中华劳动卫生职业病杂志最新文献

This paper reports a case of acute pulmonary edema caused by exertional heat stroke due to imbalance of body heat production and heat dissipation caused by high intensity military training physical activities. The patient's lesions developed rapidly and pulmonary edema progressed rapidly and diffusingly. After early identification, active invasive mechanical ventilation and hormone therapy, the pulmonary imaging lesions of pulmonary edema were rapidly absorbed, and the dyspnea was improved. This article discusses the incidence, imaging features and treatment of acute pulmonary edema caused by exertional heat stroke, and provides reference for clinical diagnosis and treatment.

Mushroom poisoning is the most important cause of death in food-borne poisoning in China, mainly caused by amanitin, which is caused by rapid progression, complex mechanism and latency. Early identification, diagnosis and treatment are important to improve the prognosis of fatal mushroom poisoning. This article analyzes the clinical characteristics, identification process and treatment of 14 patients with amanitin-containing Galerina sulciceps mushroom poisoning in a family, so as to improve the identification ability of the first physician in recognizing and managing early-stage mushroom poisoning, and to increase the cure rate through early bundle therapy of mushroom poisoning.

Objective: To evaluate the risk of major chemical exposure positions in copper and nickel smelting enterprises, and provide a basis for risk assessment and prevention control measures. Methods: From September to October 2023, two copper nickel ore smelting enterprises in Xinjiang Uygur Autonomous Region were selected as the research objects. Relevant information on chemicals was collected through occupational hazard field investigations. Qualitative analysis and exposure index methods were used in GBZ/T 298-2017 "Technical Guidelines for Occupational Health Risk Assessment of Chemical Hazardous Factors in the Workplace" to conduct risk assessments on the main chemical exposure positions. The qualitative risk assessment results were checked for consistency using the Weighted Kappa coefficient. Results: The positions with high risk of exposure to hazardous chemicals in copper nickel smelting enterprises are saponification positions exposed to hydrochloric acid in refining processes, black nickel positions exposed to sodium hydroxide, and tail suction positions. The consistency between the two occupational health risk assessment results is poor (Kappa=0.14) . Conclusion: The amount of major hazardous chemicals in copper-nickel smelting enterprises is large, and the occupational health risks caused by exposure are complex and diverse, so the effects of chronic occupational health should be strengthened.

Objective: To systematically evaluate the effect of overtime work on neck musculoskeletal disorders of occupational population in China. Methods: In August 2023, the literatures on the relationship between overtime work and neck musculoskeletal disorders were searched in China National Knowledge Infrasture (CNKI), WanFang Database, Chinese Science & Technology Journal Database (VIP), China Biomedical Literature Service System (SinoMed) and PubMed. The search scope was Chinese and English literatures published before June 30, 2023. The Quality of literature studies was evaluated using the Agency for Healthcare Research and Quality (AHRQ) cross-sectional study quality evaluation criteria. The Stata 15.0 software was used to calculate combined OR values, and subgroup analysis and meta regression were used to explore the sources of heterogeneity. Results: A total of 32 literatures were included, all of which were in Chinese, with a total sample size of 36003 people, and the literature quality scores were 5-7 points. Heterogeneity test showed that there was no heterogeneity between the literatures (I(2)=20.3%, P=0.156), so fixed effect model was selected to calculate the combined OR value. The combined OR value of overtime work on neck musculoskeletal disorders was 1.51 (95%CI: 1.42-1.60, P<0.001). Subgroup analysis showed that the combined OR of occupational population <35 years old group was higher than that in the ≥35 years old group (P<0.05). But there were no significant differences in the combined OR values in the subgroups classified by average years of service, male proportion, type of OR values, sample size and industry classification (P>0.05) . Conclusion: Overtime work is a risk factor for neck musculoskeletal disorders in Chinese occupational population. Working hours should be rationally arranged to reduce the prevalence of neck musculoskeletal disorders.

