理化检验人员的职业危害与防护

目的探讨理化检验人员职业危害,提出防护措施。方法分析理化检验人员职业危害,制定科学有效的防护措施。结果提高了理化检验人员职业危害与安全防护意识,有效地防止职业感染的发生,确保了工作人员的健康安全。结论根据理化检验人员职业危害因素,制定合理的职业防护措施,让职业危害降到最低限度。     

某化工厂二异氰酸甲苯酯危害调查分析

目的 调查某化工厂二异氰酸甲苯酯(TDI)对作业工人健康的影响。方法 对作业场所进行职业卫生调查及空气中TDI浓度检测，并对作业工人进行使康检查。结果 作业场所通风状况较差，两个车间空气中TDI平均浓度分别为2．8mg／m^3，2．9m6／m^3。部分作业工人出现神经及呼吸系统症状。结论 该厂Ⅲ危害较为严重，需及时采取措施加以控制。     

Skin protection and percutaneous absorption of chemical hazards

Hazardous substances that penetrate the skin barrier may induce dermal irritation, inflammation or sensitisation, as well as systemically toxic effects. Air threshold limits are insufficient to prevent adverse health effects in the case of contact with substances with a high dermal absorption potential. Biological monitoring is a useful tool to quantify internal exposure of an individual and allows an assessment to be made of the dermal absorption pathway. Additionally, the efficacy of protective equipment can be proved. Standard gloves are ineffective to decrease dermal uptake. Various skin-care products include emulgators, which are used as penetration enhancers in transdermal therapeutic drugs. Hence, specific skin-care products potentially enhance dermal absorption of certain chemicals. On the other hand, the best protection from dermal absorption is the physiological skin barrier-the stratum corneum. Skin-care products that accelerate regeneration of the stratum corneum are obliged to have positive effects to prevent dermal absorption. With regard to the increasing number of occupational skin diseases and the large quantity of skin-care products that are used at workplaces it is essential that the mechanism of protection and efficacy be assessed. In the future, we require evidence-based prevention or evidence-based medicine that includes evidence-based prevention.     

某化工企业化学危害呼吸防护现状调查

目的了解脲醛树脂黏胶生产企业化学性危害防护现状,探讨存在的问题与不足,为指导企业合理配置、使用和管理呼吸防护用品提供依据。方法对广州市番禺区某化工企业生产过程中的化学物质浓度、工人配带的呼吸防护器和化学性危害因素等防护措施进行调查。结果该企业职业危害因素是甲醛、尿素、氨水、氢氧化钠。工作场所3个工种的甲醛超出职业限值:胶池放料14号CMC0.52 mg/m3、6号反应釜取样口CMC0.77 mg/m3、甲醛卸载CMC0.65 mg/m3。该企业为作业人员通配了半呼吸面罩,P-A-1型滤毒元件,呼吸保护恰当,但存在对作业场所多种化学物质和粉尘也有保护不恰当的现象。结论呼吸器配置应根据作业场所化学物质的种类、理化性质、暴露浓度、呼吸防护指数、预期暴露降低浓度来综合考虑。     

Exploring respiratory protection practices for prominent hazards in healthcare settings

The use of respiratory protection, an important component of personal protective equipment (PPE) in healthcare, is dependent on the hazard and environmental conditions in the workplace. This requires the employer and healthcare worker (HCW) to be knowledgeable about potential exposures and their respective protective measures. However, the use of respirators is inconsistent in healthcare settings, potentially putting HCWs at risk for illness or injury. To better understand respirator use, barriers, and influences, the National Institute for Occupational Safety and Health (NIOSH) Health and Safety Practices Survey of Healthcare Workers provided an opportunity to examine self-reported use of respirators and surgical masks for targeted hazards. The hazards of interest included aerosolized medications, antineoplastic drugs, chemical sterilants, high-level disinfectants, influenza-like illness (ILI), and surgical smoke. Of the 10,383 HCWs who reported respiratory protection behaviors, 1,904 (18%) reported wearing a respirator for at least one hazard. Hazard type, job duties, site characteristics, and organizational factors played a greater role in the likelihood of respirator use than individual factors. The proportion of respirator users was highest for aerosolized medications and lowest for chemical sterilants. Most respondents reported using a surgical mask for at least one of the hazards, with highest use for surgical smoke generated by electrosurgical techniques and ILI. The high proportion of respirator non-users who used surgical masks is concerning because HCWs may be using a surgical mask in situations that require a respirator, specifically for surgical smoke. Improved guidance on hazard recognition, risk evaluation, and appropriate respirator selection could potentially help HCWs better understand how to protect themselves at work.     

