鞍钢工伤与职业病及其相关费用的分析

目的　探讨鞍钢工伤、职业病及其费用的发生、发展规律, 为建立鞍钢工伤保险收缴模型提供依据。方法　采用流行病学现况调查方法, 对鞍钢集团公司116家企事业单1997年1月~1999年6月所有工业外伤、职业病及其费用发生情况进行调查与分析。结果　事故发生主要集中在黑色金属冶炼及压延加工业、非金属矿物制品业、石油加工及炼焦业(事故率均>3%)等; 事故工亡主要集中发生在普通机械制造业、黑色金属矿采选业(事故工亡率均>3%)等; 职业病发生率以黑色金属矿物采选业位居第一, 其次为非金属矿物制品业、石油加工及炼焦业等; 职业病多为尘肺病, 其次为噪声聋(包括中度和重度听力损伤),个别有焦炉工肺癌、职业性中毒等; 工伤支出费用占工资总额的百分比以铁路运输业为最高(多为工亡事故费用), 其次为黑色金属矿采选业。结论　工伤、职业病的预防与管理应立足于上述行业。     

Current topics for occupational and environmental medicine and physiology in the U.S.A.--with special reference to occupational lung diseases

Current topics for occupational and environmental medicine and physiology in the U.S.A., especially in the National Institute for Occupational Safety and Health (NIOSH), and the University of California, San Francisco, are reviewed. Reduction of the rate for occupational lung diseases is one of the national objectives for occupational safety and health in the U.S.A., and NIOSH has rated it as the top disease of ten-leading work-related diseases and injuries. Current topics for occupational lung diseases--asbestosis, byssinosis, silicosis, coal worker's pneumoconiosis, lung cancer, and occupational asthma & hyperreactivity, and for pathophysiology of airway hyperreactiveness and pulmonary edema are discussed.     

Summary of "Proposed national strategies for the prevention of leading work-related diseases and injuries, Part 1"

Strategies for the prevention of leading occupational health problems have been proposed by the National Institute for Occupational Safety and Health (NIOSH). NIOSH prepared these strategies following publication in 1983 of its suggested list of ten leading work-related diseases and injuries. At a national symposium in 1985, occupational health experts from academia, organized labor, management, professional associations, and voluntary organizations conducted an in-depth evaluation of the prevention strategies for the first five conditions on the list: occupational lung diseases, musculoskeletal injuries, occupational cancers, severe occupational traumatic injuries, and occupational cardiovascular diseases. The strategies were then revised to incorporate improvements suggested at the symposium and were published in booklet form. A summary of the revised strategies is provided.     

Occupational health research in India

India being a developing nation is faced with traditional public health problems like communicable diseases, malnutrition, poor environmental sanitation and inadequate medical care. However, globalization and rapid industrial growth in the last few years has resulted in emergence of occupational health related issues. Agriculture (cultivators i.e. land owners + agriculture labourers) is the main occupation in India giving employment to about 58% of the people. The major occupational diseases/morbidity of concern in India are silicosis, musculo-skeletal injuries, coal workers' pneumoconiosis, chronic obstructive lung diseases, asbestosis, byssinosis, pesticide poisoning and noise induced hearing loss. There are many agencies like National Institute of Occupational Health, Industrial Toxicology Research Centre, Central Labour Institute, etc. are working on researchable issues like Asbestos and asbestos related diseases, Pesticide poisoning, Silica related diseases other than silicosis and Musculoskeletal disorders. Still much more is to be done for improving the occupational health research. The measures such as creation of advanced research facilities, human resources development, creation of environmental and occupational health cells and development of database and information system should be taken.     

Disturbance of respiratory system in workers in smelter plants

Workers from smelter plants are at high risk from lung injuries due to exposure to quartz sand, clay, resin, loams, airborne metals etc. The aim of this study was to investigate the relevance of the problem and the risk of occupational pathology in metallurgy at "ELMA" plant--Troyan. The study revealed decreased number of occupational lung diseases but the percentage rate (about 10%) of registered new cases with occupational lung diseases was maintained. No new cases with mixed silicosis were recorded. The results were compared to respective national data. Slowly evolving forms of diffusely outlined lung chart with late functional breathing disturbances were prevailing. Chronic bronchitis are presented as a polyetiologic paraoccupational disease.     

