Chow C Y, Lee H, Lau J, Yu I T S
Occupational Health Services, Labour Department, Hong Kong SAR Government, China.
Occup Environ Med. 2007 Jan;64(1):47-52. doi: 10.1136/oem.2006.028589. Epub 2006 Sep 14.
To identify the remediable transient risk factors of occupational hand injuries in Hong Kong in order to guide the development of prevention strategies.
The case-crossover study design was adopted. Study subjects were workers with acute hand injuries presenting to the government Occupational Medicine Unit for compensation claims within 90 days from the date of injury. Detailed information on exposures to specific transient factors during the 60 minutes prior to the occurrence of the injury, during the same time interval on the day prior to the injury, as well as the usual exposure during the past work-month was obtained through telephone interviews. Both matched-pair interval approach and usual frequency approach were adopted to assess the associations between transient exposures in the workplace and the short-term risk of sustaining a hand injury.
A total of 196 injured workers were interviewed. The results of the matched-pair interval analysis matched well with the results obtained using the usual frequency analysis. Seven significant transient risk factors were identified: using malfunctioning equipment/materials, using a different work method, performing an unusual work task, working overtime, feeling ill, being distracted and rushing, with odds ratios ranging from 10.5 to 26.0 in the matched-pair interval analysis and relative risks ranging between 8.0 and 28.3 with the usual frequency analysis. Wearing gloves was found to have an insignificant protective effect on the occurrence of hand injury in both analyses.
Using the case-crossover study design for acute occupational hand injuries, seven transient risk factors that were mostly modifiable were identified. It is suggested that workers and their employers should increase their awareness of these risk factors, and efforts should be made to avoid exposures to these factors by means of engineering and administrative controls supplemented by safety education and training.
确定香港职业性手部损伤的可纠正的短暂风险因素，以指导预防策略的制定。
采用病例交叉研究设计。研究对象为在受伤之日起90天内到政府职业医学科提出工伤赔偿申请的急性手部损伤工人。通过电话访谈获取受伤前60分钟内、受伤前一天同一时间间隔内以及过去一个工作月内特定短暂因素暴露的详细信息。采用配对间隔法和常规频率法评估工作场所短暂暴露与手部受伤短期风险之间的关联。
共访谈了196名受伤工人。配对间隔分析结果与常规频率分析结果吻合良好。确定了七个显著的短暂风险因素：使用故障设备/材料、采用不同工作方法、执行不寻常工作任务、加班、生病、分心和匆忙，配对间隔分析中的优势比为10.5至26.0，常规频率分析中的相对风险为8.0至28.3。在两种分析中，戴手套对手部受伤的发生均无显著保护作用。
采用病例交叉研究设计对急性职业性手部损伤进行研究，确定了七个大多可改变的短暂风险因素。建议工人及其雇主应提高对这些风险因素的认识，并应通过工程和行政控制措施，辅以安全教育和培训，努力避免接触这些因素。
