鲁豫冀三省农业机械伤害流行情况及相关因素调查

Prevalence and related factors of injury caused by agricultural machinery in the 3 provinces Shandong, Henan and Hebei of China

目的 了解鲁豫冀3个省农业机械伤害发生率及流行特征,探讨伤害发生相关因素.方法 于2009年采用多阶段分层立意整群抽样抽取鲁豫冀3省18～ 60岁农业机械操作人员共1621名,采用自行设计的问卷调查其基本人口特征,过去1年农业机械伤害发生情况及相关社会心理因素状况.对农业机械伤害基本特征进行描述,并对伤害发生相关因素进行单因素和多因素分析.结果 所调查的农业机械操作人群机械伤害发生率为13.44％ （213/1585）,其中男性为14.46％（202/1397）,女性5.85％ （11/188） （x2=10.56,P＜0.01）.伤害主要发生于4-8月（155例,72.77％）;主要致伤原因为被转柄打伤（45例,占21.13％）、被机械压伤或砸伤（32例,占15.02％）、从机器上跌落摔伤（28例,占13.15％）;主要伤害类型为皮肤损伤（115例,占53.99％）、拉伤或扭伤（68例,占31.92％）和骨折（37例,占17.37％）;主要致伤机械为拖拉机或机动三轮车（133例,占62.44％）.多因素logistic回归分析结果显示,男性（OR=3.18,95％CI：1.65～6.15）、高中以上文化程度（OR=1.69,95％ CI：1.21 ～2.34）、家庭年收入＜2000元（OR=1.94,95％ CI：1.13 ～3.32）、农业机械操作年限≤5年（OR=1.70,95％CI：1.13～2.55）、白天困倦感强烈（OR=2.89,95％ CI：1.66～5.01）、生产劳动过程中吸烟（OR=1.43,95％ CI：1.05 ～ 1.96）、负债（OR=1.88,95％CI：1.35～2.63）、患相关疾病（OR=1.42,95％ CI：1.02 ～ 1.98）为农业机械伤害的危险因素.结论 鲁豫冀3个省农业机械伤害在农业机械操作者群体特别是男性人群中发生率较高,农业机械伤害已成为影响我国农村劳动力健康的一个重要公共卫生问题.

Objective To study the prevalent characteristics and related factors of injuries caused by agricultural machinery in 3 provinces Shandong, Henan and Hebei in China. Methods A total of 1621 agricultural machinery operators aged between 18 and 60 years old from Shandong, Henan and Hebei provinces were selected by purposive-cluster sampling method in 2009. Demographic characteristics, injury history caused by agricultural machinery in the last year and the related social and psychological factors were collected by self-designed questionnaire. We used statistical description to report the injury prevalence, and adopted the univariate and multivariate analysis to explore the risk factors. Results The average incidence of injuries caused by agricultural machinery was 13.44% （213/1585） in the three provinces, of which 14.46% （202/1397） in males and 5.85% （11/188） in females （X2 = 10. 56,P 〈0. 01 ）. Most of injuries （155 cases, 72.77% ） occurred between April and August. Being stuck by rolling starting handles （45 cases, 21.13% ） , being crushed by running or dropping machineries （32 cases, 15.02% ）, fall from machines （28 cases, 13.15% ） ranked the top three causes of injuries. The main related machines were tractors and motor tricycles （133 cases, 62.44% ）. The leading types of injuries were scratch （115 cases, 53.99% ）, strain （68 cases, 31.92% ） and fracture （37 cases, 17.37% ）. Results of multivariate logistic regression analysis showed that being male （ OR = 3.18, 95% CI： 1.65 - 6. 15 ） , educational level above high school（ OR = 1.69, 95% CI： 1.21 - 2. 34） , annual family income 〈 2000 yuan （ OR = 1.94, 95% CI： 1.13 - 3.32） , operating experience ≤ 5 years （ OR = 1.70, 95% CI： 1.13 - 2. 55 ） , daytime sleepiness （ OR =2.89, 95% CI： 1.66 - 5.01 ） , smoking during machinery operation （ OR = 1.43, 95% CI： 1.05 - 1.96） , bearing debts （ OR = 1.88, 95% CI： 1.35 - 2. 63 ） and suffering from other diseases （ OR = 1.42, 95%CI： 1.02 - 1.98 ） were risk factors of agricultural machinery injuries. Conclusion The average incidence of injuries caused by agricultural machinery in the three provinces Shandong, Henan and Hebei, was rather high among agricultural machinery operators, especially in the males. Agricultural machinery injury has been an important issue endangering the health of rural labor force in recent years.