Emergency room visits for work-related injuries: characteristics and associated factors - Capitals and the Federal District, Brazil, 2011

Mascarenhas, Márcio Dênis Medeiros; Freitas, Mariana Gonçalves de; Monteiro, Rosane Aparecida; Silva, Marta Maria Alves da; Malta, Deborah Carvalho; Gómez, Carlos Minayo

doi:10.1590/1413-81232015203.16842014

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Article • Ciênc. saúde coletiva 20 (3) • Mar 2015 • https://doi.org/10.1590/1413-81232015203.16842014 copy

Emergency room visits for work-related injuries: characteristics and associated factors - Capitals and the Federal District, Brazil, 2011

Authorship SCIMAGO INSTITUTIONS RANKINGS

Work-related injuries, often classified as occupational injuries (OI), stand out among visits due to external causes (accidents and violence) in health services. To describe the characteristics and factors associated with emergency room visits for OI, a cross-sectional study was conducted using data from the Survey of Violence and Injuries in Emergency Services (VIVA Inquérito 2011) in 24 state capitals and the Federal District. The prevalence of treatment for OI and prevalence ratios (PR) with confidence intervals of 95% (95%CI) were calculated. There were 29,463 emergency room visits due to accidental injuries in the population above 18 years of age. The prevalence of OI was 33.4% and was positively and significantly associated with the male gender, age 30-59 years old, industrial workers, agricultural sector or repair and maintenance services. The occurrence of OI was significantly higher in attendance for objects falling on people (PR = 3.37, 95% CI 2.80 to 4.05) and injuries due to perforating object (PR = 3.01, 95% CI 2.50-3.65). The results support the surveillance of external causes and direct public policies to promote occupational health.

Occupational health; Work-related accidents; External causes; Emergency medical services

		Work-related event
	Total				95%CI
Characteristics	Total	Yes	No	PR	95%CI	p
	(n = 29,463)^b	(n = 9,754)^b	(n = 19,709)^b			value
	%^c	%^c	%^c

Gender
Female	35.0	22.3	77.7	1.00	-	-
Male	65.0	39.4	60.6	1.77	1.68-1.86	0.000
Age range (years)
18 to 29	38.2	34.3	65.8	1.00	-	-
30 to 39	23.4	40.1	59.9	1.17	1.12-1.23	0.000
40 to 59	26.5	36.3	63.7	1.06	1.01-1.12	0.023
60 and older	11.9	11.4	88.6	0.33	0.30-0.37	0.000
Race/skin color
White	32.6	32.1	67.9	1.00	-	-
Black/brown	65.2	34.1	65.9	1.06	1.00-1.13	0.063
Yellow/Amerindian	2.2	34.1	65.9	1.06	0.95-1.20	0.302
Educational level (years of education)
9 and above	51.1	33.3	66.7	1.00	-	-
0 to 8	48.9	34.4	65.6	1.03	0.99-1.08	0.136
Disability
No	95.9	34.2	65.8	1.00	-	-
Yes	4.1	17.3	82.7	0.50	0.42-0.60	0.000
Occupational group
Science and arts professionals	5.5	30.0	70.0	1.00	-	-
Industrial goods production and services	34.0	55.4	44.7	1.85	1.63-2.09	0.000
Service providers and salespersons	33.5	44.1	55.9	1.47	1.29-1.68	0.000
Administrative service providers	7.2	40.8	59.2	1.36	1.17-1.59	0.000
Medium-level technicians	6.4	39.0	61.0	1.30	1.13-1.50	0.000
Agricultural laborers	4.7	45.7	54.3	1.52	1.33-1.75	0.000
Repair and maintenance services	4.5	51.6	48.4	1.72	1.48-2.00	0.000
Public and business managers	3.4	33.2	66.8	1.11	0.91-1.34	0.298
Armed and police forces, and fire service	0.8	34.8	65.2	1.16	0.89-1.52	0.279

			Work-related
			event
						95%IC
Characteristics	Total		Yes	No	PR	95%IC	p
	(n = 29,463)^b	(n = 9,754)^b		(n = 19,709)^b			value
	%^c		%^c	%^c

