[Investigation on occupational hazards in a refrigeration equipment manufacturing enterprise]

Objective: To investigate the distribution and intensity of noise and ultraviolet radiation of welding posts in a refrigeration equipment manufacturing enterprise, in conjunction with the health status of welding workers, providing scientific evidence for the prevention and control of occupational diseases in this type of post. Methods: In May 2019, a cross-sectional survey method was used to select 576 welding workers in the pressure vessel workshop and the unit assembly workshop of a refrigeration complete equipment manufacturer from 2016 to 2018 as the research objects. The occupational hygiene survey and occupational hazard factor measurement were carried out in the workplace, and the measurement data and occupational health examination results were statistically analyzed. Results: The over standard rate of individual Lex in pressure vessel workshop was 82.2% (37/45) . Compared with the unit assembly workshop, the individual Lex of welding workers in pressure vessel workshop was higher than that in unit assembly workshop (t=13.43, P= 0.00) ; the effective irradiance exceeding rate of welding workers in pressure vessel workshop and unit assembly workshop was 33.3% (4/12) and 25.0% (3/12) , The meacurement of ovradiation in the moskment the occupational exposure limit. The deaf rate and hearing loss rate in pressure vessel workshop were 1.5% (5/336) 20.5% (69/336) , respectively, significantly higher than that in umit assembly workshop (P<0.05) . The detection rate of hearing loss of pressure vessel workshop workers increased year by year, and the difference was statistically significant (χ(2trend)=22.42, P<0.01) ; compared with the unit assembly workshop from 2016 to 2018, the detection rates of lens opacity, corneal cloudiness and hearing loss of pressure vessel workshop workers were statistically significant (χ(2)=9.45, 14.80, 55.99, P<0.01) . Conclusion: Welding workers exposed to noise and ultraviolet radiation are easy to be ignored. The enterprise management department should attach great importance to it and take comprehensive measures to protect the health of welding workers.

[Investigation and analysis of occupational hazards and control measures in waste incineration power generation enterprises]

Objective: To investigate occupational hazards in waste incineration power generation enterprises. Methods: From May 2016 to September 2018, four garbage incineration power generation enterprises in different regions and scales were selected as the survey objects. Investigated and analyzed the types of occupational hazards, workplace distribution and occupational disease prevention facilities and the concentration (intensity) of major types of work and workplace occupational hazards were also improved Line detection and analysis. Results: Silica dust could be seen in slag tank, slag sorting and crusher operation position. The concentration of silica dust in each workplace fluctuates within 0.3-1.1 mg/m(3). Both the concentration of silica dust in the workplace and the time weighted average allowable concentration (C-TWA) of dust exposure of dust exposed workers were detected, but none of them exceeds the requirements of the national occupational exposure limit. Carbon monoxide, ammonia, nitrogen dioxide, hydrogen sulfide, non methane total hydrocarbon, formaldehyde, hydrogen fluoride, hydrogen cyanide, hydrochloric acid, sodium hydroxide and ozone were detected, but all meet the requirements of national occupational exposure limit. The 8-hour equivalent a sound level (L(ex·8h)) over 85 dB (A) mainly includes boiler, steam turbine, electrical inspector and auxiliary value of water treatment. Conclusion: The occupational hazards of waste incineration power generation enterprises are serious. Occupational health management and occupational health monitoring to reduce their occupational hazards to workers.

[Analysis of 2-level logistic model on influencing factors of suspected occupational diseases]

Objective: To investigate the detection of suspected occupational diseases in the occupational health examination population in Hangzhou, and to establish a two-level logistic model of influencing factors. Methods: In October 2018, the information of physical examinees was collected through the 2015-2017 occupational health examination and reexamination database of Hangzhou Hospital for the Prevention and Treatment of Occupational Disease. MlwiN 2.02 software was used to establish a 2-level logistic model of suspected occupational diseases, with the occupational hazard factors as the level 2 unit and the employees as the level 1 unit. χ(2) test was used to compare the detection rates of suspected occupational diseases with different characteristics. The trend of detection rates of suspected occupational diseases with age and working age were tested by Cochran-Armitage trend test. Results: The morbidity rate of suspected occupational diseases in 2965 workers was 59.6% (1767/2965) , and the rates caused by different occupational hazardous factors were significantly difference (χ(2)=1615.27, P<0.01) , that caused by noises was the highest (98.0%, 1206/1231) , and the next was the dust (87.5%, 70/80) . The rate in male was 61.5% (1532/2492) , and that in female was 49.7% (235/473) , they were significantly difference (χ(2)=22.96, P<0.01) . The rates of suspected occupational diseases increased with the ages (Z=8.77, P<0.01) and working years (Z=3.62, P<0.01) . The multivariate analysis by 2-level logistic model indicated that gender, age and working year were all no significant, instead the level 2 unit random effect was significant (χ(2)=4.77, P<0.05) . Conclusion: Suspected occupational diseases will occur in clusters in occupational hazardous factors. The influence of occupational hazardous factors on suspected occupational diseases was more than that of personal characteristics.

