Mancini G, Baldasseroni A, Laffi G, Curti S, Mattioli S, Violante F S
Occupational Health Service, Azienda USL di Ravenna, Ravenna, Italy.
Occup Environ Med. 2005 Dec;62(12):830-5. doi: 10.1136/oem.2004.019570.
Systematic assessments of the effectiveness of interventions to prevent work related eye injuries are needed.
To investigate the long term effectiveness of a multicomponent prevention campaign.
The campaign (conducted in collaboration with the local Employers' Association and Trade Unions) targeted all 237 metal-ware factories in the district of Imola, Italy. Based on preliminary inspections, the main intervention included distribution to all factories of specific educational brochures and broadcasting/publication of television/radio programmes and local newspaper articles containing expert advice on the subject. This was followed by a four year "post-intervention reinforcement" period of unannounced official inspections. Main outcome measures analysed were eye injury rates (versus non-eye injury rates) among metal workers during "pre-intervention" (1988-90), "peri-intervention" (1991-92), "post-intervention reinforcement" (1993-96), "late post-intervention" (1997-2000), and "very late post-intervention" (2001-03) periods with respect to two comparison sectors (construction and wood/ceramics).
A Poisson regression in which the eye injury rates were modelled for each sector, period, and interaction, adjusting for non-eye injury rates, was chosen. The periods did not by themselves determine an overall reduction in eye injuries. The period/sector interaction terms were related to significant reductions for the metal sector when crossed with the "post-intervention reinforcement" (IRR = 0.77, 95% CI 0.61 to 0.97; % decline = 23.4), the "late post-intervention" (IRR = 0.63, 95% CI 0.50 to 0.79; % decline = 37.4), and the "very late post-intervention" (IRR = 0.58, 95% CI 0.43 to 0.77; % decline = 42.4) periods, suggesting a sustained reduction in eye injury risk following the main intervention.
Results suggest that a carefully coordinated, extensive, multicomponent intervention can lead to lasting reductions in the burden of eye injuries.
需要对预防与工作相关眼外伤的干预措施的有效性进行系统评估。
调查一项多组分预防活动的长期有效性。
该活动(与当地雇主协会和工会合作开展)针对意大利伊莫拉地区的所有237家金属制品工厂。基于初步检查,主要干预措施包括向所有工厂分发特定的教育宣传册,并播放/发布包含该主题专家建议的电视/广播节目和当地报纸文章。随后是为期四年的“干预后强化”期,期间进行不定期的官方检查。分析的主要结局指标是金属工人在“干预前”(1988 - 1990年)、“干预期间”(1991 - 1992年)、“干预后强化”(1993 - 1996年)、“干预后期”(1997 - 2000年)和“干预非常后期”(2001 - 2003年)期间相对于两个对照行业(建筑和木材/陶瓷)的眼外伤发生率(与非眼外伤发生率相比)。
选择了一种泊松回归模型,其中针对每个行业、时期和相互作用对眼外伤发生率进行建模,并对非眼外伤发生率进行调整。这些时期本身并没有导致眼外伤总体减少。当与“干预后强化”期(发病率比 = 0.77,95%置信区间0.61至0.97;下降百分比 = 23.4)、“干预后期”(发病率比 = 0.63,95%置信区间0.50至0.79;下降百分比 = 37.4)和“干预非常后期”(发病率比 = 0.58,95%置信区间0.43至0.77;下降百分比 = 4,2.4)交叉时,时期/行业相互作用项与金属行业的显著减少相关,这表明主要干预后眼外伤风险持续降低。
结果表明,精心协调、广泛的多组分干预可导致眼外伤负担的持续减轻。