参与式职业健康安全培训效果的自评研究

目的 研究深圳市劳务工对参与式培训效果的自我评价,探讨参与式培训的适用性.方法 2008年6月至2010年11月在深圳市开展随机对照试验,对60家企业的3479名工人进行参与式和集中授课式职业健康安全培训,培训后进行问卷调查,分析工人对培训内容、培训形式、知识的提高和行为的改善,对工人和工厂之间沟通等方面的自评.结果 85％的受训工人认为工作环境、机械安全、工作岗位的改善,个人防护用品的佩戴演示和伸展运动5项培训内容对他们的健康和安全有益.培训后1年,38.4％的干预组工人、45％的对照组工人分别认为个人防护用品的佩戴演示、讲课最有效.培训后3个月,85％以上的工人认为他们的各项知识和行为得到提高和改善;相比于对照组,更多的干预组工人认为他们的各项知识和行为得到提高或改善.培训后3个月、培训后1年,80％以上的工人对工厂和工人在职业健康安全方面加强沟通、工厂职业健康安全的改善、接受更多培训的看法上持肯定态度;相比于对照组工人,干预组工人持肯定态度率更高,其中,培训后1年,干预组工人对工厂和工人在职业健康安全方面的沟通上的持肯定态度率明显高于对照组,差异有统计学意义(P＜0.05),培训后3个月、培训后1年,干预组工人对工厂是否采取了更多的促进职业健康安全的活动上的持肯定态度率明显高于对照组,差异有统计学意义(P＜0.05).结论 参与式职业健康安全培训得到了工人的认可,值得推广,培训应以职业健康安全防护知识的传播为主.     

社区卫生服务中心提供基本职业卫生培训效果评价

目的探讨、评价社区卫生服务中心(CHSC)提供的基本职业卫生服务(BOHS)培训工作,以增强劳动者保护自身职业健康的能力。方法以中小企业焊接作业工人和部分管理者为培训对象,采用参与式培训方法,改善工人及管理者的职业危害相关知识、信念和行为。结果共25家企业525名劳动者接受了培训。干预后焊接工人的职业卫生知识、态度、行为3部分及总均分均显著提高。干预前后工人法律法规认知总分分别为(5.090±0.105)和(6.071±0.076),信念总均分分别为(16.334±0.122)和(16.732±0.085),行为改变总均分分别为(19.139±0.033)和(20.114±0.053)。结论 CHS职业卫生专业人员可以为企业提供有效的BOHS培训;参与式培训是职业卫生工作中高效的培训方法。     

职业卫生参与式培训效果分析

目的分析参与式方法应用于职业卫生培训中的效果,为参与式培训方法在职业卫生培训中的应用提供参考。方法对接触不同职业病危害因素的不同类型企业中216名劳动者进行职业卫生参与式培训,在开展培训前、培训后1个月和培训后3个月分别进行问卷调查,分析职业卫生参与式培训的效果。结果培训后1个月和培训后3个月,劳动者对法律知晓率高于培训前差异有统计学意义(P0.05),培训后1个月和培训后3个月劳动者对法律知晓率比较差异无统计学意义(P0.05);培训后1个月和培训后3个月劳动者职业卫生知识总得分及职业卫生知识、信念(态度)、行为分别得分均高于培训前差异有统计学意义(P0.05)。结论职业卫生参与式培训可有效提高劳动者的法律和职业卫生知识水平,可以作为开展职业卫生培训的有效方法之一。     

家具制造业工人职业卫生知识掌握和职业卫生服务享受状况

目的 了解中小型家具制造企业劳动者职业卫生知识和职业卫生服务享受状况,评估其职业健康教育和职业卫生服务水平.方法 对香河县1 521名家具制造企业职业性接触苯、粉尘、噪声的工人关于职业卫生知识和职业卫生服务享受状况进行问卷调查,对调查结果进行统计分析.结果 1521名工人中,参加上岗前职业卫生与安全防护知识培训的有457人(30.0％),最近2年参加过岗位职业卫生与安全防护知识培训的有473人(31.1％).对企业存在的3种主要职业危害因素完全了解的仅有127人(8.3％),趋势卡方分析显示,工人对职业卫生知识掌握基本有随工龄增加和文化程度增高而呈逐渐升高趋势;经常使用防护用品的有703人(46.2％),趋势卡方分析显示,工人对职业卫生知识掌握有随工龄增加和文化程度增高而呈逐渐升高趋势.517人(34.0％)通过培训途径了解职业卫生知识;参加过岗前健康检查的有128人(8.4％),接受定期职业健康检查的有809人(53.2％).结论 香河县家具制造企业职业卫生与安全防护培训、职业健康检查工作薄弱,工人防护知识较缺乏,防护意识不强,企业应采取有效措施加强对工人的职业健康教育和职业卫生服务工作.     

