International Journal of Epidemiology, Vol 26, 814-821, Copyright © 1997 by International Epidemiological Association
SM Barreto, AJ Swerdlow, PG Smith and CD Higgins
OBJECTIVES: In a cohort of 21,816 Brazilian steelworkers we found mortality
from motor-vehicle injury was twice that in the State population. A nested
case-control study was therefore undertaken to investigate possible
socio-demographic, medical and occupational risk factors for this increased
risk. METHODS: Cases were defined as all steelworkers in the cohort who
died of motor-vehicle injury during employment in the period 1977-1992. For
each case, four controls were selected at random from workers in the cohort
who were employed at the time of death of the case, and who were born in
the same year as the case. Data on socio-demographic factors, and medical
and occupational histories were obtained from personnel, industrial hygiene
and medical records, and the relation of these factors to risk of
motor-vehicle injury was analysed using conditional logistic regression.
RESULTS: In a multivariate analysis, the risk of death from motor-vehicle
injury was independently associated with being unmarried (odds ratio [OR]
compared to married = 3.21, 95% confidence interval [CI]: 1.84-5.59),
having a hearing defect (OR = 2.28, 95% CI: 1.10-4.74) and exposure to
moderate (OR = 1.71, 95% CI: 1.03-2.83) or high (OR = 2.00, 95% CI:
1.18-3.39) levels of noise at work. The risk of fatal motor-vehicle injury
increased with intensity of occupational noise exposure (P = 0.004).
CONCLUSIONS: The raised risk of motor-vehicle injury death associated with
single marital status is likely to relate to selective factors in the types
of individual who remain single, and behaviours associated with being
unmarried. The raised risks in relation to hearing defects and exposure to
occupational noise, factors that do not appear to have been examined
previously, imply that occupational noise exposures might be a cause of
fatal motor-vehicle accidents outside the workplace. This finding may have
widespread public health consequences since high levels of noise in the
workplace and occupationally acquired hearing deficits are prevalent in
several occupations. Further investigation is needed to confirm the
associated and its mechanisms and, if it is causal, to develop preventive
strategies.
ARTICLES
Risk of death from motor-vehicle injury in Brazilian steelworkers: a nested case-control study
Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, UK.
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