8%) aged 20-49 years old (84.9%) riding buses (60.1%) or electric bikes (16.1%) in working time (15%). The network spatial analysis pinpointed the hotspots of RTC at the street level in the Songjiang new urban area, and more RTCs occurred at road intersections than on road segments. Findings from this research may help the authorities develop efficient programmes to target high-risk locations and specific vulnerable populations.

High road utilizers surveys compared to police data for road traffic crash hotspot localization in Rwanda and Sri Lanka.

BACKGROUND: Road traffic crashes (RTCs) are a leading cause of death. In low and middle income countries (LMIC) data to conduct hotspot analyses and safety audits are usually incomplete, poor quality, and not computerized. Police data are often limited, but there are no alternative gold standards. This project evaluates high road utilizer surveys as an alternative to police data to identify RTC hotspots. METHODS: Retrospective police RTC data was compared to prospective data from high road utilizer surveys regarding dangerous road locations. Spatial analysis using geographic information systems was used to map dangerous locations and identify RTC hotspots. We assessed agreement (Cohen's Kappa), sensitivity/specificity, and cost differences. RESULTS: In Rwanda police data identified 1866 RTC locations from 2589 records while surveys identified 1264 locations from 602 surveys. In Sri Lanka, police data identified 721 RTC locations from 752 records while survey data found 3000 locations from 300 surveys. There was high agreement (97 %, 83 %) and kappa (0.60, 0.60) for Rwanda and Sri Lanka respectively. Sensitivity and specificity are 92 % and 95 % for Rwanda and 74 % and 93 % for Sri Lanka. The cost per crash location identified was $2.88 for police and $2.75 for survey data in Rwanda and $2.75 for police and $1.21 for survey data in Sri Lanka. CONCLUSION: Surveys to locate RTC hotspots have high sensitivity and specificity compared to police data. Therefore, surveys can be a viable, inexpensive, and rapid alternative to the use of police data in LMIC.

The impact of shift starting time on sleep duration, sleep quality, and alertness prior to injury in the People's Republic of China.

Early shift start time and night shifts are associated with reduced sleep duration and poor sleep quality that often lead to increased fatigue levels, performance decrements and adverse safety and health outcomes. This study investigates the impact of shift starting time on sleep patterns, including the duration and quality of sleep and alertness/sleepiness at the time of injury, in a large epidemiological field study of hospitalized adults with severe work-related hand injury in the People's Republic of China (PRC) from multiple industries with severe work-related traumatic hand injury were recruited from 11 hospitals in three industrially-developed cities in the PRC: Ningbo, Liuzhou and Wuxi. Analysis of covariance (ANCOVA) was used to compare sleep duration, sleep quality and alertness/sleepiness across 3 h increments of shift start time, while adjusting for age, gender, work hours, shift duration, day of injury and several transient work-related factors. Effect modification by gender was also evaluated. Seven-hundred and three hospitalized adults (96.4%) completed a face-to-face interview within 4 days of injury; 527 (75.0%) were male, with a mean (±SEM) age of 31.8 ± 0.4 years. Overall, these adults worked relatively long weekly (55.7 ± 0.6 h) and daily hours (8.6 ± 0.07 h). Average sleep duration prior to injury was 8.5 h (±0.07), and showed significant variations (p value <0.05) across shift starting time increments. Overall mean prior sleep duration was shortest for individuals starting shifts from "21:00-23:59" (5.6±0.8 h) followed by midnight "00:00-02:59" (6.1 ± 0.6 h). However, a statistically significant interaction (p < 0.05) was observed between gender and shift starting time on mean sleep duration. For males the shortest sleep duration was 5.6 h ("21:00-23:59") and for females the shortest was 4.3 h ("24:00-02:59" and "15:00-17:59"). Sleep quality (generally quite well) and alertness/sleepiness based on the KSS (generally alert) did not vary significantly across shift starting time. Results suggest that sleep duration is shortest among injured PRC adults starting shifts late night and early morning. However, with more than 8.5 h of sleep on average work days, Chinese slept much longer than typical US day workers (Sleep in America Poll, 2012, 6:44 on workdays, 7:35 on free days), and this may help to explain higher than expected alertness/sleepiness scores at the time of injury.

Workplace social capital and mental health among Chinese employees: a multi-level, cross-sectional study.

