目的:调查医院医师的工作时间和值班与职业伤害风险的关系。
方法:在这项针对556名芬兰医院医生的嵌套队列研究中,我们将工作时间和值班工资数据的电子记录与从芬兰工人赔偿中心获得的2005-2019年期间的职业伤害数据相关联.我们采用了病例交叉设计,在职业伤害发生前7天的“病例窗口”和“病例窗口”开始前7天的“控制窗口”匹配间隔。并使用条件逻辑回归模型分析了它们的关联。
结果:我们注意到556个职业伤害,281在工作场所,275在通勤时。在前7天进行三到四次长时间(>12小时)轮班与职业伤害的可能性更高(优势比[OR]2.14,95%置信区间[CI]1.11,4.09),与没有这些工作班次类型相比,三到四个值班班次的OR为3.54(95CI2.11,5.92)。连续几个工作日的较高数量与剂量反应方式的较高损伤概率相关。此外,每周工作时间的增加与受伤可能性的增加有关(OR1.03,95CI1.01,1.04),而正常(≤12h)工作轮班次数降低了这种可能性(OR0.79,95CI0.64,0.98).
结论:我们的研究结果表明,累积的工作时间负荷,相对于单身,很长(>24小时)的工作轮班,可能会增加医院医生职业伤害的风险。
OBJECTIVE: To investigate the association of hospital physicians\' working hours and on-call shifts with the risk of occupational injuries.
METHODS: In this nested cohort study of 556 Finnish hospital physicians, we linked electronic records from working-hour and on-call duty payroll data to occupational injury data obtained from the Finnish Workers\' Compensation Center for the period 2005-2019. We used a
case-crossover design with matched intervals for a 7-day \'
case window\' immediately prior to occupational injury and a \'control window\' 7 days prior to the beginning of the
case window, and analyzed their associations using conditional logistic regression models.
RESULTS: We noted 556 occupational injuries, 281 at the workplace and 275 while commuting. Having three to four long (>12 h) work shifts on the preceding 7 days was associated with a higher probability of an occupational injury (odds ratio [OR] 2.14, 95% confidence interval [CI] 1.11, 4.09), and the OR for three to four on-call shifts was 3.54 (95%CI 2.11, 5.92) in comparison to having none of these work shift types. A higher number of several consecutive working days was associated with a higher probability of injury in a dose-response manner. Moreover, increasing weekly working hours was associated with an increased likelihood of injury (OR 1.03, 95%CI 1.01, 1.04), whereas the number of normal (≤12 h) work shifts reduced this likelihood (OR 0.79, 95%CI 0.64, 0.98).
CONCLUSIONS: Our findings suggest that accumulated working-hour load, as opposed to single, very long (>24 h) work shifts, may increase the risk of occupational injury among hospital physicians.