1989至2003年全国金属及类金属化合物重大急性职业中毒的特征

目的通过分析我国报告发生的金属及类金属化合物重大急性职业中毒事故的发生特点,提出优先、重点的防制建议。方法对1989至2003年全国报告发生的金属及类金属化合物重大急性职业中毒资料进行整理和分析。结果15年间共报告金属及类金属化合物重大急性职业中毒39起,年均2．6起,直接导致中毒的金属及类金属化合物约13种。确诊中毒609例,死亡32例,平均每起事故中毒15．6例,中毒死亡0．8例,总中毒率为52．9%,总中毒死亡率为5．3%；平均中毒年龄(29．2±9．0)岁,平均中毒死亡年龄(32．3±9．9)岁。自1997年起报告的中毒事故增多,43．6%的中毒由砷化氢导致；发生在制造业和化学工业的中毒较多,清洗和搬运作业易发生中毒。导致中毒事故发生的主要原因是没有密闭通风排毒设备或效果不好(22．5%)、没有个人防护设备(19．8%)、缺乏安全教育(19．8%)和没有安全操作规程(15．3%)等。结论加强砷化氢、砷及其化合物的急性中毒防治,注意在冬夏两季有针对性地加强安全教育和个人防护。     

1989至2003年全国有机溶剂重大急性职业中毒的特征

目的探讨有机溶剂重大急性职业中毒事故的发生规律和特点,为制定有机溶剂中毒的防制策略提供科学依据。方法对1989至2003年15年间收集到的有机溶剂重大急性职业中毒资料进行描述性分析。结果(1)15年间共报告有机溶剂重大急性职业中毒事故58起,中毒393例,中毒死亡48人,总中毒率为51．2%,总中毒死亡率为12．2%；平均中毒年龄(30．9±8．8)岁,平均中毒死亡年龄(30．6±12．0)岁。(2)直接导致中毒的有机溶剂有11种,以苯及其同系物为主。(3)有机溶剂重大急性职业中毒以制造业、化学工业、建筑、运输与仓储、服务业与商业等行业多发,喷漆和清洗岗位的危险性较高,事故相对集中发生在4～7月份。(4)导致中毒事故发生的主要原因是没有密闭通风排毒设备或效果不好、没有个人防护设备、缺乏安全教育和没有安全操作规程等。结论作业场所要加强通风,避免劳动者皮肤直接接触有机溶剂,使用无毒或低毒的替代物质。     

1989至2003年全国重大急性职业中毒事故的特征

目的探讨我国重大急性职业中毒事故的发生特点,为制定职业中毒的防制策略提供科学依据。方法对1989至2003年15年间全国报告的重大急性职业中毒资料进行了描述性分析。结果(1)15年间全国共报告重大急性职业中毒事故506起,中毒患者4657例,总的中毒率为54．8%,总的中毒死亡率为16．5%,平均中毒年龄(31．9±9．8)岁,平均中毒死亡年龄(33．7±10．3)岁；男性多于女性。(2)直接导致职业中毒的化学物超过112种,主要以硫化氢、一氧化碳、苯及其同系物、金属和类金属、二氧化碳为主,不同行业职业中毒的化学物有所不同。(3)急性重大职业中毒事故以化学、制造、水处理、开采、建筑等行业多发,清洗、检修、生产、采矿、挖掘等岗位的危险性为高,事故相对集中发生在4～8月份。结论(1)我国重大急性职业中毒事故危害严重；(2)我国重大急性职业中毒事故的发生在高危行业、重点毒物和主要岗位有明显的集中趋势；(3)不同行业的职业中毒呈现不同的特点；(4)强化管理是预防控制职业中毒的重要环节。     