参与式培训在预防艾滋病母婴传播培训中的应用价值

目的分析和评价传统培训模式和参与式培训模式对医务人员进行艾滋病预防母婴传播知识培训的效果。方法将2014年4-7月凉山州各县参加凉山州预防艾滋病母婴传播师资培训班的447名医务人员随机分为两组,223名医务人员采用传统培训模式,224名采用传统培训模式基础上加入参与式培训方法,有角色扮演、辩论法和演示法等多种培训方法,对培训知识的考核结果和满意度进行分析和评估。结果两种模式培训后测试成绩均有显著提高,差异有统计学意义(P<0.05),都提升了学员对艾滋病母婴传播基础知识的掌握;参与式培训组明显提高了医务人员对艾滋病预防母婴传播的病毒检测和咨询能力(P<0.05);培训后满意度调查,参与式培训组满意度达98.8%,传统培训组满意度为89.5%,差异有统计学意义(P<0.05)。结论参与式培训有利于学员更有效地掌握艾滋病预防母婴传播知识,提高培训效果。     

北京市549名中学生参与式急救知识技能培训效果评估

目的了解参与式中学生急救知识技能培训效果,探索适合中学生的急救培训模式。方法选取北京市14所完全中学的549名中学生,运用参与式培训方式进行急救知识技能培训,并对培训效果进行评价。结果急救培训后,培训对象的急救知识水平有所提高,合格率从培训前的40.4%提高到了96.1%(P0.05)。在24个知识点中,有20个知识点的正确率与培训前相比有不同程度的提高(P值均0.05)。72.6%的培训对象认为急救培训课程的效果很好。72.5%的学生喜欢"分小组实习"的培训方式。无论校医还是急救中心培训教师,均对参与式培训效果感到满意。结论参与式急救培训能有效提高中学生急救知识水平,方法有效。     

企业职业卫生管理培训模式分析

目的 建立一种企业职业卫生培训模式,提高职业卫生培训的有效性和延续性.方法 通过请职业卫生专家培训企业管理者,然后由这些管理者对自己企业的劳动者进行职业危害告知和培训教育,提高劳动者的职业卫生知识知晓率,促使企业和劳动者主动采取预防控制措施,保障广大劳动者的身体健康.结果 企业职业卫生管理者培训前后比较:员工的相关知识得分率由51.9％提高到73.5％(x2＝622.7,P＜0.01),相关信念得分率由56.8％上升到79.4％( x2=598.2,P＜0.01),相关行为的得分率由44.4％上升到68.9％(x2=530.4,P＜0.01).与普通培训企业比较:员工的相关知识得分率由61.6％上升到73.5％(x2＝143.4,P＜0.01),相关信念得分率由66.3％上升到79.4％(x2=159.8,P＜0.01),相关行为的得分率由57.1％上升到68.9％(x2=92.1,P＜0.01).培训后企业健康监护情况比培训前有了明显的改善,管理制度方面的改善最明显,由33.3％上升到83.3％(x＝15.4,P＜0.01),上岗前职业健康检查方面的改善相对较小,由16.7％上升到40.0％(x2=4.0,P＜0.05).结论 企业职业卫生管理者培训模式是一种有效可行的培训方式.     

