山西部分煤矿接尘工人生活质量与工作相关因素的关系研究

目的了解山西煤矿接尘工人生活质量的工作相关影响因素,为有针对性地制定提高矿工生活质量的干预措施提供科学依据。方法以班组为单位,整群抽样随机抽取山西煤矿接尘工人330名,以问卷形式调查了解接尘工人的工作相关情况,采用世界卫生组织生活质量测定量表简表(QOL-BREF)量表对生活质量进行测评。结果本次调查共发放问卷330份,收回有效问卷305份,应答率为94%。生活质量生理领域得分影响因素为:工作年限、福利满意情况、工作的社会地位和工作危险情况。心理领域得分影响因素为工种、日工作时间、福利满意情况、工作的社会地位和工作危险情况。社会领域得分影响因素为:工种、日工作时间、时间制度、福利满意情况、工作的社会地位和工作危险情况。环境领域得分影响因素为:时间制度、福利满意情况、工作的社会地位和工作危险情况。结论生活质量生理、心理、社会和环境4个领域得分与诸多工作因素存在相关关系,据此可制定相应的卫生保健干预措施,提高煤矿接尘工人生活质量。     

山西省煤矿接尘工人工作相关因素与生存质量关系研究

目的评价山西省煤矿接尘工人的生存质量,并探讨其与工作相关因素的关系。方法选取山西省7家煤矿的2 300名接尘工人为调查对象,采用自编的工作相关因素问卷以及健康状况量表(SF-36)生存质量量表进行调查,采用SPSS 13.0统计软件进行分析。结果煤矿接尘工人生存质量7个维度的得分偏低。总的工作年限、井下工作年限、接尘工龄等16种因素与生存质量的生理领域和心理领域有关系(P<0.05)。结论影响煤矿接尘工人生存质量的工作相关因素是多方面的,需采取综合措施提高其生存质量。     

煤矿接尘工人职业任务现状调查研究

目的探讨煤矿接尘工人职业任务与社会人口学、生活习惯、疾病史、职业因素、工作特征的关系。方法采用分层整群抽样方法抽取山西省煤矿工人2300名进行一般情况问卷和职业任务量表调查。结果煤矿工人职业任务的重点人群特征为:年龄>40岁,来自市区,经济状况较差,吸烟,饮酒,身体状况较差,井下工作、接尘时间>6年,工作危险度大,社会地位较低等。结论煤矿接尘工人面临着较重的职业任务,可制定相应的卫生政策减轻煤矿工人职业任务。     

某玻璃厂矽尘对作业工人呼吸系统危害的调查

目的 探讨某玻璃厂矽尘对作业工作呼吸系统危害的程度。方法 对某玻璃厂的生产环境进行流行病学调查,并对373例接尘工人进行职业健康体检。结果 该厂生产环境矽尘浓度在0．9mg／m^3～10．7mg／m^3之间,矽尘中游离SiO2含量为24．0％～60．6％。373例接尘工人大都有咳嗽、胸闷、气短等症状。慢性鼻炎检出率20．11％,慢性咽炎占8．85％,眼结膜炎占9．12％。证实了长期接触粉尘可引致呼吸道症状和上呼吸道疾病。接尘工人中,肺纹理增多、增粗并有网影者占47．3％,诊断无尘肺(0^ )2例。由于该厂矽尘浓度超标,矽尘中游离SiO2含量较高,应做好通风防尘工作,加强个人卫生防护。结论 某玻璃厂矽尘对作业个人呼吸系统危害较大,应做好控制预防矽尘危害工作。     

山西煤矿接尘工人生存现状研究

<正>生存质量研究是近年来国内外研究的热点,山西省地处北方地区,气候干燥,特别是在矿井中密闭式作业,空气流通差,漂浮粉尘多、时间长,这导致接尘工人职业性肺部疾患的情况更加突出、严重。有研究表明尘肺患者生存质量降低[1,2],但未患尘肺的接尘工人生存质量的研究较少[3]。本文应用世界卫生组织QOL-BREF量表对山西煤矿接尘工人的生存质量进行调查,以期了解山西煤矿接尘工人生存质量的整体状况。     

粉尘危害及应对措施探析

目的加强作业场所的职业卫生监督管理,促进尘毒危害治理。方法本文通过对容易引起粉尘危害事件工厂的高危地带进行粉尘检测并对作业工人进行健康检查,分析粉尘对人体造成的危害并提出治理措施。结果空气中平均粉尘浓度都在不同程度上超过最高允许浓度,不同工龄的接尘工人相关呼吸道和肺部症状高于非接尘组。结论建议采取分级管理,加强预防,工人定期体检等措施应对粉尘危害,减少环境污染,保护劳动者的生命健康。     

