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。     

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。     

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.     

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。     

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.