School employees: the forgotten municipal workers

The occupational health and safety issues of public school employees in large urban areas are many and complex. Crumbling school infrastructure and crowded classrooms are associated with inadequate indoor air quality, asbestos exposure, noisy environments, and enhanced transmission of communicable and infectious diseases. Poor ventilation in vocational education classrooms, duplicator rooms, kitchens, and science laboratories may also contribute to hazardous exposures. Ergonomic hazards may be responsible for increasing rates of musculoskeletal disorders. Other work-related illnesses and injuries now documented among school employees include asthma, mesothelioma, asbestos-related lung cancer, violent assault, voice disorders, and depression. Such a diverse industry with many potentially hazardous activities and conditions calls for a comprehensive research and intervention agenda.     

Status of occupational health and safety in Iran

In recent decades, Iran has had a steadily growing economy with an annual rate of 6% on average. The country's economy is dominantly influenced by oil and natural gas production and related industries like petrochemicals and fertilizers. There are two million job units and sixteen million employees. The occupational health and safety (OHS) system is mainly regulated by two bodies: the Ministry of Health and Medical Education, responsible for occupational health services and legislations; and the Ministry of Labour and Social Affairs, which undertakes the enactment and enforcement of occupational safety legal issues. Inspectorates in each ministry carry out regular health and safety monitoring according to the OHS legislations. The most common occupational health disorders are musculoskeletal problems, respiratory diseases, noise induced hearing loss, and occupational injuries. Because the OHS is a complex system with overlapping responsibilities among the co-responders, its improvement needs well-organized collaboration among Iranian universities, industries, and governmental agencies, and reliable basic data. The present study takes a glance at the situation and activities of the Iranian OHS system.     

Occupational safety and health: progress toward the 1990 objectives for the nation

Occupational safety and health is 1 of 15 areas addressed in the Public Health Service's Objectives for the Nation. This area represents 104 million working men and women and the deaths, diseases, and injuries that result from exposures to hazards in their work environment. Characteristics of public health practice are compared with characteristics of occupational safety and health practice. The National Institute for Occupational Safety and Health (NIOSH), created by the Occupational Safety and Health Act, is discussed. NIOSH has developed a list of 10 leading work-related diseases and injuries. The list is headed by occupational lung diseases. Twenty Objectives for the Nation in the area of occupational safety and health are reviewed, and the status of NIOSH efforts toward their attainment is discussed. Five categories of objectives are covered: (a) improved health status, (b) reduced risk factors, (c) improved public and professional awareness, (d) improved service and protection, and (e) improved surveillance and evaluation. The potential for achieving these objectives is discussed, with special attention given to the lack of a data base for monitoring progress. A major conclusion is that surveillance in occupational safety and health needs to be strengthened.     

Global Estimates of the Burden of Injury and Illness at Work in 2012

This article reviews the present indicators, trends, and recent solutions and strategies to tackle major global and country problems in safety and health at work. The article is based on the Yant Award Lecture of the American Industrial Hygiene Association (AIHA) at its 2013 Congress. We reviewed employment figures, mortality rates, occupational burden of disease and injuries, reported accidents, surveys on self-reported occupational illnesses and injuries, attributable fractions, national economic cost estimates of work-related injuries and ill health, and the most recent information on the problems from published papers, documents, and electronic data sources of international and regional organizations, in particular the International Labor Organization (ILO), World Health Organization (WHO), and European Union (EU), institutions, agencies, and public websites. We identified and analyzed successful solutions, programs, and strategies to reduce the work-related negative outcomes at various levels. Work-related illnesses that have a long latency period and are linked to ageing are clearly on the increase, while the number of occupational injuries has gone down in industrialized countries thanks to both better prevention and structural changes. We have estimated that globally there are 2.3 million deaths annually for reasons attributed to work. The biggest component is linked to work-related diseases, 2.0 million, and 0.3 million linked to occupational injuries. However, the division of these two factors varies depending on the level of development. In industrialized countries the share of deaths caused by occupational injuries and work-related communicable diseases is very low while non-communicable diseases are the overwhelming causes in those countries. Economic costs of work-related injury and illness vary between 1.8 and 6.0% of GDP in country estimates, the average being 4% according to the ILO. Singapore's economic costs were estimated to be equivalent to 3.2% of GDP based on a preliminary study. If economic losses would take into account involuntary early retirement then costs may be considerably higher, for example, in Finland up to 15% of GDP, while this estimate covers various disorders where work and working conditions may be just one factor of many or where work may aggravate the disease, injury, or disorders, such as traffic injuries, mental disorders, alcoholism, and genetically induced problems. Workplace health promotion, services, and safety and health management, however, may have a major preventive impact on those as well. Leadership and management at all levels, and engagement of workers are key issues in changing the workplace culture. Vision Zero is a useful concept and philosophy in gradually eliminating any harm at work. Legal and enforcement measures that themselves support companies and organizations need to be supplemented with economic justification and convincing arguments to reduce corner-cutting in risk management, and to avoid short- and long-term disabilities, premature retirement, and corporate closures due to mismanagement and poor and unsustainable work life. We consider that a new paradigm is needed where good work is not just considered a daily activity. We need to foster stable conditions and circumstances and sustainable work life where the objective is to maintain your health and work ability beyond the legal retirement age. We need safe and healthy work, for life.     

