2017年中山市接触重点职业病危害因素劳动者职业健康现状分析

目的 了解中山市接触重点职业病危害因素劳动者的职业健康状况,掌握需重点防控的职业病危害因素和接触人群。
方法 收集2017年中山市重点职业病危害因素相关信息、职业健康检查数据,对其进行统计分析。
结果 中山市接触重点职业病危害因素企业主要集中于小型（占55.06%）、私有经济（占66.55%）、制造业企业（占93.74%）中。中山市2017年开展重点职业危害因素在岗职业健康检查的企业共有1 166家,应检46 719人,共体检了33 162名劳动人员,总受检率为70.98%;检出疑似职业病患者429人,检出率为1.29%;检出职业病禁忌证450人,检出率为1.36%。不同职业病危害因素检测超标率比较,噪声的超标率最高（P < 0.01）。对不同职业病危害因素、不同企业规模的受检率、疑似职业病检出率和职业禁忌证检出率比较,噪声的受检率最低,检出率最高,小微型企业的受检率低于大中型企业,而检出率高于大中型企业,差异有统计学意义（P < 0.05）。不同性别、不同企业规模工人的职业健康检查关键项目异常率比较,差异均有统计学意义（P < 0.05）,其中小微型企业的异常率均高于大中型企业。
结论 中山市目前接触重点职业病危害因素的劳动者职业健康状况不容乐观,建议加强职业卫生监管力度,增强小微型企业和劳动者的职业病防范意识,重点行业专项治理,尤其要加强噪声的职业病危害控制和职业健康监护工作,减少职业病的发生。
     

某家电制造企业职工五官科查体情况分析

目的 了解某家电制造企业职业健康检查五官科查体情况，为预防职业相关疾病提供依据。
方法 以该企业在岗及离岗人员为接触组，对其职业健康体检中五官科结果进行统计分析；并以岗前人员为对照组，就危害因素对2组人群进行分析比较。
结果 该企业职业病危害因素包括噪声、粉尘、高温、紫外线、苯乙烯、锰及其化合物、苯及苯系物等60多种。该企业接触组五官科总异常检出率为25.78%，接触组的五官科异常率高于对照组（P < 0.05），接触组男性的异常检出率高于女性（P < 0.05），不同年龄工人异常检出率差异有统计学意义（P < 0.05），接害工龄越长，异常检出率越高（P < 0.05）。五官各部位异常检出率亦有差异，其中以耳部的异常检出率最高；眼部、耳部、鼻部、咽部的主要检出病症分别为翼状胬肉、耵聍栓塞、鼻炎、咽炎。不同危害因素接触组的五官科异常检出率差异并无统计学意义（P>0.05），但噪声、紫外线+电焊烟尘、噪声+粉尘、苯及苯系物接触者的异常检出率处于较高水平。
结论 性别、年龄、工龄、接触职业病危害因素均可能影响五官科异常检出率，应采取积极的针对性预防措施。
     

职业健康检查前期资料填报质量分析及质量控制对策研究

目的 探讨影响职业健康检查前期资料质量的各个因素, 并提出相应的质量控制策略。
方法 收集2014-2015年广州市203家欲开展职业健康检查的用人单位初次提供的前期资料中存在的各种问题, 对其成因进行归纳分析, 结合经验探讨质控策略。
结果 作为关键资料, 劳动者职业接触史完整提供率最低, 填报时出错种类最多、不规范填报率高, 其中受检者总工龄和接触职业病危害因素工龄混淆的厂企达34.41%。接触职业病危害类型及人数在用人单位基本情况填报中不符合率最高。小型企业提供的职业病危害因素检测情况资料情况较差。
结论 用人单位职业卫生管理水平偏低、相关职业卫生档案资料欠缺和目前职业健康检查机构行业内前期资料填报要求尚未形成统一标准等因素是使前期资料质量降低的主要原因。用人单位需和职业健康检查服务机构合作, 从技术、管理、宣教等多方面对填报质量进行控制。
     

