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1.
J Orthop Sports Phys Ther ; 51(8): 382, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34338003

RESUMO

When we experience an injury or illness, it can affect our ability to work. Work rehabilitation helps people return to work after an illness or injury. When possible, work rehabilitation can also help people stay at work as they manage their illness or injury. To understand how physical therapists can best support people as they return to work, experts in work rehabilitation reviewed all the available research and discussed what the research means. These experts shared their findings and recommendations in "Clinical Guidance to Optimize Work Participation After Injury or Illness: The Role of Physical Therapists," published in JOSPT in August 2021. J Orthop Sports Phys Ther 2021;51(8):382. doi:10.2519/jospt.2021.0506.


Assuntos
Doenças Profissionais/terapia , Saúde do Trabalhador , Traumatismos Ocupacionais/terapia , Modalidades de Fisioterapia , Retorno ao Trabalho , Humanos , Guias de Prática Clínica como Assunto
2.
J Orthop Sports Phys Ther ; 51(8): 380-381, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34338004

RESUMO

Work rehabilitation refers to the process of assisting workers to remain at work or return to work (RTW) in a safe and productive manner, while limiting the negative impact of work restriction, unemployment, and work disability. The clinical practice guideline (CPG) published in the August 2021 issue of JOSPT provides guidance for physical therapy clinicians when evaluating, treating, and managing individuals who experience limitations in the ability to participate in work following injury or illness. J Orthop Sports Phys Ther 2021;51(8):380-381. doi:10.2519/jospt.2021.0505.


Assuntos
Medicina Baseada em Evidências , Doenças Profissionais/terapia , Saúde do Trabalhador , Traumatismos Ocupacionais/terapia , Modalidades de Fisioterapia , Retorno ao Trabalho , Humanos , Guias de Prática Clínica como Assunto , Fatores de Risco
3.
J Orthop Sports Phys Ther ; 51(8): CPG1-CPG102, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34338006

RESUMO

Work rehabilitation refers to the process of assisting workers to remain at work or return to work (RTW) in a safe and productive manner, while limiting the negative impact of restricted work, unemployment, and work disability. The primary purpose of this clinical practice guideline (CPG) is to systematically review available scientific evidence and provide a set of evidence-based recommendations for effective physical therapy evaluation, treatment, and management of individuals experiencing limitations in the ability to participate in work following injury or illness. J Orthop Sports Phys Ther 2021;51(8):CPG1-CPG102. doi:10.2519/jospt.2021.0303.


Assuntos
Doenças Profissionais/terapia , Saúde do Trabalhador , Traumatismos Ocupacionais/terapia , Modalidades de Fisioterapia , Retorno ao Trabalho , Avaliação da Deficiência , Humanos
4.
Br J Sports Med ; 55(15): 843-850, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33837002

RESUMO

OBJECTIVES: To describe the incidence rate, severity, burden and aetiology of medical attention and time-loss injuries across five consecutive seasons at a professional ballet company. METHODS: Medical attention injuries, time-loss injuries and dance exposure hours of 123 professional ballet dancers (women: n=66, age: 28.0±8.3 years; men: n=57, age: 27.9±8.5 years) were prospectively recorded between the 2015/2016 and 2019/2020 seasons. RESULTS: The incidence rate (per 1000 hours) of medical attention injury was 3.9 (95% CI 3.3 to 4.4) for women and 3.1 (95% CI 2.6 to 3.5) for men. The incidence rate (per 1000 hours) of time-loss injury was 1.2 (95% CI 1.0 to 1.5) for women and 1.1 (95% CI 0.9 to 1.3) for men. First Soloists and Principals experienced between 2.0-2.2 additional medical attention injuries per 1000 hours and 0.9-1.1 additional time-loss injuries per 1000 hours compared with Apprentices (p≤0.025). Further, intraseason differences were observed in medical attention, but not time-loss, injury incidence rates with the highest incidence rates in early (August and September) and late (June) season months. Thirty-five per cent of time-loss injuries resulted in over 28 days of modified dance training. A greater percentage of time-loss injuries were classified as overuse (women: 50%; men: 51%) compared with traumatic (women: 40%; men: 41%). CONCLUSION: This is the first study to report the incidence rate of medical attention and time-loss injuries in professional ballet dancers. Incidence rates differed across company ranks and months, which may inform targeted injury prevention strategies.