某化工企业四起急性职业中毒事故分析

目的了解某化工企业急性职业中毒事故发生状况,寻找事故原因,为预防和控制急性职业中毒提供科学依据和防治对策。方法采用回顾性调查方法,对该企业6年间发生的4起急性职业中毒事故进行分析。结果该企业发生急性职业中毒事故4起,其中一般事故3起、重大事故1起;中毒人数9人,中毒罹患率为18.00%,死亡1人,病死率为11.11%;引起职业中毒毒物为砷化氢;中毒事故主要发生在高温净化车间高温净化操作岗位;中毒主要原因是"设备跑、冒、滴、漏"、"违反操作规程超负荷生产"和"个人防护不当"。结论企业及政府相关部门一定要高度重视乡镇企业的职业病防治工作,从源头上预防和控制职业中毒事故的发生。     

用秩和比法综合评价1997-2005年上海市急性职业中毒事故发生情况

[目的]应用秩和比法对1997～2005年间急性职业中毒事故资料进行综合分析,为进一步加强急性职业中毒事故的防控工作提供相关依据。[方法]选用事故发生起数、中毒病例数和病死率作为评价指标,用秩和比法（RSR）综合评价1997-2005年间急性职业中毒事故的发生情况。[结果]急性职业中毒事故种类以CO、H2S、苯的氨基硝基化合物多见。根据校正加权秩和比（RSRW）结果,急性职业中毒事故发生情况不呈逐年递减趋势,而是2002年情况最（RSR,为0．722）好,2005年情况最差（RSRW为0．287）。[结论]上海市1997～2005年间急性职业中毒事故发生情况,不容乐观。尚有待加强针对性的防控工作。     

1989至2003年全国刺激性气体重大急性职业中毒的特征

目的探讨我国刺激性气体重大急性职业中毒事故的发生特点，为制定相应防制策略提供科学依据。方法对15年间全国报告的刺激性气体重大急性职业中毒资料进行描述性分析。结果（1）15年间共发生刺激性气体重大急性职业中毒事故92起，年均6．1起，直接导致中毒的物质有40种，平均每起事故中毒14．5例，中毒死亡0．8人；单起事故最多中毒116例，最多中毒死亡7人。氯气的中毒起数、中毒病例数和中毒死亡例数均居前列；（2）中毒事故发生的高峰期为每年的7、8月份，化学工业的生产、检修和清洗岗位刺激性气体中毒事故多发。结论（1）刺激性气体重大急性职业中毒事故危害严重。（2）刺激性气体重大职业中毒事故毒物、行业和岗位分布集中趋势明显，要对重点毒物、重点行业和重点岗位进行预防控制。（3）做好刺激性气体重大事故发生的预警、预报和应急救援工作。     

北京市朝阳区2003-2005年急性职业中毒事故调查

目的 分析北京市朝阳区2003—2005年急性职业中毒事故发生的原因和规律,为探索预防对策和措施提供依据。方法 收集该区职业中毒和职业病报告卡和急性职业中毒个案调查报告,分析中毒事故发生的时间、行业、毒物分布和事故发生的原因。结果 2003—2005年北京市朝阳区共发生14起职业性急性中毒事故,30人中毒,死亡9人,病死率为30.00%;市政服务行业的中毒和死亡人数最高,构成比分别是46.67%和55.56%;甲烷和苯是引起中毒的主要毒物,均占36.67%;导致中毒的原因主要是缺乏安全教育、没有个人防护用品、没有密闭通风排毒设备、没有安全操作制度和规程等。结论 急性职业中毒由多种因素造成,卫生监督部门应重点预防、控制市政服务等行业的中毒事故,及早发现急性中毒隐患,减少职业中毒事故的发生。     

甘肃省1986～2003年职业中毒发病情况分析

目的　了解甘肃省职业中毒的发病情况,为职业病防治提供依据。方法　依据报表统计资料,对 1986~2003年所发生的职业中毒分别按年代、种类、行业系统进行汇总分析。结果　18年间急、慢性职业中毒1 160例(急性672例、慢性488例),分别高发于1990和1993年,以后呈波动性变化趋势;急性职业中毒以二氧化碳中毒为主,主要发生在冶金系统和有色金属系统;慢性职业中毒以铅及其化合物中毒为主,有色金属系统最为严重。结论　应加大职业卫生监管和职业危害专项整治的力度,有效防范职业中毒事故的发生,提高劳动者的健康水平。     

