某风力发电桨叶制造企业职业卫生学调查与分析

目的 了解某风力发电桨叶制造企业职业病危害现状.方法 采取职业流行病学方法对风力发电桨叶制造企业进行职业病危害现状调查.结果 风力发电桨叶制造企业主要的职业病危害因素为玻璃钢粉尘、噪声及苯、丙酮等化学物质,检测合格率分别为80％、80％、100％、100％.职工健康检查发现听力异常3例,血常规异常2例,皮炎7例,其他异常24例.结论 风力发电桨叶制造企业存在多种职业病危害因素,该企业的职业病危害控制措施是可行的,但应加强管理,切实做好职业病预防工作.     

风力发电场职业性危害风险辨识与防控措施要点

目的 提出风力发电场的职业病防控措施,为行政监管部门分类监管提供参考,为用人单位职业病防治管理提供指导。方法 在工程分析的基础上,系统地辨识了风力发电场可能存在或产生的主要职业病危害因素及其分布情况。结果 风力发电场可能存在或产生的职业病危害因素主要为工频电磁场和六氟化硫。结论 风电场应该从多个方面加强管理与防护,切实保证劳动者的人身健康与权益。     

小鼠背部变应性接触性皮炎模型的建立

目的建立小鼠背部变应性接触性皮炎(allergic contact dermatitis,ACD)模型.方法用二硝基氟苯(dinitrofluorobenzene,DNFB)分别建立小鼠背部及耳廓ACD模型,比较两种模型在不同时间点皮肤肿胀度及HE染色炎细胞数量变化情况.结果①背部ACD肿胀度大于耳廓ACD肿胀度,配对t检验,t=6.39,P＜0.01,并且两种模型的肿胀度变化呈正相关. ②背部ACD较耳廓ACD单一核细胞数量少,多形核细胞数量多,前者t=8.59,P＜0 .01,后者t=6.05,P＜0.01;两模型的细胞数量变化呈正相关.结论背部ACD模型可以代替耳廓ACD模型用于评价抗炎药物.背部模型肿胀度高,适合肉眼判断皮炎程度.     

Occupational protein contact dermatitis with type I allergy to different kinds of meat and vegetables

Objective: Even though occupational protein contact dermatitis is not an uncommon finding in occupational dermatology, reports about multiple sensitizations are rare. High-molecular-weight substances such as proteins can pass the epidermis only if it is damaged and cause a sensitization. In a high percentage of cases, atopic dermatitis might be the cause of this damage but cannot be regarded as the only cause. An interesting case is presented that was carefully worked up. Methods: Scratch, intracutaneous, and prick or prick-to-prick tests with native occupational allergens were performed as single tests. The patient was patch-tested with the European Standard Series. The determination of allergen-specific IgE was performed by ImmunoCAP. The results were subdivided into six classes. In addition, oral provocations with relevant allergens were performed. Results: The skin tests showed positive type I allergies to beef, lamb, horse, and pork meat, to pork and horse blood as well as to rye and wheat flour, raw potato, and pasta. Weak positive reactions could be found for fowl, duck, goose, and turkey in intracutaneous testing. The ImmunoCAP showed elevated specific IgE values for pork meat, raw potato, and rye and wheat flour. The oral provocation did not show any systemic or skin change. Conclusions: This case report demonstrates how an initial case of contact urticaria turns into protein contact dermatitis. It shows that the diagnosis can be made by means of scratch or prick tests with native occupational allergens. The determination of allergen-specific IgE by ImmunoCAP might be helpful, but a negative result does not exclude protein contact dermatitis. Received: 26 August 1997 / Accepted: 14 November 1997     

Safety and immunogenicity of modified vaccinia Ankara as a smallpox vaccine in people with atopic dermatitis

Background

Following vaccination with traditional smallpox vaccines or after exposure to vaccinated individuals, subjects with atopic dermatitis (AD) can develop eczema vaccinatum, a severe disease with disseminated eruption of pustular contagious lesions. Alternative smallpox vaccines with an improved safety profile would address this unmet medical need.

Methods

An open-label controlled Phase I clinical trial was conducted to investigate the safety and immunogenicity of modified vaccinia Ankara (MVA) in 15 healthy subjects compared to 45 subjects with either mild allergic rhinitis, a history of AD or presenting with mild active AD. MVA was given (Week 0 and 4) by a subcutaneous injection during a 28-week observation period.