Assuntos
Absenteísmo , Dança/lesões , Traumatismos Ocupacionais/epidemiologia , Adulto , Intervalos de Confiança , Dança/estatística & dados numéricos , Feminino , Humanos , Incidência , Escala de Gravidade do Ferimento , Masculino , Sistema Musculoesquelético/lesões , Traumatismos Ocupacionais/classificação , Traumatismos Ocupacionais/terapia , Estudos Prospectivos , Estações do Ano , Distribuição por Sexo , Fatores de Tempo
5.
J Hand Surg Asian Pac Vol ; 26(2): 274-279, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33928866

RESUMO

Closed traumatic rupture of forearm flexor muscles has been reported rarely. Previous reports have included ruptures of the flexor digitorum profundus, flexor digitorum superficialis, flexor pollicis longus, flexor carpi radialis, pronator quadratus and the palmaris longus. We report a patient with a closed traumatic rupture through the muscle belly of the flexor carpi ulnaris and summarise the published literature on ruptures involving the forearm flexor muscles. Overall, conservative treatment can result in excellent outcomes. Early surgical intervention is recommended in patients with nerve involvement and compartment syndrome and delayed reconstruction may be considered for patients with functional deficits.


Assuntos
Traumatismos do Antebraço/terapia , Músculo Esquelético/lesões , Ruptura/terapia , Adulto , Terapia por Exercício , Traumatismos do Antebraço/diagnóstico por imagem , Humanos , Imobilização , Imageamento por Ressonância Magnética , Masculino , Músculo Esquelético/diagnóstico por imagem , Traumatismos Ocupacionais/terapia , Ruptura/diagnóstico por imagem , Contenções
6.
Int J Mol Sci ; 22(3)2021 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-33525484

RESUMO

Each day, about 2000 U.S. workers have a job-related eye injury requiring medical treatment. Corneal diseases are the fifth cause of blindness worldwide. Most of these diseases can be cured using one form or another of corneal transplantation, which is the most successful transplantation in humans. In 2012, it was estimated that 12.7 million people were waiting for a corneal transplantation worldwide. Unfortunately, only 1 in 70 patients received a corneal graft that same year. In order to provide alternatives to the shortage of graftable corneas, considerable progress has been achieved in the development of living corneal substitutes produced by tissue engineering and designed to mimic their in vivo counterpart in terms of cell phenotype and tissue architecture. Most of these substitutes use synthetic biomaterials combined with immortalized cells, which makes them dissimilar from the native cornea. However, studies have emerged that describe the production of tridimensional (3D) tissue-engineered corneas using untransformed human corneal epithelial cells grown on a totally natural stroma synthesized by living corneal fibroblasts, that also show appropriate histology and expression of both extracellular matrix (ECM) components and integrins. This review highlights contributions from laboratories working on the production of human tissue-engineered corneas (hTECs) as future substitutes for grafting purposes. It overviews alternative models to the grafting of cadaveric corneas where cell organization is provided by the substrate, and then focuses on their 3D counterparts that are closer to the native human corneal architecture because of their tissue development and cell arrangement properties. These completely biological hTECs are therefore very promising as models that may help understand many aspects of the molecular and cellular mechanistic response of the cornea toward different types of diseases or wounds, as well as assist in the development of novel drugs that might be promising for therapeutic purposes.


