中华劳动卫生职业病杂志最新文献

In workplaces where formaldehyde, hydrochloric acid and water vapor coexist, dichloromethyl ether can be produced. Dichloromethyl ether has strong carcinogenicity. Its target organ is the lungs, and the common tissue type of lung cancer is small cell lung cancer. This paper analyzes the cause of a case of occupational tumor (lung cancer caused by dichloromethyl ether) in the electroplating industry. Through the use of on-site occupational health investigation method, engineering analysis method and detection and inspection method, the occupational disease diagnosis is diagnosed in combination with the patient's occupational contact history, clinical symptoms and workplace occupational disease hazard factors. According to GBZ 94-2017 "Diagnosis of Occupational Tumor", the patient in this case was clearly diagnosed with primary lung cancer and was diagnosed as an occupational tumor (lung cancer caused by dichloromethyl ether) .

Objective: To construct a structural equation model for neck work-related musculoskeletal disorders (WMSDs) in the footwear industry and analyze the mediating effect of fatigue in the model. Methods: From November 2018 to December 2019, stratified cluster sampling was adopted to select all the workers (3565 people) from 7 footwear enterprises in Fujian Province as the research subjects. The incidence of WMSDs, fatigue and work-related condition were investigated by using the Chinese version of the Musculoskeletal Disorders Questionnaire. A structural equation model of individual factors, work type, work posture, work organization factors, and fatigue on neck WMSDs was constructed to analyze the mediating effect of fatigue among them. Results: The incidence rate of WMSDs in the neck of footwear workers was 39.6% (1413/3565) , and the incidence rate of neck fatigue was 46.6% (1662/3565) .The final structural equation model was constructed with a χ(2)/df of 9.927, a goodness-of-fit index of 0.961, an adjusted goodness-of-fit index of 0.946, and a root mean square error of approximation of 0.050. Except for the χ(2)/df, all other fit indicators met the standard. Individual factors and work posture factors had a direct effect on neck WMSDs, with standardized path coefficients of 0.101 and 0.077, respectively (P<0.05) . Individual factors, work type, work posture, and work organization had indirect effects on neck WMSDs through fatigue, the standardized path coefficients of indirect effects were 0.163, 0.090, 0.206, 0.105, respectively, and the standardized path coefficients of the total effect were 0.264, 0.090, 0.282, and 0.105 respectively (P<0.05) . The indirect effects of individual factors and work posture factors on neck WMSDs through fatigue accounted for 61.74% and 73.05% of the total effects, respectively. The standardized path coefficient of fatigue on WMSDs was 0.689 (P<0.001) , with the highest coefficient among all paths. Conclusion: Individual factors, work type, work posture, and work organization factors are important influencing factors in the occurrence and development of neck WMSDs in the footwear industry, and fatigue plays an important mediating role in them.

As a new strategic resource, rare earth elements have important applications in modernization and sustainable development, and are widely used in many fields such as clean energy, industrial materials and medical imaging. However, rare earth elements are also an emerging group of pollutants that can be transferred from the environment to humans through various pathways, with potential hazards to our health. Occupational and environmental exposures are common ways of exposure to rare earth elements. This work provides an overview of the distribution of rare earth elements in humans, discusses the potential harmful effects of occupational and environmental exposures to rare earth elements in terms of respiratory, reproductive, neurological systems, etc.

Occupational heavy metal exposure has become a critical issue in China's high-quality economic development within the field of occupational health. Current occupational exposure now extends beyond traditional contaminants like lead and mercury to include emerging materials such as rare earth elements, forming a dual pollution pattern that combines both conventional and novel pollutants. These substances can damage multiple bodily systems including the nervous and respiratory systems, imposing significant disease burdens on working populations. This paper examines the mechanisms of traditional heavy metals' toxicity, highlighting their distinct indirect neurotoxic effects compared to previous understanding. It analyzes exposure pathways and multi-system toxicological effects of rare earth elements, clarifying current gaps in their toxicology research and standardization efforts while identifying future research directions. The study aims to provide theoretical references for improving occupational heavy metal exposure prevention systems, thereby laying the foundation for safeguarding workers' health and addressing new challenges in modern occupational health.