BACKGROUND: Whereas the majority of previous research on social capital and health has been on residential neighborhoods and communities, the evidence remains sparse on workplace social capital. To address this gap in the literature, we examined the association between workplace social capital and health status among Chinese employees in a large, multi-level, cross-sectional study. METHODS: By employing a two-stage stratified random sampling procedure, 2,796 employees were identified from 35 workplaces in Shanghai during March to November 2012. Workplace social capital was assessed using a validated and psychometrically tested eight-item measure, and the Chinese language version of the WHO-Five Well-Being Index (WHO-5) was used to assess mental health. Control variables included sex, age, marital status, education level, occupation status, smoking status, physical activity, and job stress. Multilevel logistic regression analysis was conducted to explore whether individual- and workplace-level social capital was associated with mental health status. RESULTS: In total, 34.9% of workers reported poor mental health (WHO-5<13). After controlling for individual-level socio-demographic and lifestyle variables, compared to workers with the highest quartile of personal social capital, workers with the third, second, and lowest quartiles exhibited 1.39 to 3.54 times greater odds of poor mental health, 1.39 (95% CI: 1.10-1.75), 1.85 (95% CI: 1.38-2.46) and 3.54 (95% CI: 2.73-4.59), respectively. Corresponding odds ratios for workplace-level social capital were 0.95 (95% CI: 0.61-1.49), 1.14 (95% CI: 0.72-1.81) and 1.63 (95% CI: 1.05-2.53) for the third, second, and lowest quartiles, respectively. CONCLUSIONS: Higher workplace social capital is associated with lower odds of poor mental health among Chinese employees. Promoting social capital at the workplace may contribute to enhancing employees' mental health in China.

The effects of rest breaks, work shift start time, and sleep on the onset of severe injury among workers in the People's Republic of China.

OBJECTIVE: The aim of the present study was to investigate the effects of the duration and timing of rest breaks on traumatic injury risk across a shift in a relatively large sample of hospitalized workers with severe work-related hand injury in the People's Republic of China (PRC). METHODS: Hospitalized workers from multiple industries with severe work-related traumatic hand injury were recruited from 11 hospitals in three industrially-developed cities in the PRC: Ningbo, Liuzhou, and Wuxi. Cox regression was used to compare time into the work shift of injury across categories of rest breaks, while evaluating several potential covariates including age, gender, work hours, work start time and duration, injury day and time, duration and quality of last sleep, alertness/sleepiness, job control, and several transient work-related factors. Effect modification by work shift start time was also evaluated. RESULTS: With four days of injury, 703 hospitalized workers completed a face-to-face interview. After adjusting for significant covariates, workers with rest breaks of 1-30, 31-60, and >60 minutes were able to work significantly (P<0.001) longer into their work shift without an injury (>5 hours) then those with no rest break. A significant interaction was also observed between rest break status and start time of the work shift. CONCLUSION: The results of this study suggest that rest breaks of any duration have a significant effect on delaying the onset of a work-related injury, which is modified by the time of day in which a shift begins.

A case-crossover study of work-related acute traumatic hand injuries in the People's Republic of China.

OBJECTIVE: The aim of this study was to quantify potential transient risk factors for occupational acute hand injury among hospitalized workers in the People's Republic of China (PRC). METHODS: Participants were recruited from 11 medical facilities in 3 cities of the PRC. A face-to-face interview was used to collect information on the occurrence of 8 potential risk factors within a 90-minute time period before an acute traumatic hand injury and during a control period within the month before the injury. The reliability of reporting transient risk factors was assessed, and a case-crossover design was used to estimate the injury incidence risk ratio (IRR) of each risk factor. RESULTS: In total,703 hospitalized workers completed the interview (527 male, 176 female), with a mean age of 31.8 [standard deviation (SD) 10.3] years. The median time interval between injury and interview was four days. Thirty percent of participants had a crush injury and 25.7% had an amputation. Using malfunctioning machinery/tools/material, performing a task with a different method, working overtime, and wearing gloves were found to have good reliability in test-retest examination [intra-class correlation coefficient (ICC)>0.9]. The IRR of a hand injury were markedly increased while using malfunctioning machinery/tools/material [110.4, 95% confidence interval (95% CI) 97.4-125.2], performing a task with a different method than usual (84.3, 95% CI 67.7-105.1), or being distracted (69.6, 95% CI 57.9-83.7). Gender and size of company were associated with differences in glove usage. CONCLUSIONS: The results suggest the importance of transient, potentially modifiable factors in the etiology of occupational acute hand injury in the PRC. Regular maintenance of machinery/tools, work practice controls, and avoiding distractions should be priorities for reducing the risk of occupational acute hand injuries.

Patterns of work-related traumatic hand injury among hospitalised workers in the People's Republic of China.

