Epidemiology of occupational acute traumatic hand injuries: a literature review

The purpose of this review was to summarize the literature on occupational, acute, traumatic hand injury and suggest directions for future research. In 1996, the leading occupational injury treated in United States' hospital emergency departments was an acute hand injury (e.g. laceration, crush or fracture). These injuries affected 30% of an estimated 3.3 million injured workers (990,000). Cuts and lacerations of the fingers ranked third after back and leg strains in the number of lost workday cases in the USA in 1994. The incidence rate of hand injuries studied in seven manufacturing environments around the world ranged from 4 to 11 per 100 workers per year. Workers aged 24 years or less had the highest risk of hand injury. Men had higher rates of severe hand injury than women.Despite the high frequency and significant amount of lost work time associated with these injuries, they are poorly understood from an etiological perspective. There is only one case-control study of occupational hand injury in the literature. That study suggested an important role for both fixed (age) and transient risk factors (doing an unusual task) at the time of the injury. More analytic epidemiological research is needed to identify potentially modifiable risk or protective factors (e.g. glove use) for acute hand injuries. In this regard, the case-crossover design, a relatively new epidemiological approach using cases as their own controls, could prove an efficient method for determining transient, modifiable risk factors for acute, occupational hand injury.     

我国工伤保险费率机制的探讨

工伤保险费率机制是工伤保险制度的核心问题 ,对工伤保险基金的稳定性、工伤预防效能的发挥和企业参与的积极性等多方面产生直接影响。笔者在调查和研究我国工伤保险现状的基础上 ,结合欧美等国的成功经验 ,分析了我国工伤保险费率机制存在的问题 ,并在差别费率划分、档次、费率调整、风险共担模式、收支平衡和促进工伤预防等方面提出了独自见解和相应的建议。     

德国工伤保险事故预防机制评介

工伤保险事故预防机制就是工伤保险制度中促进预防工伤事故和职业病的一系列的措施和办法。笔者从管理、经济、法律、技术、心理5个方面具体分析德国工伤保险事故预防机制的具体特点,其中,对管理方面的上层管理机构、研究机构、培训机构、监督机构的设置及其人员配置、企业内部的劳动安全机构及其人员配备进行了研讨;以经济途径为重点从工伤保险费的征收与支出两方面进行了评介;在安全技术方面着重对管理内容即监督事故的隐患、咨询、进行职业病预防、监测与调查、产品安全标准鉴定等进行了介绍;简述了心理方面所开展的安全宣传、教育和培训工作以及相关法律手段。综合分析了工伤保险事故预防机制的形成和运作方式,对其成功经验进行了总结。     

事故致因理论的研究与应用简评

阐明事故致因理论的重要性和应用情况对于促进其发展、应用及提高事故预防效果十分重要。通过分析国内外的重要观点得知,安全科学是事故预防的科学,事故致因理论是发现事故原因、有效预防事故的工具,当然具有特别的重要性;但事故致因理论研究在我国开展较晚,所以目前的研究与应用并不充分。综合以往文献,给出了事故致因理论的实质性科学含义是事故的原因定义、原因间、原因与事故间的逻辑关系,它们可形象地综合表达为事故致因模型,其获取过程中不可或缺的方法是对以往事故案例的原因分析;通过观察安全管理实务认识到,社会组织要有效管理其安全健康和环保业务,选择一种事故致因模型作为总体思路且连续运转,十分必要。     

欧洲国家工伤保险费率管理实践及其对我国的启示——用经济手段促进企业改善劳动安全条件的尝试

笔者从平均基准费率水平、工伤保险基金期望的支出构成比较和工伤保险刺激事故预防的费率机制的形成 3个方面 ,对欧洲国家工伤保险费率进行了分析 ,对若干欧洲国家用工伤保险经济手段促进企业改善劳动条件的成功经验给以总结 ,并对我国新近出台的《工伤保险条例》提出一些修改建议。     

Occupational injuries and health problems in the Egyptian Mediterranean fisheries

Marine fishing is one of the most dangerous occupations. So far, no studies addressing occupational safety and health in the Egyptian fisheries have been conducted. The objective of this study is to explore and identify the types and causes of, as well as some factors associated with, occupational accidents and illnesses in the Egyptian marine fisheries. A sample of 686 fishermen in El-Maaddiya fishing port were interviewed for collecting relevant data. This paper presents the types of injuries mentioned by the interviewed fishermen and their potential causes in terms of accident type and involved agency/agency part. Also, major health problems and potential causes are presented. Furthermore, a logistic regression analysis was performed to study the significance of the association of some factors, such as age, experience, education and fishing gear with the occurrence of injuries and illnesses. The results of this study show that the Egyptian fishing industry involve many hazardous work conditions and practices that result in high morbidity and mortality rates, and high injury rates. The study recommends further research on suitable measures for the management of this problem.     

