Countermeasures for the construction of occupational health information standard system / 中华劳动卫生职业病杂志

As an important part of health information standard system, occupational health information standard system is the foundation and guarantee of promoting the construction of occupational health information. This article is based on the literature research about current situation of domestic and foreign health information standards and occupational health information standard system, thus take "the National Health Information Standardization System" and "the National Public Health Information Construction Standards and Norms" into account, focus on the requirements of occupational health information construction and related work. Thus, put forward suggestions on the construction of occupational health information standard system, to accelerate the occupational health information construction, data collection, transmission and application.

Construction and prospect of healthy enterprises in the new era / 中华劳动卫生职业病杂志

The construction of health enterprises practice the concept of big health. It is an important solution to protect the overall health of occupational groups in the new era, which is of great significance to promoting a healthy city and helping to build a healthy China. This paper clarifies the connotation of healthy enterprises in the new era, discusses the key points of healthy enterprise construction around the "four in one" construction content, "PDCA" construction procedures, and evaluation methods of healthy enterprises. It focuses on the progress of healthy enterprise construction, analyzes the problems faced by the construction of health enterprises in China, and puts forward suggestions to improve the construction efficiency, with a view to providing ideas for further promoting the construction of health enterprises in China.

Occurrence pattern of musculoskeletal disorders and its influencing factors among manufacturing workers / 北京大学学报(医学版)

OBJECTIVE@#To explore the occurrence pattern and its influencing factors of multi-site work-related musculoskeletal disorders (WMSDs) of the main affected body sites among manufacturing workers.@*METHODS@#Musculoskeletal disorders questionnaire was adopted to investigate the prevalence of WMSDs and the influencing factors among workers from four manufacturing factories in China. The case of WMSDs was defined as the one who had symptoms such as pain, numbness, discomfort, or limitation of activities in one or more of the nine body sites, including neck, shoulder, elbow, wrist/hand, upper back, lower back, hip/thigh, knee and ankle/foot during the last year, which lasted for more than 24 hours and did not completely relieve after rest. Besides, trauma, disability, other acute injuries or sequelae were excluded. The correlation of WMSDs between different body sites was estimated by the prevalence ratio (PR) calculated by log-binominal model. The influencing factors of multi-site WMSDs of the main affected body sites were analyzed by multinomial logistic regression model.@*RESULTS@#The overall prevalence rate of WMSDs was 79.7% among the manufacturing workers. The main affected body sites were lower back, neck, shoulder and upper back, of which the prevalence rates were 62.3%, 55.7%, 45.6%, and 38.7%, respectively. The PR values of WMSDs among these sites were relatively high. The prevalence of multi-site WMSDs involving these four sites at the same time was 25.2%, and that of three to four sites was 41.4%. Multinomial Logistic regression analysis suggested that influencing factors of multi-site WMSDs in 3-4 sites of neck, shoulder, upper back and lower back involved several aspects. Among these factors, females (OR=2.86, 95%CI 2.38-3.33) and individuals with job tenure of 15-19 years (OR=1.87, 95%CI 1.49-2.34) might have higher risk of disease. Biomechanical factors, such as often bending neck forward or holding neck in a forward position for long periods (OR=2.15, 95%CI 1.86-2.48), often twisting neck or holding neck in a twisted position for long periods (OR=1.64, 95%CI 1.40-1.92) and often twisting trunk heavily (OR=1.40, 95%CI 1.20-1.64) might be risk factors. In the aspect of work organization, doing the same work every day (OR=1.73, 95%CI 1.44-2.08), shortage of workers (OR=1.50, 95%CI 1.31-1.71) and often working overtime (OR=1.38, 95%CI 1.20-1.60) might increase the risk of disease. Factors, such as often standing for long periods at work (OR=0.77, 95%CI 0.65-0.91) and feeling breaks sufficient (OR=0.51, 95%CI 0.44-0.59) were suggested to be protective factors with OR<1.@*CONCLUSION@#The pre-valence rates of WMSDs in neck, shoulder, upper back, and lower back were high among manufacturing workers in this study. The correlation of WMSDs of these four sites was close in this study, and the comorbidity rate of 3-4 sites of these sites was relatively high, suggesting that there might be a multi-site occurrence pattern of WMSDs in "neck-shoulder-upper back-lower back" among manufacturing workers. The main influencing factors of this pattern included individual factors, biomechanical factors and work organization factors.

