某客车制造企业个体噪声暴露水平的 职业危害风险评估

目的 监测某客车制造企业工人个体噪声水平,评估该企业工人由于噪声暴露所致的听力损失以及噪声性耳聋风险水平。方法 对某客车制造企业35名工人进行个体噪声监测,运用噪声职业病危害风险管理指南法对个体噪声8 h工作日等效声级（L EX,8h）≥80 dB(A)的岗位进行噪声风险评估。结果 噪声强度≥85 dB(A)的工人有21名,占60%（21/35）;预测暴露年数≤30年时,发生高频听阈损失和职业性噪声聋风险等级最高的是铸造车间打磨工和涂装车间重抛光工,为较高风险;暴露年数>30年时,发生高频听阈损失和职业性噪声聋风险等级最高的是涂装车间重抛光工,为高风险。结论 该企业噪声危害较为严重,应采取改进工艺措施降低噪声水平,加强个人防护,建立听力保护计划等方案保护工人听力健康。     

晋江市某热电厂噪声对工人听力影响的调查

目的了解晋江市某热电厂噪声环境作业工人听力损伤的特点,为制定控制措施提供依据。方法2013—2015年连续3年对热电厂进行职业卫生调查,以噪声作业车间工人150人为噪声组,无职业危害作业人员50人为对照组,进行纯音听阈测定,比较两组人员听力状况,并对噪声组听力损失进行统计分析。结果所有车间工种噪声属于连续稳态噪声,接噪工人均佩戴耳塞或耳罩,个人防护较好。噪声作业组高频听力异常检出率(28.7%)比对照组(6.0%)高,语频听力异常检出率(16.7%)也比对照组(2.0%)高;接噪各工种高频听力异常检出率和语频听力异常检出率差异均无统计学意义;听力损失检出率随工龄、年龄的增长呈增高趋势,但未检出噪声聋病例。结论该热电厂高强度噪声引起作业人员听力损伤,应加强职业病防护措施,以降低职业性噪声聋的危害。     

2021年四川省噪声作业人员高频段听力损失情况分析

目的 分析四川省噪声作业工人高频段听力损失和疑似职业性噪声聋病例分布情况,为预防和控制职业性噪声聋提供参考。方法 收集2021年四川省所有职业健康检查机构上报的噪声作业工人体检资料,采用SPSS 26.0软件对其高频段听力损失、疑似职业性噪声聋病例等指标进行统计分析,以P<0.05为差异有统计学意义。结果 共收集379 375名噪声作业工人职业健康检查资料,疑似职业性噪声聋检出率为0.09%,噪声作业职业禁忌症检出率为1.20%,高频段听力损失检出率为7.59%,语频段听力损失检出率为0.63%,高血压检出率为12.12%,心电图异常率为16.60%。高频段听力损失人员以男性、35～60岁人群居多,主要集中在中小型制造业和采矿业,地区分布以成都、德阳和广元为主,听力损失率随年龄和工龄的增加而升高。结论 2021年四川省噪声危害暴露基数较大,听力损失检出率偏高,应加大对重点人群、重点行业与中小型企业的综合性预防措施,降低职业性噪声聋的发生。     

湖北省噪声作业工人职业健康检查情况分析

对湖北省171179名噪声作业工人职业健康检查发现,高频听力损失检出率10.20%,职业禁忌证检出率4.87%,疑似职业性噪声聋检出率0.33%;职业禁忌证和疑职业性噪声聋检出率以非金属矿采选业最高,高频听力损失检出率以汽车制造业最高。应加大对重点行业接噪工人职业健康检查工作的重视程度,加强监测干预力度。     

新疆某企业2016年接触噪声为主要职业病危害因素的劳动者职业健康检查结果分析

目的 了解生产性噪声对劳动者听力的影响,及时发现听力受损情况,采取切实有效的措施.方法 对新疆某企业2016年215名接触噪声为主要职业病危害因素的劳动者进行职业健康体检并对检查结果进行分析.结果 接噪时间＜ 10年组、11～20年组和＞20年组听力损失发生率分别为6.62％、18.92％、22.22％,听力损失发生率随接噪时间增加而增加.结论 长期处在噪声环境中,在噪声强度相近的情况下,听力损失与工人的年龄、接噪时间有一定的联系,有随着工龄和年龄的增长而增加的趋势.因此建议加强职业健康监护,采取防护措施,控制职业性噪声聋发生,保证噪声岗位人员的身体健康.     

河北省某炼铁厂噪声暴露致作业人员听力损失的定量风险评估

目的 了解某炼铁厂作业工人噪声暴露情况,并对噪声致听力损失情况进行风险评估.方法 选取河北省某炼铁厂的主要噪声暴露岗位,测量噪声强度,运用ISO1999.2013《声学噪声引起的听力损失评价》中的风险评估方法计算作业人员高频听力损失风险,并依据AQ/T 4276-2016《噪声职业病危害风险管理指南》进行风险分级.结果 所有岗位的LEX.8h均超过我国职业接触限值.男性员工40、50、55、60岁时单纯因噪声发生高频听力损失的风险分别为0.0％～8.5％、4.6％～19.9％、6.4％～22.8％和6.8％～21.9％,女性员工40、50、55、60岁时发生高频听力损失的风险分别为0％～5.0％、0％～13.6％、0％～20.8％和5.4％～22.6％,男性高于女性(Z=339.5,P=0.019).各噪声岗位作业人员单纯因噪声致高频听力损失的风险随噪声暴露年数的增加而增加(r=0.716,P＜0.01),且与噪声强度呈正相关(r=0.504,P＜0.01).结论 ISO1999:2013法可评估噪声致听力损失的风险,在职业活动中,应加强对噪声作业场所中男性和年龄较大劳动者的管理和保护.     