Assuntos
Córnea/citologia , Lesões da Córnea/terapia , Traumatismos Ocupacionais/terapia , Engenharia Tecidual/métodos , Transplante de Córnea , Humanos , Modelos Biológicos , Tecidos Suporte
7.
Phys Ther ; 101(1)2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-32949123

RESUMO

OBJECTIVE: Persistent low back pain (PLBP) is a common and costly health problem worldwide. Better strategies to manage it are required. The purpose of this study was to longitudinally evaluate absenteeism, pain, and disability in nurses with PLBP following a cognitive functional therapy (CFT) intervention. METHODS: In this case series pilot study, 33 eligible nurses with PLBP were recruited. During the baseline phase (phase A; no intervention), outcome measures were collected on 2 occasions 6 months apart (A1 and A2). During phase B, participants received an individualized CFT intervention for 14 weeks. During phase C (no intervention), outcomes were measured immediately after the intervention, as well as 3, 6, 9, 12, and 36 months after the intervention (secondary outcomes only until 12 months). LBP-related work absenteeism, pain intensity (numerical pain rating scale) and disability (Oswestry Disability Index) were the primary outcomes. Health care seeking, a range of psychological and lifestyle variables, and global perceived effect were secondary outcomes. RESULTS: Days of absenteeism due to LBP were significantly reduced in the first and second calendar years after the CFT intervention but not the third and fourth. Disability was significantly reduced immediately after (-4.4; 95% CI = -6.5 to -2.2) and at 3 months (-4.3; 95% CI = -6.6 to -2.0), 9 months (-6.0; 95% CI = -8.1 to -3.9), and 12 months (-4.9; 95% CI = -7.0 to -2.8) after the intervention. Pain was significantly reduced immediately after (-1.2; 95% CI = -1.7 to -0.8) and at 3 months (-1.5; 95% CI = -2.0 to -0.9), 9 months (-1.1; 95% CI = -1.9 to -0.3), and 12 months (-0.9; 95% CI = -1.5 to -0.2) after the intervention. Total health care seeking (consults and proportion of participants) was significantly reduced after the intervention. All psychosocial variables, except for 1, demonstrated significant improvements at all follow-up assessments. CONCLUSIONS: This case series pilot study demonstrated significant reductions in LBP-related absenteeism, pain intensity, disability, health care seeking, and several psychological and lifestyle behaviors until the 1-year follow-up among nurses with PLBP following an individualized CFT intervention. Further evaluation of the efficacy of CFT in high-quality randomized clinical trials among nurses is recommended.


Assuntos
Absenteísmo , Dor Crônica/terapia , Terapia Cognitivo-Comportamental/métodos , Exercício Físico , Dor Lombar/terapia , Enfermeiras e Enfermeiros , Traumatismos Ocupacionais/terapia , Adulto , Avaliação da Deficiência , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Saúde do Trabalhador , Medição da Dor , Projetos Piloto
8.
Workplace Health Saf ; 69(3): 109-114, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33357039

RESUMO

BACKGROUND: Cryogenic burns induced by coolant gases used in refrigerators and air conditioners are rarely encountered, despite the wide use of these gases. To date, only a few cases have been reported in the literature. This study examined the occupational circumstances leading to such injuries, relevant injury sites, types of chemicals involved, and treatment measures. METHODS: This study was conducted in a tertiary burn center in India between March 2015 and March 2019. The demographic details, chemicals involved, and burn regions and characteristics were analyzed. FINDINGS: There were 15 burn cases all involving injury to the hand. All injuries were managed initially with dressings and nonoperative management. One patient required anti-edema therapy with limb elevation and fingertip debridement, while another patient required skin grafting. All patients had satisfactory hand function after treatment. CONCLUSIONS/APPLICATION TO PRACTICE: Cryogenic burn injuries caused by refrigerants are rare, and their etiology varies considerably. Exposure time is the primary factor that determines burn depth and severity; hence, reducing exposure time is important in first aid. Our findings suggest that after exposure, the patient should be treated in a specialized burn center. Adequate knowledge regarding the pathophysiology of these types of burn injuries and their management is necessary; otherwise, misjudgments in the treatment plan can lead to adverse consequences.


