Pesticide-related illnesses associated with the use of a plant growth regulator--Italy, 2001

During January-February 2001, eight cases of acute illness in the county of Ragusa, Italy, were reported to the Italian National Institute for Health (INIH) by the Milan Poison Control Center (MPCC) and were attributed to exposure to Dormex, a plant growth regulator with hydrogen cyanamide as the active ingredient. These cases were identified during a pilot project for acute pesticide-related illness surveillance. Subsequent active case finding at health-care clinics by the Ragusa Occupational Health Unit identified six additional cases. MPCC identified nine cases in other areas of Italy. Of the 23 cases of acute illness, 22 resulted from occupational exposure during mixing and/or applying of Dormex, and one was from unintentional ingestion. This report summarizes the investigation of these cases, which implicates a pesticide as the causative agent and demonstrates the usefulness of surveillance for detecting pesticide-related illnesses.     

Surveillance of occupational illness through a national poison control center: an approach to reach small-scale enterprises?

A pilot study was performed in order to evaluate the usefulness of the Swiss Toxicological Information Center (STIC) in detecting cases of occupational illness. One hundred and fifty-two symptomatic occupational exposure cases were collected, comprising 3.2% of 4830 cases reported to the STIC between 1 April 1992 and 15 August 1992. In 114 cases a follow-up could be performed by a structured telephone interview. On the basis of these interview data it was estimated that 72% of the cases in small enterprises were reported to the STIC without additional notification to an occupational insurance fund. By contrast, only 28% of the occupational illness cases that occurred in companies employing more than 15 workers were not reported to an occupational insurance fund. This discrepancy could have resulted in part from the fact that occupational insurance in Switzerland is mandatory only for salaried employees, not for self-supporting persons. It is concluded that the monitoring of the occurrence of occupational illnesses in small-scale enterprises must be improved. Poison control centers could play a major role in this respect.     

The utility of Poison Control Center data for assessing toxic occupational exposures among young workers

This study assessed the utility of Poison Control Center data for identifying and describing occupational toxic exposures to youth and the associated health outcomes of such exposures. The authors reviewed 1997 data from the American Association of Poison Control Centers' Toxic Exposure Surveillance System for occupational exposures to persons 6 to 19 years old. In 1997, there were 3442 reported occupational exposure cases among 6- to 19-year-olds. Exposure cases included underage workers, exposure to multiple substances, continuous or repeated exposure to the offending substance, and exposures occurring in the home. Poison Control Centers provide unique and valuable information on toxic workplace exposures to youth. Child labor laws may be violated in many cases, and risks exist with respect to industrial work done in the home. Prospective studies with immediate follow-back are needed.     

Occupational and environmental exposures reported to poison centers.

This analysis of 25,368 occupational and 7,565 environmental exposure cases characterizes the occupational and environmental exposures reported to the American Association of Poison Control Centers Toxic Exposure Surveillance System. Compared with other poisonings, occupational and environmental exposures were predominantly inhalation exposures rather than ingestions, were more often subacute or chronic, and demonstrated greater morbidity, mortality, and increased use of health care resources. As regional poison centers evolve to fill a critical information void in the management and assessment of environmental and occupational exposures, the American Association of Poison Control Centers Toxic Exposure Surveillance System provides an important, untapped passive surveillance mechanism.     

Poison Control Center follow-up of occupational disease.

We followed up 73 of 372 calls to a Regional Poison Control Center (RPCC) that involved workplace disease/exposure(s); most other calls were not made by the workers. An average of 12 additional people per workplace were potentially exposed. Six of the 73 contacted a government agency for investigation of the hazard/illness. Twenty-five percent of callers were still exposed an average of seven months after the original call. The results indicate that poison control centers should develop a public health component to calls about possible workplace poisonings.     

The surveillance of work-related pesticide illness: an application of the Sentinel Event Notification System for Occupational Risks (SENSOR)

OBJECTIVES. In response to limitations in state-based occupational disease surveillance, the California Department of Health Services developed a model for surveillance of acute, work-related pesticide illness. The objectives were to enhance case reporting and link case reports to preventive interventions. METHODS. Elements from surveillance of communicable diseases and sentinel health events were used to integrate a model into the preexisting system in one agricultural country. RESULTS. Between 1988 and 1991, 45 Fresno County health care providers reported 230 suspected cases, of which 217 from 80 work sites met reporting guidelines. Risk factors were profiled from interviews of 81 prioritized case patients and 36 employers. Fifteen work sites were visited and 117 recommendations were made, of which 6% were identified in enforcement inspections. Pest management experts consulted with growers on reducing future pesticide use. CONCLUSIONS. Risk factors for pesticide illness were prevalent. Agricultural inspectors did not detect routine and serious hazards. Integrated pest management should be expanded and linked to occupational health. Agricultural enforcement personnel should be oriented and trained in occupational safety and health.     

