Betriebliche Gesundheitsförderung im öffentlichen Dienst

Aim

The longitudinal survey analyses the changes in workplace health promotion within the public administration in Hessen and Thüringen between 1999 and 2004.

Methods

A sample of 153 executives was interviewed by telephone.

Results

The results show that the level of workplace health promotion in the questioned departments rose significantly in comparison to 1999. Departments, which conduct workplace health promotion enlarged their scope of measures in the last five years. But on average the performance of workplace heath promotion is still poor. The need of information and consulting in questions about workplace health promotion rose slightly: major topic of interest is mental stress at workplace. The departments expect support particularly from the institutions of the statutory occupational accident insurance, health insurance companies and public occupational safety and health administration. One alarming result is that only 64% of the interviewed departments reported that they realized the statutory analyses of work-related health risks.

Conclusion

The future main focus should lie on prevention and reduction of mental stress at the workplace as well as on an enforced regard on small departments and on the implementation of legal orders.     

Social context for workplace health promotion: feasibility considerations in Costa Rica,Finland, Germany,Spain and Sweden

We constructed a simple, flexible procedure that facilitates the pre-assessment of feasibility of workplace health promotion (WHP) programmes. It evaluates cancer hazards, workers' need for hazard reduction, acceptability of WHP, and social context. It was tested and applied in 16 workplace communities and among 1085 employees in industry, construction, transport, services, teaching and municipal works in Costa Rica, Finland, Germany, Spain and Sweden. Social context is inseparable from WHP. It covers workers' organizations and representatives, management, safety committees, occupational health services, health and safety enforcement agencies, general health services, non-government organizations, insurance systems, academic and other institutions, regulatory stipulations pertaining WHP, and material resources. Priorities, risk definitions, attitudes, hazard profiles, motivations and assessment methods were highly contextual. Management preferred passive interventions, helping cover expert costs, participating in planning and granting time. Trade unions, workers' representatives, safety committees and occupational health services appeared to be important operational partners. Occupational health services may however be loaded with curative and screening functions or be non-existent. We advocate participatory, multifaceted WHP based on the needs and empowerment of the workers themselves, integrating occupational and lifestyle hazards. Workforce in irregular and shift work, in agriculture, in small enterprises, in the informal sector, and immigrant, seasonal and temporary workers represent groups in need of particular strategies such as community health promotion. In a more general framework, social context itself may become a target for intervention.     

某蓄电池企业工人健康促进措施效果评价

[目的]通过制定和实施一系列健康促进措施，对铅作业工人开展健康促进工作，并评价其效果。[方法]以某蓄电池企业145名铅作业工人为干预组，以同类型企业铅作业工人118人为对照组。制定和实施干预措施，比较干预措施实施前、后工人作业环境铅烟（尘）浓度及工人接铅后生物监测指标的变化，还对两组工人职业性慢性铅中毒发病率进行比较。[结果]通过干预措施的制定和实施，干预组工人改变了许多不良的工作和生活习惯。健康促进前、后作业场所铅尘浓度中位数分别为0．037mg／m^3、0．025mg／m^3，差异有统计学意义（P=0．016）；健康促进前、后接铅工人尿铅中位数分别为0．053mg／L和0．024mg／L，差异有统计学意义（P〈0．001）。该企业职业性慢性铅中毒发病率（11％），与同类企业（38％）相比差异有统计学意义（X^2=26．82，P〈0．0001）。[结论]开展职业健康促进能明显降低作业场所铅尘浓度以及工人尿铅水平，也是降低铅作业工人慢性铅中毒发病率的有效方法，对促进企业职业病防治工作大有帮助。     

某供电企业员工职业卫生知识认知与需求情况

目的调查某供电企业员工对职业卫生知识的认知和需求情况,为有针对性地开展供电作业场所健康促进工作奠定基础。方法随机整群抽取某供电企业400名员工,以调查问卷的方式进行职业卫生相关问题调查。结果员工对《中华人民共和国职业病防治法》知晓率为75．2％;员工对自己所在岗位存在的职业病危害因素知晓率为59．0％;35．2％的员工提出了防止职业病危害的建议措施;员工对职业病及工作相关疾病症状及防治知识的需求率为53．7％。结论员工对职业卫生知识认知度较高,但对职业病及其防治措施知识仍有较大的需求。供电企业应针对员工需求开展职业卫生相关领域知识培训,并进行健康促进干预。     

