马来西亚新山市工作相关眼外伤调查分析（英文）

Work-related ocular injuries in Johor Bahru,Malaysia

目的：调查马来西亚南部三级医院的工作相关眼外伤的流行病学与其视力情况。方法：回顾性调查研究。选取2011年1月至2013年12月在马来西亚新山市Sultan Ismail医院就诊的工作相关眼外伤患者的病历资料。运用标准表格形式收集临床表现,损伤种类,眼部保护装置的使用和视力情况等数据。结果：在3y内共935例眼外伤患者于Sultan Ismail医院就诊,其中440例为工作相关眼外伤,且男性占绝大多数（98.19%）,常见年龄在21y至30y之间（45%）。最常见的损伤种类为眼表损伤（70.9%）,其次是化学损伤（11.13%）,开放性眼外伤（8.4%）,闭合性眼外伤（6.83%）和热灼伤（2.7%）。虽然工作相关眼外伤普遍为当地人（78.5%）,但其中三分之二的开放性眼外伤出现在外来劳工中。仅59例患者（13.4%）在受伤时配戴眼部保护装置。通常89.9%（n=399）的患者视力良好,5.45%（n=24）的患者视力一般,3.86%（n=17）的患者视力较差。视力预后与损伤类型的相关性分析表明,开放性眼外伤的视力较闭合性眼外伤差（OR=3.33,95%CI=0.68-16.33）。2011/2013年,工作相关眼外伤新病例的整体就诊率为20.7译~51.9译,大约每年下降1.5%（P〈0.05）。相比之下,工作相关眼外伤住院患者在3y期间有所增加。工作相关眼外伤致单眼盲或低视力患者（最佳矫正视力≤3/60）约占就诊人数的1.26译（95%可信区间为0.74至2.02）。结论：工作相关眼外伤是致从业人员眼病的重要原因,特别是年轻人。当地21y到40y的男性为高危人群。大多数我院接收的工作相关眼外伤患者均为可避免的眼表损伤。本研究表明劳工们需要加强安全措施,预防意外失明,避免增加社会经济负担。除此之外,还需建立眼损伤信息记录系统。

AIM：To describe the epidemiology of work- related ocular injuries and its visual outcome in tertiary hospital in southern Malaysia.·METHODS：Retrospective review of medical records of patients diagnosed as work-related ocular injuries who attended to the eye casualty of Hospital Sultan Ismail in Johor Bahru,Malaysia from Jan.2011 to Dec.2013.Data for clinical presentation,types of injuries,use of eye protective device（EPD） and visual outcome were collected using a standardized proforma.·RESULTS：A total of 935 ocular injuries attended to Hospital Sultan Ismail during 3y period.Among them 440 cases were work-related ocular injuries and included in the study.There was significant male preponderance（98.19%） and commonest age group affected was 21 to 30y（45%）.The most common type of injury was superficial injuries（70.91%）,followed by chemical（11.13%）,open globe（8.41%）,closed globe（6.83%） and thermal（2.72%）.Although Malays are commonly involved in work-related ocular injury accounted for 78.47%,twothirds of open globe injuries were seen in foreign workers.Only 59 patients（13.41%） reported that they wore EPD at the time of incident.Generally,89.86%（n =399） had good vision,5.45%（n = 24） had moderate vision and 3.86%（n = 17） poor vision.Visual outcome related to specific types of injuries showed that poor outcome was higher in open globe injuries groups compared with closed globe injuries[odd ratio（OR） =3.33,95%confidence interval（Cl） = 0.68 to 16.33].Overall hospital attendance rate of work-related ocular trauma ranged from 20.7 to 51.9 per 1000 new cases and decline of approximately 1.5%per year（P0.05） from2011 to 2013.In contrast,the in-patient admission due to work-related ocular injuries increased over 3y period.Estimated rate of monocular blindness or low vision[bestcorrected visual acuity（BCVA）≤3/60]due to workrelated ocular injury was 1.26 per 1000 hospital attendance（95%Cl = 0.74 to 2.02）.·CONCLUSION：Work-related ocular trauma is important cause of ocular morbidity in working forces particularly young men.Malay males between 21 to 40 y have higher risk.Majority of work-related ocular trauma seen in our hospital are generally of superficial injuries and potentially preventable.This study indicates they need to improve safety measures to prevent undesirable sight loss and economic burden to society as well as to establish for eye injury registry.