2006—2013年苏州市疾病预防控制中心职业病诊断分析

目的了解2006—2013年苏州市疾病预防控制中心职业病诊断现状、职业病发病数量、种类、分布及发展趋势。方法收集汇总2006—2013职业病网络报告系统的职业病病例及相关资料进行统计分析。结果 2006—2013年苏州地区5家诊断机构共诊断职业病1 615例,其中苏州市疾病预防控制中心诊断1 237例,占总病例的76.59%;除尘肺外的其他种类职业病384例,占89.71%。2006—2013年苏州市疾病预防控制中心共诊断尘肺853例,慢性职业中毒174例,急性职业中毒119例,物理因素所致疾病31例,职业性耳鼻喉疾病60例;经济类型分布：尘肺以集体企业为主,物理因素所致疾病以私营企业为主;急性中毒第1顺位为私营企业,慢性中毒第1顺位为港澳台企业,耳鼻喉疾病第1顺位为外资企业。行业类型分布：尘肺第1顺位为采矿业,急性中毒和慢性中毒的第1顺位均为电子信息类,中暑和噪声聋第1顺位均为制造业。急性职业中毒、慢性职业中毒、耳鼻喉疾病发病逐年上升,尘肺逐年下降。结论职业病诊断机构发展不均衡,职业病诊断机构亟待加强;产业结构的调整、转型升级对职业病的发病具有一定的影响。不同经济类型、不同行业存在不同的发病特征,职业病防治面临新的形势。     

Enhanced Disease Surveillance during the 2012 Republican National Convention,Tampa, FL

Objective

To describe disease and illness surveillance utilized during the 2012 Republican National Convention (RNC) held August 26–30, 2012 in Tampa, FL.

Introduction

While the Tampa Bay Area has previously hosted other high profile events that required heightened disease surveillance (e.g., two Super Bowls), the 2012 RNC marked the first national special security event (NSSE) held in Florida. The Hillsborough County Health Department (HCHD), in conjunction with the Pinellas County Health Department (PinCHD) coordinated disease surveillance activities during this time frame. This presentation will focus of the disease surveillance efforts of the Hillsborough County Health Department during the 2012 RNC.In addition to the surveillance systems that are used routinely, the HCHD Epidemiology Program implemented additional systems designed to rapidly detect individual cases and outbreaks of public health importance. The short duration of RNC, coupled with the large number of visitors to our area, provided additional surveillance challenges.Tropical Storm Isaac, which threatened Tampa in the days leading up to RNC, and an overwhelming law enforcement presence likely dissuaded many protestors from coming to Tampa. As a result, a tiny fraction of the number of protestors that were expected actually showed up.

Methods

Our normal daily analysis of the emergency department (ED) data using the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) was expanded to look in detail at ED volumes and chief complaints of those patients who live outside of a 5-county Tampa Bay area. This analysis used patient zip code to determine place of residence. Additionally, ESSENCE queries were utilized to look for heat, tear gas, and RNC related exposures. The ESSENCE system also receives Poison Control data every 15 minutes. Expanded analyses of the Poison Control data were conducted as well. Two Disaster Medical Assistance Teams (DMATs) were deployed in Tampa during the RNC. Data was collected electronically and transmitted through ESSENCE as well.The HCHD also asked infection preventionists, health care providers, hotels, labs, and Mosquito Control to lower their reporting threshold to us during the RNC period. We provided updates to all our partners with respect to diseases and outbreaks of public health importance occurring in our county.

Results

No epidemiologic events linked to the RNC were detected through the HCHD’s enhanced surveillance that was conducted. Decreased patient volumes were seen during the RNC at our EDs closest to the convention site. No significant increases in ED visits from outside of our 5-county area were noted during the RNC. Urgent care centers reported seeing patients associated with the RNC for a variety of reasons including respiratory and gastrointestinal illness. DMAT surveillance showed mainly routine visits but four secret service agents did seek care for respiratory illness during the convention.