自我效能感在职业健康与安全促进领域的研究进展（英文）

提升工人的自我效能感对职业安全与健康的积极作用得到越来越多的重视。本文介绍了自我效能的来源,通过实例,综述了近年来自我效能对职业人群的健康促进与工厂生产安全的影响、作用和研究方法。提示应结合自我效能感的多个来源对影响职业发展的健康与安全的关系进行深入的研究。     

Status of health promotion programme implementation in small-scale enterprises in Japan.

This study was conducted to determine the status of the implementation of health promotion programmes (HPPs) in Japanese small-scale enterprises (SSEs). A survey was conducted in 1996 using a questionnaire mailed to all the member construction companies (n = 772) of a health insurance society, and a response rate of 84% was obtained. Health examination was most frequently conducted (90%), followed by exercise/fitness programmes (17%), smoking measures (12%), health guidance (11%) and nutrition education (6%). Mental health programmes and the government-advocated Total Health Promotion Plan (THP) were implemented at less than 2% of SSEs. The implementation rates for these programmes, except for smoking measures and the THP, were higher at large enterprises than at SSEs. The employment rate for occupational physicians (OPs) was 9% and 49% at SSEs and large enterprises, respectively. The activity most frequently conducted by OPs was health examination, followed by curative services and health education. Advising employees to undergo re-examination or more valid examination after the annual health examination was most frequently conducted by non-health professionals.     

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.     

Health promotion practices of restaurants and cafés in Australia: changes from 1997 to 2000 using an annual telemarketing intervention

This study looked at whether rates of health promotion practices among restaurants and cafés in the Hunter Region of New South Wales (NSW), Australia, increased between 1997 and 2000. During the project period all restaurants and cafés in the region were offered an annual direct marketing telephone interview (1997, 1998 and 1999), during which resources were offered to assist in the adoption of health promotion practices. Owners or managers of restaurants and cafés completed phone interviews that assessed 18 health promotion practices relating to: environmental tobacco smoke (two practices); responsible service of alcohol (five practices); healthy food choices (one practice); food safety (four practices); occupational health and safety (three practices); and the prevention of infectious diseases (three practices). Changes in practices were examined by comparing data from cross-sectional samples in 1997 (before any offers of resources) and 2000 (after up to three annual telemarketing calls), and among a cohort interviewed in both 1997 and 2000. Ninety-one per cent of restaurants and cafés (321) participated in the 1997 survey and 239 (81%) participated in the 2000 survey. A cohort of 122 restaurants and cafés participated in both surveys. Significant increases were present for 14 of the 18 health promotion initiatives in the cross-sectional sample and for 10 of the 18 health promotion initiatives in the cohort. For both cross-sectional and cohort samples, a change in at least one practice in each area was evident, with the exception of nutrition. The proportion of restaurants and cafés in the project region that undertake health promotion initiatives is increasing. A telephone-based intervention may contribute to such an increase. The suggestion that the prevalence of health promotion initiatives in restaurants and cafés can be increased highlights the potential for health promotion to be more actively involved in this setting.     

重庆市永川区煤矿企业职业卫生现状

目的了解重庆市永川区煤矿企业职业卫生现状,明确卫生监督及技术服务工作的重点。方法采用随机抽样方法 ,对企业职业病防治管理机构及人员、管理制度及操作规程、防治计划及实施方案、职业卫生档案、职业卫生经费、职业病防护设施及个人防护用品情况等进行调查。结果调查的45家煤矿企业中,77.2%的企业未设置职业卫生管理机构及人员,4.4%的企业建立了职业卫生档案,26.7%的企业进行了职业病危害告知,60%的企业未进行作业场所的职业病危害检测与评价,66.7%以上的企业配备了职业病防护设施,其中建立台账的占44.4%,发放防护用品的企业占26.7%。结论煤矿职业卫生工作与《中华人民共和国职业病防治法》的要求相差甚远,政府应加强职业卫生管理,多部门协作,加强职业病防治宣贯,提高职业病防治意识,从源头上控制职业病。     