Place of occurrence
Home	32.4	10.5		89.5	1.00	-	-
Public street	41.5	30.2		69.8	2.88	2.66-3.13	0.000
Store/service establishment/bar	13.4	85.8		14.2	8.18	7.49-8.92	0.000
Recreational area	5.0	4.5		95.5	0.43	0.32-0.59	0.000
Factory/plant/construction site	4.7	95.6		4.5	9.11	8.33-9.97	0.000
School	0.7	30.4		69.7	2.89	2.26-3.71	0.000
Other	2.3	44.9		55.1	4.28	3.81-4.80	0.000
Type of injury
No injury	5.9	35.4		64.6	1.00	-	-
Cut/laceration/amputation	27.8	36.0		64.0	1.02	0.92-1.12	0.739
Sprain/dislocation	20.7	32.2		67.8	0.91	0.83-1.00	0.056
Bruise	19.3	34.5		65.5	0.97	0.89-1.07	0.581
Fracture	11.9	29.0		71.0	0.82	0.74-0.91	0.000
Trauma	8.3	25.4		74.6	0.72	0.63-0.82	0.000
Other	6.2	40.8		59.3	1.15	1.03-1.29	0.014
Afflicted body part
Head/neck	17.6	29.6		70.4	1.00	-	-
Thorax/abdomen/pelvis	9.2	34.6		65.4	1.17	1.07-1.27	0.000
Limbs	62.6	35.1		64.9	1.18	1.11-1.26	0.000
Multiple organs/sites	10.6	28.4		71.6	0.96	0.88-1.05	0.374
Alcohol use
No	88.8	36.6		63.5	1.00	-	-
Yes	11.2	9.0		91.0	0.25	0.21-0.28	0.000
Type of occurrence
Accident with animals	3.2	18.1		82.0	1.00	-	-
Traffic accident	33.9	31.3		68.7	1.73	1.44-2.09	0.000
Fall	29.4	23.1		76.9	1.28	1.08-1.52	0.005
Puncture wound	6.9	54.4		45.6	3.01	2.50-3.64	0.000
Struck by an object/person	5.7	28.2		71.9	1.56	1.30-1.87	0.000
Sprain	5.7	38.2		61.8	2.12	1.72-2.60	0.000
Foreign body	4.8	49.7		50.3	2.75	2.26-3.34	0.000
Struck by falling object	4.4	60.8		39.2	3.37	2.80-4.05	0.000
Burn	2.0	38.9		61.2	2.15	1.74-2.66	0.000
Other accidents^d	4.0	52.6		47.4	2.92	2.41-3.53	0.000

		Work-related event
	Total				95% IC
Characteristics	Total	Yes	No	PR	95% IC	p
	(n = 29,463)^b	(n = 9,754)^b	(n = 19,709)^b			value
	%^c	%^c	%^c

Means of travel to the hospital
MECS/ambulance/rescue	26.8	30.0	70.0	1.00	-	-
Private vehicle	52.0	32.6	67.4	1.09	1.02-1.15	0.007
Bus/van (public)	15.0	39.3	60.7	1.31	1.22-1.41	0.000
On foot	3.4	42.2	57.8	1.41	1.24-1.60	0.000
Police car	0.8	30.2	69.8	1.01	0.81-1.26	0.946
Other	2.0	43.2	56.8	1.44	1.27-1.63	0.000
Time of treatment
Nighttime	36.6	21.1	78.9	1.00	-	-
Daytime	63.4	40.5	59.5	1.92	1.80-2.05	0.000
Weekday of treatment
Sunday	14.9	13.3	86.7	1.00	-	-
Monday	14.7	34.7	65.3	2.61	2.31-2.96	0.000
Tuesday	15.3	41.0	59.0	3.09	2.72-3.50	0.000
Wednesday	13.1	35.9	64.1	2.70	2.35-3.11	0.000
Thursday	13.6	41.5	58.5	3.12	2.74-3.56	0.000
Friday	14.8	41.3	58.7	3.11	2.77-3.49	0.000
Saturday	13.6	26.5	73.5	1.99	1.76-2.26	0.000
Evolution
Discharge	77.7	34.2	65.8	1.00	-	-
Hospitalization	15.3	29.2	70.8	0.85	0.79-0.92	0.000
Referral to outpatient treatment	5.8	34.6	65.4	1.01	0.92-1.11	0.801
Discharge against medical advice	1.0	23.5	76.5	0.69	0.53-0.89	0.004
Death	0.1	33.6	66.4	0.98	0.62-1.56	0.934

