消毒供应室护士锐器致伤相关危险因素调查

目的:探讨消毒供应室护士锐器致伤原因及相关因素,为制定合理的职业暴露防护措施提供依据。方法:对都江堰市3家综合医院消毒供应室人员进行锐器致伤问卷调查,评估消毒供应室锐器致伤发生率及其致伤原因。结果:调查共发放问卷36份,收回有效问卷33份,回收率为91.67%。33份有效问卷中共发生锐器致伤事件88例次,平均发生2.7例次/人,其中28人至少发生过1次锐器伤。锐器致伤的主要原因前3位为缝针(31.82%)、手术刀片(22.73%)、剪刀(20.45%)。接受过职业暴露防护培训人员锐器致伤发生例次明显低于未培训人员;低年资人员锐器致伤发生率显著高于高年资人员,与工作时间呈负相关。结论:消毒供应室锐器伤发生率较高,应加强消毒供应室护士锐器损伤防护知识学习,降低职业暴露风险。     

加强供应室工作人员职业感染防护行为的干预效果评价

目的探讨提高供应室工作人员职业感染防护行为的干预方法及效果。方法选取我院供应室15名工作人员,对其行针对性的干预,对干预前后1年工作人员的职业感染防护知识评分及防护依从性评分进行对比。结果干预后工作人员的职业感染防护知识评分、防护行为依从性均明显优于干预前,(P<0.05)。结论给予供应室工作人员针对性的职业感染防护干预可有效的提高其职业感染防护知识知晓情况及依从性,临床效果显著,值得推广和应用。     

供应室工作人员职业暴露防护行为的干预效果分析

目的探索研究针对供应室工作人员职业暴露防护行为进行干预的作用和效果。方法将本医院供应室的工作人员作为研究对象,针对职业暴露感染风险实施防护干预。将干预前后所发生的职业暴露感染事件进行对比。结果实施针对性干预后,供应室工作人员未有效防护、锐器刺伤、血液污染、违规洗手、药物污染等相关职业感染发生率均显著低于干预前(P0.05)。予以针对性干预后,供应室人员的锐器刺伤处理、锐器刺伤上报等相关方面职业暴露感染防护行为评分均显著高于干预前,差异具有统计学意义(P0.05)。结论针对供应室工作人员职业暴露感染实施防护,可以产生显著的效果,能够有效降低工作人员的职业暴露感染率,对于确保工作人员以及患者的健康和安全具有积极意义。     

供应室护士的职业安全与防护

目的 根据消毒供应室的职业危险因素,加强消毒供应室护士的自我防护意识.对供应室进行科学的管理,运用现代防护措施,供应室工作人员的身体健康就能得到充分的保证.     

消毒供应室护士的职业危害分析及自我防护

目的 探讨消毒供应室护士的职业危害因素及自我防护措施.方法 本院自2011年起,针对消毒供应室的职业危害因素,提出以提高护士自我防护意识为主的防护措施,比较2011年12月（观察组）和2010年12月（对照组）的风险事件发生情况及护士对其职业的满意度.结果 较之对照组,观察组的风险事件发生情况明显减少,护士对自身职业的满意度明显提高（P ＜ 0.05）.结论 针对消毒供应室职业危害的防护措施,有助于降低职业危害性,值得推广.     

南昌市肿瘤科护士职业防护情况的调查

目的：通过对医院肿瘤科护士职业危害的调查,了解职业危害的因素,探讨相应的防护对策。方法采用问卷调查方法对南昌市10所医院肿瘤科200名护士发放问卷进行无记名调查。调查内容为肿瘤科护士的职业暴露的危害和防护的现状。结果有160名护士发生职业危害,其中脱发比例最高140名(70%),其次白细胞减少100名(50%),血小板减少60名(30%),流产2名(1%)。结论肿瘤科护士应重视职业危害,加强防护,做好预防性自我防护措施。     

感染科护士职业暴露调查分析

目的 分析感染科护士职业暴露的危险因素及防护措施,以提高护士的自我防护意识.方法 对2006-2010年感染性疾病科从事护理工作人员45名进行调查,分析感染科护士职业暴露的危险因素及防护情况.结果 感染科护士职业暴露发生率高,锐器刺伤所占比例较高.结论 要强化必要防护措施,确保职业安全.     