三资企业噪声作业职业危害调查分析

目的：了解天津市河东区三资企业噪声作业职业危害状况。方法：重点调查了8家企业405名从事噪声作业的工人和作业环境。结果：现场监测噪声作业点73个，点合格率9．59％，检出高频和语频听力损失132人次，噪声作业工人随着接噪工龄的延长，接噪级的增加高频和语频听力损失的阳性率逐渐提高。结论：增强职业卫生监督执法力度，实施行之有效的声学控制措施，从中青年抓起，预防职业性噪声聋疾病的发生。     

对甘蔗制糖噪声的3种风险评估方法研究

目的 探讨3种风险评估方法在甘蔗制糖噪声危害预测的应用,比较不同评估方法的差异,以期为噪声风险评估与管理提供科学依据。方法 选择南宁某甘蔗制糖生产企业的分蜜岗位为研究对象,使用EASC-IHSTAT软件进行噪声检测数据分析,结合噪声职业健康检查结果,应用我国职业病危害作业分级、澳大利亚职业安全健康危险度评估方法、国际标准化组织(ISO)噪声引起的听力损失评估法对其噪声危害进行风险评估,对评估结果进行分析。结果 检测数据统计分析显示,分蜜岗位噪声8 h等效声级为(86.7±1.6)dB(A),检测及统计超标率分别为88.9%、84.5%,噪声暴露风险不可接受。3种风险评估方法中,我国职业病危害作业分级结果为Ⅰ级轻度危害,适用于噪声严重健康危害后果评估;澳大利亚职业安全健康危险度评估中高频听力损失为重大风险、职业性噪声聋为高风险,更适用于评估噪声轻微健康危害后果;ISO噪声引起的听力损失评估体现了动态变化,随着年龄的增长,高频听阈偏移风险由高降低到可接受、职业性噪声聋风险由可接受上升到中等,评估结果更准确且更具客观性。结论 3种方法在甘蔗制糖噪声风险评估中均有一定适用性,可根据需求单独或综...     

深圳市77 319名噪声作业员工听力监测结果分析

目的 了解深圳市噪声作业员工职业健康状况, 为该市预防与控制职业性噪声聋提供科学依据。
方法 按照《国家重点职业病监测与职业健康风险评估工作方案》要求, 收集深圳市噪声作业员工重点职业病监测数据进行统计学分析。
结果 2017年深圳市所监测的噪声作业员工为77 319人, 监测对象听力损失检出率为9.48%, 疑似职业性噪声聋检出率0.28%, 职业性噪声聋检出率0.17%。男性听力损失、疑似职业性噪声聋和职业性噪声聋检出率均高于女性, 差异有统计学意义(P < 0.05)。听力损失、疑似职业性噪声聋和职业性噪声聋检出率均有随年龄增长和工龄增长而升高的趋势(P < 0.05)。来自不同规模、不同经济类型企业的员工听力损失、疑似职业性噪声聋和职业性噪声聋检出率差异均有统计学意义(P < 0.05)。听力损失检出率以大型企业最低, 港、澳、台商投资企业的听力损失、疑似职业性噪声聋和职业性噪声聋检出率均较低。不同行业类型企业听力损失异常率、疑似职业病检出率的差异有统计学意义(P < 0.05), 均以建筑行业噪声作业企业员工最高。
结论 深圳市噪声作业员工职业健康状况不容乐观。亟须加强对中型及以下规模企业、建筑行业等重点企业的专项调查与职业健康风险评估, 采取有针对性的预防控制对策, 预防职业性听力损失的发生。
     

某汽车制造企业噪声作业工人听力损失影响因素分析

目的 了解天津市某汽车制造企业噪声暴露和作业工人听力损失状况，分析可能影响职业性噪声听力损失的危险因素，提出相应防护措施，保护工人职业健康。方法 通过对某汽车制造企业开展职业卫生学现场调查、噪声暴露水平检测、职业健康检查，采用χ²检验、非条件logistic回归分析噪声暴露情况与听力损失之间的关系。结果 噪声作业岗位噪声暴露水平总超标率为22.41%（26/116）,其中焊装车间噪声暴露水平超标率最高，为50.00%;听力损失检出率为11.42%（62/543）,均为高频听力损失；不同接噪工龄、接害种类和婚姻状况比较，差异有统计学意义（χ²=6.648、9.983、4.631,P<0.05）;非条件logistic回归分析表明，接噪工龄、婚姻状况、接害种类在听力损失的影响分析中比较，差异均无统计学意义（OR=1.071～2.047、1.342、0.809～2.070,P>0.05）。结论 汽车制造企业应积极采取有效措施预防生产性噪声对工人健康的危害，加强工作场所噪声治理尤其是焊装车间，做好职业健康监护工作，预防职业性噪声聋的发生。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.