对3家玩具厂的喷漆工及管理人员进行职业卫生健康教育的效果

目的调查分析喷漆工职业卫生健康教育干预措施成效,为开展苯及其同系物作业工人健康教育与健康促进工作提供科学依据。方法通过＂参与式＂培训对企业管理层、喷漆工进行多种形式的职业卫生健康教育,并对干预前后企业管理人员、喷漆工的知识、态度和行为等改变进行调查,同时对作业环境进行职业病危害因素检测。结果 3家玩具生产企业的管理人员职业病防治知识知晓率由干预前的21.6%～26.2%提高至干预后的72.4%～87.8%（P〈0.01）,喷漆工职业卫生知识、态度及行为变化正确率由干预前的5.8%～11.6%提高至干预后的60.0%～69.9%（P〈0.01）。3家玩具生产企业工作场所空气中的苯及同系物浓度逐年降低,工人岗前和在岗职业健康检查率逐年提高。结论 ＂参与式＂健康教育与健康促进模式对提高作业工人自我防护意识,养成良好的卫生习惯,减少苯及同系物职业病危害事故的发生有着十分重要的意义。     

参与式与讲授式在企业职工职业卫生培训中的效果比较

目的比较参与式与传统讲授培训方法在职业卫生培训中的效果,分析职业卫生参与式培训效果的影响因素,为开展职业卫生参与式培训提供参考。方法对不同类型企业中的436名劳动者职业卫生知识掌握情况进行调查后分组,分别采用讲授式和参与式职业卫生培训,培训后1个月、3个月进行调查,比较培训效果,探讨影响因素。结果培训前两种培训方法劳动者的总分差异无统计学意义(P=0.29);培训后1个月、3个月参与式培训效果均优于讲授培训(均有P0.01)。培训前两种方法劳动者的知信行3方面得分差异均无统计学意义(P分别为0.57、0.41和0.62);培训后3个月,两种培训方法劳动者的信念得分差异无统计学意义(P=0.082),两种培训方法劳动者的知信行3方面其余时间点比较均显示参与式培训效果优于讲授式培训(P值均0.05)。结论职业卫生参与式培训效果优于讲授式培训,参与式培训能显著提高职业卫生培训效果。     

参与式方法在职业卫生培训中的效果分析

目的探讨参与式方法在职业卫生培训中的效果。方法对深圳市福田区10家企业300名员工开展参与式培训,并对培训前后存在主要职业危害因素相关知识正确回答率和培训后满意度进行调查。结果干预后,被培训人员对辖区存在主要危害因素噪声、粉尘和有机溶剂等相关知识正确回答率都有明显提高,差异均有统计学意义(P0.05),培训内容满意度调查结果显示有90%以上被培训人员表示基本满意或非常满意。结论参与式方法在职业卫生培训中效果显著。     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.     

The Life Events Inventory: re-scaling based on an occupational sample.

The objective of this study was to compare the validity of the original weightings used by the Life Events Inventory (LEI) with those obtained from a contemporary occupational sample. Fifty male and 62 female manufacturing employees (age range 16-55 years) assigned scores to each item on a slightly modified version of the LEI scale. The current sample consistently assigned higher weights to events/items than did the original sample, but there was high agreement in terms of item ranking. Some distinct age and gender differences in scoring were apparent, and are discussed further. It was concluded that when separate weightings are employed for age and gender groups, the LEI remains a useful tool for quantifying background levels of stress in both workplace stress audits and epidemiological studies where statistical control for non-occupational sources of stress is required.     

Maxillofacial injuries related to work accidents: a new concept of a hospital-based full electronic occupational trauma surveillance system

The objective of this study was to investigate the occurrence of occupational maxillofacial injuries using a newly installed relational database. Twenty-six injuries were identified out of 28,624 patients admitted to the emergency unit during a 12 month period. Falls from height or being struck by moving objects were common causes of these injuries. Two-thirds of those identified were construction workers. This paper demonstrates the power of modern databases to identify specific occurrences that may provide the basis for prevention in the future.     

Rôles physiologiques des endocannabinoïdes dans le contrôle de l’homéostasie énergétique

Endocannabinoids are endogenous lipids which modulate the release of neurotransmitters and activate different signaling pathways, through the binding to cannabinoïd receptors, CB1 and CB2. Endocannabinoids are involved in the control of a variety of behavioural and neuroendocrine functions, including feeding behaviour. In the central nervous system, they essentially modulate the expression of orexigen or anorexigen neuropeptides thus resulting in the stimulation of food intake. Their peripheral targets are mainly the liver and the white adipose tissue where they stimulate lipogenesis, through the modulation of several enzymes and proteins expressions. Cannabinoïd receptor agonists are nowadays prescribed to improve appetite of people suffering from cancer or AIDS. In the same way, CB1 antagonist, such as Rimonabant, could provide efficient treatment of obesity.