Department of Surgery, University of Massachusetts, Worcester, Massachusetts, USA.
J Trauma Acute Care Surg. 2012 Aug;73(2):469-73; discussion 473. doi: 10.1097/TA.0b013e318258437c.
Nonprofessionals routinely perform high-risk home maintenance activities otherwise regulated by the Occupational Health and Safety Administration when professionals perform the same work. Reducing the risks taken by these "weekend warriors" has not been the focus of injury prevention efforts. This study describes injury patterns and outcomes for nonprofessionals attempting home roof and tree maintenance.
We queried our trauma registry for all adult patients (age, ≥18 years) with injury codes for "fall-from-height" or "struck-by-tree" (2005-present) and reviewed charts to determine injuries sustained during home roof or tree work. Patients injured during occupational duties (indicated by Workman's Compensation) were excluded. Descriptive statistics were used to determine patient demographics, injury patterns, and outcomes.
A total of 129 patients were injured performing roof and tree maintenance during the study period. Of these patients, 90 (69.8%) were fall from height and 39 (30.2%) were struck by tree. Mean (SD) age was 45 (14) years. The majority were male (124, 96.1%) and white (116, 89.9%). Nearly half (59, 45.7%) were privately insured; a quarter (32, 24.8%) had no insurance. Mean (SD) Injury Severity Score was 12.7 (9.3). Injury distributions were as follows: head injury, 48.8%; facial fractures, 10.1%; cervical spine fractures, 3.9%; thoracic, lumbar, and sacral spine fractures, 28.1%; rib fractures, 27.3%; intrathoracic injuries, 22.5%; liver/spleen injuries, 6.2%; pelvic fractures, 15.6%; upper-extremity fractures, 27.3%; and lower-extremity fractures, 14.7%. Of the patients, 19 (14.7%) had one or more regions with Abbreviated Injury Scale score of higher than 3. Mean (SD) length of stay was 5.3 (7.6) days. Except for 2 deaths (1.6%), discharge dispositions were as follows: home, 64.2%; home with services, 10.1%; rehabilitation, 17.8%; and skilled nursing, 5.4%.
Weekend warriors performing home roof and tree maintenance sustain serious injuries with a potential for a long-term disability at young ages. Injury prevention efforts should educate the public about the hazards of high-risk home maintenance, possibly encouraging Occupational Health and Safety Administration-regulated protective measures or deferral to trained professionals.
当专业人员从事相同工作时,非专业人员通常会进行职业健康与安全管理局监管的高危家庭维护活动。降低这些“周末勇士”所承担的风险并不是伤害预防工作的重点。本研究描述了非专业人员在家中进行屋顶和树木维护时的伤害模式和结果。
我们在创伤登记处查询了所有年龄在 18 岁及以上的成年患者(2005 年至今),这些患者的伤害代码为“高处坠落”或“被树击中”,并查看了病历以确定在家中进行屋顶或树木工作时受伤的情况。因职业职责受伤的患者(由工人赔偿指示)被排除在外。我们使用描述性统计数据来确定患者的人口统计学特征、伤害模式和结果。
在研究期间,共有 129 名患者在进行屋顶和树木维护时受伤。这些患者中,90 名(69.8%)是从高处坠落,39 名(30.2%)是被树击中。平均(标准差)年龄为 45(14)岁。大多数是男性(124 名,96.1%)和白人(116 名,89.9%)。近一半(59 名,45.7%)是私人保险;四分之一(32 名,24.8%)没有保险。平均(标准差)损伤严重程度评分(ISS)为 12.7(9.3)。损伤分布如下:头部损伤,48.8%;面部骨折,10.1%;颈椎骨折,3.9%;胸、腰、骶脊柱骨折,28.1%;肋骨骨折,27.3%;胸内损伤,22.5%;肝/脾损伤,6.2%;骨盆骨折,15.6%;上肢骨折,27.3%;下肢骨折,14.7%。在这些患者中,有 19 名(14.7%)有一个或多个部位的损伤严重程度评分(Abbreviated Injury Scale,AIS)高于 3。平均(标准差)住院时间为 5.3(7.6)天。除了 2 例死亡(1.6%)外,出院情况如下:居家,64.2%;居家护理,10.1%;康复,17.8%;和熟练护理,5.4%。
在家中进行屋顶和树木维护的周末勇士会遭受严重伤害,且在年轻时期可能会长期残疾。伤害预防工作应教育公众有关高危家庭维护的危险,这可能鼓励职业健康与安全管理局监管的保护措施或推迟给受过训练的专业人员。