中华劳动卫生职业病杂志最新文献

This paper reports two cases of occupational severe toxic encephalopathy caused by inhaling excessive nitrogen in an accident. The main reasons are failure to performing field-work standards of limited space operation and emergency rescue. Hypoxia asphyxia is the main pathogenic link of nitrogen toxicity, which can cause brain edema. At the same time, hypoxia can lead to the destruction of intracellular calcium environment, exacerbating ischemia and hypoxia. Clinical case data shows that 2 cases presented with clinical manifestations mainly including coma, high limb muscle tone, and neurological damage, but also cause different degrees of lung, myocardium, liver and kidney damage. Early treatments, hyperbaric oxygen therapy, active prevention and treatment of brain edema, correction of acidosis, maintenance of water and electrolyte balance, anti-infection and corresponding symptomatic support therapy are key treatments.

Objective: To explore the occupational contact characteristics of work-related musculoskeletal disorders (WMSDs) among key occupational groups in China, assess the impact of occupational factors on the occurrence of WMSDs, and propose corresponding preventive strategies. Methods: Between January 1, 2018, and December 31, 2023, a cross-sectional epidemiological survey method was employed to retrospectively investigate the occurrence of WMSDs and related occupational factors. Valid questionnaire data from 88609 on-the-job workers in 441 enterprises across 29 industries or job types in seven regions of China were collected, and the relationship between WMSDs and various occupational factors was discussed using multifactorial logistic regression analysis. Odds ratios (OR) and their 95% confidence intervals (CI) were calculated to assess the impact of different factors on the risk of WMSDs occurrence, with all statistical tests performed as two-tailed tests, using P<0.05 as the criterion for statistical significance. Results: Among the surveyed subjects, 59989 were male, accounting for 67.7% (59989/88609) ; 28620 women, accounting for 32.3% (28620/88609). The standardized incidence rate of work related musculoskeletal disorders (WMSDs) in 9 parts of the body was statistically significant (P<0.05) among different working age groups without considering specific parts. The average length of service for onset of WMSDs (regardless of location) is (4.52±2.67) years, and there is a statistically significant difference in the length of service for onset of WMSDs in different locations (P<0.05). As the frequency of heavy object handling increases, the standardization rate and OR value of WMSDs in various parts show a significant increase trend. The incidence of WMSDs is significantly correlated with maintaining poor work posture for a long time, frequent repetitive operations, and heavy object handling (OR=1.52, 1.45, 1.63, P<0.01) . Conclusion: This study reveals that the risk of WMSDs in China's occupational population shows a non-linear change with increasing length of service, especially with a significant increase in 10 to 25 years of service. Poor work posture, frequent repetitive operations, and heavy object handling are significantly correlated with WMSDs, providing a scientific basis for developing more accurate and effective prevention strategies for WMSDs.

Objective: To study aims to examine the current state and future trajectory of research on work-related musculoskeletal disorders (WMSDs) both domestically and internationally. Methods: In February 2024, Using CiteSpace software and bibliometrics, a bibliometric analysis and knowledge map study were conducted on the Web of Science core journal collection and 3144 related documents from CNKI as of December 31, 2023. Results: This study included a total of 3144 articles (723 in Chinese and 2421 in English). Research on WMSDs both domestically and internationally has entered a phase of rapid growth. The United States ranks first in terms of publication regions, accounting for 20.96% of the global publication volume, followed by Canada (7.45%), Brazil (6.51%), Australia (6.34%), and China (6.34%). The main institutions in China are the Institute of Occupational Health and Poison Control of the Chinese Center for Disease Control and Prevention (101 articles), Peking University and its affiliated hospitals (86 articles), Xinjiang Medical University and its affiliated hospitals (59 articles), Guangzhou Occupational Disease Prevention and Control Institute (45 articles), and Hubei Xinhua Hospital (34 articles). The core scholars conducting research on WMSDs in China are mainly from three research groups: Wang Zhongxu's team from the Institute of Occupational Health and Poison Control of the Chinese Center for Disease Control and Prevention (84 articles), He Lihua's team from the School of Public Health at Peking University (50 articles), and Ling Ruijie's team from Xinhua Hospital in Hubei Province (32 articles). The collaborative network analysis of Chinese literature authors obtained a total of 569 nodes and 1026 connections, with a network density of 0.0063. The clustering of literature keywords in China mainly includes incidence rate, ergonomic load, biomechanics, musculoskeletal disorders, musculoskeletal system, risk factors, nurses, rehabilitation, occupational health, automobile manufacturing, middle-aged and elderly patients, and hospitalized patients; Abroad, the main diseases include osteoporosis, occupational health, rheumatoid arthritis, musculoskeletal disorders, rehabilitation, return to work, arthritis, rheumatology, work-related musculoskeletal disorders, juvenile idiopathic arthritis, and network pharmacology. Conclusion: The research on WMSDs in China has formed a relatively complete methodology, epidemiological characteristics, and risk factor investigation data, and has explored the prevention and intervention of diseases to some extent.

