中华劳动卫生职业病杂志最新文献

Objective: To understand the noise hazard levels at mining industry workplaces to provide a scientific basis for occupational disease prevention policies. Methods: The monitoring result data on occupational hazard factors in the workplace for 2023 were obtained from the National Surveillance System for Occupational Hazards during September to October 2024. Descriptive analysis was then conducted on the noise exposure results at workplace positions in mining industry enterprises, categorized by industry type, geographical distribution, enterprise size, economic type, and key positions. Noise levels at workplace positions were expressed as M (Q(1), Q(3)). The Kruskal-Wallis and Mann-Whitney U tests were used to compare noise levels between groups, while noise exposure exceedance rates were compared using the χ(2) test or Fisher's exact test. Results: A total of 8417 enterprises in the mining industry were monitored, with the non-metallic mining and beneficiation industry constituting the majority at 41.6% (3503/8417). Regionally, enterprises in North China and Southwest China dominated, accounting for 24.0% (2019/8417) and 21.9% (1843/8417) respectively. Small-sized enterprises were the primary type, accounting for 51.4% (4322/8417). In terms of economic types, limited liability companies dominated, accounting for 60.2% (5072/8417). The metal mining and beneficiation industry exhibited the highest noise exposure exceedance rate, at 39.5% (2698/6833), with the drilling position showing an exceptionally high rate of 81.7% (508/622). Northwest China and East China showed higher noise exceedance rates, at 34.8% (1331/3823) and 31.7%(1550/4893) respectively. The small-sized enterprises exhibited the highest exceedance rate of noise exposure, at 28.0% (4328/15476). In metal mining and beneficiation industry, the exceedance rate and the median of noise levels among large and medium-sized enterprises were 41.8% (665/1592) and 84.2 dB (A), respectively, both higher than those among small and micro-sized enterprises[38.8% (2033/5241) and 83.7 dB (A) ] (P<0.05). State-owned enterprises exhibited the lowest workplace noise exceedance rate at 20.1%. Statistically significant differences were found in workplace noise exceedance rates and median noise levels among different industries, regions, enterprise sizes, economic types, and key positions (P<0.05) . Conclusion: The situation of noise hazards in China's mining industry remain severe. Effective workplace noise control in the mining industry should be strengthened to reduce noise exposure at workplace positions and truely safeguard the occupational health of workers.

Objective: Meta-analysis was performed to determine the influencing factors on the progression of pneumoconiosis, providing a basis for optimizing prevention and treatment strategies for pneumoconiosis. Methods: The research date was from April 10(th), 2025 to May 5(th), 2025, PubMed, Embase, Web of Science, CNKI, VIP Chinese Science and Technology Journal Database, Wanfang and other Chinese and English databases were searched, and the search time was from the establishment of the database to April 19(th), 2025. A combined search method of subject terms and free terms was adopted to collect research on the influencing factors of the progression of pneumoconiosis. Based on the results of the heterogeneity test, a fixed-effect model or a random-effect model was selected for analysis, and the sources of heterogeneity were explored through subgroup analysis. Results: Sixteen articles were included, encompassing 20 related risk factors. Meta-analysis results showed that the stage of pneumoconiosis (OR=2.85, 95%CI=2.15-3.77), duration of dust exposure (OR=1.77, 95%CI=1.34-2.33), smoking (OR=2.47, 95%CI=1.40-4.35), comorbidities (OR=1.73, 95%CI=1.35-2.21), age at onset (OR=1.78, 95%CI=1.21-2.61), and protective measures (OR=0.74, 95%CI=0.63-0.86) were all influencing factors for the progression of pneumoconiosis (P<0.05). Body mass index and age were not significantly associated with the progression of pneumoconiosis (P>0.05) . Conclusion: The influencing factors of pneumoconiosis progression include smoking history, stage of pneumoconiosis, duration of dust exposure, comorbidities, age at onset, protective measures. Among them, stage of pneumoconiosis showing the strongest association with the progression of pneumoconiosis.