曲靖市2015—2018年重点职业病监测结果分析

目的 分析曲靖市2015-2018年重点职业病监测结果,为该市制定职业病防治策略提供科学依据。
方法 通过职业病危害项目申报表、重点职业病监测报表和职业病与职业卫生信息监测系统收集曲靖市2015-2018年接触煤尘(煤矽尘)、矽尘、石棉、苯、铅、噪声、布鲁氏菌、水泥尘、砷及其化合物、氟及其化合物10种重点职业病危害因素的在岗劳动者职业健康检查和职业病诊断资料,进行描述性统计分析。
结果 2015-2018年曲靖市诊断的重点职业病分别为87、102、140和29例,2018年病例数出现了明显下降。2015-2018年疑似职业病检出率和职业禁忌证检出率均呈下降趋势(P < 0.01)。2015-2018年报告的358例重点职业病中尘肺病350例(占97.77%)。职业健康检查检出疑似重点职业病830例,其中疑似尘肺病796例(占95.90%),疑似噪声聋34例(占4.10%);检出重点职业病职业禁忌证4 029例,其中粉尘作业禁忌证3 850例,占95.56%;噪声作业禁忌证161例,占4.00%。
结论 煤工尘肺、矽肺和噪声聋3种职业病是曲靖市重点关注的重点职业病。
     

北京市西城区2016年重点职业病监测现状分析

目的 评估西城区重点职业病的职业健康风险, 为政府制定职业病防治策略提供技术依据。
方法 通过安全生产监督管理部门、职业健康检查机构及劳动保障部门分别收集与重点职业病相关的职业病危害因素申报信息、职业健康检查情况及职业病病人工伤保险待遇落实情况等资料, 对收集的数据进行汇总和分析。
结果 2016年西城区存在重点职业病危害因素的企业共72家, 职业病危害风险分类均为严重。辖区中接触重点职业病危害因素的工人共2 003人, 其中接受职业健康检查人数为695人, 占应接受职业健康检查人数的34.70%。重点职业病专项检查中, 苯作业人员专项检查异常率为1.36%(2/147), 噪声作业工人专项检查异常率为76.44%(279/365);重点职业病危害因素检测结果中不符合国家限值标准的全部为噪声岗位, 超标率9.88%(8/81)。辖区共报告职业病6例。
结论 西城区重点职业病监测点企业职业健康检查率较低, 噪声仍然是主要的职业病危害因素, 职业病仍然以尘肺病为主。建议进一步加强安监部门、健康检查机构和卫生部门的交流和沟通, 充分利用北京市职业健康监护系统, 形成动态监测体系。
     

安徽省2017年重点职业病分布及其调查结果分析

目的 通过对2017年安徽省重点职业病监测结果的分析,了解安徽省重点职业病的发病特点、变化趋势和规律,为制定安徽省职业病防治策略提供技术依据。
方法 在安徽省16市中选取接触10种职业病危害因素所致的13种职业病为监测的重点职业病,通过收集作业场所职业病危害情况、劳动者在岗期间健康检查指标、职业病诊断与鉴定情况等信息资料,并对数据进行整理、汇总、分析,对安徽省重点职业病进行职业健康风险评估。
结果 2017年安徽省共有12 452家企业申报了职业病危害情况,其中存在重点职业病危害的企业共5 591家;2017年安徽省开展职业健康检查企业有4 484家,开展率为80.2%;接受职业健康检查的劳动者有283 584人,体检率为95.1%;共收集在岗期间职业健康检查个案卡168 936例,其中包含10种重点职业病危害因素信息183 891条;2017年安徽省共诊断重点职业病206人,主要为煤工尘肺、矽肺,行业主要集中在采矿业和制造业;2017年安徽省共申请鉴定16人,其结果均与原诊断结论相符。
结论 2017年安徽省接触重点职业病危害因素劳动者健康状况不容乐观,尘肺病是安徽省需要重点防控的职业病,采矿业和制造业是需要重点防控的行业,化学及物理因素所致职业病处于散发态势,但仍须引起警惕。
     