Assuntos
Lesão por Frio/etiologia , Traumatismos da Mão/etiologia , Traumatismos Ocupacionais/etiologia , Adolescente , Adulto , Lesão por Frio/terapia , Fluorcarbonetos , Traumatismos da Mão/terapia , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Traumatismos Ocupacionais/terapia , Estudos Retrospectivos , Transplante de Pele
9.
Jt Dis Relat Surg ; 31(3): 614-618, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32962598

RESUMO

This case report presents a 21-year-old male construction worker with ipsilateral inferior shoulder and posterior elbow dislocations, accompanied with other injuries. Such a combination of injury undoubtedly occurs; however, to the best of our knowledge, this is the first reported case. The prompt closed reductions without waiting for anesthesia were accomplished without the help of an assistant using a novel technique. The patient returned to his job with considerable recovery of motion and strength despite his permanent paralysis of the deltoid muscle and he was still employed as a worker after four years. He was abducting his arm by using his accessory muscles, which contribute to abduction when arm is externally rotated. The maneuver described in the report can be used to reduce all inferior shoulder dislocations and it is worth to know that working at a job requiring high level of activity is still possible despite a permanent loss of axillary nerve function.


Assuntos
Indústria da Construção , Articulação do Cotovelo/lesões , Traumatismo Múltiplo/terapia , Traumatismos Ocupacionais/terapia , Procedimentos Ortopédicos/métodos , Luxação do Ombro/terapia , Plexo Braquial/lesões , Humanos , Masculino , Retorno ao Trabalho , Adulto Jovem
10.
J Safety Res ; 74: 227-232, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32951787

RESUMO

INTRODUCTION: Symptoms of depression and anxiety are a common consequence of occupational injury regardless of its cause and type. Nevertheless, mental health care is rarely covered by workers' compensation systems. The aim of this study was to assess the use of mental health care post-injury. METHODS: We used a subsample of patient-care workers from the Boston Hospital Workers Health Study (BHWHS). We matched one injured worker with three uninjured workers during the period of 2012-2014 based on age and job title (nurse or patient-care associate) and looked at their mental health care use pre- and post-injury using medical claims data from the employer sponsored health plan. We used logistic regression analysis to assess the likelihood of mental health care use three and six months post-injury controlling for any pre-injury visits. Analyses were repeated separately by job title. RESULTS: There were 556 injured workers between 2012 and 2014 that were matched with three uninjured workers at the time of injury (n = 1,649). Injured workers had a higher likelihood of seeking mental health care services than their uninjured counterparts during the six months after injury (OR = 1.646, 95% CI: 1.23-2.20), but not three months post-injury (OR = 0.825, 95% CI: 0.57-1.19). Patient-care associates had a higher likelihood to seek mental health care post-injury, than nurses (OR: 2.133 vs OR: 1.556) during the six months period. CONCLUSIONS: Injured workers have a higher likelihood to experience symptoms of depression and anxiety based on their use of mental health care post-injury and use is more predominant among patient-care associates; however, our sample has a small number of patient-care associates. Practical Applications: Treating depression and anxiety as part of the workers' compensation system has the potential of preventing further physical ailment and improving the return to work process regardless of nature of injury.


Assuntos
Atenção à Saúde/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Saúde Mental/estatística & dados numéricos , Saúde do Trabalhador/estatística & dados numéricos , Traumatismos Ocupacionais/terapia , Boston , Estudos de Coortes , Pessoal de Saúde/classificação , Hospitais , Traumatismos Ocupacionais/psicologia , Indenização aos Trabalhadores/normas
11.
J Occup Environ Med ; 62(7): e328-e333, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32730036

RESUMO

OBJECTIVE: To quantify the association between physical therapy (PT) visits and workers' compensation costs and lost time. METHOD: A total of 40,203 lost-time claims (1998 to 2018) were analyzed. RESULTS: The odds ratio of total paid claim costs more than or equal to $100,000 increased with the number of PT visits from 1.91 with 1 to 3 PT visits (95% confidence interval [CI]: 1.62 to 2.26) to 5.56 (95% CI: 4.86 to 6.37) for workers with a surgical procedure and more than or equal to 50 PT visits versus those without PT visits, when controlling for confounding factors. The risk of remaining at an off work status is greatest among claims involving surgery, escalating among claims with 15 or more PT visits (hazard ratio more than or equal to 3.76). CONCLUSIONS: PT visits may be used as a marker for high workers' compensation cost and delayed return-to-work.