[Epidemiological study of occupational diseases in Shenzhen City, China in 2006~2017]

Objective: To study the epidemiological characteristics of occupational diseases in Shenzhen City, China in 2006-2017, and to provide a scientific basis for prevention and control of occupational diseases. Methods: Cases of occupational diseases in 2006-2017 were collected from the Information System of Occupational Diseases and Occupational Health. A statistical analysis was performed to identify the characteristics of the disease distribution in terms of spectrum of disease, year, area, industry, type of economy and enterprise scale. Results: A total of 1673 cases of occupational disease (64 types, 8 classes) were diagnosed and reported in 2006-2017, chemical poisoning (31.50%) , ear, nose and throat diseases (28.21%) , and pneumoconiosis and other respiratory diseases (21.34%) were the most three commonest occupational diseases. The constituent of ratio of ear, nose and throat diseases and occupational diseases caused by physical factors increased in turn, the constituent of chemical poisoning, pneumoconiosis and other respiratory diseases, and skin disease reduced in turn, which all showed the difference was statistically significant (P<0.01) . Occupational diseases were often seen in districts of Baoan, Longgang, Longhua and Pingshan, as well as in private economy and small enterprise, mainly occurred in manufacturing industry. Conclusion: The incidence of occupational diseases increased steadily in 2006-2017, and we need to strengthen common occupational diseases, especially occupational noise-induced hearing loss, pay attention to districts of Baoan, Longgang, Longhua and Pingshan, as well as private economy and small enterprise.

Assessment of the Risks of Occupational Diseases of the Passenger Bus Drivers

Background

The working conditions of bus drivers are difficult; they lead to occupational diseases and require careful study, particularly in Ukraine. The objective of the article is the description of occupational health risks of passenger bus drivers that lead to deteriorating health.

Methods

The risk assessment was performed using a modified Risk Score method, which allowed determining the generalized level of danger to the driver's health. The hygienic hazards level was assessed as based on Stevenson's law, which was generalized later.

Results

Based on the modification of the Risk Score method, it was possible to depart from expert assessments method of the risk level and calculate the general indicator based on the degree of dependence of the impact on the human body on its intensity, proposed by V. Minko. This allows objective determining of the impact of hygiene hazards on the health of the driver and to predict the occurrence of occupational diseases associated with the cardiovascular system, musculoskeletal system, and partial or complete disability due to the accumulation of emotional fatigue. The hazard assessment was carried out for three brands of passenger buses common in Ukraine, in which the driver is exposed to the dangers of fever, vibration, noise, harmful impurities in the bus cabin, and emotional load.

Conclusion

The health of drivers in the cabins of passenger buses is most affected by hygiene hazards: fever, vibration, and emotional stress. The generalized level of risk is calculated by the modified method of Risk Score is 0.83; -0.99, -0.92 respectively.

Risk of mental illness after the diagnosis of occupational injury or disease: a retrospective cohort study

OBJECTIVES

As studies on mental disorders in victims of occupational injury or disease are limited, this study aims to evaluate the risk of, and factors associated with, the development of mental illness in patients with occupational injury or disease using insurance claims data from Taiwan.

METHODS

This retrospective cohort study analyzed insurance records in Taiwan to identify 18,285 adults who experienced occupational injury or disease in 2002-2013 and 18,285 adults without occupational injury or disease who were matched by propensity score. The risks of mental disorders during a follow-up period of up to 2 years were estimated and compared between the two cohorts.

RESULTS

After controlling for other variables, the odds of mental illness in patients with occupational injury or disease was significantly higher compared to patients without occupational injury or disease. Additional factors associated with higher odds of mental disorders included female gender, age ≥ 30 years (vs. 20-29 years), Charlson comorbidity index ≥ 1, occupation category of labor union member, soldier, insured by social security, religious group member (vs. private or government employee), lower premium-based monthly salary (≤ 576 US$), treatment at a district hospital or clinic (vs. medical center), treatment at a publically-owned or consortium-owned hospital (vs. private hospital), and central or southeast geographic location (vs. Taipei). The main types of mental illness were anxiety disorder (2.79%) and other psychoses (3.29%).

