Journal of Korean Society of Occupational and Environmental Hygiene
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v.31
no.2
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pp.156-172
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2021
Objectives: To investigate the trends of industrial injuries among long-term health care workers in Korea Methods: T7866 injuries were selected from the total industrial injuries approved by the Industrial Accident Compensation Insurance Act(Occupational Safety and Health Act) among long-term health care workers between 2007 and 2016 in Korea. We analyzied the trends of industrial injuries according to work process, occurrence type, and causes. Results: The industrial injuries among long-term health care workers increased since 2012. The mostly occurred area for industrial injuries were low back areas, which is related that the most serious industrial injuries occurred when the one long-term healthcare worker lift manually the recipient, from bed(ondol, Korean floor heating system) to a wheelchair, bed to bath bed, and wheelchair to bath chair. In addition to this, lack of workforce, increased work intensity due to overwork contributed the increasing of occupational injury. Conclusions: This study suggests that the main causes of industrial injuries were Lack of facilities and equipment for small private long-term care institutions, The physical load that goes into lifting the recipient directly, work intensity such as excessive workload and increased work speed. We suggest that the social publicization of long-term care service for the elderly, avoiding ways to lift recipients directly, introducing lifting machines as well as improving working methods, and reducing the workload of caregivers are required.
Ahn, So Ra;Lee, Joo Hyun;Kim, Keun Young;Park, Chan Yong
Journal of Trauma and Injury
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v.34
no.4
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pp.288-293
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2021
In South Korea, most patients who visit trauma centers with abdominal injuries have blunt trauma, and penetrating injuries are relatively rare. In extremely rare cases, some patients are admitted with a long object penetrating their abdomen, and these injuries are referred to as abdominal impalement injuries. Most cases of impalement injuries lead to fatal bleeding, and patients often die at the scene of the accident. However, patients who survive until reaching the hospital can have a good prognosis with optimal treatment. A 68-year-old female patient was admitted to the trauma center with a 4-cm-thick tree branch impaling her abdomen. The patient was transported by a medical helicopter and had stable vital signs at admission. The branch sticking out of the abdomen was quite long; thus, we carefully cut the branch with an electric saw to perform computed tomography (CT). CT revealed no signs of major blood vessel injury, but intestinal perforation was observed. During laparotomy, the tree branch was removed after confirming that there were no vascular injuries, and enterostomy was performed because of extensive intestinal injury. After treating other injuries, the patient was discharged without any complications except colostomy. Abdominal impalement injuries are treated using various approaches depending on the injury mechanism and injured region. However, the most important consideration is that the impaled object should not be removed during transportation and resuscitation. Instead, it should only be removed after checking for injuries to blood vessels during laparotomy in an environment where injury control is possible.
Traumatic brachial plexus injuries can be devastating, causing partial to total denervation of the muscles of the upper extremities. Surgical reconstruction can restore motor and/or sensory function following nerve injuries. Direct nerve-to-nerve transfers can provide a closer nerve source to the target muscle, thereby enhancing the quality and rate of recovery. Restoration of elbow flexion is the primary goal for patients with brachial plexus injuries. A 4-year-old right-hand-dominant male sustained a fracture of the left scapula in a car accident. He was treated conservatively. After the accident, he presented with motor weakness of the left upper extremity. Shoulder abduction was grade 3 and elbow flexor was grade 0. Hand function was intact. Nerve conduction studies and an electromyogram were performed, which revealed left lateral and posterior cord brachial plexopathy with axonotmesis. He was admitted to Rehabilitation Medicine and treated. However, marked neurological dysfunction in the left upper extremity was still observed. Six months after trauma, under general anesthesia with the patient in the supine position, the brachial plexus was explored through infraclavicular and supraclavicular incisions. Each terminal branch was confirmed by electrophysiology. Avulsion of the C5 roots and absence of usable stump proximally were confirmed intraoperatively. Under a microscope, neurotization from the musculocutaneous nerve to two medial pectoral nerves was performed with nylon 8-0. Physical treatment and electrostimulation started 2 weeks postoperatively. At a 3-month postoperative visit, evidence of reinnervation of the elbow flexors was observed. At his last follow-up, 2 years following trauma, the patient had recovered Medical Research Council (MRC) grade 4+ elbow flexors. We propose that neurotization from medial pectoral nerves to musculocutaneous nerve can be used successfully to restore elbow flexion in patients with brachial plexus injuries.
