Analysis of the status of occupational disease prevention and control of enterprises in mining and manufacturing industries in China in 2019 / 中华劳动卫生职业病杂志

Objective: To analyze the status of prevention and treatment of occupational diseases among mining and manufacturing industries in China in 2019, provide the scientific basis for the formulation and revision of policies and standards of prevention and treatment of occupational diseases. Methods: In May 2022, Collecting data of a project named Surveillance of Occupational Hazards in the Workplace in 2019 through the National Surveillance System for Occupational Hazards in the workplace. Compare the status of prevention and treatment of occupational diseases in 63 563 enterprises of mining and manufacturing industries among different dimensions. Results: The training rate of managers was 76.17% and that of occupational health managers was 76.97%. The rate of reporting of occupational diseases hazardous items was 67.58%, the rate of launching of the detection of occupational hazards was 57.16%, and the rate of launching of occupational health examination was 62.42%. Excluding the distribution rate of dust mask, the installation rate of various occupational prevention facilities and the distribution rate of gas mask and hearing protector were less than 80%. The differences in all the indicators among different areas, enterprise scales, economic types were statistically significant (P<0.05) . Conclusion: There are still some enterprises which are relatively weak in the ability of the prevention and treatment of occupational diseases in China. Measures such as special support, guidance and strengthen supervision should be taken towards those enterprises toimprove the awareness of prevention and treatment of occupational diseases and the level of that.

Analyses on the characteristics and the trends of pneumoconiosis notified between 1997 and 2009, in China / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To describe the incidence of pneumoconiosis reported in China from 1997 to 2009 and investigate the epidemiological trends and characteristics of pneumoconiosis, and to provide basic data for formulating the guidelines and policies for control of pneumoconiosis, research on pneumoconiosis, and establishing the time series model for monitoring and early warning of pneumoconiosis.</p><p><b>METHODS</b>The national database of new cases of pneumoconiosis reported from 1997 to 2009 was subjected to systematic arrangement, descriptive analysis, and trend test using SPSS 15.0. The statistical indices included number of new pneumoconiosis cases in each year, types of pneumoconiosis, regional and industrial distributions of pneumoconiosis cases, work types of pneumoconiosis cases, and the annual changes in mean length of service and mean age at the onset of pneumoconiosis.</p><p><b>RESULTS</b>From 1997 to 2009, a total of 122 333 new cases of pneumoconiosis were reported; the number of new cases increased since 1998, but fell to 7620 in 2003, and then it increased again to a maximum of 12 492 in 2009. Of all patients, 87.5% were cases of coal-workers' pneumoconiosis and silicosis; 54 068 (44.2%) were coal-workers' pneumoconiosis cases, and 52 930 (43.3%) were silicosis cases. The pneumoconiosis cases were distributed mainly in Hunan Province (12 995 cases, 10.6%), Shandong Province (8952 cases, 7.3%), and Sichuan Province (8417 cases, 6.9%). Most cases were distributed in coal industry (61270 cases, 50.1%), architectural, material industry (9754 cases, 8.0%), nonferrous metals industry (9380 cases, 7.7%), and metallurgical industry (8773 cases, 7.2%). The work types of these cases mainly included tunneling as the main work (15 659 cases, 12.8%), mining as the main work (15 009 cases, 12.3%), drilling (14 010 cases, 11.5%), tunneling (12 122 cases, 9.9%), and hybrid coalmine work (10 612 cases, 8.7%). The mean length of service at the onset of pneumoconiosis in new cases of pneumoconiosis was shortened from 1997 to 2009, with a median length of service of 20.00 years; the median lengths of service at the onsets of coal-workers' pneumoconiosis, silicosis, and asbestosis were 21.58, 17.00, and 20.00 years, respectively. The median age at the onset of pneumoconiosis was 51.00 years, and the mean age of onset in new cases of pneumoconiosis increased over the 13 years.</p><p><b>CONCLUSION</b>The incidence of pneumoconiosis is still high, with a marked concentrated trend in several industries, work types, and pneumoconiosis types, a marked rising trend in number of new cases, and a marked shortening trend in length of service at the onset of pneumoconiosis. The prevention and control of pneumoconiosis should be enhanced in key industries and for people engaging in key types of work according to the epidemiological characteristics of pneumoconiosis. In addition, the demonstration project of comprehensive prevention and control of occupational dust hazards should be carried out, and the monitoring and early warning system for pneumoconiosis should be established.</p>

