Xujun Zhang

Road Traffic Injuries in the People's Republic of China, 1951–2008

Objective: Road traffic injuries (RTIs) have become the leading cause of injury deaths in China. This article analyzed the trends in all crashes, nonfatal injuries, and fatalities from road traffic crashes from 1951 to 2008 and compared the crash frequency, crash severity, and crash patterns by provinces, types of road, and injured road users. Methods: Road traffic crash data were obtained from the Bureau of Traffic Management at the Ministry of Public Security and National Bureau of Statistics of China. Descriptive statistical analyses were conducted. Results: Over the past 5 decades, road traffic injuries have increased substantially in China. From 1951 to 2008, the total number of road traffic crashes, nonfatal injuries, and fatalities increased by 43-fold, 58-fold, and 85-fold, respectively. Linear regression suggested a significant decline of 30.1 percent (95% confidence interval [CI]: 24.8–35.3) in the mortality rate per 100,000 people during the period 2002 to 2008. From 2004 to 2008, road traffic crash mortality rate per 100,000 people varied greatly in China from the lowest of 3.0 in Henan in 2008 to the highest of 21.7 in Xizang in 2004. RTIs in China disproportionally affected the following populations: males, persons 21 to 50 years of age, pedestrians, and motorcyclists/bicyclists. Adults aged more than 65 years accounted for approximately 10 percent of total road traffic deaths. Road types and RTIs severity were closely related; highways were associated with greater mortality rates. Conclusion: Road traffic injuries have become a burgeoning public health problem in China. Programs need to be developed to prevent nonfatal injuries and fatalities caused by road traffic crashes in this emerging country.

Pesticide poisoning and neurobehavioral function among farm workers in Jiangsu, People's Republic of China

Pesticides remain an integral part of agricultural activities worldwide. Although there have been a number of studies over the last two decades concerning the adverse effects of pesticide poisoning and chronic long term exposures on neurobehavioral function, the impact of recent pesticide poisoning and long term pesticide exposure on neurobehavioral function in Chinese farm workers has not been reported. China is the largest user of pesticides worldwide and figures suggest 53,300-123,000 Chinese people are poisoned every year. A case control study was conducted to examine the impact of recent pesticide poisoning on neurobehavioral function and the relationship between years worked in agriculture and lower performance on neurobehavioral tests. A total of 121 farm workers who self-reported recent pesticide poisonings within the previous 12 months (case group) and 80 farm workers who reported no pesticide poisoning in the previous 12 months (control group) were recruited from three areas of Jiangsu Province, China. The World Health Organization (WHO) recommended neurobehavioral core test battery (NCTB) was used to assess neurobehavioral functioning among cases and controls. Students t tests and two-way covariance analysis (ANCOVA) were used to test for significant differences in the neurobehavioral test results between the groups. Scores on the Profile of Mood States (POMS) in the recently poisoned group were significantly higher for anger-hostility, depression-dejection, tension-anxiety and lower for vigor-activity compared to controls (p < .05). Digit span, digit symbol, Benton visual retention and pursuit aiming scores were all significantly lower among the recently poisoned group compared to the controls (p < .05). Two-way ANCOVA indicated significantly lower performance in correct pursuit aiming and higher error pursuit aiming amongst the recently poisoned group and those who had worked for more than 30 years in agriculture (p < .05). These findings provide important preliminary epidemiological evidence regarding the association between occupational pesticide exposure and neurobehavioral functioning in Chinese farm workers.

The injury mortality burden in Guinea

BackgroundThe injury mortality burden of Guinea has been rarely addressed. The paper aimed to report patterns of injury mortality burden in Guinea.MethodsWe retrieved the mortality data from the Guinean Annual Health Statistics Report 2007. The information about underlying cause of deaths was collected based on Guinean hospital discharge data, Hospital Mortuary and City Council Mortuary data. The causes of death are coded in the 9th International Classification of Diseases (ICD-9). Multivariate Poisson regression was used to test the impacts of sex and age on mortality rates. The statistical analyses were performed using Statatm 10.0.ResultsIn 2007, 7066 persons were reported dying of injuries in Guinea (mortality: 72.8 per 100,000 population). Transportation, fire/burn, falls, homicide and drowning were the five leading causes of fatal injuries for the whole population, accounting for 37%, 22%, 12%, 10% and 6% of total deaths, respectively. In general, age-specific injury causes displayed similar patterns of the whole population except that poisoning replaced falls as a leading cause among children under five years old. Males were at 30-50% more risk of dying from six commonest causes than females and old age groups had higher injury mortality rates than younger age groups.ConclusionTransportation, fire/burn, falls, homicide, and drowning accounted for the majority of total injury mortality burden in Guinea. Males and old adults were high-risk population of fatal injuries and should be targeted by injury prevention. Lots of work is needed to improve weak capacities for injury control in order to reduce the injury mortality burden.