Work-related accidents and occupational diseases in veterinarians and their staff

Objectives: We assessed the occupational hazards in veterinary practice by analysing accident insurance data in order to stimulate strategies to prevent occupational accidents and diseases in veterinarians and their staff. Methods: Approximately 10,000 veterinary practices comprising about 27,500 veterinarians and their staff are covered by the Institution of Statutory Accident Insurance of the Health and Welfare Service (BGW). Each year about 2,000 accident and occupational disease claims are filed by these veterinarians and their staff. The claims for the 5-year period from 1998 to 2002 are analysed in this paper. Results: For 2002, the incidence rate for accidents in the workplace was 105.4 per 1,000 full-time workers, a rate 2.9-times higher than for general practitioners of human medicine. When only severe accidents resulting in a loss of work time of more than 3 days were analysed, the relative risk increased to 9.2. Approximately 66% of the reported accidents are due to scratches, bites, or kicks from animals. Claims of occupational disease are filed 2.7-times more often by veterinarians and their staff than by general practitioners and their staff. The occupational diseases filed most often concern the skin (39%), followed by allergic respiratory diseases (30.5%), and infectious diseases (19.1%). Conclusions: Prevention strategies for veterinarians should focus on accidents caused by animals. The prevention of occupational diseases should focus on skin diseases, respiratory disease, and infections.Dedicated to Prof. Jürgen Berger, Department of Biostatistics, University Hospital Eppendorf, emeritus in 2004     

Respirator use and protection from exposure to carbon monoxide

Investigations of the protective effect afforded by respirators in Baltimore firefighters are presented. The data indicates that the continuous use of respirators offers significant protection from exposure to carbon monoxide but that this protection is not absolute. A surprising finding is that the intermittent use of the face mask offers as little protection to the men as does non-use. These findings emphasize the difficulties in relying upon respiratory personal protective equipment for protection from exposure.     

临床核医学诊疗中的辐射剂量与防护研究

目的通过对临床核医学诊疗中辐射剂量的研究,探索核医疗安全管理和辐射防护的具体方法,以保障患者、医疗工作人员以及广大社会群众的身体健康。方法针对最为常见的核医疗方法 131I治疗,选取68例接受131I治疗的患者,并将他们随机分为两组,每组分别由一名医师和两名护士负责治疗工作,一组采用常规治疗防护措施进行治疗,一组采用综合治疗防护措施,并记录两组患者服用131I后的有效剂量和医护人员1年所受的总辐射剂量,然后进行对比分析。结果经过1年的治疗之后,采用常规治疗防护措施的患者受辐射剂量为（59.63±0.56）mSv,医生和护士受辐射剂量为（4.692±0.056）mSv;采用综合治疗防护措施的患者受辐射剂量为（50.21±0.69）mSv,医生和护士受辐射剂量为（1.216±0.037）mSv。结论患者接受131I治疗所受到的辐射量大于公众照射年剂量限值,但比职业照射的年剂量限值低,但通过综合的防护措施,可以有效降低131I治疗对患者和医护人员的辐射剂量,能够保障接受临床核医学诊疗的患者和医护人员的安全健康。     

某国有大型煤矿职业危害因素调查与建立完善矿山职业危害防控体系的建议

目的调查并分析地下矿山职业危害因素现状及在职业危害防治工作中存在的问题,提出建立职业危害预防控制体系建议。方法于2012年4月7—10日,以安徽省某煤矿企业为例,采用职业卫生现场调查和现场监测相结合的方法。结果该矿山企业的主要职业危害因素为粉尘、噪声、有毒有害气体、不良气象条件。粉尘测试总计采集60个样品,其中49个未超过国家卫生标准,样品合格率81.7%。时间加权平均容许浓度设测试点7个,合格率71.4%。2个作业场所噪声超标,合格率75.0%。结论矿山企业存在诸多危害从业人员健康的职业病危害因素,需要从矿山企业与职业病危害整体层面,建立完善职业危害防控体系。     