CONCLUSION

The risk of mental illness slightly increased during the 2-year period after the diagnosis of occupational injury or disease.

Work-relatedness of inguinal hernia: a systematic review including meta-analysis and GRADE

Purpose

Clinicians need to know whether inguinal hernia (IH) can be attributed to work to answer questions regarding prevention and medical causation. This review describes whether work-related risk factors are associated with IH.

Methods

A systematic review was performed in Medline via PubMed until February 3rd, 2020. Inclusion criteria were that IH was diagnosed by a clinician, and workers exposed to work-related risk factors were compared to workers less exposed or not at all. A quality assessment and a meta-analysis using Cochrane’s RevMan 5.3 were performed, including GRADE for quality of evidence.

Results

The search resulted in 540 references. Fourteen studies fulfilled the inclusion criteria, of which three were included in a meta-analysis, all three being of high quality, including 621 workers diagnosed with IH. The meta-analysis revealed significant associations with physically demanding work (OR 2.30, 95% CI 1.56–3.40). Two prospective studies, including 382 and 22,926 cases revealed associations that this was true for male workers with a lateral IH that reported standing or walking for more than six hours per workday (OR 1.45, 95% CI 1.12–1.88) or lifting cumulative loads of more than 4000 kg per workday (OR 1.32, 95% CI 1.27–1.38). The level of certainty for the latter two work-related risk factors was moderate and high according to GRADE.

Conclusion

Lateral IH among males is associated with work-related risk factors depending on the level of exposure to the time standing/walking per workday, or the amount of load lifted per workday.

Electronic supplementary material

The online version of this article (10.1007/s10029-020-02236-0) contains supplementary material, which is available to authorized users.

Prevention of exposure to and spread of COVID-19 using air purifiers: challenges and concerns

Coronavirus disease 2019 (COVID-19) is now a pandemic. The Korean government has declared a red alert, which is the highest level of the national infectious disease alert system, and the World Health Organization has similarly declared its highest-level pandemic alert (phase 6). The spread of COVID-19 is an unprecedented worldwide public health problem that governments and individuals must work to overcome. Recently, an infection cluster arose in a call center in Seoul. To support call center companies, the Korean Ministry of Employment and Labor has proposed covering the costs of installing partitions and air purifiers, providing hand sanitizers, and supplying masks to prevent droplet and aerosol infections. Air purifiers are expected to be installed on the floor with the exhaust outlets at a higher level, such as the level of the desks or breathing zones of workers. When a worker coughs or releases droplets near a colleague’s respiratory system, the droplets may spread throughout the call center via air flow from air purifier. In this fashion, a single infected person can give rise to an infection cluster. Attempts to prevent infection must not lead to new infections, and the installation of air purifiers may cause new problems. Therefore, using air purifiers to control the spread of COVID-19 should be approached with caution.

[Analysis on monitoring results of occupational hazards in Yangzhou city from 2014 to 2018]

Objective: To undersand the monitor of occupational hazards in the enterprises in the past 5 years, as well as the distribution of occupational disease hazards and their dynamic changes in their respective jurisdictions, for providing scientific basis for prevention and control of occupational diseases in relevant departments. Methods: Taking the method of cluster sampling, select the monitoring results of the occupational disease hazard factors commissioned by the Municipal Center for Disease Control and Prevention from 2014 to 2018 and the annual monitoring data of the network of the occupational hazard declaration system of the Safety Supervision Bureau, using chi-square test, trend Statistical analysis was performed by chi-square test or Fisher exact probability method. Results: There were 461 testing companies in the past 5 years, with a total of 15, 186 monitoring points and 43428 samples. The pass rate was 94.32% (14324/15186) . The pass rate was increasing year by year from 2014 to 2017 (P<0.05) ; The pass rate of various occupational disease hazards surveillance were greater than 90% except the rate of physical factors. In 2014, the qualified rate of physical factors was the lowest, which was 86.99% (1558/1791) ; the production rate of different production scale enterprises in 2018 was higher than that of 2014. From 2014 to 2018, the number of inspection enterprises and the number of inspection points of the joint-stock economy and state-owned economic enterprises are both high, 58 (10091 points) and 71 (1830 points) respectively; The qualified rate of state-owned economy and collective economy monitoring is high, 98.36% (1800/1830) and 100% (74/74) respectively. It had reached more than 95%; The enterprises tested mainly from the economic development zone and Guangling, respectively accounting for 34.27% (158/461) and 33.84% (156/461) of the total number of enterprises. Which followed by the Hanjiang, accounting for 23.21% of the total number of enterprises (107/461) ; The monitoring enterprises were mainly distributed in the manufacturing and power industries, which accounted for 85.25% (393/461) and 6.07% (28/461) of the total number of enterprises, respectively. Conclusion: The monitoring rate of enterprises had been increasing year by year from 2014 to 2018. Noise was the main disease prevention and controlling factor in the area.In addition, micro-enterprises, individual economy and foreign-invested economy were the key targets for occupational health.

