Application of the Case-Crossover Design to the Study of Occupational Acute Traumatic Hand Injury
Gary S. Sorock, David A. Lombardi, Russ Hauser, Ellen A. Eisen, Robert F. Herrick, Murray A. Mittleman
Abstract
Gary S. Sorock, David A. Lombardi, Russ Hauser, Ellen A. Eisen, Robert F. Herrick, Murray A. Mittleman
Abstract
We conducted a case-crossover study of transient risk factors for occupational acute traumatic hand injury in 232 subjects recruited from occupational health clinics in New England. The a priori hazard period was 10 minutes before the injury. The control period for each subject was the total work-time exposed in the previous month. The relative risk for using malfunctioning or different from usual equipment or tools in the hazard period was 21.2 (95% confidence interval = 15.7–28.6). Relative risks were also significantly elevated for performing a task using an unusual work method, doing an unusual task, being distracted, or being rushed. Wearing gloves was protective (relative risk = 0.6, 95% confidence interval = 0.3–0.9). We conclude that the case-crossover design is an appropriate method for studying transient risk factors for sudden-onset occupational injury.
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We conducted a case-crossover study of transient risk factors for occupational acute traumatic hand injury in 232 subjects recruited from occupational health clinics in New England. The a priori hazard period was 10 minutes before the injury. The control period for each subject was the total work-time exposed in the previous month. The relative risk for using malfunctioning or different from usual equipment or tools in the hazard period was 21.2 (95% confidence interval = 15.7–28.6). Relative risks were also significantly elevated for performing a task using an unusual work method, doing an unusual task, being distracted, or being rushed. Wearing gloves was protective (relative risk = 0.6, 95% confidence interval = 0.3–0.9). We conclude that the case-crossover design is an appropriate method for studying transient risk factors for sudden-onset occupational injury.
Key concepts: Confidence interval, Crossover study, Medicine, Relative risk, Occupational safety and health, Hazard ratio, Poison control, Injury prevention