Injury proneness and personality

Trends in Cause-Specific Injury Mortality in China in 2005-2019: Longitudinal Observational Study

BACKGROUND

Over the last few decades, although the age-standardized mortality rate (ASMR) of injury has shown a significant declining trend in China, this pattern has dramatically reversed recently.

OBJECTIVE

We aimed to elucidate the geographical, demographic, and temporal trends of cause-specific injuries, the reversal phenomenon of these trends, and the fluctuations of injury burden from 2005 to 2019 in China.

METHODS

A longitudinal observational study was performed using the raw data of injury deaths in the National Cause-of-Death surveillance data provided by the disease surveillance points system in 2005-2019. The cause-specific injuries were divided into disparate subgroups by sex, age, urban/rural region, and eastern/central/western areas of China. The burden of injury was assessed using potential years of life lost (PYLL), average years of life lost (AYLL), and PYLL rate (PYLLR). Temporal trends of mortality rates and burden were evaluated using best-fitting joinpoint models.

RESULTS

Injury deaths accounted for 7.51% (1,156,504/15,403,835) of all-cause deaths in China in 2005-2019. The crude mortality rate of all-cause injury was 47.74 per 100,000 persons. The top 3 injury types (traffic accident, falls, and suicide) accounted for 70.57% (816,145/1,156,504) of all injury-related deaths. The ASMR of all-cause injury decreased (P=.003), while the crude mortality rate remained unchanged (P=.52) during 2005-2019. A significant reverse trend in ASMR of all-cause injury was observed in urban older adults since 2013, mainly due to the inverted trend in injuries from falls. A reverse trend in ASMR of suicide was observed among individuals aged 10-24 years, with notable increases by 35.18% (annual percentage change 15.4%, 95% CI 4.1%-28.0%) in men since 2017. The AYLL and PYLLR of all-cause injury among older adults showed consistent ascending trends from 2005 to 2019 (average annual percentage change [AAPC] 6.1%, 95% CI 5.4%-6.9%, 129.04% increase for AYLL; AAPC 5.4%, 95% CI 2.4%-8.4%, 105.52% increase for PYLLR). The AYLL due to suicide for individuals aged 10-24 years showed a considerable upswing tendency (AAPC 0.5%, 95% CI 0.4%-0.7%, 8.02% increase).

CONCLUSIONS

Although the ASMR of all-cause injury decreased in China from 2005 to 2019, the trend in suicide among adolescents and young adults and falls among older adults has been on the rise in recent years. Interventions should be encouraged to mitigate the cause-specific burdens of injury death.

Association of lifestyle factors with osteoporosis and fracture in postmenopausal women: a Japanese cohort study

OBJECTIVE

Osteoporosis is a major risk factor for fracture later in life; however, few studies have examined the association of lifestyle factors with osteoporosis and fracture. This study aimed to identify factors associated with osteoporosis and fracture in postmenopausal women.

METHODS

We evaluated the association between baseline characteristics and outcomes (diagnosis of osteoporosis or incidence of fracture) in 4,427 postmenopausal women who participated in the Kyushu University Fukuoka Cohort Study on lifestyle-related diseases (baseline: February 2004 to August 2007; follow-up: February 2010 to December 2012). Among the women, 626 were diagnosed as having osteoporosis without a fracture, 294 sustained a fracture without a diagnosis of osteoporosis, and 137 were diagnosed with both osteoporosis and fracture during the average 5.3-year follow-up period; the remaining 3,370 participants were not diagnosed with osteoporosis or did not sustain a fracture. The association between lifestyle factors and the occurrence of osteoporosis and fracture was evaluated using logistic regression analysis.

RESULTS

Skipping breakfast was associated negatively with osteoporosis without fracture (odds ratio [OR] = 0.40, P = 0.009) but positively with fracture without osteoporosis (OR = 2.30, P = 0.0009). Glycated hemoglobin A1c levels were associated negatively with osteoporosis without fracture (OR = 0.81, P = 0.0003) but positively with fracture without osteoporosis (OR = 1.18, P = 0.03). Parental history of fracture and extraversion personality trait were both associated with fracture without osteoporosis.

CONCLUSIONS

Osteoporosis and fracture showed different association patterns with lifestyle factors, and no factors were correlated with an increase in both osteoporosis and fracture.

Personality and the use of cancer screenings. A systematic review

BACKGROUND

No systematic review exists synthesizing studies examining the association between personality factors and use of cancer screenings. Hence, the aim of this systematic review is to provide an overview of empirical findings from observational studies investigating the link between personality factors (in terms of agreeableness, conscientiousness, extraversion, neuroticism and openness to experience) and use of cancer screenings.