Needlestick and Sharps Injuries Among Nurses at a Teaching Hospital in China.

Needlestick and sharps injuries (NSIs) are a major occupational injury to health care workers worldwide. This study aimed to report the prevalence and risk factors of NSIs among nurses working at a Chinese teaching hospital. From 463 nurses, 402 completed questionnaires were obtained. A total of 261 (64.9%) nurses reported needlestick or sharps injuries. NSIs were more common among females, young nurses, surgical nurses, and junior nurses. Logistic regression analysis suggests that age and work department were independent risk factors for NSIs. By type of devices, syringe needles accounted for the highest proportion of all NSIs (59%), followed by glass items (22%), and trocar core/catheter wires (4%). NSIs remain an important occupational hazard issue or Chinese nurses. Programs must be developed to prevent injuries caused by needlesticks and sharps.

Road traffic crashes among farm vehicle drivers in southern China: A cross-sectional survey

ABSTRACT Objective: The objective of this study was to identify the prevalence and potential risk factors of farm vehicle–related road traffic crashes among farm vehicle drivers in southern China. Methods: A cross-sectional study was used to interview 1,422 farm vehicle drivers in southern China. Farm vehicle–related road traffic crashes that occurred from December 2013 to November 2014 were investigated. Data on farm vehicle–related road traffic crashes and related factors were collected by face-to-face interviews. Results: The prevalence of farm vehicle–related road traffic crashes among the investigated drivers was 7.2%. Farm vehicle–related road traffic crashes were significantly associated with self-reported vision problem (adjusted odds ratio [AOR] = 6.48, 95% confidence interval [CI], 3.86–10.87), self-reported sleep disorders (AOR = 10.03, 95% CI, 6.28–15.99), self-reported stress (AOR = 20.47, 95% CI, 9.96–42.08), reported history of crashes (AOR = 5.40, 95% CI, 3.47–8.42), reported history of drunk driving (AOR = 5.07, 95% CI, 2.97–8.65), and reported history of fatigued driving (AOR = 5.72, 95% CI, 3.73–8.78). The number of road traffic crashes was highest in the daytime and during harvest season. In over 96% of farm vehicle–related road traffic crashes, drivers were believed to be responsible for the crash. Major crash-causing factors included improper driving, careless driving, violating of traffic signals or signs, and being in the wrong lane. Conclusion: Findings of this study suggest that farm vehicle–related road traffic crashes have become a burgeoning public health problem in China. Programs need to be developed to prevent farm vehicle–related road traffic crashes in this emerging country.

Road traffic injuries among riders of electric bike/electric moped in southern China

ABSTRACT Objective: Electric bike/moped-related road traffic injuries have become a burgeoning public health problem in China. The objective of this study was to identify the prevalence and potential risk factors of electric bike/moped-related road traffic injuries among electric bike/moped riders in southern China. Methods: A cross-sectional study was used to interview 3,151 electric bike/moped riders in southern China. Electric bike/moped-related road traffic injuries that occurred from July 2014 to June 2015 were investigated. Data were collected by face-to-face interviews and analyzed between July 2015 and June 2017. Results: The prevalence of electric bike/moped-related road traffic injuries among the investigated riders was 15.99%. Electric bike/moped-related road traffic injuries were significantly associated with category of electric bike (adjusted odds ratio [AOR] = 1.36, 95% confidence interval [CI], 1.01–1.82), self-reported confusion (AOR = 1.77, 95% CI, 1.13–2.78), history of crashes (AOR = 6.14, 95% CI, 4.68–8.07), running red lights (AOR = 3.57, 95% CI, 2.42–5.25), carrying children while riding (AOR = 1.96, 95% CI, 1.37–2.85), carrying adults while riding (AOR = 1.68, 95% CI, 1.23–2.28), riding in the motor lane (AOR = 2.42, 95% CI, 1.05–3.93), and riding in the wrong traffic direction (AOR = 1.63, 95% CI, 1.13–2.35). In over 77.58% of electric bike/moped-related road traffic crashes, riders were determined by the police to be responsible for the crash. Major crash-causing factors included violating traffic signals or signs, careless riding, speeding, and riding in the wrong lane. Conclusion: Traffic safety related to electric bikes/moped is becoming more problematic with growing popularity compared with other 2-wheeled vehicles. Programs need to be developed to prevent electric bike/moped-related road traffic injuries in this emerging country.

