Preventive Effects of Safety Helmets on Traumatic Brain Injury after Work-Related Falls
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Setting
2.2. Data Source and Collection
2.3. Study Population
2.4. Main Outcomes
2.5. Variables and Measurements
2.6. Statistical Analysis
2.7. Ethics Statements
3. Results
4. Discussion
Limitation
5. Conclusions
Acknowledgments
Funding Statement
Author Contributions
Conflicts of Interest
References
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Characteristics | Total | Safety Helmet | No Safety Helmet | p-Value | |||
---|---|---|---|---|---|---|---|
N | % | n | % | n | % | ||
Total | 1298 | 100.0 | 584 | 714 | |||
Patient characteristics | |||||||
Age, year | 0.578 | ||||||
18–29 | 77 | 5.9 | 35 | 6.0 | 42 | 5.9 | |
30–49 | 589 | 45.4 | 272 | 46.6 | 317 | 44.4 | |
50–64 | 548 | 42.2 | 245 | 42.0 | 303 | 42.4 | |
65 and over | 84 | 6.5 | 32 | 5.5 | 52 | 7.3 | |
Median (IQR) | 49 (41–56) | 49 (41–55) | 49 (41–56) | 0.055 | |||
Gender | <0.0001 | ||||||
Male | 1207 | 93.0 | 569 | 97.4 | 638 | 89.4 | |
Female | 91 | 7.0 | 15 | 2.6 | 76 | 10.6 | |
Occupation | <0.0001 | ||||||
Managers | 14 | 1.1 | 7 | 1.2 | 7 | 1.0 | |
Professionals | 23 | 1.8 | 6 | 1.0 | 17 | 2.4 | |
Technicians and associate professionals | 174 | 13.4 | 106 | 18.2 | 68 | 9.5 | |
Clerical support workers | 22 | 1.7 | 4 | 0.7 | 18 | 2.5 | |
Service and sales workers | 74 | 5.7 | 8 | 1.4 | 66 | 9.2 | |
Skilled agricultural, forestry and fishery workers | 84 | 6.5 | 7 | 1.2 | 77 | 10.8 | |
Craft and related trades workers | 378 | 29.1 | 211 | 36.1 | 167 | 23.4 | |
Plant and machine operators and assemblers | 107 | 8.2 | 30 | 5.1 | 77 | 10.8 | |
Elementary occupations | 387 | 29.8 | 195 | 33.4 | 192 | 26.9 | |
Other | 35 | 2.7 | 10 | 1.7 | 25 | 3.5 | |
Educational level | 0.001 | ||||||
Middle school or below | 389 | 30.0 | 177 | 30.3 | 212 | 29.7 | |
High school | 596 | 45.9 | 296 | 50.7 | 300 | 42.0 | |
College or above | 179 | 13.8 | 70 | 12.0 | 109 | 15.3 | |
Unknown | 134 | 10.3 | 41 | 7.0 | 93 | 13.0 | |
Annual income, USD | 0.001 | ||||||
0–30,000 | 631 | 48.6 | 291 | 49.8 | 340 | 47.6 | |
Over 30,000 | 324 | 25.0 | 169 | 28.9 | 155 | 21.7 | |
Unknown | 343 | 26.4 | 124 | 21.2 | 219 | 30.7 | |
Occupation and workplace information | |||||||
Type of employment | <0.0001 | ||||||
Contracted worker | 652 | 50.2 | 266 | 45.5 | 386 | 54.1 | |
Daily worker | 573 | 44.1 | 296 | 50.7 | 277 | 38.8 | |
Other | 73 | 5.6 | 22 | 3.8 | 51 | 7.1 | |
Working type | <0.0001 | ||||||
Lone work | 402 | 31.0 | 118 | 20.2 | 284 | 39.8 | |
Cooperative work | 896 | 69.0 | 466 | 79.8 | 430 | 60.2 | |
Safety education enrollment | <0.0001 | ||||||
Yes | 680 | 52.4 | 429 | 73.5 | 251 | 35.2 | |
No | 543 | 41.8 | 138 | 23.6 | 405 | 56.7 | |
Unknown | 75 | 5.8 | 17 | 2.9 | 58 | 8.1 | |
Construction-related work | <0.0001 | ||||||
Yes | 383 | 29.5 | 254 | 43.5 | 129 | 18.1 | |
