某金矿凿岩工症状自评量表调查分析

探讨局部振动对工人心理,行为功能的影响。方法 应用ＳＣＬ－９０量表及一般症状查体资料,对４０名金矿井正业凿岩机工人及其对照组２０名工人进行了调查分析。结果 与对照组比较,凿岩组工人在耳鸣,听力下降,高血压等方面有显著性意义;症状量表听各项指标均与对照组有显著差异,且在工作后１０年内易发生。结论局部振动可造成工人心理,行为功能的改变及一些症状的出现,二者又可相互作用,进一步加重对工人身心健康的危害。     

Critical evaluation of medical, statistical, and occupational data sources in the Kola Peninsula of Russia pertinent to reproductive health studies

Background: The feasibility study described herein was prompted by a report in 1992 of possible reproductive and developmental health concerns among female workers in a Russian nickel refinery. Objective: The primary goal was to ascertain whether medical, statistical, and occupational data bases could be accessed for information about the pregnancy histories, occupational histories, and life-style factors of the women affected. Methods: The project was facilitated by construction of a registry of all births in three towns with a nickel refinery and verification of its contents against patients' records obtained from hospital delivery and gynecology departments and community polyclinics. Municipal Registration Board, Regional Health Statistics Board, and nickel company records were also reviewed. Results: Reproductive/developmental outcome information and workplace histories were acceptable. Sample-size calculations indicated that a cohort or cross-sectional study would be amenable and suitable for the detection of an excess risk for spontaneous abortion with adequate statistical significance and power. Such investigations would need to be supplemented by workplace environmental/biological monitoring assessments for evaluation of exposure to occupational hazardous factors and a worker's questionnaire to obtain information about life-style factors. A case-control design is recommended for the study of congenital defects. Conclusions: A well-designed, comprehensive epidemiology study is technically feasible because of the availability of a favorable pool of study subjects, reproductive/developmental outcome data, information to control for major confounders, and suitable occupational records. Received: 13 July 1998 / Accepted: 7 February 1999     

Manganese exposure in foundry furnacemen and scrap recycling workers

Objectives: Cast iron products are alloyed with small quantities of manganese, and foundry furnacemen are potentially exposed to manganese during tapping and handling of smelts. Manganese is a neurotoxic substance that accumulates in the central nervous system, where it may cause a neurological disorder that bears many similarities to Parkinson's disease. The aim of the study was to investigate the sources and levels of manganese exposure in foundry furnacemen by a combined measuring of blood-manganese (B-Mn) and manganese in ambient air (air-Mn). Methods: During a period of 16 months, Air-Mn and B-Mn (denoted `exposure values') were measured involving 24 furnacemen employed in three small size foundries and 21 scrap recycling workers from one plant. In the study period, 18 furnacemen had B-Mn measured 3–4 weeks after decreasing or stopping exposure (denoted `post-exposure values'). The reference group for the B-Mn measurements consisted of 90 Danish male subjects. Results: Furnacemen who work in insufficiently ventilated smelting departments inhale, absorb, and retain significant amounts of manganese in their blood (approx. 2.5–5 μg/l above reference values) despite a generally low measured airborne level of manganese fumes (0.002–0.064 mg/m³). The `exposure values' compared with `post-exposure values' revealed a significant decrease in the B-Mn (on average 3.7 μg/l) level of the most exposed furnacemen. Two persons in our study were suspected of suffering clinically subacute manganese intoxication as both had B-Mn levels beyond the normal limit (25 and 29 μg/l, respectively). The potential problem disappeared completely after cessation of exposure, and the B-Mn levels decreased to 9.4 and 14.1 μg/l, respectively. Conclusions: Risk assessment based on combined measurements of B-Mn and air-Mn seems to be valid in the interpretation of workers' hazard. Our study indicates that B-Mn may be a valuable parameter for estimating recent exposure (within 1–2 weeks). However, more knowledge is needed about the B-Mn level and its relation to neurological symptoms. Received: 20 January 1999 / Accepted: 14 June 1999     

Respiratory abnormalities among male foundry workers in central Taiwan

The objectives of this study were to determine the relationship between exposure levels and respiratory abnormalities, to measure FVC and FEV1(1) changes per year based on work duties and to investigate the prevalence of and factors related to pneumoconiosis. A total of 583 male workers from 50 iron foundries in central Taiwan were investigated. First, workers' respiratory symptoms were categorized using a modified American Thoracic Society (ATS) questionnaire and then were verified by physician's examination. Next, pulmonary function tests were performed including: forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and forced expiratory flow rate. A chest radiograph was used to diagnose pneumoconiosis according to ILO criteria. Furnace workers were found to have the highest prevalence of chronic phlegm, thoracic disorders and chronic bronchitis. In general, smokers had a higher prevalence of respiratory symptoms as compared with non-smokers. Pulmonary function abnormalities and pneumoconiosis were closely linked to smoking and work duration. After adjusting for age, height and smoking there was a significant decrease based on work duration in FVC and FEV1 for furnace and moulding workers compared with after-processing and administrative workers. The overall prevalence of pneumoconiosis was 8.8%, highest among furnace (16.3%) and after-processing workers (11.4%) and lowest among administrative workers (2.5%). Using multiple logistic regression, the risk of developing pneumoconiosis (as compared with the administrative workers) for furnace workers was highest (8.98 times greater risk), followed by after-processing workers (6.77 times greater risk) and moulding workers (5.41 times greater risk). Prolonged exposure to free silica, and smoking habits, can result in respiratory abnormalities among foundry workers.     

