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Objective To analyze the distribution features of newly reported cases of occupational welder′s pneumoconiosis (OWP) in Guangdong Province from 2013 to 2022. Methods Data of newly reported cases of OWP from National Occupational Disease Network Direct Reporting System of Guangdong Province from 2013 to 2022 was analyzed using conventional data analyzing Methods. Results A total of 294 cases of OWP were reported in Guangdong Province from 2013 to 2022 with an overall downward trend. The average age at diagnosis for new OWP cases was 44±6 years old, and the median of dust exposure duration was 11 years. Males accounted for 99.3% of the cases, and 94.2% of the cases were phase Ⅰ OWP. Guangzhou City had the highest regional distribution with 74.8% of the cases. The industry distribution was mainly manufacturing, accounting for 86.7% of the cases. The scale of enterprises was most common in small enterprises, followed by large and medium-sized enterprises, accounting for 38.4%, 30.6% and 24.5% of the cases respectively. The economic types of enterprises were mostly private enterprises, followed by state-owned enterprises, accounting for 54.1% and 32.0% of the cases respectively. Conclusion In Guangdong Province, the newly reported OWP cases were clustered in terms of disease stage, regional distribution, industry, enterprise scale and enterprise economic type. There was a tendency of younger age at diagnosis and shorter dust exposure duration.
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Objective To analyze the epidemiological characteristics of newly diagnosed occupational pneumoconiosis (hereinafter referred to as "pneumoconiosis") in Guangdong Province from 2011 to 2020. Methods Clinical data of newly diagnosed pneumoconiosis in Guangdong Province from 2011 to 2020 was collected from the “Health Hazards Monitoring Information System” under “China Disease Prevention and Control Information System”. The distribution of the cases was analyzed retrospectively. Results A total of 2 731 cases of newly diagnosed pneumoconiosis were reported from 2011 to 2020 in Guangdong Province, with cases at stages Ⅰ,Ⅱ, and Ⅲ accounting for 61.6%, 23.8%, and 14.6%, respectively. Except for talc pneumoconiosis, 12 other types of pneumoconiosis were reported. The top three incidence of diseases were silicosis, other pneumoconiosis, and welder's pneumoconiosis, accounting for 58.8%, 22.0% and 11.0%, respectively. Males accounted for 97.5%, and females 2.5%. The median age of onset was 47 years old. The median dust exposure duration was 9.8 years, with 19.4% of cases having a dust exposure duration less than 5.0 years. And 80.7% of the cases were distributed in the Pearl River Delta region. The industries with the new cases were mainly the manufacturing (accounting for 69.4%), and 34.8% of cases were found in private limited liability companies. Cases in medium- and small-sized enterprises accounted for 35.7% and 34.3% respectively. Conclusion Silicosis, other pneumoconiosis, and welder's pneumoconiosis are predominant in Guangdong Province. The prevention and control of pneumoconiosis should focus on small- and medium-sized private enterprises in the concentrated manufacturing industry in the Pearl River Delta region.
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Objective: To investigate the specificity of endogenous metabolic profile in plasma of patients with occupational acute methyl acetate poisoning using non-targeted metabolomics. Methods: A total of six patients with occupational acute methyl acetate poisoning were selected as the poisoning group, while 10 healthy workers without occupational exposure history of chemical hazards in the same industry were selected as the control group using the judgment sampling method. Metabolites in patient plasma of the two groups were detected using ultra-high performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry, and non-targeted metabolomics analysis was performed. Principal component analysis and partial least squares discriminant analysis were used to identify differential metabolites and analyze their metabolic pathways. Results: There were significant differences in metabolite profiles in patient plasma between poisoning group and control group. A total of 195 differentially expressed metabolites were screened in plasma of patients in poisoning group, including 119 upregulated and 76 downregulated metabolites. Lipid substances (lipids and lipid-like molecules) accounted for the highest proportion (21.5%). The differential metabolites of poisoning group were related to folate biosynthesis, amino acid metabolism, pyrimidine metabolism, sphingolipid biosynthesis and other metabolic pathways in plasma compared with the control group (all P<0.05). Conclusion: Occupational acute methyl acetate poisoning affects metabolism of the body. The folic acid biosynthesis, amino acid and lipid metabolism and other pathways may be involved in the occurrence and development of poisoning.