Results

No serious adverse event was reported and vaccinations with MVA did not lead to any clinically relevant skin reactions in AD subjects. Unsolicited administration site reactions did not show any trends compared to the healthy subject group. The majority of adverse reactions were mild to moderate, and all reactions were transient and resolved without intervention. The majority of vaccinees had seroconverted by ELISA (80–93%) and PRNT (69–79%) already two weeks after the first vaccination, increasing to 100% after the second immunization, with peak GMT above 1000 and 145 for ELISA and PRNT, respectively.

Conclusions

MVA was equally well tolerated and immunogenic in all enrolled subjects with mild to moderate pain and redness at the injection site being the most frequent adverse reactions. There were no differences in the safety or immunogenicity profile of MVA in healthy subjects or those with AD or allergic rhinitis. The study has confirmed MVA as a promising smallpox vaccine candidate and demonstrated in a small study population that the vaccine has a similar safety and immunogenicity profile in healthy subjects and people with active AD.Clinical trials registration: NCT00189917.     

Association between occupation and contact allergy to the fragrance mix: a multifactorial analysis of national surveillance data

OBJECTIVES—To assess the role of potential (occupational) risk factors for fragrance contact allergy (FCA). Most studies assessing the range of contact sensitisation in various clinical populations found the fragrance mix, a good screening tool for the detection of FCA in general, to be one of the leading allergens. The role of occupational exposure to fragrances is, however, yet unclear.
METHODS—Firstly, crude analyses of the prevalence of FCA in various occupational fields including all 57 779 patients patch tested in the participating centres of the Information Network of Departments of Dermatology (IVDK) between January 1992 and December 1998. Secondly, a multifactorial Poisson regression analysis of these patients, including several potential risk factors.
RESULTS—(a) The proportion of patients with FCA varied greatly between different occupational groups from 2.5% to 17.4%, (b) the highest occupational risk of FCA was associated with work as a masseur or physiotherapist, metal furnace operator, potter or glass maker etc, or geriatric nurse, (c) non-occupational factors that influenced risk of FCA included atopy, female sex, several sites, in particular the axillae, and increasing age.
CONCLUSIONS—Occupations with a high risk of FCA were identified as targets of preventive action—that is, the substitution of scented products with fragrance free materials with which to work (skin disinfectants, cleaning solutions, personal care products) wherever possible.


Keywords: contact allergy; occupational risk factors; fragrances     

Isocyanate induced allergic contact dermatitis in a university undergraduate student: An occupational dermatitis case report,review of laboratory safety regulations,and implications for campus research

A 19-year-old female college undergraduate developed an intensely swollen, erythematous and pruritic rash on the face and hands while working in an optical fabrication lab producing photosensitive polymers. She had no respiratory symptoms. The rash was consistent with contact dermatitis and there was no clinical evidence of respiratory involvement with normal spirometry. A review of the safety data sheets of chemicals used in the laboratory revealed several known sensitizers, including 6-hexamethylene diisocyanate (HDI), dibutyl phthalate, and 2,4,6-tribromophenyl acrylate. Patch testing confirmed the patient's sensitization to HDI. A subsequent worksite visit identified several hazardous chemicals that were used without appropriate hazard communication, training, standard operating procedures, or personal protective equipment. Simple exposure controls were recommended and instituted, and the patient was able to return to work in the laboratory without the recurrence of symptoms. This case demonstrates the importance of hazard identification, communication, and safety training in academic laboratories, for students and workers. A medical evaluation can identify hazards as well as lead to improvements in exposure controls and safe return to research.     

Risk reduction assessment of waterborne Salmonella and Vibrio by a chlorine contact disinfectant point-of-use device

Unsafe drinking water continues to burden developing countries despite improvements in clean water delivery and sanitation, in response to Millennium Development Goal 7. Salmonella serotype Typhi and Vibrio cholerae bacteria can contaminate drinking water, causing waterborne typhoid fever and cholera, respectively. Household water treatment (HWT) systems are widely promoted to consumers in developing countries but it is difficult to establish their benefits to the population for specific disease reduction. This research uses a laboratory assessment of halogenated chlorine beads treating contaminated water to inform a quantitative microbial risk assessment (QMRA) of S. Typhi and V. cholerae disease in a developing country community of 1000 people. Laboratory challenges using seeded well water resulted in log₁₀ reductions of 5.44 (±0.98 standard error (SE)) and 6.07 (±0.09 SE) for Salmonella serotype Typhimurium and V. cholerae, respectively. In well water with 10% sewage and seeded bacteria, the log₁₀ reductions were 6.06 (±0.62 SE) and 7.78 (±0.11 SE) for S. Typhimurium and V. cholerae, respectively. When one infected individual was contributing to the water contamination through fecal material leaking into the water source, the risk of disease associated with drinking untreated water was high according to a Monte Carlo analysis: a median of 0.20 (interquartile range [IQR] 0.017–0.54) for typhoid fever and a median of 0.11 (IQR 0.039–0.20) for cholera. If water was treated, risk greatly decreased, to a median of 4.1 × 10⁻⁷ (IQR 1.6 × 10⁻⁸ to 1.1 × 10⁻⁵) for typhoid fever and a median of 3.5 × 10⁻⁹ (IQR 8.0 × 10⁻¹⁰ to 1.3 × 10⁻⁸) for cholera. Insights on risk management policies and strategies for public health workers were gained using a simple QMRA scenario informed by laboratory assessment of HWT.     