Indicators of cardiovascular risk among workers exposed to high intermittent levels of carbon disulphide

The effects of exposure to carbon disulphide have been studied mostly among workers in the viscous rayon industry, where the usual exposure profile has been relatively steady exposure over work shifts. We investigated 13 workers in a small chemical company who were exposed to low levels, peaking intermittently to relatively high levels in the range of 100-200 ppm at the end of the work shift, a pattern that may change the risk profile. Our investigation was part of a compliance order that was fought by the company and our access and follow-up was limited. Two workers had burns on their bodies associated with exposure to caustic. Four had elevations in total serum cholesterol, one had elevated serum triglycerides and three had elevations in fasting blood glucose--two of them were known to be diabetics before employment and one had a history of unexplained peripheral neuropathy. No consistent pattern suggestive of a defined lipoprotein abnormality was obvious but several atherogenic profiles were observed. Five had abnormalities on electrocardiogram, four of whom appeared to be among the most heavily exposed. The presence of these changes taken together in this context may suggest accelerated atherosclerotic changes. Tests of liver and kidney function were within the normal range for all workers, as was a complete blood count. Four of the workers had evidence of a bilateral reduction in hearing threshold at 4,000 Hz. A complete set of recommendations was forwarded to the employer, emphasizing further control of exposure to carbon disulphide, personal protection requirements and a cardiovascular risk reduction programme. Conditions improved in the plant following modifications introduced in response to a stop work order from the provincial government's occupational health and safety agency. However, a fire in 1998 put the company out of business and ended further follow-up or interventions. We conclude that these findings, while difficult to interpret because of the circumstances of the investigation, are compatible with an atherogenic effect of exposure to peaking levels of carbon disulphide. The observation should be tested in a larger population with fewer confounding factors and greater control over the investigation.     

Reported needlestick and sharp injuries among health care workers in a Greek general hospital

Between July 1990 and June 1996, 284 exposures to infectious material were reported by 247 health care workers (HCWs) at AHEPA University Hospital, Thessaloniki, Greece, representing an overall rate of 2.4% reported injuries per 100 HCWs/year. Nurses reported the highest rates of incidents (3.0%) and in all but one working group women exhibited higher injury rates per year than male HCWs. Young workers (21-30 years old) were primarily affected in incidents (P < 0.001). Needles were the most common implement causing injury (60.6%) and resheathing of used needles as well as garbage collection were common causes of injury. None of the HCWs seroconverted in exposures where immune status to blood-borne pathogens was estimated. Efforts by the infection control committee need to be more intense, in order to increase the rate of reported staff injuries. This will facilitate identification of unsafe practices and provide more adequate preventive measures.     

汽油对作业工人神经行为的影响

目的　了解汽油对职业人群神经行为功能的影响。方法　应用ＷＨＯ 推荐的神经行为测试组合（ＮＣＴＢ） 对９２ 名汽油作业工人和８８ 名对照人员进行了神经行为功能测试,同时测定作业环境空气中汽油浓度。结果　接触组明显存在忧郁－ 沮丧的不良情绪状态,简单反应时慢于对照组,数字跨度、提转敏捷度、数字译码和目标追踪得分明显低于对照组,且行为功能得分随浓度的增高而降低。结论　提示长期接触汽油可影响工人神经行为功能。     

健康成人和放射工作者体细胞HPRT基因位点突变率的检测和比较

目的为了解健康成人和放射工作者体细胞ＨＰＲＴ基因位点突变率。方法应用人外周血淋巴细胞抗６－ＴＧ分析技术检测了３０例健康成人和３０例放射工作者体细胞ＨＰＲＴ位点突变频率。结果健康成人ＨＰＲＴ基因位点突变频率均值为０１６２８×１０－３,变化范围为０１３００×１０－４～０２９０３×１０－３,放射工作ＨＰＲＴ基因位点的突变频率均值为０２２２５×１０－３,变化范围为０３３７×１０－４～０４７８×１０－３。ｔ检验Ｐ＜００５,两者差异显著。从检测结果亦可看出,随着放射工龄的延长,ＨＰＲＴ基因位点突变频率也随之增加。结论体细胞ＨＰＲＴ基因位点突变频率可作为各种有害因素对机体遗传损伤的生物标识物之一。     

实施越冬疗养的煤工尘肺患者生命质量评价

采用自行设计并经过质量检验的调查表,对某矿务局职业病防治院的全部Ⅰ期尘肺虎科疗养前后进行了调查,并采用整群对照的方法,选取未实施越冬疗养的Ⅰ期尘肺患者作对照。结果表明,疗养组越冬疗养前后生命质量的有显著差异,疗养后患者生命质量明显提高;而对照组在越冬前后生命质量无显著改变,说明越冬疗养对煤工尘肺患者生命质量有着积极的作用。