“Patpat” Tarım Aracıyla Oluşan Damar Yaralanmasının Eşlik Ettiği İş Kazalarının Değerlendirilmesi

Year 2023, Volume: 6 Issue: 2, 47 - 52, 30.06.2023

Semih Murat Yücel Özlem Terzi

https://doi.org/10.54996/anatolianjem.1122349

Abstract

Amaç: Patpat tarım aracı Karadeniz bölgesinde ulaşım, sulama, taşıma, çapalama amacıyla kullanılmaktadır. Patpat aracının altında ezilme veya çapalama ekipmanlarının arasına sıkışma neticesinde ekstremiteler başta olmak üzere tüm vücutta yaralanmalar meydana gelmektedir. Bu hastalarda oluşabilecek damar yaralanmaları önemli bir morbidite ve mortalite sebebidir. Bu çalışmada patpat tarım aracı kazası nedeniyle büyük damar yaralanması olan ve Kalp Damar Cerrahisi Kliniğinde takip edilen hastaların retrospektif olarak değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntemler: Tanımlayıcı tipte planlanan çalışmaya, retrospektif olarak 01.01.2008-31.12.2021 tarihleri arasında patpat kazasına bağlı büyük damar yaralanması nedeniyle Ondokuz Mayıs Üniversitesi Hastanesi Kalp Damar Cerrahisi (KDC) Kliniğinde takip edilen hastalar dahil edildi. Hastane kayıtlarından elde edilen veriler tanımlayıcı istatistikler şeklinde ifade edildi.

Bulgular: Son 14 yılda 32 hastanın patpat kazası nedeniyle KDC kliniğinde opere edildiği belirlendi. Hastaların yaş ortalaması 36,7±21,2 yıldı ve %71,9’u erkekti. Kazaların %62,5’i tarlada meydana gelmişti ve %59,4’ü ezilme, %31,3’ü sıkışma tipindeydi. Hastalarda en sık alt ekstremite (%50,0) yaralanması ve bunlara eşlik eden arter-ven yaralanması (%25,0 popliteal, %18,8 femoral ve % 18,8 iliak) olduğu belirlendi. Hastaların hastanede kalış süreleri ortanca değeri 21,5 (3,5-75,0) gündü. Hastaların 4’üne (%12,5) ekstremite amputasyonu yapılırken, 25’i (%78,1) tam şifa ile taburcu oldu. Bu 29 hastanın ortanca iş gücü kaybı 75 (35-124) gündü. Hastaların 3’ü (%9,4) ise patpat kazası sonucu hayatını kaybetmişti.

Sonuç: Tarımda kullanılan patpat aracına bağlı oluşan iş kazaları, başta ekstremiteler olmak üzere tüm vücutta çoklu yaralanmalar meydana getirmektedir. Büyük damar yaralanması olan hastalarda ölüm veya sakatlıkların görülmesinin yanı sıra çok sayıda iş günü kayıplarının da olduğu belirlenmiştir

Keywords

İş kazası, tarım aracı, damar yaralanması, cerrahi

Supporting Institution

yok

Project Number

yok

Evaluation of Occupational Accidents Associated with Vascular Injury Caused by the "Patpat" Agricultural Vehicle

Abstract

Aim: “Patpat” agriculture tool is used for transportation, irrigation carrying, hoeing in the Blacksea region. Injuries occur in the whole body especially in the extremities due to crushing under the patpat vehicle or jamming between ıt's hoeing equipment’s. The vascular injuries that may occur in these patients is an important cause of morbidity and mortality. In this study, it is aimed to retrospectively evaluate the patients who were major vascular injury due to patpat agricultural vehicle accident and followed up in a cardiovascular surgery clinic.

Material and Methods: In the descriptive study, patients who were followed up at the Cardiovascular Surgery Clinic of Ondokuz Mayıs University Hospital due to major vascular injuries related to the patpat accident between 01.01.2008 and 31.12.2021 were retrospectively included. The data obtained from hospital records were expressed in the form of descriptive statistics.

Results: In the last 14 years, 32 patients were determined to be operated in the CVS clinic due to patpat accident. The mean age of the patients was 36.7 ±21.2 years and 71.9% were male. Of the
accidents, 62.5% occurred in the field and 59.4% were crushed and 31.3% were of the compression type. The most common injuries in the patients were lower extremity injury (50.0%) and accompanying artery-vein injury (25.0% popliteal, 18.8% femoral and 18.8% iliac). The median hospital stay of the patients was 21.5 (3.5-75.0) days. Extremity amputation was performed in four
(12.5%) patients, while 25 (78.1%) patients were discharged with complete recovery. The median loss of working days in these 29 patients was 75 (35-124) days. Three of the patients (9.4%) died as
a result of a patpat accident.

Conclusion: Occupational accidents due to patpat vehicle used in agriculture, produces multiple injuries in the entire body, especially extremities. It has been determined that in addition to the occurrence of death or disability in patients with large vessel injuries, there are also losses of a large number of working days.

