Karl Morgan and Alice Stewart,Survivors on the Nuclear Stage

Abstract

Background:

Health care workers (HCWs) are exposed to occupational related health hazards. Measuring worker perception and the prevalence of these hazards can help facilitate better risk management for HCWs, as these workers are envisaged to be the first point of contact, especially in resource poor settings.

Objective:

To describe the perception of occupational health hazards and self-reported exposure prevalence among HCWs in Southern India.

Methods:

We used cross sectional design with stratified random sampling of HCWs from different levels of health facilities and categories in a randomly selected district in Southern India. Data on perception and exposure prevalence were collected using a structured interview schedule developed by occupational health experts and administered by trained investigators.

Results:

A total of 482 HCWs participated. Thirty nine percent did not recognize work-related health hazards, but reported exposure to at least one hazard upon further probing. Among the 81·5% who reported exposure to biological hazard, 93·9% had direct skin contact with infectious materials. Among HCWs reporting needle stick injury, 70·5% had at least one in the previous three months. Ergonomic hazards included lifting heavy objects (42%) and standing for long hours (37%). Psychological hazards included negative feelings (20·3%) and verbal or physical abuse during work (20·5%).

Conclusion:

More than a third of HCWs failed to recognize work-related health hazards. Despite training in handling infectious materials, HCWs reported direct skin contact with infectious materials and needle stick injuries. Results indicate the need for training oriented toward behavioral change and provision of occupational health services.     

2010年龙岩市新罗区职业卫生健康危害因素监测分析

目的为进一步科学指导龙岩市新罗区职业卫生防治工作、合理制定职业病危害因素预防控制措施提供依据。方法回顾性分析2010年辖区健康危害因素监测信息系统(职业卫生)网报数据。结果 2010年新罗区监测较多的职业危害因素为噪声、粉尘,超标较严重的为铅及其化合物、高温、煤尘、水泥尘、噪声、甲醛、一氧化碳,说明该辖区存在多种职业危害因素。对工人健康影响较大的职业危害因素为铅及其化合物、苯、煤尘。职业危害因素超标率与在岗期间工人职业禁忌证检出率间相关系数r=0.623,r 0.10(3)=0.672,P﹤0.10。结论铅及其化合物、煤尘、苯是新罗区危害较大的职业危害因素,铅及其化合物、高温、煤尘、水泥尘、噪声、甲醛、一氧化碳作业是较大的职业危害岗位,故今后应加强对铅及其化合物、煤尘、苯等有毒有害因素的企业的监督监测,将其列入"预警企业"名单,切实保护工人健康。     

2010—2013年南通市市区接触职业病危害因素的在岗职工职业健康检查结果

目的了解和掌握南通市区接触职业病危害因素企业的职业病危害现状及其趋势,为该市制定职业病防治策略提供依据。方法利用职工职业健康检查信息系统中2010—2013年在岗职工的健康检查数据进行统计描述和分析。结果 2010—2013年,4年间共有1 615名在岗职工患有职业禁忌证,检出率2010年最低（2.65%）,2013年最高（4.61%）,差异有统计学意义（x^2=113.26,P〈0.01）;408名在岗职工患有疑似职业病,病例数呈逐年增加态势;职业病高危行业仍然集中在传统的接触粉尘、化学毒物、噪声、高温等作业。结论该市越来越多的职工暴露于有毒有害的环境当中,疑似职业病人数呈逐年增加态势,企业应改善职工工作环境,定期为职工进行健康检查,预防和控制职业病的发生。     

某汽车制造厂主要职业病危害因素及其对工人健康的影响

目的了解广州市某汽车制造企业存在的主要职业病危害因素和工人的健康状况,以便及时发现存在的问题,提出合理化建议。方法对2011年该汽车制造企业的职业病危害因素监测和工人健康检查资料进行分析。结果该企业的主要职业病危害因素是噪声、电焊烟尘、锰及其化合物等,作业场所噪声强度和空气中锰及其化合物浓度合格率分别为59.6%、87.5%,电焊烟尘、其他粉尘合格率分别为87.5%、88.9%,其余均符合国家职业卫生标准。工人慢性咽炎、心电图异常、脂肪肝和慢性鼻炎患病率分别为35.5%、24.2%、11.2%和10.4%。噪声接触工人较非接触工人听力明显下降(χ2=13.409,P0.01),接触粉尘工人慢性鼻炎患病率显著高于非接触工人(χ2=3.905,P=0.048);电焊作业工人尿锰含量明显高于非电焊工人(χ2=47.477,P0.01)。结论噪声是该企业最严重的职业病危害因素,对接触工人造成了听力损伤,听力损伤发生率随接触工龄延长而增加,存在剂量-反应关系,值得重视,同时应加强对粉尘和电焊烟尘接触工人的健康检查。     