感染科护士职业暴露的危险因素调查及防护措施

目的探讨感染科护士职业暴露的危险因素及防护措施。方法 2009年1月至2012年3月对我院感染科护士进行职业暴露的危险因素调查及防护情况进行回顾性分析。结果本组调查的职业暴露中被刀、剪、针等锐器损伤及皮肤接触血液为主要危险因素,经防护知识培训干预后与干预前比较,职业暴露的发生率明显减少,与治疗前比较差异显著(P<0.05),具有统计学意义。结论感染科护士在护理操作过程中的危险性相应增加,给护士的身心构成了极大的威胁。应加强护理人员职业暴露防护知识的培训,有效避免和减少职业危害的发生。     

感染科护士职业暴露调查分析

目的分析感染科护士职业暴露的危险因素及防护措施,以提高护士的自我防护意识。方法对2006-2010年感染性疾病科从事护理工作人员45名进行调查,分析感染科护士职业暴露的危险因素及防护情况。结果感染科护士职业暴露发生率高,锐器刺伤所占比例较高。结论要强化必要防护措施,确保职业安全。     

结核科护士职业危害的因素及防护措施分析

目的分析结核科护士职业危害因素,探讨有效防护措施。方法对我院结核科自2010年8月至2011年8月工作的12名护理人员(参考组)进行调查,采用调查问卷方式对护理人员出现的职业危险因素进行调查并采取有效的防护措施,采用相同问卷对2011年9月至2012年9月结核科13名护士(观察组)进行调查,比较实施先后职业危险因素变化及发生职业传染情况。结果生物因素、物理因素、化学因素、心理社会性因素是主要的职业危险因素,采取有效防护措施后,观察组护士发生职业感染明显少于参考组,P<0.05,有统计学意义。结论熟练掌握结核科职业危险因素并采取有效措施预防,加强对护理人员的宣传教育有助于减少职业感染的发生。     

Sensory irritation as a basis for setting occupational exposure limits

There is a need of guidance on how local irritancy data should be incorporated into risk assessment procedures, particularly with respect to the derivation of occupational exposure limits (OELs). Therefore, a board of experts from German committees in charge of the derivation of OELs discussed the major challenges of this particular end point for regulatory toxicology. As a result, this overview deals with the question of integrating results of local toxicity at the eyes and the upper respiratory tract (URT). Part 1 describes the morphology and physiology of the relevant target sites, i.e., the outer eye, nasal cavity, and larynx/pharynx in humans. Special emphasis is placed on sensory innervation, species differences between humans and rodents, and possible effects of obnoxious odor in humans. Based on this physiological basis, Part 2 describes a conceptual model for the causation of adverse health effects at these targets that is composed of two pathways. The first, “sensory irritation” pathway is initiated by the interaction of local irritants with receptors of the nervous system (e.g., trigeminal nerve endings) and a downstream cascade of reflexes and defense mechanisms (e.g., eyeblinks, coughing). While the first stages of this pathway are thought to be completely reversible, high or prolonged exposure can lead to neurogenic inflammation and subsequently tissue damage. The second, “tissue irritation” pathway starts with the interaction of the local irritant with the epithelial cell layers of the eyes and the URT. Adaptive changes are the first response on that pathway followed by inflammation and irreversible damages. Regardless of these initial steps, at high concentrations and prolonged exposures, the two pathways converge to the adverse effect of morphologically and biochemically ascertainable changes. Experimental exposure studies with human volunteers provide the empirical basis for effects along the sensory irritation pathway and thus, “sensory NOAEC_human” can be derived. In contrast, inhalation studies with rodents investigate the second pathway that yields an “irritative NOAEC_animal.” Usually the data for both pathways is not available and extrapolation across species is necessary. Part 3 comprises an empirical approach for the derivation of a default factor for interspecies differences. Therefore, from those substances under discussion in German scientific and regulatory bodies, 19 substances were identified known to be human irritants with available human and animal data. The evaluation started with three substances: ethyl acrylate, formaldehyde, and methyl methacrylate. For these substances, appropriate chronic animal and a controlled human exposure studies were available. The comparison of the sensory NOAEC_human with the irritative NOAEC_animal (chronic) resulted in an interspecies extrapolation factor (iEF) of 3 for extrapolating animal data concerning local sensory irritating effects. The adequacy of this iEF was confirmed by its application to additional substances with lower data density (acetaldehyde, ammonia, n-butyl acetate, hydrogen sulfide, and 2-ethylhexanol). Thus, extrapolating from animal studies, an iEF of 3 should be applied for local sensory irritants without reliable human data, unless individual data argue for a substance-specific approach.     

Urinary mutagenicity as an indicator of occupational exposure in a cohort of cosmetologists.

Epidemiological studies suggest a higher risk of hematopoietic disorders including lymphoma among cosmetologists. The etiology of these disorders among cosmetologists is unknown, but beauticians are exposed to a wide variety of chemicals in the workplace. In this study, the urinary mutagenicity of cosmetologists was studied as an indicator of occupational exposure. A microsuspension modification of the Ames assay with Salmonella typhimurium strain TA98 was used to detect direct-acting mutagens and promutagens in urine. A comparable group of teachers of similar age and gender, and living in the same geographic area was used as the control group. There was no elevated risk for urinary mutagenicity among the cosmetologists after controlling for a number of confounders including smoking. In a multivariate model, smoking regularly or within 24 h of sample collection was found to be positively associated with urinary mutagenicity among both groups. The number of cigarettes smoked daily, age, and length of employment were not associated with urinary mutagenicity. Analysis of urine samples collected successively from each participant showed a fair to good agreement between promutagens in samples, suggesting a fairly constant exposure to promutagens.     