OBJECTIVES: This study describes the type, location and severity of work-related acute traumatic hand injuries of 560 workers treated in 11 hospitals in three economically active cities in the People's Republic of China (PRC) over a 2-year period. METHODS: A structured questionnaire was used to collect participant's information. Log-linear and logistic models were constructed to identify factors associated with injury occurrence and severity, respectively. RESULTS: Participants (n=560) had a mean age of 31.7 years (SD 10.5), 74.4% were men. 85.4% of participants were employed in manufacturing industries; 51.7% of 750 injuries were to the left hand. The index finger was injured most often and the most severe injury occurred to the right thumb. 68.3% of participants had only a single type of injury (29.7% crushes, 25.7% amputations and 18.5% fractures). Severe injuries occurred most often while working with food products (79.2% severe), furniture (72.2%), non-metallic mineral products (71.4%) and wood products (70.6%). Powered machines were involved in 59.5% of injuries. Injury frequency was associated with gender (male vs female, odds ratio (OR) 2.9, 95% CI 2.4 to 3.5) and company size (100 employees, OR 2.5, 95% CI 2.1 to 3.1). Injury severity was associated with gender (male vs female OR 0.6, 95% CI 0.4 to 0.9) and powered machine use (OR 2.2, 95% CI 1.3 to 3.7). CONCLUSIONS: The present study suggests that working in manufacturing industries and working with powered machines are the primary sources of severe hand injuries in hospitalised workers in economically active areas of the PRC.

Work-related fatalities in the People's Republic of China.

Over the past several decades, work-related fatal incident reporting in China has become faster, more publicly accessible and, hence, a potentially more valuable process in support of the decision-making and enforcement actions of the government and safety professionals. A study was conducted to examine the characteristics of work-related fatalities in the People's Republic of China (PRC) available from the State Work Accident Briefing (SWAB) system. Injury incident records related to industries other than coal mining were downloaded from the SWAB system (April 2001 to March 2003). The findings were compared with a previously published regional work fatality study in China, data from the U.S. Census of Fatal Occupational Injuries, and estimates from the International Labor Organization (ILO). During the 2-year period, 1538 work-related events (7046 worker fatalities) were recorded. Collisions (25.6%), drownings (14.6%), and structural collapses (12.5%) were the most frequently reported fatal events. Collisions (24.5%) and falls (14.5%) were the most frequent causes of cited fatal events. Transportation (105.87 per 100 000); mining industries other than coal mining and quarrying (73.28); and electricity, gas, and water supply (14.88) were the industries with the highest estimated fatality rates. Generally, regions with lower economic activity reported more fatalities. The fatal injury rate estimated from the SWAB system was 4.80 per 100,000 (U.S. rate 4.00). ILO estimates for 1994 and 2002 were substantially higher than the estimates derived from the SWAB system. SWAB system differences with other data sources analyzed herein indicate that there remains room for system refinement.

The challenge of cross-cultural collaborative research: lessons learnt from a pilot case-crossover study of severe occupational hand trauma in the People's Republic of China.

OBJECTIVE: A pilot epidemiologic study was conducted in the People's Republic of China to assess the feasibility of applying the study protocol from a US case-crossover study on transient work-related exposures and the risk of an acute occupational hand injury. DESIGN: Injured workers were recruited from a hand surgery center in Ningbo, Zhejiang, People's Republic of China. A structured face-to-face interview questionnaire was administered. RESULTS: 156 workers with hand injury completed the study (73% men). The enrollment rate was 91%. Of those who refused participation, most indicated their reluctance was due to the requirement to sign the written consent form. Considerable variability was found among interviewers in ascertaining responses from participants to important exposure questions (21.3% v 97%). CONCLUSIONS: Recommendations include the following: (1) exploring effective oral-consent protocols that reduce participant concern and still meet human participant protection requirements; (2) using non-physician interviewers; and (3) increasing the intensity and standardization of interviewer training.

Prevalence of low back pain in three occupational groups in Shanghai, People's Republic of China.

PROBLEM: Low back pain (LBP) is one of the most prevalent work-related conditions affecting employed populations in developed countries, yet little is known about this condition among the world's largest, single-nation labor force: The People's Republic of China. METHOD: This is a cross-sectional study of the prevalence of low back pain (LBP) among garment workers, battery/kiln workers, and teachers in Shanghai, People's Republic of China. Data were collected by personal interview and physical examination at six work sites. The overall response rate was 78%. RESULTS: The overall (N=383) self-reported annual prevalence of LBP symptoms lasting 24 hours or more was 50%. Garment workers had a higher annual prevalence of LBP (74%) than teachers (40%), prevalence ratio (PR=1.9, 95% CI=1.4-2.4). DISCUSSION: The overall annual prevalence of self-reported LBP (50%) was higher than that reported among 50 other Chinese employed study populations (30%). Healthy worker effects may have limited the conclusions from this cross-sectional study. SUMMARY: These results suggest that LBP is a prevalent condition in Chinese workers and that more work should be done to estimate its impact on the Chinese workforce. The findings for garment workers were consistent with increased risk of LBP among persons doing work in fixed, sedentary postures.