医护人员职业压力现状及管理策略

医务人员长期处于高压状态,如果调整不当会出现一系列身心问题,从而影响医疗质量。深入了解医护人员的职业压力状况、压力影响及减压策略,对处理好医患关系、提高医疗质量及保护医护人员身心健康有着重要意义。     

Agricultural Health and Safety Performance in Australia

ABSTRACT

This study aimed to determine the proportion of Australian farming enterprises with systems and processes that meet current regulatory and industry standards for health and safety. Data from 683 farming enterprises were drawn from a nationally stratified random sample representing seven commodity sectors: beef cattle, cotton, dairy, horticulture, grain growing, sheep, and sugar cane. Results indicated low levels of implementation for farm health and safety plans as well as induction for new workers and contractors. Improvements to control major safety hazards are required for farm machinery and implements, farm vehicles, reducing exposure of children to hazards, and the use of helmets when riding quad bikes, motorbikes, and horses. There were considerable variations between commodity sectors. There remains significant scope to enhance the safety of farmers in Australia.     

Farm Safety Practices and Farm Size in New South Wales

Objective: There is some evidence to suggest that safety on small-area farms may not be high priority due to economic constraints and lack of knowledge. This has important ramifications for injury and economic burden. The objective of this research was to conduct a pilot study to investigate whether small- to medium-area farms implement fewer safety practices than large-area farms. Methods: Farmers were recruited from farm safety training days, field days, and produce stores in rural New South Wales (NSW), Australia. Small- and medium-area farms less than 500 ha (1235 acres) in size were aggregated for analysis and compared with large-area farms (≥500 ha) for survey items, including safety equipment owned and used, safety practices protecting children, barriers to improving safety, and causes of injury. Results: Overall, small/medium-area farms were found to own less safety equipment and to employ less safety practices than large-area farms. In particular, fewer tractors were fitted with rollover protection structures, there was less signage, less hearing protection, and fewer machinery guides. Injury rates were slightly less for small/medium-area farms, particularly involving vehicles. Small- and medium-area farmers were more likely to report lack of skills as barriers to making safety improvements. Conclusion: This pilot study found some evidence that small/medium-area farms implement fewer safety practices than large-area farms. A larger study is warranted to investigate this further, with particular focus on barriers and ways to overcome them. This could have important ramifications for government policies supporting struggling farmers on small/medium-area farms.     

上海市闵行区严重职业病危害企业的职业卫生管理现状及分析

[目的]了解上海市闭行区内严重职业病危害企业的职业卫生管理现状,提出相应的职业卫生管理对策。[方法]采用单纯随机抽样方法抽取该区99家严重职业病危害企业,对其基本情况、职业病危害因素识别、现场职业卫生防护、职业健康监护、职业卫生档案建立等进行问卷调查和专题讨论。[结果]闵行区严重职业病危害企业存在的主要职业卫生管理问题是：①自动化程度不高,职业病危害防护设施不到位,防护设施的配备率仅为69．7％;（参设置警示线、警示标识等警示说明的用人单位约为50％;③应急救援设施设置率仅为49．4％,应急救援工作有待加强。[结论]闵行区严重职业病危害企业的职业卫生管理工作不容忽视,应继续加强职业卫生监督管理工作。     

职业健康安全管理体系在我国的应用

通过国内外文献资料的研究,探寻职业健康安全管理体系(OHSMS)引入我国后的发展轨迹及运用现状,并提出在新标准下企业的管理和生产行为将发生较大的变化。     

医师职业紧张和紧张反应的研究

[目的]评价医师职业紧张和紧张反应强度。[方法]应用职业紧张量表修订版(OSI-R)(1998修订版)对 342名医师(医师组)和362名非卫生部门脑力劳动者(对照组)进行了测试。[结果]医师职业任务得分高于对照组, 差异有非常显著性(P<0．01)。医师的主要紧张源为任务过重、任务不适和责任感。医师仅人际关系紧张反应因子得分显著高于对照组(P<0．01)。医师的职业紧张水平和紧张反应强度随年龄增长而增高,不同年龄段之间差异呈非常显著性(P<0．01);男医师的职业紧张水平和紧张反应显著高于女医师(P<0．01)。[结论]医师职业是个紧张的职业,加强医师业务和医德学习,缓解医患矛盾,减少工作压力可保护和促进他们的健康。     

