Screening for occupational health hazards in the rubber industry. Part I

Multiphasic health testing (MHT) is often offered to populations of workers usually with the objective of identifying individuals who may be ill. Results are typically not analyzed in relation to estimates of workplace exposure. We describe the results of combining MHT with industrial hygiene assessment of workplace exposures as a method of identifying possible health hazards rather than merely potentially ill individuals. MHT was offered to all production and maintenance workers employed at a tire manufacturing plant. Of 954, 744 participated. We measured worker exposure to respirable particulates, solvent vapor, and noise. We computed the frequency of positive screens among workers classified by exposure and compared these frequencies with expected values adjusted for confounding variables including age, sex, race, and smoking and drinking habits. Workers exposed to higher concentrations of respirable particulates exhibited signs of respiratory and gastrointestinal morbidity. Workers exposed to emissions from heated, uncured rubber undergoing plastic deformation reported chest tightness on return to work. We conclude that combining MHT with assessment of workplace exposure is a valid method for identifying possible occupational health hazards.     

Workplace Exposures and Protective Practices of Hispanic Warehouse Workers

Background This study was undertaken to assess workplace hazards and protective practices among Hispanic men and women working post-harvest in asparagus, apple and pear packaging warehouses. Methods Three focus groups were conducted in July 2003 with 25 workers (20 women, 5 men) recruited from communities in the Yakima Valley, Washington. Focus group content informed the design of an in-person structured interview administered to 50 additional warehouse workers from August to November 2006. Results Focus group participants reported difficult working conditions, exposure to chemicals, adverse health effects and use of work and home protective practices to minimize exposures for themselves and their families. Structured interview participants reported few workplace exposures to chemicals although many reported engaging in workplace and home protective practices. Discussion Findings from this research can direct initial efforts to determine if and how interventions for warehouse workers may be designed to protect against hazardous workplace exposures.     

Historical and political overview

There are more than 10 million local government workers in the United States. Municipal workers are exposed to a wide variety of serious chemical, biological, physical, ergonomic, and safety hazards. Decisions made by legislative bodies and policy makers historically have had a severe impact on the health and safety of local government workers. In over half of the states, city workers are not covered by safety and health programs approved by the Occupational Safety and Health Administration. They also lack universal coverage under laws providing union recognition and the right to collectively bargain over working conditions. Collective action in the workplace and the political arena remains the most important vehicle for municipal workers to secure safe working conditions.     

The management of occupational health by NHS Trusts in the north of England

This paper reports the findings of an audit of the management of occupational health arrangements in 36 NHS Trusts in the Northern and Yorkshire region of England. A questionnaire was designed based on a national NHS occupational health standard to obtain data on eight categories of occupational health activity: health and safety; pre-employment assessments; Infection Control; health surveillance; sickness absence; ill-health retirement; health promotion and record storage. The management arrangements for occupational health were varied. Assessments of workplace hazards, prevention of HIV-positive workers from performing exposure-prone invasive procedures and the assessment of pregnant workers were identified as issues for further consideration. Provision of competent and effective occupational health services will assist in the management of sickness absence and in the protection and promotion of health of staff. It will also contribute to the health and safety of patients.     

Interaction of working conditions, job satisfaction, and sickness absences: evidence from a representative sample of employees

We study the predictors of sickness absences among 2800 Finnish workers responding to the cross-sectional Quality of Work Life Survey in 1997. The data contain detailed information on the prevalence of adverse working conditions at the workplace from a representative sample of wage and salary earners. We show by using recursive multivariate models that the prevalence of harms at the workplace is associated with job dissatisfaction and dissatisfaction with sickness absences. The policy lesson is that the improvement of working conditions should be an integral part of any scheme aimed at decreasing sickness absence.     

The inverse hazard law: blood pressure, sexual harassment, racial discrimination, workplace abuse and occupational exposures in US low-income black, white and Latino workers

Research on societal determinants of health suggests the existence of an "inverse hazard law," which we define as: "The accumulation of health hazards tends to vary inversely with the power and resources of the populations affected." Yet, little empirical research has systematically investigated this topic, including in relation to workplace exposures. We accordingly designed the United for Health study (Greater Boston Area, Massachusetts, 2003-2004) to investigate the joint distribution and health implications of workplace occupational hazards (dust, fumes, chemical, noise, ergonomic strain) and social hazards (racial discrimination, sexual harassment, workplace abuse). Focusing on blood pressure as our health outcome, we found that among the 1202 low-income multi-racial/ethnic working class participants in our cohort - of whom 40% lived below the US poverty line - 79% reported exposure to at least one social hazard and 82% to at least one high-exposure occupational hazard. Only sexual harassment, the least common social hazard, was associated with elevated systolic blood pressure (SBP) among the women workers. By contrast, no statistically significant associations were detectable between the other additional highly prevalent social and occupational hazards and SBP; we did, however, find suggestive evidence of an association between SBP and response to unfair treatment, implying that in a context of high exposure, differential susceptibility to the exposure matters. These results interestingly contrast to our prior findings for this same cohort, in which we found associations between self-reported experiences of racial discrimination and two other health outcomes: psychological distress and cigarette smoking. Likely explanations for these contrasting findings include: (a) the differential etiologic periods and pathways involving somatic health, mental health, and health behaviors, and (b) the high prevalence of adverse exposures, limiting the ability to detect significant associations. As clarified by the "inverse hazard law," to understand health inequities, research is needed that contrasts exposures and health status population-wide, not just among those most inequitably exposed.     

