中华劳动卫生职业病杂志最新文献

This article briefly introduces the new concept of burnout and the new burnout assessment tool BAT. In the past, the most famous burnout definition was proposed by Maslach and Leiter. The Maslach Burnout Inventory (MBI) developed by Maslach has also been the gold standard for evaluating burnout. With the development of burnout research, the concept of burnout has a certain defect. MBI has also been criticized in conceptual, practical and psychological measurement. It may hinder new research, and urgently needs to improve the concept and evaluation of burnout. Therefore, Schaufeli redefined the concept of burnout, and developed a new burnout assessment tool for groups and individuals based on the new concept of burnout-Burnout Assessment Tool (BAT) . This paper systematically reviews the proposal of the new concept of burnout, the development of the BAT scale and its application at home and abroad, and analyzes the advantages and application prospects of the BAT scale.

This article analyzes the treatment process of a patient with respiratory failure caused by occupational acute acetonitrile poisoning. Due to operational errors, the patient's body was sprayed with a large amount of acetonitrile liquid, leading to the absorption of acetonitrile through the skin and resulting in acute poisoning. The clinical manifestations were nervous system and respiratory system damage, accompanied by severe lactic acidosis. After active comprehensive treatments such as tracheal intubation, mechanical ventilation, continuous renal replacement therapy (CRRT) , and glucocorticoids, the patient basically recovered. The treatment process of this patient indicates that early identification and correct first aid of acetonitrile poisoning are the keys to improving prognosis and can provide a reference for the handling of similar clinical cases.

Objective: To investigate the characteristics, influencing factors, consequences, coping strategies, and preventive measures of workplace violence in medical consortiums. Methods: Medical professionals from a specialized hospital in South China and its consortium members (2 primary-level, 1 secondary-level, and 1 tertiary-level hospitals) were surveyed in December 2022 and July 2023. Quantitative research included 1013 participants, while qualitative research involved 35 participants. Workplace violence was assessed using the "National Case Study Tool for Workplace Violence in Healthcare Institutions-Survey Questionnaire", with qualitative analysis conducted through semi-structured interviews. Inter-group comparisons employed chi-square tests or Fisher's exact probability test, with logistic regression models for bivariate analysis. Results: The overall incidence rates of violence, psychological violence, and physical violence in this medical consortium were 31.7% (321/1, 013) , 30.6% (310/1, 013) , and 3.3% (33/1, 013) , respectively. Specifically, the overall violence rates in Level 1, Level 2, and Level 3 hospitals were 22.7% (41/181) , 27.4% (43/157) , and 35.1% (237/675) . The physical violence rates were 1.1% (2/181) , 10.2% (16/157) , and 2.2% (15/675) , respectively. The psychological violence rates stood at 22.7% (41/181) , 24.8% (39/157) , and 34.1% (230/675) . The total violence in tertiary hospitals was significantly higher than that in tertiary hospitals (F=10.10, P=0.002) , and the incidence of psychological violence in tertiary hospitals was significantly higher than that in tertiary hospitals (F(level 1 vs level 3)=8.61, P=0.003; F(level 2 vs level 3)=4.96, P=0.026) , incidence of verbal insults (F(level 1 vs level 3)=8.25, P=0.004; F(level 2 vs level 3)=6.36, P= 0.012) was significantly higher than that of level 1 and level 2 hospitals. The incidence of physical violence in secondary hospitals was significantly higher than that of other two-level hospitals (P<0.001) . Compared with other types of violence, the incidence of verbal insults is highest in hospitals at all levels. Higher anxiety about violence was a risk factor for psychological violence in hospitals at all levels (F(level1 hospital)=15.44, P=0.004; F(level2 hospital)=22.87, P<0.001; F(level3 hospital)=84.12, P<0.001) . Health workers in all three levels of hospitals has a high level of approval of existing workplace violence interventions. The main causes of workplace violence were poor communication between doctors and patients (13.2%) , service attitude problems (12.5%) and patient illness (16.9%) . Conclusion: Workplace violence remains prevalent within this medical consortium. Targeted measures should be implemented based on hospital size, functions, and patient demographics.