2006—2010年北京市海淀区工业企业职业有害因素监测及职工健康状况

目的了解近5年北京市海淀区工业企业生产环境监测情况及接触职业有害因素人群的健康状况。方法对2006—2010年该区职业有害因素监测结果、职业健康监护检查结果进行统计分析。结果对530户企业5 913个作业点进行职业有害因素检测,有害因素检测超标率为5.8%;其中化学物质、粉尘及噪声的超标率分别为0.7%、11.5%、11.3%,化学性有害因素不合格样品主要为甲醛、臭氧、三氯甲烷、甲苯、二甲苯,粉尘中不合格样品以矽尘、木粉尘及其他粉尘为主;共对1 090户企业中的50 935名职工进行职业健康检查,其中接触化学因素、粉尘、噪声的健康指标异常检出率分别为0.4%、0.2%、15.9%,接触化学有害因素的异常人群以苯系物接触为主。结论该区职业病危害的重点是噪声接触行业,其次是粉尘及苯系物。     

Occupational exposure to Aspergillus and aflatoxins among food-grain workers in India

Background:

Aflatoxins are a metabolite of Aspergillus molds and are widespread in the natural environment. Workers who handle food grains are at increased risk of exposure to aflatoxins and subsequently certain respiratory conditions. In India, more than half of the employed population is engaged in some type of agricultural work, yet little known about the respiratory problems as a result of exposure to aflatoxins among workers who handle food grains in India.

Objectives:

The aim of this study was to determine the risk of occupational exposure to aflatoxins in food-grain workers compared to workers who are not occupationally exposed to food grains.

Methods:

Bronchoalveolar lavage (BAL) and serum samples from 46 food-grain workers and 44 non-food-grain workers were analyzed for the presence of aflatoxins. Microscopy and culture of BAL samples were performed to detect Aspergillus species.

Results:

Aflatoxins were detected in 32.6% of the food-grain workers and 9.1% of non food grain workers (P<0.01). A significant difference was also found in BAL culture for Aspergillus (P<0.01) between the two groups. About 47.8% of the food-grain workers and 11.4% of non-food-grain workers had chronic respiratory symptoms.

Conclusion:

Occupational exposure to aflatoxins in food-grain workers was found to be associated with the increased presence of respiratory symptoms.     

医疗卫生机构医务人员结核病感染控制现状

目的分析我国医务人员结核感染和患病情况以及相应的危险因素,为加强医疗卫生机构医务人员的结核病感染预防控制工作提供理论依据。方法采取系统综述的方法,对1995-2010年关于医疗卫生机构中医务人员结核感染和患病情况及其影响因素的相关文献资料进行综合分析。结果我国关于医务人员结核感染预防控制方面的研究很欠缺。文献资料显示,我国医务人员的结核感染率明显高于普通人群,其PPD阳性率达60.4%～62.8%;医务人员的结核病患病率也比一般人群高,达6.7/1 000人年。对医务人员感染结核的危险因素分析显示,其结核感染和患病风险主要与在工作场所暴露和感染预防控制措施不足等有关。结论医务人员的结核感染控制工作十分薄弱,相关研究不足,目前已成为我国结核病控制面临的重要问题。     

Occupational health hazards among health care personnel working in public health facilities in Bhubaneswar,India

Background

Health care personnel working in public health facilities comprise a major part of the health care workforce in India and are exposed to a variety of workplace hazards.

Aim

To assess the occupational health hazards and associated risk factors among health care personnel working in public health facilities in Bhubaneswar.

Subject and methods

A cross-sectional study was conducted involving 172 health care personnel working in 22 urban primary health centers and four community health centers in the Bhubaneswar Block of the Khordha district in the state of Odisha, during the period from January to December 2017. Relevant data were collected using a semi-structured interview schedule.

