中华劳动卫生职业病杂志最新文献

Carpal tunnel syndrome is the most common peripheral nerve compression syndrome and a well-studied form of nerve entrapment syndrome as well. According to the etiology, the risk factors can be divided into individual risk factors and occupational risk factors. Individual risk factors include older age, gender (female), pregnancy, family history, hypothyroidism, diabetes, autoimmune diseases, advanced age, obesity, and wrist trauma, they are also associated with abnormal in the shapes and structures of the wist canal bones and tissues in individuals carpal tunnel bones and tissues. Occupational risk factors include the working posture of hands and wrists, work intensity, and tools, etc., that have attracted more and more attention from occupational disease prevention and control experts and management departments. In addition, the latest research also indicates that social psychosocial factors may also be an important factor in the occurrence and development of carpal tunnel syndrome. Therefore, it is necessary to actively carry out the prevention of occupational carpal tunnel syndrome, reduce the risk of the disease among workers and detect clinical symptoms as early as possible and intervene in time.

Objective: To analyze the differences in pediatric CT radiation dose and scanning parameter Settings between children's specialized hospitals and general hospitals, and to provide reference for the optimization strategy of pediatric CT radiation dose. Methods: From July to August 2022, a stratified sampling method was used to select 7 comprehensive hospitals and 2 children's hospitals in Tianjin, and on-site survey was conducted to collect the dose data of children's head, chest, and abdomen and pelvic CT examinations in these hospitals. The Wilcoxon rank sum test was used to analyze the differences in CTDI(vol) and DLP of the same age group and examination site among different types of hospitals, and the stepwise regression analysis method was used to analyze the effects of age, examination site, and scanning parameters on radiation dose CTDI(vol) and DLP. Results: The CTDI(vol) and DLP of head (1-<5, 5-<10, 10-<15 years old group), chest (5-<10, 10-<15 years old group) and abdomen (1-<5, 5-<10, 10-<15 years old group) in children's specialized hospitals were lower than those in general hospitals (head, 1-<5, 5-<10, 10-<15 years old group, CTDI(vol): Z=-9.32, -6.17, -9.86, P<0.001, DLP, Z=-4.41, -4.14, -5.76, P<0.001; chest, 5-<10, 10-<15 years old group, CTDI(vol): Z=-3.84, -5.35, P<0.001, DLP, Z=-3.59, -4.63, P<0.001; abdomen, 1-<5、5-<10 and 10-<15 years old group, CTDI(vol): Z=-7.88, -7.78, -8.53, P<0.001, DLP, Z=-7.24, -5.92, -3.44, P<0.001). The CT radiation dose in children was positively correlated with age, tube voltage, tube current time product and scan length, and negatively correlated with pitch and hospital type (general hospital and children's hospital) . Conclusion: There are some differences in the CT radiation dose and scanning parameters between children's hospitals and general hospitals. The results indicate that there is still much room for improvement in the optimization of radiation dose in pediatric CT examination.

Chinorhodopyr is a widely used pesticide in agriculture, and the mortality rate of acute chinorhodopyr poisoning patients is high, with no effective treatment currently available. This paper summarized the clinical data of 8 patients with acute chlorfenapyr poisoning recently admitted to the First Affiliated Hospital of Wenzhou Medical University, including clinical manifestations, auxiliary examination and treatment process, so as to provide references for disease diagnosis and treatment, and improve clinicians' understanding of acute chlorfenapyr poisoning.

Objective: To establish an inductively coupled plasma mass spectrometry (ICP-MS) method for the rapid determination of total bromine in whole blood, and to provide technical support for the monitoring of bromine exposure in occupational populations. Methods: In September 2023, 0.25 ml of whole blood sample was added with 0.25% tetramethylammonium hydroxide solution to a volume of 5.0 ml, ultrasonicated and homogenized, and then quantified by ICP-MS with rhodium solution as the online internal standard solution. Results: The linear relationship of bromine in blood was good within the range of 0~10.00 mg/L, with a correlation coefficient (r) >0.999. The limit of detection of the method was 0.07 mg/L, and the quantification limit was 0.22 mg/L. The recoveries of the total bromine in whole blood were in the range of 95.5%-102.9%, and the relative standard deviations (RSDs) were in the range of 3.1%-4.7% (n=7) . Conclusion: An ICP-MS method was established for the rapid determination of total bromine in whole blood, which is accurate, simple, rapid, highly automated, and can be used for the determination of total bromine in whole blood of occupationally exposed people.

Acetamiprid and pyridaben is a compound pesticide, Due to its characteristics of high efficiency, and environmental safety, it has been widely used in agriculture in recent years.This article reports a case of poisoning from a mixture of pymetrozine and propargite pesticides. The patient experienced severe symptoms of poisoning such as vomiting, shortness of breath, abdominal discomfort, generalized cyanosis, bradycardia, and shock after self-administering the pesticide. After admission to the hospital, the patient was treated with atropine to increase heart rate, endotracheal intubation to assist breathing, and norepinephrine to maintain blood pressure. In addition, the patient received gastric lavage, catharsis, hemoperfusion, and continuous blood purification therapy to eliminate the toxins. The patient was successfully treated and discharged after recovery.