上海市95家铸造企业职业病危害现况及管理对策

[目的]调查铸造企业的职业病危害状况及职业病防治工作现状,提出职业卫生管理对策。[方法]对上海市7个区县95家铸造企业的职业卫生管理制度、职业健康监护等现状进行问卷调查,并对主要职业病危害因素粉尘、噪声、高温进行监督检测。[结果]铸造行业从业人员中接触职业病危害的劳动者比例大,占30．67％;接触职业病危害劳动者参加职业健康体检率较高,为93．21％;作业岗位主要职业病危害因素粉尘的检测点合格率为86．37％,噪声的检测点合格率为77．83％,高温的检测点合格率为51．49％;检测超标岗位主要集中在铸造落砂、清理、熔炼、浇铸。[结论]上海市铸造企业的职业卫生管理状况基本符合监管要求,但尚未能全面达标;铸造行业的职业病潜在危害不容忽视,应继续加强职业卫生监督管理工作。     

对农药引起敏感性疾病的综合、系统预防体系

由于职业原因，农业从业人员会在劳动中接触大量、不同种类的农药，关于农药对农业从业人员的健康危害已经有大量的报道。因为缺乏适当的预防措施，在这些危害健康的疾病中，呼吸道和皮肤的过敏性疾病，尤其是接触性皮肤炎，已成为最严重的问题。但目前这种系统的、综合的预防体系还没有建立。为此，我们研究农药引起过敏性疾病的病因学和预防医学，主要的研究方法是使用吸入激惹试验对速发性过敏性疾病进行研究，使用贴附试验和豚鼠最大量实验对迟发性过敏性疾病进行研究，现在发展到使用细胞培养。目前，我们试图建立一种系统、综合和连续的预防体系对于发现农药对农业从业人员致敏因素和建立适当的控制措施。根据我们的研究结果，我们的预防体系包括以下6个步骤：通过专业采样调查发现可疑的致敏化学物质和工作环境因素；对致敏化学物质进行文献检索，查找有无致敏作用的相关报道；对致敏因素的可靠性进行证实；如果没有可疑化学物质致敏的相关文献报道，就通过实验研究证实可疑化学物质的致敏作用和机制；建立对农业从业人员工作环境的保护体系。最后，我们希望通过建立区域性的过敏和免疫中心，以便能有效地管理上述的预防体系。     

Development and Reduction of Hypertension and Oxidative Stress among Detergent Industry Workers

Hypertension status and oxidative stress parameters were assessed in 291 workers (hypertensive workers were divided into three grades, non-equivalently) at two detergent production plants, one of which included enzymes in the detergent (n = 138) and another which did not (n = 153), and 45 control workers in another industry three times (at the time of employment, 7 yr later at the time of installation of a filter system, and about 3 yr later). Malondialdehyde (MDA) was measured by high-performance liquid chromatography, antioxidant enzymes and lipid status by ultraviolet-visible spectrophotometry, trace elements by atomic absorption spectroscopy, and blood pressure using an oscilometric device. Prior to filter system installation, enzyme-exposed workers had significantly higher MDA, antioxidant enzyme activities, and prevalence of hypertension, compared with controls. The filter system reduced airborne detergent and enzyme dusts, resulting in a decreased prevalence of hypertension and a significant improvement in workers' oxidative stress indicators. Alterations in antioxidant status may result from the cumulative effect of high levels of detergent and enzyme in airborne dust in the workplace.     

