2009-2011年某化工厂氯乙烯作业工人健康状况分析

目的 探讨氯乙烯慢性接触造成的职业病危害,更好地保护氯乙烯作业工人的健康.方法 分析四川省某职业病防治院2009-2011年对成都市某化工厂在岗职工的职业健康检查资料共350份.结果 2009-2011年氯乙烯接触工人的脂肪肝检出率呈上升趋势,差异有统计学意义(x2 =12.825,P＜0.01).2009-2011年在接触组工人中发现肝血管瘤4例,手指关节异常3例.结论 慢性接触氯乙烯可引起作业工人肝功能损害和脂肪肝,企业应加强监护,保护工人健康.     

海南橡胶生产和初级加工工人恶性肿瘤发病率调查

目的 了解海南橡胶生产和初级加工工人恶性肿瘤发生情况.方法 对海南省9个农场2005年1月1日至2010年10月31日橡胶工人发生恶性肿瘤的情况进行回顾性调查.结果 9个农场年均胶工人数为10320名,发生恶性肿瘤167例,年均粗发病率为279.01/10万,标化发病率为159.03/10万;非胶工14228人,发生恶性肿瘤94例,发病率为113.91/10万,标化发病率为64.93/10万.橡胶工人恶性肿瘤发生率明显高于非胶工,差异有统计学意义(P＜0.01).前5位恶性肿瘤依次是肺癌(17.96％)、肝癌(17.36％)、胃癌(13.17％)、结直肠癌、鼻咽癌,共计116例,占总病例数的69.45％.结论 海南橡胶工人恶性肿瘤发病率较高,但与国内其他地区基本一致.     

广西某工厂三硝基甲苯对眼晶状体损害致白内障的职业危害分析

目的 分析三硝基甲苯(TNT)对作业工人眼晶状体的职业危害,为制定防制措施提供依据.方法 对广西某厂职业接触TNT 300名作业工人进行职业健康检查,了解TNT对眼晶状体职业危害所致白内障的发生情况.结果 300名工人经检查白内障的患病率达18.3％,其中粉碎工与压药工的患病率达38.9％与34.1％,明显高于装药工、包装工及纸筒工的16.7％、10.3％和6.7％,统计学分析显示,不同工种工人白内障发病率差异有统计学意义(x2=23.94,P＜0.01).检查诊断为职业性TNT白内障的55例,其中男52例,女3例;工作环境空气中TNT浓度越高发病率也会越高.结论 预防或降低职业性TNT白内障的发生,应避免TNT的接触累积,作业工人应定期的工种调整.在工作过程中要注意通风,降低工作环境中的TNT浓度,要加强自身防护,严禁在工作场所内饮食.     

职业噪声对作业工人血压的影响

目的探讨职业噪声对作业工人高血压患病的影响,为作业工人慢性病防制和预防提供参考依据。方法对通辽市2016年41家不同类型规模企业接触职业噪声的在岗职工进行职业健康体检,相同企业非接触职业噪声的作业工人进行对照;接触职业噪声作业7 099人,其他非接触噪声作业3 194人。应用SPSS 19.0统计软件进行分析。结果 31～40岁、41～50岁、51～60岁年龄组噪声作业工人高血压患病率(10.49%、36.19%、90.74%)明显高于非噪声作业(5.22%、19.73%、86.12%); 6～10岁、11～15岁、16年及以上工龄组噪声作业工人高血压患病率(17.74%、22.15%、40.52%)明显高于非噪声作业(14.43%、17.82%、30.14%),差异有统计学意义(均P0.05)。进一步Logistic回归分析显示,性别对高血压的患病率没有影响,年龄、工龄、接触噪声作业能提高作业工人高血压的患病率。结论职业噪声能提高作业工人高血压的患病率,应加强职业卫生管理,做好职业防护。     

深圳市某木门制造企业接尘工人职业健康检查结果

目的 分析木尘对作业工人的健康损害,探讨健康监护指标.方法 对深圳市某木门制造企业接触木尘作业工人257名及对照组243人进行职业健康检查.结果 接触木粉尘作业工人临床症状以咳嗽、咳痰、气促、胸部不适为主,检出率分别为18.7％、17.9％、19.1％和19.5％;接尘工人肺功能指标FEV1.0、FVC、FEV1.0/FVC分别为(3 124.3 ±432.7)ml、(4 012.6±465.6)ml、(77.9±8.32)ml,明显低于对照组,差异有统计学意义(t值分别为5.405、3.054、4.122,均P值＜0.01),接尘工人肺功能损害随年龄、工龄呈增长而升高,差异有统计学意义(x2值分别为30.142和14.316,均P＜0.01);高千伏X线胸片结果显示观察组肺纹理增多增粗比例明显高于对照组,差异有统计学意义(x2=6.733,P值＜0.01).观察组还确诊2例尘肺,5例肺结核;对照组确诊1例肺结核.结论 木尘对作业工人呼吸系统和心血管系统有一定的损害,木粉尘暴露是否可致肺组织纤维化病变仍不确定.     

