中华劳动卫生职业病杂志最新文献

Objective: To investigate the relationship between serum tumor markers and the severity of silicosis. Methods: In April 2024, A cluster sampling was conducted on the pulmonary rehabilitation centers in Jiangsu Province. A retrospective analysis was carried out on 629 patients who received follow-up physical examinations for pneumoconiosis from April to November 2023 at the selected rehabilitation centers. 281 healthy volunteers who underwent occupational health examinations at our institution were selected as the blank control group, and 384 dust exposed workers from a coal mining enterprise were selected as the dust exposed control group. Detect the levels of peripheral bloodtumor markers carcinoembryonic antigen CEA, carbohydrate antigen CA199, and neuron-specific enolase NSE in specimens. Measure the patient's forced vital capacity (FVC), forced expiratory volume in one second (FEV(1)), and lactate acid dehydrogenase (LDH) levels in the blood. The Jonckheere-Terpstra test, a non-parametric test for ordered independent samples, was used to compare the expression levels of tumor markers among multiple groups. Spearman's rank correlation analysis was adopted to explore the correlations between serum tumor markers and the staging of pneumoconiosis as well as lung function parameters. Results: Among the 629 patients with pneumoconiosis, 454 were in stage Ⅰ, 150 were in stage Ⅱ, 25 were in stage Ⅲ. There were significant differences in serum CEA, CA199 and NSE levels among patients with different periods of pneumoconiosis, blank control group and dust-exposed control group (P<0.001). Serum CEA, CA199 and NSE levels were positively correlated with pneumoconiosis stage (P<0.05). There is a negative correlation between serum CA199 levels and FEV(1)% in patients with pneumoconiosis (r=-0.082, P<0.05). The serum CA199 level was positively correlated with LDH in patients with pneumoconiosis (r=0.108, P<0.05) .The serum NSE level of pneumoconiosis patients was negatively correlated with FVC% (r=-0.079, P<0.05) .There is a positive correlation between serum NSE levels and LDH in patients with pneumoconiosis (r=0.435, P<0.05) . Conclusion: The serum CA199 and NSE of pneumoconiosis patients are directly related to the severity and stage of the disease, which have practical significance in judging the treatment effect of pneumoconiosis patients and monitoring the development of the disease.

Objective: To identify and evaluate the important risk factor set of anxiety and depression in occupational population, establish a risk prediction model, and provide scientific basis for making targeted mental health protection plan and promoting the mental health of workers. Methods: In August 2016, a cluster random sampling method was used to investigate 807 employees who underwent physical examination in a hospital as research objects. The simplified Chinese version of the core job content questionnaire, Athens Insomnia Scale, AIS-5 and Symptom Check List-90 (SCL-90) were used for the Occupational stress, insomnai and negative emotional symptom investigation. Chi-square and Fisher exact probability method were used for data analysis, and Bayesian network was used for model construcion and analysis. Results: The score of occupational stress was 0.88±0.15, and the incidence of occupational stress was 18.09% (146/807). AIS-5 scores were (3.03±2.82), and the incidence of insomnia was 15.99% (129/807). Depression (16.89±5.73) scores, anxiety (12.36±4.11) scores. Depression (16.89±5.73) score, anxiety (12.36±4.11) score, the detection rate was 8.55% (69/755), 7.31% (59/762). Gender, illness, education, insomnia and occupational stress were correlated with depression (P<0.01), while education, illness, insomnia and anxiety were correlated (P<0.05). When both occupational stress and insomnia existed, the detection rate of depression was the highest (0.4006) . Conclusion: Insomnia was a valid predictor of anxiety and depression, suggesting that occupational groups should pay attention to sleep quality and managers should rationalize work tasks in order to reduce the risk of anxiety and depression.