A case-control study of lung cancer at a dye and resin manufacturing plant.

This case-control study evaluated the relationship between lung cancer and occupational factors among employees at a dye and resin manufacturing plant. The study included 51 lung cancer cases and 102 controls who were members of a cohort of workers investigated in a previous retrospective follow-up study. Information on area of employment and on potential exposure to certain chemicals was obtained from plant personnel and medical records and from interviews with long-term employees. Information on potential confounders, including cigarette smoking, was obtained by interviewing study subjects or their next-of-kin. The odds ratio (OR) for heavy smokers compared with light or nonsmokers was 5.9 (95% confidence interval (CI) = 2.4-15). An elevated OR for lung cancer was observed for subjects who worked in the anthraquinone dye and epichlorohydrin manufacturing area of the plant (OR = 2.4; 95% CI = 1.1-5.2) and for employees who were seen at the plant infirmary for acute exposure to chlorine (OR, adjusted for smoking = 27; 95% CI = 3.5-205). Pipefitters employed at the plant for five or more years also had an elevated OR (3.3; 95% CI = 0.8-14).     

Exposures and health effects: An evaluation of workers at a sodium azide production plant

Sodium azide is the principal gas-generating agent used to inflate automobile supplemental restraint systems, more commonly called airbags. Although sodium azide is known to affect the cardiovascular system by causing peripheral vasodilation, there is no published literature describing occupational exposures to sodium azide in the rapidly growing automobile airbag industry. In 1994–1995, the National Institute for Occupational Safety and Health (NIOSH) conducted a cross-sectional study of health complaints reported by sodium azide production workers at the only continuous sodium azide production facility in the United States. The NIOSH evaluation consisted of a plant industrial hygiene survey, a symptom questionnaire, ambulatory blood pressure monitoring, and blood azide analysis. Personal breathing zone air monitoring revealed exposures to sodium azide and hydrazoic acid (a reactant product) at levels greater than the NIOSH Recommended Exposure Limits (RELs). In some cases, exposures exceeded the REL despite the use of air-supplied respirators. The questionnaire revealed that most workers reported headache (10 of 11 [91%]), episodes of low blood pressure (9 of 11 [82%]), and palpitations (8 of 11 [73%]) occurring in the production areas within the 6 months preceding the study. Mild headache (4 of 11 [36%]) was the only symptom reported during our 24-hr medical survey. Ambulatory blood pressure monitoring revealed one asymptomatic employee with a drop in blood pressure (defined as a drop in systolic [at least 20 mm Hg] and diastolic [at least 10 mm Hg] blood pressure) during a period of exposure to sodium azide at a level five times the NIOSH REL. Improvements in plant engineering controls, increased attention to employee hygiene practices, and a more comprehensive respiratory protection program were recommendations made by NIOSH to reduce exposures at the plant. All facilities handling sodium aside should be aware of the potential toxicity of sodium azide and hydrazoic acid. (This article is a US Government work and, as such, is in the public domain in the United States of America.) © 1996 Wiley-Liss, Inc.     

Efficacy of A SIDS Risk Factor Education Methodology at a Native American and Caucasian Site

Objective: To complete a community based efficacy study of a SIDS risk reduction methodology. Methods: We utilized two community sites for this study: 1) a Native American home visiting program for pregnant and young mothers; and 2) an obstetrics department in a community hospital. Pre and posttests were used to measure learning. The risk reduction intervention was delivered by hospital nurses or the home visiting staff and required about 20 minutes. Each of the nine risk factors was discussed. Results: We completed paired pre and post testing with 341 women. The pre tests found substantial knowledge deficits about SIDS risk factors in both groups. The pre and posttest changes for the nine risk factors ranged from 5% to 74%. Participants from both groups demonstrated nearly equivalent rates of learning for all nine of the risk concepts. Conclusion: This study demonstrated the efficacy of this brief intervention program. The program was effective in increasing parental knowledge of the risk factors targeted by this study in both settings. The magnitude of change supports additional research with this program in other settings and with additional populations.     