谷物粉尘对呼吸道急慢性损害的研究

对沈阳市面粉厂639名职工进行了上班一天和一周前后的症状和肺功能变化观察．结果发现谷仓工人中，重度接尘组的呼吸道症状发生率非常显地高于轻度接尘组(P<0．005)；通气功能和小气道功能均较对照组差(P<0.05或0．01)，而且上班一天或一周后．肺功能各项指标降低率两组间差异有显意义或非常显意义(P<0．05或0.01)。4年后对其中164名随访，发现重度接尘组症状加重占59．09％．轻度接尘组占40．91%。两组FEV1分别平均下降8．21士12.22％和4．135±11．14%．上述结果表明，谷物粉尘对呼吸道的通气功能、小气道功能均有急性或慢性损害作用．其程度与接尘浓度和接尘时间有关。     

92例直肠癌手术患者生活质量及其影响因素的分析

目的：探讨直肠癌手术患者的生活质量及其影响因素,为制定有效的措施改善其生活质量提供依据。方法：选取直肠癌术后患者92例,采用自制的调查问卷了解患者的一般情况,通过生存质量核心问卷（QLQ-C30）评价患者的生活质量。分析直肠癌手术患者生活质量影响因素和QLQ-C30量表功能模块的相关性,通过多元逐步回归分析了解影响直肠癌手术患者生活质量的主要因素。结果：直肠癌手术患者的角色功能、社会功能、疲倦、气促、食欲丧失得分显著低于常模,而腹泻、经济困难得分显著高于常模（P＜0.05）。功能模块、总体生活质量和患者心理状态呈正相关而与造口并发症呈负相关（P＜0.05）;造口术后时间和躯体功能、角色功能、社会功能、总体生活质量均呈正相关（P＜0.05）。多元逐步回归分析结果显示,心理状态、造口并发症、造口术后时间是影响总体生活质量的主要因素。结论：临床上应加强心理疏导、健康宣教等改善患者的生活质量。     

肺癌高龄患者术后4个月内症状和生活质量的变化及其影响因素

目的 研究肺癌高龄患者手术后症状与生活质量变化特点及其影响因素。方法 选取手术治疗的肺癌患者146例作为研究对象,采用焦虑自评量表SAS、抑郁自评定量表SDS和欧洲癌症研究与治疗协作组生活质量核心问卷(EORTC QLQ—C30)评价研究对象焦虑、抑郁情况、生活质量及症状。数据分析采用方差分析和多元线性回归的方法。结果 SAS及SDS结果显示术后1、2和4个月内患者SAS及SDS得分逐渐降低(F=61.215、23.752,P<0.05)。EORTC QLQ—C30问卷结果显示术后4个月内生理、角色、社会、情绪及全身健康状况维度得分逐渐增高(F=9.195、6.868、10.610、16.470、6.472：P<0.05)；疲劳、疼痛、呼吸困难、食欲丧失、失眠得分逐渐降低(F=9.541、40.216、5.739、10.481、7.384：P<0.05)；认知、恶心或呕吐、腹泻、便秘、经济困难无统计学差异(P>0.05)。多元线性回归结果显示术后第1个月症状的影响因素为焦虑、吸烟状况和手术方式(P<0.05),生活质量影响因素为吸烟状况、抑郁及焦虑(P<0.05)；术后第2、4个月症状的影响因素均为焦虑和辅助治疗,生活质量影响因素均为抑郁、焦虑和辅助治疗(P<0.05)。结论 肺癌高龄患者术后4个月内生活质量不断提高,大部分症状在不断改善。术后各个阶段症状及生活质量的影响因素略有不同,医护人员及家属应采取有针对性的措施,改善患者的症状及生活质量。     

余姚市尘肺患者生存质量及影响因素研究

目的了解余姚市尘肺患者生存质量现状及其影响因素,为尘肺病的预防与治疗提供依据。方法选取2009年1月至2012年12月余姚市尘肺病患者作为病例组,非尘肺病者作为对照组,应用《世界卫生组织生存质量测定表简表》（WHOQOL—BREF）、《St George’s呼吸问卷》（SGRQ）和自制问卷进行调查。结果病例组社会关系（53．16±13．74）分、心理健康（50．09±12．93）分、环境（46．21±12．05）分和躯体健康（42．94±11．46）分,得分均低于对照组。病例组活动受限（66．43±18．17）分、呼吸症状（62．77±17．35）分和疾病影响（58．12±15．92）分,得分均高于对照组。多元线性回归分析结果显示：年龄每增加1岁,尘肺患者的WHOQOL．BREF总得分下降0．274分,而SCRQ得分增高0．268分;尘肺患者接尘工龄每增加1年,WHOQOL-BREF总得分下降0．237分,SGRQ增高0．301分。此外,家庭人均收入、Covinsky同病得分、尘肺分期也是尘肺患者生存质量的影响因素。结论余姚市尘肺病患者生存质量较低,其影响因素为年龄、接尘工龄、家庭人均收入。     

