泉州某煤矿2009-2014年尘肺发病分析

目的 分析泉州某煤矿2009-2014年新发尘肺发病规律,探讨发病特点,为制定防治措施提供依据.方法 对矿区2009-2014年所有新发尘肺病例资料进行分析.结果 2009-2014年共受检4157人,检出新发尘肺病175例,检出率4.2％.各年度检出率类似.患者平均发病年龄(51.6±10.8)岁,各年发病年龄总体上年轻化趋势;平均发病工龄(17.2±9.8)年,各年度发病工龄整体呈缩短趋势.新发尘肺病1 75例中,工期占65.7％;Ⅰ期检出率(2.8％)高于Ⅱ期(0.8％)和Ⅲ期(0.7％).结论 泉州某煤矿尘肺病平均发病年龄呈年轻化趋势、发病工龄呈缩短趋势.应根据发病特征,加强尘肺病的综合防治.     

淮南煤矿接尘职工尘肺患病状况调查

目的研究淮南煤矿尘肺病发病规律,探讨尘肺病防治对策。方法用流行病学调查方法,对淮南矿区接尘作业职工50年来尘肺病发病情况进行调查、统计分析。结果1954年至2003年,共诊断各期尘肺病6 115例,其中合并肺结核1 109例,合并率18.14%。Ⅰ期尘肺5 578例,综合防尘前接尘发病5 196例(93.15%),综合防尘后接尘发病382例(6.85%)。现患尘肺病3 140例,其中合并肺结核327例,合并率10.41%。Ⅰ期尘肺平均发病工龄22.1±7.7年,平均发病年龄52.2±10.0岁;尘肺平均晋期年限,0 ~Ⅰ5.7±4.3年,Ⅰ~Ⅱ7.2±5.3年,Ⅱ~Ⅲ8.0±5.5年;死亡尘肺病2 975例,病死率48.65%,尘肺平均死亡年龄64.27±10.9岁。1991~2003年,平均每年新诊断尘肺病114例。结论粉尘危害产生了严重的后果。由于采取有效的防尘措施,尘肺病的发病工龄、年龄逐渐延长。应继续加强粉尘治理,直至消除尘肺病。     

某地区不同管理体制煤矿的尘肺发病分析

目的 探索安徽省淮北地区不同管理体制煤矿尘肺发病现状,为防治尘肺病提供依据.方法 对1963年1月至2007年12月确诊的9237例尘肺病例,进行回顾分析.结果 国有煤矿尘肺检出率为5.57%,明显低于地方煤矿(9.59%).国有煤矿Ⅰ期尘肺平均发病工龄为(23.0±7.7)年,比地方煤矿的(20.0±9.0)年明显延长;Ⅰ期尘肺病平均发病年龄为(50.6±8.4)岁,比地方煤矿的(46.1±8.2)岁明显后移;国有煤矿Ⅰ期晋Ⅱ期平均年限为(8.7±6.0)年.比地方煤矿的(7.2±6.9)年明显延长;上述差异均有统计学意义(P<0.05).结论 地方煤矿尘肺检出率明显高于国有煤矿,Ⅰ期尘肺病平均发病工龄和年龄地方煤矿比国有煤矿明显缩短.地方煤矿应加大综合防尘力度.     

煤矿在职接尘工人煤工尘肺的发病情况

目的 探讨煤矿在职接尘工人煤工尘肺病发病特点,为指导煤工尘肺防治工作提供依据.方法 选择某矿业集团坚持定期健康检查、资料保存完整的3个煤矿,以调查前一年进行过尘肺病检查,但未诊断为尘肺的全部在岗接尘工人为调查对象,共8535人,收集调查对象的一般情况和职业史,对其进行尘肺健康检查,由具有尘肺病诊断资质的尘肺诊断组按GBZ 70-2002<尘肺病诊断标准>做出尘肺诊断.比较煤工尘肺的发病率,分析煤工尘肺患者发病年龄、发病工龄及不同工龄、不同工种人群煤工尘肺发病率的分布.结果 共8527人受检,受检率为99.9%(8527/8535).新发现Ⅰ期煤工尘肺49人,发病率为0.57%;平均发病年龄为(44.4±2.7)岁,平均发病工龄为(26.1±4.7)年.掘进工煤工尘肺病的发病率为0.92%(21/2282),高于采煤工(0.35%,5/1430)和辅助工(0.35%,5/1430),差异有统计学意义(P＜0.05).掘进工和混合工的平均发病工龄分别为(21.7±4.8)和(22.3±5.1)年,明显低于采煤工(27.8±4.6年)和辅助工(29.4±4.7年),各工种煤工尘肺平均发病工龄比较,差异具有统计学意义(F=6.42,P=0.001).煤工尘肺发病工龄多在20～30年,发病年龄多集中在45～55岁.结论 煤矿在职接尘工人煤工尘肺发病率为0.57%,掘进工的发病率高于采煤工和辅助工.掘进工和混合工的平均发病工龄较采煤工和辅助工短.     