Objective: Analyze the correlation between exposure to occupational hazard factors and clinical characteristics of chronic obstructive pulmonary disease (COPD) to provide a basis for early identification and prevention of occupational-related COPD. Methods: In May 2020, a study was conducted involving 258 chronic obstructive pulmonary disease (COPD) patients with occupational exposure history from three general hospitals in Jinan City. Such as symptoms, signs and the percentage of forced expiratory volnmein one second to predicted valve (FEV(1)%pred) collectted exposure to occupational hazard factors such as length of strvice and types of exposure. Clinical characteristics were analyzed through questionnaire surveys and COPD-related data collection. Group comparisons employed t-tests or F-tests, while non-parametric tests were applied to non-normal distribution data. Differences in categorical variables between groups were examined using χ(2)-tests or Fisher's exact test. Multivariate analysis was performed using generalized linear models, with normal distribution correlation analyses conducted through linear regression. Results: Among 258 patients, 145 were male (56.2%) and 113 were female (43.8%), with 210 being smokers (81.4%). The exposure dust primarily consisted of plant-based organic dust (157 cases, 75.5%) and carbon-containing inorganic dust (24 cases, 11.5%). The majority (94 cases, 36.4%) were diagnosed in the 60+ age group. Regarding pulmonary function severity, 55 patients (21.3%) had mild airflow limitation, 99 (38.4%) moderate, 64 (24.8%) severe, and 40 (15.5%) very severe. For acute exacerbation hospitalizations within the past year, 195 (75.6%) had fewer than 2 hospitalizations, while 63 (24.4%) had more than 2. Comprehensive severity assessment showed most patients (91 cases, 35.3%) were in Group B and 62 (24.0%) in Group D. mMRC scores ranged from 0-1 (58.9%) and 2-4 (106 cases, 41.1%). The average CAT questionnaire score was 17.45±1.68. Respiratory symptoms significantly increased with higher occupational hazard exposure levels (P<0.05). Moderate-to-high risk exposure showed a correlation with disease severity, with OR values (95%CI) of 1.30 (1.10-1.53) and 1.38 (1.20-1.59). There was a certain correlation between high risk exposure and the number of acute exacerbations in COPD patients in the past year, OR value (95%CI) was 1.410 (1.33-1.50) . Conclusion: Contact level is a major hazard factor affecting COPD respiratory symptoms, disease severity, and number of acute exacerbations. Older age at diagnosis, lower literacy, more smoking and higher exposure level, patients had worse lung function and more severe clinical symptoms.

With the advancement of information technology and intelligent systems, smart workplaces have become mainstream, accompanied by a growing workforce engaged in screen-based work. The persistent or prolonged close-up use of computer and visual display terminal (VDT) equipment has significantly increased occupational eye health risks. This paper provides a comprehensive review of common workplace eye disorders (such as visual fatigue and dry eye syndrome) among screen users, analyzes associated risk factors, and proposes management strategies to identify occupational hazards and promote workforce wellness.

Objective: It aims to build a scientific and reasonable occupational safety and health risk assessment index system for chemical enterprises, and provide theoretical guidance and scientific basis for the systematic identification, quantification and prevention and control of occupational safety and healthrisk in chemical enterprises. Methods: February 2024, based on relevant literature, national and industry standards as the theoretical foundation, Broussonetia papyrifera established an occupational safety and health risk assessment indicator system for chemical enterprises. Twenty-three experts in occupational health and related fields were invited to score the importance of the indicators; Broussonetia papyrifera constructed an AHP model to calculate the individual expert indicator weights and test matrix consistency, applied the systematic clustering method to allocate expert weights, and employed the weighted average method of weight vectors to calculate the expert group indicator weights. Results: The index system includes 5 first-level indicators, 15 second-level indicators and 42 third-level indicators.A total of 22 experts participated in the questionnaire survey, and the degree of expert activity was 96.5% (22/23), and the mean authority coefficient was 0.88, the questionnaire Cronbach's α coefficient was 0.954. The top three are production facilities, equipment and process technology (0.3694), occupational harmful factors (0.2381) and occupational health management (0.1486). Its subordinate secondary index production technology, production facilities and equipment, chemical harmful factors and tertiary indicators of raw materials selection, process technology, equipment quality and safety weight is also higher than other indicators of the same level. Conclusion: Based on the AHP model and systematic cluster analysis, the occupational safety and health risk assessment index system established for Broussonetia papyrifera chemical enterprises is scientifically reasonable and can provide reference for corporate risk assessment.