Research on the reliability and validity of postural workload assessment method and the relation to work-related musculoskeletal disorders of workers / 北京大学学报(医学版)

OBJECTIVE@#To form a new assessment method to evaluate postural workload comprehensively analyzing the dynamic and static postural workload for workers during their work process to analyze the reliability and validity, and to study the relation between workers' postural workload and work-related musculoskeletal disorders (WMSDs).@*METHODS@#In the study, 844 workers from electronic and railway vehicle manufacturing factories were selected as subjects investigated by using the China Musculoskeletal Questionnaire (CMQ) to form the postural workload comprehensive assessment method. The Cronbach's α, cluster analysis and factor analysis were used to assess the reliability and validity of the new assessment method. Non-conditional Logistic regression was used to analyze the relation between workers' postural workload and WMSDs.@*RESULTS@#Reliability of the assessment method for postural workload: internal consistency analysis results showed that Cronbach's α was 0.934 and the results of split-half reliability indicated that Spearman-Brown coefficient was 0.881 and the correlation coefficient between the first part and the second was 0.787. Validity of the assessment method for postural workload: the results of cluster analysis indicated that square Euclidean distance between dynamic and static postural workload assessment in the same part or work posture was the shortest. The results of factor analysis showed that 2 components were extracted and the cumulative percentage of variance achieved 65.604%. The postural workload score of the different occupational workers showed significant difference (P<0.05) by covariance analysis. The results of nonconditional Logistic regression indicated that alcohol intake (OR=2.141, 95%CI 1.337-3.428) and obesity (OR=3.408, 95%CI 1.629-7.130) were risk factors for WMSDs. The risk for WMSDs would rise as workers' postural workload rose (OR=1.035, 95%CI 1.022-1.048). There was significant different risk for WMSDs in the different groups of workers distinguished by work type, gender and age. Female workers exhibited a higher prevalence for WMSDs (OR=2.626, 95%CI 1.414-4.879) and workers between 30-40 years of age (OR=1.909, 95%CI 1.237-2.946) as compared with those under 30.@*CONCLUSION@#This method for comprehensively assessing postural workload is reliable and effective when used in assembling workers, and there is certain relation between the postural workload and WMSDs.

A randomized controlled trial of initial Valproic acid dosage in epileptic children / 中华实用儿科临床杂志

Objective To investigate whether the population pharmacokinetics (PPK)models can optimize the initial dosage of individualized Valproic acid (VPA)in children with epilepsy. Methods The epileptic children without taking VPA previously were recruited from October 2015 to May 2017 at the Department of Pediatrics,Peking University First Hospital,and they were divided into the PPK model group and the traditional empirical method group by randomized method. The initial VPA dosages for the PPK model group were calculated by PPK model,whereas those of the traditional empirical method group were dosed at 20-25 mg/(kg·d)regularly. The steady-state serum trough concentrations of VPA were extracted,and then the number and percentage of the patients whose serum trough concen-trations of VPA were 50-100 mg/L in the 2 groups were analyzed and compared with prospectively randomized me-thod. Results Totally 65 epileptic children were recruited and they were randomly divided into the traditional empirical method group (32 cases)and the PPK model group (33 cases). Twenty-seven children in the traditional empirical method group were observed,and 12 children had local epilepsy attack and 15 had generalized seizures;whereas among 29 cases in the PPK model group,there were 12 local attack of epilepsy and 17 had generalized seizures. VPA add-on therapy was administrated in 9 cases and 15 cases in the traditional empirical method group and the PPK model group, respectively. There were 5 cases,21 cases and 1 case with VPA serum concentrations of ＜50 mg/L,50-100 mg/L and＞100 mg/L in the traditional empirical group;while there were 9 cases,20 cases and 0 case in the PPK model group. The VPA serum concentrations of 21 cases (77. 8%,21/27 cases)in the traditional empirical method group and 20 ca-ses (69. 0%,20/29 cases)in the PPK model group were 50-100 mg/L,respectively,and the difference was not sta-tistically significant(P＞0. 05). Conclusion Although the study doesn't suggest that the established PPK model of VPA in Chinese epileptic children is superior to the traditional empirical method,the PPK model might be potentially valuable for optimized individualized dosage adjustment for those with serum trough concentrations not in the reasonable range by the traditional empirical method and with clinical seizure or brain firing activities.

