中华劳动卫生职业病杂志最新文献

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 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.

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.

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.

Objective: To establish an evaluation index system for the emergency capability of occupational poisoning incidents in Tianjin, providing a reference basis for evaluating the emergency capability level of occupational poisoning incidents in Tianjin. Methods: In February 2023, the Delphi method was applied to conduct expert consultation and establish the framework of the emergency response capability evaluation index system for occupational poisoning incidents in Tianjin. The positive coefficient, authority coefficient and coordination coefficient of experts were calculated. The weights of indicators at all levels were determined by using the Analytic Hierarchy Process (AHP) and the proportional allocation method, and the internal consistency reliability of the evaluation index system was tested by using the Cronbach's α wefficient. Results: Regarding the evaluation index system for the emergency capability of occupational poisoning incidents in Tianjin, the expert positive coefficient in both rounds of consultation was 100.00% (33/33), the expert authority coefficients were 0.80 and 0.74 respectively, the expert coordination coefficients were 0.59 and 0.62 respectively (P<0.001), and the Cronbach's α coefficient of all indicators was 0.998. The evaluation index system of emergency capability for occupational poisoning incidents in Tianjin was finally determined, including 7 first-level indicators, 30 second-level indicators and 135 third-level indicators. Conclusion: The evaluation index system of emergency capability for occupational poisoning incidents in Tianjin constructed based on the Delphi method shows that the expert consultation is active, representative and authoritative. The indicator system covers the emergency response capability to occupational poisoning incidents and has high internal consistency, providing a reliable and quantifiable reference for improving the emergency response level of occupational poisoning incidents in Tianjin.

Silica dust is known as the most important risk factor of chronic obstructive pulmonary disease (COPD), and COPD is a leading cause of the third mortality worldwide. Workers exposed to silica dust are at increased risk of COPD as a result of being exposed to silica particles for extended periods of time. While clear links have been established between silica exposure and the development of COPD, the mechanisms are still poorly understood. However, both cigarette and silica combination exposure can be easy to result in COPD. Here we review the current understanding of silica-induced COPD, including incubation period, and the use of experimental animal models for better understanding these mechanisms of pathogenesis. The review summarizes important new knowledge and presents new research directions that are likely to provide new insights, diagnosis and treatments of silica-induced COPD.

Objective: To investigate the relationship between susceptibility to hearing loss in noise-exposed Han Chinese male homo sapiens and glutathione S-transferase (GST) gene polymorphisms, providing a scientific basis for further understanding the pathogenic mechanisms of noise-induced hearing loss (NIHL) and screening for genetic susceptibility biomarkers. Methods: In May 2024, a cross-sectional survey was conducted to recruit 332 male Han workers exposed to noise from a prominent mechanical maintenance enterprise. Workers were classified into the hearing loss group if they exhibited a binaural high-frequency average hearing threshold exceeding 25 dB and a binaural speech frequency average hearing threshold loss that was less than the binaural high-frequency average hearing threshold loss, resulting in a total of 332 individuals in this group. Furthermore, a matched group of 332 hearing-normal workers was established on a 1∶1 basis for each hearing-impaired worker, using criteria such as the same job type, age, and a noise exposure duration of ≤4 years. Basic data of worker was collected through a questionnaire survey, and individual noise exposure levels were assessed using cumulative noise exposure (CNE). Various PCR and high-throughput sequencing techniques were employed to identify polymorphisms in the GSTT1, GSTM1, and GSTP1rs1695 genes. The basic information and genotypes of the two groups were compared using paired t-tests and paired chi-square tests. A Cox regression model was utilized to establish a 1∶1 paired logistic regression model to examine the correlation between GST gene polymorphisms and susceptibility to NIHL. Results: Individuals with GSTM1 and GSTT1 gene deletion are more susceptible to NIHL compared to those with existing genes, even after adjusting for other factors (OR=1.464, 95%CI: 1.02-2.09; OR=0.68, 95%CI: 1.06-2.02). Wearing protective equipment occasionally, rather than consistently, significantly increases the risk of NIHL (OR=1.38, 95%CI: 1.01-1.88). There was no link between GSTP1rs1695 polymorphism and NIHL risk (P>0.05) . Conclusion: The deletion of GSTM1 and GSTT1 genes is an independent influencing factor that increases the risk of NIHL, and can be considered as a genetic susceptibility biomarker for the NIHL population. Strengthening personal hearing protection is an effective measure to reduce the risk of NIHL.

Heavy metals are common occupational hazards that can enter the human body through ingestion, skin contact, and inhalation, damaging various systems including the nervous system and causing a serious disease burden. Numerous studies have shown that heavy metal-induced neurotoxicity is closely linked to intestinal flora imbalance, with exposure to heavy metals leading to a reduction in the diversity of intestinal flora and a decrease in beneficial intestinal bacteria. Due to their few adverse reactions and significant health-regulating effects, probiotics and their formulations are widely used. Supplementing probiotics can alleviate heavy metal-induced neurotoxicity by modulating intestinal flora and their metabolites, reducing inflammation and oxidative stress, and adsorbing heavy metal ions to facilitate their excretion. This article takes four common heavy metals, namely lead, mercury, cadmium and manganese, as examples to review the role of intestinal flora imbalance in the neurotoxicity of heavy metals and the mechanism and application of probiotic intervention treatment, aiming to provide new ideas for the prevention and treatment of heavy metal neurotoxicity and explore the potential mechanism and application value of probiotic intervention.

Objective: To understand the current situation of occupational internal exposure dose research using direct measurement method in China, and to explore the occupational internal dose level of nuclear medicine staff. Methods: From 2023 to April 2024, search on platforms such as China National Knowledge Infrastructure and Chinese Medical Journal Network, to collect research literature on the internal exposure dose monitoring of nuclear medicine staff and discuss the internal exposure dose assessment method. According to the literature reported thyroid (131)I activity level at the measuring time, the internal exposure dose level was estimated using the method recommended by GBZ 129-2016. Results: According to existing research reports on direct measurement using portable γ spectrometers, 6.1% of nuclear medicine workers may receive a (131)I dose greater than 1 mSv/a. Conclusion: It is necessary to conduct periodic continuous monitoring for personnel whose internal exposure dose may greater than 1 mSv/a, and it is necessary to explore the feasibility of periodic internal exposure monitoring method carried out by hospitals.