Symptom onset in the first 2 years of employment at a wood products plant using diisocyanates: some observations relevant to occupational medical screening

BACKGROUND: Questionnaires are essential tools for medical screening, but their role in monitoring workers at increased risk of occupational asthma (OA) remains indeterminate. METHODS: Employees who were at a newly established wood products plant without previous exposure to methylene diphenyl diisocyanate (MDI) completed an initial questionnaire and from one to four follow-up questionnaires during a 2-year period. Onset of symptoms in 132 workers was assessed by exposure groups and modeled using generalized estimating equations. RESULTS: Onset of attacks of dyspnea with wheeze, attacks of dyspnea or cough at rest, and chest tightness were significantly associated with MDI exposure after controlling for age, smoking, and wood dust exposure. Onset of cough on most days was significantly related to smoking and dust. Onset of phlegm production was significantly related to both MDI and dust exposure. CONCLUSIONS: Onset of certain symptoms is significantly associated with MDI exposure. Early detection of MDI-associated health effects using a short screening questionnaire appears feasible.     

Sexual Risk Behavior of Men Who have Sex with Men: Comparison of Behavior at Home and at a Gay Resort

This study compared sexual behavior of gay and bisexual men (N = 551) while at their primary residence to their behavior while vacationing at a gay resort community. Participants reported behavior for the days they spent in the resort and for their last 60 days in their home residences. Overall, 11 times more non-main partners were reported for unprotected anal intercourse (UAI) per day while in the resort as for the “at home” period. Regression analysis identified negative attitudes toward condoms, less concern about AIDS, and daily number of non-main, male partners at home with whom UAI occurred as significant predictors of the daily number of non-main male partners with whom holidaymakers engaged in UAI while in the resort area. The results suggest that sexual risk taking by men who have sex with men (MSM) while on holiday may be elevated over that at home and that prevention efforts need to be promoted in gay resorts. Behavioral surveillance research would be helpful in better characterizing the current social contexts of sexual risk taking by MSM. Theory-based studies of the nature of risk-taking and sexual decision-making on “gay holiday” could inform the development of empirically proven and conceptually grounded interventions.     

Identification of an industrial cohort and verification of its completeness using a complicated system of plant records

The published literature on occupational mortality studies seldom describes the manner in which cohorts were assembled and efforts made to ensure that all, or nearly all, eligible persons had been enumerated. Researchers must struggle unassisted through a morass of plant records, often not knowing how to utilize important sources of information to the fullest extent. This paper describes the identification of a cohort of over 8,700 foundry workers and the verification of its completeness using existing plant data sources. By understanding the techniques for manipulating data sources in this investigation, researchers may gain insight into the use of materials available to them.     

Isomer pattern and elimination of dioxins in workers exposed at a municipal waste incineration plant

The aim of this study was to clarify patterns of serum concentrations of dioxins in the employees of a waste incineration plant and to estimate elimination rates and half-lives of serum dioxin isomers, and the maximum serum concentrations of dioxin isomers at the time of plant shutdown. Sixteen subjects participating 3 times or more in annual health examinations during an 8-yr period from 2000 to 2007 were recruited for this study. Serum concentrations of dioxins expressed as TEQ/g lipid decreased gradually after plant shutdown with the highest decrease observed in polychlorinated dibenzofurans (PCDFs) followed by polychlorinated deibenzo-p-dioxins (PCDDs) and then coplanar PCBs. The serum toxic equivalency (TEQ) concentrations of PCDF and PCDD congeners in the employees were higher than those in the general population survey by the Ministry of the Environment, Japan, whereas the serum concentrations of coplanar PCBs were similar to those in the general population. The estimated half-lives and elimination rates of PCDDs and PCDFs in the highly exposed workers increased compared with the moderately exposed workers. The estimated geometric mean serum concentrations of PCDDs, PCDFs and total dioxins at the time of plant shutdown were 35, 53 and 107 pg TEQ/g lipid, respectively.     