Different Eukaryotic Initiation Factor 2Bε Mutations Lead to Various Degrees of Intolerance to the Stress of Endoplasmic Reticulum in Oligodendrocytes / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Vanishing white matter disease (VWM), a human autosomal recessive inherited leukoencephalopathy, is due to mutations in eukaryotic initiation factor 2B (eIF2B). eIF2B is responsible for the initiation of protein synthesis by its guanine nucleotide exchange factor (GEF) activity. Mutations of eIF2B impair GEF activity at different degree. Previous studies implied improperly activated unfolded protein response (UPR) and endoplasmic reticulum stress (ERS) participated in the pathogenesis of VWM. Autophagy relieves endoplasmic reticulum load by eliminating the unfolded protein. It is still unknown the effects of genotypes on the pathogenesis. In this work, UPR and autophagy flux were analyzed with different mutational types.</p><p><b>METHODS</b>ERS tolerance, reflected by apoptosis and cell viability, was detected in human oligodendrocyte cell line transfected with the wild type, or different mutations of p. Arg113His, p. Arg269FNx01 or p. Ser610-Asp613del in eIF2Bε. A representative UPR-PERK component of activating transcription factor 4 (ATF4) was measured under the basal condition and ERS induction. Autophagy was analyzed the flux in the presence of lysosomal inhibitors.</p><p><b>RESULTS</b>The degree of ERS tolerance varied in different genotypes. The truncated or deletion mutant showed prominent apoptosis cell viability declination after ERS induction. The most seriously damaged GEF activity of p. Arg269FNx01 group underwent spontaneous apoptosis. The truncated or deletion mutant showed elevated ATF4 under basal as well as ERS condition. Decreased expression of LC3-I and LC3-II in the mutants reflected an impaired autophagy flux, which was more obvious in the truncated or deletion mutants after ERS induction.</p><p><b>CONCLUSIONS</b>GEF activities in different genotypes could influence the cell ERS tolerance as well as compensatory pathways of UPR and autophagy. Oligodendrocytes with truncated or deletion mutants showed less tolerable to ERS.</p>

Association analysis of polymorphisms of metabolizing enzyme genes with chronic benzene poisoning based on logistic regression and multifactor dimensionality reduction / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the association of polymorphisms of metabolizing enzyme genes with chronic benzene poisoning (CBP) comprehensively by case-control design.</p><p><b>METHODS</b>152 CBP patients and 152 workers occupationally exposed to benzene without poisoning manifestations were investigated. 30 single nucleotide polymorphisms (SNPs) in 13 genes such as CYP2E1 were tested by PCR-RFLP, sequencing approaches. Logistic regression model was used to detect main effects and 2-order interaction effects of gene and/or environment. Multifactor dimensionality reduction (MDR) was used to detect high-order gene-gene or gene-environment interactions.</p><p><b>RESULTS</b>Based on logistic regression, the main effects of GSTP1 rs947894, EPHX1 rs1051740, CYP1A1 rs4646903, CYP2D6 rs1065852 and rs1135840 were found to be significant (P < 0.05) while the confounding factors of sex, cigarette smoking, alcohol consumption and the intensity of benzene exposure were controlled. EPHX1 rs1051740 might be associated with CBP (P = 0.06). There existed 3 types of interactions were as followed: interactions of GSTP1 rs947894 with alcohol consumption, CYP2E1 rs3813867 with EPHX1 rs3738047, EPHX1 rs3738047 with alcohol consumption(P < 0.05), while the main effects of CYP2E1 rs3813867 and EPHX1 rs3738047 were not significant (P > 0.05). The other SNPs did not show any significant associations with CBP. According to MDR, a 3-order interaction with the strongest combined effect was found, i.e. the 3-factor combination of CYP1A1 rs4646903, CYP2D6 rs1065852 and CYP2D6 rs1135840.</p><p><b>CONCLUSION</b>Gene-gene, gene-environment interactions are important mechanism to genetic susceptibility of CBP.</p>

Relationship between genetic polymorphism in hMTH1c.83, hOGG1c.326 and hMYHc.335 and risks of chronic benzene poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the relationship between genetic polymorphisms in hMTH1, hOGG1 and hMYH and risks of chronic benzene poisoning (CBP).</p><p><b>METHODS</b>A case control study was conducted. One hundred and fifty-two BP patients and 152 workers occupationally exposed to benzene without poisoning manifestations were investigated. The polymerase chain reaction restrained fragment length polymorphism technique (PCR-RFLP) was applied to detect the single nucleotide polymorphisms (SNPs) on c.83 of hMTH1 gene, c.326 of hOGG1 gene and c.335 of hMYH gene.</p><p><b>RESULTS</b>There were 2.51 times (OR(adj) = 2.51, 95% CI: 1.14-5.49, P = 0.02) and 2.49 times (OR(adj) = 2.49, 95% CI: 1.52-4.07, P < 0.01) risks of BP for individuals carrying genotypes of hMTH1c.83Val/Met + Met/Met or hOGG1c.326Cys/Cys compared with individuals carrying genotypes of hMTH1c.83Val/Val or hOGG1c.326Ser/Cys + Ser/Ser, respectively. Compared with individuals carrying genotypes of hOGG1c.326Cys/Cy and hMYHc.335 is/His at the same time, there was 0.33 times (OR(adj) = 0.33, 95% CI = 0.15-0.72, P = 0.01) risks of BP for these with genotypes of hOGG1c.326Ser/Cys + Ser/Ser and hMYHc.335His/Gln + Gln/Gln simultaneously. In the smoking group, there was 0.15 times (OR(adj) = 0.15, 95% CI: 0.03-0.68, P = 0.01) risks of BP for subjects carrying genotypes of hMYHc.335His/Gln + Gln/Gln compared with these carrying genotypes of hMYHc.335His/His.</p><p><b>CONCLUSION</b>Polymorphisms of hMTH1 Val83 Met and hOGG1 Ser326Cys may contribute to altered risks of CBP, and potential interaction may exist among polymorphisms of hOGG1 Ser326Cys and hMYH His335Gln.</p>