10种事故致因模型的对比研究

为了给事故致因模型的研究提供理论支持,为日常管理中事故致因模型的选用提供参考依据,从事故的影响对象、模型的组成和事故发生的路径3个维度对10种事故致因模型进行了对比分析。研究结果表明:事故致因模型对事故影响对象的涵盖越来越全面;事故致因模型的组成日趋全面,且趋于对模型中各模块给出清晰定义以能保证分析结果的准确性;故发生的路径描述由链式向系统网状发展;根据充分性和效率的需求对模块化模型和非模块化的模型进行选择。     

工伤保险风险分类及风险分类表研究

以风险理论为基础,笔者对工伤保险费率确定中风险分类的作用、分类的原则,风险分类表的定义、组成及其制定规则进行了研究,并将风险分类表分为3类,即行业风险分类表、行为风险分类表和混合风险分类表,目前许多发达国家多采用第三种类型。对建立风险分类表的相关因素进行了分析,在此基础上对我国工伤保险分类表的建立与完善提出一些建议。例如,针对制定风险分类表的规则;风险类目要不断修正;我国工伤保险分类表比较粗略,缺乏一定的科学依据,不符合风险分类的促进事故预防和损失控制的基本原则,提出最好能考虑使用“混合风险分类表”,对企业中特殊岗位采用一个或多个分类号。     

A survey on occupational accidents’ reporting and registration systems in the European Union

This paper presents the results of a survey on the procedures for reporting occupational accidents in the EU countries. It focuses particularly on the reporting and registration systems, as well as on the main characteristics of National Databases being used for the production of official statistics. The survey shows that many European countries have different methods and procedures for collecting and compiling data on occupational accidents, which inevitably pose problems when comparing accident statistics between the EU member states.The paper includes a brief review of the main goals and achievements of the European Project ESAW (European Statistics on Accidents at Work), which was launched in 1990 by the Eurostat (European Statistics), for the harmonisation of occupational accidents’ statistics among the member states. It is believed that the new variables being introduced by the harmonised methodology will quickly affect the way in which managers and insurance companies carry out their current procedures in several EU member states.The International Labour Organisation (ILO) recommendations and the future trends are also analysed. In conclusion, the study identifies opportunities for further development and research in the reporting and registration systems of occupational accidents.     

乡镇企业的工伤问题初探

本文总结了珠江三角洲地区部分乡镇企业发生工伤事故的现状、职业安全卫生方面存在的问题及由工伤事故所造成的经济损失的思考等。从研究的资料分析发现，近几年乡镇企业中工伤事故重伤率在１８．００／１０万以上，死亡率在７０．００／１０万以上，均高于国有企业。其中重伤率以村办企业（２．４１‰）和中外合资企业（１．９６‰）最高，死亡率以村办和国内独资企业最高（０．３３‰，０．２９‰）。     

Age and lost working days as a result of an occupational accident: A study in a shiftwork rotation system

The present work analyzed the relationship of age and tenure with occupational accident severity of 156 male shiftworkers at an industrial plant. Based on past research, negative binomial regression analyses were performed to examine the association of age and tenure with the lost working days due to medically certified occupational accidents (LWDI). The main effects of age and tenure and the contribution of age by tenure interaction and age squared terms were examined. Regression results indicated a significant association of age by tenure interaction with LWDI. However, this relationship was non-significant when considering an age squared term in the regression equation, suggesting a non-linear association of age with LWDI. The findings are discussed in regard to the specific preventative measures of occupational accidents in shiftwork systems that could be addressed to different age groups.     

基于DEMATEL/ISM的深水井喷风险影响因素研究*

为提高深水井喷事故风险管理水平,提出研究深水井喷风险影响因素的分析方法。从技术、人员、环境和管理4个方面,识别深水井喷事故风险致因因素,建立深水井喷事故风险评价指标体系;运用矩阵决策实验室分析法（DEMATEL）,研究风险因素之间的相互影响关系,计算不同风险因素的中心度和原因度,确定关键风险因素;进一步基于解释结构模型（ISM）划分不同影响因素的层次结构,分析风险因素之间的综合影响关系,建立深水井喷事故风险影响因素模型。结果表明:层级1为近邻致因,可直接导致井喷事故的发生;层级2~7为过渡致因,在风险传递过程中起到桥梁作用,对井喷事故的直接影响较小;而层级8则为本质致因,重视本质致因的改善有利于从根源上降低井喷事故的风险。研究结果可为深水井喷事故风险的预防和控制提供理论依据。     

