某制鞋企业化学有害因素的职业健康风险分析

目的 了解东莞市某制鞋企业化学有害因素产生的职业健康风险,为制鞋行业职业病危害防控提供科学依据。
方法 于2019年对东莞市某制鞋企业进行职业卫生调查、职业病危害因素检测,根据《工作场所化学有害因素职业健康风险评估技术导则》（GBZ/T 298-2017）采用半定量模型进行职业健康风险评估。
结果 该制鞋企业现有生产人员445人,实行每周工作6 d、每天11 h。该企业存在的17种化学有害因素中,丁酮、三氯乙烯、乙酸甲酯和乙酸乙酯存在超标情况。刷胶、擦拭、水印和补色4个岗位丁酮、二氯甲烷、环己酮、三氯甲烷、三氯乙烯、乙酸甲酯、乙酸乙酯、正庚烷的健康损害风险等级为低风险;补色、刷胶、水印3个岗位丙酮的健康损害风险等级为低风险;擦拭岗位乙酸丁酯、甲醇的健康损害风险等级为低风险。其余物质对各岗位工作人员健康损害的风险等级为可忽略风险。酯类、卤代烃联合接触引起的健康风险等级高于苯系物。刷胶岗位酯类、卤代烃联合接触有中等健康风险,高于其他岗位。
结论 东莞市制鞋企业中化学有害因素可诱发潜在的职业健康风险,企业及职业卫生部门应采取有效的防控措施。
     

澳大利亚职业风险评估模型在蓄电池生产企业中的应用

目的 探索适用于我国职业危害风险评估的模型.方法 将澳大利亚职业风险评估模型的6个基本步骤（确定环境、识别危害、分析危害潜在的风险、评价风险、治理风险、监测与复查风险）逐步应用于某蓄电池生产企业职业风险评估,获得评估结论,并总结分析该模型的优缺点.结果 蓄电池生产企业存在的主要职业病危害因素包括铅烟、铅尘、硫酸、噪声和高温.暴露于硫酸的劳动者存在＂高风险＂职业危害,其他危害因素存在＂重大风险＂.存在＂高风险＂的岗位经优先采取职业卫生控制措施,已取得显著成效;存在＂重大风险＂的岗位企业也应尽快完善各项防护措施.结论 澳大利亚职业风险评估模型有助于发现企业职业危害关键控制点,但应用于某特定企业职业危害风险评估难以避免偏倚.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

ICMM职业健康风险评估模型在某金融机具工程项目职业病危害评价中的应用

目的探讨国际采矿与金属委员会（ICMM）职业健康风险评估模型在某金融机具工程项目职业健康风险评估中的适用性,为我国制定相关标准或规范以及职业卫生评价提供科学依据。方法运用该模型的矩阵法和定量法分别对某金融机具工程项目关键岗位的职业病危害进行职业健康风险评估,并对2种方法结果的一致性进行比较,同时运用现场检测结果和相关研究进行结果验证。结果该模型矩阵法和定量法得出结果一致的岗位有2个,不一致的岗位有5个。矩阵法将机加车间车工、铣工、磨工接触噪声所致噪声聋和组装车间装配接触手传振动所致手臂振动病定为中风险,与现场检测结果和相关研究一致。定量法将电子车间焊接岗位的二氧化锡和铅烟的健康风险定为潜在风险,与现场检测结果和相关研究一致。其他岗位职业健康风险2种评估方法基本一致。结论 ICMM职业健康风险评估模型可用于某金融机具工程项目职业健康风险评估,矩阵法和定量法各有优缺点。     

Using physiologically-based pharmacokinetic models to incorporate chemical and non-chemical stressors into cumulative risk assessment: a case study of pesticide exposures

