RESUMEN
Workplace injuries constitute a serious and growing public health concern worldwide. Despite work-related injuries being highly common, especially among workers in the manufacturing industry, their growing complexities are not adequately addressed in the current literature. Therefore this study aims to investigate the association between sociodemographic, workplace, and behavioral characteristics with work-related injuries among large-scale factory workers in Ethiopia. A cross-sectional study was conducted from February to April 2020 with 457 workers selected from large-scale factories in Addis Ababa, the capital of Ethiopia. Survey data included sociodemographic characteristics, working and safety conditions, and behavioral factors as predictors of occupational injuries. A logistic regression model was fitted to estimate the probability of injury and identify its associated factors. The 12-month prevalence of work-related injuries was 25%. Most injuries occurred at midnight (8.8%). Factors associated with work-related injury were excessive working hours (OR = 3.26; 95%CI: 1.26-8.41), cigarette smoking (OR = 2.72; 95%CI: 1.22-6.08), and manual handling (OR = 2.30; 95%CI: 1.13-4.72). Use of personal protective equipment reduced the odds of injury (OR = 0.42; 95%CI: 0.21-0.83). Although our estimated prevalence of occupational injury was lower than that found in other studies, our findings suggest that actions on modifiable conditions must be taken to reduce the burden of workplace injuries in Ethiopia. The results could inform preparedness and policy efforts aimed at improving worker safety and health.
Asunto(s)
Traumatismos Ocupacionales , Factores Socioeconómicos , Lugar de Trabajo , Humanos , Etiopía/epidemiología , Estudios Transversales , Femenino , Masculino , Traumatismos Ocupacionales/epidemiología , Adulto , Lugar de Trabajo/estadística & datos numéricos , Adulto Joven , Prevalencia , Factores de Riesgo , Persona de Mediana Edad , Factores Sociodemográficos , Adolescente , Encuestas y Cuestionarios , Accidentes de Trabajo/estadística & datos numéricos , Salud Laboral/estadística & datos numéricosRESUMEN
BACKGROUND: Traumatic brain injury (TBI) is a leading contributor to emergency department (ED) mortalities in Ethiopia. Mild TBI patients comprise half of all TBI patients presenting for care in Ethiopia and have a high potential for recovery. As such, context-specific care-improving strategies may be highly impactful for this group of patients. OBJECTIVE: This study examines the presentation and disposition of mTBI patients who received a computed tomography scan of the head upon arrival at the largest teaching hospital in Ethiopia. METHODS: A retrospective cohort study was conducted from 2018 to2021 including patients >13 years old with a head injury and a Glasgow Coma Score of 13-15 who obtained a computed tomography scan of the head. Variables were collected from medical charts and single and multivariable analyses assessed outcomes of clinically important TBI (ciTBI) requiring a neurosurgical procedure or admission. RESULTS: A total of 193 patients were included. They were predominantly young men with no comorbidities, injured in road traffic accidents or by assault, had stable vital signs and were treated in lower-acuity ED areas. A minority demonstrated focal deficits, and 29.5% of patients had ciTBI. Most patients were discharged from the ED, but 13% were taken for operative neurosurgical procedures and 10.4% were admitted to the neurosurgery ward for observation. ED stays ranged from 8 hours to 10 days, as patients waited for CT availability, neurosurgical decision, or transportation. Female sex was independently protective of ciTBI. Self-referral status was independently protective against operative intervention. Female sex and self-referral status were independently protective of a disposition of admission and/or going to the operating room. CONCLUSIONS: This study characterizes the mTBI subgroup of head injury patients in Ethiopia's busiest ED: predominantly healthy young men with low-acuity presentations and only a fraction with abnormal neurological examinations. Nonetheless, about one-third had ciTBI and a minority were taken for neurosurgical procedures or admission, with female sex and self-referral identified as protective factors. Meanwhile, many patients stayed in the ED for days due to social or other nonmedical reasons. As TBI care in Ethiopia continues to improve, optimizing care for the mTBI subgroup is tantamount given their high recovery potential. This care will benefit from efficiently identifying those who need intervention or hospital level of care, and discharging those who do not.
Asunto(s)
Centros de Atención Terciaria , Tomografía Computarizada por Rayos X , Humanos , Masculino , Etiopía/epidemiología , Femenino , Adulto , Estudios Retrospectivos , Adulto Joven , Persona de Mediana Edad , Adolescente , Conmoción Encefálica/diagnóstico por imagen , Conmoción Encefálica/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Escala de Coma de Glasgow , Anciano , Estudios de CohortesRESUMEN
Workplace injuries constitute a serious and growing public health concern worldwide. Despite work-related injuries being highly common, especially among workers in the manufacturing industry, their growing complexities are not adequately addressed in the current literature. Therefore this study aims to investigate the association between sociodemographic, workplace, and behavioral characteristics with work-related injuries among large-scale factory workers in Ethiopia. A cross-sectional study was conducted from February to April 2020 with 457 workers selected from large-scale factories in Addis Ababa, the capital of Ethiopia. Survey data included sociodemographic characteristics, working and safety conditions, and behavioral factors as predictors of occupational injuries. A logistic regression model was fitted to estimate the probability of injury and identify its associated factors. The 12-month prevalence of work-related injuries was 25%. Most injuries occurred at midnight (8.8%). Factors associated with work-related injury were excessive working hours (OR = 3.26; 95%CI: 1.26-8.41), cigarette smoking (OR = 2.72; 95%CI: 1.22-6.08), and manual handling (OR = 2.30; 95%CI: 1.13-4.72). Use of personal protective equipment reduced the odds of injury (OR = 0.42; 95%CI: 0.21-0.83). Although our estimated prevalence of occupational injury was lower than that found in other studies, our findings suggest that actions on modifiable conditions must be taken to reduce the burden of workplace injuries in Ethiopia. The results could inform preparedness and policy efforts aimed at improving worker safety and health.
