广西职业卫生技术服务机构现状调查分析

职业卫生技术机构的稳定与发展,直接关系到职业病防治法能否公正、有效地实施[1].为了解广西职业卫生技术服务机构现状,2006年8月,我们对广西各级职业卫生技术服务机构的人力资源、资质认证和工作开展情况进行了调查,现将结果报告如下.     

上海市职业卫生技术服务机构服务质量调查

目的了解上海市职业卫生技术服务机构的服务水平,为开展职业卫生技术服务监督管理提供技术依据。方法使用调查表对职业卫生技术服务机构的基本情况进行现场调查;采用专家评分法,对职业卫生技术服务机构报告进行评分。结果本次调查中,甲级资质服务机构的预评价报告得分高于乙级的(t=2.189, P=0.042);甲级资质服务机构的控制效果评价和现状评价得分均高于乙级,但差异无统计学意义。公立机构的预评价报告和控制效果评价得分高于民营,差异无统计学意义;而现状评价得分则是民营机构高于公立机构,差异无统计学意义。结论本地区职业卫生技术服务机构的数量和能力不容乐观,需要政府部门积极的政策引导并加大支持力度,尤其要提升乙级和民营机构的服务能力及水平。     

民营职业卫生技术服务机构服务能力调查

为了解为深圳市企业提供职业卫生技术服务的民营职业卫生技术服务机构现状与服务能力，对其人力资源配置、报告及档案的质量、企业对服务机构的满意度等服务能力进行了调查分析。结果显示，技术服务人员不同年龄组学历与职称构成差异有统计学意义（P<0.05）；定期检测报告扣分最多的为现场采样、现场调查及数据结果处理不规范；现场复核扣分主要在职业病危害因素识别与分析以及采样点、采样对象、采样时段的设置上。企业对技术服务机构的技术能力、服务态度及服务效率满意率均在70%以上，对指导和协助企业开展职业病防治工作的满意率仅21.7%。提示民营职业卫生技术服务机构的服务质量和技术水平均需加强。     

合肥市公立与民营机构职业卫生技术服务能力调查比较

  目的  对比合肥市公立与民营机构职业卫生技术服务能力,为完善合肥市职业病防治技术支撑体系提供科学依据。
  方法  通过调查表和现场调查等方式收集相关资料,对合肥市所有具有职业卫生技术服务能力的公立与民营机构的服务资质、人员、设备、服务质量等方面展开分析、比较。
  结果  合肥市共有职业卫生技术服务机构13家,其中公立机构7家,民营机构6家。公立机构中具备职业卫生技术服务资质的有2家,民营机构全都具备服务资质。民营机构技术服务量占比连续3年超过90%,远高于公立机构。合肥市共有职业卫生技术人员284人,各类职业卫生仪器设备548台（件）,其中公立机构专业人员总数、每家机构人员平均数,以及设备总数、每家机构设备数均少于民营机构。公立机构专业技术人员学历、专业结构、职称优于民营机构,公立机构人员年龄更大、工龄更长,而民营机构具备个人资质的人员占比更多,以上差异均有统计学意义（P < 0.05）。公立机构职业卫生检测能力为69.16%,低于民营机构的163.52%。公立机构服务质量总体符合率高于民营机构,差异有统计学意义（P < 0.05）。
  结论  合肥市公立机构职业卫生技术服务规模小,技术人员匮乏;民营机构职业卫生服务质量有待提高。应强化政府意识,加强公立机构建设,提升民营机构的服务质量,以全面提高该市的职业病防治工作能力。
     

温州市职业卫生技术服务机构现状调查与改进建议

目的 掌握温州市职业卫生技术服务机构情况, 为有关部门开展职业卫生监管提供政策参考。
方法 制作调查问卷, 采用普查法, 对所有在温州开展业务的职业卫生技术服务机构的基本情况、人员结构、业务范围、检测能力及其2014-2016年在温州的工作业绩进行调查。
结果 在温州开展业务的职业卫生技术服务机构共有17家, 包括本地机构3家(占17.7%), 外地机构14家(占82.3%); 民营机构15家(占88.2%), 公立机构2家(占11.8%); 甲级机构4家(占23.5%), 乙级机构13家(占76.5%), 无丙级机构; 专业技术人员学历结构呈梭形, 年龄、职称结构呈金字塔型; 外地机构的业务范围、重点检测项目整体实现了全覆盖; 职业卫生技术服务工作业绩逐年增长, 3年累计完成检测、评价8 898家次, 但职业卫生技术服务需求远低于职业卫生技术服务需要。
结论 有关部门应当加强对企业和职业卫生技术服务机构的监管, 在保障企业获得职业卫生技术服务的同时保证其质量。
     