METHODS

Medline, PsycInfo and CINAHL were searched using predefined search terms. Observational studies examining the link between personality factors and use of cancer screenings using validated tools were included. Study selection, data extraction, and quality assessment were performed by two reviewers.

RESULTS

In total, n = 11 studies were included in our systematic review. There is mostly inconclusive evidence regarding the link between agreeableness, neuroticism, openness to experience and the use of cancer screenings. Clearer evidence was identified for an association between increased extraversion and an increased use of cancer screenings. Moreover, the majority of studies identified a link between increased conscientiousness and an increased use of cancer screenings.

DISCUSSION

Studies indicate that personality factors, particularly an increased extraversion and increased conscientiousness, are associated with an increased use of cancer screenings. This knowledge may be beneficial to address individuals at risk for underuse.

PROSPERO REGISTRATION NUMBER

CRD42020176830.

Personality, Healthcare Use and Costs-A Systematic Review

BACKGROUND

Thus far, there is a lack of a systematic review synthesizing empirical studies that analyze the link between personality factors and healthcare use (HCU) or costs. Consequently, the purpose of our systematic review is to give an overview of empirical findings from observational studies examining the association between personality factors and HCU or costs.

METHODS

PubMed, PsycINFO, and NHS EED (NHS Economic Evaluation Database) were searched. Observational studies examining the association between personality factors and HCU costs by using validated tools were included. Two reviewers performed study selection and data extraction and evaluated the study quality. Findings were synthesized qualitatively.

RESULTS

In total, n = 15 studies (HCU, n = 14; cost studies, n = 1) were included in the final synthesis. A few studies point to an association between conscientiousness and HCU (with mixed evidence). Some more evidence was found for an association between higher agreeableness, higher extraversion, and higher openness to experience and increased HCU. The majority of studies analyzed found a link between higher neuroticism and increased HCU.

CONCLUSION

Personality factors, and particularly neuroticism, are associated with HCU. This knowledge is important to manage healthcare use. However, future research based on longitudinal data and studies investigating the link between personality characteristics and costs are required.

The role of personality in health care use: Results of a population-based longitudinal study in Germany

Objective

To determine the role of personality in health care use longitudinally.

Methods

Data were derived from the German Socio-Economic Panel (GSOEP), a nationally representative, longitudinal cohort study of German households starting in 1984. Concentrating on the role of personality, we used data from the years 2005, 2009 and 2013. Personality was measured by using the GSOEP Big Five Inventory (BFI-S). Number of physician visits in the last 3 months and hospital stays in the last year were used as measures of health care use.

Results

Adjusting for predisposing factors, enabling resources, and need factors, fixed effects regressions revealed that physician visits increased with increasing neuroticism, whereas extraversion, openness to experience, agreeableness and conscientiousness did not affect physician visits in a significant way. The effect of self-rated health on physician visits was significantly moderated by neuroticism. Moreover, fixed effects regressions revealed that the probability of hospitalization in the past year increased with increasing extraversion, whereas the other personality factors did not affect this outcome measure significantly.

Conclusion

Our findings suggest that changes in neuroticism are associated with changes in physician visits and that changes in extraversion are associated with the probability of hospitalization. Since recent studies have shown that treatments can modify personality traits, developing interventional strategies should take into account personality factors. For example, efforts to intervene in changing neuroticism might have beneficial effects for the healthcare system.

Workers' Risk Tolerance and Occupational Injuries

This study explores the relationship between individuals' risk tolerance and occupational injuries. We analyze data from a national representative survey of U.S. workers that includes information about injuries, risk tolerance, cognitive and noncognitive attributes, and risky behaviors. We measure risk tolerance through questions regarding individuals' willingness to gamble on their lifetime income. We estimate zero-inflated count models to assess the role played by such measures on workers' recurrent injuries. We discuss some implications of our results for future research and occupational safety policies. Our results highlight the concurrent and changing role played by individual, work, and environmental factors in explaining recurrent incidents. They show that risk tolerance affects recurrent injuries, although not in the direction that proponents of the concept of proneness would expect. Our measure of risk aversion shows that individuals who are somewhat more risk tolerant have fewer recurrent injuries than those who are risk averse. But the estimated relationship is U-shaped, not monotonic and, therefore, not easy to predict. At the same time, we find that individuals' "revealed risk preferences"-specific risky behaviors-are related to higher injury probabilities. Demanding working conditions, measures of socioeconomic status, health, and safety problems experienced by workers during their youth remain among the most important factors explaining the phenomena of recurrent injuries. So our results contribute also to the important debate about the relationship between health and socioeconomic status.