护理干预对煤工肺尘埃沉着症患者防治的影响

目的探讨护理质量对煤工肺尘埃沉着症患者生活质量的影响。方法选择笔者所在医院2008年1月～2011年7月收治的126例煤工肺尘埃沉着症患者,随机分为观察组和对照组各63例,观察组实行护理干预,对照组按常规护理,比较两组护理效果。结果观察组呼吸道功能好转率显著高于对照组,住院次数显著低于对照组。结论对煤工肺尘埃沉着症患者进行护理干预,能显著降低患者感染发生率,住院次数明显减少,从而减轻患者痛苦,提高生活质量。     

2009年某县煤工尘肺流行病学调查分析

目的:观察某县2009年煤工尘肺患病情况及其影响因素,为制定相应的预防措施、降低煤工尘肺的患病率提供理论依据.方法:对某县2009年煤工尘肺患病情况进行分析.结果:某县2009年煤工尘肺患病率3.89%,以Ⅰ期煤工尘肺为主.不同工种煤工尘肺患病率不同.掘进325.45%,采煤工3.53%,井下运输工1.19%,其他工种1.52%,各工种间煤工尘肺患病率差异均具有显著性(P<0.05).煤工尘肺患者的平均接尘工龄为10年,以接尘工龄5～15年患病率最高,患病率与接尘工龄呈正相关(R=0.81,P<0.05);接尘工人各工龄段.主要以Ⅰ期煤工尘肺为主.但随着接尘工龄的增加Ⅲ期煤工尘肺的患病率也在增加(P<0.05).结论:某县2009年煤工尘肺患病率较低,以Ⅰ期煤工尘肺为主;不同的工种之间煤工尘肺的患病率不同,其中以掘进作业工人患病率最高;接尘工龄越高,煤工尘肺患病率越高.病情也越严重.     

Ocular findings in coal miners diagnosed with pneumoconiosis

Objective: Our study aimed at evaluating ocular findings and structural changes in coal mine workers who were chronically exposed to coal mine dust and diagnosed with pneumoconiosis.

Methods: Ocular findings of 161 eyes of 81 patients diagnosed with pneumoconiosis who had previously worked or are currently working in coal mines were analyzed. Forty-six coal mine workers and sex matched healthy people (n?=?20) participated in the study. Workers who had early changes of pneumoconiosis were included in Group 1 (n?=?17), workers diagnosed with pneumoconiosis were included in Group 2 (n?=?29), and healthy subjects were included in Group 3 (n?=?20). Outcome measures were the difference in peripapillary retinal nerve fiber layer (RNFL) thickness, choroidal thickness (CT), central macular thickness (CMT) and tear function tests between the groups.

Results: RNFL thickness values in Group 1 and 2 were lower than in Group 3, the control group, in all quadrants except the temporal quadrant. However, there was no statistically significant difference in peripapillary RNFL thickness values in any quadrants among the three groups (p?>?0.05). Central subfoveal choroidal thickness and CMT measurements were thinner in Group 1 and 2 than in the control group. However, this difference among groups was not statistically significant (p?>?0.05). Mean schirmer's test result was 8.8?±?1.6?mm in group 1, 7.1?±?1.8?mm in Group 2 and 11.5?±?3.6?mm in the control group. Mean tear break up time (BUT) test result was 7.1?±?1.3?seconds (sec) in Group 1, 6.5?±?1.8?sec in Group 2 and 10.4?±?2.9?s in the control group. The Schirmer's test and BUT test results were both statistically significantly lower in coal mine workers (Group 1 and 2) compared to the control group. Group 1 and Group 2 did not show statistically significant difference in terms of Schirmer's test and BUT test results.

Discussion: The association between pneumoconiosis and coal mine dust contiguity is thought to be due to the effect of coal dust by producing chronic inflammation. In addition, there are several trace elements in coal dust which are toxic to vital tissues. In this study, ocular findings suggest that systemic levels of trace elements and chronic inflammation may not reach to a level that influences ocular structures. Nonetheless, tear functions seem to be affected in coal mine workers.

Conclusion: This study suggests that the systemic effect of coal mine dust in ocular structures is not evident. However, direct contact with coal mine and fume leads to a decrease in tear function tests.     

石场接尘工人肺通气功能检查结果分析

目的 探讨石场接尘工人肺通气功能异常情况.方法 运用流行病学手段,对8间石场260例接尘工人进行肺功能测定(包括FVC、FEV1、MMF、V50、V75),并与246例无接尘正常工人做对照.结果 石场接尘工人肺通气功能显著低于对照组工人,肺通气功能异常有随着工龄增长而增加的趋势,并女工肺功能异常率高于男工.结论 石场接尘人工肺功能有损伤,并在接尘工龄、性别上有差异,因此,提倡加强职业防护,做好粉尘作业工人健康监护.     