开滦矿区2005-2012年煤工尘肺发病情况分析

目的浅析近8年开滦煤矿尘肺发病特点。方法对2005年1月1日-2012年12月31日开滦职业病防治所尘肺诊断组新诊尘肺患者的检出数、检出率、构成比、发病年龄、接尘工龄及接尘工种等方面进行调查。结果 8年来开滦煤矿共有46 091人受检,受检率28.52%(46 091/161 624),检出尘肺病人827例,尘肺检出率1.79%(827/46 091);2008年开滦尘肺病人检出率最高,2009年开滦尘肺病人检出率最低,2010、2011、2012年尘肺病人检出率趋于平稳,略有下降;尘肺病人平均发病工龄为(35.86±9.92)年,平均发病年龄(57.76±10.08)岁;主要接尘工种中,平均发病年龄以纯掘进工为最短,主掘进工与纯掘进工两者之间差异有统计学意义(P0.05),主采煤工与纯采煤工之间差异有统计学意义(P0.05);新发尘肺检出率以Ⅰ期煤工尘肺居多,占尘肺总数的94.56%(728/827);Ⅱ期占煤工尘肺总数的4.72%(39/827);Ⅲ期占煤工尘肺总数的0.72%(6/827),新发尘肺中Ⅰ期与Ⅱ期比较,Ⅰ期与Ⅲ期比较,Ⅱ期与Ⅲ期比较差异有统计学意义。结论近8年来开滦煤矿尘肺检出率1.79%,新发尘肺中以Ⅰ期轻症为主;尘肺平均发病年龄超过工人退休年龄;众多工种中发病以煤矿混合工最多,以纯掘进工的发病工龄最短,辅助工种发病人数有上升趋势。     

中国煤矿职业病防治现状调查分析

目的为国家制订具有针对性的政策提供科学依据,促进和提升煤炭企业尘肺病防治工作,降低尘肺病的发生。方法采用现场调查、资料研究、抽检等方法,对华北、东北、华东、西南4个地区的5个国有重点煤炭集团(共有47对矿井)、14个地方国有煤矿以及26个乡镇煤矿职业病防治现状进行研究。结果 5个国有重点煤炭集团综采工作面和机掘工作面粉尘浓度平均分别为66.8、65.5 mg/m3,尘肺病平均发病工龄为21.5 a。尘肺患者的平均发病年龄为51.6岁,在职职工平均尘肺病检出率为6.6%,离退休人员尘肺病平均检出率为13.7%;11个地方国有煤矿采煤工作面的平均总粉尘浓度为64.17 mg/m3,超标10.7倍,采煤工作面平均呼吸性粉尘浓度为16.08 mg/m3,超标4.6倍,尘肺病平均发病工龄18.5 a,Ⅰ期尘肺平均发病年龄43.8岁,尘肺病检出率7.4%;26个乡镇煤矿尘肺病的检出率7.5%,平均发病工龄6.8 a。结论煤炭企业尘肺病危害较严重;适应市场经济条件的尘肺病防治体系亟待建立。     

皖北地区尘肺流行病学调查

目的探讨本地区尘肺发病规律、综合防尘效果及预防措施。方法对确诊8985例尘肺病患者按全国尘肺流行病学调查办公室设计的统一方案填写“尘肺病例卡”所有内容,用SQLSERVER2000建立数据库,SPSS10.0统计软件包进行统计学处理。结果①该地区尘肺发病率6.94%,病死率29.88%,肺结核合并率18.99%,平均病程12.56年,前10位死因肺结核居首位,其次是尘肺和肺癌;②发病工龄(21.64±7.09)年,发病年龄(49.71±7.99)岁,晋期年限Ⅰ→Ⅱ(8.29±6.56)年,Ⅱ→Ⅲ(9.96±5.88)年;③随着尘肺期别增加,尘肺结核合并率和病死率明显上升。结论该地区尘肺病检出率和病死率较高,防治重点是建井公司和乡镇煤矿,防痨工作应加强。     