Agricultural Media Coverage of Farm Safety: Review of the Literature

Agricultural media merit increased attention in addressing dynamic changes in safety aspects of one of the nation’s most hazardous industries. Changes in farming, such as larger-scale, new “niche” enterprises and new technologies, bring new forms of risk to the safety of those who live and work on farms and ranches. At the same time, traditional agricultural media—commercial firms that publish farm periodicals and commercial radio/television stations and networks that provide farm programming—are changing dramatically. In the face of media convergence, these enterprises provide an increasing menu of agricultural information services delivered by print, radio, and television, plus a host of new electronic media. This review of literature addressed the role and importance of commercial agricultural media in the United States, the scope and pattern of their safety coverage, and the opportunities they represent. The review involved searches of 14 bibliographic databases, as well as reference lists of relevant studies and contacts with farm safety experts. Analysis of 122 documents suggested that limited focus has been directed to the role of commercial agricultural media in safety decisions on US farms. Findings revealed that they continue to serve an efficient, early-stage role in creating awareness and interest, providing information, forming attitudes, and stirring consideration of farm safety. Potentials are seen as expanding through the interactive features of social media and other new services offered by these media firms. Findings also identified research needs, 100 farm safety topics for reporting, and opportunities for strengthening safety coverage by commercial agricultural media.     

Agricultural Chemical Safety Awareness Program for Farm Wives and Children

ABSTRACT

Agriculture is one of the nation's most dangerous occupations. One of the contributing reasons for this is the use of chemicals. To ensure proper use of pesticides, one of the most dangerous groups of these chemicals, states require Pesticide Applicator Training for people who handle pesticides. Unfortunately, little training is available for people who have casual contact with farm chemicals such as farm wives and children. Because of the acute danger of small quantities of some of these products, as well as the chronic effects of long-term exposure, it is vitally important to promote educating these two groups. With this in mind, The University of Iowa developed an informative program to teach farm wives and children about farm chemical safety. A Farm Chemical Safety Guide was developed which provides details on organizing a program. The guide was disseminated at a training program held for farm safety commu-nity leaders.     

Agricultural Injury in California Hispanic Farm Workers: MICASA Follow-up Survey

ABSTRACT

The authors report here results from the first follow-up survey of the Mexican Immigration to California: Agricultural Safety and Acculturation (MICASA) cohort of community-dwelling immigrant Hispanic farm workers in California's Central Valley. Among 560 participants the authors observed cumulative 1-year injury incidence of 6.6% (all injuries) and 4.3% (agricultural injuries). Increased prospective injury risk was associated with males, US birth, years lived in the United States, family income, and poor self-rated health. Agricultural injuries were associated most frequently with being struck by an object, falls, and cutting instruments, whereas over two thirds of nonagricultural injuries involved motor vehicles. Prevention should focus on safe handling of tools and materials, falls, and motor vehicle safety.     

Impact of Long Farm Working Hours on Child Safety Practices in Agricultural Settings

Objectives: To characterize working hours of adult farm owner-operators and their spouses by season, and to examine associations between working hours and farm safety practices affecting children. Methods: We conducted a secondary analysis of cross-sectional survey data collected as part of an existing study of injury and its determinants. Results: Owner-operators reported a median of 60 to 70 hours of farm work per week during warm weather months, with declines in hours over the winter. Spouses reported similar seasonal patterns, although their median reported hours were much lower. Longer farm working hours by owner-operators were marginally associated with increased exposure of teenagers to farm work hazards. Exposures of young children to worksite hazards rose in association with longer farm working hours by spouses. Conclusion: Exposures of children to farm worksite hazards and demands may be consequences of adult long working hours.     

某医院护理人员工作能力与职业紧张相关性分析

[目的]探讨影响护理人员工作能力的职业紧张和职业心理卫生因素,为提高护理人员的工作能力提供科学依据. [方法]采取职业紧张测量问卷和工作能力指数调查表对某医院545名护理人员进行调查,对获得的数据进行相关与逐步回归分析. [结果]与护理人员的工作能力指数呈正相关的因素是职业心理卫生(P＜0.01);与工作能力指数呈负相关的因素是物理环境、缺乏社会支持、缺乏提升机会、缺乏参与机会、工作前景、工作危险、工作冲突、工作负荷(P＜0.01).引入逐步回归方程的3个因素是职业心理卫生、物理环境和缺乏社会支持. [结论]影响护理人员工作能力的职业因素是多方面的,主要是职业心理卫生、缺乏社会支持和物理环境.     