Objective: To investigate the health status and the influencing factors of abnormal lung function of welding fumes exposure workers in Tianjin from 2020 to 2022, and to provide theoretical basis for the protection and intervention of key occupational diseases. Methods: In October 2023, the relevant data of occupational health examination of welding fumes exposure workers in Tianjin from 2020 to 2022 (10831, 10758 and 21717 in 2020, 2021 and 2022, respectively) were collected from the China Disease Prevention and Control Information Platform. The electrocardiogram, chest radiograph and lung function abnormalities of workers in each year were analyzed, as well as the association between lung function abnormalities and gender, age, working age, region, etc. With gender, age and years of service as independent variables, logistic regression analysis was performed year by year on the influencing factors of abnormal lung function. Results: From 2020 to 2022, electrocardiogram, chest radiograph and lung function abnormality rates of workers exposed to welding fumes had statistical significances (χ(2)=301.79, 7.87, 1614.54, P<0.05), and the lung function abnormality rate showed a downward trend year by year (χ(2)(trend)=1516.19, P<0.001). The abnormal rates of lung function in male workers exposed to welding fumes were higher than those in female workers (χ(2)=61.65, 8.04, 15.22, P<0.05). With the increase of age, the abnormal rate of lung function showed an increasing trend (χ(2)(trend)=6.47, 10.81, 4.72, P<0.05). The abnormal rates of lung function in the four districts around the city in each year were 22.05% (318/1442), 8.91% (171/1919) and 6.48% (273/4212), respectively. Year by year logistic regression analysis showed that females were the protective factors for abnormal lung function (OR=0.369, 0.568, 0.546; 95%CI: 0.298-0.458, 0.367-0.879, 0.388-0.767; P<0.05) . Conclusion: Attention should be paid to the health status of welding fumes workers in Tianjin, focusing on the protection of middle-aged male workers, and effective prevention measures should be taken for key areas and industries such as the four districts around the city.

Pleural mesothelioma (PMe) was associated with asbestos exposure.The Diagnosis of PMe is difficult due to the lack of specificity of clinical signs and symptoms, although there are many tools available for early diagnosis of mesothelioma. Most PMe patients are diagnosed at an advanced stage. This article reviews advances in strategies for early diagnosis of mesothelioma, focusing on breath analysis, early diagnosis of pleural effusion cytology in patients with mesothelioma, serum biomarkers and miRNA.

Chloromethyl ether and diclomethyl ether are statutory substances that cause occupational lung cancer. From 2021 to 2022, the Department of Occupational Diseases of the Eighth People's Hospital of Hebei Province successively received 4 cases of lung cancer from a chemical company that required occupational disease diagnosis. All four patients had a clear occupational history of chloromethyl ether and diclomethyl ether for more than 1 year, diagnosis of primary small cell lung cancer supported by relevant histopathology, immunohistochemistry, and tumor markers. All the 4 patients were diagnosed as occupational lung cancer (chloromethyl ether, diclomethyl ether) .

Hazardous drugs represented by antineoplastic drugs have clear health hazards to occupational exposed populations, and this issue has received widespread attention all over the world in recent years. This article reviewed the laws, regulations, guidelines, and industry guidance documents for the prevention and control of occupational exposure to hazardous drugs issued by relevant departments and associations in the United States. It could provide a reference basis for the development of occupational environmental health standards and protection guidelines, with the aim of reducing the risk of occupational exposure to hazardous drugs and promoting the healthy development of healthcare services in China.

Objective: To analyze and understand the level of occupational external radiation personal dose of radiation workers in a hospital, and provide a reference for radiation protection. Methods: In May 2023, the personal dose monitoring data of all radiation workers in the hospital from 2018 to 2022 were collected, and their occupational external radiation exposure levels were analyzed and evaluated. All radiation workers were divided into radiation diagnosis, radiotherapy, interventional radiology, and nuclear medicine according to their occupational categories. Results: A total of 1626 person-times were monitored from 2018 to 2022, and the average annual effective dose per person (0.13-0.36 mSV) was lower than the national limit of 20 mSv. The average annual dose of nuclear medicine was the highest (0.36 mSv), and interventional radiology was lower (0.13 mSv). The average annual dose of individuals was the highest in 2020 (0.24 mSv) . Conclusion: The average annual effective dose per person of radiation workers in this hospital is lower than the national standard, and it is still necessary to strengthen the inspection of the wearing of personal dosimeters and the using of protective equipment for radiation workers.