北京市公共卫生从业人员健康检查现状调查分析

目的 了解北京市公共卫生从业人员健康检查现状,进一步规范公共卫生从业人员健康管理。方法 通过问卷调查、个人访谈了解公共卫生从业人员基本情况、体检情况、培训情况、卫生法规相关知识掌握情况以及满意度等,两两比较采用χ²检验,多因素分析采用多元线性回归。结果 97.0%的人员接受抽血检查,77.6%的人接受X线检查,86.4%的人接受粪便检查,51.0%的人接受皮肤检查,剔除皮肤检查后其他检查项目完成的比例为72.1%。公立医院与民营医院体检相比,X线检查、粪便检查以及剔除皮肤检查后其他检查项目完成的比例差异有统计学意义（ χ²=36.22,P<0.001; χ²=9.09,P=0.003; χ²=31.06,P<0.001）。5道知识全部答对的百分比为3.2%,年龄、工龄、文化程度均与公共卫生从业人员知识得分呈正相关。结论 北京市公共卫生从业人员健康检查存在质量较差、缺乏监管、无法溯源、相关卫生知识知晓率低等问题,需采取针对性措施。     

Excess risk of head and chest colds among teachers and other school workers

BACKGROUND: Work‐related injuries and illnesses in the educational services sector have not been well studied. This analysis examined whether teachers and other school workers are at higher risk of head/chest cold compared to all other workers in the United States. METHODS: Seven years (1998‐2004) of National Health Interview Survey data on currently employed workers were combined to provide a basis for estimating the incidence proportion of head/chest cold. RESULTS: The adjusted odds ratio for head/chest cold was significantly elevated for teachers and other workers employed at schools compared to all other workers. When examined by month, an excess of increased head/chest cold risk during the school year suggested that a portion of head/chest cold among teachers and other school workers is attributable to their workplace, perhaps due to close contact with students at school. CONCLUSION: Head/chest cold, a surrogate for acute respiratory infection, was more common among school workers during the school year and less common during July than for all other workers in the United States. Targeted training for school workers and students may be beneficial to reduce work‐related exposure to viruses and bacteria that infect the respiratory system.     

Employee psychological distress and treated prevalence by indices of rurality

Objective: Although there is population data on the prevalence and treated prevalence of mental disorders by urban‐rural indices, there is a lacuna of information pertaining to employees. This paper examines the prevalence and treated prevalence of psychological distress in employees by urban‐rural indicators. Methods: Cross‐sectional employee Health and Performance at Work Questionnaire responses (n=78,726 from 58 large companies) are interrogated by indices of remoteness (Accessibility/Remoteness Index of Australia), psychological distress (Kessler 6) and treatment‐seeking behaviours for mental health problems. Results: The overall prevalence of moderate or high psychological distress in employees was 35.2%. The prevalence varied only slightly (maximum to minimum difference of 4.6%) by rural/remote indices. Overall treatment‐seeking behaviour for psychological distress was low (22.5%). The percentage of employees seeking treatment for high levels of psychological distress was the lowest in very remote regions (15.1%). Conclusion: Very remote employees are less likely to access mental health treatments and may be an employee subgroup that would benefit from specific employer health interventions aimed to increase treatment‐seeking behaviours. Implications: Employees in very remote Australia could benefit from specific interventions aimed to increase mental health awareness/literacy.     

新疆大型国有企业员工心理健康状况与睡眠质量关系的研究

［目的］ 研究新疆国有大型企业员工不同心理健康状况与睡眠质量的关系。 ［方法］ 采用分层整群抽样法,首先按照新疆国有大型企业体力劳动者相对集中的行业分层,于每层中抽取体力劳动比较集中的工种,再随机从各工种人群抽取调查对象进行问卷调查。分别采用症状自评量表（SCL-90）和匹兹堡睡眠质量指数（PSQI）问卷进行心理健康状态及睡眠质量的调查。 ［结果］ 共调查900 名员工,回收有效问卷858 份,有效率为95.3%。除该人群SCL-90 量表躯体化得分（1.35±0.52）与常模比较差别无统计学意义（P 〉 0.05）外,其余指标均低于全国常模和新疆职业人群常模（P 〈0.05）;心理健康状况阳性组睡眠效率得分（423.39）,与正常组比较差别无统计学意义（P 〉 0.05）,其余PSQI 各因子得分均高于正常组（P 〈 0.05）;多因素logistic 回归分析发现,睡眠质量危险因素有工龄、躯体化、强迫症状和焦虑,并且工龄、躯体化、强迫症状和焦虑与睡眠障碍呈正性关联（分别为β=0.46,OR=1.58;β=0.94,OR=2.56;β=0.52,OR=1.68;β=0.83,OR=2.30）。 ［结论］ 新疆国有大型企业中的体力劳动者,年纪较轻,心理健康状况较好;心理健康状况与睡眠质量关系密切;随着工龄、躯体化、强迫症状以及焦虑程度的增高,产生睡眠障碍的可能性越大。     