80起急性职业中毒事件流行病学分析

[目的]分析上海市浦东新区80起急性职业中毒事件的行业、人群和时间分布特征及主要原因,为制订防治对策提供依据。[方法]用回顾性调查的方法,对该区1996年1月至2008年12月间发生的80起急性职业中毒事件进行回顾性调查分析。[结果]80起急性职业中毒事件共造成157人中毒,其中男性129人（82.2%）,女性28人（17.8%）;年发生数以2003至2005年为高峰,共发生43起;致中毒化学物质中,硫化氢共造成急性职业中毒42人（26.8%）,死亡15人（71.4%）;发生于7—9月的急性职业中毒事件共45起（56.3%）。事故发生的主要原因有防护设施失效（35.0%）、未使用个人防护用品（28.7%）、违反安全操作规程（18.3%）等。[结论]针对该区发生急性职业中毒主要原因,应采取加强安全教育、配备防护设施及相应个人防护用品等综合防制措施。     

湖南省3年急性职业中毒与事故分析

为了解我省急性职业中毒的特点与发生原因,使有关部门和单位更好地制订防治对策与措施,我们对1996～1998年全省报告的急性职业中毒结果进行初步分析,现报告如下。1　资料与内容　　资料来源于1996～1998年全省急性职业中毒的统计报告。根据其报表的规定,主要内容有患者一般情况、工业系统、中毒物、病种、专业工龄及中毒原因的调查。2　结果21　1996～1998年全省共报告急性职业中毒127例,其中重大中毒事故10起,中毒56人,死亡19人。22　急性职业中毒患者的工业系统分布见表1。23　发生急性职业中毒的毒物种类有:硫化氢33例,一氧化碳24例,苯的…     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.     

Assessing occupational and environmental exposure

Exposure assessment is a poorly understood component of the science of epidemiology. The relationship between exposure to chemicals and ill-health outcomes is often calculated using crude exposure measures such as ever/never exposed or duration. When investigating subtle effects, exposures need to be characterized much more fully in terms of intensity, frequency, duration and route. While occupational exposures tend to be much greater than those experienced from the wider environment there is a need to remember that, for many chemicals, exposure can occur occupationally, environmentally and through consumer use of products containing the material of interest. Inhalation exposure has generally been the traditional focus for most epidemiological investigations but there is now growing awareness of the importance of the dermal and ingested routes of contact and internalization. Quantification of the exposure also needs to be related to a biological mechanism of action and exposure metrics need to be selected accordingly. Occupational exposures can generally be measured using simple well-validated techniques. Environmental exposures require much more sensitive instruments and are more difficult to assess. Exposure modelling, particularly for the environmental fate of chemicals has undergone many recent developments and Monte Carlo techniques can be used to characterize model uncertainty and variability. This approach to exposure assessment can now be used in the setting of the wider environment and will enable a far better understanding of the relationship between exposure and disease.     

Mercury toxicity due to the smelting of placer gold recovered by mercury amalgam

A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [Mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (Mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited.     

How Adults with Acquired Brain Damage Perceive Computer Training as a Rehabilitation Tool: A Focus-group Study

The aim of this study was to explore and describe how adult outpatients with acquired brain damage and referred to occupational therapy perceive computer training with the RehaCom programs, in order to evaluate the method of treatment as a tool in the rehabilitation of persons with cognitive disorders. By using focus-group discussions as a qualitative method of research when analysing the result, five themes with corresponding categories emerged, describing a development of understanding and learning about capacities. Themes describing how the participants could apply strategies to overcome shortcomings in daily occupations and the therapeutic role of the occupational therapist were identified as well. The result shows that a computer training program such as RehaCom can be used as an educational tool, for example, to guide a person who is trying to adopt compensatory strategies to avoid overload by taking pauses. It was found that anything the participants learned was also applicable to occupational performance in daily life.