新型冠状病毒肺炎疫情下职业健康检查中的感染风险及防护对策

在新型冠状病毒肺炎疫情防控的关键阶段，必须在做好疫情有效防控的前提下，帮助企业安全有序复工复产。在此期间，企业要统筹安排员工的职业健康检查工作。通过分析疫情下职业健康检查可能存在的感染风险，制订出职业健康检查过程中相应的防控对策。建议在职业健康检查的准备工作、检前工作、检中工作、检后处理等四个阶段，合理、规范安排体检工作；确保疫情期间既做到职业健康，又做好疫情防控。     

合肥市2005—2008年急性职业中毒事故分析

目的了解合肥市职业中毒的发病情况,为职业病防治工作提供依据。方法依据该市职业中毒报表和相关统计资料,对2005—2008年所发生的职业中毒进行汇总分析。结果4年间急性职业中毒91例,以一氧化碳中毒(25.3%)、硫化氢(19.8%)为主,主要发生在冶金系统(21.2%)和化工企业(38.5%)。结论合肥市近几年职业中毒事故频发,应加大该市职业卫生监管的力度,有效防范职业中毒事故的发生,提高劳动者的健康水平。     

医务人员职业感染HIV的影响因素及其防护

随着我国艾滋病疫情发展，医务人员因职业感染人类免疫缺陷病毒(HIV)的风险越来越大，防止医务人员职业性HIV感染已成为当务之急。为此，本文对职业性感染HIV的影响因素、防治对策及意外事故处理措施进行了探讨，以增强和提高医护人员的自我防护意识和职业感染的防治水平，从而达到减少职业感染HIV风险的目的。影响医务人员的职业感染：HIV的主要因素包括医务人员的自我防护意识；医务人员的职业暴露和针对职业暴露采取的措施。医务人员需要加强：HIV职业感染知识的教育和防护技能的培训，同时应针对艾滋病(AIDS)职业暴露的特点采取必要的防护措施，还应建立医护人员艾滋病职业暴露风险的保障机制。     

职业卫生管理档案指南

目的根据大中型企业的职业病预防控制的内在规律和运行机制,探讨大中型企业的职业卫生管理档案技术要求。方法根据用人单位职业病防治指南要求,借鉴国际劳工组织文件以及我国既往管理经验,提出企业职业卫生管理档案体系和技术指南,通过同行评议、现场验证以及全国征求意见、标委会审议等方式进行修正完善。结果提出职业卫生管理档案体系,并从11个方面50个细目提出技术要求,具体包括：组织机构和规章制度建设档案、前期预防的档案、材料和设备管理档案、工作场所管理档案、工作场所职业性有害因素监测、评价档案、个人职业病防护用品档案、职业健康监护档案、职业病危害事故的应急救援档案、职业卫生培训档案、职业病诊断管理档案、群众监督档案等。结论该职业卫生管理档案体系和技术指南对用人单位提出了详尽的技术要求,规范化的职业卫生管理档案可为职业病防治效果评估、职业卫生监督和科学研究提供重要的基础数据。     

Risk assessment and health surveillance of pesticide workers

Occupational health has two main objectives: the protection of workers from health hazards associated with the working environment, and the promotion of workers' health. Fundamental aspects of health protection are health risk management, information and training, first aid and medical treatment. Risk management comprises risk characterization, and exposure assessment. Integrating information on the identified hazards and exposure levels, and assessing the likelihood and severity of health effects performs risk characterization. Health surveillance includes medical surveillance and biological monitoring. The physician in charge of the occupational health programme, taking into account the results of the risk assessment process should determine frequency and contents of periodical medical examinations. Pre-employment medical examinations should be carried out in order to determine the physical ability to do the job the candidate is recruited for. Periodical medical examinations are aimed at detecting, in an early and reversible phase, any adverse effect attributable to exposure. A worker should undergo a broad medical examination when returning to work after a significant illness. Records of occupational health programmes should be filed and kept for at least 30 years.     

Management of impaired physicians in Europe

INTRODUCTION: A significant percentage of physicians may be impaired at some point in their career by substance dependence, psychiatric and neurological disease. MATERIALS AND METHODS: Literature review. RESULTS: While the United States and a few other countries have addressed the problem since the 70's, most European countries still have no national or hospital policy to deal with impaired physicians. DISCUSSION: According to European directives on workers' health and safety, the occupational health physician entrusted with medical surveillance of hospital workers is often mandated to manage impaired professionals. CONCLUSIONS: Strategies for early identification, treatment and rehabilitation of impaired physicians are reviewed and suggestions for preventive action in European countries are given.     