Cumulative risk assessment has been proposed as an approach to evaluate the health risks associated with simultaneous exposure to multiple chemical and non-chemical stressors. Physiologically based pharmacokinetic/pharmacodynamic (PBPK/PD) models can allow for the inclusion and evaluation of multiple stressors, including non-chemical stressors, but studies have not leveraged PBPK/PD models to jointly consider these disparate exposures in a cumulative risk context. In this study, we focused on exposures to organophosphate (OP) pesticides for children in urban low-income environments, where these children would be simultaneously exposed to other pesticides (including pyrethroids) and non-chemical stressors that may modify the effects of these exposures (including diet). We developed a methodological framework to evaluate chemical and non-chemical stressor impacts on OPs, utilizing an existing PBPK/PD model for chlorpyrifos. We evaluated population-specific stressors that would influence OP doses or acetylcholinesterase (AChE) inhibition, the relevant PD outcome. We incorporated the impact of simultaneous exposure to pyrethroids and dietary factors on OP dose through the compartments of metabolism and PD outcome within the PBPK model, and simulated combinations of stressors across multiple exposure ranges and potential body weights. Our analyses demonstrated that both chemical and non-chemical stressors can influence the health implications of OP exposures, with up to 5-fold variability in AChE inhibition across combinations of stressor values for a given OP dose. We demonstrate an approach for modeling OP risks in the presence of other population-specific environmental stressors, providing insight about co-exposures and variability factors that most impact OP health risks and contribute to children's cumulative health risk from pesticides. More generally, this framework can be used to inform cumulative risk assessment for any compound impacted by chemical and non-chemical stressors through metabolism or PD outcomes.     

Risk assessment and management of occupational exposure to pesticides in agriculture

Nearly 50% of the world labour force is employed in agriculture. Over the last 50 years, agriculture has deeply changed with a massive utilisation of pesticides and fertilisers to enhance crop protection and production, food quality and food preservation. Pesticides are also increasingly employed for public health purposes and for domestic use. Pesticide are unique chemicals as they are intrinsically toxic for several biological targets, are deliberately spread into the environment, and their toxicity has a limited species selectivity. Pesticide toxicity depends on the compound family and is generally greater for the older compounds; in humans, they are responsible for acute poisonings as well as for long term health effects, including cancer and adverse effects on reproduction. Due to their intrinsic toxicity, in most countries a specific and complex legislation prescribes a thorough risk assessment process for pesticides prior to their entrance to the market (pre-marketing risk assessment). The post-marketing risk assessment takes place during the use of pesticides and aims at assessing the risk for exposed operators. The results of the risk assessment are the base for the health surveillance of exposed workers. Occupational exposure to pesticides in agriculture concerns product distributors, mixers and loaders, applicators, bystanders, and rural workers re-entering the fields shortly after treatment. Assessing and managing the occupational health risks posed by the use of pesticides in agriculture is a complex but essential task for occupational health specialists and toxicologists. In spite of the economic and social importance of agriculture, the health protection of agricultural workforce has been overlooked for too many years, causing an heavy tribute paid in terms of avoidable diseases, human sufferance, and economic losses. Particularly in the developing countries, where agricultural work is one of the predominant job, a sustainable model of development calls for more attention to occupational risks in agriculture. The experience of many countries has shown that prevention of health risk caused by pesticides is technically feasible and economically rewarding for the individuals and the whole community. A proper risk assessment and management of pesticide use is an essential component of this preventative     

农药职业接触的生物监测指标

近年来,随着生产环境的改善,有效管理和防护措施的采取,农药职业接触中急性中毒病例已较前明显减少,而长期低剂量接触农药所致的健康危害则越来越引起重视.这些危害通常在临床症状出现前即已发生,因此对农药职业接触者进行生物监测不仅有助于对农药这一职业性有害因素进行全面评价,而且对控制和降低人体接触水平、预防职业危害有着重要意义.该文总结了可以用于农药职业接触者的生物监测指标,期望对实际工作有所帮助.     