Los accidentes laborales constituyen un grave y creciente problema de salud pública mundial. Aunque este tipo de accidente es frecuente, especialmente entre los trabajadores de las industrias manufactureras, su creciente complejidad no ha sido abordada adecuadamente en la literatura actual. El objetivo de este estudio fue analizar la asociación entre las características sociodemográficas, ambientales y conductuales y los accidentes laborales en trabajadores de grandes fábricas de Etiopía. Se trató de un estudio transversal, realizado de febrero a abril de 2020 con 457 trabajadores de grandes fábricas en Adís Abeba, la capital de Etiopía. Los datos recopilados contenían características sociodemográficas, condiciones de trabajo, de seguridad y factores conductuales como predictores de accidentes laborales. Se utilizó un modelo de regresión logística para estimar la probabilidad de lesión e identificar sus factores asociados. La prevalencia de accidentes laborales en 12 meses fue del 25%. La mayoría de las lesiones se produjeron a medianoche (8,8%). Los factores asociados a los accidentes laborales fueron el exceso de horas de trabajo (OR = 3,26; IC95%: 1,26-8,41), el tabaquismo (OR = 2,72; IC95%: 1,22-6,08) y la manipulación manual (OR = 2,30; IC95%: 1,13-4,72). El uso de equipos de protección individual redujo la probabilidad de lesiones (OR = 0,42; IC95%: 0,21-0,83). Aunque la prevalencia estimada de accidentes laborales fue inferior a la de otros estudios, los resultados apuntan a acciones que deben adoptarse para reducir la carga de accidentes laborales en Etiopía. Los resultados permiten reflexionar sobre los esfuerzos de preparación y las políticas dirigidas a mejorar la seguridad y la salud de los trabajadores.
Acidentes de trabalho são preocupações de saúde pública sérias e crescentes em todo o mundo. Apesar de acidentes de trabalho serem comuns, especialmente entre trabalhadores de indústrias manufatureiras, suas crescentes complexidades não são adequadamente abordadas na literatura atual. O objetivo deste estudo foi investigar a associação de características sociodemográficas, de ambiente e comportamentais com acidentes de trabalho em trabalhadores de fábricas de grande porte na Etiópia. Um estudo transversal foi conduzido de fevereiro a abril de 2020 com 457 trabalhadores selecionados de fábricas de grande escala em Adis Abeba, capital da Etiópia. Os dados da pesquisa incluíram características sociodemográficas, condições de trabalho e segurança e fatores comportamentais como preditores de acidentes de trabalho. Ajustou-se um modelo de regressão logística para estimar a probabilidade de lesão e identificar seus fatores associados. A prevalência de 12 meses de acidentes de trabalho foi de 25%. A maioria das lesões ocorreu à meia-noite (8,8%). Os fatores associados aos acidentes de trabalho foram jornada excessiva (OR = 3,26; IC95%: 1,26-8,41), tabagismo (OR = 2,72; IC95%: 1,22-6,08) e manuseio manual (OR = 2,30; IC95%: 1,13-4,72). O uso de equipamentos de proteção individual diminuiu a chance de lesão (OR = 0,42; IC95%: 0,21-0,83). Embora nossa prevalência estimada de acidentes ocupacionais tenha sido menor em comparação com outros estudos, nossos resultados apontam para ações pendentes sobre condições modificáveis a serem tomadas para reduzir a carga de acidentes de trabalho na Etiópia. Os resultados poderão informar os esforços de preparação e políticas destinados a melhorar a segurança e a saúde dos trabalhadores.
RESUMEN
BACKGROUND: Traumatic brain injury (TBI) is a major public health problem worldwide. Although computed tomography (CT) scans are often used for TBI workup, clinicians in low-income countries are limited by fewer radiographic resources. The Canadian CT Head Rule (CCHR) and the New Orleans Criteria (NOC) are widely used screening tools to rule out clinically important brain injury without CT imaging. Although these tools are well validated in studies from upper- and middle-income countries, it is important to study these tools in low-income countries. This study sought to validate the CCHR and NOC in a tertiary teaching hospital population in Addis Ababa, Ethiopia. METHODS: This single-center retrospective cohort study included patients older than 13 years presenting from December 2018 to July 2021 with a head injury and a Glasgow Coma Scale score of 13-15. Retrospective chart review collected demographic, clinical, radiographic, and hospital course variables. Proportion tables were constructed to determine the sensitivity and specificity of these tools. RESULTS: A total of 193 patients were included. Both tools showed 100% sensitivity for identifying patients requiring neurosurgical intervention and abnormal CT scans. The specificity for the CCHR was 41.5% and 26.5% for the NOC. Male gender, falling accidents, and headaches had the strongest association with abnormal CT findings. CONCLUSIONS: The NOC and the CCHR are highly sensitive screening tools that can help rule out clinically important brain injury in mild TBI patients without a head CT in an urban Ethiopian population. Their implementation in this low-resource setting may help spare a significant number of CT scans.