title: A case-crossover study of work-related acute traumatic hand injuries in the People's Republic of         China.
abstract: OBJECTIVE
  The aim of this study was to quantify potential transient risk factors for occupational acute hand         injury among hospitalized workers in the People's Republic of China (PRC).
  
  
  METHODS
  Participants were recruited         from 11 medical facilities in 3 cities of the PRC. A face-to-face interview was used to collect information on the         occurrence of 8 potential risk factors within a 90-minute time period before an acute traumatic hand injury and during         a control period within the month before the injury. The reliability of reporting transient risk factors was assessed,         and a case-crossover design was used to estimate the injury incidence risk ratio (IRR) of each risk factor.
  
  
  RESULTS
  In         total,703 hospitalized workers completed the interview (527 male, 176 female), with a mean age of 31.8 [standard         deviation (SD) 10.3] years. The median time interval between injury and interview was four days. Thirty percent of         participants had a crush injury and 25.7% had an amputation. Using malfunctioning machinery/tools/material, performing         a task with a different method, working overtime, and wearing gloves were found to have good reliability in test-retest         examination [intra-class correlation coefficient (ICC)>0.9]. The IRR of a hand injury were markedly increased while         using malfunctioning machinery/tools/material [110.4, 95% confidence interval (95% CI) 97.4-125.2], performing a         task with a different method than usual (84.3, 95% CI 67.7-105.1), or being distracted (69.6, 95% CI         57.9-83.7). Gender and size of company were associated with differences in glove usage.
  
  
  CONCLUSIONS
  The results         suggest the importance of transient, potentially modifiable factors in the etiology of occupational acute hand injury         in the PRC. Regular maintenance of machinery/tools, work practice controls, and avoiding distractions should be         priorities for reducing the risk of occupational acute hand injuries.
authors: Department of Occupational Health, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, People's Republic of China. zhkjin@fudan.edu.cn
authors: Kezhi
authors: K
authors: Jin
authors: David A
authors: DA
authors: Lombardi
authors: Theodore K
authors: TK
authors: Courtney
authors: Gary S
authors: GS
authors: Sorock
authors: Mingqiang
authors: M
authors: Li
authors: Rong
authors: R
authors: Pan
authors: Xin
authors: X
authors: Wang
authors: Jie
authors: J
authors: Lin
authors: Youxin
authors: Y
authors: Liang
authors: Melissa J
authors: MJ
authors: Perry
mesh_terms: D000208:Acute Disease; D000328:Adult; D002681:China / Q000453:epidemiology; D016001:Confidence Intervals; D005260:Female; D006230:Hand Injuries / Q000453:epidemiology / Q000209:etiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects*; D016272:Occupational Health / Q000706:statistics & numerical data*; D016017:Odds Ratio; D012307:Risk Factors; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D013997:Time Factors; D017132:Workplace; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology*