内燃机车乘务员和轮轴工外周血淋巴细胞微核观察

本文作者对５１名内燃机车乘务员和车辆维修车间的３０名轮轴工外周血淋巴细胞微核进行了分析。结果表明,机车乘务员和轮轴工微核阳性检出率、微核细胞率和微核率均明显高于对照组（Ｐ＜０．０１）,而且随着作业工龄的延长,微核细胞率和微核率有接近显著（０．０５＜Ｐ＜０．０１）或显著（Ｐ＜０．０５）意义的增高。对两类作业工作人员微核增高的原因进行了讨论     

Electric and magnetic fields (EMF): What do we know about the health effects?

Because we use electric power throughout our homes and workplaces, we are all subject to electric and magnetic fields (EMF) that are created by the voltages and currents present in electrical conductors and electrical equipment. Interest in the health effects of electric-power EMF has been motivated by several epidemiologic studies showing weak associations between surrogate measures of low-level EMF exposure and both childhood cancers and adult cancers. Due to the ubiquitous presence of electric power, the public health implications of this association are potentially very significant; however, good evidence for a causal relationship between exposure to EMF and any health effect has not been found. Yet, uncertainty, plus the suggestive epidemiologic findings, have fueled public anxiety and media attention. To put this potential health threat into perspective, it is important to consider the strength of the epidemiology, the availability of supporting animal studies, and mechanistic or biophysical information about the interaction of EMF with matter. Any discussion of steps that might be taken to avoid potential EMF health-effects needs to incorporate a perspective on how hypothetical EMF risks relate to other hazards to life and health.Work presented at the 23rd Congress on Occupational and Environmental Health in the Chemical Industry (Medichem 1995) The Chemical Industry as a Global Citizen - Balancing Risks and Benefits, 19-22 September 1995, Massachusetts Institute of Technology, Cambridge, Massachusetts     

Recovery of slowed nerve conduction velocity in lead-exposed workers

Summary Maximum motor nerve conduction velocities in the median nerve (MCV) and blood lead (PbB) were repeatedly measured in 14 lead exposed workers with an initial PbB from 0.7 to 4.0 mol/kg (median 2.3 mol/kg) for a period from 3 months to 7 years: A certain dose of Calcium Disodium Ethylenediaminetetraacetic Acid (CaEDTA) was injected intravenously into most of the subjects during the period.In seven subjects, MCV improved by more than 4 m/s during the observation period which involved the first two successive measurements of MCV and PbB, but the remaining seven subjects showed the minimal alteration (within ± 4.0 m/s). The initial value of MCV was significantly slower (P < 0.01) and the decrease in PbB was significantly greater (P < 0.05) in the group of subjects having shown the improvement of MCV by more than 4 m/s.The initial value of MCV was significant in determining the alteration in MCV in multiple regression analysis and, together with the change in PbB, explained 31% of the alteration in MCV between the first two successive measurements. The initial level of PbB, dose of CaEDTA, time interval between the measurements and age played no essential part in the alteration in MCV.The alteration in MCV throughout the whole observation period in each subject significantly correlated with the concurrent change in PbB (r=–0.573, P < 0.001).     

An historical prospective study of mortality within a cohort of gas distribution workers

An historical prospective study of mortality within a cohort of 1,410 gas distribution workers was conducted. This cohort was followed for ten years (1971-1980) and data on 118 deaths were obtained. Five-year (1973-1977) averages of both St. Louis and United States age-specific mortality figures were used to create "expected" mortality rates for comparison with the observed deaths in the cohort. Analyses of the cohort were done according to: 1) person-years contributed during the study period (the "age-attained" method) and 2) the number of years from commencement of work in the company until the end of the study period (1980) or death (the "latency" methods of analysis, Standardized Mortality Ratios (SMRs) were calculated for all causes of death, all malignant neoplasms, and for cardiovascular disease and malignant neoplasms of the respiratory and digestive systems. In no case was the SMR found to be beyond the range of what would be expected in the "standard" populations. While the present study does not contradict the negative findings of the one previous investigation of mortality of gas distribution workers, the limitations of small cohort size, reliance on death certificates and non-industrial comparison populations make any conclusions at best provisional.     

Human immunodeficiency virus/acquired immunodeficiency syndrome training from a union perspective.

The authors developed a union sponsored 2-day human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) "train the trainer" program for healthcare workers in the San Francisco Bay Area. The program incorporated the "education for action" approach in an effort to respond to the inadequacies in many traditional, institutional trainings. Service Employees International Union (SEIU) and Labor Occupational Health Program (LOHP) conducted the HIV/AIDS "train the trainer" program for approximately 100 healthcare workers in county public hospitals and community health clinics. After completing the program, these workers went back to their healthcare facilities, or community organizations, and led additional classes on HIV/AIDS transmission and prevention for approximately 600 more people. The goal of the program was to empower healthcare workers to: 1) identify the occupational risks associated with exposure to blood and potentially infectious body fluids at the workplace; 2) develop strategies to reduce those risks; 3) discuss their feelings about caring for an HIV/AIDS patient; and, 4) conduct HIV/AIDS workshops at the workplace.     