Magnitude and distribution of trunk stresses in telecommunications engineers.

The incidence of back injuries has been shown to be greater in occupations as heavy manual work than light manual work. To plan a programme aimed at reducing the incidence of back injuries in industry those workers at high risk of incurring handling accidents and back injuries need to be identified and a knowledge of the specific occupational factors causing such injuries sought. This has been achieved for telecommunications engineers using epidemiological and radio pressure pill methodologies. The results verify the correlation between the back injury rates and physical work stresses of different occupational groups. The magnitude and relative frequency of trunk stresses in hazardous tasks has been determined and compared with those with lower incidences of back disorders. The study has confirmed that in examining manual handling hazards in industrial male populations a critical value of truncal stress can be applied and used to determine the safety of occupational factors in relation to their potential causing or contributing to degenerative back diseases.     

Occupational hazards of municipal solid waste workers

The removal of municipal solid waste is a job associated with a variety of physical, chemical, and biological hazards. Municipal solid waste workers (MSWWs) have a risk of fatal occupational injuries that is much higher than for the general workforce. Among this group of workers, non-fatal injuries are mainly musculoskeletal. Other common injuries are fractures, ocular trauma, and bites, and diseases include skin and gastrointestinal disorders. Workers at municipal solid waste incinerators are exposed to a variety of concerning substances, such as heavy metals, respirable quartz dust, dioxins, furans, and mutagens. Workers can be protected by using safety procedures on and around garbage trucks and with personal protective equipment. The burden of morbidity due to occupational exposure to bioaerosols and carcinogens among MSWWs is unknown.     

Environmental isocyanate-induced asthma: morphologic and pathogenetic aspects of an increasing occupational disease

Occupational diseases affect more and more people every year. According to the International Labour Organization (ILO), in 2000 an estimated amount of at least 160 million people became ill as a result of occupational-related hazards or injuries. Globally, occupational deaths, diseases and injuries account for an estimated loss of 4% of the Gross Domestic Product. Important substances that are related to occupational diseases are isocyanates and their products. These substances, which are used in a lot of different industrial processes, are not only toxic and irritant, but also allergenic. Although the exposure to higher concentrations could be monitored and restricted by technical means, very low concentrations are difficult to monitor and may, over time, lead to allergic reactions in some workers, ending in an occupational disease. In order to prevent the people from sickening, the mechanisms underlying the disease, by patho-physiological and genetical means, have to be known and understood so that high risk groups and early signs in the development of an allergic reaction could be detected before the exposure to isocyanates leads to an occupational disease. Therefore, this paper reviews the so far known facts concerning the patho-physiologic appearance and mechanisms of isocyanate-associated toxic reactions and possible genetic involvement that might trigger the allergic reactions.     

Occupational respiratory diseases in the Czech Republic

This paper presents the profile of occupational respiratory diseases in the Czech Republic. In a retrospective study the author analyzes structure, causes, occurrence, and trends of occupational diseases. Between 1996 and 2000, a total of 2,127 new cases were recorded, of which 62.0% were pneumoconioses caused by dust containing free silica, 21.0% were occupational asthma or allergic rhinitis and the rest were divided between lung cancer (10.0%), asbestos-related disorders (4.4%) and variety of other respiratory diseases (2.7%). During the period of the investigations, the decreasing trend of occupational respiratory diseases, which began in 1992, has continued.     

The current status and the future of occupational safety and health in Korea

From the 1970s to 2000, the occupational accident rate in Korea showed a continuous decline. However, the rate has remained stagnant since 2000 even when the fatal injury rate has decreased 40% from that year. Injuries caused by being caught in objects have decreased while those caused by slips and falls on same level and falls from the height have increased. In 2010, the non-fatal injury rate per 100 employees was 0.63 while the fatal injury rate per 100,000 employees was 9.74. The construction industry accounted for 40.2% of all fatal injuries, and falls from the height caused 54.3% of the fatality. Musculoskeletal diseases accounted for 78.8% of the non-fatal occupational diseases while cardio-cerebrovascular diseases and pneumoconiosis are the two major fatal occupational diseases. Occupational diseases caused by chemical agents have decreased to 0.6% of all cases. However, there were several social disputes related to occupational diseases caused by low level of chemicals such as leukemia in a semiconductor company. Korea planned to reduce the fatal injury rate and total workday loss by 30% by 2015. In order to achieve this goal, the government will focus on vulnerable groups in collaboration with allies such as professional associations or organizations.     