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Unclear labor relationship is the most common challenging issue in occupational disease diagnosis. At present, there are three main errors in the understanding regarding labor relationship in the process of occupational disease diagnosis. Firstly, labor relationship does not need to be considered in occupational disease diagnosis. Secondly, labor relationship must exist in order to initiate the occupational disease diagnosis procedure. Lastly, there is an overreach in handling labor relationship issues beyond one's authority. Labor relationship is the basic and antecedent problem which cannot be avoided in occupational diseases diagnosis. While officially, labor relationship issue should be considered in occupational disease diagnosis, they are not a necessary condition. The occupational diseases diagnosis requires actual labor and employment relations. If the workers with actual labor-relation are suspected to have health injuries caused by occupational hazards in the workplace, they are eligible for occupational diseases diagnosis. But it is not the responsibility of health department to judge the labor relationship. When a dispute arises between a worker and an employer regarding labor relationship, the resolution of the relevant dispute shall be submitted to the human resources and social services department or the labor and personnel arbitration committee, or submitted to the court for adjudication according to law. In the process of occupational disease diagnosis, the two reasonable disposal procedures for verifying actual labor and employment relationship involve workers submitting evidence of their labor relationship with the employer, and the employer's verification. If the employer disputes the labor relationship as presented by the worker, the occupational disease diagnosis institution should inform the worker to apply for labor dispute arbitration. However, it is important to note that arbitration or mediation documents from the court cannot be used as evidence in occupational disease diagnosis.
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Objective: To analyze the status of occupational medical examination (OME) institutions in Guangdong Province and the critical control points affecting their future development. Methods: A total of 211 OME institutions registered in Guangdong Province were selected as the research subjects. Their current statue was investigated, and the risk assessment of their future development was carried out based on hazard analysis and critical control point theory. Results: The OME institutions were mainly concentrated in the Pearl River Delta, accounting for 72.0%. The public and private medical and health institutions accounted for 70.6% and 29.4% respectively. The filing rates of different OME categories from high to low in the order were physical factors, chemical factors, dust, other, radiation factors, biological factors (P<0.01), and the filing rates were 89.6%, 88.6%, 84.8%, 63.0%, 7.1% and 1.0%, respectively. The rates of excellence in the field assessment from high to low in the order were hearing atlas analysis personnel, lung function examination operators, chest film reading personnel, chief examination physician, technical director, quality director (P<0.01), and the rates of excellence were 49.4%, 26.2%, 20.6%, 10.8%, 8.2% and 4.6%, respectively. A total of 37 institutions did not submit OME information, of which 23 institutions did not carry out OME work after filing. The required diagnosis rate and confirmed diagnosis rate of suspected occupational diseases in 2020 were 34.3% and 55.3%, respectively. In 2021, the detection rate of suspected occupational diseases was only 1.1‰. Among the institutions with biological monitoring records, 64.1% did not participate in external quality assessment program in laboratory, and the unqualified rate of 38 participating institutions was 55.3%. The risk assessment results show that the future development of OME institutions needs to focus on private institutions, institutions that have not reported OME information, institutions that have missed diagnosis and missed reporting of suspected occupational diseases, institutions that have not participated in external quality assessment program in laboratory and core personnel such as quality managers, technical leaders, and main inspection physicians. Conclusion: OME institutions in Guangdong Province show the characteristics of centralized filing category, centralized filing region and centralized filing institution nature. Combined with the potential risks of OME institutional capacity building, it is necessary to implement classified management, strengthen information construction, supervision and management, implement post responsibilities, and promote the high-quality development of OME institutions.