上海市青浦区职业病危害企业基本职业卫生服务需求调查

[目的]通过了解青浦区职业病危害企业对基本职业卫生服务的需求状况,进一步推动该区的职业卫生服务工作。[方法]2010年3月采用单纯随机抽样方法抽取338家企业,对338名职业卫生管理人员进行一对一问卷调查。[结果]受访对象主要需求的职业卫生服务内容,分别为培训指导（62.7%）、职业健康检查（64.5%）、工作场所有害因素监测（60.9%）、职业病危害因素评价（64.5%）。[结论]该区企业对职业卫生服务需求较大,需要政府的投入与扶持。     

广州市船舶修造企业劳务工人职业健康状况分析

目的了解广州市船舶修造企业劳务工人职业健康状况。方法对2011、2012年广州市4家国有大型造船企业劳务工人职业健康检查数据进行分析。结果职业健康检查结果异常率为10.43%,其中胸片异常率为6.40%、血常规为4.57%、电测听为13.85%;上岗前职业健康检查异常率为8.79%、在岗期间职业健康检查异常率为11.85%,离岗时职业健康检查异常率为8.70%。结论船舶修造企业劳务工人职业健康状况严峻,应加强对用工单位和用人单位的监管,加强工作场所通风、降温措施,加强个体防护。     

上海市杨浦区涉苯企业职业卫生危害现状调查

目的调查涉苯企业贯彻国家职业卫生法规执行情况及现状,为建立辖区职业卫生监督的有效管理提供依据.方法依据<中华人民共和国职业病防治法>、<使用有毒物品作业场所劳动保护条例>等法律、法规和国家职业卫生标准,依法对辖区60家涉苯企业进行监督检查.结果部分用人单位法制意识淡薄,作业场所职业病危害因素检测与评价等管理制度及措施不健全 ,作业场所三苯浓度抽测点合格率为87.1%,其中7家企业三苯浓度超过国家卫生标准,苯白血病检出1例,检出率为17.7/10万.结论用人单位在职业卫生管理方面与国家职业卫生法律、法规要求尚有较大差距,潜在职业危害依然存在.因此,建立有效的职业卫生监督管理机制,是治本之策.     

矿业工人职业健康监护现况调查

目的掌握矿山企业职业病健康监护现状,以便及时采取干预措施,保护劳动者健康。方法完全随机选择白山市19家矿山企业,采用现场调查方法。调查内容包括企业的基本情况、职业卫生组织与管理制度、职业安全卫生培训情况、存在的职业危害因素、职业病危害防护措施、接触职业病危害因素人员的健康监护情况。结果白山市矿山企业职业健康监护现状不容乐观,职业卫生管理机构不完善,个体私营矿山企业健康监护现状堪忧,职业健康体检工作开展得普遍不好。结论提出了强化宣传,形成氛围;创新培训方式,确保培训效果;健全工作机制,完善制度;加大科技投入,改善作业环境;强化过程监督,确保个体防护效果;完善监管体系,建立联席会议制度,落实监管责任等六项建议。     

新医改背景下安徽省乡镇卫生院运行分析

目的：分析新医改前后安徽省乡镇卫生院发展现状,探讨其存在的问题,为进一步完善基层医改举措提供建议.方法：对乡镇卫生院基本情况、人力资源配置、医疗服务、药占比情况进行分析.结果：乡镇卫生院建设和发展滞后;基层人才匮乏,职称和学历偏低;缺乏补偿和激励措施;药占比依然偏大.结论：科学发展乡镇卫生院,建立激励相容的良性共同体;明确政府责任,完善激励制度;加强人才培养,提高业务水平.     

