Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, 1959 NE Pacific Street, Box 357234, Seattle, WA 98195, USA.
Scand J Work Environ Health. 2019 Nov 1;45(6):588-599. doi: 10.5271/sjweh.3814. Epub 2019 Mar 14.
Objectives The primary objective of this study was to assess the relationship between heat exposure and occupational traumatic injuries among construction workers. Methods We assessed the relationship between humidex, a measure of apparent temperature, and Washington State Fund workers' compensation injuries among outdoor construction workers using a case-crossover design with time-stratified referent selection. Warm month (March-October) adult outdoor construction traumatic injury claims from 2000-2012 were spatiotemporally joined with high-resolution meteorological data. We used conditional logistic regression with linear splines to assess the association between maximum daily humidex and injuries. Results There were 63 720 occupational traumatic injury claims in construction that met our eligibility criteria during the study period. The traumatic injury odds ratio (OR) was 1.005 [95% confidence interval (CI) 1.003-1.007] per one °C change in humidex. In the spline analyses, we observed a nearly linear association of humidex with the risk of a traumatic injury. Effect estimates were higher among younger (18-24 years) and older (>54 years) workers, workers with lower extremity injuries, workers with less job experience, smaller employers, workers working in Western Washington, and time of injury before 12:30 hours, although CI of effect estimates overlapped in stratified analysis categories. Conclusions In this study of Washington outdoor construction workers, increasing maximum daily humidex was associated with increasing traumatic injury risk. Further work should explore mechanisms of the association between heat exposure and traumatic injuries. Injury prevention efforts targeted at construction should address heat-related risk factors. In addition, heat awareness campaigns should address outcomes beyond heat-related illness.
本研究的主要目的是评估热暴露与建筑工人职业性创伤之间的关系。
我们采用时间分层参考选择的病例交叉设计，评估湿热指数（一种表观温度的衡量指标）与华盛顿州基金工人赔偿外伤之间的关系。2000-2012 年，湿热指数与成年户外建筑外伤索赔的时空关联，并与高分辨率气象数据相结合。我们使用条件逻辑回归和线性样条来评估每日最高湿热指数与外伤之间的关系。
在研究期间，有 63720 例符合条件的职业性创伤索赔符合建筑行业的标准。湿热指数每变化 1°C，创伤的比值比（OR）为 1.005（95%置信区间 [CI] 1.003-1.007）。在样条分析中，我们观察到湿热指数与创伤风险之间存在近乎线性的关联。在年轻（18-24 岁）和年老（>54 岁）工人、下肢受伤工人、工作经验较少的工人、较小的雇主、在华盛顿西部工作的工人以及受伤时间在 12:30 之前的工人中，效应估计值较高，尽管分层分析类别的效应估计值的置信区间重叠。
在这项对华盛顿州户外建筑工人的研究中，每日最高湿热指数的增加与创伤风险的增加有关。进一步的研究应该探索热暴露与创伤之间的关联机制。针对建筑行业的伤害预防工作应针对与热相关的危险因素。此外，防暑宣传活动应针对除与热相关的疾病以外的后果。