佛山市三水区2015年接触重点职业病危害因素工人健康监护结果分析

目的 掌握佛山市三水区接触职业病危害因素工人的健康状况。
方法 将三水区辖区内2015年81家重点监控企业2 961名接触粉尘、噪声、苯、铅的作业工人作为职业健康监护对象, 对其检查结果进行统计分析。
结果 共受检2 961名工人, 受检率为76.51%(2 961/3 870)。检出疑似职业病者20例, 检出率0.68%;其中疑似噪声聋者18例, 疑似慢性苯中毒者2例; 粉尘和铅作业工人均未发现疑似职业病者。职业禁忌证检出率2.30%(68/2 961);其中粉尘作业禁忌证检出率2.40%(12/500), 噪声作业禁忌证检出率2.32%(54/2 336), 苯作业禁忌证检出率1.95%(2/103), 铅作业未发现职业禁忌证者。不同职业病危害因素接触工人、不同规模企业工人、不同经济类型工人、不同风险类别企业工人受检率比较, 差异均有统计学意义(P < 0.05), 其中尤其以大型企业、私有企业和风险类别严重企业工人的受检率为低。不同规模企业的作业工人疑似职业病检出率差异有统计学意义(P < 0.05), 以大型企业为最高; 不同经济类型企业的作业工人职业禁忌证检出率差异有统计学意义(P < 0.05), 以国有企业为最高。
结论 佛山市三水区应改善接触职业病危害因素工人的监护工作, 将职业健康监护重点放在大型企业以及存在噪声和苯系物等重要职业病危害因素的企业。
     

2021年四川省职业健康检查结果分析

目的分析四川省2021年职业健康检查结果,为明确职业卫生工作重点提供依据和支撑。方法收集四川省2021年所有参加有毒有害作业职业健康检查的劳动者职业健康检查个案卡,对目标疾病和健康损害的分布情况进行描述性分析,重点分析接触煤尘、矽尘、噪声、苯、铅等主要职业危害因素的职业健康检查结果,采用SPSS 26.0软件进行统计分析,组间比较采用Pearsonχ^(2)检验,检验水准α=0.05。结果2021年四川省共收集到628270名劳动者的职业健康检查资料,疑似职业病检出率为0.30%,不同职业病危害因素的疑似职业病检出率差异有统计学意义(χ^(2)=8309.014,P<0.001);职业禁忌证检出率为1.08%,不同职业病危害因素接触劳动者职业禁忌证检出率差异有统计学意义(χ^(2)=912.115,P<0.001)。煤尘作业劳动者的疑似职业病检出率(3.42%)和职业禁忌证检出率(1.63%)均为最高,而噪声作业体检人数和专项指标异常人数最多。专项指标异常人员主要分布在煤炭开采、建筑材料制造、汽车制造、家具制造和建筑业等行业,企业规模以小型为主。随着年龄和工龄的增加,煤尘、矽尘和噪声作业劳动者的专项指标异常检出率有上升趋势。结论四川省应重点加强煤尘、噪声等职业危害的治理,以职业健康检查发现的关键指标异常数据作为开展风险评估的基础,预测和分析职业病发病特点和规律。     

郑州市加油站职业病危害与作业人员健康现况调查

目的 了解郑州市加油站职业病危害现状。
方法 选择郑州及所属周边县、市156家加油站进行现场职业病危害调查, 并分析320名加油作业人员的职业健康体检资料。
结果 加油站主要职业病危害因素为汽油、苯、甲苯、二甲苯。加油工接触的毒物浓度均高于计量员, 加油机旁的毒物浓度均高于值班室, 差异均有统计学意义(P < 0.01或0.05), 但均未超过国家职业卫生标准。作业人员职业健康体检结果:神经衰弱症状检出率6.3%, 血常规异常检出率16.3%, 尿常规异常检出率10.0%, 心电图异常检出率9.1%, 血压异常检出率6.3%, 肝功能及B超异常检出率各为12.2%, 皮肤异常检出率11.9%。11~15年工龄组血常规、B超、神经系统和皮肤异常检出率均高于1~10年工龄组(P < 0.05)。高血压、尿常规、肝功能、心电图异常检出率在2个工龄组间差异无统计学意义(P>0.05)。
结论 现阶段加油站存在的职业病危害因素的浓度较低, 但对作业人员健康仍可能会产生一定的影响, 应加强监管。
     