Assuntos
Modalidades de Fisioterapia/estatística & dados numéricos , Licença Médica/economia , Indenização aos Trabalhadores/economia , Feminino , Humanos , Revisão da Utilização de Seguros , Louisiana/epidemiologia , Masculino , Traumatismos Ocupacionais/economia , Traumatismos Ocupacionais/epidemiologia , Traumatismos Ocupacionais/terapia , Razão de Chances , Modalidades de Fisioterapia/economia , Licença Médica/estatística & dados numéricos , Indenização aos Trabalhadores/estatística & dados numéricos
12.
J Cardiothorac Surg ; 15(1): 143, 2020 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-32552776

RESUMO

BACKGROUND: High voltage electrical injury (HVEI) of more than 1000 V is a potentially devastating form of a multisystem injury associated with high morbidity and mortality. We present the first case of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) as a life saving device for treating a patient with severe cardiogenic shock after a high voltage electrical injury. CASE PRESENTATION: A 26-year-old male sustained HVEI while working with a concrete mixer pump that came in contact with a high voltage cable of 10,000 V. He was immediately disconnected from the mixer pump, underwent cardiopulmonary resuscitation and was transported to the nearest medical centre with severe cardiogenic shock with an ejection fraction (EF) of < 10%. Upon arrival, he was in critical condition, sedated and mechanically ventilated, haemodynamically unstable and supported by intravenous (IV) inotropes after a few events of ventricular fibrillation, with an electrical entry point on the left hand and an exit point located on his right leg. Blood pH was 6.8, PCO2 53 mmHg, PaO2 of 57 mmHg, lactate 8 mmol/L, and Troponin 38,000 ng/dl. The EF was 10% with global severe left ventricular dysfunction. During cardiopulmonary resuscitation (CPR), including cardiac massage and few electrical shocks, he was immediately connected to the VA-ECMO via open right femoral approach with distal arterial leg perfusion. He was treated with IV broad spectrum antibiotics, and high volume fluids to prevent rhabdomyolysis-induced acute kidney injury, total parenteral nutrition, topical silver sulfadiazine cream, and Granuflex for severe electrical burns. He was gradually weaned from inotropes over the next 3 days, during which his clinical condition and bloodwork improved tremendously. His EF gradually increased to 50% and he was weaned from the VA-ECMO, and underwent decannulation 86 h after initialization. He was discharged on day 27 without any sequelae. CONCLUSION: The VA-ECMO treatment can be a lifesaving device for treating severe cardiogenic shock caused by high voltage electrical injury, and should be considered while treating these "high-mortality risk" patients.


Assuntos
Reanimação Cardiopulmonar , Traumatismos por Eletricidade/terapia , Oxigenação por Membrana Extracorpórea , Hemodinâmica , Choque Cardiogênico/terapia , Adulto , Queimaduras por Corrente Elétrica , Ecocardiografia , Massagem Cardíaca , Humanos , Masculino , Traumatismos Ocupacionais/terapia , Radiografia Torácica , Choque Cardiogênico/etiologia
13.
Med Probl Perform Art ; 35(2): 110-115, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32479587

RESUMO

BACKGROUND: Professional musicians frequently suffer from musculoskeletal complaints and disorders (MCD), which can be treated by osteopathic manipulative treatment (OMT). The aim of this systematic review was to evaluate the effectiveness and efficacy of OMT in adult musicians. METHODS: A systematic literature search included the electronic databases PubMed/MEDLINE, Medpilot, EBSCOhost, BioMedCentral, OSTMED-Dr, osteopathic-research.com, PEDro, hand searches, and contact to European osteopathic academies. Interventional and observational studies published between January 1999 and January 2019, of professional or amateur musicians who were either healthy or had MCD treated by OMT, were included. The quality of the randomized controlled trials (RCTs) was assessed by the Physiotherapy Evidence Database (PEDro) Scale ranging between 0 and 10 points. RESULTS: Only 5 studies were identified investigating OMT in musicians, including 1 RCT (cross-over design), 3 clinical controlled trials, and 1 case report. The internal validity of the RCT was assessed as 6 points. OMT was reported to have a positive impact on healthy singers, improving phonation time, voice quality, and voice range. It also improved the cervical range of motion in violinists. No adverse events were observed, although only the cross-over RCT reported partly an assessment of adverse events. CONCLUSIONS: The evidence for OMT in adult musicians is very limited. Prospective controlled clinical trials investigating OMT in musicians are required.