事故损失分析与综合评价

事故是来自系统和环境的风险,导致死亡、职业相关病征、伤害、财产损失或其他损失,危害人类的生产、生活和生存。对事故造成的损失进行分析与评价是事故处理的依据,也是安全管理的重要基础。分析了事故损失的多属性特征,确定了属性指标和评价矩阵,建立了基于TOPSIS的事故损失综合评价模型,并进行了实证分析。     

工伤保险行业差别费率确定方法探讨

制定合理的行业差别费率对于工伤保险基金的稳定、促进企业改善安全生产状况具有积极作用.我国工伤保险制度处于起步阶段,有些地区对行业差别费率厘定进行了探索,但费率与风险的关联性不强,影响了低风险企业参加工伤保险统筹的积极性.本文针对工伤统计数据缺乏的现状,分析了现阶段工伤保险行业差别费率确定方法的研究现状,重点讨论了确定行业风险等级的3种方法,即聚类分析法、风险系数测评和模糊风险评估法的应用过程以及优缺点;另外,强调了在确定行业风险指数时,应注意根据不同事故类别的严重度来确定各风险因素指标的权重大小.最后,应用风险评估理论分析工伤保险行业差别费率的运作机理,提出应用工伤赔付支出费用计算行业差别费率的数学公式,此公式原理清晰、操作方便,且有利于各统筹地区根据实际情况划分行业差别费率.     

建立职业安全健康管理体系 对控制伤亡事故的对比分析

对 15 1家企业的伤亡事故状况进行了调查 ,采用平行对比分析法和前后对比分析法对调查结果进行了统计分析。通过分析发现 ,已建立和实施职业安全健康管理体系的企业的伤亡事故值低于正在建立和未建立职业安全健康管理体系企业的伤亡事故值 ;同一企业 ,建立职业安全健康管理体系后的伤亡事故值比在建和建前有所下降。这表明建立与实施职业安全健康管理体系是企业控制伤亡事故的一种有效方法 ,同时 ,体系的不断运行与完善 ,对企业持续地降低事故的发生及其损失也具有积极的作用。     

安全生产“十二五”规划若干统计指标考量

生产安全事故统计指标是安全生产监督管理及宏观决策重要依据。为进一步完善我国职业伤害统计指标体系,对安全生产规划中若干指标的科学性和实用性以及存在问题进行了探索。在进行初步实验计算、理论分析和国内外安全生产事故主要统计指标特点对比研究后,提出：在该规划指标中调整或删去＂亿元国内生产总值死亡率＂;增加非致死性事故统计数据,以能更好代表职业伤害事故总量;适度应用重特大事故起数指标和提高十万人死亡率统计指标精确性等几点建议。作者认为应加强职业伤害指标体系研究,从而尽快实现我国统计指标与国际接轨,在《国际劳工统计年鉴》中重现中国职业伤害统计数据。     

事故致因因素和危险源理论分析

基于事故的致因因素,国内外提出了各种危险源的概念和分类方式,如能量单元的危险源、两类危险源和三类危险源。我国安全生产法规和标准对事故致因因素也有"危险因素"、"有害因素"、"不安全因素"、"事故隐患"等术语形式的表述。为准确理解和运用系统安全理论和方法,应基于事故致因理论,系统分析事故致因因素,在该基础上,诠释各种危险源理论,明晰各种涉及事故致因因素的概念。分析表明:事故致因因素包括能量物质或载体、物的不安全状态和人的不安全行为以及管理因素;各种危险源的概念和分类,都是基于事故致因因素的划分和表述。     

Global trend according to estimated number of occupational accidents and fatal work-related diseases at region and country level

Background

Although occupational accidents and work-related diseases have been of interest for a long time, due to lack of proper recording and notification systems the official numbers of occupational accidents and work-related diseases are missing for many countries. Presently, the demand for effectiveness and an interest in the economic aspects of accidents have increased prevention activities at company and country levels.

Methods

Occupational accident data of selected countries and of World Health Organization regional divisions together with the global burden of disease were used in estimating global occupational accidents and fatal work-related diseases. The trend of global occupational accidents and work-related diseases is presented at region and country levels. The years 1998, 2001, and 2003 are compared in the case of occupational accidents and the years 2000 and 2002 in the case of work-related diseases.

Results

The total number of occupational accidents and fatal work-related diseases has increased, but the fatality rates per 100,000 workers have decreased. There were almost 360,000 fatal occupational accidents in 2003 and almost 2 million fatal work-related diseases in 2002. Every day more than 960,000 workers get hurt because of accidents. Each day 5,330 people die because of work-related diseases.

Conclusions

Information on occupational accidents and work-related diseases is needed so that countries may understand better the importance of occupational health and safety at country and company level. Especially companies in developing countries are not familiar with occupational safety and health. Statistical data is essential for accident prevention; it is a starting point for the safety work.