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OBJECTIVE: To summarize and analyze the diagnostic ideas of new occupational lung tumors in Guangdong Province.METHODS: According to the Law of the People′s Republic of China on the Prevention and Control of Occupational Disease and the GBZ 94-2002 Diagnostic Criteria of Occupational Cancer, the key diagnostic points of 6 new occupational lung tumors diagnosed in Guangdong Province from 2010 to 2011 were analyzed. RESULTS: There were 9 cases of 6 new kinds of new occupational tumors were diagnosed in Guangdong Province in 2010-2011. The cases included 3 occupational lung cancer of coke oven workers, 2 occupational lung cancer caused by asbestos, 1 occupational mesothelioma caused by asbestos, 1 occupational lung cancer caused by arsenate, 1 occupational lung cancer caused by chromate salt, and 1 occupational lung cancer caused by asphalt. During the process, the diagnosis was based on the principles of the comprehensive analysis and the attribution diagnosis, combined with occupational history, occupational disease hazard exposure history, clinical data and auxiliary examination results. If the patients were diagnosed with a primary tumor, the patients′ exposure history to occupational carcinogens should be tracked, traced and confirmed, and the diagnosis should be confirmed by referring to the list of occupational carcinogens and literature reports of the International Labor Organization, and not limited to only the personnel in a particular industry. CONCLUSION: During the diagnostic process of occupational tumors, attention should be paid to confirm the exposure history of occupational carcinogen. The key is to determine the exposure of corresponding occupational carcinogen, the route and the time of exposure and the incubation period.
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OBJECTIVE: To analyze the distribution of network reported suspected occupational diseases( SOD),and the follow-up of confirmed diagnosis of occupational diseases in Guangdong Province from 2014 to 2017. METHODS: In July2018,the SOD cases reported from 2014 to 2017 in the direct network of Guangdong Province were collected as study subjects through the Suspected Occupational Diseases Report Card,Occupational Disease Report Card and Pneumoconiosis Report Card from the subsystem of National Information Surveillance System for Occupational Disease and Occupational Health. And the institutions for occupational disease diagnosis were asked to collect related data of applying for diagnosis and to investigate the final confirmed diagnostic status through the report cards of occupational diseases and pneumoconiosis. RESULTS: A total of 10 155 SOD cases were reported in Guangdong Province from 2014 to 2017,with an average annual growth rate of 62. 2% and an increasing trend year by year. The top three SOD were: suspected occupational otorhinolaryngological oral diseases( 58. 9%), particularly the suspected occupational noise deafness( 99. 9%); suspected occupational chronic chemical poisoning( 24. 6%),particularly suspected occupational chronic benzene poisoning( 88. 4%); and suspected occupational pneumoconiosis( 12. 8%). In total,there were 3 514 SOD cases applying for occupational diseases diagnosis,and the appication rate was 34. 6%. The final confirmed diagnosis rate was 59. 5%( 2 090/3 514). The application rate of occupational otorhinolaryngological oral diseases,occupational chronic chemical poisoning,occupational pneumoconiosis was 33. 8%,31. 3% and 35. 7%,while the final confirmed diagnosis rate was 54. 0%,49. 9% and 89. 5%. The application rate and the final confirmed diagnosis rate were the highest in the occupational disease prevention and treatment institutions, with the rate of 58. 1% and 70. 2% respectively. The application rate and the final confirmed diagnosis rate from occupational health examination were lower than those from occupational disease diagnosis institution,outpatient department and hospitalization( P < 0. 005). CONCLUSION: There is a rapid increasing trend of SOD in Guangdong Province from 2014 to 2017,but the confirmed diagnosis rate is low.