Conclusions

Substantial time and resources were devoted to disease surveillance in the 6 months leading up to the RNC and during the event. While no epidemiologic events were detected, the public health surveillance infrastructure has clearly been strengthened in our county. We are receiving our ED syndromic data, from many of our hospitals, every two hours as opposed to every day. We have established relationships with our urgent case centers and hope to begin receiving urgent care center data on a daily basis in the near future. Receiving DMAT data through ESSENCE could prove very useful in the future, especially in Florida where hurricanes are always a threat. Lastly the improved relationships with our health care providers should be beneficial as we move forward.     

Challenges for improving surveillance for pesticide poisoning: policy implications for developing countries.

BACKGROUND: Surveillance is a critical public health tool for the control of pesticide poisoning. However, surveillance activities in developing countries are bedevilled by multiple problems, and inferences made from review of flawed data may lead to mistaken policy decisions. METHODS: Results of intensified surveillance from an intervention project in the Western Cape Province of South Africa were compared to the pattern of poisonings reported in routine notifications to the health authorities for a control farming district and in the study district over a 5-year period preceding the study. Intensified surveillance data results were also contrasted with policy approaches based on routine notifications and on Regional Poison Centre reports. RESULTS: Poisoning rates reported in the study area increased almost 10-fold during the intervention period. Compared to intensified surveillance, hospital and health authority sources greatly underestimate the proportion of cases due to occupational poisoning, and overestimate suicide as a proportional cause. In addition, the risks for women appear underestimated from routine notifications. Assumptions that a lack of awareness is responsible for most poisonings are not borne out by the empirical data when reporting is intensified. CONCLUSIONS: Current policy assumptions are faulty, may result in inappropriate blame being attributed to victims and, by relying on information as the main element of education, may shift responsibility onto the individual. Improvements in the surveillance system should aim to restructure the types of data collected, and facilitate intra-governmental and inter-sector collaboration. The culture of monitoring based on report writing must change to one of surveillance that leads to intervention.     

Self reported rate of occupational asthma in Sweden 1990-2.

OBJECTIVES: To estimate the annual rates of self reported occupational asthma in different occupational groups in Sweden. METHODS: All claims of occupational asthma 1990-2 in the Swedish register of reported occupational diseases were classified according to occupation. The number of people employed in each occupational group in the general population was obtained from the 1990 national census. Reporting rates (cases/million/ year) were calculated for each occupation with more than five reported cases, according to sex and age (20 to 64 years, and 20 to 44 years). RESULTS: 1010 cases were reported giving an annual crude reporting rate of 80/million (95% confidence interval (95% CI) 70 to 90). For men, the crude reporting rate was 91/million (95% CI 84 to 98), and for women 70/million (95% CI 80 to 106). The highest reporting rates were among male bakers-(775/million), furnacemen (702/million), male welders (647/million), female chemical and plastic production workers (629/million), and female poultry and dairy farm workers (602/million). CONCLUSIONS: A surveillance system based on self reporting is influenced by considerable bias, especially reporting bias. However, results for the specific occupations with high rates were similar to those found with other surveillance systems. This indicates that our system is a useful one.     

Physician reports of work-related asthma in California, 1993-1996

BACKGROUND: Work-related asthma is a leading cause of occupational respiratory illness. METHODS: Work-related asthma was studied in California over a 36-month period, from March 1, 1993 to February 29, 1996. The surveillance system identified cases from Doctor's First Reports (DFRs), a mandated physician reporting system. Structured follow-up telephone interviews of DFR asthma cases were conducted to collect work history, exposure, and medical information. Statewide employment data was used to calculate disease rates among industry groups. RESULTS: Based on 945 cases of work-related asthma, the average annual reporting rate for work-related asthma in California was 25/million workers. We estimate that the actual rate is 78/million, adjusted for likely underreporting. Janitors and cleaners (625/million) and firefighters (300/million) had the highest reporting rates of work-related asthma. Half of all work-related asthma cases were associated with agents not known to be allergens. CONCLUSIONS: A greater proportion of work-related asthma associated with irritant exposures was identified than has previously been reported. The surveillance data provide a very conservative estimate of the incidence of work-related asthma.     