[The relationship between occupational wood dust exposure and nasal cancer]

Nasal cancer has not been included in the current list of legal occupational diseases in China. There is also a lack of systematic and in-depth study on the relationship between nasal cancer and occupational exposure factors in China. In September 2018, the department for work and pensions of UK released the latest edition of the "List of diseases covered by industrial injuries disablement benefit", which lists nasal cancer and nasopharyngeal carcinoma associated with wood dust exposure on the UK's occupational disease list. In order to better protect the health of workers, the relationship between occupational wood dust exposure and nasal cancer is reviewed, which provides a reference for further revision and improvement of occupational disease catalogue.

[Exploration and application of occupational disease risk assessment model based on information diffusion theory]

Objective: To research build a kind of occupational disease risk assessment model which provides scientific basis for prevention and control of occupational diseases. Methods: Based on the principle of information diffusion, this paper uses spread function to extend the incomplete gathered information, establishes the mapping relationship between observation samples and risk probability distributions, and constructs the occupational disease risk assessment model, to analyzes the risk data of occupational disease reported cases in Guangdong Province in the past five years. Results: Through evaluation analysis, every year, 200-300 cases of pneumoconiosis probability is 67.77%, 100-200 cases of occupational poisoning probability is 68.52%, 20-40 cases of occupational cancers probability is 71.62%, each year, the incidence of occupation otorhinolaryngology and oral diseases in 200 cases was 62.23%. Conclusion: A model of occupational disease risk assessment based on information diffusion theory is constructed, the evaluation result is basically consistent with the actual situation of occupational disease, which can provide reference for occupational disease prevention and control.

[Analysis of the prevalence and influencing factors of occupational musculoskeletal disorders among rural migrant workers in Tianjin]

Objective: To explore the prevalence of occupational musculoskeletal disorders (OMD) and its influencing factors among rural migrant workers in Tianjin, with the aim of developing strategies to improve the health condition of this specific population. Methods: Questionnaire survey was conducted among 415 rural migrant workers working in Tianjin about their fundamental state and occupational musculoskeletal disorders (OMD) during January 2015 to January 2016. Statistical methods were utilized to analyze the influencing factor. Results: A total of 415 rural migrant workers were investigated, in which young Young adults and low education level were in the majority of rural migrant workers. The prevalence of OMD for whole population, male and female were 28.92% (120/415), 33.06% (81/245) and 22.94% (39/170), respectively. Prevalence showed significant differences njin and workplace hygiene. Multivariate logistic regression analysis showed that the risks of OMD increased with age group, and decreased with higher education level. The risk of OMD among rural migrant workers with monthly income between 3000 to 5000 yuan was 2.26 times (95%CI: 1.37-3.75) higher than that of low-income workers (<3000 yuan per month). Workers engaged in housekeeping service had 2.28 times higher risk of OMD than those in manufacturing industry (95%CI: 1.06-4.89) . Conclusion: Prevalence of OMD among rural migrant workers is higher than that of general people. Age, education, monthly income, occupation are the independent influencing factors for OMD among rural migrant workers.

[Disturbance of the voice in teachers]

OBJECTIVE

The voice in the academic context is a determining factor in the life of the teaching staff. The objective of this study was to evaluate the index vocal inability of in-service teachers and check your involvement the occupational conditions.

METHODS

For it, a descriptive-inferential study is done of cross-section to 480 teachers (average age: 45.14 ± 9.22), applying the questionnaire of vocal disability index (HIV-30). Using descriptive statistical techniques (mean and standard deviation) and inferential techniques (ANOVA). Statistical analysis was performed using SPSS v.23.0.

RESULTS

When applying the Voice Handicap Index (VHI-30) evidenced that teachers present a moderate vocal disability (41.2 rating), with increased risk in physical ability and own vocal function. Moreover, it was found that gender, educational stage, teaching load, antique, daily and weekly hours, student ratio and level of noise in the classroom, significantly affect the disturbance of the voice. It also shows more presence of dysphonia in teachers who perceive a progressive worsening of her voice throughout the day or week, and is absent in the work due to disorders of the voice.