Estimation of burden of lead for offspring of female lead workers: a quality-adjusted life year (QALY) assessment

This study demonstrates an empirical example that uses quality-adjusted life year (QALY) as a common metric for occupational health assessment to measure the utility loss of potential lead-exposed children delivered by female lead-battery-exposed workers. A set of nationwide health examination data was used for 1726 lead workers. Among them, there were 649 female workers. The numbers of offspring from female lead workers were estimated by multiplying the age-specific fertility rate (ASFR) by the number of workers in each age stratum. The quality of life assessment for these offspring was assumed impaired by increased absorption of lead using a measure of utility for quality of life that was adapted from Rosser's index of health-related quality of life. The total utility loss was calculated by summing up the loss of QALY for these expected offspring. Dose-response and exposure assessments were based on their mothers' blood lead levels. It was estimated that more than 38 babies were delivered in 1 yr. There would be 19 babies born with blood lead levels over 30 microg/dl, and about 17 babies with blood lead between 10 and 29 microg/dl. The expected utility loss of the babies was estimated to be about 216 QALY, of which 51.6 QALY was attributed to the babies with moderate blood lead level, while that of high blood lead was 164.4 QALY. An effective industrial hygiene program to reduce blood lead to 5, 10, and 15 microg/dl in female lead-exposed workers would decrease the utility loss to 169.5, 126.8, and 92.3 QALY, respectively, in the offspring. An alternative policy of raising the age of female workers by 5 or 10 yr before employment would also reduce the loss to 174.6 or 107.4 QALY. Data suggest that an effective industrial hygiene program should be implemented, and the use of QALY as a common metric for comparative assessment of occupational health policy may be feasible.     

饲料加工企业职业危害情况调查分析

目的了解饲料加工企业的职业危害情况及对作业工人健康的影响。方法对15家饲料加工企业进行职业危害情况调查,同时对工作场所空气中有害因素进行检测和作业工人进行职业健康检查,将资料汇总并进行综合分析。结果工作场所空气中粉尘检测点的合格率为83．7％,噪声检测点的合格率为84．3％。接触组临床自觉症状头痛、头晕、咳嗽、睡眠障碍、皮疹发生率与对照组比较差异有显著性（P〈0．05）;慢性鼻炎、慢性咽喉炎、窦性心动过缓、窦性心律不齐的检出率接触组高于对照组（P〈0．05）。结论饲料加工业对作业工人的身体健康可造成一定职业危害,今后应加强这类企业的劳动保护和做好作业工人的职业宣传教育工作。     

Influence of mineral dust surface chemistry on eicosanoid production by the alveolar macrophage.

It has been suggested that radicals on the surface of dust particles are key chemical factors in the pathophysiology that results from the occupational inhalation of coal and silica dust. In addition, oxygenated derivatives of arachidonic acid (eicosanoids) have been implicated as important biochemical mediators of mineral dust-induced lung disease through their role in bronchial and vascular smooth muscle reactivity, inflammation, and fibrosis. Therefore, we assessed eicosanoid production by the rat alveolar macrophage (AM) exposed in vitro to mineral dusts with varying surface chemical characteristics in order to determine if radicals associated with the mineral dust could influence the production of proinflammatory mediators in the lung environment. Primary cultures of rat AM were exposed to freshly fractured or "stale" bituminous coal dust, as well as untreated silica or silica calcined to 500 and 1100 degrees C. Prostaglandin E2 (PGE2), thromboxane A2 (TXA2), and leukotriene B4 (LTB4) levels in incubation medium were determined by specific radioimmunoassay. When AM were exposed to freshly fractured coal dust, PGE2 production was markedly increased. In contrast, exposure of AM to "stale" dust significantly reduced PGE2 production. Exposure of AM to freshly fractured coal dust resulted in a significant increase in production by AM, while exposure to stale coal dust did not influence AM TXA2 production. Neither "fresh" nor "stale" coal dust had any effect on LTB4 production. In vitro exposure of AM to untreated silica resulted in a significant increase in TXA2 PGE2, TXA2, and LTB4 production compared with control. However, exposure of AM to silica calcined to 1100 degrees C resulted in eicosanoid levels that were not significantly different from control. These effects were still apparent 8 wk after calcination of the silica particles. Silica was a more potent activator of AM eicosanoid production than was coal, and amorphous fumed silica was a more potent activator of AM eicosanoid production than was crystalline silica. These findings suggest that radicals associated with respirable coal and silica particles may play a key role in the ability of mineral dust to activate AM eicosanoid production and therefore may be important in the pathophysiological consequences of occupational mineral dust inhalation.