Silicosis in automobile foundry workers: a 29-year cohort study / 生物医学与环境科学（英文）

<p><b>OBJECTIVES</b>The purposes were to determine the relationship between silicosis among foundry workers and their cumulative exposure to silica dust, and to establish a regression model to predict the risk for developing silicosis by a given length of employment and air concentrations of silica at worksites.</p><p><b>METHODS</b>A 29-year cohort study was conducted, including all those employed for more than one year during January 1, 1980 to December 31, 1996 and all members of the cohort were followed-up to December 31, 2008. In total, 2009 workers of an automobile foundry in Shiyan, Hubei province were recruited in the study, 1300 at eight worksites including sand preparation, cast shakeout, and finishing, melting, moulding, core-making, overhead crane operation and pouring as exposed group, and the other 709 auxiliary workers at the same factory, such as electricians, inspectors, fitters, and so on, as control group. Person-years of observation were calculated by persons observed and years followed-up for each of them. Person-year incidence of silicosis and its relative risk (RR) or odds ratio (OR) and 95% confidence intervals (CI) among the workers were estimated, adjusted for relevant factors with logistic regression model using SPSS version 15.0 software.</p><p><b>RESULTS</b>Totally, 2009 workers were followed-up for 37 151 person-years and 48 cases of silicosis were found, with an overall incidence of 1.34 per thousand, 2.02 per thousand in exposed group, and 0.15 per thousand in control one. Risk of silicosis was significantly higher in the exposed group than that in the control one (RR = 13.13, 95% CI 3.18-54.13), higher in men than that in women (RR = 13.92, 95% CI 1.92-100.93). Risks of silicosis varied by job, highest in those exposed to cast shakeout and finishing (RR = 28.14, 95% CI 6.43-123.11), followed by those exposed to pouring (RR = 22.23, 95% CI 5.01-98.55) in the foundry. Average length of employment at onset of silicosis was 25.94 years, and silicosis incidence increased with length of employment. Average age at onset of silicosis was 47.83 years old. The risk of silicosis in workers with pulmonary tuberculosis was 2.57 folds as those without it (P < 0.01). Ten deaths were recorded in those with silicosis, with a case-fatality rate of 20.83 percent three of them died of lung cancer, three of liver cancer, two of ischemic heart disease, and two of other diseases as their immediate causes of death. Incidence of silicosis in foundry workers positively correlated with their cumulative silica exposure (OR = 3.00, 95% CI 2.34-3.83). Risks of silicosis increased by 4.38 folds with an increase of 1 mg/m3-year of cumulative silica exposure, and by 3.79 folds with smoking, respectively, adjusted for alcohol drinking and age. Based on a logistic regression model fitted, incidence of silicosis is expected to be 44.6 per thousand for those with daily exposure to silica of 4.18 mg/m3 in average for 30 years, and if incidence of silicosis is expected to be less than 1 per thousand, daily exposure to silica should be controlled below 0.2 mg/m3 for those with 20 years of employment, or below 0.1 mg/m3 for those with 30 or 40 years of silica exposure.</p><p><b>CONCLUSIONS</b>At present, foundry workers in China still face high risk of developing silicosis. For lowering occurrence of silicosis in exposed workers, it seems necessary that current occupational exposure limits for silica at worksites in China should be reexamined and silica dust control measures be strengthened.</p>