Potassium methylsilanetriolate is an organic silicon waterproofing agent widely used in the construction industry. It can be obtained by the reaction of methyltrichlorosilane with water and potassium hydroxide, and the solution is a colorless or light yellow transparent liquid with a pH of 12-13. This article shares the diagnosis and treatment process of one case of accidental ingestion of potassium methylsilanetriolate, in order to supplement and improve treatment experience. This case suggests that gastric lavage and blood perfusion are both treatment options for patients with digestive tract chemical injuries who have mistakenly taken strong alkalis. The provision of medical history and reasonable dietary adjustments are particularly important for treatment.

Objective: To tracked and analyze the follow-up diagnosis of suspected occupational noise-induced deafness (ONID) patients in an occupational disease diagnosis institution in Guangzhou City from 2020 to 2024. Methods: In December 2024, a retrospective survey method was used to track the reporting, medical consultation, and diagnosis status of suspected ONID patients, as well as to analyze the influencing factors for the confirmation of suspected ONID as ONID. Rate comparisons were conducted using Pearson's χ(2) test or Fisher's exact test for univariate analysis, while related influencing factors were analyzed using multivariate logistic regression analysis. Results: Occupational health examination was the most important reporting channel of ONID, and the tracking results showed that the number of confirmed cases, exclusion, incomplete diagnosis and non-treatment accounted for 29.58% (21/71), 32.39% (23/71), 5.63% (4/71) and 32.39% (23/71), respectively. Among the 71 suspected cases, 44 entered the diagnostic procedure and completed the diagnosis, and 21 were finally diagnosed, the diagnosis rate was 47.73% (21/44). There was a statistically significant difference in the confirmed diagnosis rate among patients with different noise exposure working years, better weighted values of auditory threshold, and whether the re-examination interval was standardized or not (P<0.05). Multivariate logistic regression analysis revealed that the length of noise-exposed working years and the standardized time interval for re-examination were the influencing factors for the final diagnosis of ONID in patients with suspected ONID (OR=0.28, 95%CI: 0.08-0.93; OR=14.92, 95%CI: 2.64-84.39; P<0.05) . Conclusion: Micro-sized enterprises are key monitoring targets for suspected ONID. Diagnosing physicians should strengthen management of non-standard re-examination intervals, emphasizing the scientific rigor and accuracy in diagnosing patients with suspected ONID.

Objective: To grasp the concentration levels of coal dust, silica dust and other dusts in the workplaces of employers in the national mining industry in 2023, and to identify the key points for occupational disease prevention and control. Methods: In December 2024, the concentrations of coal dust, silica dust and other dusts in the workplaces of 7903 mining enterprises across the country in 2023 were analyzed. Methods such as Kruskal-Wallis H rank sum test and Chi-square test were used to compare the differences in dust concentrations and over-limit ratios in the workplaces of enterprises of different scales, industries and regions. Results: The over-limit ratios of coal dust, silica dust and other dusts positions were 18.80% (1945/10343), 30.10% (4525/15033) and 5.75% (241/4194), respectively. Among them, the over-limit ratios of silica dust positions with free silica content >80% was as high as 73.46% (238/324). The time-weighted average exposure concentrations of coal dust, silica dust and other dusts were 1.50 (0.78, 2.23), 0.45 (0.28, 0.60) and 1.15 (0.56, 2.20) mg/m(3), respectively. There were statistically significant differences in the dust concentrations and over-limit ratios of free silica content ≤50% and 50% P<0.05), with higher ratios in large enterprises. There were statistically significant differences in the content of free silica ≤50%, other dusts concentrations and over-limit ratios in the workplaces of employers in different industries (P<0.05), with higher levels in the coal mining and washing industry and the non-metallic mineral mining and selection industry, respectively. There were statistically significant differences in the over-limit ratios of coal dust and silica dust in different regions (P<0.05), with higher ratios in the Northwest, Southwest and North China regions. Conclusion: The over-limit ratios of dust concentration in the workplace of the mining industry remains at a relatively high level. In the future, the supervision of enterprises in key areas and industries with serious over-limit should be strengthened to protect the health of workers.

