O24.1 IMPAIRMENT OF HEARING AND VISION AND THE RISK OF ACCIDENTAL INJURY: A SYSTEMATIC LITERATURE REVIEW

K. T. Palmer, E. C. Harris, D. Coggon.MRC Environmental Epidemiology Unit, University of Southampton, Southampton SO16 6YD, UK

Introduction: A systematic literature review was performed to estimate the risks of accidental injury arising from impairments of hearing and vision. The findings from occupational studies were compared with those on non-vocational accidents (mainly road traffic accidents (RTAs).

Methods: Systematic searches were conducted of the MedLine (1966–Oct 2002) and EmBase (1980–Oct 2002) databases using MESH headings and key words for hearing and visual impairment, and accidents (workplace, occupational, work related; traffic, motor vehicle, car, driving). Abstracts were read by two independent observers and primary research reports with control data were retrieved and summarised.

Results: 13 studies on hearing (6 occupational, 7 on RTAs) and 20 on visual problems (4 occupational, 16 others) were retrieved, covering each of the main study designs. Half reported >1 positive association (risk ratio (RR) >1.5, p<0.05), but most risk estimates were moderate (<2). Studies of RTAs and vision entailed many measurements of visual performance (visual acuity, field of vision (FOV), binocularity, contrast sensitivity) and covered several specific eye diseases (cataracts, glaucoma, macular degeneration). Only reduced FOV was consistently associated with accident risk (RR estimates ranging from 1.9 to 22.0 for a >40% reduced FOV). There was less evidence that risks were increased by hearing impairment, and none for the only two studies that directly measured hearing loss. Of the occupational studies identified across both impairments, only one attempted any direct measure of functional loss, and none distinguished risks for different categories of accidental event.

Discussion: Different impairments may give rise to different kinds of accident, especially in the workplace …