Objective: To study investigates the current healthcare-seeking status of patients with pneumoconiosis at grassroots rehabilitation stations in Henan Province, analyzes their healthcare-seeking behaviors and influencing factors, and provides references for formulating relevant rehabilitation treatment and health management policies. Methods: In July 2024, a total of 492 cases of pneumoconiosis patients registered at 7 grassroots pneumoconiosis rehabilitation stations from July to December 2021 were selected. The "Healthcare-Seeking Behavior and Influencing Factors of Pneumoconiosis Patients" questionnaire was used to collect information through a combination of rehabilitation station consultations and household interviews. Data on medical insurance type, whether the employer had purchased work-related injury insurance, patient condition characteristics (years of dust exposure, pneumoconiosis stage, patient condition score) , and reasons for not visiting rehabilitation stations were gathered and statistically analyzed. Univariate analysis was conducted using the chi-square test and logistic regression analysis was used to identify the influencing factors of patients' medical-seeking behavior. Results: A total of 492 pneumoconiosis patients were registered in basic rehabilitation stations in Henan Province. Among them, 204 cases (41.5%) went to the rehabilitation station, In the past year, 288 cases (58.5%) did not visit. Patients with pneumoconiosis who have no income, whose employer has purchased work-related injury insurance, whose pneumoconiosis type is silicosis, and whose disease score is 15-20 points have a high rate of visits to rehabilitation stations (OR=8.35, 95%CI: 4.40-15.84; OR=13.89, 95%CI: 7.69-25.08; OR=3.20, 95%CI: 1.18-8.68; OR=5.18, 95%CI: 2.04-13.14) . The top five reasons for the analysis of not visiting were: the self-induction symptoms lighter (58.7%, 169/288) , online consultation or telephone follow-up (17.0%, 49/288) , buying medicine in a drugstore (14.6%, 42/288) , thinking of seeing a doctor is useless, can not be cured (6.9%, 20/288) , medical expenses are high and cannot be reimbursed (6.3%, 18/288) . Conclusion: Economically disadvantaged silicosis patients with work-related injury insurance and severe conditions prefer seeking treatment at nearby rehabilitation stations. The main reasons for reluctance to seek medical care are low treatment demand and concerns over high costs. Greater attention should be paid to the demand of pneumoconiosis patients for "Internet+healthcare" services at grassroots-level rehabilitation stations.

This paper analyzes the treatment process of a patient who developed severe acute respiratory distress syndrome (ARDS) following a chemical leak of dimethyl sulfate caused by factory operational error in February 2023, and explores the efficacy of extracorporeal membrane oxygenation (ECMO) in patient management. The patient developed severe respiratory symptoms five hours after chemical exposure and received sequential treatment with nasal high-flow oxygen therapy and invasive mechanical ventilation upon admission. When the oxygenation index dropped below 100 mmHg, veno-venous (VV) ECMO was initiated alongside 12-hour daily prone position ventilation to improve oxygenation and lung compliance. The patient recovered and was discharged following treatment. For patients with dimethyl sulfate poisoning complicated by severe ARDS, early implementation of VV-ECMO significantly improves treatment outcomes and prognosis.

Objective: To explore the moderating effect of social support on the effect of occupational stress affecting job burnout, and to provide a theoretical basis for effectively reducing job burnout of medical workers. Methods: In April 2021, a cluster sampling method was adopted. Two units were randomly selected from the tertiary, secondary and primary medical institutions in Shanghai to carry out the survey. The survey was conducted by distributing electronic questionnaires online, and a total of 1963 valid questionnaires were collected. The questionnaire employed Maslach Burnout Inventory-General Survey (MBI-GS) to measure job burnout, and Job Content Questionnaire to measure occupational stress and social support. The questionnaire also collected demographic characteristics and work-related information. Mann-Whitney U test and Kruskal-Wallis H test were used for one-way analysis to test whether there was any difference in the distribution of occupational stress, job burnout, and social support on different demographic characteristics. Spearman's rank correlation coefficient was used to analyze the correlation between occupational stress, job burnout, and social support. Bootstrap method was used to analyze the moderating effect of social support on occupational stress affecting job burnout. Results: The occupational stress score was 1.232 (1.039, 1.530) , the job burnout score was 2.480 (1.560, 3.240) , and the social support score was 3.500 (3.125, 4.000) . Occupational stress, job burnout and social support were distributed differently on sex, job position, hospital level, monthly income, daily working hours, break duration per shift, and break duration between shifts (P<0.05) . Occupational stress was positively associated with job burnout (r(s)=0.49, P<0.001) , and social support was negatively associated with both occupational stress (r(s)=-0.44, P<0.001) and job burnout (r(s)=-0.48, P<0.001) . Social support played a moderating role in the influence of occupational stress on job burnout (B=0.321, 95%CI: 0.216~0.426) . Conclusion: The problem of job burnout is more prominent among medical workers. In the context of enhanced social support, improving job stress condition can lead to a greater decrease in job burnout.