Brief Relaxation Training Program for Hospital Employees

Employee stress leads to attrition, burnout, and increased medical costs. We aimed to assess if relaxation training leads to decreased stress levels based on questionnaire and thermal biofeedback. Thirty-minute relaxation training sessions were conducted for hospital employees and for cancer patients. Perceived Stress levels and skin temperature were analyzed before and after relaxation training.     

从业人员戊型肝炎抗-HEV总抗体、IgM、IgG的检测价值

目的加强从业人员戊型肝炎防治和检测工作的科学性,健全从业人员健康管理制度。方法梳理法律法规、标准规范等对从业人员的戊型肝炎检测要求,综合分析有关文献报道,结合重庆国际旅行卫生保健中心监测数据进行讨论,提出建议。结果从业人员戊型肝炎监测有明确的法律法规依据,但具体检测抗-HEV总抗体、IgM还是IgG,存在不明确性。实际执行情况以检测IgM为主。有关科学研究支持检测戊型肝炎抗-HEV总抗体。结论从业人员戊型肝炎监测存在不足,亟需加强管理。建议使用抗-HEV总抗体进行筛查,对阳性者再做IgM和IgG检测,视情况进一步做HEV-Ag和HEV RNA等其他检测。     

服务行业女性从业人员性病、艾滋病认知调查

目的 了解深圳市某娱乐场所从业人员的人口学状况、行为特征及对HIV/AIDS相关知识的知晓程度。方法 利用随机抽样方法,对深圳市某社区13家娱乐场所的245名女性从业人员进行性病、艾滋病知识的宣传教育;教育前后进行现场调查。结果 首次性生活年龄最小13岁、最大25岁,中位数19岁;曾自愿接受HIV抗体检测占9.2%;经常使用安全套的仅占13.6%;教育前:HIV/AIDS相关知识知晓率2.0%(5/245);HIV/AIDS经性传播相关知识知晓率22.0%(54/245);教育后:HIV/AIDS相关知识知晓率16.7%(41/245);HIV/AIDS经性传播相关知识知晓率35.5%(81/245)。结论 娱乐场所从业人员对性病、艾滋病相关知识的了解和安全性行为的认知度低,有必要加强教育,以减少该人群性病和艾滋病的发生,遏制性病、艾滋病由高危人群向一般人群的蔓延。     

Evaluating occupational health and safety programs in the public sector

Background Two case studies are presented of public sector occupational health and safety (OHS) program evaluations, one of an occupational medicine and safety program (OMSP), one of an employee assistance and wellness program (EAWP). Methods Both audits involved interviews with key personnel, review of written documentation and physical resources, chart audits, and surveys of the programs' stakeholders. Results Key findings of the OMSP evaluation were that the various functions were substantially hampered by the absence of an integrated information system. Mechanisms for effective coordination, communication, and feedback were also lacking. The EAWP audit concluded that it provided a valuable and needed service. The mission, staff, facilities, and services offered were in line with the needs of the served community. Discussion Differences between private and public sector OHS program evaluation include programmatic and environmental factors such as resource availability, organizational structure, and accountability. Similarities include trends in both sectors forcing programs to justify themselves in terms of economic benefits to their respective organizations. Am. J. Ind. Med. 34:600–606,1998. © 1998 Wiley-Liss, Inc.     