This paper uses a dynamic sled test approach to understand the effects of impact speed on the risk of occupant in KHST. The sled impact tests simulate a predefined accident scenarios. This study shows the effect of relative velocity between occupant and struck vehicle while occupant is impacted to a front seat's seatback. Although, base on the current accident scenarios, KHST is performed well enough to protect average adult male occupants. However, Results from the tests indicate small size occupant or higher impact speed may cause sever neck and femur injuries.
A clinical analysis was performed on 383 cases of chest injurjes experienced at Department of Thoracic Surgery, Seoul National University Hospital during 21 year period from 1957 to 1977. Of 383 patients of chest injuries, 209 cases were result from nonpenetrating injuries whereas 175 were from penetrating injuries, and there were 258 cases of hemothorax or/and pneumothorax, 162 of rib fracture, 33 of foreign body, 26 of clavicle fracture, 26 of lung contusion, 17 of diaphragmatic laceration, 14 of hemopericardium, 14 of flail chest and others. Stab wound was the most common in penetrating injuries and followed by gunshot and shell fragments. The majority of nonpenetrating chest injury patients were traffic accident victims. and fails accounted for the next largest group of accidents. Chest injuries were frequently encountered in the age group between 16 and 50 years, and 321 patients were male comparing to 62 of female. In blunt chest injuries the patients with five or more rib fractures had a 85 per cent incidence-of intrathoracic injury and 19 per cent had an intraabdominal organ damage, whereas those with four or less rib fractures had a 69 per cent and a 6 per cent incidence respectively. The principal associated injuries were cerebral contusion on 19 cases, renal contusion on 10, liver laceration on 7, peripheral vessel laceration on 5, spleen laceration on 3 and extremity fracture on 18 patients. The principles of therapy for early complications of chest trauma were rapid reexpansion of the lungs by thoracentesis [46 cases] and closed thoracotomy [125 cases] but open thoracotomy .had to be done on 90 cases [23-5%] because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic laceration and bronchial rupture. The over all mortality was 2.87 per cent [11 among 383 cases], 8 cases were from penetrating injuries and 3 from nonpenetrating injuries.
Purpose: Vascular injuries caused by traffic, industrial accidents and by outside activities have increased in Korea. Especially, vascular injuries to the extremities can lead to limb loss and even mortality if they are not appropriately treated. The aim of the study was to evaluate the surgical outcomes of femoropopliteal vascular management after trauma. Methods: The medical records of 12 patients with femoropopliteal vascular injuries who were treated at Dankook University Hospital from 2011 to 2013 were reviewed. Iatrogenic vascular injuries were excluded. The clinical data including the causes of injury, associated injuries and surgical outcomes were analyzed retrospectively. Results: All patients were male, with a mean age of $46.8{\pm}16.3years$ (range: 26~69 years). The causes of vascular injuries were four traffic accidents, three industrial accidents, two iron plates, one outside activity, one glass injury and one knife injury. The average transit time between the place of the accident place and the emergency department was $3.0{\pm}2.1$ (0.5~12.5) hours, and the average preparation time for surgery was $8.0{\pm}6.7$ (1.7~23.3) hours. The anatomic injuries included the popliteal vessel in seven cases and the femoral vessel in five cases. The average Injury Severity Score (ISS) was $12.0{\pm}5.0$ (5~17), and the average Mangled Extremity Severity Score (MESS) was $5.7{\pm}2.1$ (2~9). The operation methods were four interposition grafts, three end-to-end anastomoses, two direct repairs and three patch angioplasties. One case required amputation of the injured extremity. Conclusion: Early recognition and revascularization of the injured vessel are mandatory to reduce limb loss and to obtain satisfactory outcomes. Therefore, careful/rapid evaluation of the vascular injuries and timely/successful surgical treatment are the keys to salvaging an injured limb.