Genetic polymorphism of CYP-1A1, CYP2D6 and risks of chronic benzene poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the relationship between genetic polymorphisms of CYP-1A1 and CYP2D6 and risks of chronic benzene poisoning (BP).</p><p><b>METHODS</b>A case control study was conducted. 152 BP patients and 152 workers occupationally exposed to benzene without poisoning manifestations were involved. Polymerase chain reaction followed by restriction fragment length polymorphism (PCR-RFLP) technology was used for detecting the single nucleotide polymorphisms (SNPs) of MspI in the non-coding region of CYP-1A1 gene and c.188, g.212 position in the first extron of CYP2D6 gene.</p><p><b>RESULTS</b>The individuals with CYP1A1 MspI T/T genotype had a 1.32 times (95% CI: 1.05 approximately 1.65, P = 0.02) increased risk of BP compared with those carrying T/C and C/C genotypes. In no-smoking population, there was a 1.56 times (95% CI: 1.15 approximately 2.12, P = 0.003) increased risk of BP for subjects carrying CYP1A1 MspIT/T genotype compared with those carrying T/C and C/C genotypes. The individuals carrying CYP2D6 c.188 C/C or C/T genotype had a 1.23 times (95% CI: 1.05 approximately 1.42, P = 0.01) increased risk compared with those carrying T/T genotypes. In no-smoking population, there was a 1.23 times (95% CI: 1.04 approximately 1.47, P = 0.01) increased risk of BP for subjects carrying CYP2D6 c.188 C/C or C/T genotypes compared with those carrying T/T genotype. The single nucleotide polymorphism of g.212 position in the first extron of CYP2D6 gene had not been validated.</p><p><b>CONCLUSION</b>The individuals with CYP2D6 c.188 C/C, CYP2D6 c.188 C/T and CYP1A1 MspIT/T genotypes tend to be more susceptible to benzene toxicity.</p>

Relationship of genetic polymorphism in APE1 and ADPRT to risks of chronic benzene poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the relationship between genetic polymorphisms in apurinic/apyrimidinic endonuclease (APE1) and ADP ribosyltransferase (ADPRT) and individuals' susceptibility to chronic benzene poison ing (BP).</p><p><b>METHODS</b>A case-control study was conducted. One hundred and fifty-two B P patients and 152 workers occupationally exposed to benzene without poisoning manifestations were investigated. The mismatched bases combined to create restriction site with restrained fragment length polymorphism technique (CRS-RFLP) was used for detecting the single nucleotide polymorphisms (SNPs) at Asp148Glu of APE1 gene and Val762Ala of ADPRT gene.</p><p><b>RESULTS</b>There was no significant difference in the distribution of genotypes of APE1Asp148Glu and ADPRTVal762Ala between the patients and the control groups. Compared with individuals having genotype of APE1Asp148Glu T/T without habit of alcohol consumption, there was a 4.13 times increased risk of BP for the alcohol user with genotype of APE1Asp148Glu T/T (OR = 4.13, 95% CI: 1.07 - 15.85, P = 0.03). The analysis of Logistic regression showed that smoking may play some role in modifying the risk of cironic benzene poisoning (OR = 0.33, 95% CI: 0.14 - 0.75, P = 0.01).</p><p><b>CONCLUSION</b>The genetic polymorphisms in APE1Asp148Glu, ADPRTVal762Ala are not related to the risk of BP. Potential interaction is found between alcohol consumption and polymorphism of APE1Asp148Glu. Further study is needed to elucidate this interaction.</p>