Objective: To explore the risk factors of pneumoconiosis complicated with pulmonary tuberculosis, to construct a clinical prediction model for patients with pneumoconiosis complicated with pulmonary tuberculosis, and to provide a scientific basis for the prevention of pneumoconiosis complicated with pulmonary tuberculosis. Methods: In January 2024, a total of 232 patients with pneumoconiosis (including coal workers' pneumoconiosis and silicosis) who were treated in the Department of Respiratory and Critical Care Medicine of the Third People's Hospital of Xinjiang Uygur Autonomous Region (Xinjiang Uygur Autonomous Region Occupational Disease Hospital) from January 2022 to January 2023 were randomly selected as the study subjects. Collectted basic patient information and diagnostic data. Multivariate logistic regression analysis was used to screen the risk factors related to pneumoconiosis complicated with pulmonary tuberculosis. According to the results of multivariate logistic regression analysis, a nomogram was established, and the area under the receiver operating characteristic (ROC) curve (AUC), calibration curve and decision curve analysis (DCA) were used to evaluate the predictive ability. Results: Among the 232 patients with pneumoconiosis, 73 were complicated with pulmonary tuberculosis, accounting for 31.47% (73/232). Multivariate logistic regression analysis determined that dust exposure time, type of work, smoking history, and lung function level were all risk factors for pneumoconiosis complicated with tuberculosis (OR=10.33, 95%CI=1.92~55.66, OR=5.43, 95% CI=1.91~15.44, OR=3.10, 95% CI=1.15~8.37, OR=4.00, 95% CI=1.62~9.87; P<0.05). The constructed nomogram model has good clinical applicability when the area under the receiver operating characteristic (ROC) curve is 0.77 [95% CI (0.69, 0.73) ], the calibration curve is close to the ideal diagonal, the absolute error between the simulation curve and the actual curve is 0.03, and the DCA decision curve shows that the probability threshold of the nomogram model is 1%-90%. Conclusion: The risk of pneumoconiosis complicated with tuberculosis is high, and the risk factors of dust exposure time, smoking history, type of work and lung function level are high. This nomogram model can be used to predict the risk of pulmonary tuberculosis in patients with pneumoconiosis, which is helpful for early intervention.

Objective: To investigatethe effects of different blood lead levels on indicators of immune function in occupationally lead-exposed populations. Methods: From October to December 2023, a total of 126 occupationally exposed lead workers of a company in Guizhou Province were selected, and their basic information was collected through questionnaires. Inductively coupled plasma mass spectrometry was used to detect blood lead levels in the study population. Workers were categorized into Group 1, Group 2 and Group 3 based on blood lead levels (blood lead levels <200 μg/L, 200~400 μg/L and >400 μg/L). Lymphocyte subpopulation marker leukocyte differentiation antigen (CD) in peripheral blood and interleukin (IL) -1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17, tumor necrosis factor-alpha (TNF-α), and interferon (IFN) -γ in serum were examined by flow cytometry. Serum levels of immunoglobulin (Ig) A, IgG, IgM, and complement proteins (C3, C4) were measured by immunoscattering turbidimetry. Data were statistically analyzed using rank sum test, Chi-square test or Fisher exact probability method for multiple samples. Results: Compared with group 1, the percentage of CD3(+)CD8(+) and CD4(+)CD25(+) cells decreased (P<0.05) and the percentage of CD4(+) CD95(+) cells increased in the lead-exposed populations in groups 2 and 3 (P<0.05) ; however, the serum IL-1β, IL-2, IL- 5, IL-8, IL-12p70, and IFN-γ levels were decreased (P<0.05) in group 3. Meanwhile, IgG (P<0.05) and IgM levels in serum of lead-exposed population in group 2 and group 3 were reduced (P<0.05) comparing with group 1. Spearman correlation analysis showed that blood lead levels of workers were negatively correlated with the percentage of peripheral blood CD8(+)CD95(+) cells, CD3(+)CD8(+) cells, CD3(-)CD16(+) CD56(+) cells, IgG, IgM, and IgA (r(s)=-0.20, -0.22, -0.23, -0.24, -0.26, -0.35, P<0.05), but was positively correlated with the level of CD3(+)CD4(+) cells (r(s)= 0.18, P<0.05). Regression analysis revealed that blood lead level was a risk factor for the percentage of CD8(+)CD95(+) cells, CD3(+)CD8(+) cells, CD3(-)CD16(+) CD56(+) cells, IgG, IgM, and IgA (P<0.05) . Conclusion: Different lead loads can lead to abnormal changes in peripheral blood lymphocyte subsets, cytokines, and immunoglobulin levels in occupationally lead-exposed people. Lead exposure in occupationally lead-exposed populations may affect their immune function.

Objective: To investigate the current situation of uncivilized behavior in workplace encountered by nurses in Xianyang City, and analyze its influencing factors, so as to provide a basis for formulating corresponding intervention measures. Methods: In May 2023, convenience sampling was used to investigate the general information, current situation of uncivilized behavior in workplace and coping style of 1310 nurses in 8 secondary and tertiary general hospitals in Xianyang City by using the general information questionnaire, the Chinese version of the Nurse Incivility Scale and the Simplified Coping Style Questionnaire. Multiple linear regression analysis was used to analyze the influencing factors of uncivilized behavior encountered by nurses. Results: A total of 1285 valid questionnaires were collected, with an effective recovery rate of 98.09%. The total score of uncivilized behavior encountered by nurses was (86.41±22.49) points. Among them, the scores of five dimensions were nurses' uncivilized behavior (19.95±4.70) points, patients' uncivilized behavior (23.66±8.96) points, supervisors' uncivilized behavior (13.25±4.87) points, doctors' uncivilized behavior (14.32±5.63) points and colleagues' uncivilized behavior (15.23±4.93) points. The multiple linear regression analysis results showed that the hospital level and coping style were the significant influencing factors of uncivilized behavior in workplace encountered by nurses (β=0.104, 0.056; P<0.05) . Conclusion: The current situation of uncivilized behavior in workplace encountered by nurses needs to be improved. Hospital managers should focus on coping styles, such as setting up simulation scene exercises, team cooperation training, training and counseling, so as to reduce the uncivilized behavior in workplace encountered by nurses.