Occupational health in Australia

Australia is a developed country in the Asia-Pacific Region with a large land area but a small population. Its main economic activities are mining, agriculture and manufacturing, with its service and high-technology industries being the fastest growing sectors in recent years. The regulation and enforcement of Occupational Health and Safety policies are mainly administered by the Industrial Relations Departments of eight State and Territory jurisdictions in the country. A National Occupational Health and Safety Commission coordinates occupational health and safety at the Commonwealth level. In 1987 the six occupational health and safety priorities in Australia were listed as occupational back pain, management of chemicals used at work, occupational noise-induced hearing loss, occupational skin disorders, occupational cancer and mechanical equipment injury. Australia has probably the highest incidence of malignant mesothelioma in the world, although the use of asbestos has been largely phased out. There was an almost explosive “epidemic” of repetition strain injury in the 1980s. Approximately 500 work-related fatalities and 10,000 work-related injuries are notified for workers' compensation every year. In addition, it is estimated that there are several thousand cases of work-related diseases every year, many of which go unreported. Occupational physicians undergo 4 years of specialisation training. Occupational hygienists, nurses and ergonomists receive training supervised by their respective professional organisations. Received: 2 March 1998 / Accepted: 10 March 1998     

Research challenges arising from changes in worklife

Great challenges for occupational health research are set by the rapid changes in the world of work as a consequence of globalization, new technologies, demographic workforce changes, fragmentation of enterprises and work contracts, high time pressures, high demands for learning new skills, and growing worker mobility. The occupational health problems are of 2 types, the persistent and reemerging old problems of occupational injuries and diseases and new challenges from psychological stress, musculoskeletal disorders caused by computerized work, cognitive ergonomics in information-intensive work, the work ability of aging workers, and new trends in occupational allergies. The 3 roles of research, improvement of knowledge, improvement of understanding, and support of the development of work conditions in practice, all call for new initiatives in occupational health research. The new comprehensive strategy for the development and promotion of work ability has been found to respond effectively to these new needs.     

The occupational disease and injury compensatory system in the Czech Republic

The article deals with methods of evaluation of occupational diseases and injuries in the Czech Republic (occupational injuries, occupational diseases and intoxications, other damage caused by work) and with the types of social and financial compensation of patients suffering from the above conditions: Am. J. Ind. Med. 31:381–384, 1997. © 1997 Wiley-Liss, Inc.     

Analysis of incidence rates of occupational diseases in Mongolia, 1986-2006

The purpose of this study was to determine incidence rates and time trends of major occupational diseases in Mongolia. We retrieved information about all 4598 patients from 1986 to 2006 who were diagnosed and registered with occupational diseases by the National Center of Workplace Conditions and Occupational Diseases. There was an increasing trend for new cases as well as for incidence rates of reported occupational respiratory diseases (ORD), musculoskeletal disorders (MSD), cardiovascular diseases, skin diseases, toxic hepatitis, and noise-induced hearing loss. Such a trend may result from both rapid industrialization in Mongolia and increased recognition of occupational disease. Actions must be taken immediately to allocate more resources for prevention and early recognition of occupational diseases, establishment of a comprehensive hazard communication system, and enforcement of all regulations. Key words: occupational diseases, incidence rate, epidemiology, Mongolia.     

Relationships between certain individual characteristics and occupational injuries for various jobs in the construction industry: a case-control study

BACKGROUND: There is little published about the role of individual characteristics in occupational injuries. Construction workers have a high rate of injury; we assessed 11 personal characteristics in this professional sector. METHODS: A case-control study was conducted on 880 male workers who had had at least one occupational injury during a 2-year period and 880 controls. A questionnaire was administered by an occupational physician. Statistical analysis was made via logistic regression method. RESULTS: Young age (<30 years), sleep disorders and current smoker influenced all the injuries combined. Sleep disorders and young age were common risk factors for several jobs. Physical disabilities and no sporting activity had a role in masons, and 5 years or less in present job in plumbers and electricians only. Sleep disorders influenced both the injuries with and without hospitalization; young age, current smoker, and physical disability influenced those without hospitalization only. CONCLUSIONS: Young age, sleep disorders, smoking, disabilities, sporting activity, and experience influenced the occupational injuries. The risk for each worker depended on his job. Occupational physicians could inform the workers of these risks and encourage them to take remedial action.