CONCLUSIONS

In conclusion, teachers attributed their laryngeal discomfort mainly to factors of the teaching context.

The risk of cytomegalovirus infection in daycare workers: a systematic review and meta-analysis

PURPOSE

The primary aim of this review was to summarize the evidence on the relationship between being a daycare worker working with children and the possible increased risk of cytomegalovirus infection.

METHODS

We searched the Medline and Embase databases using search strings defined according to the population, exposure, comparison, and outcomes (PECO) applicable to our research questions in order to find studies published since 2000. Two independent reviewers evaluated the search hits using predefined inclusion and exclusion criteria. A manual search was performed to identify additional relevant literature. We extracted the resulting studies and assessed them in eight domains of bias. The pooled CMV seroprevalence for daycare workers compared to the general population was calculated.

RESULTS

After evaluating the 6879 records, six methodologically adequate studies were identified: five cross-sectional studies and one cohort study. The pooled seroprevalence of daycare workers was 59.3% (95% CI 47.6-70.9). The four studies investigating risk of infection indicated an increased seroprevalence for daycare workers compared to a reference population (prevalence ratio, PR = 1.54, 95% CI 1.33-1.77). No study evaluated CMV seroconversions for daycare workers.

CONCLUSIONS

Our findings suggest a higher CMV seroprevalence for daycare workers compared to the general population. Notwithstanding the need for longitudinal and intervention studies, preventative efforts are needed. A pooled PR of 1.54 is compatible with a doubled seroconversion risk corresponding to a vocational probability of 50% if the substantial underestimation of the actual occupational seroconversion risk by prevalence-based estimators is considered.

Background and Activities of the Samsung Ombudsperson Commission in Korea

OBJECTIVES

The Samsung Ombudsperson Commission was launched as an independent third-party institution following an agreement among Samsung Electronics, Supporters for Health and Right of People in Semiconductor Industry (Banolim in Korean, an independent NGO), and the Family Compensation Committee, in accordance with the industry accident prevention measure required by the settlement committee to address the issues related to employees who allegedly died from leukemia and other diseases as a result of working at Samsung's semiconductor production facilities.

METHODS

The Commission has carried out a comprehensive range of activities to review and evaluate the status of the company's occupational accidents management system, as well as occupational safety and health risk management within its facilities.

RESULTS

Based on the results of this review, termed a comprehensive diagnosis, the Commission presented action plans for improvement to strengthen the company's existing safety and health management system and to effectively address uncertain risks in this area going forward.

CONCLUSIONS

The Commission will monitor the execution of the suggested tasks and provide advice and guidance to ensure that Samsung's semiconductor and liquid crystal display production lines are safer.

The Back College for nurses - an evaluation of intermediate effects

BACKGROUND

Nursing staff and care workers run an increased risk of work related musculoskeletal disorders such as low back pain. The Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW) offers its insured persons the opportunity to participate in a three-week Back College with the aim of preventing them having to abandon their profession due to back problems. The aim of the study was to record the effectiveness and sustainability of the Back College on an intermediate basis (6 months).

METHODS

As part of a single-group pre-post measurement on three survey dates - at the start (T0) and end (T1) of rehabilitation and 6 months later (T2) - in 2013 all participants in the Back College at three locations were surveyed using a standard questionnaire. Wilcoxon signed-rank tests were performed to evaluate statistically significant changes.

RESULTS

For measurement dates T0 to T2 we had 570 complete datasets (response rate 70.81%). There was a significant decrease in reported back pain and the general state of health and quality of life index improved. Participants' emotional strain decreased and they showed an improved understanding of illness as well as of having acquired knowledge-based abilities and skills for dealing with the disease. After training, they recorded back-friendly behaviour in everyday life and opportunities to relieve strain on the spinal column were utilised at work more often. Participants' subjective assessment of their ability to work (Work Ability Index) improved.

CONCLUSION

The present study proved the intermediate effectiveness of the Back College curriculum. Whether these effects remain stable in the long term will be tested on the subsequent measurement date (T3, after 24 months).

A preliminary evaluation of psychological stress amongst workers in Taiwan: a cross-sectional survey

Background

Stress and psychological disorders have been assigned increasing significance in the field of occupational health. Based on Japan's psychiatric disability occupational disease recognition regulation, Taiwan's Council of Labor Affairs announced "Evaluation Guidelines for psychiatric diseases induced by work-related stress" in 2009. This evaluation tool was designed to assess the source and intensity of work-related and non-work-related mental stress, and references existing Japanese guidelines. However, empirical data from workers in various sectors in Taiwan are still required to validate the utility of the guidelines.