Results

Overall, 143 (83.1%) of the participants reported experiencing occupational health hazards, with 89 (51.7%) encountering biological hazards and 130 (75.6%) experiencing non-biological hazards. Stress (38.9%), assault (38.4%), needlestick injury (34.3%), and direct contact with contaminated specimens/body fluids (32.6%) were the most frequently experienced occupational hazards. Multivariate regression analysis revealed that female gender, health care personnel other than doctors, working overtime, dissatisfaction with workplace atmosphere, and not using the necessary personal protective equipment (PPE) were independent predictors for experiencing a biological hazard. Similarly, female gender, presence of family conflict, and not using the required PPE were found to be independent predictors for experiencing non-biological hazards.

Conclusion

Health care personnel in public health facilities experience multiple hazards in their workplaces. Results indicate the need for designing and implementing strategies to promote the occupational health of this important section of society.

     

高密市流动人口中女工职业健康状况和卫生的需求方式调查

目的了解高密市流动人口中女工(简称流动女工)的职业健康状况和职业卫生需求方式。方法选择纺织行业3个企业和制鞋行业3个企业的流动女工共3 804人,填写职业健康调查问卷。全部数据录入EpiData数据库,应用SPSS17.0统计软件进行统计分析,进行t检验,χ2检验。结果制鞋行业流动女工年龄小,工龄低,多未婚,纺织行业流动女工年龄大、工龄较长、多已婚(均P0.01)。两行业生殖健康表现为痛经和淤血,躯体健康方面表现为头痛、头晕、腰背痛、抑郁等。纺织行业重复单调动作(60.9%)、连续站立(45.1%)工作较多;职业病危害因素知晓率(43.4%)比制鞋行业低(85.3%)。两行业目前对职业健康知识了解的主要途径是知识读本、电视途径,希望通过知识读本获得职业健康知识。结论高密市纺织、制鞋行业流动女工存在较为严重的生殖健康和职业健康问题,期望通过知识读本获得职业卫生知识。     

南通市船舶修造业农民工职业病危害现状调查及管理对策

目的 了解南通市船舶修造业农民工职业病危害现状和存在问题,探讨改善农民工职业健康现状的对策和建议.方法 采用问卷调查,对船舶修造企业的299名农民工的调查结果进行统计分析.结果 接触2种或以上职业病危害因素的农民工占71.2％,岗前健康检查率为48.8％,在岗健康检查率为42.8％,42.5％的农民工不了解职业病内容,23.1％的农民工不知道依法所拥有的权利,合格劳保用品配备率为43.5％,工作时坚持使用个体防护用品的农民工只有54.5％.结论 船舶修造业农民工职业病危害现状不容乐观,政府须加强对职业病防治的组织领导,建立完善农民工职业病防治相关体系,各职能部门加强沟通切实提高监管水平.     

Risk for occupational transmission of HIV infection among health care workers

The aim of this study was to evaluate the HIV seroconversion rate associated with different types of occupational exposures in health care workers. A longitudinal study was conducted from January 1986 to October 1992 in a teaching hospital in Spain, where HIV infection is prevalent among patients. Each health care worker was asked to complete a questionnaire regarding age, sex, staff category, lace of exposure, other exposures, type of exposure, body fluid, infected material and HIV status of source patient. These health care workers were then followed up at 6 weeks, 3 months, 6 months and 12 months with repeated test for HIV antibody. Four hundred twenty three reports of occupational exposure were analysed. Nursing was the profession with more exposures (42.8%). Ninety five percent of total exposures were percutaneous, 4% mucous membrane contacts and 1% skin contacts, 88.3% were described as blood contact and 71.8% had resulted from needlestick and suture needles. Exposures from HIV-positive patients comprised 23.2% of occupational exposures. There was a significant difference in the length of follow-up in physicians (p=0.00009) and nurses (p=0.00001), when we compared HIV-positive patients with patients in whom the HIV status was unknown or negative. The HIV seroconversion rate was 0.00%. We consider that the risk of acquiring HIV infection via contact with a patient is low, but not zero. Well documented cases of seroconversion have been published. Because it is often impossible to know a patient's infection status, health care workers should follow for rotine the universal precautions for all patients when there is a possibility of exposure to blood or other body fluid. Equally important is the development of new techniques to minimize the risk of exposures to blood.     

