Search

Ocular trauma in the workplace is a worldwide cause of visual morbidity, but is largely preventable. We established a pilot surveillance system of occupational eye injuries at emergency service of National Cheng Kung University Hospital (NCKUH) from Feb 2015 to Feb 2017. During the study period, 114 events of occupational eye injuries were collected with 22 patients further hospitalised. Among them, 3 cases of severe ocular trauma were accompanied with other injuries resulting in an Injury Severity Score of more than 16. Foreign body injury (28%, n=32) and chemical burn (21%, n=24) were the most frequent eye injuries. Notably, 12 cases (10.5%) eyeball rupture were identified. The total medical costs charged through the NCKUH were about 66,000 USD for these ocular trauma patients, counting emergency and hospitalisation fees within 90 days after the first encounter. Eyeball ruptures accounted for 57.5% of the total medical charges. Only about 18% of occupational ocular trauma cases were reported to the National Labour Insurance and would usually be compensated. This study highlights the urgent needs of comprehensive compulsory regulations of recognition and report, compensation, and prevention and control of occupational eye injuries in the workplace of Taiwan.

Underreporting of occupational injury and illness has been an important issue in Taiwan. We tried to implement an integrated surveillance system in the emergency services of National Cheng Kung University Hospital to screen work-related accidents. The system mobilised staffs of triage, registration and doctors to report occupational causes. A total of 4097 events were identified from Feb 2015 to Feb 2017, among which 2722 were work-related, and 1375 commuting injuries. Work-related events were predominant males (71.7%), but equally in commuting injuries. 1532 events were sent by ambulance, 498 cases hospitalised in the first month, and 4 patients died within 30 days after emergency services and all fatal cases were work-related injuries. The majority of diagnoses were contusions, abrasions and lacerations, totally accounting for 43.1%. However, significant proportion of head injuries (n=751, 18.3%), fractures (n=351, 8.6%), burns (n=264, 6.4%) including 62 cases (1.5%) of chemical burns, and 106 cases (4.4%) of amputations were found. The results were different from the government funded reporting system where most frequently reported were chronic musculoskeletal diseases. The total medical costs were about 2.9 million USD, based on a conservative estimation accounting 90 days from the first encounter. This study revealed the fact of underestimation of occupational injuries and illness resulting in significant health and societal impacts. The emergency room based surveillance system can augment the conventional reporting system. Furthermore, cluster analysis and work associated disability should be investigated to improve occupational safety and labour right.

Introduction We conducted the present study to evaluate the changes in serum total antioxidant capacity (TAC) in patients with severe sepsis and to investigate the association between serum TAC and clinical severity.Method This was a prospective observational study involving a sample of patients who met established criteria for severe sepsis and were admitted to the emergency department of a university teaching hospital. Serum TAC was determined using the total radical-trapping antioxidant parameter method. The levels of TAC, uric acid, albumin, and bilirubin in sera were obtained in the emergency department and evaluated to determine whether there were any correlations between the major antioxidant biomarkers and clinical severity of sepsis. The Acute Physiology and Chronic Health Evaluation (APACHE) II score was used for clinical evaluation of the severity of sepsis.Results A total of 73 patients with sepsis, with a mean (± standard deviation) APACHE II score of 23.2 ± 8.2 and a mortality rate of 26.0%, were included. Seventy-six healthy individuals served as control individuals. Among the patients, serum TAC levels correlated significantly with APACHE II scores. Patients who died also had higher TAC than did those who survived. Serum uric acid levels correlated significantly with serum TAC and APACHE II scores in patients with severe sepsis.Conclusion Elevated serum TAC level may reflect clinical severity of sepsis. In addition, serum uric acid levels appear to contribute importantly to the higher TAC levels observed in patients with severe sepsis.