实施员工关爱计划保障医务人员职业安全与健康

医务人员的身心健康和执业满意度直接影响医疗服务质量。复旦大学附属华山医院从员工需求切入,建立并实施员工关爱计划:横向包括身心健康、社会支持、个人成长与职业生涯发展等;纵向贯彻危机前、危机中、危机后三级援助体系。实践后,员工满意度、社会支持水平、幸福感有所提升,职业倦怠阳性率有所下降。员工关爱计划在管理理念、方案完善、人才培养等方面还有待进一步改进。     

US Food and Drug Administration Analysis of Patient-Reported Diarrhea and Its Impact on Function and Quality of Life in Patients Receiving Treatment for Breast Cancer

ObjectivesMany trials conclude “no clinically meaningful detriment” to health-related quality of life (HRQL) or function between arms, even when notable differential toxicity is observed. Mean change from baseline analyses of function or HRQL can possibly obscure important change in subgroups experiencing symptomatic toxicity. We evaluate the impact of diarrhea, a key treatment arm toxicity, on patient-reported HRQL and functioning in clinical trials submitted to US Food and Drug Administration.MethodsThis study used 4 randomized, breast cancer trials (adjuvant to late-line metastatic) as case examples. Diarrhea, physical functioning (PF), and global health status and quality of life (GHS/QoL) from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 were analyzed at baseline and approximately 3 and 6 months.ResultsGenerally, patients reporting very much diarrhea at months 3 and 6 had worse PF (9-19 points lower) and GHS/QoL (16-19 points lower) than patients reporting no diarrhea regardless of treatment arm. In the change from baseline analysis, patients reporting very much diarrhea also experienced a greater decrease in PF (6-13 points) and GHS/QoL (6-16 points) versus patients reporting no diarrhea in both arms.ConclusionsIn trials with moderate to large differences in symptomatic toxicity by arm, reporting “no meaningful difference in functioning and HRQL between arms” based on mean change from baseline analysis is insufficient and may obscure important impacts on subgroups experiencing symptomatic adverse events. Additional exploratory analyses with simple data visualizations evaluating functioning or HRQL in patient subgroups experiencing expected symptomatic toxicities can further inform the safety and tolerability of an investigational agent.     

某钢丝绳生产企业职业危害现状调查及控制对策

目的了解某钢丝绳生产企业职业病危害现状,为控制该企业职业病危害因素提供依据。方法通过对某钢丝绳生产企业进行职业卫生现场调查、职业病危害因素检测,收集有关数据和资料,结合职业病危害防护设施、个人职业病危害防护、应急救援措施、职业健康检查结果等进行分析评价。结果粉尘、毒物、高温检测结果均符合国家职业卫生标准,合绳捻股车间捻股机、合绳机岗位噪声强度检测结果超标率100%,拉丝车间噪声检测合格率16.7%。职业卫生管理措施不够完善。结论该公司属于职业病危害较重企业,劳动者有发生职业性慢性铅中毒、职业性化学性灼伤、职业性噪声聋的风险,需采取有效措施进行整改。     

石家庄市居民慢性阻塞性肺疾病检出情况及影响因素研究

目的探讨石家庄市居民慢性阻塞性肺疾病检出情况及影响因素。方法2021年9—12月采用整群随机抽样方法抽取石家庄市3个社区,对抽中社区的所有居民进行问卷调查和肺功能检查。利用描述流行病学方法分析社区人群慢性阻塞性肺疾病患病现状。应用单、多因素方法分析影响慢性阻塞性肺疾病发生的危险因素。结果共2348名居民完成问卷调查和肺功能检查,其中男1205人,占51.32%,女1143人,占48.68%,年龄31~76岁。共有146例检出慢性阻塞性肺疾病,检出率为6.22%,其中轻度69例,占47.26%,中度54例,占36.99%,重度23例,占15.75%,未检出极重度者。检出来的症状分布中,以咳嗽及咳痰的比例较高,分别为52.05%(76例)和49.32%(72例)。多因素Logistic回归分析结果显示年龄≥40岁(OR=1.705、1.936)、男性(OR=3.404)、居住在农村(OR=2.469)、偶尔或经常吸烟(OR=1.592、1.800)、有职业粉尘接触史(OR=2.179)、有哮喘家族史(OR=3.164)、有慢性阻塞性肺疾病家族史(OR=5.170)、有呼吸道反复感染史(OR=3.414)是石家庄市居民慢性阻塞性肺病患病的影响因素。结论石家庄市居民的慢性阻塞性肺疾病患病情况不容乐观,且危险因素众多。重点针对中老年、吸烟、农村、有各种相关家族史的男性高危人群开展早期筛查和采取针对性干预措施,有助于对居民慢性阻塞性肺疾病进行防控。     

Examining the relationship between the demand-control model and incident myocardial infarction and congestive heart failure in a representative sample of the employed women and men in Ontario,Canada, over a 15-year period