Objective: To explore the method of CT quantitative evaluation of silicosis fibrosis in artificial stone and analyze its correlation with the stage of chest X-ray and lung function impairment. Methods: The clinical data of 142 patients with artificial stone silicosis who were treated at Shanghai Pulmonary Hospital from January 2018 to December 2022 were collected. These patients were diagnosed based on GBZ 70-2015 Diagnosis of Occupational Pneumoconiosis and underwent chest X-rays, chest CT scans, and lung function tests within a two-month period. The chest CT scoring method is based on the CT characteristics of silicosis, including ground-glass shadows, small nodule shadows, point-line shadows/cord-line shadows, emphysema/pulmonary bullae and patch shadows/mass shadows, with a scoring range of 0 to 25 points. Lung function indicators included FVC, FEV(1) and DLco. For inter-group comparisons of normally distributed quantitative data, one-way ANOVA was employed with LSD post-hoc test for multiple comparisons. Chi-square test was used for multi-group ratio comparisons. Kruskal-Wallis H test was applied to non-normally distributed quantitative data, followed by LSD post-hoc test. Spearman's rank correlation was used to analyze the relationship between pulmonary function indicators and CT fibrosis scores, Trend test was conducted using the Pearson test. Results: As the silicosis stage progressed, both the CT fibrosis score (R=0.87, P(trend)<0.001) and the degree of lung function impairment (FVC: R=-0.41, P(trend)<0.001; FEV(1): R=-0.52, P(trend)<0.001) ; DLco: R=-0.38, P(trend)<0.001) showed an increasing trend. The CT fibrosis Score demonstrated a strong positive correlation with silicosis stage (r(s)=0.85, P(trend)<0.001) and a moderate negative correlation with FVC, FEV(1), and DLco (r(s)=-0.48, -0.56, and -0.45, respectively, with all P<0.05) . Over an average follow-up period of 14 months, it was observed that changes in the CT score had a strong to moderate negative correlation with variations in FVC and FEV(1) (r(s)=-0.63 and -0.52, P<0.05) . Additionally, there was a moderate negative correlation between ground glass opacity and DLco (r(s)=-0.52, P<0.001) . Conclusion: The CT fibrosis score not only reflects pathological changes associated with artificial stone-related silicosis but also provides a more precise representation of lung function injury.

Objective: To establish a rapid method for the determination of glyphosate and glufosinate residues in plasma samples by solid-phase extraction-liquid chromatography-tandem mass spectrometry (SPE-LC-MS/MS) . Methods: In March 2024, plasma samples were extracted and protein precipitated with methanol and purified using a weak cation exchange (WCX) SPE cartridge. Then the samples were separated on a Dikma Polyamino HILIC column (150 mm×2.0 mm, 5 μm) with a gradient elution of 1.0 mmol/L ammonium fluoride aqueous solution (pH=11) and acetonitrile as mobile phases. Analysis was performed using an electrospray ionization source (ESI) in multiple reaction monitoring (MRM) mode with internal standard quantification. The method's linearity, detection limits, spiked recovery and precision were then evaluated. Results: Glyphosate and glufosinate exhibited good linearity in the concentration range of 1.0-200.0 μg/L, with correlation coefficients of 0.9986-0.9992. The limits of detection (LODs) of glyphosate and glufosinate were 0.5 and 1.0 μg/L, respectively. At low, medium and high spiked concentrations, the spiked recovery rates and precision for glyphosate and glufosinate in plasma ranged from 92.5% to 113.2% and 3.01% to 11.23%, respectively. Conclusion: The SPE-LC-MS/MS method is simple, rapid, sensitive and accurate, and is suitable for the qualitative and quantitative analysis of glyphosate and glufosinate in plasma from poisoned patients.

