美国劳动者与热相关疾病的风险因素：职业安全与健康管理局的一系列病例。
Risk Factors for Heat-Related Illness in U.S. Workers: An OSHA Case Series.
机构信息
Office of Occupational Medicine and Nursing, Directorate of Technical Support and Emergency Management, Occupational Safety and Health Administration, Washington, District of Columbia.
出版信息
J Occup Environ Med. 2018 Aug;60(8):e383-e389. doi: 10.1097/JOM.0000000000001365.
OBJECTIVE
The aim of this study was to describe risk factors for heat-related illness (HRI) in U.S. workers.
METHODS
We reviewed a subset of HRI enforcement investigations conducted by the Occupational Safety and Health Administration (OSHA) from 2011 through 2016. We assessed characteristics of the workers, employers, and events. We stratified cases by severity to assess whether risk factors were more prevalent in fatal HRIs.
RESULTS
We analyzed 38 investigations involving 66 HRIs. Many workers had predisposing medical conditions or used predisposing medications. Comorbidities were more prevalent in workers who died. Most (73%) fatal HRIs occurred during the first week on the job. Common clinical findings in heat stroke cases included multiorgan failure, muscle breakdown, and systemic inflammation.
CONCLUSION
Severe HRI is more likely when personal susceptibilities coexist with work-related and environmental risk factors. Almost all HRIs occur when employers do not adhere to preventive guidelines.
目的
本研究旨在描述美国劳动者因热相关疾病（HRI）的风险因素。
方法
我们对职业安全与健康管理局（OSHA）于 2011 年至 2016 年进行的 HRI 执法调查的一个子集中的病例进行了审查。我们评估了劳动者、雇主和事件的特征。我们对病例进行了严重程度分层，以评估风险因素是否在致命 HRI 中更为普遍。
结果
我们分析了涉及 66 例 HRI 的 38 项调查。许多劳动者有潜在的医疗条件或使用潜在的药物。合并症在死亡的劳动者中更为普遍。大多数（73%）致命 HRI 发生在工作的第一周。热射病病例的常见临床发现包括多器官衰竭、肌肉分解和全身炎症。
结论
当个人易感性与工作相关和环境风险因素并存时，严重的 HRI 更有可能发生。几乎所有的 HRI 都发生在雇主不遵守预防指南的情况下。
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