基于两种ICMM风险评估模型研究某蓄电池生产企业职业健康风险

  目的  采用国际采矿与金属委员会（ICMM）职业健康风险评估方法评估某蓄电池企业职业健康风险,探讨该方法的适用性,为企业采取合适的职业卫生管理方法提供科学依据。
  方法  采用ICMM风险评估技术中定性评估矩阵和定量评估模型两种方法,对某蓄电池企业关键岗位工人的职业健康风险进行评估,并比较、分析方法的适用性。
  结果  矩阵法评估结果:极板打磨、分板、极板入壳、铸板、极板焊接等岗位接触铅所致铅中毒的健康风险为中等风险,分板、极板入壳、铸板等岗位接触噪声所致听力损失或噪声聋的健康风险为高风险,其他岗位健康风险水平为低风险或非常低风险。定量评估模型评估结果:和膏、分板打磨、极板打磨、分板、极板入壳、铸板、极板焊接等岗位接触铅所致铅中毒的健康风险为不可容忍风险,涂板、极板打磨、分板、极板入壳、铸板等岗位接触噪声所致听力损失或噪声聋的健康风险为不可容忍风险;其他岗位健康风险水平为可容忍的风险。
  结论  铅和噪声是蓄电池企业健康风险水平最高的危害因素,企业应采取改进生产工艺、调整原有防护设施和加强职业卫生管理等措施来降低职业健康风险。矩阵法和定量法评估结果各有偏倚,矩阵法风险评估结果所得危害等级比定量法的低。在实际应用中应结合现场检测结果和职业健康检查结果来综合考虑岗位健康风险水平。
     

国际采矿与金属委员会职业健康风险评估模型在火力发电厂的应用研究

目的研究国际采矿与金属委员会（ICMM）风险评估模型在火力发电厂职业健康风险评估中的适用性,为相关标准或规范制定以及职业卫生评价提供科学依据。方法以某火力发电厂为研究对象,对现场进行劳动卫生学调查,运用该模型的定量法和矩阵法分别对电厂关键岗位的职业病危害进行风险评估,并与现场检测、职业健康体检结果和文献报道进行结果验证。结果模型得出电厂噪声导致听力异常、粉尘导致尘肺、氨泄漏引起的氨中毒风险高,其他化学毒物风险低。模型评估有高听力异常风险结果得到了现场检测、职业健康体检以及文献报道的验证;高尘肺风险结果与现场检测和文献报道一致;氨中毒风险高与文献报道一致。对职业病危害因素导致常见健康后果的风险评定上,定量法较矩阵法易出现风险高估。结论该模型可应用于火力发电厂的噪声、粉尘、化学毒物等职业危害因素风险评估,推荐使用模型中的矩阵法。     

上海市27个行业职业病危害风险定量分析研究

[目的]运用定量方法分析上海市27个行业职业病危害风险。[方法]综合比较美国道化学公司火灾、爆炸危险指数评价法和英国帝国化学公司蒙德法,将行业固有危害性、接触危害性和职业危害作用3个系数相乘得到行业职业病危害风险系数。选取上海市1996--2003年职业卫生数据进行统计,分析上海市27个行业职业病危害风险。[结果]对上海市27个行业职业病危害风险的分析结果表明,职业病危害风险系数（R值）为0．0280-3．5811;汽车制造业的职业病危害风险相对最小,R值只有0．0280;玻璃及其制品制造业等3个行业的R值在3．0000～3．4999;皮革制造业的职业病危害风险相对最大,R值为3．5811。[结论]进行职业病危害风险定量分析要有相对足够的资料和合适的方法,本研究首次运用定量方法对一个地区一段时期的多个行业进行职业病危害风险分析。在20世纪经济结构调整中,上海市的汽车制造业、设备制造、化工等支柱行业的职业病危害风险得到相对控制,而玻璃、文教、日用五金以及皮革制品业的职业病危害凸显,职业病危害风险相对加大。     