核燃料芯块制备生产线对作业人员辐射影响

目的对核燃料芯块制备生产线工作人员可能受到的辐射影响进行综合分析和评价。方法通过对某压水堆核燃料芯块制备生产线放射性职业病危害因素及辐射防护措施现场考察和分析,结合对生产线工作场所辐射水平及作业人员个人受照剂量的估算结果,与国家相关标准比较。结果在正常运行时,作业场所的放射性水平符合《电离辐射防护与辐射源安全基本标准》GB18871—2002和《铀加工与燃料制造设施辐射防护规定》（EJ1056—2005）的要求;工作人员的个人剂量每年的最大值为9．49mSv／a,低于行业标准EJ056—2005规定的年有效剂量当量管理控制值10mSv／a。结论在正常运行条件下核燃料芯块制备生产线不会对工作人员的身体造成有意义的辐射危害。     

青海农村学校饮水与环境卫生现状

目的了解青海省农村学校饮用水与厕所卫生状况,探索农村学校改水改厕对策和方法。方法按"青海省农村学校水与环境卫生现状调查方案"的要求,对青海省6个县的60所学校和1 872名学生进行调查。结果 76.7%的学校采用集中式供水,23.3%的学校为独立供水,50.0%的学校饮用水不合格;学生饮水33.0%从家中自带,33.1%由学校提供,14.5%喝生水。93.3%的学校厕所为旱厕,40.0%的学校没有教师专用厕所,78.3%的厕所没有可使用的洗手设施,63.3%的厕所粪池无盖;厕所粪便63.3%用土掩埋,3.3%排入下水道,1.7%直接排入河塘。结论青海省农村学校饮用水和厕所均存在卫生安全隐患。需加大农村学校尤其是半农半牧区学校的改水改厕工作力度,加强学生健康教育工作。     

Networking grassroots efforts to improve safety and health in informal economy workplaces in Asia

Many workers in Asia are in the informal economy. They often work in substandard conditions, exposed to hazards in the workplace. Learning from the recent successes of participatory training programmes to improve safety and health in Asia, the ILO has strengthened its partnership efforts with local people to improve safety and health of informal economy workplaces. The target groups were: (1) home workplaces in Cambodia and Thailand, (2) salt fields and fishing villages in Cambodia where many young workers are working, and (3) small construction sites in Cambodia, Laos, Mongolia, Thailand and Vietnam. The walk-through survey results showed that the workers and owners in the target informal economy workplaces had the strong will to improve safety and health at their own initiatives and needed practical support. In the participatory, action-oriented training workshops carried out, the participated workers and owners were able to identify their priority safety and health actions. Commonly identified were clear and safe transport ways, safer handling of hazardous substances, basic welfare needs such as drinking water and sanitary toilets, and work posture. The follow-up visits confirmed that many of the proposed actions were actually taken by using low-cost available materials. These positive changes were possible by applying the participatory training tools such as illustrated checklists and extensive use of photographs showing local good examples and placing emphasis on facilitator roles of trainers. In conclusion, the target informal economy workplaces in Asia made positive changes in safety and health through the participatory, action-oriented training focusing on local initiative and low-cost improvement measures. Local network support mechanisms to share lessons from good practices played essential roles in encouraging the voluntary implementation of practical improvement actions. It is important to increase our joint efforts to reach more informal economy workplaces in industrially developing countries and provide practical support measures focusing on local self-help initiatives.     

When urban taps run dry: sachet water consumption and health effects in low income neighborhoods of Accra, Ghana

Intraurban differentials in safe drinking water in developing cities have been exacerbated by rapid population growth that exceeds expansion of local water infrastructure. In Accra, Ghana, municipal water is rationed to meet demand, and the gap in water services is increasingly being filled by private water vendors selling packaged "sachet" water. Sachets extend drinking water coverage deeper into low-income areas and alleviate the need for safe water storage, potentially introducing a health benefit over stored tap water. We explore correlates of using sachets as the primary drinking water source for 2093 women in 37 census areas classified as slums by UN-Habitat, and links between sachet water and reported diarrhea episodes in a subset of 810 children under five. We find that neighborhood rationing exerts a strong effect on a household's likelihood of buying sachet water, and that sachet customers tend to be the poorest of the poor. Sachet use is also associated with higher levels of self-reported overall health in women, and lower likelihood of diarrhea in children. We conclude with implications for sachet regulation in Accra and other sub-Saharan cities facing drinking water shortages.     

