酶的职业性致敏效应

酶是由生物体（细菌、真菌等）所产生的大分子蛋白，相对分子质量通常在20000～483000之间。酶作为催化剂，可以高度特异地增加化学反应的速率，而DNA重组技术和发酵技术的发展大大增强了工业酶在生产中的作用，同时可减少生产成本。因而，广泛应用于生产中。据估计，2000年全球工业酶销售额达15亿美元川。按其用途，工业酶可分为三类：第一类主要用于洗涤剂、淀粉、纺织品、皮革、纸张等的生产，其消耗量约占生产总量的65％；第二类用于食品生产，约占25％；第三类用于饲料生产，约占10％。按其作用底物，又可分为蛋白酶、脂肪酶、淀粉酶、纤维素酶、乳糖酶、糖化酶等。其存在形式有粉末、颗粒、液态等。     

Occupational risk and toxicology evaluations of industrial water conditioning

This study addresses the chemical and toxicological questionsdue to the wide use of chemical treatment programmes for industrialcooling water. First, natural problems encountered in coolingtower systems were presented and grouped into three categories:(i) scaling; (ii) corrosion and (iii) biofouling. Chemical solutionsadopted in industrial plants were outlined for each one in orderto minimize damage and catagorized as shut-down, productionloss, heat transfer reduction, upsets, etc. Above all, the purposeof the work was to identify the most dangerous chemicals normallyused, which mean sources of chemical risk for safety workersand their environment; thus, symptoms of exposure, preventionmeasures and protection tools are also described.     

Occupational risk factors for radial tunnel syndrome in industrial workers

OBJECTIVES: The aim of the study was to evaluate both nonoccupational and occupational factors associated with radial tunnel syndrome (RTS) among industrial workers in 3 large plants. METHODS: Twenty-one cases of RTS were compared with 21 referents matched for gender, age, and plant. RTS was associated with carpal tunnel syndrome (CTS) in 9 cases. Past medical history, household activities, and ergonomic and organizational characteristics of the job were analyzed. RESULTS: The study found 3 occupational risk factors for RTS. Exertion of force of over 1 kg [odds ratio (OR) 9.1, 95% confidence interval (95% CI) 1.4-56.9] more than 10 times per hour was the main biomechanical risk factor. Prolonged static load applied to the hand during work was strongly associated with RTS (OR 5.9, 95% CI 1.2-29.9). Work posture with the elbow fully extended (0-45 degrees) was associated with RTS (OR 4.9, 95% CI 1.0-25.0). Full extension of the elbow, associated with a twisted posture of the forearm, stressed the radial nerve at the elbow. However, personal activities, household chores, and sport and leisure activities were not associated with RTS. CONCLUSIONS: The study confirms that RTS occurs in workers performing hard manual labor that requires forceful and repetitive movements involving elbow extension and forearm prosupination.     

Occupational and individual factors in acute shoulder-neck disorders among industrial workers.

Twenty workers, consecutively attending the industrial health care centre for the first time with acute shoulder-neck pains, were subject to extensive rheumatological and ergonomic examinations. In seven patients congenital malformations for diseases causing musculoskeletal symptoms, or both, were probable aetiological factors. In the remaining 13 patients a significantly higher load was found on both shoulders (assessed by biomechanical film analysis) than in matched control. Age, anthropometric measures, muscle strength, or HLAB27 did not appear as significant predisposing factors. Most patients could return to work within a year.     

Occupational medicine practice in the United States since the industrial revolution