Injury characteristics | |||||||
Height of fall injury, meter | <0.0001 | ||||||
0–2 | 370 | 28.5 | 116 | 19.9 | 254 | 35.6 | |
2–4 | 595 | 45.8 | 275 | 47.1 | 320 | 44.8 | |
4–6 | 192 | 14.8 | 100 | 17.1 | 92 | 12.9 | |
Over 6 | 141 | 10.9 | 93 | 8.2 | 48 | 6.7 | |
Median (IQR) | 2.2 (1.5–4.0) | 3.0 (2.0–4.0) | 2.0 (1.5–3.0) | <0.0001 | |||
Time of injury | <0.0001 | ||||||
Scheduled job | 1200 | 92.4 | 550 | 94.2 | 650 | 91.0 | |
Extended/holiday work | 70 | 5.4 | 33 | 5.7 | 37 | 5.2 | |
Other | 28 | 2.2 | 1 | 0.2 | 27 | 3.8 | |
Place of injury | <0.0001 | ||||||
Industrial or construction area | 816 | 62.9 | 450 | 77.1 | 366 | 51.3 | |
Farm or other place of primary production | 139 | 10.7 | 46 | 7.9 | 93 | 13.0 | |
Transport area (road) | 70 | 5.4 | 20 | 3.4 | 50 | 7.0 | |
Other public area | 166 | 12.8 | 26 | 4.5 | 140 | 19.6 | |
Home and residential institution | 107 | 8.2 | 42 | 7.2 | 65 | 9.1 | |
Cause of the incident | <0.0001 | ||||||
Fall from step or ladder | 393 | 30.3 | 166 | 28.4 | 227 | 31.8 | |
Fall from existing floor openings | 67 | 5.2 | 32 | 5.5 | 35 | 4.9 | |
Fall from a stack of luggage or payload | 93 | 7.2 | 37 | 6.3 | 56 | 7.8 | |
Fall from roof | 78 | 6.0 | 26 | 4.5 | 52 | 7.3 | |
Fall from scaffolding or staging | 174 | 13.4 | 111 | 19.0 | 63 | 8.8 | |
Fall from building girders or other structural steel | 210 | 16.2 | 142 | 24.3 | 68 | 9.5 | |
Fall from nonmoving vehicle or machine equipment | 208 | 16.0 | 61 | 10.4 | 147 | 20.6 | |
Other | 75 | 5.8 | 9 | 1.5 | 66 | 9.2 | |
Clinical outcomes | |||||||
Mode of transportation | 0.048 | ||||||
EMS use | 888 | 68.4 | 416 | 71.2 | 472 | 66.1 | |
Head injury | |||||||
Head injury (S06.0–S06.9) | 174 | 13.4 | 67 | 11.5 | 107 | 15.0 | 0.065 |
Intracranial injury (S06.1–S06.9) | 89 | 6.9 | 27 | 4.6 | 62 | 8.7 | 0.004 |
Anatomical classification of injury | |||||||
Head, face, neck | 597 | 46.0 | 236 | 40.4 | 361 | 50.6 | <0.0001 |
Thorax | 285 | 22.0 | 132 | 22.6 | 153 | 21.4 | 0.611 |
Abdomen | 325 | 25.0 | 164 | 28.1 | 161 | 22.5 | 0.022 |
Extremity | 640 | 49.3 | 287 | 49.1 | 353 | 49.4 | 0.916 |
External and other | 112 | 8.6 | 78 | 13.4 | 34 | 4.8 | <0.0001 |
Multiple injury | 0.038 | ||||||
More than 2 anatomical region | 513 | 39.5 | 249 | 42.6 | 264 | 37.0 | |
Operation | 0.047 | ||||||
Yes | 343 | 26.4 | 170 | 29.1 | 173 | 24.2 | |
ED disposition | 0.008 | ||||||
Discharge | 409 | 31.5 | 159 | 27.2 | 250 | 35.0 | |
Transfer to other hospital | 131 | 10.1 | 70 | 12.0 | 61 | 8.5 | |
Admission | 739 | 56.9 | 344 | 58.9 | 395 | 55.3 | |
Death | 19 | 1.5 | 11 | 1.9 | 8 | 1.1 | |
In-hospital mortality | |||||||
Total | 39 | 3.0 | 18 | 3.1 | 21 | 2.9 | 0.882 |
In ED | 19 | 1.5 | 11 | 1.9 | 8 | 1.1 | |
In Ward or ICU | 20 | 2.7 | 7 | 2.0 | 13 | 3.3 | |
Expected days away from work | 0.001 | ||||||
Median (IQR) | 21 (7–42) | 28 (8–46) | 20 (5–40) | ||||