Objective: To investigate the relationship between work fit, work stress, and occupational fatigue among medical staff, and to analyze the independent and interactive effects of work fit and work stress on occupational fatigue. Methods: A stratified random sampling method was employed to select 1162 employees from two top-tier hospitals as the research subjects. A questionnaire survey was conducted to collect information on basic demographics, work stress, work fit, and occupational fatigue. Chi-square test, analysis of variance, and logistic regression equations were used to evaluate the interactive effects of work fit and work stress on occupational fatigue. Results: This study included 1162 medical Homo sapiens personnel, among whom 884 were job-adapted and 362 were in a stressful state. Univariate logistic regression analysis showed that the risk of occupational fatigue significantly increased in the 40-49 age group (OR=1.89) and the bachelor's degree group (OR=2.52, P<0.01). Smoking and alcohol consumption were also associated with a significantly higher risk of occupational fatigue (P<0.01). In terms of occupational characteristics, compared to clinical doctors, nurses and pharmaceutical/technical Homo sapiens personnel had lower risks (OR=0.57, 0.43, P<0.05). Compared to high-ranking Homo sapiens personnel, those with no title or junior titles exhibited lower risks (OR=0.51, 0.43, P<0.05). Working hours exceeding 55 hours per week and night shifts 3-4 times per week significantly increased fatigue risk (OR=1.94, 1.90, P<0.05). Occupational stress and job discomfort were identified as risk factors for occupational fatigue (OR=11.94, 3.26, P<0.05). Job adaptation and occupational stress exhibited a multiplicative interaction on physical fatigue after adjusting for confounders[OR (95%CI) =0.43 (0.22, 0.84) ]. Additionally, job adaptation and occupational stress demonstrated an additive interaction on mental fatigue, with RERI (95%CI) =2.64 (0.11, 5.59), API (95%CI) =0.38 (0.08, 0.67), and SI (95%CI) =1.78 (1.01, 3.14). Medical Homo sapiens personnel in a stressful state had a 7.25-fold higher risk of fatigue compared to those not in a stressful state, while those with job discomfort had a 2.01-fold higher risk compared to those in an adapted state. Conclusion: Occupational stress and job fit have interactive effects on physical fatigue and mental fatigue in medical Homo sapiens personnel. A stressful state combined with job discomfort increases the risk of fatigue occurrence, providing a basis for developing intervention strategies for occupational fatigue among medical Homo sapiens personnel.

Objective: To explore the clinical characteristics, treatment and prognosis of hard metal lung disease (HMLD), and to provide a theoretical reference basis for the prevention, control and intervention of HMLD in China. Methods: In April 2024, literatures related to HMLD and giant cell interstitial pneumonia (GIP) published before March 31, 2024 were retrieved in China National Knowledge Infrastructure (CNKI), Wanfang, VIP database, Embase and PubMed. The search terms in Chinese and English included hard metal lung disease, cobalt, tungsten carbide, giant cell interstitial pneumonia, hard metal, etc. Literature was screened and data were extracted. A systematic review was conducted to analyze the clinical characteristics, imaging, pulmonary function, pathological features, treatment and prognosis of HMLD. Results: A total of 55 literatures were included, including 1 cohort study, 4 cross-sectional studies, 4 case series reports and 46 case reports, involving a total of 227 patients with HMLD and GIP. There were 174 male cases, 51 female cases, and 2 cases whose gender was not mentioned. The age was (43.9±13.4) years old, and the dust exposure time was 7 (4, 13) years. The chest images of the patients showed ground glass shadow, micro-nodule shadow, grid shadow, honeycomb shadow, consolidation shadow, etc. Pulmonary function test showed restrictive ventilation dysfunction with gas exchange disorder. The pathological manifestations of lung tissue were typical GIP, but there were also hypersensitivity pneumonitis, common interstitial pneumonia, diffuse alveolar damage, non-specific interstitial pneumonia, and even honeycomb lung. Clinical diagnosis and treatment evaluation were performed by combining the occupational exposure history of hard metal dust or cobalt-containing dust, clinical manifestations, imaging, lung function and histopathology. Treatment involved cessation of exposure, with glucocorticoids alleviating symptoms and improving imaging and pulmonary function. Conclusion: HMLD can be caused by hard metal dust exposure. The clinical symptoms of HMLD are not specific, and the pathology shows typical GIP or other pulmonary interstitial changes. The treatment involves cessation of exposure and administration of glucocorticoids, and the overall prognosis is good.

The German Technical Rules for Noise and Vibration at the Workplace (Technical Rules for Noise) represent a distinctive regulatory framework for occupational noise protection. It emphasizes engineering controls for noise management, selects quiet equipment by referencing sound emission values of machinery provided in EU directives, and integrates noise reduction considerations during the design phase. Hearing protectors are selected and used based on action levels, and medical examinations are provided accordingly. In contrast, China's approach to occupational noise hazard control primarily relies on health-based exposure limits. This paper provides a critical overview of the four sections of the German Technical Rules for Noise: General Provisions, Risk Assessment, Noise Measurement, and Protective Measures. A comparative section with noise regulations in the United States and the United Kingdom is also included, examining differences and commonalities in standard limits, risk assessment, and protection strategies. Finally, strategies for improving the occupational noise protection system in China are proposed.