Objective: To establish the model of acute kidney injury (AKI), search for more sensitive and reliable biomarkers. Methods: In April 2018, 100 male Wister rats aged 6 to 8 weeks were selected and randomly divided into experimental group (n=90) and control group (n=10). The experimental group was given Diachalefin (140 mg/kg body weight) by intragastric administration, while the control group was given saline intragastric administration. Ten rats in the experimental group were killed 0.5 h, 2 h, 6 h, 24 h, 3 d, 7 d, 14 d, 21 d and 28 d after intragastric administration, respectively. Serum creatinine (Cr), urea nitrogen (BUN) and uric acid (UA) were detected by automatic biochemical analyzer with 5 ml of blood from inferior vena cava puncture. Serum neutrophil gelatinase-associated lipid carrier protein (NGAL), kidney damage molecule-1 (KIM-1) and transforming growth factor-β1 (TGF-β1) levels were determined by enzyme-linked immunosorbent assay (ELISA). The data between groups were compared using two independent sample t tests. Results: The renal tissue structure of rats in the control group was not significantly abnormal, while the renal tissue cell damage of rats in the experimental group was obvious, which gradually increased with the extension of time in the early stage, and gradually recovered in the later stage. UA in experimental group reached its peak at 24 h after exposure and was still higher than that in control group at 14 d (P<0.05), Cr reached its peak at 7 d, and then gradually decreased, and there was no statistical significance between experimental group and control group at 28 d (P>0.05). BUN increased at 6 h after exposure and reached the highest value at 7~14 d (P<0.05). Blood NGAL increased at 0.5 h after exposure, reached its peak at 24 h, continued to increase at 3, 7 and 14 days (P<0.05), and began to decrease at 21 days. KIM-1 began to increase at 0.5 h, continued to peak at 24 h, 3 and 7 d after exposure, and began to decrease at 14 d, but it was still higher than that in control group (P<0.05). There was no significant difference in TGF-β1 at each time point (P>0.05). Western blot assay results: Compared with control group, there was no significant difference in the expression level of TGF-β1 in kidney tissue of experimental group (P>0.05). NGAL increased gradually from 2 h and was higher at 7 and 14 d, with statistical significance (P<0.05). KIM-1 increased at 2 h, decreased at 6 and 24 h, and increased again at 3 and 7 d. Conclusion: NGAL and KIM-1 can be used as early diagnostic biomarkers for diquat-induced acute kidney injury.

Objective: To analyze the characteristics of patients with pneumoconiosis complicated with chronic obstructive pulmonary disease (COPD), and to explore the comorbidity of pneumoconiosis and COPD and its influencing factors. Methods: From October to December 2022, 255 pneumoconiosis patients admitted to an occupational disease prevention and control hospital from January 2018 to December 2021 were selected as the study subjects. According to whether the pneumoconiosis patients were complicated with COPD or not, they were divided into pneumoconiosis and COPD comorbidity group and pneumoconiosis group. The general condition and dust exposure of the two groups of patients were analyzed, and the relationship between different types and different periods of pneumoconiosis and COPD comorbidity was analyzed by multivariate logistic regression. Results: A total of 255 subjects were collected, including 64 patients with comorbidity of pneumoconiosis and COPD, and the comorbidity rate was 25.1%. There were 186 males (72.9%) and 69 females (27.1%), ranging in age from 35 to 90 (63.79±11.79) years, and working age from 1 to 45 (20.31±10.57) years. The comorbidity of pneumoconiosis and COPD increased with the increase of working age (χ(2) (trend)=8.19, P=0.004), and the comorbidity rate for COPD with working age of more than 30 years was 37.7% (23/61). The comorbidity rate of pneumoconiosis and COPD also increased with the increase of the stage of pneumoconiosis (χ(2)(trend)=13.14, P<0.001), and the comorbidity rate of pneumoconiosis and COPD in the stage Ⅲ was as high as 44.0% (11/25). The cumulative dust exposure was negatively correlated with forced expiratory volume in one second/forced vital capacity (FEV(1)/FVC), and the linear regression equation y=-0.04x+78.4. Multivariate logistic regression analysis showed that the length of services ≥30 years (OR=3.30, 95%CI: 1.15-9.52) and stageⅡ (OR=3.05, 95%CI: 1.03-9.04) were the risk factors for comorbidity between pneumoconiosis and COPD (P<0.05) . Conclusion: The comorbidity rate of pneumoconiosis and COPD is high. Working age, pneumoconiosis stage and cumulative dust exposure are the main influencing factors of pneumoconiosis and COPD comorbidity, so more attention should be paid to the comorbidity of pneumoconiosis and COPD.

Objective: To explore the effect of the interaction between plasma aluminum concentration and schooling year on cognitive function, it provides the basis for early identification of its damaging effect. Methods: From October to December, 2014, 1114 on-the-job aluminum exposed workers in a large aluminum factory in Shanxi Province were investigated. The plasma aluminum concentrations were measured by inductively coupled plasma-mass spectrometry (ICP-MS) as an internal exposure indicator. The subjects were divided into low, medium, and high aluminum exposure group based on the blood lead concentration levels. The general information was collected with a self-designed questionnaire, and their cognitive function was evaluated with the mini-mental state examination and the clock drawing test. The interaction between plasma aluminum concentration level and education level was analyzed by using unconditional logistic regression fitting multiplication model and cross analysis fitting addition model. Results: The average level of plasma aluminum of the subjects was 21.68 (10.51, 45.78) μg/L. The detection rate of cognitive impairment was 19.9%. The influencing factors of cognitive function were plasma aluminum concentration, age, education level and marital status, among which high schooling year, and being married were the protective factors (all P<0.05), plasma aluminum concentration, and age were the risk factors (all P<0.05) ; After adjusting the confounding factors, such as age, marital status, schooling year, income level, smoking, and drinking, logistic regression model and the multiple linear regression model showed that there was a dose response relationship between plasma aluminum concentration and cognitive impairment. With the increase of plasma aluminum concentration, the score gradually decreased, and the risk of cognitive impairment increased (P(trend)<0.05) ; There were multiplicative interaction (AOR=2.15, 95%CI: 1.10-4.19) and additive interaction (RERI=5.38, 95%CI: 2.60-8.16; AP=0.65, 95% CI: 0.51-0.80; S=3.88, 95% CI: 2.00-7.56) between plasma aluminum concentration and low schooling year on cognitive function. Conclusion: There was a dose-response relationship between aluminum exposure and cognitive impairment. There was an interaction between aluminum exposure and low schooling year. When both of them worked together, the risk of cognitive impairment increases.