Assuntos
Manipulação Osteopática , Doenças Musculoesqueléticas , Música , Traumatismos Ocupacionais , Adulto , Nível de Saúde , Humanos , Traumatismos Ocupacionais/terapia , Estudos Prospectivos , Resultado do Tratamento
14.
Work ; 66(2): 383-404, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32568155

RESUMO

BACKGROUND: Living and working with chronic pain requires persons to alter lifestyles and have the knowledge as well as support to manage unforeseen challenges. Knowledge for persons living with pain who want to participate in meaningful paid and unpaid work is not easily accessible. While there is literature on chronic pain management, work transitions and return to work, less emphasis has been placed on the complexity of living and working with chronic pain. The Creating a Way Forward Project was envisioned to address this gap and to identify the informational needs of workers with pain, health/helping professionals (workers' advisors, return to work specialists, legal representatives), and stakeholders. The overarching aim of the project was to use evidence and experiential knowledge to inform the development of a foundation for educational guides and toolkits to support workers with pain to achieve their outcomes for remaining at work. METHODS: Phase one of the project involved a scoping review of chronic pain and work. Phase two involved stakeholder consultations, a focus group and knowledge integration of the literature and experiential insights. Knowledge synthesis drew on a Template Analysis of multiple sources of data. RESULTS: Knowledge domains and key components were identified for persons with pain and for the health/helping professions. CONCLUSION: These domains reflect a foundation for knowledge in practical training and the development of curriculum for education in self-management program and in inter professional health profession education. These knowledge domains provide a basis for future research in integrated approaches and knowledge use toward improving transitions for persons living with chronic pain who want to participate in productive paid and unpaid work. Ongoing research in knowledge domains that health providers and persons with pain need will expand the potential for improving health outcomes in living with and managing pain.


Assuntos
Dor Crônica/terapia , Guias como Assunto/normas , Traumatismos Ocupacionais/terapia , Grupos Focais/métodos , Humanos , Pesquisa Qualitativa , Autogestão/métodos
16.
Am J Ind Med ; 63(5): 381-393, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32144801

RESUMO

Exposure to retained metal fragments from war-related injuries can result in increased systemic metal concentrations, thereby posing potential health risks to target organs far from the site of injury. Given the large number of veterans who have retained fragments and the lack of clear guidance on how to medically manage these individuals, the Department of Veterans Affairs (VA) convened a meeting of chelation experts and clinicians who care for embedded fragment patients to discuss current practices and provide medical management guidance. Based on this group's clinical expertise and review of published literature, the evidence presented suggests that, at least in the case of lead fragments, short-term chelation therapy may be beneficial for embedded fragment patients experiencing acute symptoms associated with metal toxicity; however, in the absence of clinical symptoms or significantly elevated blood lead concentrations (greater than 80 µg/dL), chelation therapy may offer little to no benefit for individuals with retained fragments and pose greater risks due to remobilization of metals stored in bone and other soft tissues. The combination of periodic biomonitoring to assess metal body burden, longitudinal fragment imaging, and selective fragment removal when metal concentrations approach critical injury thresholds offers a more conservative management approach to caring for patients with embedded fragments.