医务人员艾滋病职业暴露危险因素评估与防护现况调查

医务人员艾滋病职业暴露是关系到公众及医务人员身体健康和生命安全的公共卫生问题。保护医务人员免受艾滋病职业暴露的威胁已臼益成为艾滋病防治的关键．北京市东城区疾病控制中心率先在北京市医务人员中开展艾滋病职业暴露危险因素及防护现状的调查,旨在了解和掌握医务人员艾滋病职业暴露危险因素及防护现况,为医务人员艾滋病职业暴露防护对策提供科学依据。     

Occupational risk and prevention in the biotechnology industry: a review

BACKGROUND: The biotechnology industry has expanded greatly in the last 20-30 years and has led to a number of applications in different sectors of work, i.e., medical and pharmaceutical, agricultural, chemical, energetic and others. Nowadays hundreds of thousands of workers worldwide are employed in biotechnology plants. Health and safety issues related to such working activities are considered as relevant to workers as well as to the general public. In particular, when compared to traditional biotechnology, modern methods of processing microrganisms have given rise to public concern that they might generate hazards to human beings and to the environment. OBJECTIVES AND METHODS: After summarizing the most important products and fields of application, the paper sets out to detail potential adverse effects for the health of biotechnology workers; in addition, an analysis of the literature highlights the various concepts of primary and secondary prevention. RESULTS AND CONCLUSION: Along with occupational risk factors common to other working activities (i.e. the well-known physical and chemical hazards), the peculiarity of handling microrganisms and/or different biologic systems may induce infections, immunological alterations or non-infective and non-immunologic toxic reactions in the workers involved The need is emphasized for an accurate risk assessment, careful control by means of the current monitoring strategies and implementation of the confinement measures, taking into account the criteria set by Italian legislation for occupational biological risk. Lastly, attention is focussed on examinations for the medical surveillance of workers at risk.     

Occupational health in Brazil

Brazil is a recently industrialised country with marked contrasts in social and economic development. The availability of public/private services in its different regions also varies. Health indicators follow these trends. Occupational health is a vast new field, as in other developing countries. Occupational medicine is a required subject in graduation courses for physicians. Specialisation courses for university graduated professionals have more than 700 hours of lectures and train occupational health physicians, safety engineers and nursing staff. At the technical level, there are courses with up to 1300 hours for the training of safety inspectors. Until 1986 about 19 000 occupational health physicians, 18 000 safety engineers and 51 000 safety inspectors had been officially registered. Although in its infancy, postgraduation has attracted professionals at university level, through residence programmes as well as masters and doctors degrees, whereby at least a hundred good-quality research studies have been produced so far. Occupational health activities are controlled by law. Undertakings with higher risks and larger number of employees are required to hire specialised technical staff. In 1995 the Ministry of Labour demanded programmes of medical control of occupational health (PCMSO) for every worker as well as a programme of prevention of environmental hazards (PPRA). This was considered as a positive measure for the improvement of working conditions and health at work. Physicians specialising in occupational medicine are the professionals more often hired by the enterprises. Reference centres (CRSTs) for workers' health are connected to the State or City Health Secretariat primary health care units. They exist in more populated areas and are accepted by workers as the best way to accomplish the diagnosis of occupational diseases. There is important participation by the trade unions in the management of these reference centres. For 30 years now employers organisations have also kept specialised services for safety and occupational health. Although they are better equipped they are less well used by the workers than the CRSTs. At the federal level, activities concerned with occupational health are connected to three ministries: Labour, Health and Social Security. The Ministry of Labour enacts legislation on hygiene, safety and occupational medicine, performs inspections through its regional units and runs a number of research projects. The Ministry of Health provides medical care for workers injured or affected by occupational diseases and also has surveillance programmes for certain occupational diseases. The Ministry of Social Security provides rehabilitation and compensation for registered workers. In spite of a decrease in the number of accidents at work during the past 25 years, working conditions have not improved. Changes in the laws of social security in the 1970s discouraged registration and reporting of occupational injuries and diseases. In consequence death rates due to accidents increased. With the implementation of the CRSTs, the recorded incidence of occupational diseases has risen, not only because of improved diagnosis, but also because of stronger pressure from the unions and better organisation of public services and enterprises. Received: 24 February 1997 / Accepted: 14 March 1997     