南宁市职业卫生现状及对策探讨

目的了解南宁市职业卫生现状,探讨存在的问题并提出相应的对策。方法对近3年南宁市(含6县6区)的职业卫生技术工作及职业卫生监督工作总结资料进行综合分析。结果在存在职业病危害因素的456家企业中,能按《中华人民共和国职业病防治法》要求,设立职业病管理机构企业、落实法人责任制企业267家;制定职业病防治计划或方案企业244家,有专(兼)职职业卫生管理人员306人;共有从业人员总数67 619人,其中接触职业病危害因素作业人员31 130人,占职工总数的46.04%。近3年开展职业健康检查20 297人,体检率65.2%;检出尘肺病113人,职业禁忌证223人,职业禁忌人员的调离达到了100%。按要求建立职业健康监护档案17 977份,建档率57.75%,并对35家违法单位进行了行政处罚。南宁市取得职业卫生技术服务机构资质的有3家单位(南宁市市区的仅1家)。结论南宁市职业病危害状况较严重,用人单位特别是中小企业缺乏有效的管理制度,职业卫生技术服务机构严重不足,职业卫生专业技术人员水平有待提高。     

Safety climate and its association with injuries and safety practices in public hospitals in Costa Rica

In response to growing concern for occupational health and safety in the public hospital system in Costa Rica, a cross-sectional survey of 1,000 hospital-based health care workers was conducted in 1997 to collect baseline data that are being used to develop worker training programs in occupational health in Costa Rica. The objectives of this survey were to: 1) describe the safety climate within the national hospital system, 2) identify factors associated with safety, and 3) evaluate the relationship between safety climate and workplace injuries and safety practices of employees. The safety climate was found to be very poor. The two most significant predictors of safety climate were training and administrative support for safety. Safety climate was a statistically significant predictor of workplace injuries and safety practices, respectively, and there was an underreporting rate of 71% of workplace injuries. These findings underscore the need for improvement of the safety climate in the public hospital system in Costa Rica.     

常熟市电焊作业企业职业卫生工作现状与对策

目的了解常熟市电焊作业企业职业卫生工作基本情况,针对存在的问题提出对策措施。方法于2012年对常熟市95家电焊作业企业进行职业卫生工作现状调查。结果多数企业职业卫生制度较为完善,部分企业未设置或设置不够全面;现场检测率及职业健康检查率偏低,仅为53.7%及36.8%。结论该市电焊作业场所现场管理情况不容乐观。应完善企业职业卫生管理体系,建立、健全职业卫生管理制度,规范作业场所现场管理,督促企业全面开展作业场所现场检测与职工职业健康监护工作。     

瑞金市2003年部分企业职业卫生情况调查

目的：了解和掌握用人单位职业卫生状况，预防、控制和消除职业病危害。方法：职业卫生基本情况调查按《2003年江西省职业卫生监督检查表》进行；职业危害因素监测按国家或卫生部制定的相关职业病危害因素监测规范进行；职业健康检查按卫生部《职业健康监护管理办法》规定的项目进行。结果：存在职业病危害因素的企业中，私营、有限责任、港商投资、中外合资、股份合作企业占94．4％(17／18)；职业危害因素监测合格率为48．5％(81／167)；职业健康体检异常率为85．1％(222／261)。所监测单位职业病危害主要集中在建材业、矿山开采业、机械制造业，有害因素中以粉尘、噪声最为严重。大部分用人单位未落实职业病防治管理措施。结论：用人单位职业卫生状况堪忧，存在职业病发生的隐患，应强化职业卫生责任和执法职能。     

北京市顺义区试点企业员工职业卫生知识认知与需求现状

目的了解北京市顺义区试点企业员工对职业卫生知识的认知和需求情况,为有针对性开展职业健康教育、促进干预活动提供依据。方法选择试点企业6个车间的全部员工188人进行问卷调查。结果39.4％的员工不知道《中华人民共和国职业病防治法》,员工对职业病预防措施的认知正确率为1.1％,63.8％的员工能够正确回答职业病的定义;员工对“职业病危害因素种类及对人体危害”的知识需求率达73.4％。结论该区试点企业员工对职业卫生知识的认知率较低,但对职业卫生知识等相关内容的需求较高,应继续加强企业员工职业健康教育与健康促进。