Methods

This study recruited 2319 workers from the manufacturing, service, and public administration sectors to participate in a survey between 2010  and  2011. The survey included questions regarding participants' demographic characteristics, job type or attributes, a life event stress intensity evaluation Table (35 work-related and 23 non-work-related items on a scale of 1-10). The Chinese version of the Copenhagen Burnout Inventory (C-CBI) and Chinese Health Questionnaire (CHQ-12) were also included to explore associations between work-related/non-work-related stress and health outcomes.

Results

Analyses of survey results showed events relating to employment security (e.g., "company bankruptcy" and "being fired or forced to retire" scores; mean stress intensity scores both 6.18) were the cause of the highest intensity work-related stress. Within different demographic/job type categories, women had higher stress intensity scores for most items than men (greatest difference in "sexual harassment in the workplace" score). Furthermore, executive class workers generally experienced more psychological stress than blue-collar workers (greatest difference in "serious injury or disease due to work" score). Results from regression analysis supported the observation that employees' burnout and work-related stress was more significant than non-work-related stress. Moreover, work-related/non-work-related stress intensity levels both had significant negative predictive effects on mental health.

Conclusions

Regarding policy, this study provides empirical evidence and practical suggestions for establishing a psychological stress intensity database of workers under specific social contexts in a newly industrialized East Asian country. Such a database can be employed to help identify workers with work-related psychological disorders. Additionally, this study also provides a point of reference for enterprises to prioritize agendas when developing employee stress management and support protocols.

[A study on the status and problem countermeasures of key occupational disease monitoring in Shandong, China, from 2015 to 2017]

Objective: To analyze the completion status, monitoring results, and existing problems of key occupational disease monitoring in Shandong, China, from 2015 to 2017, and to provide reference materials for improving monitoring quality and carrying out occupational disease prevention and control. Methods: The monitoring situation including project coverage, data collection, monitoring results, and monitoring quality of key occupational diseases in Shandong from 2015 to 2017 were described and comparatively analyzed. Results: In the past three years, the uncoverage rate of monitored counties (38.69% in 2015, 10.95% in 2016, and 5.11% in 2017) , the non-work rate of occupational health examination institutions (41.67% in 2015, 18.02% in 2016, and 8.72% in 2017) , and the non-work rate of occupational disease diagnosis institutions (42.31% in 2015, 38.46% in 2016, and 38.46% in 2017) in Shandong decreased year by year. The number of institutions with key occupational hazard factors reported to the safety supervision and management department increased year by year (it was 24140 in 2017, with an increase of 40.50% compared with 2016 and an increase of 114.62% compared with 2015) ; the key occupational hazard factors in enterprises were mainly noise (72.76%) , followed by benzene, silica dust, and coal dust. The number of workers exposed to key occupational hazard factors reported to the safety supervision and management department increased year by year; in 2017, it was 729245, with an increase of 39.78% compared with 2016 and an increase of 84.81% compared with 2015. The ratio of people exposed to key occupational hazard factors identified by the medical examination to the total people in the safety supervision system in a year decreased year by year (40.87% in 2015, 23.86% in 2016, and 17.95% in 2017) . Conclusion: In Shandong, the supervision of enterprises with key occupational hazard factors and the responsibility of enterprise protection should be strengthened. The occupational health examination rate of workers should be improved. It is suggested that we should carry out the special investigations and occupational health risk assessment for key enterprises and key populations.

[Occupational characteristics and clinical manifestations of 245 cases of occupational brucellosis]

Objective: To analyse epidemiological, clinical characteristics and laboratory examination results of 245 occupational brucellosis form 2008 to 2018, which providing theoretical basis for prevention and control of occupational brucellosis. Methods: Based on the China Center for Disease Control and Prevention Information System, a database of occupational brucellosis cases in HunlunBuir from January 2008 to July 2018 was established. The Epidemiological characteristics, Clinical manifestation, laboratory examination of 245 occupational brucellosis and 359 without occupational brucellosis were comparatively analyzed about the same period. Results: Among the 245 patients, 219 were males, 254 in 359, malese were significantly higher than control group (χ(2)=21.331, P<0.05) . Fever, fatigue, hyperhidrosis and splenomegaly are common in patients with occupational brucellosis and non occupational brucellosis. Arthralgia (54.3%/44.8%) and CRP (81.2%/71.3%) were significantly also higher than control group (χ(2)=5.193, P<0.05; χ(2)=7.704, P<0.05) Fever, hyperhidrosis, fatigue and splenomegaly were common clinical manifestation and signs in the two groups. Brucellosis can cause a variety of complications, including osteoarticular hematological system and hepatic involvement, some patients with multiple system damage. Conclusion: The incidence of occupational brucellosis in HulunBuir is concentrated in agriculture and animal husbandry. Veterinarians are the main occupational groups, Occupational health interventions should be strengthened for key occupational hazards, regular occupational health examination, avoid chronic brucellosis and protect the health of key occupational groups.