ObjectivesTo examine the relationship between job strain and incident myocardial infarction and congestive heart failure in a representative population of men and women in Ontario, Canada, over a 15-year period.MethodsA total of 14,508 respondents having provided responses to either the 2000/2001, 2002, or 2003 cycles of the Canadian Community Health Survey (CCHS) were aged 35 and older at the time and working. After removing respondents with pre-existing heart disease and missing data, our sample totaled 13,291 respondents. Responses were linked to administrative health care and hospitalization data to capture incident cases of myocardial infarction and congestive heart failure up to March 31, 2017. Job control and psychological demands were assessed using 5 items and 2 items respectively. A series of time-to-event regression models were run, adjusting sequentially for socio-demographic variables and health, other psychosocial work exposures, and health behaviours and body mass index.ResultsOver the study period, there were 199,583 person-years of follow-up (median follow-up: 15 years, 233 days). Higher incidence rates were observed for men (6.69 per 100 persons) than for women (2.77 per 100 persons). No clear relationship was observed for demand-control exposures and incidence of myocardial infarction and congestive heart failure in either men or women. After adjustment for socio-demographic factors, pre-existing health conditions, and other psychosocial exposures, the hazard ratio for high strain exposure (compared with low strain exposure) was 0.92 (0.46–1.84) for women and 0.75 (0.44–1.27) for men.ConclusionIn this large prospective cohort in Canada, we observed no relationship between components of the demand-control model and incident myocardial infarction and congestive heart failure over a 15-year period.     

Occupational contact dermatitis in a gender perspective: North East Italian data 1996-2016

Background:Occupational contact dermatitis (OCD) ranks high among occupational diseases in Europe, but little is known as regards OCD and jobs in a gender perspective.Objectives:To evaluate sex prevalence of OCD according to occupational sectors and agents involved. 27381 patients (1996–2016) with suspected irritant/allergic contact dermatitis (ICD-ACD) were evaluated in North-Eastern Italy. Each patient underwent: a standardized questionnaire, a dermatologist/occupational physician evaluation and a patch test.Results:Females were younger at diagnosis (35.2 ± 11.6 years vs 37.7 ± 12.6 in males, p< 0.001) and had a lower ICD prevalence (OR 0.58, C.I. 95% 0.51 - 0.66, p < 0.001). Job categories most involved differed between sexes, with highest rank for healthcare professionals in females and machinery mechanics and filters for males. In females ACD percentage was higher in all job categories.Conclusions:OCD characteristics differ between sexes, according to intrinsic and extrinsic factors. Use of personal care products, housekeeping products and outdoor work activities may account for different sensitization profiles.     

流动人口职业病防治教育现状及影响因素分析

目的 了解流动人口职业病防治教育现状及影响因素。方法 运用SPSS 25.0软件对2017年全国流动人口卫生计生动态监测中的154586名流动人口的相关数据进行分析,主要分析方法有统计描述、χ2检验和二元logistic回归等。结果 154586名流动人口中,51578人接受过职业病防治教育,接受率为33.4%。二元logistic回归分析表明,男性（OR=1.165,95%CI:1.137~1.193）、30～44岁（OR=1.169,95%CI:1.088~1.256）、文化程度高中或中专（OR=1.278,95%CI:1.227~1.330）、在婚（OR=1.172,95%CI:1.134~1.211）、流动原因为经济性质（OR=1.283,95%CI:1.115~1.475）、流入西部地区（OR=1.749,95%CI:1.700~1.799）、有稳定工作（OR=1.071,95%CI:1.016~1.128）、机关或国企或股份联营企业（OR=1.765,95%CI:1.666~1.870）、自评状况为健康（OR=1.479,95%CI:1.363~1.606）的流动人口职业病防治教育接受率较高;未签订劳动合同（OR=0.684,95%CI:0.661~0.708）、未听过“国家基本公共卫生服务项目”（OR=0.231,95%CI:0.225~0.237）的流动人口职业病防治教育接受率较低。结论 流动人口职业病防治教育接受率较低,需加强流动人群职业病防治教育的宣传力度,提高职业病防治教育的覆盖面。     

ATTITUDES TOWARDS AND KNOWLEDGE OF OCCUPATIONAL SKIN DISEASE AMONGST SUPPORT PERSONNEL

Liaison with support personnel is important in the management of workers with occupational skin disease (OSD). This study shows that there are many areas of concern regarding the knowledge and understanding of OSD in these groups. There needs to be a comprehensive education programme concerning OSD within the working community and support personnel. Dermatologists need to simplify their "language' in the reporting of OSD. Insurers need to take a more sympathetic attitude towards the partially fit worker. Rehabilitation personnel must become more familiar with OSD.     

Sexual functioning of male anabolic steroid abusers

The effects of anabolic steroid use on male sexual behavior were assessed using a structured clinical interview administered to male body builders currently using steroids, and to two comparison groups (body builders with a past but not current history of steroid use, and a group of natural body builders who had never used steroids). Current anabolic steroid users had a significantly higher coital and orgasmic frequency than did comparison athletes. They also reported a significantly higher incidence of erectile difficulties during the past month. Beliefs concerning the sexually stimulating effects of steroids did not correlate with the frequencies of specific sexual behaviors. The data support the contention that anabolic steroids, as androgenic compounds, enhance sexual desire.