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Epidemiology of Traumatic SCI

Work-Related Incidents

There were 17 papers reporting on SCI due to work-related accidents (Table 12). Fifteen papers used admission data from one or multiple hospitals; one paper used data from a SCI registry. Studies on SCI due to work-related accidents came from Europe (N=4), Oceania (N=3), North America (N=4), Asia (N=4), South America (N=1) and Africa (N=1).

Proportions of SCI due to work-related injuries ranged from a low of 0.8% in Tinajin, China (Ning et al. 2011) to a high of 26.8% in Israel (Catz et al. 2002). Seven studies reported specific types of work leading to SCI with industrial work such as mining, forestry, farming as most frequent (Dixon et al. 1993Tator et al. 1993Stavrev et al. 1994Igun et al. 1999O’Connor 2001Singh et al. 2003McCammon and Ethans 2011). There was one paper reporting on SCIs specifically due to work- related accidents in Chile (Correa et al. 2011). The average annual incidence was 7.8 per million workers in Chile from 1986 to 2005. The 2005 prevalence rate was 112 cases per million workers. The most frequently affected ages ranged from 25 to 34 years. Cause of SCIs in the Chilean workplace included falls, being struck by objects, and MVCs (Correa et al. 2011).

Author
Year
N of study
population
Geographic
region
Inclusion/
exclusion criteria
Study

population

Injury features Cause: %(n of

cases)