某化工厂过氯酸铵粉尘作业工人健康状况调查

目的 了解过氯酸铵(AP)粉尘对作业工人健康的影响,为其预防措施提供依据.方法 选择该厂接触AP粉尘的36名作业工人为接触组,不接触AP粉尘的48名该厂工人为对照组.调查工厂的一般情况,监测作业场所的AP粉尘浓度,对两组人群进行职业健康体检,检测血常规、肝肾功能、甲状腺激素指标,进行肺通气功能和X线胸片检查.结果 AP总粉尘浓度以组批车间最高,为(51.63±43.27) mg/m3.接触组收缩压[(146.14±21.03)mmHg]明显高于对照组[(134.67±18.58)mmHg],差异有统计学意义(P＜0.05).接触组全身各系统症状(皮粗、皮痒、气短、咳嗽、咳痰、咽干、疲乏无力等)累计检出率、气短及皮痒的检出率分别为86.11％、30.56％、36.11％,均明显高于对照组(66.67％、12.50％、10.42％),差异均有统计学意义(P＜0.05).接触组的游离三碘甲状腺原氨酸(FT3)水平[(1.29±0.20) ng/ml]明显低于对照组[(1.41±0.23) ng/ml],差异有统计学意义(P＜0.01).接触组工人的1秒用力肺活量与用力肺活量百分比值(FEV1.0/FVC)低于对照组,但差异无统计学意义(P＞0.05).接触组检出1例肺部X线影像异常者,并诊断为尘肺,对照组检出1例左肺门区有1约1.0x1.0小结节影.结论 接触组工人的收缩压明显高于对照组,不排除与接触AP粉尘有关;接触组工人的FT3低于对照组,提示长期接触AP粉尘可能会对作业工人甲状腺功能造成影响.     

常熟市2015-2019年噪声作业工人听力状况调查分析

目的 分析对比噪声作业工人听力变化情况,为更好地保护劳动者健康提供依据.方法 分析常熟市2015-2019年职业健康检查中完成听力检查的110903人次噪声检查结果.结果 2015-2019年噪声作业工人听力语频损失检出率19.2％,不同年份在11.7％～22.9％,差异有统计学意义(x2=413.6,P＜0.01),且呈增加趋势(F趋势=15.471,P＜0.05);高频损失检出率11.3％,不同年份在8.2％～12.4％,差异有统计学意义(x2=176.2,P＜0.01);异常检出率在不同规模、经济类型企业以及职工工龄之间差异均有统计学意义(P值均＜0.05).异常检出率和各频率平均听阈在2015-2019年间逐年增高(P值均＜0.05).小微企业对比大中型企业,私营经济企业对比公有制经济、港澳台经济、外商经济企业异常率较高(P值均＜0.05).结论 应进一步加强噪声作业工人的健康监护工作,加强微型、私营企业的监管,提高工人自身防护意识,减少噪声对劳动者的危害.     

沥青烟作业工人肺通气功能和胸片的改变

目的 探讨沥青烟作业工人肺通气功能和X线胸片的改变.方法 选择碳素分厂生阳极车间接触沥青烟工人53名作为接触组,选择该厂非沥青烟作业职工50名作为对照组,比较两组肺通气功能和胸部X线片的变化.结果 接触组肺活量(VC)、用力肺活量(FVC)、1秒钟用力呼气量(FEV10)、最大自主通气量(MVV)的异常率分别为34.0%、30.2%、35.8%、37.7%,对照组的异常率分别为10.0%、16.0%、12.0%、10.0%,两组比较,差异有统计学意义(P＜0.01).与对照组比较,接触组VC、MVV、FEV10明显降低,差异有统计学意义(P＜0.05或P＜0.01).接触组FEV10与接触工龄呈负相关(r=-0.321,P＜0.05),MVV与接触工龄呈负相关(r=-0.287,P＜0.05).接触组肺纹理改变阳性检出率为34.0%,对照组肺纹理改变阳性检出率为16.0%,两组比较,差异有统计学意义(P＜0.05).接触工龄5～20年组和＞20年组肺纹理改变阳性胸片检出率均高于＜5年组,差异均有统计学意义(P＜0.05).结论 沥青烟能引起作业工人肺通气功能的改变,与接触工龄有关.     

某蓄电池厂铅作业工人血细胞参数分析

目的 测定1270名铅接触工人的血细胞参数,了解职业铅接触对工人造血系统的影响以及血细胞参数的变化.方法 以1270名职业接触铅工人为接触组、696名非铅接触工人为对照组,将2组的血细胞参数进行比对分析.血细胞参数的测定采用全自动血细胞分析仪进行测定.结果 接触组的红细胞数目、血红蛋白、红细胞压积、平均红细胞体积、平均红细胞血红蛋白含量、平均红细胞血红蛋白浓度、红细胞体积分布宽度、血小板数目、平均血小板体积、血小板分布宽度、血小板压积和对照组比较差异均有统计学意义(其中红细胞数目P＜0.05,其余检测项目P＜0.01).接触组贫血25人(1.97%),对照组贫血1人(0.14%),差异有统计学意义(P＜0.05).结论 铅作业工人的多项血细胞参数发生变化,有贫血倾向.     

石化企业质检工人苯职业暴露的健康效应

为探讨苯对石化企业质检工人健康的影响,于2010年选择某石化企业质检车间87名存在苯职业暴露的质检工人为接触组,选择162名不接触职业有害因素的管理人员作为对照组.对该石化企业质检工人作业环境中苯的职业暴露浓度进行测定.结果显示接触组白细胞计数降低的发生率高于对照组,差别有统计学意义(x2=8.592,P＜0.05),说明该石化企业质检车间质检工人白细胞计数减少与苯职业暴露有关.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.