National Institute for Occupational Safety and Health, Division of Safety Research, Analysis and Field Evaluations Branch, Morgantown, West Virginia 26506, USA.
Am J Prev Med. 2011 Jul;41(1):61-7. doi: 10.1016/j.amepre.2011.03.007.
Although traumatic brain injury (TBI) is one of the leading causes of death and disability in the U.S., work-related TBI has not been well documented.
The aim of this study was to describe the epidemiologic characteristics and temporal trends of fatal occupational TBI in the U.S between 2003 and 2008.
A cross-sectional analysis of the Census of Fatal Occupational Injury database was performed. Both the Occupational Injury and Illness Classification System nature of injury codes and body part codes were used to define TBIs. Fatality rates were calculated using denominators derived from the Current Population Survey. Fatality rates were compared among industries, cause of death, and demographics with rate ratios (RRs) and 95% CIs. Poisson regression was used to assess trends in fatality rates. Data were analyzed in 2009-2010.
Nearly 7300 occupational TBI deaths occurred between 2003 and 2008, for an average fatality rate of 0.8 per 100,000 workers per year. The leading causes of occupational TBI death were as follows: motor vehicle (31%); falls (29%); assaults and violent acts (20%); and contact with objects/equipment (18%). Fatality rates were 15 times higher in men compared with women (RR=15, 95% CI=13.7, 16.3). Workers aged ≥65 years experienced the highest TBI fatality rate of all age groups (2.5 per 100,000 per year). Construction, transportation, and agriculture/forestry/fishing industries recorded nearly half of all TBI fatalities (n=1828, n=825, n=761, respectively). Occupational TBI death rates declined 23% over the 6-year period (p<0.0001).
This study provides the first national profile of fatal TBIs occurring in the U.S. workplace. Prevention efforts should be directed at those industries with the highest frequency and/or highest risk. The construction industry had the highest number of TBIs, and the agriculture, forestry, and fishing industry had the highest rates. Additionally, workers aged >65 years in all industries would be a good target for future prevention efforts.
尽管创伤性脑损伤（TBI）是美国导致死亡和残疾的主要原因之一，但与工作相关的 TBI 并未得到很好的记录。
本研究旨在描述 2003 年至 2008 年期间美国致命职业性 TBI 的流行病学特征和时间趋势。
对职业伤害和疾病分类系统的伤害性质代码和身体部位代码进行了普查性死亡职业伤害数据库的横断面分析，以定义 TBI。使用来自当前人口调查的分母计算死亡率。使用率比（RR）和 95%置信区间（CI）比较行业、死因和人口统计学之间的死亡率。使用泊松回归评估死亡率趋势。数据于 2009-2010 年进行分析。
2003 年至 2008 年间发生了近 7300 例职业性 TBI 死亡，平均每年每 100000 名工人中有 0.8 人死亡。职业性 TBI 死亡的主要原因如下：机动车（31%）；跌倒（29%）；攻击和暴力行为（20%）；以及与物体/设备接触（18%）。男性的死亡率是女性的 15 倍（RR=15，95%CI=13.7，16.3）。所有年龄组中，年龄≥65 岁的工人 TBI 死亡率最高（每年每 100000 人 2.5）。建筑、运输和农业/林业/渔业行业记录了近一半的所有 TBI 死亡人数（分别为 1828 人、825 人、761 人）。在 6 年期间，职业性 TBI 死亡率下降了 23%（p<0.0001）。
本研究提供了美国工作场所发生致命性 TBI 的首个全国概况。预防工作应针对那些频率最高和/或风险最高的行业。建筑行业 TBI 数量最多，农业、林业和渔业行业发病率最高。此外，所有行业中年龄>65 岁的工人将是未来预防工作的一个很好的目标。
