Knowledge, attitude, and practice of sugarcane crushers towards hand injury prevention strategies in India

A Proposed Classification for Sugarcane Crusher Injuries of the Hand and Its Correlation with Patient Rated Outcome Scores at 6 Months

Background: Crush injuries of the hand sustained from sugarcane juice extracting machines have a unique mechanism of injury and clinical presentation. The severity of the injury can vary from simple skin lacerations to mangling of the hand. We devised a classification for these injuries based on the severity level that has helped with the management. The aim of this study is to determine whether the classification correlates with patient rated outcome score at 6 months. Methods: We prospectively studied 30 consecutive patients with a sugarcane crusher injury of the hand. The patients were classified into Class I, II, III or IV based on our classification and managed accordingly. Patient outcomes were assessed at 6 months after the injury, using the Michigan Hand Outcomes Questionnaire (MHQ). Spearman's rank correlation test was used to analyse the correlation between the different classes of hand injury and functional outcomes at 6 months following injury (measured using MHQ). Results: The study included 6 patients (20%) with Class I injury, 11 patients (36.6%) with Class II, 9 patients (30%) with Class III and 4 patients (13.4%) with Class IV injury. The mean MHQ scores at 6-month follow-up were 72.3% in Class I, 62.1% in Class II, 52.9% in Class III and 32% in Class IV injuries. An inversely proportional association between the severity grade as per the classification and MHQ scores was noted. Conclusion: Our proposed classification of sugarcane crusher injuries of the hand correlates well with the MHQ score. The use of the classification can help with management and predicting prognosis. In addition, wider use will permit comparison of outcomes between different centres. Level of Evidence: Level IV (Therapeutic).

Occupational physical risk factors and prevalence of musculoskeletal disorders among the traditional lacquerware toy makers of South India

BACKGROUND

The majority of handicraft workers in India falls under the informal sector, which plays a prominent role in the employment generation. Artisans in handicraft sectors encounter various hazards and risks causing occupational diseases.

OBJECTIVE

The key objective of the study is to identify the prevalence of musculoskeletal disorders and occupational risk factors among the artisans involved in making traditional lacquerware toys in Karnataka and Andhra Pradesh, South India.

METHODS

The subjects considered in this study are 177 artisans who work in mechanized lathes at Channapatna of Karnataka and Etikoppaka of Andhra Pradesh, South India. The information regarding the reported work-related musculoskeletal disorders (WMSD) symptoms from 7 days to 12 months are collected through modified Standardized Nordic Questionnaire and by direct observations. Moreover, the intervention of WMSD in their day-to-day life and the overall comfort of their body are also determined. The questionnaire survey is conducted through face-to-face interviews and by direct field study.

RESULTS

From the statistical analysis, it is found that about 76.83%of the study population (77.4%male and 74.28%female) has self-reported WMSDs. The prevalence of WMSD is most common in the age group of 30-40 years. Physical factors like workplace adaptability, stress at work, body postures, health status, body mass index, active and enough breaks during work and body condition at the end of work have a significant association with WMSD.

CONCLUSION

In this study, many of the work-related and lifestyle/health-related factors show a significant association with WMSD in artisans. The sub-standard working environment and the nature of work expose artisans to many occupational risks in their day-to-day life. To mitigate the occupational risks and musculoskeletal disorders, the workspace needs to be redesigned ergonomically.

Injury-related unsafe behavior among households from different socioeconomic strata in pune city

Introduction:

Behavior pattern influences the risk of unintentional injuries. This study was conducted to identify the pattern of household unsafe behavior in different socioeconomic strata, in Pune city, India.

Materials and Method:

Population-based, cross-sectional study. Behaviors influencing the risk of burn, poisoning, drowning, and road traffic injuries were questioned from 200 randomly selected households.

Results:

Nearly 28% of the households did not have a separate kitchen, 37.5% cooked at the ground level, 33.5% used a kerosene pressure stove, 12% used unprotected open fire as a source of warmth in winter, and 34.5% stored inflammable substances at home. Ninety one percent of the households reported storing poisonous chemicals in places that could not be locked. In 68.3% of the households with children below five years, these chemicals were kept in places accessible to children. Nearly 21% of the individuals, who could swim, did so in unsafe places and 25.2% of them were not trained in swimming. In 35.5% of the households, children used streets as playgrounds. Among all two-wheeled vehicle riders, 35.6% reported not having a helmet and 57.7% of those who had a helmet did not use it regularly. Socioeconomic status was strongly associated with the unsafe behaviors related to burns, drowning, and road traffic injuries.