Wu et al.
2012
N=143
Tianjin,
China
Patients admitted to
Tianjin Medical
University General
hospital with
diagnosis of tSCI
Mean age 54.6
years
Male:Female =
5:1
ASIA A = 5.6%
ASIA B = 16.8%
ASIA C = 18.9%
ASIA D = 58.7%
Work Related:
2.1%
Correa et al.
2011
N=173
Chile 1986-2005
Patients with
traumatic SCI
incurred in the
workplace admitted
to Hospital del
Trabajador in
Santiago, Santiago,
Chile
99.4% (172)
male
Age at TSCI
onset was
38.2±12.1 years.
78 (45.1%) – complete
paraplegia
54 (31.2%) – incomplete
paraplegia
18 (10.4%) -complete
tetraplegia
23 (13.3%) – incomplete
tetraplegia.
Work-related
incidents:
Falls from a
height-49.7% (86
cases)
Trauma blows to
the vertebral spine
– 35.3% (61
cases)
Traffic accident –
8.7% (15 cases)
Other causes –
6.4% (11 cases)
McCammon
and Ethans
2011
N=553
Manitoba,
Canada
1981-1985, 1998-
2002, 2003-2007
Inclusion criteria:
survival to hospital
admission with
TSCI, or outpatient
referral to an SCI
rehabilitation
specialist.
Exclusion criteria:
congenital causes of
paralysis such as
spina bifida or
cerebral palsy as
well as acquired
paralysis from
multiple sclerosis or
Guillan-Barre
syndrome.
75.8% male
Mean Age:
1981-1985: 29.0
years
1998-2002: 35.3
years
2003-2007: 39.8
years
1981-1985:
Cervical: 46.2%
Thoracic:33.0%
Lumbar: 20.9%
Sacral:0.0%
1998-2002:
Cervical:45.0%
Thoracic:33.3%
Lumbar: 21.6%
Sacral:0.0%
2003-2007:
Cervical:51.3%
Thoracic:34.9%
Lumbar:12.5%
Sacral:1.3%
Work:
81-85: 3.6%
98-02: 2.6%
03-07: 4.0%
Ning et al.
2011
N=869
Tianjin,
China
All patients with
TSCI aged 15 or
older admitted to
tertiary hospitals in
Tianjin from Jan 1,
2004- Dec 31, 2008
738 male
(84.9%)
Mean age (sd)
46.0 (14.2)
Cervical (71.5%)
Thoracic (13.3%)
Lumbar (15.1%)
Sacral (0.1%)
Work-related
incident:
0.8%
(n=7)
Pickett et al
2006
N=151
London,
Ontario,
Canada
1997-2006
Admissions to
hospital in London,
Ontario with SCI
Men=74.2%
Mean age =
42.2 ± 20.9 (9-
96) years
Mortality=12
(8%)
Cervical=75%
Thoracic= 10%
Lumbar=9%
Junctional=6%
Complete=35%
Incomplete=65%
Work-related:
6.6% (n=10)
Krassioukov
et al.
2003
N=58
Toronto,
Canada
1998-2000
Admissions to
hospital in Toronto
with traumatic SCI.
Exclusion Criteria:
Patients admitted
with ASIA E.
Males=87%
Ages 17-59
years:
Mean age=38.7
(17-56) years
ASIA A and B=30%
ASIA C and D=70%
Work-related
10.3%
(n=6)
Singh et al.
2003
N=483
Haryana,
India
2000-2001
Accident and
emergency services
and department of
Orthopaedic Surgery
and Rehabilitation of
Pt. B.D. Sharma
PGIMS, Rohtak.
Males = 74.7%)
Mean age at
injury=35.4
years
164 tetraplegia
283 paraplegia
Mine
cave-in:
6.42%
(n=31)
Catz et al.
2002
N=250
Israel 1959-1992
Traumatic SCI,
admitted to the
Loewenstein
Rehabilitation
Center, the major
referral center for
rehabilitation
medicine in Israel.
Males=75.6%
Mean age =
34.5 years
(range 6-83
years).
High cervical 7.6%
low cervical 28.8%
thoracic 32.4%
lumbar 31.2%
Work-related:
26.8% (n=34)
O’Connor
2001
N=369
Australia 1986-1997
Australian Spinal
Cord Injury Register
Males= 95%
75% aged 25-54
years
28% labourers
(construction,
mining)
Data for 358 subjects:
35% incomplete
paraplegia
34% complete paraplegia
21% incomplete
tetraplegia
10% complete tetraplegia
34.4% (n=123) cervical
45.5% (n=163) thoracic
23.2% (n=83) lumbar
Work-related:
13% (n=369)
van Asbeck et
al.
2000
N=126
(specific data
for 113)
Netherlands 1994
Patients with SCI in
National Registration
system with medical
records.
Exclusion Criteria:
Spinal contusions
with no or temporary
neurological
symptoms
Males=77% <20 years=15 (13%) 21-30 years=28 (25%) 31-60 years=36 (32%) >61=34 (30%) Mortality=18 (16%) Complete tetraplegia=26
(23%)
Incomplete tetraplegia=39
(34%)
Complete paraplegia=29
(26%)
Incomplete paraplegia=19
(17%)
Work-related:
4.4%
(n=5)
Igun et al.
1999
N=68
Plateau
State,
Nigeria
1984-1997
Radiologically
confirmed diagnosis
of spinal cord injury
Males = 91.2%
Mean age = 30
years
Cervico-thoracic n=32
Cervico-thoracic n=36
Deaths n=18
Mining cave-in
17.96% (n=12)
Caldana and
Lucca
1998
N=127
Veneto,
Italy
1994-1995
New cases of
traumatic spinal cord
injury and nontraumatic spinal cord
disease treated in
regional hospitals
(small hospitals
excluded)
Male = 83.5%;
Average age
(male) of 39.8
years
Average age
(female) of 36
years
Cervical=62 (21 were
complete)
Thoracic=29(25)
Thoracolumbar (T12-
L1)=18(11)
Caudal=14(3)
Unidentified=1
Work-related:
22%
(n=28)
Exner and
Meinecke
1997
N= 22,212
Germany 1976-1996
All traumatic and
non-traumatic SCI
72% male. 62% paraplegic
38% tetraplegic
Work-related:
14%
(n=3119)
Stavrev et al.
1994
N=980
Plovdiv and
Plovdiv
region,
Bulgaria
1983-1992
Treatment for SCI at
2 clinics in Plovdiv
region
Males=72%
21-40 years
=387 (40%)
41-60 years
=298 (30%)
61-70 years
=137 (14%)
>70 years
=76 (8%)
Mortality=72
(7%)
Cervical=206 (21%)
Thoracic (>T7) =275
(28%)
Lumbar=399, (41%)
Other=100 (10%)
Neurological deficit=409
(42%)
No neurological
deficit=572 (58%)
Work-related:
7.2% (n=71)
Dixon et al.
1993
N=164
New Zealand 1988
SCI cases in Health
Services Statistics
files.
Males=73.2%
Males aged 15-
29 years=46%
C1-C4=49 (30%)
C5-C7=30 (18%)
T1-T6=19 (12%)
T7-T12-19 (12%)
Work-related:
3% (n=5)
Tator et al.
1993
N=201
Toronto,
Canada
1974-1981
First 220 admissions
to Acute Spinal Cord
Injury Unit in
Toronto.
Exclusion Criteria:
Admissions >30
days after injury;
injuries without cord
involvement; nerve
root involvement
only; penetrating
injuries; injuries
below L2; Patients
who died on scene
or upon arrival.
Males=79.6%
Mean age=34.5
years
Median
age=27.0 years
Cervical=63.2%,
Thoracic=16.9%, Thoracolumbar=19.9%
Complete=46.2%,
Incomplete=53.8%
Work-related:
13.9% (n=28)
Ring et al.
1986
N=202
New South
Wales,
Australia
1977-1978
Admissions to New
South Wales
hospitals with spinal
injury; death
certificates that
involved spinal
injury. 99% of cases
had neurological
involvement.
Males=81%
15-24 years
= 84 (42%)
25-44 years
=58 (29%)
45-64 years
=30 (15%)
≥65 years=15
(7%)
Mortality=69
(39%)
Glasgow Outcome Scale:
Severe disability=98(49%)
Moderate
disability=19(9%)
Good recovery=13(6%)
Not recorded=3(1%)
Work-related:
9.4% (n=19)
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