Environmental and occupational exposure to lead as a potential risk factor for cardiovascular disease

We have evaluated current knowledge on relations between environmental and occupational exposure to lead with a strong emphasis on cardiovascular disease risk factors, such as the influence of lead compounds on lipid disturbances and arterial blood pressure. In addition, "novel" biochemical and vascular risk factors for cardiovascular diseases were discussed, as well as the combination of lead exposure and genetic predisposition to cardiovascular diseases. Occupationally and educationally, awareness of the unfavourable effects of lead on cardiovascular diseases risk factors should be emphasised. Indeed, accurate identification of the various mechanisms that might account for the effects of lead on the cardiovascular system should be of the highest priority in this field of research.     

Drinking as conformity; a critique of sociological literature on occupational differences in drinking

Research on occupational differences in drinking has focused on deviant drinking. The deficiencies of this perspective are discussed, and a subcultural theory is proposed.     

职业健康监护在职业病防治中的作用探讨

目的为广大企业尤其是中小企业职业卫生工作进行合理有效的监督管理和服务提供线索。方法通过对日常职业卫生监督工作中遇见的2个具体案例进行分析。结果2个案例中，1个通过开展职业健康监护，及时发现了14名员工白细胞异常，避免了一起群体性苯中毒事故的发生；另外1个由于没有开展上岗前职业健康检查，从而导致职业性轻度噪声聋的发生。结论职业健康监护能有效的防止职业病的发生。     

职业病门诊患者职业卫生健康教育效果探讨

目的 通过对我院职业病门诊就诊病人进行职业健康教育,使患者掌握更多的职业卫生知识,提高自我保护能力,预防职业病的发生.方法 以随机性地对就诊前、就诊期间、检查与治疗期间以及就诊后等不同时间的患者进行针对性职业卫生健康教育,并以提供问题解答、职业卫生健康教育宣传手册等方法.结果 通过各种形式的职业卫生健康教育,使患者对职...     

Serum clara-cell protein and beta2-microglobulin as early markers of occupational exposure to nitric oxides

Biochemical effects of NOx on 60 workers (both genders) of nitric acid production were studied. The control group consisted of 61 nonexposed people employed elsewhere in the plant. Although the actual threshold limit valuetime weighted averages (TLV-TWA) were not exceeded in the specific conditions of our study, the subjects were exposed to NO2 and NO during several exposure episodes with peak maximal concentrations of 140 ppm and 515 ppm, respectively. Additional cross-week evaluation of several biochemical biomarkers in 15 NOx-exposed workers from one shift was performed. The objective of the study was to evaluate the value of serum Clara-cell protein (CC16) as a marker of bronchoalveolar epithelium activity. Antioxidant status was assessed by measuring activity of enzymes: glutathione peroxidase (GSH-Px), ceruloplasmin (Cp) in plasma, or superoxide dismutase (SOD), gluthatione S-transferase (GST), and nonenzymatic alpha-tocopherol in erythrocytes and thiobarbituric acid-reactive substances (TBARS) in plasma. Serum hyaluronic acid (HA) determining the connective tissue matrix status of airways, and beta2-microglobulin in serum (beta2M-S) and urine (beta2M-U) as a marker of renal function in occupational exposure to NOx were also employed. Exposure to NOx initiates peroxidative chain depleting of lipoprotein pool (alpha-tocopherol) in blood. Serum CC16 levels in NOx-exposed workers were found to be closely connected with alpha-tocopherol content. In NOx-exposed workers, the beta2M-S level was significantly higher than in the nonexposed ones, with the exception of smokers. Results of the cross-week study confirm cumulative systemic effects of NOx on several examined biomarkers. SOD and GST were found to be depleted. A transient higher level of HA after a 5-d shift significantly inversely correlated with CC16 level. The data imply that NOx-depleted levels of CC16 are detectable already after an 8-h shift. Our results demonstrate that even low NOx human exposure can cause characteristic changes in bronchiolar epithelium cells and renal effects. Serum CC16 level, although a nonspecific marker, was lowest in NOx-exposed subjects. The most sensitive parameters in exposed workers were beta2M-S and a-tocopherol. Spirometric assessment was not useful to describe low occupational exposure to NOx. In studying the effects of NOx on biomarkers, it is essential to carefully select suitable time of sampling. Screening of CC16, beta2M-S, and a-tocopherol can be successfully employed for biological monitoring of exposure to NOx.