Associations of Individual-Related and Job-Related Risk Factors with Nonfatal Occupational Injury in the Coal Workers of Shanxi Province: A Cross-Sectional Study

OBJECTIVES

To assess the relationships between the risk factors and the incidence of nonfatal occupational injury of coal mine workers of Shanxi Province.

METHODS

A cross-sectional study was conducted from July 2013 to December 2013, and 4319 workers were recruited from more than 200,000 coal mine employees who are exposed to continuous potential risk of occupational injuries by using a two-stage stratified cluster sampling method. Trained interviewers having necessary medical knowledge conducted face-to-face interviews with the participants. Univariate and multivariable logistic regression models were used to estimate the odds ratio (OR) and the 95% confidence interval (CI).

RESULTS

A total number of 3618 effective respondents were got from 4319 participants (83.77%) and the mean age of the participants was 41.5 years with the standard deviation of 8.65. Significant crude odds ratios were observed for all factors considered except for marital status, education, work duration, BMI, EPQ-RSC(P) scale and EPQ-RSC(L) scale. Results from multivariable logistic regression model showed significant adjusted odds ratios for risk factors including gender (female vs male 0.275, 0.094-0.800), age (≥55 vs ≤25yr 0.169, 0.032-0.900), work type (light physical labor vs heavy physical labor 0.504, 0.328-0.774), workplace (underground auxiliary vs underground front-line 0.595, 0.385-0.919), length of shiftwork experience (0~5yr vs no shift 2.075, 1.287-3.344 and ≥15yr vs no shift 2.076, 1.230-3.504) and EPQ-RSC(E) score (extraversion vs introversion 0.538, 0.334-0.867).

CONCLUSIONS

Several risk factors of nonfatal occupational injury were identified including male, age, heavy physical labor, underground front-line, length of shiftwork experience and introversion. The coal mining enterprises should pay attention to controlling the hazards associated with frontline physical work. Workers' behaviors, life styles and personality traits should also be considered, so that the enterprises could set achievable targets for workers and lessen the exposed period to the risky underground workstation.

Associations of Individual-Related and Job-Related Risk Factors with Nonfatal Occupational Injury in the Coal Workers of Shanxi Province: A Cross-Sectional Study

OBJECTIVES

To assess the relationships between the risk factors and the incidence of nonfatal occupational injury of coal mine workers of Shanxi Province.

METHODS

A cross-sectional study was conducted from July 2013 to December 2013, and 4319 workers were recruited from more than 200,000 coal mine employees who are exposed to continuous potential risk of occupational injuries by using a two-stage stratified cluster sampling method. Trained interviewers having necessary medical knowledge conducted face-to-face interviews with the participants. Univariate and multivariable logistic regression models were used to estimate the odds ratio (OR) and the 95% confidence interval (CI).

RESULTS

A total number of 3618 effective respondents were got from 4319 participants (83.77%) and the mean age of the participants was 41.5 years with the standard deviation of 8.65. Significant crude odds ratios were observed for all factors considered except for marital status, education, work duration, BMI, EPQ-RSC(P) scale and EPQ-RSC(L) scale. Results from multivariable logistic regression model showed significant adjusted odds ratios for risk factors including gender (female vs male 0.275, 0.094-0.800), age (≥55 vs ≤25yr 0.169, 0.032-0.900), work type (light physical labor vs heavy physical labor 0.504, 0.328-0.774), workplace (underground auxiliary vs underground front-line 0.595, 0.385-0.919), length of shiftwork experience (0~5yr vs no shift 2.075, 1.287-3.344 and ≥15yr vs no shift 2.076, 1.230-3.504) and EPQ-RSC(E) score (extraversion vs introversion 0.538, 0.334-0.867).

CONCLUSIONS

Several risk factors of nonfatal occupational injury were identified including male, age, heavy physical labor, underground front-line, length of shiftwork experience and introversion. The coal mining enterprises should pay attention to controlling the hazards associated with frontline physical work. Workers' behaviors, life styles and personality traits should also be considered, so that the enterprises could set achievable targets for workers and lessen the exposed period to the risky underground workstation.

Accident occurrence and functional health patterns: a pilot study of relationships in a graduate population

PURPOSE

This pilot study sought to examine the relationship between functional health patterns and accident proneness.

METHODS

A quantitative-descriptive design was employed assessing accident proneness by collecting data on the occurrence of accidents among a sample of university graduates, and examining this in relation to biographical data and information collated using the Functional Health Pattern Assessment Screening Tool (FHPAST). Data were analyzed using descriptive and inferential statistics.