							Type of occurrence

		Traffic accident						Fall				Puncture wound
Characteristics			(n = 10,463)				(n = 8,317)						(n = 2,302)
Characteristics
		%	PR (95%CI)			%		PR (95%CI)				%	PR (95%CI)

Total		31.3	-			23.1		-				54.4	-
Gender
Female		25.8	1.00			16.9		1.00				33.5	1.00
Male		33.2	1.28 (1.17-1.41)			29.3		1.74 (1.55-1.95)				61.4	1.83 (1.56-2.15)
Age range (years)
18 to 29		28.8	1.00			26.5		1.00				54.9	1.00
30 to 39		35.0	1.21 (1.13-1.31)			32.4		1.22 (1.08-1.38)				59.3	1.08 (0.96-1.21)
40 to 59		36.4	1.26 (1.17-1.37)			27.5		1.04 (0.91-1.18)				54.9	1.00 (0.89-1.12)
60 and older		14.8	0.51 (0.39-0.67)			6.9		0.26 (0.21-0.33)				31.8	0.58 (0.43-0.78)
Race/skin color
White		33.3	1.00			20.3		1.00				48.4	1.00
Black/brown		30.6	0.92 (0.84-1.01)			24.4		1.21 (1.07-1.36)				56.8	1.17 (1.02-1.35)
Yellow/Amerindian		29.1	0.87 (0.69-1.11)			31.7		1.56 (1.23-1.99)				59.9	1.24 (0.94-1.62)
Educational level (years
of education)
9 and above		33.3	1.00			23.9		1.00				47.9	1.00
0 to 8		30.0	0.90 (0.84-0.96)			22.9		0.96 (0.87-1.06)				60.5	1.26 (1.12-1.42)
Disability
No		31.5	1.00			24.3		1.00				55.2	1.00
Yes		29.3	0.93 (0.71-1.22)			9.3		0.38 (0.28-0.52)				20.5	0.37 (0.18-0.79)
Alcohol use
No		36.9	1.00			24.8		1.00				56.9	1.00
Yes		8.2	0.22 (0.19-0.26)			7.5		0.30 (0.23-0.40)				20.8	0.37 (0.25-0.52)

								Type of occurrence

				Struck by object/person								Sprain
Characteristics					(n = 1,607)							(n = 1,512)
Characteristics
			%			PR (95%CI)				%		PR (95%CI)

Total			28.2			-				38.2			-
Gender
Female			25.1			1.00				33.8			1.00
Male			29.5		1.17 (0.95-1.44)					41.5		1.23 (1.03-1.46)
Age range (years)
18 to 29			22.0			1.00				35.9			1.00
30 to 39			38.0		1.73 (1.35-2.22)					44.2		1.23 (1.03-1.47)
40 to 59			34.6		1.57 (1.22-2.04)					42.2		1.18 (0.98-1.40)
60 and older			13.1		0.60 (0.29-1.24)					12.9		0.36 (0.17-0.76)
Race/skin color
White			29.9			1.00				38.3			1.00
Black/brown			27.0		0.90 (0.78-1.04)					38.6		1.01 (0.84-1.21)
Yellow/Amerindian			31.7		1.06 (0.62-1.82)					28.2		0.74 (0.45-1.21)
Educational level (years of education)
9 and above			26.1			1.00				34.3			1.00
0 to 8			31.8		1.22 (1.03-1.46)					44.1		1.29 (1.13-1.46)
Disability
No			28.3			1.00				38.8			1.00
Yes			23.3		0.82 (0.40-1.67)					17.4		0.45 (0.20-0.99)
Alcohol use
No			29.0			1.00				39.6			1.00
Yes			10.5		0.36 (0.15-0.88)					8.9		0.22 (0.10-0.53)
								Type of occurrence