Occupational exposure to chemicals and risk of thyroid cancer in Sweden

Purpose  To explore thyroid cancer (TC) risk in the Swedish population, associated with occupational exposure to certain chemicals. Methods  National cancer and death registries were used to follow-up (1971–1989) all Swedish workers employed in the 1970 census. Each combination of occupation and industry was linked to a Swedish job-exposure matrix (JEM), with exposure to 13 chemicals classified as “possible exposure”, “probable exposure” or “unexposed”. Relative risks were obtained using Poisson models adjusted for age, period and geographical area. A second analysis was performed, in which adjustment was additionally made for simultaneous exposure to other matrix chemicals and ionising radiations. Results  Probable exposure to solvents among women displayed an increased risk (RR = 1.91; 95%CI:1.05–3.45), mainly due to a higher risk observed among shoe-cutters, lasters and sewers engaged in shoe-making. Conclusions  Exposure to solvents, used mainly in the shoe and leather industry, seems to be associated with excess TC among women.     

Correlates of serum dioxin to self-reported exposure factors

The aim of the current analysis was to examine the determinates of lipid-adjusted body levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) from occupational histories, age, body mass index, and self-reported information from a questionnaire. We collected serum from 346 workers at a New Zealand chemical plant that manufactured and formulated the herbicide, 2,4,5-trichlorophenoxyacetic acid (2,4,5-T). Age, body mass index, and employment history were significant determinates of TCDD. The self-reported data on occupation, residence, and general diet were not predictive of serum levels and we observed no evidence of increased TCDD levels from living close to the site. For participants with putative occupational exposure, employment history and personal factors were important to understand the range of TCDD serum levels. For employees without direct occupational exposure, and resulting lower dioxin levels, we recommend further efforts to develop and validate questionnaires to better evaluate environmental sources of dioxins.     

洁净手术室保洁员职业防护调查与管理

目的了解洁净手术室保洁员医院感染相关知识、职业暴露危害认知率、职业防护合格率,以便针对性的采取干预措施,减少保洁员职业暴露的发生。方法 2012年12月-2013年2月采用自行设计的调查表,以问卷与访谈相结合的方法,对16名洁净手术室保洁员进行医院感染相关知识、职业暴露危害的认知、保洁人员职业防护的调查。结果 16名保洁员对保洁工具分区使用和终末处置、消毒剂正确配置和使用、医疗废物收集及保存要求的认知率较高,分别为93.75%、87.50%、81.25%;手术室保洁员对锐器刺伤可导致血源性传染病、医疗废物具有危险性的认知率较高,分别为56.25%、43.75%,对锐器刺伤后伤口正确处理方法的认知率为0;对职业防护的重要性认识不足,职业防护合格率低。结论手术室管理者有必要对保洁员采取培训、教育、监督、指导等干预对策,提高保洁员医院感染知识及职业防护认知水平。     

Occupational exposure to diesel and gasoline emissions and lung cancer in Canadian men

The International Agency for Research on Cancer classifies diesel exhaust as a probable human carcinogen; this decision is based largely from lung cancer evidence. Gasoline exhaust is classified as a possible carcinogen. Epidemiological studies are needed that improve upon some of the limitations of previous research with respect to the characterization of exposure, and the control for the potential confounding influence of smoking and other occupational exposures. Our objective was to investigate associations between occupational exposure to diesel and gasoline engine emissions and lung cancer. We used a case-control study design that involved men 40 years of age and older at the time of interview. Analyses are based on 1681 incident cases of lung cancer and 2053 population controls. A self-reported questionnaire elicited a lifetime occupational history, including general tasks, and information on other potential risk factors. Occupational exposures to diesel and gasoline emissions, crystalline silica, and asbestos were assigned to each job held by study subjects by industrial hygienists who were blind to case-control status. Exposure metrics for diesel and gasoline emissions that were modeled included: ever exposure, cumulative exposure, and concentration of exposure. We found a dose–response relationship between cumulative occupational exposure to diesel engine emissions and lung cancer. This association was more pronounced for the squamous and large cell subtypes with adjusted odds ratios across the three increasing tertiles of cumulative lifetime exposure relative to those with no exposure of 0.99, 1.25, and 1.32 (p=0.04) for squamous cell carcinoma, and 1.06, 1.19, 1.68 (p=0.02) for large cell carcinoma. While the association with cumulative exposure to gasoline was weakly positive, it was not statistically significant. Our findings suggest that exposure to diesel engine emissions increases the risk of lung cancer particularly for squamous and large cell carcinoma subtypes.     