Statement on national worklife priorities

The National Institute for Occupational Safety and Health (NIOSH) WorkLife Initiative (WLI) [http://www.cdc.gov/niosh/worklife] seeks to promote workplace programs, policies, and practices that result in healthier, more productive employees through a focus simultaneously on disease prevention, health promotion, and accommodations to age, family, and life stage. The Initiative incorporates the Institute's foundational commitment to workplaces free of recognized hazards into broader consideration of the factors that affect worker health and wellbeing. Workplace hazards, such as physical demands, chemical exposures, and work organization, often interact with non-work factors such as family demands and health behaviors to increase health and safety risks. New workplace interventions being tested by the first three NIOSH WLI Centers of WorkLife Excellence are exploring innovative models for employee health programs to reduce the human, social, and economic costs of compromised health and quality of life. Many parties in industry, labor, and government share the goals of improving employee health while controlling health care costs. NIOSH convened a workshop in 2008 with representatives of the three Centers of Excellence to develop a comprehensive, long-range strategy for advancing the WorkLife Initiative. The recommendations below fall into three areas: practice, research, and policy. Responding to these recommendations would permit the WorkLife Center system to establish a new infrastructure for workplace prevention programs by compiling and disseminating the innovative practices being developed and tested at the Centers, and elsewhere. The WLI would also extend the customary scope of NIOSH by engaging with multiple NIH Institutes that are already generating research-to-practice programs involving the working-age population, in areas such as chronic disease prevention and management. Research to Practice (r2p) is a concept focused on the translation of research findings, technologies, and information into evidence-based prevention practices and products that are adopted in the workplace or other "real-world" settings. NIOSH's goal is to overcome the translational issues that now prevent state-of-the-art occupational health, health promotion, and chronic disease research findings from benefiting working age populations immediately, regardless of workplace size, work sector, or region of the country.     

国境口岸从业人员戊型肝炎监测工作亟待加强

目的完善国境口岸从业人员（以下简称从业人员）戊型肝炎监测工作,加强国境口岸预防性健康体检工作的科学性,健全从业人员健康管理制度。方法梳理对从业人员的戊型肝炎检测要求的有关法律法规、管理规范,调查全国主要口岸从业人员戊型肝炎监测情况,结合各地监测数据和全球HE疫情概况进行讨论,提出建议。结果从业人员戊型肝炎监测有明确的法律法规依据。分东南西北中五个区域抽查10个代表性的国境口岸对从业人员戊型肝炎监测情况,结果是做和不做HE检测的分别有4各口岸,有条件地开展的有2个口岸。各地HE疫情依然不容乐观,部分地区有逐年上升趋势。世界各地主要地区都有HE感染报告。结论口岸从业人员戊型肝炎监测存在不足,法律法规和疫情形势都要求亟需加强统一监测管理。     

江苏省综合性医院医务人员心理健康状况调查

目的了解江苏省综合性三级甲等医院医务人员的心理健康状况。方法采用症状自评量表(SCL-90)对江苏省7家综合性三级甲等医院医务人员进行调查,以总均分和躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐惧、偏执、精神病性等10个因子分来评价医务人员的心理健康水平。结果发放问卷1 600份,收回合格问卷1 418份,有效率88.69%。医务工作人员的症状自评量表总均分及各项因子分与国内常模比较,除躯体化因子外其他各因子分均显著低于常模(P<0.05)。医院男性医务人员组的症状自评量表总分,躯体化、强迫、抑郁、焦虑、敌对、精神病性的因子分均显著低于女性(P<0.05),其他因子分无明显差别(P>0.05)。不同岗位医务人员的症状自评量表的总均分及各项因子分差异有统计学意义(P<0.05)。结论江苏省综合性医院医务人员心理健康状况总体好于全国常模,男性医务工作人员健康状况好于女性,不同岗位医务人员心理健康状况有明显不同。     

怀柔区企事业单位女职工更年期症状与保健需求调查

目的:了解怀柔区妇女更年期症状及保健需求,为妇幼保健机构开展更年期健康教育提供依据。方法:随机抽取怀柔区部分企事业单位更年期女职工330人,采用自行设计的封闭式问卷进行调查,对所得资料录入SPSS 10.0统计软件对数据进行分析。结果:妇女更年期症状主要为记忆力减退、潮热盗汗、烦躁易激动、月经紊乱、犹豫焦虑、心悸多疑等,约20%的妇女症状明显;更年期妇女获取健康知识的途径主要为电视、报刊杂志和健康讲座,分别占63.5%、59.8%和57.6%。78%的妇女对更年期保健知识具有强烈的需求,并希望获得医疗保健机构医务人员的帮助和指导。结论:妇女更年期保健知识亟待提高,医疗保健机构应加强妇女更年期的健康教育,以提高妇女更年期健康知识水平和生活质量。     