Objective: To establish an atomic fluorescence detection method for bismuth and bismuth telluride (Bi(2)Te(3)) in the air of workplaces. Methods: In March 2024, the acetate-fiber filter material was digested by ultrawave and detected by atomic fluorescence spectrometry to obtain the content of bismuth and Bi(2)Te(3) in the air of the workplace. Results: The correlation coefficients of standard curve were above 0.9990, The detection limit of bismuth was 0.02 μg/L, the minimum detection concentration was 0.02 μg/m(3), the minimum quantitation concentration was 0.06 μg/m(3), the minimum detection concentration and the minimum quantitation concentration of Bi(2)Te(3) was 0.03 μg/m(3) and 0.09 μg/m(3) respectively. The digestion efficiency ranged from 98.6% to 102 %, the RSDs of intra-batch and inter-batch were below 1.3% and 4.0% respectively. The samples were stable within 7 days, and interference elements of 1.0 mg/L (Ag, Al, As, B, Ba, Be, Cd, Co, Cr, Cs, Cu, Fe, Ga, Li, Mg, Mn, Mo, Ni, Pb, Rb, Sb, Se, Sn, Sr, Ti, Tl, V, Zn, Zr) do not affect the detection of bismuth. Conclusion: This method is simple, fast, accurate, and highly sensitive, and can meet the requirements of the determination of bismuth and bismuth telluride in the air of working place.

Objective: To explore the relationship between work engagement, job burnout, and mental health among full-time and part-time student management staff in universities in Xinjiang, and to provide a scientific basis for developing differentiated mental health intervention measures. Methods: By using the method of cluster random sampling, 1267 student management staff from five universities in Urumqi were selected as the research subjects from March 2020 to December 2021. Data collection was conducted using the Utrecht Work Engagement Scale (UWES-9) , the Maslach Burnout Inventory-General Survey (MBI-GS) , and the Symptom Checklist-90 (SCL-90) . Spearman rank correlation analysis was used to explore the relationship among work engagement, job burnout and mental health. Multivariate logistic regression was adopted to analyze the influencing factors of mental health, and the mediating effect of job burnout was analyzed through the mediating effect test. Results: The detection proportions of job burnout and psychological disorders were 80.5% (525/652) and 38.5% (251/652) among full-time personnel, and 75.3% (463/615) and 30.2% (186/615) among part-time personnel, respectively. Spearman rank correlation analysis showed that work engagement was negatively correlated with psychological disorders (r(s)=-0.720, -0.760, P<0.001) and job burnout (r(s)=-0.776, -0.700, P<0.001) in both full-time and part-time personnel, while job burnout was positively correlated with psychological disorders (r(s)=0.804, 0.718, P<0.001) . Multivariate logistic regression analysis indicated that high work engagement (full-time: OR=0.05, 95%CI: 0.02-0.18; part-time: OR=0.02, 95%CI: 0.01-0.04) was a protective factor for mental health (P<0.001) , whereas job burnout (full-time: OR=10.85, 95%CI: 3.50-33.58; part-time: OR=3.71, 95%CI: 1.76-7.76) was a risk factor for mental health (P<0.001) . Mediating effect tests demonstrated that job burnout played a partial mediating effect between work engagement and mental health, with mediating effect proportions of 57.3% and 27.9% for full-time and part-time personnel, respectively. Conclusion: The detection proportions of job burnout and psychological disorders among full-time and part-time student management staff in Xinjiang universities are relatively high, and job burnout acts as a mediating variable between work engagement and mental health. Universities should enhance the work engagement level of student management staff to prevent and alleviate job burnout, and thereby improving their mental health status.