环卫职工职业危害现状研究进展

环卫职工工作时间长,工作量大,工作环境恶劣,每天接触大量垃圾,暴露于各种职业病危害因素中,主要有粉尘（矽尘、有机粉尘等）、化学毒物（如铅烟、一氧化碳、二氧化碳、硫化氢、氨、二氧化硫等）、病原微生物（细菌、寄生虫、病毒等）、噪声、高温等多种因素。作者从环卫职工的职业特点、接触的职业病危害因素及职业病危害因素对健康的影响、环卫工人职业卫生防护现状及其职业危害防护和管理展望几个方面综述了环卫工人的职业危害现状研究的进展情况。     

汽车维修作业人员职业健康检查结果分析

目的 了解汽车维修作业人员职业健康现状,为该行业劳动者职业健康监护重点提供参考。方法 将2019—2021年连续在天津市某职业健康检查机构进行在岗期间职业健康检查的汽车维修作业人员作为研究对象,对异常检查结果进行统计分析。结果 3年间职业健康检查共803人次,其中机修工441人次,钣金工192人次,喷漆工170人次。尿常规异常、尿蛋白、脂肪肝、γ-谷氨酰转移酶偏高、总胆红素偏高和胸片异常检出率呈现增高趋势(趋势值分别为7.23、5.40、5.03、6.81、4.00、5.71; P值分别为0.007、0.020、0.025、0.009、0.046、0.017)。分析不同工种检查结果异常情况,发现机修工脂肪肝检出率高于钣金工(=7.29,P=0.007),喷漆工中性粒细胞计数偏低检出率高于钣金工和机修工(=4.51,P=0.034; =4.89,P=0.027),钣金工胸片异常和纯音听阈异常均高于喷漆工(=4.98,P=0.026; =9.05,P=0.003)。结论 汽车维修作业人员长期接触苯系物、有机溶剂、电焊烟尘和噪声等会对作业人员健康造成一定影响,用人单位应积极落实职业病防治主体责任,根据不同工种健康损害特点,针对性的开展宣传教育和职业健康监护。     

北京市大兴区农民工职业卫生健康教育干预效果评价

目的评价北京市大兴区农民工职业卫生健康教育干预效果。方法通过现场培训、资料发放、播放DVD等活动对大兴区13家企业的1500名农民工进行为期6个月的职业卫生行为干预,并调查干预前后农民工职业卫生知识、态度和相关行为状况。结果干预后,农民工对职业卫生知识的知晓率有了一定提高,知识得分由干预前的9．83±2．939提高到10．97±2．740,二者差异有统计学意义（P〈0．05）;态度得分与行为得分健康教育前后差异无统计学意义（P〉0．05）。结论现场培训、资料发放等职业卫生健康教育干预活动对提高农民工职业卫生知识水平、改变其职业卫生态度和职业行为习惯有着重要作用。     

深圳光明新区2013-2015年三氯乙烯作业场所危害状况及劳动者健康分析

目的 分析评估光明新区三氯乙烯职业危害现状和长期接触者的健康状况。 方法 对15间使用三氯乙烯的工作场所进行检测,对接触三氯乙烯的81名劳动者进行职业健康检查。 结果 2013-2015年间共检测126个检测点,30个点超标,三氯乙烯浓度范围为0.7~122.59 mg/m³(PC-TWA),平均浓度16.02 mg/m³(PC-TWA)。电镀行业三氯乙烯超标率高于电子行业,差异有统计学意义(χ²=6.23,P=0.013);三氯乙烯接触者2015年肝功能异常率高于2013年,差异有统计学意义(χ²=6.51,P=0.011);2015年血常规异常率高于2013和2014年,差异有统计学意义(χ²=6.69,P=0.01;χ²=5.84,P=0.016)。 结论 光明新区五金行业和电镀行业的三氯乙烯使用场所通风排毒设施仍需要加强,劳动者也需要严格按照要求佩戴防护用品。     

Prevalence and prevention of needlestick injuries among health care workers in a German university hospital

