中华劳动卫生职业病杂志最新文献

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.

Objective: To investigate the effect of microRNA-204-5p (miR-204-5P) on silica (SiO(2)) -induced inflammatory response in macrophages and its mechanism. Methods: In September 2023, SiO(2)-induced mouse macrophage (RAW264.7) model in vitro was constructed. The experiment was divided into blank control group, SiO(2) treatment group, SiO(2)(+) mimic transfection control group and SiO(2)(+) mimic transfection group. RAW264.7 cells were evenly seeded into 6-well plates and cultured for 24 hours prior to transfection. The SiO(2)+mimic control group and SiO(2)+mimic group were transfected with miR-204-5P mimic control and miR-204-5P mimic, respectively. After 6 hours of transfection, except for the blank control group, the other three groups were treated with SiO(2) suspension, while the blank control group received an equal volume of PBS for 24 hours of stimulation.Cell viability was detected by CCK-8 assay. RT-qPCR was used to detect the mRNA expression levels of miR-204-5P and dishevelled 3 (DVL-3) in cells. Western blot was used to detect Wnt/β-catenin pathway related proteins DVL-3, β-catenin, T cell factor 4 (TCF4) and matrix metalloproteinase 9 (MMP-9) . JAK2/STAT3 pathway related proteins Janus kinase 2 (JAK2) , signal transducer and activator of transcription 3 (STAT3) , phosphorylated JAK2 (p-JAK2) , phosphorylated STAT3 (p-STAT3) ; Inducible nitric oxide synthase (iNOS) expression level. ELISA was used to detect the expression levels of inflammatory factors interleukin-6 (IL-6) , tumor necrosis factor-α (TNF-α) and transforming growth factor-β1 (TGF-β1) in cell supernatant. The t test was used to compare the differences between the two groups, and the one-way analysis of variance was used to compare the differences among multiple groups. Results: Compared with SiO(2)+ mimic transfection control group, the cell viability of SiO(2)+ mimic transfection group had no significant change. The mRNA and protein levels of DVL-3 were significantly decreased (P<0.05) . The protein expression levels of β-catenin, TCF4 and MMP-9 were significantly decreased (P<0.05) . The protein expression levels of p-JAK2 and p-STAT3 decreased. The levels of inflammatory factors IL-6, TNF-α, and TGF-β(1) and the expression level of protein iNOS were significantly decreased (P<0.05) . Conclusion: miR-204-5P alleviates SiO(2)(-) induced macrophage inflammation by regulating the wnt/β-catenin pathway and JAK2/STAT3 pathway.

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 prevalence of work-related musculoskeletal disorders (WMSDs) in right-hand ultrasound physicians and identify contributing factors for carpal tunnel syndrome (CTS) . Methods: From May 2023 to February 2025, 188 ultrasound physicians from 15 hospitals in Heilongjiang Province were surveyed using questionnaires to assess their prevalence of wrist-specific mechanical strain disorders (WMSDs) over the past year. Neurophysiological tests were conducted, and logistic regression analysis was performed to identify factors affecting the right carpal tunnel syndrome (CTS) . Results: The prevalence of wrist WMSDs among ultrasound physicians was 48.4% (91/188) . Multivariate logistic regression analysis revealed that age and frequent probe pressure application were associated with 2.14-fold and 4.04-fold increased CTS risk, respectively. Conclusion: Enhance society's attention to the health of noise-exposed physiciansand providing a foundation for implementing targeted interventions.

Pulmonary siderosis caused by iron and its compound dust is prone to misdiagnosis and underdiagnosis due to its insidious exposure pathways and non-specific imaging manifestations. This study analyzes the occupational histories and clinical data of six patients with occupational pulmonary siderosis diagnosed at Qingdao Central Hospital between January 2017 and December 2023, summarizes its characteristics, and evaluates the value of AI-assisted diagnosis. All six patients were male, with five being welders. The median dust exposure duration was 9.4 years, and the median latency period was 8.4 years. The main symptoms were chest tightness, cough, and shortness of breath. High-kilovolt chest radiographs were negative in four cases and showed thickened bronchovascular markings in two cases. High-resolution computed tomography (HRCT) revealed centrilobular nodules and tree-in-bud opacities in all cases. Pulmonary siderosis caused by iron and its compound dust is characterized by mild symptoms and a favorable prognosis. Comprehensive assessment and HRCT are crucial for early diagnosis. The development of AI models could enhance diagnostic recognition efficiency and promote precision diagnosis in the future.