Objective: To investigate the decline of lung function and related risk factors in patients with coal workers' pneumoconiosis complicated with chronic obstructive pulmonary disease (COPD) . Methods: In December 2022, a retrospective analysis was performed for coal workers' pneumoconiosis complicated with COPD who were admitted to Hunan Prevention and Treatment Institute for Occupational Disease from 2017 to 2018, and the demographic data, lung function, blood eosinophil value (EOS), smoking status, occupational history, stage of pneumoconiosis, and treatment situation were collected until 2021. Multivariate Cox regression model was used to analyze the risk factor of lung function decline. Results: A total of 162 patients with coal workers' pneumoconiosis were included in this study, and the median follow-up time was 47 months. The lung function of the patients decreased to varying degrees during the follow-up period, and the annual decline of forced vital capacity (FVC) was 115.8 ml/year, percentage of predicted forced vital capacity (FVC%) was 2.9%/year, forced expiratory volume in one second (FEV(1)) was 99.6 ml/year, percentage of forced expiratory volume in one second (FEV(1)%) was 3.4%/year, ratio of forced expiratory volume in one second to forced vital capacity (FEV(1)/FVC) was 1.4%/year, diffusing capacity of the lungs for carbon monoxide (DLCO) was 0.32 mmol/min/KPa/year, and percentage of predicted diffusing capacity of the lungs for carbon monoxide (DLCO%) was 4.1%/year. The results of multivariate Cox regression analysis showed that dust exposure time (HR=1.04, 95%CI: 1.01-1.07), regular use of bronchodilators (HR=0.50, 95%CI=0.29-0.86), blood EOS (HR=1.39, 95%CI: 1.19-1.61), baseline FVC% (HR=1.02, 95%CI: 1.01-1.03, ) and cumulative cigarette smoking (HR=1.03, 95%CI: 1.02-1.05) were the influencing factor of lung function decline of patients with coal workers' pneumoconiosis complicated with COPD (P<0.05) . Conclusion: The lung function of patients with coal workers' pneumoconiosis complicated with COPD will gradually decline, and the baseline value of lung function, dust contact time, EOS, and smoking are the risk factors for the decline of lung function, and the regular use of bronchodilators is its protective factor.

This study analyzed a patient with occupational trinitrotoluene cataract, summarized occupational history, clinical manifestations, and relevant ophthalmic examinations for the diagnosis of occupational diseases, and provided a reference for the diagnosis, prevention and treatment of such occupational diseases. This patient had long-term exposure to trinitrotoluene, experiencing blurred vision and photophobia for more than half a year. After undergoing comprehensive vision improvement and other examinations in the ophthalmology department, trinitrotoluene cataract was considered. After discussion, the patient was diagnosed with stage one occupational trinitrotoluene cataract in accordance with GBZ 45-2010 "Diagnostic Criteria of Occupational Trinitrotoluene Cataract". Occupational exposure to trinitrotoluene can cause lens damage and subsequently lead to cataracts. Attention should be paid during occupational activities and enhanced protection measures should be taken.

The new version of GBZ 89-2024 "Diagnostic Standard for Occupational Mercury Poisoning" was issued on May 9, 2024 and implemented on May 1, 2025. This professional standard is a supporting of the "Law of the People's Republic of China on Prevention and Control of Occupational Diseases" and a mandatory national occupational health standard. This article interprets and expounds the background, revision process, main contents, difficulties and significance of the diagnostic criteria, to help clinical professionals in the diagnosis and treatment of occupational diseases more fully understand and implement the relevant provisions of this national occupational health standard, in line with the needs of social development, to protect the rights and interests of workers as far as possible.

The group of works exposed to occupational noise worldwide is constanthy expanding, with hearing loss becoming a pressing issue that poses serious challenges to public health, economic and society. While current clinical diagnosis primarily relies on elevated hearing thresholds, detectable pre-decibel hearing loss damage has already occurred in the inner ear. Therefore, early biomarkers of noise-induced hearing loss are crucial for the early detection of noise-induced hearing loss and the reduction of the risk of hearing imparment in the occupational population. This article synthesizes the latest research progress on early biomarkers associated with occupational noise exposure-induced hearing loss, aiming to reduce disease incidence and protect the health of occupational populations.