Combined chemical, physical hazards make exposures harder to calculate. Studies show multiple exposures must be evaluated wholly rather than 'adding up' individual risks

Clearly, current research adds to the mounting scientific evidence that combined exposures can produce greater toxicity than would be predicted using an additive model. Although there is not yet a quantitative method to determine the risks associated with multiple exposures, safety and health specialists must begin to consider the health effects from the entire work process, rather than individual chemical or physical agents. Moreover, organizations involved in risk assessment and standard-setting must evaluate the interactive effects of combined chemical and physical agent exposures. This will make personnel exposure standards comprehensive in addressing realistic occupational health risks.     

2018年广东省惠州市部分农村土壤卫生状况调查及风险评估

目的 初步评价广东省惠州市部分农村地区土壤卫生状况及其对人体的健康风险,为该地区土壤污染物健康风险评估提供科学依据和理论基础。方法 按照《土壤环境监测技术规范》（HJ/T 166 - 2004）进行监测,根据《土壤环境质量标准》（GB 15618 - 1995）进行评价,并应用国际机构推荐的人群健康风险模型评价本地居民土壤重金属污染经摄食途径和经皮肤接触引起的健康风险值。结果 本次调查的80份土壤中,有10个监测点土壤中检测出蛔虫卵,土壤中重金属铅、镉、铬二级及以上土壤质量标准达标率为97.92%;各县区的3种重金属通过2种途径的人群非致癌性风险和致癌性风险值均小于1.0×10 - 4/年,为可接受风险值。结论 惠州市农村土壤环境卫生状况总体良好,蛔虫卵轻度污染,尚未发现3种重金属的明显污染;根据风险模型评估3种重金属分布水平不会对人体产生明显的健康危害。     

格雷厄姆法（LEC法）在职业健康风险评估中的研究与应用

目的 对工业企业或建设项目实施有效的职业健康风险评估,确定职业病危害的风险级别。 方法 对应用于安全风险评估中的格雷厄姆法进行适用性改进,并通过评估某电力企业锅炉烟气脱硝项目各岗位的风险,验证该方法的科学性。 结果 格雷厄姆法中事故发生的可能性、人员暴露于危害环境的频繁程度以及发生事故后的严重性这3个指标的赋值得到了细化,建立起半定量化的风险评估方法。使用改进后的格雷厄姆法对某电力企业锅炉烟气脱硝项目进行评估,得到氨、一氧化碳、二氧化硫、一氧化氮、二氧化氮、高温的风险度等级为Ⅱ,噪声及工频电磁场的风险度等级为Ⅰ,与专家评估结果一致。 结论 改进的格雷厄姆法不仅可以在项目实施前半定量确定其职业病危害风险等级,还可以通过项目建成后的检测检验对分级结果进行验证和修正,为用人单位日常职业病防治监督与管理提供参考。     

Assessing aggregate and cumulative pesticide risks using a probabilistic model

Determining aggregate and cumulative risks from exposures to pesticides presents a number of challenges. The analysis must capture the correlations in residues that occur from both additive and exclusionary processes in the use of pesticides. The analysis also requires a quantitative mechanism for evaluating risks associated with exposures to mixtures of pesticides. This paper presents an analysis of aggregate exposures and risks associated with exposures to a pesticide, Alpha, and the cumulative exposure to and risk from three pesticides, Alpha, Beta, and Gamma. The cumulative risks are evaluated by determining the systemic (absorbed) doses that result from inhalation, dermal, and oral exposures to the pesticides. A 'relative toxicity' model is used to evaluate cumulative risks. The assessment of cumulative exposure was performed using the LifeLine Version 1.0. The model simulates pesticide exposure using an individual-based approach where daily exposures are evaluated for each person, season, and location.     