FINDINGS

One FHPAST factor predicted more frequent sports accidents. Age was also shown to be a significant predictor but in a counterintuitive way, with greater age predicting less accident proneness.

CONCLUSION

The FHPAST may have a role to play in accident prediction.

IMPLICATIONS FOR NURSING PRACTICE

Functional health pattern assessment may be useful for predicting accidents.

Personality type and patient education in hand therapy

Awareness of personality differences can improve the effectiveness of treatment and patient education in hand therapy. Therapists can create treatment plans and patient education efforts that match the communication and learning styles of each individual patient.

Judgment of line orientation depends on gender, education, and type of error

Visuospatial tasks are particularly proficient at eliciting gender differences during neuropsychological performance. Here we tested the hypothesis that gender and education are related to different types of visuospatial errors on a task of line orientation that allowed the independent scoring of correct responses ("hits", or H) and one type of incorrect responses ("commission errors", or CE). We studied 343 volunteers of roughly comparable ages and with different levels of education. Education and gender were significantly associated with H scores, which were higher in men and in the groups with higher education. In contrast, the differences between men and women on CE depended on education. We concluded that (I) the ability to find the correct responses differs from the ability to avoid the wrong responses amidst an array of possible alternatives, and that (II) education interacts with gender to promote a stable performance on CE earlier in men than in women.

Determinants of school injury proneness in adolescents: a prospective study

OBJECTIVE

Injury proneness is common in adolescents, but the role of individual factors has received little attention. This study assessed the relationships of a number of individual characteristics with frequency of school injuries.

METHODS

This prospective study was conducted on 2396 students from middle schools and high schools in an urban area in France over one school year. A questionnaire was completed by each student at the beginning of the school year, and an injury questionnaire was completed for all injuries that occurred at school during the year. Data were analysed using the chi2 independence test and logistic models.

RESULTS

Over the study year, 10.6% of the students had a single injury. Frequent injuries (two or more) were common (2.3%) and were strongly related to younger age [adjusted odds ratio (aOR) 1.52, 95% confidence interval (95%CI) 1.28-1.79], frequent use of psychotropic drugs (aOR 2.03, 95%CI 1.06-3.86) and a poorer average school mark (<10/20, aOR 2.58, 95%CI 1.30-5.12). The occurrence of a single injury was less strongly related to younger age (aOR 1.20, 95%CI 1.11-1.30) and frequent use of psychotropic drugs (aOR 1.43, 95%CI 1.04-1.96), and was also associated with parental absence (aOR 1.33, 95%CI 1.00-1.77), not being calm (aOR 1.41, 95%CI 1.03-1.89) and not being easily irritated (aOR 1.56, 95%CI 1.14-2.13).

CONCLUSIONS

This study identified a number of factors associated with injury frequency. This information could be useful for injury prevention. Physicians could help students, parents, teachers and school staff to be more aware of the risks and to find remedial measures.

Gestational exposure to cigarette smoke imperils the long-term physical and mental health of offspring

BACKGROUND

In this study, we sought to understand whether prenatal exposure to cigarette smoke would be associated with increased offspring hospitalization through age 22 years for various physical and mental health diagnoses.

METHODS

We used multivariate logistic regression to investigate the relationship between gestational exposure to cigarette smoke and offspring hospitalization for physical and mental health conditions based on International Classification of Diseases (ICD; World Health Organization) diagnoses.

RESULTS

When controlling for parental psychiatric status, maternal somatic health, socioeconomic status, parity, and maternal age, youth born to mothers who smoked six or more cigarettes per day were more likely to have experienced hospitalization for neuroses (OR, 1.97), diseases of the nervous system (i.e., neurological disorders) (OR, 1.47), respiratory infections (OR, 1.28), accidents (OR, 1.44), infections (OR, 1.54), undiagnosed symptoms (OR, 1.65), and total admissions (OR, 1.48). Female offspring prenatally exposed were more likely to have experienced hospitalization for obstetric complications (OR, 2.94). No association was found for the remaining categories analyzed: blood disorders, skin diseases, psychoses, metabolic/endocrine disease, circulatory disease, digestive disease, disease of the skeletal/muscular system, physical anomalies, neoplasms, and genital/urinary disease.

CONCLUSIONS

This is the first study to investigate the impact of gestational exposure to cigarette smoke on global measures of somatic and physical health in offspring. This study adds to the literature by demonstrating that smoking during pregnancy increases offspring risk for additional health outcomes not previously recognized in the literature, and that the effect of smoking during pregnancy persists throughout the developmental period. The possibility that these findings are related to lifestyle markers or smoke exposure during childhood should also be considered.