Conclusion:

The study identifies the sociocultural and behavioral factors leading to unsafe behaviors, placing individuals at risk of unintentional injuries, which can be used as a first step toward prevention.

Pattern of hand injuries in osogbo, South-west Nigeria

BACKGROUND

Injury to the hand leads to loss of function with attendant psychological consequences. Epidemiological studies of hand injuries from our environment are few; hence the need for this study.

AIMS AND OBJECTIVES

To assess the epidemiology of hand injuries with a view to suggesting some methods of preventing the injuries in our environment.

SETTING

This study was carried out in a Plastic surgery unit of a teaching hospital in Nigeria.

METHODS

A retrospective review of the epidemiology of hand injuries in Osogbo, Nigeria was done. Sources of information include the case notes and operating registers. Information obtained includes biodata, aetiologies, pattern of injuries, presentation, treatment as well as complications.

RESULTS

A total of 74 patients with hand injuries were managed during the study period comprising of 53 males and 21 females. The age group 21-30 was the most affected. Students form the largest group affected with 24(32.4%) followed by artisans, 16 (21.6%). The most common source of hand injuries was road traffic crash with 29 (39.2%) patients. Others were Blast injuries, 2 (2.8%), avulsion from grinding machines, 10 (13.5%), other domestic accidents, 6 (8.2%), broken bottles, 4 (5.4%), glass cut, 4 (5.4%), farm accidents, 6 (8.2%), electrical burns, 4 (5.4%), gunshot injuries, 3 (4.0%), thermal burns, 6 (8.1%) and constricting ring, 4 (5.4%). Injuries involved only the right hand in 36 (48.6%) patients, the left, 28 (37.8%) patients and both hands, 10 (13.5%) patients. Anatomical disruptions observed included avulsion, 14 (18.9%) patients, burn, 6 (8.1%)patients, bruises, 2 (2.7%) patients, crush injuries, 13 (17.6%), laceration, 24(33.8%), fractures/dislocation, 14(18,9%), and digital gangrene, 1(1.4%) patient.

CONCLUSION

Hand injury prevention will include provision of safe road and education of the people on the use of tools and machines in our environment.

The SIMPOC Philippine Survey of Children 2001: a data source for analyzing occupational injuries to children

Child labor is a global issue that exists in both industrialized and developing countries. With the unanimous adoption of International Labour Organization (ILO) Convention No. 182 in 1999 calling for the immediate elimination of the worst forms of child labor, ratifying member countries have committed themselves to identifying hazardous work for children in the context of their respective legislative frameworks. Part of tackling the problem of child labor is knowing what types of occupational activities children are engaged in, what types of work environments they are under, and what risks of injuries and illnesses they are exposed to while working. Using the Philippines as a country example, this study introduces a promising data source on children's work and presents a methodology for examining hazardous work to children through the examination of injury rates. Data for this study rely primarily on a nationally representative dataset from the Survey of Children 2001 carried out by the Philippine National Statistics Office, covering the months of October 2001 to September 2002.

Glove use and the relative risk of acute hand injury: a case-crossover study

The purpose of this study was to investigate the relationship between glove use and acute traumatic occupational hand injury. We used a case-crossover, within-subject study design to control for differences between individuals such as occupation, injury history, age, gender, risk-taking behavior, manual dexterity, and muscle strength. A total of 1166 hand-injured workers were interviewed regarding the use of gloves at the time of the injury. The self-reported average duration of glove use in the previous work month was the measure of expected exposure to wearing gloves. Nineteen percent of subjects reported wearing gloves at the time of the injury. The expected exposure to glove use in the past work month was 27.9%. Glove use was associated with a lower risk of lacerations and punctures but not crush, fractures, avulsions, amputations, dislocations; the risk of the former two injury types was estimated to be 60-70% lower while wearing gloves. Glove use is only one component of a comprehensive hand injury prevention approach that might include the identification and elimination of sharp hazards, engineering controls, safety warnings, training in high-risk situation awareness, and proper selection and timing of glove use.