Istre G R, Tinnell C, Ouimette D, Gunn R A, Shillam P, Smith G S, Hopkins R
Division of Field Services, Centers for Disease Control, Atlanta, GA.
Public Health Rep. 1989 Mar-Apr;104(2):155-7.
In an investigation of the health effects of a Christmas eve snowstorm in 1982, a review of emergency room records in the Denver area identified a cluster of 17 cases of finger amputations. Fifteen (88) percent of these amputations were associated with snowblower use. An additional 12 persons with hand or finger injuries without amputations from snowblowers were identified. A case-control study was performed comparing these patients with a control group who had used snowblowers. Patients were more likely than controls to have had their machines become clogged with snow (odds ratio [OR], 3.4, 95 percent confidence limits [CL], 0.74-15.4). Using a hand to dislodge trapped snow was the only risk factor identified for the patients (OR, 116; 95 percent CL, 16-820). No differences were found for other variables such as type of snowblower, instruction for use, or previous experience using a snowblower. The findings suggest that the most feasible measure to prevent such injuries is a change in snowblower design to preclude entry of a hand while the machine is running. This investigation illustrates the importance of surveillance in detecting and controlling injuries. Without such surveillance, the similarity among injuries reported on this paper would not have been recognized. Ongoing surveillance for injuries might identify other clusters of injuries.
在一项关于1982年圣诞前夕暴风雪对健康影响的调查中，对丹佛地区急诊室记录的回顾发现了一组17例手指截肢病例。这些截肢病例中有15例（88%）与吹雪机使用有关。另外还发现了12名因吹雪机导致手部或手指受伤但未截肢的患者。开展了一项病例对照研究，将这些患者与使用过吹雪机的对照组进行比较。与对照组相比，患者的吹雪机更有可能被雪堵塞（优势比[OR]为3.4，95%置信区间[CL]为0.74 - 15.4）。对于患者而言，用手清除堵塞的雪是唯一确定的危险因素（OR为116；95%CL为16 - 820）。在吹雪机类型、使用说明或吹雪机使用经验等其他变量方面未发现差异。研究结果表明，预防此类伤害最可行的措施是改变吹雪机设计，以防止在机器运行时手伸进去。这项调查说明了监测在发现和控制伤害方面的重要性。如果没有这种监测，本文所报告的伤害之间的相似性就不会被识别出来。持续的伤害监测可能会发现其他伤害聚集情况。