电缆辐照加工企业职业危害及防护调查

目的通过对电缆辐照加工技术职业危害的调查分析和检测,明确电缆辐照加工的职业危害种类和防护重点,并提出职业危害防护策略。方法选取1家应用辐照加工技术生产电缆的企业为研究对象,通过职业卫生调查、职业危害含放射危害的检测、职业健康检查等方法开展研究。结果电缆辐照技术生产应用中存在多种职业危害,包括辐射危害为电子束和X线,化学性危害为臭氧、氮氧化物及六氟化硫等,物理性危害为噪声。职业防护中对辐照场所合理布局与分区、开展机房与辐照厅屏蔽防护设计、设置人身安全联锁及机器安全联锁,化学性危害防护中对辐照大厅全面通风,防止有害气体蓄积,是主要的职业危害防护措施。结论电缆辐照等辐照加工技术使用日益广泛,认真开展企业职业危害防护特别是辐照安全防护,可保证辐照加工作业人员的职业安全。     

绵阳某灾后重建放射场所职业病危害放射防护控制效果评价

目的对某医院灾后重建放射场所进行控制效果评价,确定该项目的放射防护设施和措施在控制职业照射和防止潜在照射方面的有效性、适宜性,以保障灾区放射工作人员和公众的健康与安全。方法依据国家相应法律法规及标准要求,在正常工作状态下对该场所进行监测,同时结合现场卫生学调查结果,对该建设项目的放射防护设施和防护措施进行综合评价。结果该建设项目放射场所设计、布局合理,各种防护配套设施及管理制度健全,各监测点辐射水平在0.10～0.36μGy/h之间,均低于国家标准限值。结论某医院灾后重建放射场所放射防护符合国家标准要求,可投入正常运行。     

利用肿瘤登记数据评价职业和行业危险因素

本研究以肺癌为例探讨了应用肿瘤登记数据评价职业和行业肿瘤危险度的方法。以天津肿瘤登记处1981～1987年期间的登记数据为基础，利用病例一对照方法研究了肿瘤的职业和行业危险度，共分析了天津市区30个职业和27个行业。每一被研究的职业／行业为暴露组，其它是未暴露组。被研究的肿瘤为病例组，其它为对照组。统计分析方法是非条件logistic回归模型。调整因素包括性别、年龄和诊断年份。结果：以肺癌为例，研究结果与既往报告雷同。对天津市职业和行业的肿瘤危险度进行了系统的分析，提出天津市职业和行业的肿瘤危险因素。这种设计的主要优点是①可充分利用已经有的肿瘤登记的数据。②简便易行的、快速的和低成本地评价肿瘤危险因素或者潜在的危险因素。③所有肿瘤登记或任何疾病登记的数据库的因素均可以被评价，例如职业、行业、教育等。④减少分析中的混杂和偏倚。     

Workplace exposure zones for classification of employee exposures to physical and chemical agents.

A method involving classification of employee job tasks into exposure zones is proposed to guide the industrial hygienist in assigning personal samples to employees in a facility. Workers are assigned to an exposure zone on the basis of similar profiles of chemical exposures, ventilation characteristics, and job tasks. Two facilities are used to illustrate the power of the exposure zone method to reduce the number of required samples while increasing the confidence of identifying workers at high risk. Details of the zoning and calculation procedures are described in detail.     

天津市某LED芯片生产企业职业病危害因素现状评价

目的识别、明确天津市某LED芯片生产企业可能产生的职业病危害因素,评价企业现有的职业病防护设施、应急救援措施是否符合国家职业卫生标准、规范的要求。方法采用检查表法、现场调查法以及现场检测法进行评价。结果该企业作业人员在工作中直接或间接接触到的危害因素有化学毒物[氟化氢、盐酸、硫酸、硝酸(二氧化氮)、氨、氢氧化钠、丙酮、异丙醇]及噪声。化学毒物16个岗位均合格,合格率为100%;噪声9个岗位均合格,合格率为100%。结论该企业生产工艺较先进,生产设备自动化、密闭化程度较高,车间内针对其存在的职业病危害因素设置了相应的防毒、防噪声的措施,并在一定程度上保证上述设施的正常运行,保证了工作场所中毒物浓度和噪声强度合格率达100%;评价该项目职业卫生防护措施和职业卫生管理基本符合国家法律法规的要求。