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OBJECTIVE: To analyze the epidemiological characteristics and predict epidemiological trends of occupational chemical poisoning,based on directly reported data during 2006-2015 in Guangdong Province. METHODS: The data of patients with occupational chemical poisoning reported from National Information Surveillance System for Occupational Disease and Occupational Health from 2006 to 2015 in Guangdong Province were collected. The epidemiological characteristics were retrospectively analyzed. The autoregressive integral moving average model( ARIMA model) was established and validated based on the number of the new onset cases and was used to predict the trends of occupational chemical poisoning from 2017 to 2020 in Guangdong Province. RESULTS: From 2006 to 2015,1 288 new cases of occupational chemical poisoning were reported in Guangdong Province,which accounted for 24. 4% of the total number of new cases of occupational diseases in the province( 5 283 cases). Among the new cases,the percentage of acute and chronic poisoning was 21. 7%( 279/1 288) and 78. 3%( 1 009/1 288). There was 74. 7%( 962/1 288) of organic solvent poisoning. Five kinds of new occupational chemical poisoning were found. Most of the new cases were male,accounting for 56. 7%( 729/1 288). They were mainly distributed and concentrated in Pearl River Delta Region,accounting for 95. 9%(1 235/1 288). Shenzhen,Dongguan and Guangzhou were the most three cities which had 425,325 and 209 cases respectively,all of them accounted for 74. 4%( 959/1 288). The new cases of poisoning mainly distributed in medium and small enterprises( 72. 0%),private economic enterprises( 50. 9%) and manufacturing industries(70. 5%). The number of occupational chemical poisoning diseases decreased first,and increased,and the proportion to the total number of occupational diseases in Guangdong Province showed a straight downward trend(P < 0. 01). The median age at diagnosis was 35 years old and the median work year at diagnosis was 2. 0 years,and both of them showed an increasing trend( P < 0. 01). CONCLUSION: Occupational chemical poisoning in Guangdong Province has certain characteristic of crowd aggregation and epidemic trends.
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OBJECTIVE: To explore the association of interaction of noise exposure and superoxide dismutase( SOD) gene polymorphism on the susceptibility of occupational noise-induced hearing loss( ONHL) in Chinese Han population.METHODS: A simple random sampling method was used to select 2 400 Han workers as study subjects.These workers were exposed to 75.0-120.0 dB( A) of normalized continuous A-weighted sound with pressure level equivalent to a 40 hworking-week( L_(EX,W)) in Guangzhou City.A model method was set up to define 201 sensitive workers( sensitive group)and 202 resistant workers( resistant group) by combining results with hearing pure tone threshold test and the cumulative noise exposure( CNE).The genomic DNA was extracted from peripheral blood cells.The single nucleotide polymorphisms analysis of SOD was carried out by using the TaqMan probe with chemical fluorescence allelic identification test.Binary logistic regression method was used to analyze the interaction of noise exposure and SOD.RESULTS: After adjusting confounding factors such as gender,heavy metal exposure,dust exposure and high temperature exposure,the risk for ONHL in individuals interactively carry rs2040724 AG or GG and rs4880( CC + CT) was significantly higher than that in individuals interactively carry rs2040724 AA and rs4880 TT( P < 0.05).The risk for ONHL in individuals interactively carry rs10432782 GT or GG and rs4880( CC + CT) was significantly higher than that in individuals interactively carry rs10432782 TT and rs4880 TT( P < 0.05).The risk for ONHL in individuals exposed to L_(EX,W)≥85 dB( A) and interactively carried with rs2040724 GG and rs4880( CC + CT) was significantly higher than that in individuals exposed to L_(EX,W)< 85 dB( A) and interactively carry rs2040724 AA and rs4880 TT( P < 0.01).The risk for ONHL in individuals exposed to L_(EX,W)≥85 dB( A) and interactively carry rs10432782 GT or GG and rs4880( CC + CT) was significantly higher than that in individuals exposed to L_(EX,W)< 85 dB( A) and interactively carry r10432782 TT and rs4880 TT( P < 0.05).CONCLUSION: In Chinese Han population,noise exposure intensity and SOD1( rs2040724,rs10432782),SOD2( rs4880)gene polymorphism had interacting effects on ONHL susceptibility.