Objective: To accurately identify occupational health and safety hazards in different industries with distinct characteristics, a comprehensive occupational ergonomics assessment scale was developed by integrating the Rapid Upper Limb Assessment (RULA) evaluation framework, the Rapid Entire Body Assessment (REBA) and the Ovako Working Posture Analysing System (OWAS) . Methods: Between May 2023 and May 2024, based on the proportional reasoning method and segmented function method, the algorithm logic of RULA and REBA was aligned, and the evaluation rules for the revision content of the innovation scale were inferred using the method of proportion reasoning. Twenty postures were randomly selected for correlation verification. Results: The results showed that at a significance level of α=0.01, the normalized score of the comprehensive ergonomic assessment scale had a correlation coefficient of r=0.845 with RULA and r=0.633 with REBA. The behavioral level score of the comprehensive ergonomic assessment scale had a correlation coefficient of r=0.911 with RULA and r=0.737 with REBA, indicating significant correlations. Conclusion: The innovative comprehensive ergonomic assessment scale has high reliability and can be used for work activities in different workplaces and work contents, promoting the standardization of ergonomic assessment of occupational exposure hazards.

"Ergonomic guidelines for the prevention of work-related musculoskeletal disorders Part 6: Wooden furniture manufacturing work" provides comprehensive preventive measures for China's wooden furniture manufacturing industry, covering scope of application, hazard factors identification, potential affected areas, intervention measures and effect evaluation. Through systematic ergonomics strategies, the guide emphasizes improving the working environment, cultivating employee awareness, eliminating hazard factors, and providing practical guidance for creating a healthy and safe working environment. This article interprets and analyzes the standard project background, formulation process, basic basis and main content to help relevant practitioners more fully understand and implement the ergonomics scheme proposed by the standard, and provide enterprises with scientific and accurate technical support. It is expected to promote industry standardization and overall employee well-being.

Objective: To establish a structural equation model of lower back pain and its risk factors in occupational population in China based on a large-sample occupational epidemiological survey and structural equation analysis, so as to lay the foundation for the prevention of this disease. Methods: A total of 73497 occupational epidemiological cases were selected from June 2018 to December 2023 using the Chinese version of the Musculoskeletal Disorders Electronic Questionnaire. The results were analyzed using ergonomic hazard factors and their risk source classification criteria. Confirmatory factor analysis was then applied to extract individual factors, work organization, working postures, work types, muscle fatigue, and lower back pain. These factors were subsequently classified into six categories and structural equation model was established. Results: The main structural reliability and validity indexes of the structural equation model of lower back pain and its adverse ergonomic factors after adjustment were basically up to standard[goodness of fit index (GFI) was 0.956, the adjusted goodness of fit index (AGFI) was 0.944, the root mean square error of approximation (RMSEA) was 0.043, the normed fit index (NFI) was 0.922, the comparative fit index (CFI) was 0.923, and the Tucker-Lewis index (TLI) was 0.908], and the model fit was good. There were correlations among four exogenous latent variables: individual factors, work organization, working postures and work types. Among them, individual factors had a weak negative correlation with the three exogenous potential variables of work organization, working postures and work types (r=-0.30, -0.11, -0.18), and work organization had a moderate positive correlation with working postures and work types (r=0.49, 0.55). There was a strong positive correlation between work types and working postures (r=0.72). The direct path coefficients of individual factors, working postures and muscle fatigue were 0.07, 0.11 and 0.40, respectively. The direct path coefficients of work types were -0.07. There was an indirect path mediated by muscle fatigue between work types, working postures and work organization and lower back pain, and the indirect path coefficients were: work types-muscle fatigue-lower back pain (0.15), working postures-muscle fatigue-lower back pain (-0.04) and work organization-muscle fatigue-lower back pain (0.27) . Conclusion: When carrying out the prevention and control of lower back pain, the pathogenesis of lower back pain induced by workers' muscle fatigue caused by work organization, working postures, and work types factors should be comprehensively considered, so as to provide a theoretical reference for improving the prevention and control level of lower back pain.