Assuntos
Terapia por Quelação/métodos , Corpos Estranhos/terapia , Metais/efeitos adversos , Traumatismos Ocupacionais/terapia , Lesões Relacionadas à Guerra/terapia , Humanos , Medicina Militar/métodos , Militares , Exposição Ocupacional/efeitos adversos , Resultado do Tratamento , Estados Unidos , United States Department of Veterans Affairs
17.
Sci Rep ; 10(1): 1208, 2020 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-31988287

RESUMO

PURPOSE: To investigate the clinical characteristics and visual outcomes of patients with work-related open globe injuries (OGIs) and compare them with patients with non-work-related OGIs. DESIGN: Retrospective, observational, multicentre, case-control study. METHODS: A total of 374 patients with work-related OGIs and 170 patients with non-work-related OGIs who presented to hospitals that belong to the Japan-Clinical Research of Study group from 2005 to 2015 were included in this study. Clinical data including age, sex, initial and final visual acuity, type of open globe injury, lens status, zone of injury, wound length, and presence of proliferative vitreoretinopathy, retinal detachment, expulsive haemorrhage, and endophthalmitis were recorded. MAIN OUTCOME MEASURES: Visual acuity. Results Work-related OGIs were associated with younger age, male sex, better initial and final visual acuity, more laceration, smaller wounds, presence of retinal detachment, and expulsive haemorrhage, compared with non-work-related OGIs. Multiple regression analysis revealed that final visual acuity is significantly associated with initial visual acuity, wound length, and the presence of proliferative vitreoretinopathy in work-related OGIs. CONCLUSIONS: Work-related OGIs showed better visual outcomes than other OGIs. Initial visual acuity, wound length, and the presence of proliferative vitreoretinopathy are predictors of visual outcomes in patients with work-related OGIs.


Assuntos
Lesões Acidentais/patologia , Ferimentos Oculares Penetrantes/patologia , Traumatismos Ocupacionais/patologia , Lesões Acidentais/complicações , Lesões Acidentais/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Criança , Pré-Escolar , Ferimentos Oculares Penetrantes/complicações , Ferimentos Oculares Penetrantes/terapia , Feminino , Seguimentos , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Traumatismos Ocupacionais/complicações , Traumatismos Ocupacionais/terapia , Estudos Retrospectivos , Resultado do Tratamento , Acuidade Visual , Vitreorretinopatia Proliferativa/etiologia , Ferimentos e Lesões/patologia , Adulto Jovem
18.
Burns ; 46(2): 298-302, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31780278

RESUMO

INTRO: There were over 60 firefighter line of duty deaths and roughly 30,000 injuries in the United States in 2016. Modern thermoprotective gear has reduced the risks firefighters face from both thermal and inhalation injury, but must be used properly to be effective. The purpose of this study is to examine gear use and associated injury in firefighters. METHODS: Surveys were distributed with questions about demographics, gear usage, and maintenance practices. If previously injured, firefighters described the injury, treatment, and recovery. RESULTS: Of the 50 surveys distributed, 37 were returned (72%). A majority of respondents (70%) reported wearing incomplete gear. Those who reported injury were more likely to have omitted gear (81% vs 45%). For all respondents, the items most commonly omitted were hood (58%), gloves (22%), and earflaps (22%). Regular cleaning of gear was not practiced by 39% of burned respondents and 46% had not had their gear sized within 2 years. Serious burns were reported by 41% of respondents. Mean burn size was 7% total body surface area (TBSA), and 11% reported self-treating their burns, including 63.5% who continued to work despite suffering a 2nd or 3rd degree burn injury. Only 17% were treated at a burn center, and this group missed anywhere from two shifts to 8 months of work. CONCLUSIONS: Firefighters risk injury by omitting gear and not adhering to National Fire Protection Association (NFPA) guidelines on gear sizing, maintenance, and station wear. Firefighters also frequently self-treat serious burns despite unique considerations regarding re-injury. National trends related to gear use and injury risk should be studied further, and standards should be developed for ensuring safe return to work.


