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低电压电气事故、即时反应以及与自我报告的4年后总体健康状况相关的急性医疗护理。

Low-voltage electrical accidents, immediate reactions and acute health care associated with self-reported general health 4 years later.

作者信息

Goffeng Lars Ole, Skare Øivind, Brinchmann Bendik C, Bjørnsen Lars Petter, Veiersted Kaj Bo

机构信息

Group for Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway.

Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway.

出版信息

Burns. 2023 Mar;49(2):329-343. doi: 10.1016/j.burns.2022.04.007. Epub 2022 Apr 26.

Abstract

BACKGROUND AND AIMS

Electricians frequently experience low-voltage electrical accidents. Some such accidents involve long-term negative health consequences. Early identification of victims at risk for long-term injury may improve acute medical treatment and long-term follow-up. This study aimed to determine acute exposure, health effects and treatment associated with general health ≥ 2 years after low-voltage electrical accidents.

METHODS

In a cross-sectional study, 89 male electricians who had experienced an electrical accident between 1994 and 2001 participated in a 2003 follow-up health examination. They were identified from a registry of low-voltage electrical accidents and included in the study. Based on exposure descriptions in the original accident reports, they were stratified into the following three groups: a current arc accident group (N = 34, mean age 38.8 years [standard deviation, SD = 12.2, range = 21-59]) and two groups with the passage of current through the body, either fixed to the current source ("no-let-go" group; N = 35, mean age 34.0 years [SD = 10.5, range = 21-57]) or not ("let-go" group; N = 20, mean age = 38.7 years [SD = 10.3, range = 21-63]). They retrospectively described acute reactions and assessed their current general health at the health examination. Multivariate linear regression, ordinal logistic regression and Fisher's exact test were used to compare acute reactions with health at follow-up in each exposure group.

RESULTS

The multivariate analysis indicated that after accidents with the passage of current through the body, severe acute headache (β = - 0.56, p = 0.013), years since the accident (β = - 0.16, p = 0.017) and the accident being perceived as frightening (β = - 0.48, p = 0.040) were negatively associated with general health ≥ 2 years later (R = 0.25, p = 0.002). If the exposure included a no-let-go experience, then acute severe body numbness (β = - 0.53, p = 0.029) was also negatively associated with general health (R = 0.38, p = 0.002). Without such experience, only acute confusion (β = - 0.90, p = 0.029) was negatively associated with the health at follow-up (R = 0.24, p = 0.029). In univariate analyses, after the passage of current through the body, acute dizziness (p = 0.029), apathy (p = 0.028), confusion (p = 0.007) and irregular heartbeat (p ≤ 0.05) were associated with poor long-term general health. The no-let-go group, more often than the let-go group, reported panic (p = 0.001), fear of death (p = 0.029), confusion (p = 0.014), exhaustion (p = 0.009), bodily numbness (p = 0.013) and immediate unconsciousness (p = 0.019). Acute symptoms beyond the first day after a current arc accident were associated with poor long-term general health (p = 0.015).

DISCUSSION AND CONCLUSIONS

The acute reactions negatively associated with general health ≥ 2 years after low-voltage electrical accidents should alert the clinician in the acute phase after an electrical accident to the risk of developing negative long-term health effects. Future studies should specify long-term health beyond the concept of general health.

摘要

背景与目的

电工经常遭遇低压电气事故。一些此类事故会导致长期的负面健康后果。早期识别有长期损伤风险的受害者可能会改善急性医疗救治和长期随访。本研究旨在确定低压电气事故发生≥2年后与总体健康相关的急性暴露、健康影响及治疗情况。

方法

在一项横断面研究中,89名在1994年至2001年间经历过电气事故的男性电工参与了2003年的随访健康检查。他们从低压电气事故登记册中被识别出来并纳入研究。根据原始事故报告中的暴露描述,他们被分为以下三组:电流弧事故组(N = 34,平均年龄38.8岁[标准差,SD = 12.2,范围 = 21 - 59])以及两组电流通过身体的情况,一种是固定在电流源上(“不放电”组;N = 35,平均年龄34.0岁[SD = 10.5,范围 = 21 - 57]),另一种不是(“放电”组;N = 20,平均年龄 = 38.7岁[SD = 10.3,范围 = 21 - 63])。他们回顾性描述急性反应,并在健康检查时评估当前的总体健康状况。使用多变量线性回归、有序逻辑回归和费舍尔精确检验来比较各暴露组的急性反应与随访时的健康状况。

结果

多变量分析表明,在电流通过身体的事故后,严重急性头痛(β = -0.56,p = 0.013)、事故发生后的年数(β = -0.16,p = 0.017)以及事故被认为可怕(β = -0.48,p = 0.040)与2年后的总体健康呈负相关(R = 0.25,p = 0.002)。如果暴露包括不放电经历,那么急性严重身体麻木(β = -0.53,p = 0.029)也与总体健康呈负相关(R = 0.38,p = 0.002)。没有这种经历时,只有急性意识混乱(β = -0.90,p = 0.029)与随访时的健康状况呈负相关(R = 0.24,p = 0.029)。在单变量分析中,电流通过身体后,急性头晕(p = 0.029)、冷漠(p = 0.028)、意识混乱(p = 0.007)和心律不齐(p≤0.05)与长期总体健康状况不佳有关。“不放电”组比“放电”组更常报告恐慌(p = 0.001)、对死亡的恐惧(p = 0.029)、意识混乱(p = 0.014)、疲惫(p = 0.009)、身体麻木(p = 0.013)和立即失去意识(p = 0.019)。电流弧事故发生第一天后的急性症状与长期总体健康状况不佳有关(p = 0.015)。

讨论与结论

与低压电气事故发生≥2年后总体健康呈负相关的急性反应应提醒临床医生在电气事故急性期注意长期负面健康影响的发生风险。未来研究应明确除总体健康概念之外的长期健康状况。

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