Poison Center Data for Public Health Surveillance: Poison Center and Public Health Perspectives

Objective

To describe the use of poison center data for public health surveillance from the poison center, local, state, and federal public health perspectives and to generate meaningful discussion on how to address the challenges to collaboration.

Introduction

Since 2008, poisoning has become the leading cause of injury-related death in the United States (US); since 1980, the poisoning-related fatality rate in the US has almost tripled.1 Many poison-related injuries and deaths are reported to regional poison centers (PCs) which receive about 2.4 million reports of human chemical and poison exposures annually.2 Federal, state, and local public health (PH) agencies often collaborate with poison centers and use PC data for public health surveillance of poisoning-related health issues. Many state and local PH agencies have partnerships with regional PCs for direct access to local PC data which help them perform this function. At the national level, CDC conducts public health surveillance for exposures and illnesses of public health significance using the National Poison Data System (NPDS), the national PC reporting database.Though most PC and PH officials agree that PC data play an important role in PH practice and surveillance, collaboration between PH agencies and PCs has been hindered by numerous challenges. To address these challenges and bolster collaboration, the Poison Center and Public Health Collaborations Community of Practice (CoP) was created in 2010 by CDC as a means to share experiences, identify best practices, and facilitate relationships among federal, state and local public health agencies and PCs. To date, the Poison Center and Public Health Collaborations CoP includes over 200 members from state and local public health, regional PCs, CDC, the American Association of Poison Control Centers (AAPCC), and the Environmental Protection Agency (EPA). A leadership team was created with representatives of the many stakeholders of the community to drive its direction and oversee activities.

Methods

The panel will consist of 4 presenters and 1 moderator, who are members of the Poison Center and Public Health Collaborations CoP leadership team. Each presenter will bring a unique perspective of the use of PC data for PH practice and surveillance: CDC, state department of health, a local department of health, and a PC. Royal Law from the CDC National Center for Environmental Health will present on using PC data for identification of exposures and illnesses of public health significance identified from NPDS data collected from all 57 PCs. Dr. Jay Schauben from the Florida/USVI Poison Information Center - Jacksonville will discuss PC participation in surveillance and use of PC data for tracking and mitigation of PH events in Florida. Dr. Prakash Mulay from the Florida Department of Health will discuss utilization of PC data to enhance ESSENCE-based chemical-associated exposure and illness surveillance in Florida. Katherine Wheeler from the New York City (NYC) Department of Health and Mental Hygiene will discuss NYC’s use of PC data in surveillance of potential emerging issues, from energy drinks to synthetic marijuana. Each presenter will discuss the use of PC data for PH practice and surveillance in his or her organization and jurisdiction, the successes of using PC data, and their challenges.

Results

The moderator will engage the audience by facilitating discussion of the successes and challenges to using PC data for PH practice and surveillance with the audience.Sample questions:What are your current capacities and collaborative activities between your state/local health department and your poison center?What non-funding related barriers hinder the collaboration between your state/local health department and poison center?If more funding were available, how would you use this funding to increase the level of interactivity with the poison center and state/local health department?     

Evaluation of the surveillance of hemolytic uremic syndrome in British Columbia: should it remain reportable?

BACKGROUND: Hemolytic Uremic Syndrome (HUS) was made reportable in British Columbia (BC) in 1998 to detect, control and prevent verotoxigenic Escherichia coli (VTEC) cases. Concerns about under-reporting of HUS cases triggered the assessment of the sensitivity and timeliness of the reporting process in order to guide recommendations around reportability of this syndrome in BC. METHODS: The BC hospitalization database was used to estimate the total number of HUS cases from April 30, 1998 to December 31,2005. HUS and VTEC cases reported in the integrated Public Health Information System (iPHIS), and HUS cases reported by a surveillance form were linked to hospitalized cases. The proportion of HUS cases detected by each of the surveillance processes was assessed. The time interval between onset of diarrhea and reporting of HUS and VTEC cases to the BC Centre for Disease Control was compared. RESULTS: 57 HUS cases were hospitalized. Sensitivity of reporting through the surveillance form and through iPHIS was 7.0% and 19.3%, respectively. The median time interval between onset of diarrhea and reporting of both HUS and VTEC cases to iPHIS was seven days. The median time interval for reporting HUS cases via the surveillance form was 25 days. CONCLUSIONS: HUS cases were severely under-reported, the timeliness of reporting of these cases had no advantage when compared to the reporting of VTEC cases, and no public health action aimed at reducing the transmission of VTEC infections resulted from this surveillance system. The reportability of HUS in BC needs to be reconsidered, or its surveillance considerably improved.     