Objective Health care workers (HCWs) are exposed to bloodborne pathogens, especially hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) through job-related risk factors like needlestick, stab, scratch, cut, or other bloody injuries. Needlestick injuries can be prevented by safer devices. Methods The purpose of this study was to investigate the frequency and causes of needlestick injuries in a German university hospital. Data were obtained by an anonymous, self-reporting questionnaire. We calculated the share of reported needlestick injuries, which could have been prevented by using safety devices. Results 31.4% (n = 226) of participant HCWs had sustained at least one needlestick injury in the last 12 months. A wide variation in the number of reported needlestick injuries was evident across disciplines, ranging from 46.9% (n = 91/194) among medical staff in surgery and 18.7% (n = 53/283) among HCWs in pediatrics. Of all occupational groups, physicians have the highest risk to experience needlestick injuries (55.1%—n = 129/234). Evaluating the kind of activity under which the needlestick injury occurred, on average 34% (n = 191/561) of all needlestick injuries could have been avoided by the use of safety devices. Taking all medical disciplines and procedures into consideration, safety devices are available for 35.1% (n = 197/561) of needlestick injuries sustained. However, there was a significant difference across various medical disciplines in the share of needlestick injuries which might have been avoidable: Pediatrics (83.7%), gynecology (83.7%), anesthesia (59.3%), dermatology (33.3%), and surgery (11.9%). In our study, only 13.2% (n = 74/561) of needlestick injuries could have been prevented by organizational measures. Conclusion There is a high rate of needlestick injuries in the daily routine of a hospital. The rate of such injuries depends on the medical discipline. Implementation of safety devices will lead to an improvement in medical staff’s health and safety.     

北京市外来务工人员公共卫生服务利用调查

目的 了解北京市外来务工人员公共卫生服务利用的现状及其影响因素。方法 采用多阶段分层整群抽样方法抽取北京市外来务工人员1 002人进行公共卫生服务利用的现状问卷调查。结果 ≥15岁外来务工人员占77.64%（778/1 002）;778人中曾参加过健康教育讲座者占4.2%,知晓“五苗”免费接种政策的占60.5%,对艾滋病的传播途径一无所知者占26.3%,流动孕产妇产前检查率和产后访视率分别为76.6%和 32.1%,儿童计划免疫建卡率为97.5%;不同年龄、在京家庭年纯收入、文化程度、在京行业类型、在京累计居住时间、日累计工作时间、自评健康状况的外来务工人员差异均有统计学意义（P<0.05）;多因素logistic回归分析结果显示,家庭年纯收入（OR=1.165）,年龄（OR=0.974）、在京累计居住时间（OR=1.176） 、餐饮、家政、行业（OR=1.828）、日累计工作时间（OR=0.788）是外来务工人员公共卫生服务利用的主要影响因素。结论 北京市外来务工人员的公共卫生服务利用水平不高。     

Effects of bioaerosol exposure on work-related symptoms among Swiss sawmill workers

Objective Exposure to bioaerosols in the occupational environment of sawmills could be associated with a wide range of health effects, in particular respiratory impairment, allergy and organic dust toxic syndrome. The objective of the study was to assess the frequency of medical respiratory and general symptoms and their relation to bioaerosol exposure. Method Twelve sawmills in the French part of Switzerland were investigated and the relationship between levels of bioaerosols (wood dust, airborne bacteria, airborne fungi and endotoxins), medical symptoms and impaired lung function was explored. A health questionnaire was distributed to 111 sawmill workers. Results The concentration of airborne fungi exceeded the limit recommended by the Swiss National Insurance (SUVA) in the twelve sawmills. This elevated fungi level significantly influenced the occurrence of bronchial syndrome (defined by cough and expectorations). No other health effects (irritations or respiratory effects) could be associated to the measured exposures. We observed that junior workers showed significantly more irritation syndrome (defined by itching/running nose, snoring and itching/red eyes) than senior workers. Lung function tests were not influenced by bioaerosol levels nor dust exposure levels. Conclusion Results suggest that occupational exposure to wood dust in a Swiss sawmill does not promote a clinically relevant decline in lung function. However, the occurrence of bronchial syndrome is strongly influenced by airborne fungi levels.     

Tuberculosis among health care workers

To assess the annual risk for latent tuberculosis infection (LTBI) among health care workers (HCWs), the incidence rate ratio for tuberculosis (TB) among HCWs worldwide, and the population-attributable fraction of TB to exposure of HCWs in their work settings, we reviewed the literature. Stratified pooled estimates for the LTBI rate for countries with low (<50 cases/100,000 population), intermediate (50-100/100,000 population), and high (>100/100,000 population) TB incidence were 3.8% (95% confidence interval [CI] 3.0%-4.6%), 6.9% (95% CI 3.4%-10.3%), and 8.4% (95% CI 2.7%-14.0%), respectively. For TB, estimated incident rate ratios were 2.4 (95% CI 1.2-3.6), 2.4 (95% CI 1.0-3.8), and 3.7 (95% CI 2.9-4.5), respectively. Median estimated population-attributable fraction for TB was as high as 0.4%. HCWs are at higher than average risk for TB. Sound TB infection control measures should be implemented in all health care facilities with patients suspected of having infectious TB.