2015—2016年深圳市职业性苯接触工人职业病监测结果分析

目的 了解深圳市职业性苯接触工人职业健康状况及社保工伤待遇落实情况, 为预防与控制苯所致职业病提供科学依据。
方法 收集2015-2016年深圳市职业性苯接触工人职业病监测数据进行统计分析。
结果 2015、2016年深圳市所监测的职业性苯接触人数分别为27 952、22 087人, 监测对象血白细胞、血小板、中性粒细胞等关键指标的偏低检出率、职业禁忌证检出率、应复查率在两年分别为6.21%、4.11%, 2.01%、0.52%, 4.45%、1.40%, 1.67%、1.24%, 6.69%、3.80%。以上5项指标在2016年均低于2015年, 差异有统计学意义(P < 0.05)。其中女性血白细胞、血小板偏低检出率及应复查率均高于男性, 男性职业禁忌证检出率要高于女性, 差异均有统计学意义(P < 0.05);监测对象血白细胞、中性粒细胞偏低检出率及应复查率呈现随工龄增长而增高的趋势(P < 0.05);不同规模企业员工5项指标差异均有统计学意义(P < 0.05), 且均以微型企业最高。2015、2016年深圳市分别报告职业性苯中毒及苯所致白血病23例、10例, 其中已经提交工伤保险待遇申请者分别为19例、6例, 已经落实工伤保险待遇者分别为5例、2例。
结论 深圳市职业性苯接触工人职业健康状况不容乐观, 有必要继续开展涉苯企业重点职业病监测, 不断提高早期发现、早期预防、早期控制重点职业病的能力, 从而切实保护劳动者健康。
     

中国职业卫生与职业病研究的进展

近年来中国职业卫生与职业病研究取得了长足的发展,以职业暴露人群为研究中心,针对职业病的病因、发病机制、人群易感性生物标志物以及风险评估等方面开展了大量的研究,填补了中国甚至世界范围内诸多职业卫生与职业病方面的空缺,具有重要的公共卫生意义。目前中国处于高速发展阶段,大批新兴的、创新的技术正应用于各个领域,推动着中国的产业结构、生产方式和生产技术发生巨大变革,新兴领域的高速发展对职业卫生提出了新的挑战,表现为传统的职业性有害因素带来的职业卫生问题逐渐减少,新的问题不断出现。职业卫生和职业医学也迫切需要将医学科学的新理念、新技术应用于本学科,建立新型健康风险评价体系,进而满足职业人群健康监护和职业病诊断治疗的需求。     

Relations of occupational stress to occupational class in Japanese civil servants--analysis by two occupational stress models

The aim of the present study was to identify relations between occupational stress and occupational class in Japanese civil servants, using two occupational stress models-the Effort-Reward Imbalance (ERI) Model and the Job Demand-Control (JDC) Model. The subjects were employees of three local public organizations. We distributed self-administered questionnaires and assessed occupational stress by ERI and JDC. We used seven occupational categories based on the Standard Occupational Classification for Japan. The data of 6,423 male and 1,606 female subjects were analyzed by logistic regression analysis to obtain odds ratios (OR) for relations between occupational stress and occupational class. In JDC, male clerical workers, transport/communication workers and protective service workers showed a significantly higher OR of being in the high occupational stress group, compared to managers. In ERI, male professionals/technicians, transport/communication workers, clerical workers and protective service workers showed a significantly higher prevalence OR, compared to managers, the two models giving different results. In ERI, female production workers/laborers and clerical workers had a significantly lower prevalence OR, compared to managers. The results of this study showed that occupational stress differed by occupational class and the two occupational stress models gave different results for occupational classes with high occupational stress.     

The values of occupational therapy: Perceptions of occupational therapists in Quebec

Objective: Recently, there has been increasing interest in the values of occupational therapy and the values held by occupational therapists. A wide range of values has been reported in the literature. Furthermore, despite the fact that values are an important part of professional identity, empirical studies have demonstrated that several occupational therapists possess an ambiguous professional identity. This study was undertaken to explore the values of Canadian occupational therapists, specifically French-speaking occupational therapists in Quebec. Methods: Semi-structured interviews were conducted with 26 occupational therapists. Their narratives were subject to hermeneutic analysis, a method of textual analysis common in philosophical research. Results: A total of 16 values were identified in the discourses of the occupational therapists interviewed: autonomy; human dignity; occupational participation; social justice and equity; professionalism; holism; partnership, environment, or ecological approach; quality of life; solicitude; honesty; integrity; health; creativity; professional autonomy; effectiveness; and spirituality. Conclusions: The results of this study are, in general, consistent with those reported in the few other empirical studies that have documented the values perceptions of occupational therapists. Finally, the explanation of the values of occupational therapists may reinforce their professional identity and favour best, or at least desirable, professional practices related to ethics and culture.     