Effectiveness of a Lifestyle Intervention Program Among Persons at High Risk for Cardiovascular Disease and Diabetes in a Rural Community

Purpose: To evaluate the feasibility of translating the Diabetes Prevention Program (DPP) lifestyle intervention into practice in a rural community. Methods: In 2008, the Montana Diabetes Control Program worked collaboratively with Holy Rosary Healthcare to implement an adapted group-based DPP lifestyle intervention. Adults at high risk for diabetes and cardiovascular disease were recruited and enrolled (N = 101). Participants set targets to reduce fat intake and increase physical activity (≥150 mins/week) in order to achieve a 7% weight loss goal. Findings: Eighty-three percent (n = 84) of participants completed the 16-session core program and 65 (64%) participated in 1 or more after-core sessions. Of those completing the core program, the mean participation was 14.4 ± 1.6 and 3.9 ± 1.6 sessions during the core and after core, respectively. Sixty-five percent of participants met the 150-min-per-week physical activity goal during the core program. Sixty-two percent achieved the 7% weight loss goal and 78% achieved at least a 5% weight loss during the core program. The average weight loss per participant was 7.5 kg (range, 0 to 19.7 kg), which was 7.5% of initial body weight. At the last recorded weight in the after core, 52% of participants had met the 7% weight loss goal and 66% had achieved at least a 5% weight loss. Conclusion: Our findings suggest that it is feasible to implement a group-based DPP in a rural community and achieve weight loss and physical goals that are comparable to those achieved in the DPP.     

COVID-19 vaccine uptake before and after a vaccine mandate at a major academic hospital: Trends by race/ethnicity and level of patient contact

ObjectivesTo assess vaccine coverage rates before and after implementation of a COVID-19 vaccine mandate among Health care Personnel (HCP) and demographic characteristics associated with vaccine uptake Design, Setting, and Participants: Cohort study conducted among 10,889 hospital employees followed from Dec 16, 2020 - October 31, 2021, at a large academic hospital in Philadelphia. Main Outcome and Measures: Time to COVID-19 vaccination and vaccine series completion rates before and after implementation of a COVID-19 vaccine mandate based on age, gender, race/ethnicity, and level of patient contact/occupational group.ResultsThe vaccination series completion rate was 86.0% prior to mandate announcement, and increased to 98.7% after mandate implementation. Rates before mandate announcement were highest among Asians (96.2%), Whites (94.0%), males (89.7%), employees ≥ 65 years of age (95.2%), and employees with direct patient care (physicians, 99.0%, and nurses, 93.3%). Hospital educational initiatives (including Town Halls and discussions with Black and Hispanic employees with the lowest vaccination rates) appeared to improve uptake. The largest increase in series completion after mandate announcement occurred among Blacks, those of other/multiracial backgrounds, and Hispanics (35.6%, 22.4%, and 10.8%, respectively) as well as those with some or no direct patient contact (24.5% and 18.3%, respectively). Medical or religious exemptions were approved for 64 (<0.6%) employees and 38 (<0.4%) left their positions (8 voluntary, 30 involuntary) specifically due to the COVID-19 vaccine mandate. No clinically meaningful differences by age, gender, or race/ethnicity for those who were vaccinated under the mandate versus those who left their positions were noted.Conclusions and RelevanceThese results suggest that while mandates may be challenging to institutions and enforcement unpopular, they play an important role in reducing hesitancy and securing high vaccination rates among HCP, a group at high risk of COVID-19 given their employment and who can be a source of disease transmission to patients.     

Prevalence and Risk Factors of Dyslipidemia among Type 2 Diabetes Patients at a Referral Hospital,North Eastern Ethiopia

BackgroundThe prevalence of diabetes and its associated complications rising in Ethiopia ranged from 2.0%–6.5%, the primary cause of morbidity and mortality with consequential economic impact. This study aimed to assess the prevalence and risk factors of dyslipidemia among diabetes follow-up patients.MethodsInstitution-based cross-sectional study was conducted at Debre Berhan Referral Hospital from January to March 2020 in 347 Adult type 2 diabetes follow-up patients using a convenient sampling technique. Data were collected by interviews and entered using Epi-data 4.2 and analyzed using SPSS version 25. Factors having a p-value < 0.25 in the bi-variable logistic regression model were entered into a multivariable logistic regression model. Statistical Significance was declared at a p-value ≤ of 0.05.ResultsThe prevalence of dyslipidemia among type 2 diabetes patients in this study was 59 %. Significantly associated variables were being female [AOR 2.6 (95% CI 1.2–3.2), P = 0.011], smoking history [AOR 4.1 (95% CI 2–6.8), P = 0.001], Being overweight [AOR 3.5 (95% CI 1.6–7.8), P = 0.002], Being obese [AOR 4.8 (95% CI 1.7–13), P = 0.002].ConclusionPrevalence of dyslipidemia was high among diabetic patients, which accounts for 59%. Being female, smoking history, being overweight, and being obese were determinants of dyslipidemia. Patients with poor glycemic control need additional lipid-lowering therapies to prevent secondary Atherosclerotic vascular complications.