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OBJECTIVE: To explore the application of the autoregressive integrated moving average model( ARIMA model)in predicting incidence of occupational noise-induced deafness( ONID). METHODS: The ARIMA model was established and validated based on the number of new onset ONID cases in Guangdong Province from 2006 to 2015. Then the ARIMA model was used to predict the trend of new onset ONID cases from 2016 to 2020. RESULTS: The number of new ONID cases in Guangdong Province from 2006 to 2015 showed an exponential growth trend. The optimal model fitted with the number of new onset ONID cases from 2006 to 2015 was the ARIMA( 2,2,2) model,which better match the number of new onset ONID cases from 2008 to 2015. According to the ARIMA( 2,2,2) model,the number of new onset ONID cases in Guangdong Province will continue to have a rapidly increasing trend from 2016 to 2020. CONCLUSION: The ARIMA model based on time series matches the time trend of ONID onset,and it can be used for the prediction of ONID incidence trend.
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OBJECTIVE: To explore the retrospective problem of occupational disease diagnostic criteria,and to improve the correct application and the theoretic basis of legal norms of occupational disease diagnosis. METHODS: Based on the related theory and principle of laws retroaction,different retroaction and its advantages and disadvantages of the occupational disease diagnostic criteria were analyzed. The applicable methods of new and old occupational disease diagnostic criteria based on the current occupational disease diagnosis and appraisal system were discussed. RESULTS: The occupational disease diagnostic criteria are updated frequently,but there is a lack of clear specification on the application of the old and new criteria. There is misunderstanding in correct application of old and new occupational disease diagnostic criteria from the society,which could have great influence on occupational disease diagnosis and appraisal. The occupational disease diagnostic criteria are a part of laws and regulations and the essence of its correct application is the retroactive force of law.The non-retrospection of occupational disease diagnostic criteria might be against the reasonable protection of the rights of laborers' health. The retroactivity of occupational disease diagnostic criteria reflects the value orientation of social law,but at the same time it must comply with the provisions of laws,regulations or administration rules. CONCLUSION: Active occupational disease diagnostic criteria should be used in the process of occupational disease diagnosis,and occupational disease appraisal should use the criteria of diagnosis.
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Objective:To discuss the relationship between defunctionign stoma in low anterior resection for rectal carcinoma and the incidence of anastomotic leakage.Methods:Totally 270 patients who received low anterior resection for rectal carcinoma(with the distance between anastomosis and anal edge being 6 cm or less)from Jan.2005 to Oct.2006 were included in the present study.Defunctioning stoma was performed in 113(41.9%)patients considered with high risk of anastomotic leakage.The clinicopathological data were used to construct database.SPSS 10.0 software was used to analyze the incidences of anastomosis leakage in patients with and without receiving defunctioning stoma.Results:There were 20(7.4%)leakages in the 270 cases.The symptoms included abdominal pain(37%),increase of pulse(53%),fever(47%),leukocytosis(53%),pelvic fluid properties change(68%),anal discharge of bloody fluid(26%)and others(10%).The average age of patients with leakage was 57.8 years.No death was caused by anastomotic leakage.Four(3.5%)leakages happened in defunctioning stoma group,and 16(10.2%)leakages happened in non-stoma group(P=0.04).Eighteen(75%)of the 24 patients with preoperative radiotherapy history received defunctioning stoma and none of them had leakage.Two of the 6 cases who had preoperative radiotherapy history receiving no defunctioning stoma had anastomotic leakages;the fisher exact probability test showed P=0.054.The leakage rate was 4.9%(7 cases)in 142 cases who had received protective measures during low anterior resection and the rate was 10.2%(13 cases)in the rest 128 cases who had not received any protective measures(P=0.10).Leakages subsided with conservative treatment in the 4 patients with stoma,but 8 patients without stoma had severe symptoms and required surgical intervention;one developed peritonitis.The average fasting periods were significantly different between the 2 groups(P