某铸造有限公司职业病危害调查报告

目的了解某铸造有限公司在生产过程中存在的职业病危害因素,调查该公司接触职业病危害因素工人的健康状况,以采取有效的预防控制措施,保护从业人员的身体健康。方法依据相关标准和规范,采用现场职业卫生调查、职业卫生检测、职业健康监护等方法。结果该企业的主要职业病危害因素粉尘、噪声超标情况严重,粉尘超标率达70%。经改进部分防护措施后现场作业环境得到一定的改善。结论该公司的作业现场中粉尘、噪声危害非常严重,须对生产工艺、防护措施进行进一步整改,加强作业现场管理,切实保护工人的身体健康。     

农村中小学校生活饮用水和厕所卫生现状调查

目的了解我市农村学校生活饮用水和公共厕所基本卫生状况,为推进农村学校的改水改厕工作提供依据。方法对全市农村中小学校生活饮用水和公共厕所卫生状况进行现场调查及统计分析。结果85,69％的学校厕所为旱厕;54．94％的学校厕所粪池无盖;84．37％的学校厕所内无洗手池。自来水普及率为25．07％;使用浅井水和手压井的占31．16％和19．05％;90．48％的学校不对自备水源进行消毒处理;70％的水样微生物指标超标。另有80．94％的学校不提供开水;72．48％的农村学校校园内无洗手设施。结论全市农村学校在生活饮用水和公共厕所卫生方面存在的问题较多,且三县差于市区。加快农村学校的改水改厕工作刻不容缓。     

HBV- and HCV- infected workers in the Japanese workplace

Around three million Japanese are persistently infected with HBV or HCV. Though most of them work in various industries, little is known about the actual conditions in their workplaces. To clarify the workplace conditions of workers with hepatitis, three kinds of questionnaire surveys, answered by occupational health physicians and workers with hepatitis, were carried out. The rates of workers recognized as workers with hepatitis B or C by occupational health physicians were 0.82% and 0.48% of 130,092 workers, respectively. About 30% of workers with hepatitis were engaged in "hazardous work". The percentage of workers engaged in various types of hazardous work among workers with hepatitis was nearly the same as that among all Japanese workers. About 30% of occupational health physicians witnessed exacerbation of hepatitis in the workers at their workplaces, and 22% of workers with hepatitis experienced exacerbation of hepatitis. The rate of workers with hepatitis who had experienced exacerbation was not significantly different between workers with and without hazardous work. Workers with hepatitis have strong concerns about the relationship between work and exacerbation. As causes of exacerbation, occupational health physicians cited "unknown", "drinking" and "quit treatment" while workers with hepatitis answered "work-related causes", besides "unknown" and "drinking."     

The inverse hazard law: Blood pressure,sexual harassment,racial discrimination,workplace abuse and occupational exposures in US low-income black,white and Latino workers

Research on societal determinants of health suggests the existence of an “inverse hazard law,” which we define as: “The accumulation of health hazards tends to vary inversely with the power and resources of the populations affected.” Yet, little empirical research has systematically investigated this topic, including in relation to workplace exposures. We accordingly designed the United for Health study (Greater Boston Area, Massachusetts, 2003–2004) to investigate the joint distribution and health implications of workplace occupational hazards (dust, fumes, chemical, noise, ergonomic strain) and social hazards (racial discrimination, sexual harassment, workplace abuse). Focusing on blood pressure as our health outcome, we found that among the 1202 low-income multi-racial/ethnic working class participants in our cohort – of whom 40% lived below the US poverty line – 79% reported exposure to at least one social hazard and 82% to at least one high-exposure occupational hazard. Only sexual harassment, the least common social hazard, was associated with elevated systolic blood pressure (SBP) among the women workers. By contrast, no statistically significant associations were detectable between the other additional highly prevalent social and occupational hazards and SBP; we did, however, find suggestive evidence of an association between SBP and response to unfair treatment, implying that in a context of high exposure, differential susceptibility to the exposure matters. These results interestingly contrast to our prior findings for this same cohort, in which we found associations between self-reported experiences of racial discrimination and two other health outcomes: psychological distress and cigarette smoking. Likely explanations for these contrasting findings include: (a) the differential etiologic periods and pathways involving somatic health, mental health, and health behaviors, and (b) the high prevalence of adverse exposures, limiting the ability to detect significant associations. As clarified by the “inverse hazard law,” to understand health inequities, research is needed that contrasts exposures and health status population-wide, not just among those most inequitably exposed.     