Prevention of occupational asthma--practical implications for occupational physicians

BACKGROUND: Occupational factors have been estimated to contribute to approximately 10% of adult-onset asthma and occupational asthma (OA) is one of the most common occupational lung diseases in industrialized areas. Persistent asthma frequently occurs with significant socio-economic impacts. METHODS: A literature search was performed using PubMed. The key term searched was occupational asthma combined with prevention. RESULTS: Primary prevention has been effective for OA related to natural rubber latex, and may have reduced the incidence of diisocyanate-induced asthma. Medical health surveillance has been effective in settings such as the detergent enzyme industry, workers exposed to complex platinum salts and likely for diisocyanate workers in Ontario. Tertiary prevention is still required for workers with OA and can improve prognosis. CONCLUSIONS: OA is potentially preventable. Sufficient studies have demonstrated the rationale and benefit of primary preventive strategies. Medical health surveillance programs combined with occupational hygiene measures and worker education have been associated with improved outcomes but further studies are needed to understand the optimum frequency and measures for such programs and to identify the separate contribution of the components. Until primary and secondary prevention is better understood and implemented, there will also remain a need for tertiary preventive measures.     

A review and critique of well-being in occupational therapy and occupational science

Abstract

Scholars in occupational therapy and occupational science often reference well-being when discussing treatment goals or occupational engagement, but the various meanings of this reference remain unexamined in current literature. This paper reports the results of a literature review of five journals and five monographs in the occupational therapy and occupational science literature. The purpose of this review was to understand and critique how scholars in the profession and the discipline conceptualize well-being, guided by broader philosophical perspectives on the subject. The review revealed inconsistent definitions and uses of “well-being” throughout the literature, illuminating the need to reconsider this concept's purpose within the profession and the discipline. Based on these results and building on current theoretical trends, the author advocates a more nuanced and considered use of well-being that acknowledges the uncertainty faced by occupational therapists, occupational scientists, and the people with whom they practice or research.     

Perceptions by practicing occupational therapists of the clinical doctorate in occupational therapy

Despite recent discussions regarding the implementation of the clinical doctorate in occupational therapy (OTD) as the entry-level degree for occupational therapy, there is a dearth of published literature that addresses the issue of the OTD. In this study, recent alumni of an occupational therapy program from an urban midwestern university were surveyed to determine their perceptions of the OTD. Most respondents agreed or strongly agreed that the OTD curriculum should include courses about managed care and/or insurance regulations, business management/administration, effective professional communication, research, and specialization in a specific area of occupational therapy. Respondents believed that an OTD would assist in career advancement, obtaining a higher salary, and professional competence. However, the majority of respondents did not believe that an OTD would result in enhancement of interprofessional relationships, improved reimbursement from third-party payers, and enhanced public recognition of the profession or enhanced ability to practice without a referral. There was not a strong opinion whether there is an advantage to a clinical doctorate degree, and only 22% agreed or strongly agreed that they would be interested in pursuing a postprofessional OTD.     

A scoping review of time-use research in occupational therapy and occupational science

Background: Time use is a defining interest within occupational therapy and occupational science. This is evident through the range of contributions to the disciplinary knowledge base. Indeed it has been suggested that time-use methods are amongst the most established research techniques used to explore aspects of human occupation. However, the extent and nature of such activity in occupational therapy and occupational science has not been examined to date. Aim: This study sought to map the extent and nature of time-use research in occupational therapy and occupational science journals and the extent to which studies explored the relationship between time-use and health. Method: A scoping review method was used. Results: Sixty-one studies were included. Scandinavian countries contributed the largest number of studies (n = 16, 26%). While time-use diaries were used most frequently (n = 30, 49%) occupational therapists and occupational scientists have developed a range of data-collection instruments. Forty-nine studies (80%) focused on time-use in clinical or defined population sub-groups. Ten studies (16%) included an empirical examination of the relationship between time-use and health. Conclusion: Future research should examine time-use and health amongst well populations across the lifespan and in different parts of the world.