Active AIDS surveillance: hospital-based case finding in a metropolitan California county.

OBJECTIVES. Health departments that use passive surveillance alone cannot be sure of the level of complete and accurate reporting of acquired immunodeficiency syndrome (AIDS) cases. We sought to develop a model of active AIDS case reporting using limited county resources. METHODS. A validation study of AIDS case reporting using discharge diagnosis codes was undertaken to assess underreporting. Hospital-specific protocols for active surveillance were developed. RESULTS. The validation study revealed that 24% of AIDS cases in all hospitals were not reported through passive surveillance in 1990. In the first 3 months of 1991, active surveillance identified nine unreported cases (69% of the total cases reported) in one hospital. These underreporting estimates far exceed the 15% national underreporting rate estimated by the Centers for Disease Control. CONCLUSIONS. A method of hospital-based case finding was developed and serves as the model for implementing an ongoing program of active surveillance needed to ensure complete, accurate, and timely reporting of diagnosed AIDS cases. Application of this model may be helpful in attempts to minimize underreporting.     

Developing regional workplace health and hazard surveillance in the Americas.

An objective of the Workers' Health Program at the Pan American Health Organization (PAHO) is to strengthen surveillance in workers' health in the Region of the Americas in order to implement prevention and control strategies. To date, four phases of projects have been organized to develop multinational workplace health and hazard surveillance in the Region. Phase 1 was a workshop held in 1999 in Washington, D.C., for the purpose of developing a methodology for identifying and prioritizing the top three occupational sentinel health events to be incorporated into the surveillance systems in the Region. Three surveillance protocols were developed, one each for fatal occupational injuries, pesticide poisoning, and low back pain, which were identified in the workshop as the most important occupational health problems. Phase 2 comprised projects to disseminate the findings and recommendations of the Washington Workshop, including publications, pilot projects, software development, electronic communication, and meetings. Phase 3 was a sub-regional meeting in 2000 in Rosario, Argentina, to follow up on the progress in carrying out the recommendations of the Washington workshop and to create a Virtual Regional Center for Latin America that could coordinate the efforts of member countries. Currently phase 4 includes a number of projects to achieve the objectives of this Center, such as pilot projects, capacity building, editing a compact disk, analyzing legal systems and intervention strategies, software training, and developing an internet course on surveillance. By documenting the joint efforts made to initiate and develop Regional multinational surveillance of occupational injuries and diseases in the Americas, this paper aims to provide experience and guidance for others wishing to initiate and develop regional multinational surveillance for other diseases or in other regions.     

Early warning and NHS Direct: a role in community surveillance?

BACKGROUND: NHS Direct is a nurse-led telephone help line that covers the whole of England and Wales. NHS Direct derived data are being used for community surveillance, the purpose of which is to detect a local or national increase in symptoms reported by callers. The system has the potential to identify an increase in symptoms reported by callers about people in the prodromal stages of illness caused by the deliberate release of a biological or chemical agent. There are no other community surveillance projects existing on a national scale that utilize electronic daily data. METHODS: We describe the surveillance system and calls to NHS Direct between December 2001 and July 2002. Confidence limits have been constructed for 10 key algorithms at each site and control charts devised for five of these algorithms at sites covering the key urban areas. RESULTS: Daily reporting has been achieved from NHS Direct sites in England and Wales. High levels of activity in specific algorithms at both national and regional levels have been detected. A sustained national increase in calls about fever occurred in January 2002. CONCLUSION: Although the project is still at an early stage, daily analysis of NHS Direct data has the potential to detect symptoms in the community that could be related to deliberate releases of chemical or biological agents or to outbreaks of disease. For this surveillance to act as an 'early warning' of illness resulting from a microbiological or chemical cause, the NHS Direct surveillance needs to be fully integrated into an appropriate public health response (which may require diagnostic samples to be taken from callers).     