改变生产流水线工作台作业条件对劳动者职业紧张的影响

[目的]了解改变生产流水线工作台(以下称“工作台”)作业条件对深圳市福田区小型制造业劳动者职业紧张的影响. [方法]对5家小型制造企业261名劳动者采取改变工作台作业条件的人类工效学干预措施进行干预,并与271名对照组劳动者进行比较,分析干预实施效果. [结果]干预后,改变工作台作业条件组劳动者职业紧张测试得分在职业任务、任务冲突、工作环境、紧张反应、心理紧张反应、躯体紧张反应等项目得分低于对照组(P＜0.05).[结论]通过人类工效学措施,合理改变劳动者工作台作业条件和生产环境条件,能有效降低劳动者的职业紧张,应加大对人体功效学措施对降低职业紧张影响的研究力度.     

职业紧张与抑郁障碍

本文综述了职业紧张引起抑郁障碍的作用机制，介绍了研究职业紧张与抑郁障碍的方法及抑郁障碍导致的后果和经济损失。此外，还提出了综合性的干预措施。     

北京市某区职业病危害基本情况调查

北京市昌平区是全市中小企业相对较为集中的区。为了解全区工业企业的职业病危害因素分布、职业卫生状况及其对人体健康的影响，笔者于2006年1～2月对全区工业企业进行了调查分析，以便及时发现问题，为制订职业病防治规划和采取相应的防治措施，提供科学依据。     

放射医务人员压力及相关因素与健康的关系

[目的]探讨放射医务人员知觉压力及相关因素对健康的影响。[方法]采用一般健康量表、中文版知觉压力量表、艾森克人格问卷量表中文版、工作倦怠调查表,对728名放射医务人员进行调查。[结果]不同年龄、不同婚姻状况的放射医务工作人员之间的压力总分差异有统计学意义（F=2.975,P=0.036;F=3.519,P=0.030）;直接接触射线的工作人员压力总分高于间接接触者（t=3.170,P〈0.001）;不同职称之间的工作人员压力总分有统计学意义（F=6.513,P〈0.001）。放射工作人员的知觉压力分值和一般健康量表总分存在正相关（r=0.414,P〈0.01）;多重线性回归显示,知觉压力、神经质、情绪耗竭3个变量对健康均有影响作用（P〈0.05）。[结论]放射医务人员的知觉压力水平可影响其健康状况,应对他们进行有效的健康教育,减轻压力,促进身心健康。     

Safety Assessment of Foods Produced Through Agricultural Biotechnology

Often the main criticism of foods derived from biotechnology is concerns about food safety. Whereas most present-day biotechnology-derived foods are approximately 99% similar to their non-biotechnology counterparts, the scientific community must ensure the safety of the novel aspects of these foods. The three phases of safety assessment are discussed and the concept of substantial equivalence is explained.     

Anthropology in Agricultural Health and Safety Research and Intervention

ABSTRACT

Agriculture remains a dangerous industry, even as agricultural science and technology continue to advance. Research that goes beyond technological changes to address safety culture and policy are needed to improve health and safety in agriculture. In this commentary, I consider the potential for anthropology to contribute to agricultural health and safety research by addressing three aims: (1) I briefly consider what the articles in this issue of the Journal of Agromedicine say about anthropologists in agricultural health and safety; (2) I discuss what anthropologists can add to agricultural health and safety research; and (3) I examine ways in which anthropologists can participate in agricultural health and safety research. In using their traditions of rigorous field research to understand how those working in agriculture perceive and interpret factors affecting occupational health and safety (their “emic” perspective), and translating this perspective to improve the understanding of occupational health professionals and policy makers (an “etic” perspective), anthropologists can expose myths that limit improvements in agricultural health and safety. Addressing significant questions, working with the most vulnerable agricultural communities, and being outside establishment agriculture provide anthropologists with the opportunity to improve health and safety policy and regulation in agriculture.