Keywords

Occupational accident, agricultural vehicle, vascular injury, surgery

Project Number

yok

References

• Güğercin Ö, Baytorun AN. Tarımda İş Kazaları ve Gerekli Önlemler. Çukurova Tarım ve Gıda Bilimleri Dergisi. 2018;33(2):157-168.
• TÜİK, İşgücü İstatistikleri, https://data.tuik.gov.tr/Bulten/Index?p=Isgucu-Istatistikleri-2021- 45645, Erişim tarihi: 21.01.2022
• Sert Ö, Nazlıoğlu A. Tarımda İş Sağlığı ve Güvenliği Rehberi. Çalışma ve Sosyal Güvenlik Bakanlığı Genel Yayını. 2016;44.
• Health and Safety Executive U. Health and Safety in Agriculture, Forestry and Fishing in Great Britain,2021. Londra :UK Statistics Authority 2021.
• İSG Genel Müdürlüğü, İstatistiklerle Türkiye’nin İSG Görünümü, Ankara. 2020.
• Facchinetti D, Santoro S, Galli LE, Pessina D. Agricultural tractor rollover related fatalities in Italy: results from a 12 years analysis. Sustainability. 2021;13(8):4536.
• Gulec A, Durgut F, Ozdemir A, Yildirim A, Aydin BK. Lower limb injuries secondary to hoeing machine accidents. Medicine Science. 2019;8(1):7-10.
• Arslan A, Keskin M. Trailer-Attached Two-Wheel Tractor (Patpat) Accidents on Roads in Turkey. Mustafa Kemal Üniversitesi Ziraat Fakültesi Dergisi.23(2):165-179.
• Gizlenci İ, Aybek A. Doğu Akdeniz Bölgesi Tarım İşletmelerinde Oluşan İş Kazaları ve Etkili Faktörler. Kahramanmaraş Sütçü İmam Üniversitesi Tarım ve Doğa Dergisi. 2021;24(5):1068-1083.
• Ketenci HC, Altınok M, Ozsoy S, Aydoğdu HI, Celik M, Beyhun NE. Deaths due to “patpat” accidents in the Black Sea Region, Turkey. Turkish Journal of Trauma and Emergency Surgery. 2022;28(1):78-83.
• Kahveci FO, Akca ASD, Piskin IE. Evaluation of occupational traumatic injuries in rural sectors of Turkey. Acta Medica International. 2015;2(1):87.
• Akdur O, Ozkan S, Durukan P, Avsarogullari L, Koyuncu M, Ikizceli I. Machine-related farm injuries in Turkey. Annals of Agricultural and Environmental Medicine. 2010;17(1):59-63.
• Karttunen JP, Rautiainen RH. Distribution and characteristics of occupational injuries and diseases among farmers: a retrospective analysis of workers' compensation claims. American Journal of Industrial Medicine. 2013;56(8):856-869.
• Dimich-Ward H, Guernsey J, Pickett W, Rennie D, Hartling L, Brison RJ. Gender differences in the occurrence of farm related injuries. Occupational and Environmental Medicine. 2004;61(1):52-56.
• Andersson E, Lundqvist P. Gendered agricultural space and safety: Towards embodied, situated knowledge. Journal of Agromedicine. 2014;19(3):303-315.
• Kumar A, Varghese M, Mohan D. Equipment-related injuries in agriculture: An international perspective. Injury Control and Safety Promotion. 2000;7(3):175-186.
• Morrongiello BA, Pickett W, Berg RL, Linneman JG, Brison RJ, Marlenga B. Adult supervision and pediatric injuries in the agricultural worksite. Accident Analysis & Prevention. 2008;40(3):1149-1156.
• Dogan KH, Demirci S, Sunam GS, Deniz I, Gunaydin G. Evaluation of farm tractor-related fatalities. The American Journal of Forensic Medicine and Pathology. 2010;31(1):64-68.
• Turkoglu A, Sehlikoglu K, Tokdemir M. Analysis of tractor-associated fatalities. The American Journal of Forensic Medicine and Pathology. 2017;38(4):306-311.
• Karapolat S, Saritas A, Kandis H, et al. The evaluation of Patpat related injuries in the western black sea region of Turkey. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2011;19(1):1-6.
• Yaffe MA, Kaplan FT. Agricultural injuries to the hand and upper extremity. Journal of the American Academy of Orthopaedic Surgeons. 2014;22(10):605-613.
• Douphrate DI, Rosecrance JC, Reynolds SJ, Stallones L, Gilkey DP. Tractor-related injuries: an analysis of workers ’compensation data. Journal of agromedicine. 2009;14(2):198-205.
• Turgut K, Gurbuz S, Oguzturk H, Bican S, Kama AK. An unknown cause of agricultural accidents: Hoeing machine. Eurasian Journal of Emergency Medicine. 2018;17(1):28.
• Akpınar G, Demir MC. Evaluation of trailer attached-two wheel tractor (Pat-pat) accident-related pediatric injuries in Turkey's western black sea region. Medicine Science. 2021;10(1):179-183.
• Franz RW, Shah KJ, Halaharvi D, Franz ET, Hartman JF, Wright ML. A 5-year review of management of lower extremity arterial injuries at an urban level I trauma center. Journal of vascular surgery. 2011;53(6):1604-1610
• Karaca O, Mavıoglu I, Akbas M, Koc A, Karaduman Z, Kunt A. Multidisciplinary approach in" pat pat" injuries: the role of vascular surgeon. Turk J Vasc Surg. 2019;28(1):46-50.
• Reece SC, Thiruchelvam D, Redelmeier DA. Medical emergencies in farmers. The Journal of Rural Health. 2019;35(4):429-435