Estimating the total number of newly-recognized silicosis cases in the United States

BACKGROUND: The US employer-based surveillance system for documenting occupational injuries and illnesses undercounts chronic diseases. We suggest a method to estimate the number of individuals who are newly-recognized with silicosis each year in the United States. METHODS: Data from US death certificates, the Michigan state-based surveillance system, and capture-recapture analysis were used to calculate national estimates of silicosis. RESULTS: From 1987 to 1996, 2,787 deaths occurred in the United States where silicosis was mentioned on the death certificates. During the same period, in Michigan 77% of death certificates with a mention of silicosis were confirmed as silicosis-related deaths and the ratio of the number of living to deceased confirmed silicosis cases was 6.44. The proportion of confirmed silicosis deaths, the ratio of the living to deceased silicosis cases and capture-recapture analysis from the Michigan surveillance system, were used to estimate that there were 3,600-7,300 cases per year of silicosis in the United States from 1987 to 1996. CONCLUSIONS: Our estimate of the annual number of newly-recognized silicosis cases is significantly larger than the estimate from the employer-based reporting system used for counting occupational disease in the United States. This employer-based surveillance system is inadequate for determining the frequency of occupational disease. Our analysis which combines a readily-available and relatively inexpensive national administrative database (i.e., death certificates) with a more costly state-based active surveillance system is a cost-effective model that could be used to provide better estimates of a number of different occupational diseases. Accurate estimates of occupational illnesses are essential to both determine temporal trends and evaluate efforts to prevent silicosis.     

Occupational injury and illness among migrant and seasonal farmworkers in New York State and Pennsylvania, 1997-1999: pilot study of a new surveillance method

BACKGROUND: Traditional worksite injury surveillance methods are often ineffective for Northeastern farms employing seasonal harvest labor. Many are small farms, exempt from mandatory injury reporting. The high proportion of foreign workers and the temporary nature of the work further discourages reporting. Therefore, an alternative migrant health center-based occupational injury and illness surveillance system was piloted during 1997-1999. METHODS: Anonymous medical chart data from nine migrant health centers and four regional hospital emergency rooms was collected during 1997-1999. RESULTS: There were 516 injury/illness cases over two seasons. Joint/muscle straining (31%), falling (18%), poison ivy contact (10%), and object strikes (8%) were most common injurious events. The participation rate of health care was 75%; 130 cases were reported by hospital emergency rooms; and optimal health center participation was associated with: being a farmworker-dedicated program, and including the chart reviewer in the health center's decision to participate. CONCLUSIONS: Further development of a medical records-based surveillance system should include hospital emergency rooms and focus on identified health center performance factors.     

Circulation of Reassortant Influenza A(H7N9) Viruses in Poultry and Humans,Guangdong Province,China, 2013

Influenza A(H7N9) virus emerged in eastern China in February 2013 and continues to circulate in this region, but its ecology is poorly understood. In April 2013, the Guangdong Provincial Center for Disease Control and Prevention (CDC) implemented environmental and human syndromic surveillance for the virus. Environmental samples from poultry markets in 21 city CDCs (n = 8,942) and respiratory samples from persons with influenza-like illness or pneumonia (n = 32,342) were tested; viruses isolated from 6 environmental samples and 16 patients were sequenced. Sequence analysis showed co-circulation of 4 influenza A(H7N9) virus strains that evolved by reassortment with avian influenza A(H9N2) viruses circulating in this region. In addition, an increase in human cases starting in late 2013 coincided with an increase in influenza A H7 virus isolates detected by environmental surveillance. Co-circulation of multiple avian influenza viruses that can infect humans highlights the need for increased surveillance of poultry and potential environmental sources.     

2011年江南某市职业健康监护工作开展情况

目的了解江阴市职业健康监护工作的开展情况,为其行政部门制定卫生政策和职业病防治对策提供科学依据。方法根据该市2011年度健康危害因素监测信息系统年度报表,统计分析辖区内不同行业、不同规模、不同经济类型等的企业开展职业健康监护工作的状况。结果辖区内年度开展职业健康监护的用人单位有101家,对接触有毒有害作业的17 909人进行健康检查,占职工总数的40.59%;在接触的5大类职业病危害因素中,化学毒物类占51.72%,检出疑似职业病7人,检出率为0.04%;其大多分布于中外合资经营的中等规模金属制品行业,属物理因素(噪声)类所致疾病。发现职业禁忌证82人,检出率0.46%;其大多分布于私营有限责任公司和私营股份有限公司中的一般制造业、规模计算机及其他电子设备制造业,属化学毒物类及物理因素类所致疾病。结论提高用人单位职业病防治意识工作刻不容缓,广泛开展职业健康监护工作,能早期发现职业病和职业禁忌证。