Convalescence by insurance, week | <0.0001 | ||||||
Median (IQR) | 6 (2–8) | 5 (2–8) | 6 (3–10) |
Characteristics | Total | Intracranial Injury | No Intracranial Injury | p-Value | |||
---|---|---|---|---|---|---|---|
N | % | n | % | n | % | ||
Total | 1298 | 100.0 | 89 | 1209 | |||
Helmet | 0.004 | ||||||
Safety helmet | 584 | 45.0 | 27 | 30.3 | 557 | 46.1 | |
No safety helmet | 714 | 55.0 | 62 | 69.7 | 652 | 53.9 | |
Height of fall injury, meter | 0.328 | ||||||
0–2 | 370 | 28.5 | 18 | 20.2 | 352 | 29.1 | |
2–4 | 595 | 45.8 | 44 | 49.4 | 551 | 45.6 | |
4–6 | 192 | 14.8 | 15 | 16.9 | 177 | 14.6 | |
Over 6 | 141 | 10.9 | 12 | 13.5 | 129 | 10.7 | |
Median (IQR) | 2.2 (1.5–4.0) | 2.5 (2.0–4.0) | 2.0 (1.5–4.0) | 0.332 | |||
Age, year | 0.598 | ||||||
Median (IQR) | 49 (41–56) | 50 (41–57) | 49 (41–56) | ||||
Gender | 0.744 | ||||||
Male | 1207 | 93.0 | 82 | 92.1 | 1125 | 93.1 | |
Type of employment | 0.630 | ||||||
Contracted worker | 652 | 50.2 | 43 | 48.3 | 609 | 50.4 | |
Daily worker | 573 | 44.1 | 39 | 43.8 | 534 | 44.2 | |
Other | 73 | 5.6 | 7 | 7.9 | 66 | 5.5 | |
Safety education enrollment | 0.405 | ||||||
Yes | 680 | 52.4 | 45 | 50.6 | 635 | 52.5 | |
No | 543 | 41.8 | 36 | 40.4 | 507 | 41.9 | |
Unknown | 75 | 5.8 | 8 | 9.0 | 67 | 5.5 | |
Construction-related work | 0.305 | ||||||
Yes | 383 | 29.5 | 22 | 24.7 | 361 | 29.9 | |
Place of injury | 0.986 | ||||||
Industrial or construction area | 816 | 62.9 | 57 | 64.0 | 759 | 62.8 | |
Farm or other place of primary production | 139 | 10.7 | 9 | 10.1 | 130 | 10.8 | |
Transport area (road) | 70 | 5.4 | 5 | 5.6 | 65 | 5.4 | |
Other public area | 166 | 12.8 | 12 | 13.5 | 154 | 12.7 | |
Home and residential institution | 107 | 8.2 | 6 | 6.7 | 101 | 8.4 | |
Cause of the incident | <0.0001 | ||||||
Fall from step or ladder | 393 | 30.3 | 29 | 32.6 | 364 | 30.1 | |
Fall from existing floor openings | 67 | 5.2 | 3 | 3.4 | 64 | 5.3 | |
Fall from a stack of luggage or payload | 93 | 7.2 | 10 | 11.2 | 83 | 6.9 | |
Fall from roof | 78 | 6.0 | 5 | 5.6 | 73 | 6.0 | |
Fall from scaffolding or staging | 174 | 13.4 | 8 | 9.0 | 166 | 13.7 | |
Fall from building girders or other structural steel | 210 | 16.2 | 16 | 18.0 | 194 | 16.0 | |
Fall from nonmoving vehicle or machine equipment | 208 | 16.0 | 15 | 16.9 | 193 | 16.0 | |
Other | 75 | 5.8 | 3 | 3.4 | 72 | 6.0 | |
Mode of transportation | <0.0001 | ||||||
EMS use | 888 | 68.4 | 78 | 87.6 | 810 | 67.0 | |
In-hospital mortality | <0.0001 | ||||||
Death | 39 | 3.0 | 9 | 10.1 | 30 | 2.5 | |
Expected days away from work | <0.0001 | ||||||
Median (IQR) | 21 (7–42) | 33 (21–56) | 21 (6–42) | ||||
Convalescence by insurance, week | 0.001 | ||||||
Median (IQR) | 6.0 (2–8) | 7.5 (6–8) | 6.0 (2–8) |
Characteristics | Total | Outcomes | Unadjusted | Adjusted † | |||
---|---|---|---|---|---|---|---|
N | n | % | OR | 95% CI | OR | 95% CI | |
Primary Outcome: Intracranial Injury | |||||||
Helmet | |||||||