	Struck by falling object							Foreign body				Accident with animals
Characteristics			(n = 1,334)						(n = 1,200)					(n = 978)
	%		PR (95%CI)			%			PR (95%CI)				%	PR (95%CI)

Total	60.8		-			49.7			-		18.1			-
Gender
Female	28.5		1.00			20.0			1.00				8.6	1.00
Male	71.0		2.49 (2.02-3.07)			57.6			2.89 (1.99-4.20)		26.7			3.09 (2.06-4.66)
Age range (years)
18 to 29	69.9		1.00			56.9			1.00		18.4			1.00
30 to 39	61.6		0.88 (0.79-0.98)			55.4			0.97 (0.84-1.12)		20.3			1.10 (0.76-1.60)
40 to 59	58.2		0.83 (0.73-0.95)			43.5			0.76 (0.67-0.87)		20.6			1.12 (0.69-1.81)
60 and older	29.2		0.42 (0.29-0.61)			23.2			0.41 (0.27-0.61)				9.9	0.54 (0.28-1.03)
Race/skin color
White	54.4		1.00			50.8			1.00		18.9			1.00
Black/brown	64.0		1.18 (1.02-1.36)			48.8			0.96 (0.83-1.11)		17.8			0.94 (0.59-1.49)
Yellow/Amerindian	55.0		1.01 (0.69-1.47)			57.5			1.13 (0.75-1.71)				8.3	0.44 (0.15-1.29)
Educational level (years of
education)
9 and above	58.4		1.00			46.5			1.00		13.1			1.00
0 to 8	62.9		1.08 (0.96-1.21)			53.0			1.14 (0.99-1.32)		23.5			1.80 (1.22-2.65)
Disability
No	61.4		1.00			50.3			1.00		18.5			1.00
Yes	42.3		0.69 (0.39-1.21)			32.0			0.64 (0.36-1.11)				8.9	0.48 (0.10-2.30)
Alcohol use
No	62.1		1.00			50.6			1.00		18.6			1.00
Yes	26.0		0.42 (0.22-0.80)			14.3			0.28 (0.10-0.77)				9.1	0.49 (0.15-1.61)

									Type of occurrence

							Burn					Other accidents ^b
Characteristics						(n = 588)							(n = 1,119)
Characteristics
			%				PR (95%CI)				%			PR (95%CI)

Total			38.9			-					52.6			-
Gender
Female			22.8			1.00					33.6			1.00
Male			51.4		2.25 (1.55-3.26)						60.7		1.81 (1.44-2.27)
Age range (years)
18 to 29			40.0			1.00					58.1			1.00
30 to 39			50.6		1.26 (0.89-1.80)						52.4		0.90 (0.79-1.03)
40 to 59			34.0		0.85 (0.62-1.16)						51.9		0.89 (0.76-1.05)
60 and older			10.7		0.27 (0.12-0.61)						29.3		0.50 (0.30-0.84)
Race/skin color
White			27.6			1.00					49.4			1.00
Black/brown			45.7		1.65 (1.25-2.18)						54.9		1.11 (0.90-1.38)
Yellow/Amerindian			12.5		0.45 (0.07-3.12)						42.7		0.86 (0.47-1.59)
Educational level (years of education)
9 and above			41.8			1.00					50.0			1.00
0 to 8			35.6		0.85 (0.66-1.10)						57.4		1.15 (1.01-1.30)
Disability
No			39.5			1.00					53.8			1.00
Yes			24.4		0.62 (0.30-1.27)						29.5		0.55 (0.31-0.98)
Alcohol use
No			38.9			1.00					55.3			1.00
Yes			13.5		0.35 (0.07-1.85)						8.9		0.16 (0.07-0.37)

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[1] Collaborations MDM Mascarenhas contributed to the study concept and design, data analysis and writing the manuscript. RA Monteiro contributed to data mining and analysis. MG Freitas, MMA da Silva, DC Malta and C Minayo Gómes contributed to data analysis and interpretation and reviewed the manuscript. All of the authors have reviewed the text and approved the final version.