A Case-Crossover Study of Transient Risk Factors for Occupational Hand Trauma by Gender

Abstract

An estimated 8.2 million occupational injuries occur annually to women in the United States. This case-crossover study of 1166 subjects compares transient risk factors for occupational traumatic hand injury to women and men. Study subjects were recruited over a 3-year period (1997 to 2000) from 23 occupational health clinics in five New England states. The case-crossover design was used to estimate the short-term risk of an acute hand injury while controlling between-person potential confounders. Subjects reported on the occurrence of seven transient exposures within a 90-min period and provided control exposure information during the month before an acute hand injury. A total of 275 women and 891 men were interviewed a median of 1.3 days after injury. Lacerations were the most common injury type in both women (58%) and men (64%). Relative risks for women were higher for being distracted, doing unusual tasks, and working with malfunctioning equipment or materials, and were lower than men for being rushed. Gloves provided significant protection for males and females. Results suggest the importance of considering both the prevalence of various exposures and gender in modifying risk factors to reduce the incidence of acute hand injury in the workplace. Thus, greater emphasis should be placed on the planning of safer working environments for all workers.

Keywords:

• case-crossover
• gender
• hand
• risk factors
• transient
• traumatic injury

ACKNOWLEDGMENTS

This work was supported by the National Institute for Occupational Safety and Health and the Liberty Mutual Research Institute for Safety. The authors are grateful to Dr. Gordon Smith and Theodore K. Courtney for their thoughtful comments on this manuscript. The authors are pleased to also acknowledge the constructive comments of the reviewers and editor in chief of this journal.

We are indebted to the clinicians and staff of two sets of occupational health clinics in New England who recruited the majority of subjects in this study: Occupational Health + Rehabilitation (OH + R) and Industrial Health Care, Inc. (IHC), now known as Concentra. We appreciate the efforts of Judith Oulette, Kate Dwyer, Mary Dionne, and Susan Martin in conducting telephone interviews, and Roger Racine for his technical assistance.

Notes

^A SEM = standard error of mean.

^B Includes overtime.

^A SEM = standard error of mean.

^A RR = relative risk.

^B CI = confidence interval.