闽西矿区2005-2011年尘肺病发病情况分析

目的分析闽西矿区2005-2011年尘肺病发病情况及特点,为龙岩市职业健康监护体系制定尘肺病预防策略提供依据。方法选取2005-2011年龙岩市CDC上报《中国疾病预防控制信息系统》的587例尘肺病例为研究对象,采用SPSS 17.0软件包统计分析相关的报告信息。结果闽西矿区2005-2011年累计尘肺病587例。其中新发尘肺病449例,占总病例数的76.49%;晋期病例138例,占总病例数的23.51%。煤炭开采和洗选业尘肺病的平均发病年龄和平均发病工龄〔(50.48±11.06)岁,(27.28±11.69)年〕大于(或长于)其他行业尘肺病的平均发病年龄和平均发病工龄〔(45.05±6.52)岁、(10.27±5.85)〕年,差异具有统计学意义(P0.05或0.01)。不同行业壹期、贰期、叁期尘肺病例的平均发病年龄比较差异无统计学意义(均P0.05)。矽肺平均发病年龄和平均发病工龄〔(53.52±12.25)岁,(28.76±13.70)〕年大于(或长于)煤工尘肺的平均发病年龄和平均发病工龄〔(49.50±10.45)岁,(26.26±11.35)年〕,具有统计学意义(P0.05或0.01)。尘肺病合并肺TB的合并率为3.07%。结论闽西矿区尘肺发病情况严重,职业健康监护覆盖面有待提高。     

泉州市2007—2014年尘肺病流行趋势分析

目的了解泉州市尘肺病流行趋势,为制定防治措施提供依据。方法收集泉州市2007—2014年新发尘肺病例资料,对发病年龄、工龄和尘肺期别等指标进行统计分析。结果泉州市2007—2014年共诊断尘肺病331例,以矽肺(84.0%)和煤工尘肺(13.6%)为主;发病年龄31.7~79.0岁(49.7±10.7)岁,工龄1~45年(14.6±9.3)年,二者均有逐年降低趋势。≥40岁占82.2%,40~49岁和≥60岁组、发病工龄≥20年和Ⅰ、Ⅱ期尘肺发病数均呈上升趋势。随发病年龄的增加Ⅰ、Ⅱ期尘肺比重逐渐降低,Ⅲ期尘肺比重逐渐升高;发病工龄与尘肺期别无关联。结论泉州市尘肺病高年龄发病数、高工龄发病数、Ⅰ期和Ⅱ期尘肺发病数呈上升趋势,发病年龄与尘肺期别有关。应有针对性地加强健康筛查,预防尘肺病高发。     

2002-2011年泉州市煤矿尘肺发病情况

目的 分析泉州市煤炭系统尘肺病的发病情况,为煤矿作业工人尘肺病的防治提供科学依据.方法 对该市煤炭系统近10年来新诊断的192例尘肺病例进行回顾性分析.结果 ①192例尘肺病例中Ⅰ、Ⅱ、Ⅲ期分别占65.63％、30.73％、3.64％;2002、2003、2004年尘肺新病例呈逐年增多趋势,2005年以后趋于平稳,2009、2010、2011年新病例数较前有所减少.②尘肺平均发病工龄(21.78 ±7.35)a,以接尘工龄10～29年为多,占56.25％;尘肺平均发病年龄(54.44±6.25)岁,以35 ～59岁为主,占66.15％.③掘进工和采掘工发病人数较多,分别占46.35％和41.15％,纯采煤工仅占总病例数4.17％.结论 该市煤矿采取的防尘措施和加强健康监护取得了一定的成效,但粉尘危害仍较严重.应加大职业病防治宣传力度,进一步落实各项防尘措施,强化工人防尘意识,加强对掘进工、采掘工、采煤工及退休矿工等重点人群的健康监护,保护劳动者健康.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Psychopathological features of a patient population of targets of workplace bullying