Safety helmet | 584 | 27 | 4.6 | 0.51 | (0.32–0.81) | 0.42 | (0.24–0.73) |
No safety helmet | 714 | 62 | 8.7 | 1.00 | 1.00 | ||
Height of fall, meter | |||||||
0–2 | 370 | 18 | 4.9 | 1.00 | 1.00 | ||
2–4 | 595 | 44 | 7.4 | 1.56 | (0.89–2.75) | 1.65 | (0.91–2.98) |
4–6 | 192 | 15 | 7.8 | 1.66 | (0.82–3.37) | 1.73 | (0.82–3.67) |
Over 6 | 141 | 12 | 8.5 | 1.82 | (0.85–3.88) | 2.24 | (1.00–5.04) |
Secondary Outcome: In-Hospital Mortality | |||||||
Helmet | |||||||
Safety helmet | 584 | 18 | 3.1 | 1.05 | (0.55–1.99) | 0.83 | (0.34–2.03) |
No safety helmet | 714 | 21 | 2.9 | 1.00 | 1.00 | ||
Height of fall, meter | |||||||
0–2 | 370 | 3 | 0.8 | 1.00 | 1.00 | ||
2–4 | 595 | 10 | 1.7 | 2.09 | (0.57–7.65) | 3.11 | (0.80–12.09) |
4–6 | 192 | 8 | 4.2 | 5.32 | (1.40–20.29) | 10.27 | (2.42–43.54) |
Over 6 | 141 | 18 | 12.8 | 17.9 | (5.19–61.81) | 39.54 | (9.84–158.88) |
Characteristics | Total | Outcomes | Adjusted † | ||
---|---|---|---|---|---|
N | n | % | OR | 95% CI | |
Primary Outcome: Intracranial Injury | |||||
Height of fall, 0–2 m | |||||
Safety helmet | 116 | 2 | 1.7 | 0.21 | (0.05–0.96) |
No safety helmet | 254 | 16 | 6.3 | 1.00 | |
Height of fall, 2–4 m | |||||
Safety helmet | 275 | 12 | 4.4 | 0.37 | (0.18–0.77) |
No safety helmet | 320 | 32 | 10.0 | 1.00 | |
Height of fall, 4–6 m | |||||
Safety helmet | 100 | 6 | 6.0 | 0.64 | (0.21–1.98) |
No safety helmet | 92 | 9 | 9.8 | 1.00 | |
Height of fall, over 6 m | |||||
Safety helmet | 93 | 7 | 7.5 | 0.74 | (0.21–2.67) |
No safety helmet | 48 | 5 | 10.4 | 1.00 | |
Secondary Outcome: In-hospital Mortality | |||||
Height of fall, 0–2 m | |||||
Safety helmet | 116 | 0 | 0.0 | - | - |
No safety helmet | 254 | 3 | 1.2 | 1.00 | |
Height of fall, 2–4 m | |||||
Safety helmet | 275 | 4 | 1.5 | 0.99 | (0.25–3.91) |
No safety helmet | 320 | 6 | 1.9 | 1.00 | |
Height of fall, 4–6 m | |||||
Safety helmet | 100 | 4 | 4.0 | 1.20 | (0.25–5.69) |
No safety helmet | 92 | 4 | 4.3 | 1.00 | |
Height of fall, over 6 m | |||||
Safety helmet | 93 | 10 | 10.8 | 0.70 | (0.19–2.56) |
No safety helmet | 48 | 8 | 16.7 | 1.00 |
© 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Kim, S.C.; Ro, Y.S.; Shin, S.D.; Kim, J.Y. Preventive Effects of Safety Helmets on Traumatic Brain Injury after Work-Related Falls. Int. J. Environ. Res. Public Health 2016, 13, 1063. https://doi.org/10.3390/ijerph13111063
Kim SC, Ro YS, Shin SD, Kim JY. Preventive Effects of Safety Helmets on Traumatic Brain Injury after Work-Related Falls. International Journal of Environmental Research and Public Health. 2016; 13(11):1063. https://doi.org/10.3390/ijerph13111063
Chicago/Turabian StyleKim, Sang Chul, Young Sun Ro, Sang Do Shin, and Joo Yeong Kim. 2016. "Preventive Effects of Safety Helmets on Traumatic Brain Injury after Work-Related Falls" International Journal of Environmental Research and Public Health 13, no. 11: 1063. https://doi.org/10.3390/ijerph13111063