[Evaluation of permanent disability levels in occupational pulmonary diseases]

Compensation for occupational pulmonary diseases requires the establishment of guidelines based on standardized and objective criteria, in order to provide compensation that is as fair as possible to patients who suffer from them. A review of the elements necessary for the examination of an individual file was carried out by a working group. It is accepted that respiratory functional exploration is the key element in assessing the level of permanent disability in all of these conditions, with the exception of thoracic malignancies. Guiding scales have been developed for the respiratory impairment of three types of conditions: occupational asthma, thoracic malignancy, and other respiratory diseases. Additional criteria for increasing the permanent disability level are also proposed in order to take into account professional prejudice, in particular the possibility or not of continuing the occupational activity, in the same job or after changing to another. For certain respiratory diseases, a periodic reassessment of the initially attributed permanent disability level is recommended as well as the initial one at the time of definitive cessation of occupational activity.

Occupational medicine specialist referral triggers: Mixed-methods analysis of teleconsult cases

Background

Qualitative analyses can yield critical lessons for learning organizations in healthcare. Few studies have applied these techniques in the field of occupational and environmental medicine (OEM).

Aims

To describe the characteristics of complex cases referred for OEM subspecialty evaluation and variation by referring provider's training.

Methods

Using a mixed methods approach, we conducted a content analysis of clinical cases submitted to a national OEM teleconsult service. Consecutive cases entered between April 2014 and July 2015 were screened, coded and analysed.

Results

108 cases were available for analysis. Local Veterans Health Administration (VHA) non-specialist providers entered a primary medical diagnosis in 96% of cases at the time of intake. OEM speciality physicians coded significant medical conditions based on free text comments. Coder inter-rater reliability was 84%. The most frequent medical diagnosis types associated with tertiary OEM referral by non-specialists were endocrine (19%), cardiovascular (18%) and mental health (16%). Concern for usage of controlled and/or sedating medications was cited in 1% of cases. Compared to referring non-specialists, OEM physicians were more likely to attribute case complexity to musculoskeletal (OR: 2.3, 1.68-3.14) or neurological (OR: 1.69, 1.28-2.24) conditions. Medication usage (OR: 2.2, 1.49-2.26) was more likely to be a source of clinical concern among referring providers.

Conclusions

The findings highlight the range of triggers for OEM physician subspecialty referral in clinical practice with employee patients. The results of this study can be used to inform development of provider education, standardized clinical practice pathways, and quality review activities for occupational medicine practitioners.

[A cost-benefit analysis of occupational disease reporting in China]

Objective: To perform a cost-benefit analysis of the occupational disease reporting system in China, and to provide a basis for effective resource allocation. Methods: The data on the cost of occupational diseases were collected from China Health Statistics Yearbook 2013, the estimated benefit data were collected from published articles in China and foreign countries, and the probability data were collected from the occupational diseasereports published by health and family planning administrative departments. Adecision-making tree was used for the cost-benefit analysis. Results: The estimated cost of occupational disease reporting was about 102.47 million yuan/year, consisting of a cost of reporting in national medical institutions of 1.25 million yuan/year, a management cost of 30.35 million yuan/year, a management cost in local public health institutions of 69.80 million yuan/year, a management cost in national public health institutions of 370 thousand yuan/year, and a cost of construction and maintenance of reporting system of 700 thousand yuan/year. The results of the decision tree analysis showed that when an occupational disease monitoring system was established, the incremental input for occupational disease monitoring and prevention/control was 2.1 billion yuan/year, the output was 6.5 billion yuan/year, and the benefit of occupational disease reporting system was 4.4 billion yuan/year. Conclusion: The benefit of occupational disease reporting system depends on the cost-benefit of occupational disease prevention and control measures, and proper prevention and control measures are extremely important for improving the benefit of occupational disease reporting system.