A successful model of Road traffic injury surveillance in a developing country: Process and Lessons Learnt

ABSTRACT: BACKGROUND: Road Traffic Injuries (RTIs) are one of the leading causes of death and disability worldwide with 90% of global mortality concentrated in the low and middle income countries. RTI surveillance is recommended to define the burden, identify high risk groups, plan intervention and monitor their impact. Despite its stated importance in the literature, very few examples of sustained surveillance systems are reported from low income countries. This paper shares the experience of setting up an urban RTI surveillance program in the emergency departments of five major hospitals in Karachi, Pakistan. METHOD: We describe the process of establishing a surveillance system including assembling a multi-institution research group, developing a data collection methodology, carrying out data collection and analysis and dissemination of information to the relevant stakeholders. In the absence of a road safety agency, the surveillance system required developing individual partnerships with industry, police, city government, media and many other stakeholders. Impact of the surveillance is demonstrated by some initiatives in the local trauma system and improvements in road design to effect hazard reduction. CONCLUSION: We demonstrated that a functional RTI surveillance program can be established, and effectively managed in a developing country, despite lack of infrastructure and limitation of resources. Data utilization in the absence of well defined road safety infrastructure within the government is a challenge. More effective actions are hampered by the limited capacity in the transport and health sectors to do in-depth analysis through road safety audits and trauma registries.     

Prevention strategies in industrial hygiene: a critical literature review

Little is known of the extent of use of industrial hygiene prevention and control strategies in actual workplaces. The recent occupational safety and health literature was identified as a potential source for identifying which strategies are being utilized and evaluated as a means of controlling or preventing chemical hazards. Using preestablished selection criteria, the peer-reviewed industrial hygiene literature 1994-1999 was searched for articles describing prevention and control strategies for chemical hazards in actual workplaces. Ninety-two articles were found and categorized by the type of strategy discussed, whether strategies were implemented and evaluated, and by several other categories. Almost three-quarters discussed engineering control strategies, mostly local exhaust ventilation. Administrative strategies, including housekeeping, personal hygiene, and medical surveillance, appeared in about half the articles. Personal protective equipment was considered in one-third of the articles, and primary prevention strategies, such as material substitution, were considered in one-quarter. Intervention effectiveness was not consistently evaluated in these articles. In response to these findings, recommendations are made to improve the evaluation and promotion of effective prevention and control strategies.     

Epileptic disease and fitness for specific jobs involving driving motor vehicles

OBJECTIVE: Analysis of the problems the occupational health physician meets in health surveillance of workers with a clinical history of epilepsy, in order to assess fitness for specific jobs requiring driving of motor vehicles. METHODS: A health protocol was used which required acquisition of all information related to job features, work organization, past and current clinical-functional status of epilepsy and any treatment in progress. SUBJECTS: The cases of four workers with clinical history of epilepsy were examined who were judged to be representative both of the most frequent forms of epileptic disease and of jobs requiring driving of motor vehicles. RESULTS: Application of the chosen health protocol allowed us to make balanced assessments of fitness for the different specific jobs performed by the four workers. DISCUSSION: With the use of this protocol it was possible to protect the health and the safety of both the workers concerned and their fellow workers and also, as far as possible, to respect the occupational competence of such workers. We also addressed the problems related to anti-epileptic drug consumption and in itinere road accidents. Lastly, the different medical-legal aspects of the problem were further investigated, analysing national and international legislation with respect to epilepsy and fitness for driving motor vehicles.     

新医改背景下安徽省乡镇卫生院运行分析

目的：分析新医改前后安徽省乡镇卫生院发展现状,探讨其存在的问题,为进一步完善基层医改举措提供建议.方法：对乡镇卫生院基本情况、人力资源配置、医疗服务、药占比情况进行分析.结果：乡镇卫生院建设和发展滞后;基层人才匮乏,职称和学历偏低;缺乏补偿和激励措施;药占比依然偏大.结论：科学发展乡镇卫生院,建立激励相容的良性共同体;明确政府责任,完善激励制度;加强人才培养,提高业务水平.     