Objective: To investigate the changes of metabolites in urine of automobile manufacturing workers with muscle fatigue using metabolomics technology, and to explore potential biomarkers and disrupted metabolic pathways. Methods: In July 2022, urine samples were collected from 35 male workers in a certain automobile manufacturing industry before and after muscle fatigue, and metabolite analysis was conducted. Subsequently, multivariate statistical analysis was used for data processing to screen differential metabolites. Metabolic pathway enrichment was performed using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database (http: //www.kegg.jp), and potential biomarkers were screened through the receiver operating characteristic (ROC) curve. Results: Metabolomics analysis revealed that compared to pre-fatigue samples, a total of 363 differential metabolites were identified in the post-fatigue urine samples of the subjects. Among these, 201 metabolites (55.4%) showed increased relative expression, while 162 metabolites (44.6%) showed decreased relative expression. The metabolic pathways involved mainly included histidine metabolism, tryptophan metabolism, valine, leucine and isoleucine biosynthesis, caffeine metabolism, niacin and nicotinamide metabolism, and oxidative phosphorylation. The ROC curve analysis results showed that the areas under the ROC curves for 1-methylnicotinamide, 2-piperidinone, kojic acid and diferuloyl Putrescine were 0.992, 0.959, 0.937 and 0.902, respectively. Conclusion: Muscle fatigue could cause changes in urine metabolite profiles of automobile manufacturing workers. The metabolites represented by 1-methylnicotinamide in urine can be used as potential biomarkers of muscle fatigue in automobile manufacturing workers.

Objective: To analyze the main effect of improving the image quality of digital radiography (DR) high kilovoltage chest radiography in Tianjin, and to provide reference for the implementation of quality control work. Methods: In November 2023, the image quality evaluation results of DR high kilovoltage chest radiographs submitted for approval by Tianjin Occupational Health Inspection Institutions from 2022 to 2023 were analyzed. According to the results of the image quality review in 2022, the outstanding problems, causes and improvement plans were summarized, and the contents of the image quality improvement projects in 2023 were determined. χ(2) test was used to compare the evaluation results of DR high kilovoltage chest radiograph image quality and the differences among various specific evaluation indicators before and after the improvement, and to compare the differences of image quality evaluation results among groups participating in different quality control improvement projects after the improvement. Results: Compared with 2022, after the implementation of the quality control improvement projects in 2023, the rate of level 1 film (excellent film) and level 2 film (good film) of DR high kilovoltage chest radiographs increased by 3.7% and 20.0%, respectively, and the rate of level 4 film (waste film) decreased by 30.0%. After the implementation of the improvement projects, the non-conformity rate and the serious non-conformity rate of 7 indicators were significantly reduced (P<0.05). The medical institutions participating in the two quality control improvement projects of related training and on-site guidance increased the rate of level 2 film (good film) and decreased the rate of level 4 film (waste film) compared with the medical institutions participating in the one improvement project of related training (χ(2)=14.78, P<0.05) . Conclusion: The quality control improvement projects can improve the image quality of Tianjin DR high kilovoltage chest radiography, and the combination of relevant training and on-site guidance may have better improvement effect.

Objective: To investigate the sense of coherence, job stressors and mental health status of nurses practitioners, and analyze the correlation among them. Methods: In September 2020, nurses practitioners in Chengdu City, Sichuan Province were selected as the research objects by convenience sampling method. The Sense of Coherence Scale, Nurses' Job Stressors Scale and SCL-90 were used to investigate their sense of coherence, job stressors and mental health status, respectively. Pearson correlation test was used to analyze the correlation among them, and the structural equation model was constructed to explore the mechanism of them. Results: A total of 1693 nurse practitioners were included. The total scores of sense of coherence, job stressors and SCL-90 were (65.00±14.01) points, (69.08±18.38) points and (129.68±52.99) points, respectively. The mean scores of all dimensions of sense of coherence of nurse practitioners were negatively correlated with the mean scores of all dimensions of job stressors and SCL-90 (P<0.001). And there were positive correlations between the mean scores of all dimensions of job stressors and the mean scores of all dimensions of SCL-90 (P<0.001). The structural equation model fitted well. The path coefficient between job stressors and sense of coherence was -0.372 (P<0.001), and the path coefficient between sense of coherence and SCL-90 score was -0.647 (P<0.001) . Conclusion: The sense of coherence plays a significant buffering role in job stressors and mental health of nurses practitioners. Nursing managers should be committed to improving the level of sense of coherence of nurses, enhance the happiness of nurses at work, and improve their mental health level.