河北省放射卫生技术服务机构现状调查与分析

目的 进一步加强对放射卫生技术服务机构的管理,规范其服务行为,探索对放射卫生技术服务机构的监管对策.方法 设计调查表,对服务机构的基本情况、专业技术人员、设备配置及开展检测项目、工作量等进行了调查.结果 至2019年底,我省共有放射卫生技术服务机构23家,其中疾控和职防院所类8家,占34.8％,第三方(民营)机构类15...     

安徽省职业卫生技术服务机构现状与服务能力调查

为了解安徽省职业卫生技术服务机构能力及资源配置情况,2009年我中心对全省职业卫生技术服务机构现状与服务能力基本情况进行了调查。     

职业卫生技术服务机构质量体系的建立和运行探讨

随着市场经济体制的不断完善和卫生体制改革的进一步深化，职业病防治机构的职能已由依托卫生监督行政执法到向为社会提供职业卫生技术服务转变，《中华人民共和国职业病防治法》明确规定：职业卫生技术服务机构必须由省级以上人民政府卫生行政部门进行资质审定，资质审定的必备条件是申请单位必需有完善的质量体系等。随着市场经济进程的加快．一些外资、合资、民营等职业卫生技术服务机构也会进入我国职业卫生技术服务市场，因此质量体系建立和运行的成功与否将是职业卫生技术服务机构住市场竞争中立于不败之地的根本所在。本文就职业卫生技术服务机构质量体系的建立和运行加以探讨，以供同行参考。     

新形势下传统职业卫生服务机构的职能及发展方向

《中华人民共和国职业病防治法》颁布至今经历了4次修订,每次修订都会根据不同时期的职业病防治策略进行调整更新,不断推进我国职业病防治工作。自《中华人民共和国职业病防治法》第1次修订后,安全生产监督管理局全面接管了用人单位的职业卫生监督管理职责,随后将职业卫生服务市场化促使大量民营机构涌入职业卫生技术服务行业,不断冲击传统职业卫生服务机构。本文通过对传统职业卫生服务机构的发展现状进行综述,总结《中华人民共和国职业病防治法》颁布后,传统职业卫生服务机构在我国职业卫生服务体系中的职能和定位,分析当前形势下传统职业卫生服务机构在职业病防治工作中的地位以及所面临的新问题,同时结合我国基本国情进行探索研究,明确传统职业卫生服务机构在新形势下的发展方向,提出新的职业卫生服务体系模式。     

上海市职业卫生技术服务机构现状调查与技术服务质量分析

目的  掌握上海市职业卫生技术服务机构现状,分析技术服务质量,为完善技术服务体系提供决策依据。 方法  采用统一调查表对上海市20家职业卫生技术服务机构现状进行调查,使用标准的检查表对各机构的技术服务报告质量进行定量评估。对所有机构按资质等级、行业和开展职业卫生技术服务工作时间进行分类,从不同角度分析上海市职业卫生技术服务机构的现状和服务质量。 结果  上海市现有职业卫生技术服务机构20家,其中甲级机构3家,乙级17家,无丙级机构;专业技术人员720人,中级及以上职称人员占50.70%,大学本科及以上学历人员占72.09%;仪器设备平均215台/家,检定合格率97.60%;通过计量认证的检测项目平均131项/家。2015年度每家机构平均完成466份技术报告,其中评价类报告36份,检测报告431份。甲级机构中级及以上职称人员比例、大学本科及以上人员比例、评价类技术报告比例以及四类技术报告的得分均高于乙级机构,差异有统计学意义(P<0.05)。非民营机构中级及以上职称人员、大学本科及以上人员比例以及评价类技术报告比例高于民营机构,差异有统计学意义(P<0.05),但四类技术报告得分差异无统计学意义(P>0.05)。开展职业卫生技术服务的时间≥ 5年的机构其四类技术报告得分均较<5年的机构高,差异亦有统计学意义(P<0.05)。 结论  上海市职业卫生技术服务机构在人力、物力、技术服务能力等方面均有所提升,但各机构间发展不平衡的现象依然存在,职业卫生技术服务需求与供给之间还有差距。各机构在加强自身建设的同时,仍然需要政府支持。     

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.     

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.