South African farm workers' interpretation of risk assessment data expressed as pictograms on pesticide labels

Pesticide companies and regulators in developing countries use the United Nations Food and Agricultural Organization (FAO) recommended pictograms on pesticide labels to communicate risk information based on toxicological and environmental risk assessment data. The pesticide label not only is often the only access people have to pesticide risk information, but also in many countries is a legally binding document. As a result of the crucial role pesticide labels play in protecting health and the environment and as a legal instrument, pictograms are used to overcome literacy challenges in transmitting pesticide risk information. Yet, this risk communication tool is often prone to misinterpretations of the risk information which results in hazardous exposures to pesticides for farm workers and end-users generally. In this paper, results are presented from a study with 115 farm workers on commercial vineyards in the Western Cape, South Africa, assessing their interpretations of 10 commonly used pictograms. A standardized questionnaire based on four commonly used pesticide labels was administered. Overall, 50% or more of the study farm workers had misleading, incorrect and critically confused interpretations of the label pictograms. Interpretations often reflected farm workers’ social and cultural frames of reference rather than the technically intended risk information. For example, the pictogram indicating a pesticide's toxicity requires boots must be worn, evoked interpretations of “dangerous to pedestrians” and “don’t walk through pesticides”. Furthermore, there was a gender variation in pictogram comprehension whereby males generally had more correct interpretations than females. This is a result both of a lack of training for women who are assumed to not work with pesticides, as well as a lack of pictograms relevant for female exposures. These findings challenge the viability of the United Nations current initiative to globally harmonize pictograms used on all chemical labels under the new Globally Harmonized System for the Classification and Labelling of Chemicals (GHS). Particularly as the GHS pictograms were not piloted prior to adoption of the system and represent complex risk assessment data such as chronic hazards. Public health and pesticide policy, backed by relevant research, need to address developing applicable and effective pesticide risk communication tools, particularly for developing country populations. Merely providing risk assessment derived information in a pictogram does not ensure that an end-user will interpret the message as intended and be able to make risk decisions which mitigate risks from exposures to pesticides or chemicals in general.     

Pesticide exposure, safety issues, and risk assessment indicators

Pesticides are widely used in agricultural production to prevent or control pests, diseases, weeds, and other plant pathogens in an effort to reduce or eliminate yield losses and maintain high product quality. Although pesticides are developed through very strict regulation processes to function with reasonable certainty and minimal impact on human health and the environment, serious concerns have been raised about health risks resulting from occupational exposure and from residues in food and drinking water. Occupational exposure to pesticides often occurs in the case of agricultural workers in open fields and greenhouses, workers in the pesticide industry, and exterminators of house pests. Exposure of the general population to pesticides occurs primarily through eating food and drinking water contaminated with pesticide residues, whereas substantial exposure can also occur in or around the home. Regarding the adverse effects on the environment (water, soil and air contamination from leaching, runoff, and spray drift, as well as the detrimental effects on wildlife, fish, plants, and other non-target organisms), many of these effects depend on the toxicity of the pesticide, the measures taken during its application, the dosage applied, the adsorption on soil colloids, the weather conditions prevailing after application, and how long the pesticide persists in the environment. Therefore, the risk assessment of the impact of pesticides either on human health or on the environment is not an easy and particularly accurate process because of differences in the periods and levels of exposure, the types of pesticides used (regarding toxicity and persistence), and the environmental characteristics of the areas where pesticides are usually applied. Also, the number of the criteria used and the method of their implementation to assess the adverse effects of pesticides on human health could affect risk assessment and would possibly affect the characterization of the already approved pesticides and the approval of the new compounds in the near future. Thus, new tools or techniques with greater reliability than those already existing are needed to predict the potential hazards of pesticides and thus contribute to reduction of the adverse effects on human health and the environment. On the other hand, the implementation of alternative cropping systems that are less dependent on pesticides, the development of new pesticides with novel modes of action and improved safety profiles, and the improvement of the already used pesticide formulations towards safer formulations (e.g., microcapsule suspensions) could reduce the adverse effects of farming and particularly the toxic effects of pesticides. In addition, the use of appropriate and well-maintained spraying equipment along with taking all precautions that are required in all stages of pesticide handling could minimize human exposure to pesticides and their potential adverse effects on the environment.     

