McNamee R, Kemmlert K, Lundholm L, Cherry N M
Centre for Occupational Health, School of Epidemiology and Health Sciences, University of Manchester.
Occup Environ Med. 1997 Nov;54(11):785-92. doi: 10.1136/oem.54.11.785.
To describe the relation with age of risk of reported injury after a fall among women at work in two countries, the United Kingdom and Sweden, with particular emphasis on fractures, and to interpret these data.
Rates of accidents compiled under the national reporting regulations of each country during a two year period were described by age, sex, cause (fall on the level, fall from a height, other), and occurrence of fracture, with emphasis on the relative risk (RR) in workers aged 45 years and over compared with those aged under 45. For fractures (major fractures only in the United Kingdom) among women, RRs were calculated for all occupations, with the three digit occupational classification schemes of each country. Summary RRs for older versus younger women, directly standardised for occupation, were derived.
Among women, RRs for injury after a fall on the level and fall from a height were 2.77 and 1.77 respectively in Sweden and 2.28 and 1.54 in the United Kingdom. When restricted to fractures, the RRs became 4.75 and 3.66 respectively in Sweden and 3.35 and 1.97 in the United Kingdom. Standardisation for occupation gave RRs for fractures of 4.87 and 3.75 in Sweden and 3.43 and 2.16 in the United Kingdom. Almost all occupational groups with enough fractures for analysis showed an excess of fractures related to falls among older women. A different age pattern was seen for all injuries or fracture after other types of accidents and for all types of accident in men.
It is argued that, for fractures at least, the results for women are unlikely to be due to reporting bias and unlikely to be explained by a greater exposure to workplace hazards among older women. Whether there is an increased risk of falling, as distinct from sustaining a fracture, is not clear. The generality of the increased risk suggest that efforts should be made to minimise hazards in all occupational sectors, particularly those using many women.
描述英国和瑞典两国职业女性跌倒后报告损伤风险与年龄的关系，尤其着重于骨折方面，并对这些数据进行解读。
按照每个国家的国家报告规定汇编的两年期间的事故发生率，按年龄、性别、原因（在同一平面跌倒、从高处坠落、其他）以及骨折发生情况进行描述，重点关注45岁及以上工人与45岁以下工人相比的相对风险（RR）。对于女性中的骨折（英国仅包括严重骨折），使用每个国家的三位数职业分类方案，计算所有职业的RR。得出按职业直接标准化后的老年女性与年轻女性的汇总RR。
在女性中，瑞典在同一平面跌倒和从高处坠落损伤后的RR分别为2.77和1.77，英国分别为2.28和1.54。当仅限于骨折时，瑞典的RR分别变为4.75和3.66，英国分别为3.35和1.97。职业标准化后，瑞典骨折的RR为4.87和3.75，英国为3.43和2.16。几乎所有有足够骨折病例可供分析的职业群体中，老年女性因跌倒导致的骨折都更多。在男性中，其他类型事故后的所有损伤或骨折以及所有类型事故呈现出不同的年龄模式。
有人认为，至少对于骨折而言，女性的结果不太可能是由于报告偏差，也不太可能由老年女性更多地暴露于工作场所危害来解释。与骨折不同，是否存在跌倒风险增加尚不清楚。风险增加的普遍性表明，应努力将所有职业部门的危害降至最低，尤其是那些雇佣大量女性的部门。