Occupational exposure to antineoplastic agents at several departments in a hospital

Summary The occupational exposure to cyclophosphamide (CP), ifosfamide (IF), 5-fluorouracil (5FU), and methotrexate (MTX) of 25 pharmacy technicians and nurses from four departments of a hospital was investigated. Previously developed methods for the detection of exposure to some antineoplastic agents were validated. Exposure to CP, IF, 5FU, and MTX was measured by the analysis of these compounds in the environment (air samples and wipe samples from possible contaminated surfaces and objects). Contamination of the work environment was found not only on the working trays of the hoods and on the floors of the different rooms but also on other objects like tables, the sink unit, cleaned urinals and chamber pots, and drug vials and ampules used for preparation and packing of drugs. The gloves used during preparation of the drugs and during cleaning of the hoods were always contaminated. The uptake of CP or IF was determined by the analysis of both compounds in urine. CP or IF was detected in the urine of eight pharmacy technicians and nurses. The amounts ranged from < 0.01 to 0.5 g (median: 0.1 g). CP and IF were found not only in the urine of pharmacy technicians and nurses actively handling these compounds (n = 2) but also in the urine of pharmacy technicians and nurses not directly involved in the preparation and administration of these two drugs (n = 6). CP and IF were excreted during different periods ranging from 1.40 to 24.15 h after the beginning of the working day, suggesting different times of exposure, different exposure routes, and/or interindividual differences in biotransformation and excretion rate for these compounds. The urinary CP and IF determination method seems to be sensitive and suitable for monitoring the exposure to and measuring the uptake of these toxic compounds by pharmacy technicians and nurses during occupational activities.     

Hand-arm vibration syndrome and its prevalence in the present status of private forestry enterprises in Japan

Summary Currently there are no limitations on age of employment on private forestries in Japan. Hence, it was hypothesized that in these kind of enterprises, elderly chain saw operators, or those with long-term exposure, might be at higher risk of developing hand-arm vibration syndrome (HAVS). We consequently investigated the prevalence of HAVS in 447 chain saw workers on private forestries in Gifu Prefecture, Japan, with particular reference to age and exposure period. Of this population, 43 (9.6%) had signs and symptoms of vibration-induced white finger (VWF), and among these workers the severity of finger blanching was significantly correlated (P < 0.01) with the exposure period. Classification of all subjects by exposure period showed that workers with 30 years' exposure had higher prevalences of VWF (20.9%) and numbness of the hands (25.4%) compared to other groups. Significant differences (P < 0.01) were found between the functional capacities of workers with VWF and those of control subjects. We concluded that (a) the elderly chain saw operators and those with longer exposure should be moved to other jobs with a lower or no risk of exposure to vibration, and (b) the results of screening tests, even without cold water immersion (which we did not employ, in order to protect workers' hands), could be helpful for the identification of workers with VWF.     

Motor nerve conduction velocity in asymptomatic lead workers

Summary No difference was found between the nerve conduction velocities of the ulnar nerve of 32 lead exposed workers in the mill of a lead-zinc mine, compared to that of a control group of 14 persons. The lead exposure period was 2–37 months (mean: 12.9 months).The blood lead of the exposed group was as an average (± SD): 53 ± 16 g per 100 ml compared to 11 ± 4 g per 100 ml for the control group.Further studies are needed to establish a possible dose-time-response relationship for the possible, subclinical neuropathy found by some investigators.     

医疗法学在医务人员再教育中的地位

随着社会的文明进步,特别是在法制越来越健全的社会,作为医务人员在培养业务技能的同时,接受医疗法学再教育有着非常重要的意义。文章论述了医疗法学的概念及其存在、发展的客观事实;医疗法学在医疗实践中的作用;医疗法学在医务人员继续教育体系中的地位和意义。     

化工工人肌肉骨骼功能及其与工作能力的关系

目的 研究化工工人肌肉骨骼功能状况及其与工作能力的关系。方法 对101名化工作业工人进行肌肉骨骼功能(背肌耐力、手握力、躯干柔韧性、腹肌力和肌肉骨骼功能指数)测定和工作能力指数(wAI)测定。结果男性握力显著高于女性(P＜O.01)，腹肌力、背肌耐力和肌肉骨骼功能指数(MSFI)均男性较高，躯干柔韧性女性较高；年龄与MSFI呈负相关(r=O．489，P＜O．01)，随年龄增加，肌肉骨骼功能下降；不同劳动类型化工职工肌肉骨骼功能差异无显著性；肌肉骨骼功能与工作能力之间存在密切的关系，MSFI与WAI的相关系数为O.215(P＜O．05)，MSFI分级和WAI分级间有较好的一致性，完全一致率为56．7％。结论 肌肉骨骼功能的测定对于评价化工工人工作能力可能具有重要的意义。