Objective: To analyze the current situation and influencing factors of work-related musculoskeletal disorders (WMSDs) among scientific researchers in a computer workstation of a high-tech aerospace enterprise, and to provide data support for the improvement of occupational health management policies in this type of enterprise. Methods: From March to April 2023, using convenient sampling method, 1398 scientific researchers using computer workstations in an aerospace high-tech enterprise in Beijing were selected as the research subjects. The incidence of WMSDs in various parts of the body was investigated by using the Musculoskeletal Disorders Questionnaire, and the influencing factors of WMSDs in neck, lower back, shoulder and upper back were analyzed by logistic regression. Results: The total incidence of WMSDs was 55.4% (774/1398) in the scientific researchers who used computer workstations. The top 4 body parts in WMSDs incidence were neck (24.3%, 340/1398), lower back (20.4%, 285/1398), shoulder (18.7%, 262/1398), upper back (12.7%, 177/1398). The results of multivariate logistic regression analysis showed that feeling slightly tired and tired after work, setting a rest/break time of 10 to 15 min before the next continuous job, and operating computer for 2 to 4 hours and >4 hours were the influencing factors for the occurrence of neck WMSDs (OR=3.08, 1.90, 0.60, 2.00, 1.49, P<0.05). Female, 5-<10 years of working experience, feeling slightly tired, tired and very tired after work, operating computer for 6-<8 hours and 8-10 hours a day were all the influencing factors for the occurrence of WMSDs in the lower back (OR=1.82, 0.64, 2.95, 1.80, 1.61, 1.82, 1.73, P<0.05). Female, feeling slightly tired and tired after work were the influencing factors of shoulder WMSDs occurrence (OR=2.42, 2.09, 2.00, P<0.05). Female, 5-<10 years, 10-15 years of working age, 1-3 times of physical exercise/quarter, feeling slightly tired, tired and very tired after work were the influencing factors for the occurrence of upper back WMSDs (OR=2.76, 2.19, 2.78, 0.48, 4.20, 2.66, 2.19, P<0.05) . Conclusion: The incidence of WMSDs among scientific researchers in computer workstations of aerospace high-tech enterprises is high, which is closely related to individual characteristics and workstation usage characteristics. Measures should be taken to prevent and improve the WMSDs status of scientific researchers.

Objective: To screen differential proteins in the serum of workers with rare earth samarium oxide pneumoconiosis, in order to provide new ideas for finding its early diagnostic biomarkers. Methods: In April 2019, three male workers diagnosed with samarium oxide pneumoconiosis at a rare earth factory in Baotou City, Inner Mongolia Autonomous Region were selected as the observation group, and three male workers who were not exposed to dust were selected as the control group. The serum was sequenced using the Label-free proteomic method to screen for differentially expressed proteins, followed by cluster of orthologous groups of proteins (COG) annotation, gene ontology (GO) enrichment analysis, and Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis. The interaction gene library retrieval tool database and Cytoscape 3.9.1 software were used to draw protein-protein interaction networks. CytoHubba plugin was used to screen for differentially expressed proteins with high scores, and real-time fluorescence quantitative polymerase chain reaction (RT/q-PCR) was used to validate the proteomic sequencing results. Results: A total of 45 up-regulated differentially expressed proteins and 5 down-regulated differentially expressed proteins were screened out in the serum of workers with rare earth samarium oxide pneumoconiosis. In the COG functional classification, post-translational modifications, protein turnover, and chaperones were the most numerous. GO enrichment included 25 entries for biological processes such as complement activation (classical pathways), 15 entries for cellular components such as extracellular recombinants, and 10 entries for molecular functions such as protein binding. The pathways identified by KEGG enrichment analysis mainly included infectious diseases, immune system, signal transduction, and immune related diseases. The top 10 scoring proteins were haptoglobin, complement C1r subcomponent, complement C1s subcomponent, apolipoprotein C-Ⅲ, apolipoprotein A-Ⅱ, prothrombin, afamin, complement component C8 gamma chain, complement component C6, complement component C7. The RT/q-PCR validation results showed that the mRNA expression levels of haptoglobin, prothrombin and complement C1s subcomponent in the observation group were significantly higher than those in the control group, and the differences were statistically significant (P<0.05) . Conclusion: Ten differentially expressed proteins in the serum of workers with rare earth samarium oxide pneumoconiosis are screened, which provides a good idea for the screening of biomarkers for early diagnosis of samarium oxide pneumoconiosis.