Fifteen Years of Experience in Cholinesterase Monitoring of Insecticide Applicators

Abstract

Introduction: Measuring cholinesterase (ChE) enzyme levels in red blood cells (RBC) and plasma has become a useful tool in the early detection of organophosphate and carbamate poisoning in insecticide handlers. Since 1974 the State of California has required testing of pesticide applicators to prevent disease. This study is a review of the testing experience of two physicians and using one laboratory so that a comparison can be made to previous studies by the author and others.

Methods: The files of 366 workers who were referred by their employers for ChE activity monitoring were abstracted for patient data, employer identification, and testing data. Results were entered into the EPIINFO program for analysis.

Results: A total of 366 workers from 45 companies were tested over a 15-year period between 1989 and 2004. Most were applicators. There were 690 attempts to establish baselines, of which 545 (79%) were successful. There were 519 monitoring tests on 228 workers, resulting in the removal from exposure of 18 employees, most in 1996. Self-reported exposure history and symptoms resulted in only 3 responses (.6%). The costs were significant ($47,160 total and $36 per test), especially when considering the failure of 145 (21%) employees to establish baselines. There was monthly and yearly variation in plasma and RBC baselines, monthly variance in plasma monitoring tests, and no monthly variance in RBC monitoring. The use of a third baseline test when the first two varied by 15% avoided two false positives. The mean time for recovery from ChE depression was 5.38 weeks.

Discussion: The California ChE monitoring program remains a valuable tool. There was significant monthly and yearly variation in values for both baseline and monitoring plasma and RBC values, with the exception of RBC monthly variance. Self-reported symptoms were not found to be a valuable tool in measuring exposure. Rates of recovery from ChE depression were highly variable. The warning feature of the program was very effective. The costs of monitoring were substantial, but possibly not as great as a single workers' compensation case.

Conclusions: The California ChE monitoring program serves as a useful and cost-effective means of preventing organophosphate and carbamate overexposure. Elimination of the third baseline test requirement should be considered.     

Managed health care plans in Southern United States municipalities: empirical evidence on choice of plan

This study examines factors that influence choice of Southern municipal government health care plans in the United States. Using survey data, this article specifically examines the managed care offerings of Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO) and Point of Service (POS) plans. Some of the more interesting empirical results indicate that HMO plans are associated more with employee satisfaction; PPO plans are associated with cost containment; and POS plans are more likely to provide health care benefits to part-time employees. Empirical evidence also indicates that employee satisfaction is increased when there is a greater choice of managed care plans available to municipal governments.     

Cardiovascular Risk Factors and Physical Activity Behavior Among Elementary School Personnel: Baseline Results from the ACTION! Worksite Wellness Program(*)

BACKGROUND: Although the prevalence of obesity is increasing during adulthood, there have been few assessments of obesity, cardiovascular risk factors, and levels of physical activity among adult elementary school staff. METHODS: Data were collected from 745 African-American and White female school personnel in a suburban school district in southeastern Louisiana as part of the baseline assessment before implementation of a program to improve eating and physical activity behaviors. Anthropometry, blood pressure, serum lipids and lipoproteins, and glucose were measured using established protocols. Physical activity was assessed by accelerometry. RESULTS: For both White and Black females, 30% were overweight (body mass index [BMI]) ≥25 kg/m(2) but <30 kg/m(2) ). Whereas 37% of White females were obese (BMI ≥ 30 kg/m(2) ), 61% of the Black females were obese. There was a positive association between BMI and other cardiovascular risk factors except for high-density lipoprotein cholesterol, where the association was negative. The mean number of minutes of daily moderate-to-vigorous physical activity was <1 minute per day and was lower for overweight and obese women than for normal weight women. CONCLUSIONS: School personnel in the study have adverse cardiovascular risk factors, including high rates of obesity and very low levels of physical activity. Because these individuals are often called upon to promote health for children, they are an important target population for wellness interventions.