Health interventions for the metal working industry: which is the most cost-effective? A study from a developing country

This study ranked the cost-effectiveness of health interventions in the metal working industry in a developing country. Data were based on 82 034 workers of the Northern region of Mexico. Effectiveness was measured through 'healthy life years' (HeaLYs) gained. Costs were estimated per worker according to type and appropriate inputs from selected health interventions. 'Hand' was the anatomical region that yielded the most gain of HeaLYs and amputation was the injury that yielded the most gain of HeaLYs. The most effective health intervention corresponded to training, followed by medical care, education, helmets, safety shoes, lumbar supports, safety goggles, gloves and safety aprons. In dollar terms, education presented the best cost-effectiveness ratio (US$637) and safety aprons presented the worst cost-effectiveness ratio (US$1 147 770). Training proved to be a very expensive intervention, but presented the best effectiveness outcome and the second best cost-effectiveness ratio (US$2084). Cost-effectiveness analyses in developing countries are critical. Corporations might not have the same funds and technology as those in developed countries or multinational companies.     

Clinical examinations to validate self-completion questionnaires: dermatitis in the UK printing industry

A self-completion questionnaire sent to 2600 Nottinghamshire members of the Graphical Paper and Media Union elicited a 62% response. Forty one per cent of respondents reported suffering a skin complaint at some time and 11% had a current skin problem on the hand. This paper reports the validation stage of the study. Samples of 45 'cases' of self-reported dermatitis and 60 'controls', who reported they had never suffered a skin complaint, were clinically examined. All 45 self-reported cases were clinically confirmed as dermatitis. Occupationally related irritant contact dermatitis (ICD) was diagnosed in 20 (44%); 26 (58%) complaints were thought to be induced or exacerbated by occupation. Of the controls, 21 (35%) were also diagnosed with a skin complaint, the majority being mild, with an occupational association in 17, the majority (15) being ICD. Sixteen ICD cases were patch tested resulting in positive reactions to colophony, neomycin, nickel and potassium dichromate (2 of each). Two cases of basal cell carcinoma on the face were also identified, of which the participants were unaware. Although there was no false positive self-reporting there was a considerable number of false negatives, demonstrating the importance of clinical validation of questionnaires relating to industrial skin disease. This study has highlighted the need for improvement in skin care provision in the printing industry.     

饮食从业人员华支睾吸虫病防治知识水平调查

目的 了解江门市饮食从业人员对肝吸虫病防治知识掌握情况，制定健康教育对策。方法随机抽查565名饮食从业人员进行问卷调查。结果肝吸虫病知识晓率为34．16％，肝吸虫对人体危害的知晓率为18．05％．肝吸虫感染途径的知晓率为29．73％，如何预防肝吸虫的知晓率为30．27％。结论饮食从业人员肝吸虫病防治知识掌握甚少，应加强这方面的健康教育。     

强化医德医风教育促进医疗行风建设

医德是医务人员与病人和社会的联系中应遵循的行为准则与规范,由于服务对象是人与人类的健康,因此它比其他职业道德更受人们的关注.然而近年来相当的医务机构在突出经济效益的状况下淡漠了医德医风教育,本文通过对当前医德医风存在问题及原因分析,阐述针对这些问题坚持医学宗旨,强化医德医风教育,促进医疗行风建设,应作为医院管理者的首要任务.     

铸造作业粉尘的不同连续采样方法检测结果若干关系探讨

[目的]探讨铸造行业作业场所粉尘连续性采样中，个体采样和区域采样两种测定结果间的相关关系和相关程度，以及季节因素和不同作业场所对采样结果的影响。[方法]选择3家工厂的铸造车间作为采样现场，分别在各工种选取36、23、14人进行个体全工作班随身采样，并同时进行工作区域定点采样。冬、夏两季每季重复进行3次。以重量法测定粉尘总量并计算出粉尘浓度。对各工厂夏冬两季各工种以及各工作区域的空气粉尘平均浓度，进行工种浓度和区域浓度、季节和工厂之间的比较分析。[结果]工种浓度各厂都有从造型各工种到开箱各工种浓度渐高的趋势排列，其中两个厂的浓度排列趋势有极显著性的统计学意义，F值分别为9．30和16．36，P〈0．01。区域采样所得的区域浓度与相应的工人个体采样所得的工种浓度或缺乏显著性相关，或未见显著性差别。冬季各工种的个体样品和区域样品所测得的粉尘平均浓度普遍高于夏季时的相应样品，其中造型（t=4．56）、制芯（t=4．34）、开箱冷却（t=5．88）、开箱打磨（t=3．49）、以及铸造车间行车（t=2．97）工种和制芯间（t=2．79）区域的季节差异表现出统计上的显著性。3个厂之间，某些类似工种个体接触和类似工作区域的空气粉尘平均浓度的差异有极显著性，有色金属铸造厂的浓度都是最低。[结论]在大中型的黑色金属铸造生产场所，区域采样不能很好地代表或替代个体采样以反映作业者实际的粉尘接触浓度。在有色金属铸造中，如考虑到含二氧化硅砂的国家卫生标准值，区域采样还是不能代表作业者实际的粉尘接触浓度是否在国家标准以下。季节因素（实际上是工作场所的自然通风因素）在决定实际接触粉尘浓度方面，具有至关重要的作用。在中等规模生产标准产品的铸铁工艺过程在造型工段的粉尘对工人危害最大；大规模的铸钢工艺生产在熔炼和开箱清砂工段的粉尘对工人危害最大。     

珠海市建筑行业职业伤害研究

目的:了解珠海市建筑行业职业伤害情况,并进行原因分析,提出相关预防措施。为职业伤害系统资料的建立提供本底资料,也为政府决策和制订相应管理策略,增进劳动者健康,充分提高劳动效率提供科学依据。方法:根据珠海市劳动和社会保障局1 990～2 0 0 3年间的职业伤害(工伤)认定的资料进行分析。结果:1 990～2 0 0 3年间珠海市建筑行业职业伤害(工伤)人数为35 9人,以男性为主,占96 . 4 %。75 . 2 1 %的职业伤害者年龄<4 0岁。职业伤害者中30 . 6 4 %为四川籍,2 3 .6 8%为广东籍,1 4 .2 1 %为湖南籍。1 990年至2 0 0 3年间轻伤、重伤和死亡的构成比分别为2 8. 4 2 %、4 9 .30 %和2 2 . 2 8%。职业伤害主要类型为高坠(2 6 . 1 2 %)、碰撞伤(1 8. 82 %)和挤压(1 0 .39%)。职业伤害的主要部位为下肢(2 8. 70 %)、上肢(2 0 . 89%)和面部(1 2 . 5 3%)。职业伤害的主要原因为防护装置缺陷(30 . 92 %)、违反操作规程(2 5 . 0 7%)和缺乏安全操作知识(1 4 . 2 1 %)。结论:建筑业是珠海地区的高危险行业,建议改善工作场所安全设施和加强工人的安全教育和培训,从而有助于减少或杜绝建筑业职业伤害的发生。