Occupational zoonoses in animal husbandry and related activities

The fact that people working with animals or their products may contract some infections has been known for centuries, before the introduction of the concept of zoonoses. Only recently, at least in Italy, was the prevention of occupational risks taken into account by legislation in spite of the fact that some zoonoses of livestock are of noticeable socio-economic importance. Nowadays some factors such as new production technologies, trade globalization, movements of people, changes in working conditions, are generating new zoonotic and occupational risks, some of which are considered re-emerging. The prevention of occupational zoonoses must be implemented jointly by both veterinary and medical services through prevention and epidemiological surveillance of human and animal health, risk evaluation, diagnosis of infections and working safety. Hopefully, we expect that in the future there will be better interdisciplinary collaboration and that legislation be timely tailored to the need to safeguard working health and safety.     

四川省县级职业健康监护机构现状与发展前景探讨

目的通过对四川省职业健康监护机构的摸底调查,分析四川省职业健康监护机构现状,为做好职业健康监护提出建议。方法 2009年对四川省21个地、市(州)所有职业健康监护机构的摸底调查,同时统计和分析机构的从业人员的学历、职称构成和机构的体检能力。机构开展职业体检项目按GBZ188-2007职业健康监护技术规范的要求进行分类统计。结果全省181个县有77个职业健康监护机构,而机构从业人员以中专占62.88%,初级职称占50.22%,在体检项目上,具有能力的,粉尘为94.80%、中毒为87.01%、特种职业为72.72%,其余项目,70%的机构不具备能力。结论四川省要加强职业健康监护机构的建立,同时加强机构能力建设,做好职业健康监护,加强职业病防治。     

注册安全工程师职业卫生知识培训效果分析

目的 了解注册安全工程师职业卫生知识现状及培训效果,为进一步完善培训提供依据。 方法 采用自填式问卷调查方法,对注册安全工程师职业卫生知识培训效果进行调查。 结果 注册安全工程师对用人单位职责相关知识的知晓率(54.0%~98.8%)、职业病诊断的相关知识知晓率(73.3%~98.2%)较高,对职业健康检查相关知识知晓率(27.8%~98.2%)、基础知识和职业病危害预防与控制的相关知识知晓率(3.8%~96.6%)较低,经培训后大部分知识的知晓率有所升高,与培训前相比差异有统计学意义(P < 0.05或P < 0.01)。 结论 注册安全工程师对职业卫生知识的掌握较为缺乏,虽经培训后提高较为明显,但在职业健康监护、职业病危害的特点与预防控制方面仍较薄弱,可作为今后继续教育的重点。     

Occupational disease in construction work

BACKGROUND: There are very few studies in the Italian and international literature concerning occupational diseases and their prevention in the building industry. OBJECTIVES: The aim of this study was risk assessment in the building industry. METHODS: We analyzed the international literature and the results of our cross-sectional study, which involved more than 1000 workers. RESULTS: The analysis of several studies and of our experience suggests a high occupational risk in this field and shows as main risk factors: noise, dusts, fibers, manual lifting, prolonged static positions, repetitive motions, hand-shoulder and whole-body vibrations, chemicals and weather conditions. In addition, non-occupational risk factors can influence health: e.g., habits and lifestyle, like hypercaloric diet, cigarette smoking and alcohol consumption. CONCLUSIONS: Preventive measures and training initiatives are urgently needed to improve the safety and the health among building workers.     

Occupational health in the Andalusian Fisheries Sector

BACKGROUND: The conditions of work in the fisheries sector are arduous with high rates of occupational accidents. Numerous factors are known that can directly influence the health of the sailor or fisherman both in fishing and merchant fleets. AIM: To evaluate the health status, safety and working conditions in the Andalusian fishing sector. METHODS: Cross-sectional questionnaire study with proportional sampling of the health and lifestyles of fishery workers in 19 of the 23 Andalusian ports. RESULTS: A total of 247 workers employed on 202 craft fishing boats responded. In all 87% of workers reported a current medical condition. The main problems reported were musculoskeletal disorders, respiratory diseases, diseases of the digestive system, eye problems and skin problems. A total of 72% reported taking some self-prescribed medication, and 60% of fishery workers smoked. Nine per cent of fishery workers admitted taking illicit drugs and 3% reported using illicit drugs on board. Diets on board were poorly balanced. While on board, 62% of crews reported a subjective significant worsening of previous health. The lifetime prevalence of accidents was 76%. CONCLUSIONS: Fishery workers had a high prevalence of self-reported medical problems, a high prevalence of self-medication, poor diets and frequently smoked. Self-medication and some medical conditions (diabetes, angina and depression) may reflect a potential failing of health checks and pre-employment checks. National health services and insurance companies dealing with occupational health should focus more on appropriate health checks, illness prevention and health promotion activities for this population.