Needlestick and Sharps Injuries Among Nursing Students in Nanjing, China:

Needlestick and sharps injuries (NSIs) are a major cause of occupational injuries for health care workers worldwide. In this study, the authors report the prevalence of and risk factors for NSIs among Chinese nursing students. A cross-sectional survey was distributed to 442 nursing students; 393 completed questionnaires were submitted. A total of 237 (60.3%) nursing students reported NSIs, which were more commonly reported by female students, younger students, students who worked frequent night shifts, students without safety training, and students who did not use personal protective equipment. Among those injured, 59.9% were injured by syringe needles, 21.9% by glass items, and 3.4% by scissors. Of those needles and sharps causing injuries, 36.3% of devices had been used on patients, 41% were unused, and 22.7% were unknown. Opening ampoules or vials was the most common injury agent. A total of 86.9% of NSIs were not reported to hospital infection control. Nursing students are at high risk of NSIs in China. Occupational safety training should be developed and implemented to prevent NSIs among this vulnerable population.

Response to “Needlestick Injuries Among Nurses and Risk for HIV”

Thank you for allowing us to respond to the comments from Tin & Wiwanitkit pertaining to our article “Needlestick and Sharps Injuries Among Nurses at a Teaching Hospital in China” (Zhang et al., 2015). We agree that the strategy for calculating the risk of HIV infection from needlestick injuries is worthy of further study and is a significant concern when studying the incidence and prevalence of these injuries. The authors of the letter (Tin & Wiwanitkit, 2015) used data from the 1990s in the United States (Henry & Campbell, 1995) to compute the likelihood of HIV infection from needlestick injuries reported from one teaching hospital in China conducted in 2012. The use of data from hospitals in the United States to estimate HIV exposure in China is not likely to provide a valid estimate. Base rates of HIV infection will strongly influence the risk of exposure but need to be linked to the target community. In addition, seroconversion rates among United States health care workers exposed to HIV infected blood between 1983 and 1992 (Tokars et al., 1993) are unlikely to reflect the experience of workers in one teaching hospital in China in 2012. Therefore, although we believe in continued monitoring using the logic presented in the letter to the editor to assess the risk of HIV seroconversion among nurses in China, we do not believe that the computations that were presented are likely to be valid estimates of the risk of HIV-infected blood transmission in China.

The establishment of school based injury surveillance system in Jiangsu, China

Background Child injuries have been a significant public health problem worldwide. Although information technology is becoming the backbone of all injury surveillance systems, many child injury data collections are resource intensive, especially in less-developed areas. Objectives To describe the epidemiological profile for injured school children using the School Based Injury Surveillance System (SBISS) established in Jiangsu Province of China; and to demonstrate this SBISS is a useful tool to overcome resource deficiencies and to improve child injury prevention at schools. Methods The SBISS employs a network-based electronic reporting system for public schools in Jiangsu, and adopts WHO standardised injury scales to collect injury information for school children graded 1–12. It uses available resources and makes documentation readily available for schools. Data are entered online at schools and verifications are conducted manually. We collected data for injured children aged 6–18 years during September 2011 to June 2012 to describe the distributions of injury severity, mechanisms, injured body regions, place of occurrence, and activity when injured. Results The SBISS now covers 1.8% school children in Jiangsu and reported 2358 injuries to date. The morbidity of injuries was 4.16%. Among all injuries, about 6.4% lost their lives or disabled or function limited. Falls was the principal injury mechanisms accounting for 49.9% in total, followed by sharp injuries (22.6%). Lower limbs were the most common injured body regions, accounting for 38.3%. The majority of children were injured at classroom and school playground while doing sports and entertainment activities. Significance The SBISS provides efficient and quality injury information, speeds up the administration process, and lessens workforce allocation. Timely programmes addressing local injury among children are likely to benefit this E-reporting data collection.