Assuntos
Queimaduras/epidemiologia , Bombeiros/estatística & dados numéricos , Traumatismos Ocupacionais/epidemiologia , Equipamento de Proteção Individual/estatística & dados numéricos , Adulto , Idoso , Superfície Corporal , Queimaduras/patologia , Queimaduras/terapia , Vestuário/estatística & dados numéricos , Dispositivos de Proteção das Orelhas/estatística & dados numéricos , Utilização de Equipamentos e Suprimentos , Feminino , Luvas Protetoras/estatística & dados numéricos , Fidelidade a Diretrizes , Humanos , Masculino , Pessoa de Meia-Idade , Saúde do Trabalhador , Traumatismos Ocupacionais/patologia , Traumatismos Ocupacionais/terapia , Projetos Piloto , Dispositivos de Proteção Respiratória , Autocuidado , Sudeste dos Estados Unidos/epidemiologia , Inquéritos e Questionários
19.
Workplace Health Saf ; 68(5): 209-213, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31735132

RESUMO

Background: Uncontrolled blood loss is a primary source of preventable death after injury. Workplace injuries and fatalities are common, with most occurring in the agricultural/fishing/forestry/hunting or transportation/warehousing industries. Stop the Bleed (STB) training provides instruction on application of bleeding control methods to injured persons and is available to the general public. Method: We provided an overview of high-risk injury industries that could benefit from STB training. We also provided a review of the application of STB training and bleeding control methods in occupational settings with an emphasis on the role of the occupational health nurse. Findings: Suggested guidelines for occupational health nurses and employees in occupational settings who may respond to injured colleagues are provided. Implications for occupational health nurses are reviewed, including implementing STB training in the workplace and obtaining/storing bleeding control supplies. Resources for STB training, purchasing and storing bleeding control supplies, and general emergency response information are provided. Conclusions/application to practice: Occupational health nurses play a crucial role in emergency response in the workplace and have the ability to drive the implementation of STB training in their institution. Occupational health nurses often work in isolation or in small teams and serve as a primary resource for treatment of injured employees. Implementation of STB training for all employees is highly recommended given the limited availability of occupational health nurses in large or rural settings. Such training may reduce the morbidity and mortality associated with workplace injuries.


Assuntos
Hemorragia/prevenção & controle , Técnicas Hemostáticas/instrumentação , Enfermagem do Trabalho/métodos , Medicina de Emergência/educação , Medicina de Emergência/métodos , Primeiros Socorros/instrumentação , Primeiros Socorros/métodos , Primeiros Socorros/enfermagem , Hemorragia/terapia , Humanos , Enfermagem do Trabalho/educação , Traumatismos Ocupacionais/terapia , Torniquetes
20.
Am J Ind Med ; 63(2): 180-187, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31725184

RESUMO

OBJECTIVES: To identify patterns of health service use (HSU) in truck drivers with work-related injury or illness and to identify demographic and work-related factors associated with patterns of care. METHOD: All accepted workers' compensation claims from truck drivers lodged between 2004 and 2013 in Victoria were included. Episodes of HSU were categorised according to practitioner type. Latent class analysis was used to identify the distinct profiles of users with different patterns of HSU. Multinomial logistic regression was used to examine the associations between latent class and predictors. RESULTS: Four profiles of HSU were identified: (a) Low Service Users (55% of the sample) were more likely to be younger, have an injury that did not result in time off work and have conditions other than a musculoskeletal injury; (b) High Service Users (10%) tended to be those aged between 45 and 64 years, living in major cities with musculoskeletal conditions that resulted in time off work; (c) Physical Therapy Users (25%) were more likely to be aged between 45 and 64 years, live in major cities and have nontraumatic injuries that resulted in time off work; and (d) GP/Mental Health Users (10%) were more likely to be over 24 years of age, from the lowest socioeconomic band, be employed by smaller organizations and be claiming benefits for a mental health condition. CONCLUSIONS: This study identified distinct categories of HSU among truck drivers following work-related injury. The results can be used to prioritize occupational health and safety promotion to maintain a healthy truck driver work force.


Assuntos
Acidentes de Trabalho/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Condução de Veículo , Serviços de Saúde/estatística & dados numéricos , Traumatismos Ocupacionais/epidemiologia , Traumatismos Ocupacionais/terapia , Adulto , Humanos , Análise de Classes Latentes , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Vitória/epidemiologia , Indenização aos Trabalhadores
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