Re-analysis of occupational hazards in foundry / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To analyze systematically the characteristics of occupational hazards in the foundry, and provide precise data for epidemiology studies and control of occupational hazards in the foundry.</p><p><b>METHODS</b>Data of airborne dust, chemical occupational hazards and physical occupational agents in environment in the foundry from 1978 to 2008 were dynamically collected. Mean concentration and intensity (geometric mean) of occupational hazards were calculated by job in different years.</p><p><b>RESULTS</b>Main occupational hazards in the foundry were silica, metal fume, noise and heat stress. Silica existed in all of main jobs. The mean concentration of silica before 1986 was an extremely high level of 8.6 mg/m(3), and then remarkably dropped after 1986, with the level of 2.4 mg/m(3) from 1986 to 1989, 2.7 mg/m(3) from 1990 to 2002 and 2.7 mg/m(3) from 2003 to 2008. The trend of silica concentrations by job was consistent with that in general. Silica concentrations among jobs were significantly different, with highest level in melting (4.4 mg/m(3)), followed by cast shakeout and finishing (3.4 mg/m(3)), pouring (3.4 mg/m(3)), sand preparation (2.4 mg/m(3)), moulding (2.1 mg/m(3)) and core-making (1.7 mg/m(3)). Concentration of respirable dust in pouring was highest (2.76 mg/m(3)), followed by cast shakeout and finishing (1.14 mg/m(3)). Mean concentration of asbestos dust in melting was a relative high level of 2.0 mg/m(3). In core-making and sand preparation, there existed emission production of adhesive, with mean concentrations as followed, ammonia (5.84 mg/m(3)), formaldehyde (0.60 mg/m(3)), phenol (1.73 mg/m(3)) and phenol formaldehyde resin (1.3 mg/m(3)) also existed. Benzene and its homologues existed in cast shakeout and finishing, and the level of benzene, toluene, xylene was 0.2 mg/m(3), 0.1 mg/m(3) and 1.3 mg/m(3), respectively. In pouring and melting, there existed chemical occupational hazards, including benzo(a) pyrene, metal fume (lead, cadmium, manganese, nickel, chromium) and gas(hydrogen sulfide, phosphine, sulfur dioxide, carbon monoxide). Mean concentration of benzo(a) pyrene was a low level of 1.80 x 10(-4) microg/m(3). Physical occupational agents in the foundry were noise, heat stress and vibration. Intensity of heat stress was high in melting, pouring and cast shakeout and finishing, with the level of 30 degrees C, 29 degrees C and 26 degrees C, respectively. Noise was high in cast shakeout and finishing and core-making, with the level of 93.1 dB(A) and 89.5 dB(A), respectively. Vibration existed in core-making and cast shakeout and finishing. Compulsory postures included long standing, seating and bowing.</p><p><b>CONCLUSION</b>Occupational hazards in environment of the foundry are diversified and their concentrations exceed permissible exposure limits stipulated by the national occupational hygienic standards. High-concentrations of dust, metal fume, low-concentrations of variety of chemicals, high-intensity of noise and vibration, heat stress, and harmful compulsory posture, and so on all co-exist in the foundry. Control and protective measures should be strengthened.</p>

A pooling analysis of occupational sharp injury on clinical nurses in China / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To estimate the occupational sharp injury incidence and the diversity of the injury and the preventive control methods between the different levels of hospitals and the different areas of hospitals among nurses in China.</p><p><b>METHODS</b>An electronic search of relevant online databases was undertaken. Twenty six retrospective investigation reports were identified from 209 reports based on the filter standards after a systematic review of them. The data were pooled for analysis.</p><p><b>RESULTS</b>19 171 clinical nurses recalled the sharp injuries in the past year which came from 229 hospitals in 23 cities in China. 81.37% had sustained at least one sharp injury. The polled average number of episodes of occupational sharp injuries and needle stick and contaminated needle stick were 8.68, 4.17 and 2.68 episode per person per year before 2004 and fell to 3.42, 2.54 and 1.58 episode per person per year after 2005, respectively. The needle stick injuries and broken glass injuries accounted for 54.31% and 38.31%, respectively. The needle stick injuries mainly occurred in collecting or sorting of used sharps instrument (24.90%), withdrawing needle or separating it from container (22.62%), during use of the item such as inserting needle or draw a blood sample or puncturing or inject drug (21.01%), recapping used needles (15.62%). 9.42% of the episodes were reported, 19.22% of the nurses wore gloves while doing procedures on patients, 40.66% of the nurses accepted work safety training and 66.67% of them were immunized with Hepatitis B vaccine.</p><p><b>CONCLUSION</b>The sharp injuries are correlated with work load, the making and implementation of the rules, the levels and districts of the hospitals. The prevention control methods on sharp injury should be strengthened and the key point is to issue and publicize the guideline of prevention and control for occupational exposure to bloodborne pathogen.</p>

Characterization of severe acute occupational poisoning accidents in China between 1989 and 2003 / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To analyze severe acute occupational poisoning accidents reported in China between 1989 and 2003, and to study the characteristics of severe acute occupational poisoning accidents and provide scientific evidences for prevention and control strategies.</p><p><b>METHODS</b>The data from the national occupational poisoning case reporting system were analyzed with descriptive methods.</p><p><b>RESULTS</b>(1) There were 506 acute severe occupational poisoning accidents for 15 years with 4 657 workers poisoned. The total poisoning rate was 54.8%, and the total mortality was 16.5%. The average poisoning age was (31.9 +/- 9.8) years old and the average death age was (33.7 +/- 10.3) years old. The poisoning accidents occurred more in men than in women. (2) There were more than 112 chemicals which caused these poisoning accidents. Most of the accidents caused by hydrogen sulfide, carbon monoxide, benzene and homologs, metal and metalloid and carbon dioxide, and the types of chemicals varied in different types of industries. (3) The accidents mainly occurred in chemical industry, manufacture, water disposal industry, mining and construction industry, and the risk was higher in some jobs than others, such as cleanout, machine maintenance and repair, production, mine and digging. The accidents occurred more frequently from April to August each year.</p><p><b>CONCLUSION</b>(1) The control over the severe acute occupational poisoning is urgent. (2) The trend of the characteristics of severe acute occupational poisoning accidents is centralized in the high risk industries, poisons and jobs. (3) The characteristics of the accidents varied in different types of industries. (4) It is the key point to strengthen the supervision on poisoning.</p>