Job load and hazard analysis: a method for the analysis of workplace conditions for occupational health care.

One requirement for successful occupational health care is reliable information on occupational hazards. The aim of this study was to develop a simple, standardised method for workplace investigations for use in occupational health care. The theoretical framework of the method comprises the stress-strain model, the hazard-danger model, and risk behaviour theory. The new method, termed job load and hazard analysis, includes four stages: identification of hazards, their evaluation, conclusions and proposals, and follow up. Different methods are available for hazard identification. The identification starts with a rough analysis of five factors, chemical hazards, physical hazards, physical load, mental stress, and accident risk. Hazards and stress factors are assessed with an ordinal scale. Specialised methods are used if all hazards cannot otherwise be identified. The analytical procedure comprises: detection of hazards through observations and interviews at the workplace and with a questionnaire; assessment of findings as teamwork; and evaluation of the results of these assessments to yield conclusions and proposals made by occupational health care personnel. A data processing system has been developed for data storage and future use. The method has functioned in practice, improving the contents of the occupational health care programme and generating preventive measures. The method offers many new possibilities for controlling occupational hazards and studying relations between working conditions and workers' health.     

From concept to practice: including the social determinants of health in environmental assessments

The present paper examines the historical evolution of health impact assessments as part of the environmental assessment process. The development of a coherent public health framework must be based on the model of determinants of health, integrating toxic and infectious risks and social impacts of projects. The integration of common concepts, processes and methodologies from the area of public health and social impact assessment challenges the quantitative model approach to risk assessment. The expert-driven risk assessment is transformed into a social learning process where local knowledge and scientific input foster a dialogue among stakeholders. The issue-oriented, iterative and participative assessment process may be applied to the health impact assessment of public policies. Sustainable development with its social objectives of empowerment, participation, equity, poverty alleviation, social cohesion, population stability and institutional development is an appropriate framework for conducting health impact assessments.     

Managing pesticide chronic health risks: U.S. policies

This paper provides an overview of U.S. government pesticide risk management efforts over time and in recent years, relevant to chronic health risks of pesticides. Pesticides are in widespread usage in the U.S. With hundreds of active ingredients and thousands of products on the market, management of pesticide risks has been a daunting challenge. The first legislation providing federal authority for regulating pesticides was enacted in 1910. With the establishment of the U.S. Environmental Protection Agency in 1970 and amendments to the pesticide law in 1972, the federal government was for the first time given the authority to regulate health and environmental risks of pesticides. However, older pesticide risks were not addressed until legislation was enacted in 1988, requiring "reregistration" and 1996, requiring that pesticide food standards are safe for children. In result, the U.S. has seen an expansion of development of pesticide products that are registered as "reduced risk" or are biologicals. Additionally a large number of older pesticides have been cancelled or reduced from the market and/or from individual food uses. Through biomonitoring data, the U.S. may now be seeing trends in reduction of exposure to certain pesticides, the organophosphate insecticides. However, pesticide sales data through 2001 do not provide evidence for such trends.     

The Hazards of Organophosphates

ABSTRACT

The study examines aspects of the toxicological and occupational hygiene assessment of organophosphates (OPs) related to the use of sheep dips in the UK. Scientific and agricultural literature produced in the past revealed a range of potential hazards to humans from these veterinary pesticides but health and safety standards failed to address those hazards. The results of the research raise questions about the validity of past risk assessments of OPs in the UK; indicate significant under-reporting of adverse health effects in humans associated with exposure to OPs in sheep dipping; reveal shortcomings in the approval and monitoring of veterinary medicines from an occupational health and safety perspective.