OBJECTIVES: Occupational medicine lies at the interface between work and health. Not only do workplace hazards impact health, but our state of health influences our ability to get to work, to perform work, to tolerate work, and to gain a measure of satisfaction from the work we do. Comprehensive occupational medicine requires familiarity with the work that patients do; knowledge of the workplace itself and its hazards; appreciation of the social forces that shape work; and understanding of how chemical, physical, biologic, mechanical, and psychosocial agents influence health. Many practitioners who treat injured workers or provide disability assessments have no more formal training in occupational medicine than primary care physicians in general, which limits the quality, or at least the scope, of the care they give to workers. METHODS: This history has been compiled from books, journals, letters and recollections. A subset of journal issues from each decade after 1910 has been systematically reviewed, making no attempt to read through every issue. RESULTS: Industrial medicine as we recognize it began in the late-1800s, grew rapidly in the early and mid-1900s, and peaked toward the end of the 20th century, when American corporations began to outsource medical services, supporting the rise of free-standing industrial medicine facilities, chains of which now operate profitably throughout the country. Many of these facilities emphasize injury treatment, work hardening, and physical therapy rather than disease recognition and prevention. Occupational medicine is one of the very few medical specialties to be underserved. Board-certified specialists are relatively few, and when supply falls short of demand, the demand has tended to lower its sights. CONCLUSIONS: Occupational medicine has always been influenced by economics, politics, and changing patterns of employment, and today these forces include managed care, weakened unions, outsourcing and contract labor, and a generally growing political and social conservatism, not to mention multinational corporations. The globalization of manufacture and economics facilitated by rapid population growth in poor nations assures an unending supply of cheap labor, allowing limited attention to hazard control, thereby impeding progress in occupational health and safety. Some corporations are meeting the challenge of protecting their international workforce. Many, probably most, have not yet achieved this.     

Occupational health in general practice in an industrial area of Singapore

The aim of this study was to estimate the caseload with regard to the proportion of work-related medical cases in factory workers and to survey knowledge of and attitudes to occupational medicine among doctors in an industrial area in Singapore. To this end, a self-administered questionnaire was given to 74 general practitioners in the industrial district of Jurong in Singapore. Overall, there was an 89.2% response rate. Thirty-three of the 66 respondents were males. Mean age was 40.8 years (range 27-64 years). Twenty-four (36%) had some postgraduate training in occupational medicine (GP-OM) while the rest did not (GP). The caseload for all doctors was similar with regard to the number of adult patients and, more specifically, the number of factory workers seen per day. The majority of doctors (76.6%) felt that <10% of factory workers seen had work-related problems. Most (70%) felt confident in dealing with the occupational problems that arose. However, a large percentage (78% of GPs, 45.8% of GP-OMs) felt that training in occupational medicine was inadequate. This is reflected in the knowledge questions, where GPs did not score as well as GP-OMs. It was concluded that GPs working in this industrial area see a good proportion of factory workers, in a fair number of cases for work-related problems. However, only a third of the GPs are qualified in occupational medicine. These factors highlight the need for more emphasis on occupational medicine training among general practitioners, especially those working in industrial areas.     

Occupational lead exposure and amino acid profiles and liver function tests in industrial workers

The aim of the present study is to determine the effect of blood lead on the plasma levels of amino acids and serum liver enzymes in industrial workers in United Arab Emirates (UAE). This comparison study consisted of 100 industrial workers (exposed) and 100 non-industrial workers (non-exposed), matched for age, sex and nationality selected from Al-Ain, Abu-Dhabi Emirates. Industrial workers had higher proportion (19%) of smokers than non-industrial workers (11%) which was not considered to be statistically significantly different. Industrial workers had significantly higher mean of blood lead level (77.5 +/- 42.8 miccrog x dl(-1)) than non-industrial workers (19.8 +/- 12.3 microg x dl(-1)). The amino acid analysis showed higher values among industrial than non-industrial workers for histidine, isoleucine, leucine, threonine, lysine, valine, methionine and arginine (essential amino acids, (p<0.0001). Ornithine, taurine, glutamic acid, serine, glycine, proline and alanine (non-essential amino acids) showed significantly higher values in industrial when compared with the non-industrial workers (p<0.0001). Plasma liver function test, cardiac enzymes and renal function test were carried out on industrial and non-industrial workers. The results revealed alkaline phosphatase (p=0.012) and lactate dehydrogenase (p=0.029) were significantly higher in industrial than in non-industrial workers. On the basis of this study, it can be concluded that a substantial difference in amino acid profiles, blood lead and LFT between exposed and non-exposed was found. These results might be related to lead exposure and might have affects on the kidneys or liver.