Relationship between single nucleotide polymorphisms of NRAMP1 gene and susceptibility to pulmonary tuberculosis in workers exposed to silica dusts / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the relationship between polymorphisms of natural resistance-associated macrophage protein 1 (NRAMP1) gene and genetic susceptibility of pulmonary tuberculosis (PTB) in workers exposed to silica dusts.</p><p><b>METHODS</b>A 1:2 case control study of 61 male workers with PTB (50 silicosis patients and 11 unsilicosis workers) as the case group and 122 male PTB-free workers (100 silicosis patients and 22 unsilicosis workers) as the control group was conducted with the frequency matched for age of +/- 5 years, the job, the silica exposure, and the condition of cigarette smoking and alcohol drinking. The polymerase chain reaction-restrained fragment length polymorphism technique (PCR-RFLP) was used to detect the single nucleotide polymorphisms (SNPs) of NRAMP1 INT4 and D543N.</p><p><b>RESULTS</b>There was a 2.73 times (95% CI: 1.32 approximately 5.64) increased risk of silicosis for individuals with C allele of NRAMP1 INT4 compared with individuals carrying homozygote (G/G), while SNPs of NRAMP1 D543N was not associated with PTB (P > 0.05).</p><p><b>CONCLUSION</b>The G > C mutation of intron 4 of NRAMP1 gene might be a susceptible factor of silica for the workers exposed to PTB.</p>

Case-only study on the relationship between genetic polymorphisms in toxicant metabolizing enzymes and risk of occupational chronic benzene poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the effects of interaction between environmental exposure factors and genetic polymorphism in toxicant metabolizing enzymes on risk of occupational chronic benzene poisoning.</p><p><b>METHODS</b>One hundred and fifty-two cases of chronic benzene poisoning were analyzed for the risk by case-only study.</p><p><b>RESULTS</b>The frequency of non-null GSTT1 gene in benzene poisoning workers with moderate benzene exposure level was higher than that in cases with lower benzene exposure (68.63% vs 38.00%, OR(adj) = 4.32, 95% CI 1.75 - 10.66, P = 0.002). The frequency of NQO1 C.609T/T gene in alcohol drinking group was higher than that in non-drinking group (61.11% vs 20.00%, OR(adj) = 8.03, 95% CI 2.28 - 28.25, P = 0.001), moreover, it was higher in workers with smoking and drinking than that in the rest group, and in drinking x exposure level workers than that in non-drinking x exposure level workers (85.71% vs 22.76%, OR(adj) = 18.62, 95% CI 2.01 - 172.72, P = 0.01 and 61.11% vs 20.00%, OR(adj) = 3.18, 95% CI 1.55 - 6.52, P = 0.002 respectively). The frequency of non-null GSTM1 gene was also higher in drinking x exposure level workers than that in non-drinking x exposure level workers (66.67% vs 47.06%, OR(adj) = 1.99, 95% CI 1.05 - 3.76, P = 0.036).</p><p><b>CONCLUSION</b>There is interaction between the polymorphism of GSTT1 gene and moderate benzene exposure level; non-null GSTM1 gene and drinking x exposure level increase the risk of occupational chronic benzene poisoning; polymorphism of NQO1 gene C.609 also interacts with drinking, while polymorphism of NQO1 gene and drinking x smoking may further increase the risk of occupational chronic benzene poisoning.</p>

Relationship of genetic polymorphism of microsomal epoxide hydrolase with susceptibility of chronic benzene poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the relationship between genetic polymorphisms of microsomal epoxide hydrolase (mEH) and susceptibility of chronic benzene poisoning (BP).</p><p><b>METHOD</b>A case-control study was conducted. 152 BP patients and 152 workers occupationally exposed to benzene without poisoning manifestations were investigated. Polymerase chain reaction-restrained fragment length polymorphism technique (PCR-RFLP) was applied to detect the single nucleotide polymorphisms (SNPs) on c.113 and c.139 of mEH gene.</p><p><b>RESULTS</b>The risk of BP for individuals carrying mEHc.113 C/C genotype was 0.60 (OR = 0.60, 95% CI: 0.37 - 0.97, P = 0.04) of those carrying T/T and T/C genotypes. In non-smoking population, the risk of BP for subjects carrying mEHc.113 C/C genotype was 0.56 (OR = 0.56, 95% CI: 0.33 - 0.96, P = 0.03) of those carrying T/T and T/C genotypes, and in non-drinking population, the individuals carrying mEHc.113 C/C genotype was 0.51 (OR = 0.51, 95% CI: 0.30 - 0.86, P = 0.01) of those carrying T/T and T/C genotypes.</p><p><b>CONCLUSION</b>The subjects carrying mEHc.113 C/C genotype and together with non-smoking or non-drinking habit may have lower risk of chronic benaene poisoning.</p>