BACKGROUND: A strong association between workplace bullying and subsequent anxiety and depression, indicated by empirical research, suggests that bullying is an aetiological factor for mental health problems. AIMS: To evaluate levels of stress and anxiety-depression disorder developed by targets of workplace bullying together with outcome at 12 months and to characterize this population in terms of psychopathology and sociodemographic features. METHODS: Forty-eight patients (36 women and 12 men) meeting Leymann Inventory of Psychological Terror criteria for bullying were included in a prospective study. Evaluations were performed at first consultation and at 12 months using a standard clinical interview, a visual analogue scale of stress, the Hospital Anxiety and Depression (HAD) scale, the Beech scale of stress in the workplace and a projective test (Picture-Frustration Study). RESULTS: At first consultation, 81% of patients showed high levels of perceived stress at work and 83 and 52% presented with anxiety or depression, respectively. At 12 months, only 19% of working patients expressed a feeling of stress at work. There was a significant change in symptoms of anxiety while there was no change in symptoms of depression. Stress at work and depression influenced significatively capacity to go back to work. At 12-month assessments, workers showed a significantly better score on the HAD scale than non-workers. Over half the targets presented a neuroticism-related predominant personality trait. CONCLUSION: Workplace bullying can have severe mental health repercussions, triggering serious and persistent underlying disorders.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.     

Organophosphate toxicity and occupational exposure

The ubiquitous organophosphates present a continuing health hazard in agriculture, public health eradication programmes and as chemical warfare agents. Despite significant progress in understanding the potential mechanisms of toxicity far beyond the commonly accepted mechanism of cholinesterase inhibition in intentional exposures, the precise health effects following occupational exposures are yet to be completely defined. A much greater understanding exists of the clinical features of organophosphate poisoning. These are characterized by a triphasic response involving an initial acute cholinergic phase, an intermediate syndrome (both associated with high mortality) and a disabling but non-lethal delayed polyneuropathy. The delayed polyneuropathy may occur in the absence of the cholinergic or intermediate phases. However, progress is still required in order to improve the quantification and assessment of occupational exposures and the implementation of appropriate preventive measures. Finally, evidence-based guidelines for appropriate or optimal therapeutic interventions following poisoning are required urgently and collaborative work with colleagues in developing countries, where the occurrence of organophosphate exposures is more frequent, may provide the answers.     

Miliaria rubra of the lower limbs in underground miners

This report documents a case series of miliaria rubra of the lower limbs in miners at a deep underground metalliferous mine in tropical arid Australia. During the summer months of February and March 1999, all cases of miliaria rubra of the lower limbs in underground miners seen at the mine's medical centre were clinically examined and administered a questionnaire. Twenty-five patients were seen, an incidence of 56.4 cases per million man-hours. Miliaria rubra was most often located between the ankle and knee (88% of cases). Twenty-four percent had concurrent folliculitis and 20% had concurrent tinea. Thirty-two percent had a personal history of asthma. Walking through ground-water and splashing of the legs was common. Three to 4 weeks of sedentary duties in air conditioning was generally required to achieve resolution of miliaria rubra. The incidence of miliaria rubra of the lower limbs is 38% of the incidence of heat exhaustion at the same mine. The length of disablement is greater, however. Atopics may be at increased risk of miliaria rubra. Control measures are discussed.     

Planning research

The starting point for any research project should be a question.Once this has been defined and the relevant scientific literaturereviewed, a protocol should be drawn up. This will be used notonly as a guide to the conduct of the study and in the preparationof the final report, but also in seeking any financial supportand approvals that are required for the investigation. A protocolis normally arranged in sections covering the background tothe study, the question(s) that it will address, the methodsthat will be used for the collection and analysis of data, thestatistical power of the investigation (where relevant), anyethical considerations, and the financial input that will beneeded. A pilot study is often helpful where aspects of thestudy method are untried or of uncertainvalidity.     

Stress in the Norwegian police service

BACKGROUND: High levels of stress have been attributed to the conditions of police work, but there is little empirical evidence for this. AIMS: To develop a new instrument to measure job stress in the police; to assess the most severe and frequent police stressors; to compare levels of stress according to the demographic and organizational factors; and to study stress in relation to personality traits, work locus of control and coping strategies. METHODS: A comprehensive nationwide questionnaire survey of 3272 Norwegian police at all hierarchical levels, including the Norwegian Police Stress Survey (NPSS), the Job Stress Survey, the Basic Character Inventory, the Work Locus of Control Scale, and the Coping Strategies Scale. RESULTS: Work injuries were appraised as the most stressful but least frequent stressor and job pressure was reported the least severe but most frequent stressor. Females experienced job stressors less frequently, but appraised them as more severe than men did. Older police officers reported more job pressure severity and fewer work injuries. The police in districts where peer support was planned but not implemented, and who worked in districts with more than 50,000 inhabitants, perceived the lack of support more severely than others. The correlations between stress and personality traits, work locus of control, and coping were moderate. CONCLUSIONS: The NPSS captures police-specific stressors that are not adequately measured by global stress instruments. The study of stress in police work should preferably involve a nationwide use of police-specific stress instruments.