PURPOSES: The operational characteristics of roundabouts are generally influenced by location as well as traffic volume. The goal of this study is to develop urban and rural roundabout accident models and to discuss safety improvement guidelines based on the model. METHODS : To analyze accidents, count data models are utilized in this study. This study used accident data from 2010 to 2013 for 56 roundabouts collected from the Traffic Accident Analysis System (TASS) of Road Traffic Authority. Poisson and negative binomial regression models were developed for this study using NLOGIT 4.0. RESULTS : The main results are as follows. First, the hypotheses that there are distributional differences in the number of accidents and injuries/fatalities among rural and urban roundabouts were accepted. Second, Poisson and negative binomial regression accident models, which were all statistically significant, were developed. Seven independent variables, which were statistically significant, were adopted. Third, the common variable of models was evaluated to be traffic volume. CONCLUSIONS : This study developed two negative binomial roundabout accident models and suggested some accident reduction strategies. The results are expected to give some implications to the safety improvement of roundabout.
Hyuk Jin Jeon;Sang Chul Kim;Kang Hyun Lee;Ho Jung Kim
Journal of Auto-vehicle Safety Association
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v.6
no.1
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pp.22-26
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2014
Fatality of accidents on curved roads where rollover accidents are likely to take place was higher than that on straight roads. We ought to investigate factors affecting injury severity of occupant in a vehicle rollover accident. From January 2011 to December 2013, we collected data about rollover motor vehicle crash accident. We surveyed occupant's injury, vehicle type, safety devices, type of rollover accident and the number of turn in accident. Of the 132 subjects, 56.1% were males, 50.8% were drivers, 48.5% fastened seat belt, and air bag deployed in 12.1%. Among injuries sustained head, chest and abdomen were major sites of severe injury(Abbreviated injury scale>2). Seat belt use, rollover type, and the number of 1/4 turn were found to have significant positive correlations with Injury Severity Score. The regression analysis herein found significance in safety belt use and the number of 1/4 turn. Seat belt use was a significant factor affecting injury severe of occupant in rollover accident.
A clinical evaluation was done on 120 cases of chest injury patients treated in the department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital for the period of 6 years and 3 months from January, 1968 to March, 1974. 1] Of 120 cases, 52 cases[43. 3%] were non-penetrating injuries and 65 cases[56.7%] penetrating injuries. Of them, 107 cases [89.2%] were males and 13 cases[10.8%] were females. 2] The most common etiology was stab wound[64 cases] and traffic accident[23 cases] was the next. 3] In 70% of all cases, treatment was initiated within 6 hours after receiving trauma. 4] The types of lesions in order of frequency were hemothorax[35 cases], chest wall injuries alone. 27 cases], hemopneumothorax [22 cases], pneumothorax[17 cases]. Of them, right sided lesions were 52 cases[43. 3%] and left sided lesions were 65 cases[54.2%] and 3 cases were bilateral lesions. 5] Repeated thoracentesis and closed thoracostomy were the treatment of choice in most cases in order to reestablish early and rapid reexpansion of the lungs. Open thoracotomy was, however, mandatory on 39 cases[32.5%]. 6] The overall mortality was 5.8% [7 cases]; 5 cases of nonpenetrating injuries and 2 cases of penetrating ones.
Background: Agriculture ranks among the most dangerous trades worldwide. There is, however, still a lack of knowledge on nonfatal injuries in agriculture. The aim of this study was to describe the nature and occurrence of nonfatal injuries in farmers in two counties in central Norway. Methods: A questionnaire was sent to 7,004 farmers in Norway. We asked for information about the respondents and the farm, whether the farmer had had work-related injuries on the farm during the past 12 months, and details about the incidence and seriousness of the injury. Results: A total of 2,699 respondents gave a response rate of 42%. Of the respondents, 249 (9.2%) reported one or more work-related injuries. The most usual cause of injury involved an animal, and >75% of these happened inside the outbuilding. Among these, 17.5% had a consequence of sick leave or a more serious result. When all the accidents were analyzed by stepwise logistic regression, only the variables: works alone, has >3,500 stipulated working hours at the farm, and the type of production were statistical significant explanatory variables for having an injury. Conclusion: Incorporating safety aspects to a greater extend in the design and construction of outbuildings would make a substantial contribution to injury prevention in agriculture.
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