Reproductive hazards in the workplace: a case study of women firefighters

Recent attention has focused on the difficulties of providing equal employment opportunities for women while ensuring reproductive health in the workplace. This paper examines the potential hazards faced by pregnant firefighters and recommends a policy that seeks a reasonable accommodation between employment and fetal and maternal health. The potential hazards faced by firefighters include physical exertion, hyperthermia, and exposure to carbon monoxide and other toxic gases. The ideal policy option for improving reproductive health is to make the workplace safe for all employees. Where this cannot be accomplished and a unique reproductive hazard exists to women during pregnancy, temporary positions should be found that remove the pregnant woman from the hazard while allowing her to continue work.     

Workplace hazards to women's reproductive health

Women make up nearly half of Minnesota's workforce. Thus, many women, including those of reproductive age, are exposed to workplace hazards. These hazards may be chemical-toxicants such as heavy metals, pesticides, and endocrine disruptors; physical--the result of activities or proximity to something in the environment; or biological-infectious agents. And they are of growing concern among scientists and the public. Although data on the effect of these hazards on the reproductive health of women is limited, there is evidence indicating they ought to be of concern to women and the physicians who treat them. Clinicians are encouraged to assess women for exposure to workplace hazards and to communicate with them about whether such exposure might increase their risk for problems such as infertility, miscarriage, and preterm birth. This article highlights selected job-related hazards and offers suggestions for caring for working women of reproductive age.     

中国部分省、区贫困县农村家庭供水、户厕和粪便处理现状的调查

报道了我国贫困地区农村饮水、户厕和粪便处理现状的入户抽样调查结果。调查采用概率比例等量整群抽样方法,以县为基本单位进行抽样调查,共获得数十万个基本数据。结果表明,西南、西北及广西９省、区８３个国家级贫困县的有厕率为９０．０％ ,卫生厕所普及率为６．０％ ,粪便无害化处理率为２５％ ,安全饮水覆盖率为５６．７％ ,有１３．２％ 家庭存在取水困难。被调查者中有４２．３％ 的人不知道粪便会传播疾病,５６．２％ 的人不清楚苍蝇能传播疾病,７０．０％ ～８２．７％ 的人不了解肠道传染病的传播途径等基本卫生常识     

Mortality surveillance and occupational hazards: the Solutia mortality experience 1980-94

OBJECTIVES—Several investigators argue that company wide mortalities for recent workers allow early identification of potential workplace hazards. Mortalities for recent workers were compared with published studies of workers with specific exposures in the same company to find whether mortality surveillance results could be used to identify previously unknown health effects from workplace hazards.
METHODS—Relative risks for causes of death in published substance specific studies at the plants were compared with the relative risks in the mortality surveillance of workers 20 or more years after first being employed.
RESULTS—As reported by other companies, low mortalities were found among workers in the mortality surveillance. The mortality surveillance reports often found no increased risk of disease at plants in which substance specific studies had found no effects. However, disease specific relative risks were not found by the mortality surveillance predictions of relative risks in the substance specific studies with increased risk.
CONCLUSION—Mortality surveillance is of limited use for identifying health effects from past workplace exposures to specific materials. The healthy worker and survivor effects, the failure to identify subsets of workers exposed to potentially toxic substances, the typically long induction period between exposure and disease, and the inability of recent mortality levels to reflect historical conditions all may make it difficult to use mortality surveillance to identify workplace hazards. Combining mortality surveillance with studies of workers with potentially toxic exposures helps identify occupational hazards.


Keywords: mortality surveillance; occupational cancer; bladder cancer; leukaemia     

Protecting posterity: the occupational physician's ethical and legal obligations to pregnant workers

This article describes Federal and international codes and laws that relate to protection from reproductive hazards in the workplace. Occupational health practitioners are advised to shift their approach from managing the technical aspects needed to protect individual workers to the more global approach of effecting policy and supporting enforcement in the realm of reproductive health. This broader view will not only better protect women and children but will better serve the interest of society in replacing all existing workers and perpetuating civilization for posterity.     

常熟市木制品企业工人健康状况调查

目的了解常熟市木制品行业职业病危害状况、工人的职业健康监护情况。方法对该市10家木制品企业87名工人进行相关的职业健康检查和职业病危害情况调查,并选取76名从事后勤工作,销售人员作为对照组。结果 10家木制品企业木粉尘和有机挥发物的空气浓度不合格率分别为31.8%和3.4%。调查组在心电图及血常规方面的异常率明显高于对照组,差异有统计学意义(分别为χ2=4.71,P0.05;χ2=12.14,P0.01)。有机挥发物对女性的影响大于男性,差异有统计学意义(χ2=3.95,P0.05)。结论常熟市木制品企业工作场所木粉尘和有机挥发物对劳动者的健康状况已造成一定危害,健康损害主要表现在心电图和血常规方面。