[The analyze the epidemic trend and predict the incidence trend of occupational diseases in Guangdong province]

Objective: This study was aimed to analyze the epidemic trend and predict the incidence trend of occupational diseases during 2006-2015 in Guangdong province, which may provide the theoretical foundation for occupational disease risk assessment and precise control and prevention. Methods: We analyzed the number of reported occupational disease cases, the constituent ratio, the average age and working-age of patients. We also performed the linear-by-linear association test of new incidence, median age and median working-age by curve-fitting method, of which the diagnostic year was set as the independent variable. Meanwhile, we designed an ARIMA model to predict the variation tendency of occupational diseases in 2017-2020. Results: (1) During 2006-2015, the total reported cases of occupational disease is 5289, including 2101 cases of occupational pneumoconiosis (39.7%) , 1363 cases of occupational poisoning (25.8%) , and 864 cases of occupational otolaryngological and stomatological disease (16.3%) . (2) The number of occupational diseases and pneumoconiosis have a straight upward trend (R(2)=0.851, R(2)=0.856) , while the number of occupational otolaryngological and stomatological disease and occupational tumor have a exponential trend (R(2)=0.914, R(2)=0.696) . The constituent ratio of occupational poisoning is decreasing, and the constituent ratio of occupational otolaryngological and stomatological disease is increasing. (3) The average onset age is 40 (33, 46) years old, and the average onset working-age is 6 (3, 11) years. Both of them have a straight upward trend (R(2)=0.954、R(2)=0.792) . The onset age of pneumoconiosis, occupational poisoning and occupational otolaryngological and stomatological disease have a upward trend. In addition, the onset working-age of occupational poisoning and pneumoconiosis have a upward trend. (4) The number of occupational diseases in 2017-2020 is predicted to be between 902-1231. Conclusion: Occupational diseases in Guangdong province showed a trend of high incidence. The age and working-age of occupational diseases showed an extended trend. Therefore, our work of occupational epidemic trend may provide some bases for the occupational disease risk assessment and precise control and prevention.

Hand-arm vibration syndrome: Workers' experience with functional impairment and disability

STUDY DESIGN

Qualitative and descriptive study.

INTRODUCTION

Hand-arm vibration syndrome (HAVS) is a prevalent disease in Canada. There is little work on the perspectives of HAVS patients.

PURPOSE OF THE STUDY

Explore perceptions of disability and functional compromise in patients with HAVS.

METHODS

Semi-structured telephone interviews were conducted with HAVS patients and analysed using content analysis.

RESULTS

The 11 participants reported numbness, pain, and reduced dexterity, strength, and sensation. Participants noted that HAVS was an inevitable aspect of their work. They indicated frustration with their condition and viewed it as a disability. To overcome impairments risky strategies are often used. Participants reported lack of support to manage symptoms and overcome work disability.

DISCUSSION

HAVS related impairment is disabling. Workers require improved resources and support to address symptom management and safe strategies to minimize work disability.

CONCLUSION

HAVS patients experience functional, social, emotional, and psychological disability.

LEVEL OF EVIDENCE

Not applicable.

Increased Airway Wall Thickness is Associated with Adverse Longitudinal First-Second Forced Expiratory Volume Trajectories of Former World Trade Center workers

RATIONALE

Occupational exposures at the WTC site after September 11, 2001 have been associated with several presumably inflammatory lower airway diseases. In this study, we describe the trajectories of expiratory air flow decline, identify subgroups with adverse progression, and investigate the association of a quantitative computed tomography (QCT) imaging measurement of airway wall thickness, and other risk factors for adverse progression.

METHODS

We examined the trajectories of expiratory air flow decline in a group of 799 former WTC workers and volunteers with QCT-measured (with two independent systems) wall area percent (WAP) and at least 3 periodic spirometries. We calculated individual regression lines for first-second forced expiratory volume (FEV₁), identified subjects with rapidly declining and increasing ("gainers"), and compared them to subjects with normal and "stable" FEV₁ decline. We used multivariate logistic regression to model decliner vs. stable trajectories.

RESULTS

The mean longitudinal FEV₁slopes for the entire study population, and its stable, decliner, and gainer subgroups were, respectively, - 35.8, - 8, - 157.6, and + 173.62 ml/year. WAP was associated with "decliner" status (OR_adj 1.08, 95% CI 1.02, 1.14, per 5% increment) compared to stable. Age, weight gain, baseline FEV₁ percent predicted, bronchodilator response, and pre-WTC occupational exposures were also significantly associated with accelerated FEV₁ decline. Analyses of gainers vs. stable subgroup showed WAP as a significant predictor in unadjusted but not consistently in adjusted analyses.

CONCLUSIONS

The apparent normal age-related rate of FEV₁ decline results from averaging widely divergent trajectories. WAP is significantly associated with accelerated air flow decline in WTC workers.