Characterization of severe acute occupational poisoning accidents related to asphyxiating gases in China between 1989 and 2003 / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To analyze severe acute occupational poisoning accidents related to asphyxiating gases reported in China between 1989 and 2003, and to study the characteristics of severe acute occupational poisoning accidents and provide scientific evidences for prevention and control strategies.</p><p><b>METHODS</b>The data from the national occupational poisoning case reporting system were analyzed with descriptive methods.</p><p><b>RESULTS</b>(1) There were 273 severe acute occupational poisoning accidents related to asphyxiating gases for 15 years with 1638 workers poisoned and 600 workers died, which accounted for 53.95% in total accidents and 35.17% of workers poisoned and 78.64% of workers died of all severe acute occupational poisoning accidents. The average poisoning age was (33.8 +/- 9.7) years old and the average death age was (36.6 +/- 10.0) years old. (2) Most of the accidents were caused by hydrogen sulfide, carbon monoxide and carbon dioxide respectively, and mainly occurred in chemical industry, mining, water disposal industry, paper making industry and brewing industry. The risk was higher in some jobs than others, such as cleanout, machine maintenance and repair, production, mine and digging. The poisoning accidents occurred more frequently from April to September each year and occurred in the confined space, in the basement and the mine, and workers died of poisoning mostly were men.</p><p><b>CONCLUSION</b>(1) The severe acute occupational poisoning accidents related to asphyxiating gases are more dangerous than others. (2) The control of poisoning accidents related to hydrogen sulfide, carbon monoxide and carbon dioxide, which occurred easily in the confined space, should be paid more attention to, and good work practice should be developed on some posts, such as digging, cleanout, dredge, machine maintenance and repair and mine.</p>

Characterization of severe acute occupational poisoning accidents related to irritating gases in China between 1989 and 2003 / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To analyze severe acute occupational poisoning accidents related to irritating gases reported in China between 1989 and 2003, and to study the characteristics of severe acute occupational poisoning accidents and provide scientific evidences for prevention and control strategies.</p><p><b>METHODS</b>The data from the national occupational poisoning case reporting system were analyzed with descriptive methods.</p><p><b>RESULTS</b>(1) There were 92 severe acute occupational poisoning accidents related to asphyxiating gases during 15 years, which showed that there were 14.5 accidents occurred each year. Forty types of chemicals were reported to cause poisoning accidents directly. On average, there were 14.5 persons poisoned and 0.8 persons died of poisoning in each event. The number of death of poisoning reached 7 in most of the severe accidents. Chlorine was the main irritating gas resulting in poisoning accidents according to the number of accidents, cases and death.</p><p><b>CONCLUSION</b>(1) The severe acute occupational poisoning related to irritating gases are more dangerous than others because of it is involved in more cases in each accident. (2) The accidents have concentricity in the certain types of chemicals, industries and jobs, and should be focused on control. (3) It is important to develop the program about early warning and forecast and the first aid.</p>

Characterization of severe acute occupational poisoning accidents related to organic solvents in China between 1989 and 2003 / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To analyze severe acute occupational poisoning accidents related to organic solvents reported in China between 1989 and 2003, and to study the characteristics of severe acute occupational poisoning accidents and provide scientific evidences for prevention and control strategies.</p><p><b>METHODS</b>The data from the national occupational poisoning case reporting system were analyzed with descriptive methods.</p><p><b>RESULTS</b>(1) There were 58 severe acute occupational poisoning accidents related to organic solvents for 15 years with 393 workers poisoned and 48 workers died. The total poisoning rate was 51.2%, and the total mortality was 12.2%. The average poisoning age was (30.9 +/- 8.8) years old and the average death age was (30.6 +/- 12.0) years old. (2) There were 11 types of chemicals that caused these poisoning accidents, and most of the accidents were caused by benzene and homologs. (3) Most of the accidents occurred in manufacture, chemical industry, construction industry, transportation and storage industry, service and commerce. The risk was higher in some jobs than in others, such as paint spraying and cleanout. The poisoning accidents occurred more frequently from April to July each year. (4) The main causes of the accidents were poor ventilation (23.6%), lack of personal protection equipment (21.2%), lack of safety education (19.2%), and lack of safety work practice (15.8%) etc.</p><p><b>CONCLUSION</b>The ventilation at the workplace involved in organic solvents should be maintained and the skin contacting directly with the organic solvents should be avoided, and it is encouraged to replace the poison with the nontoxic or lower toxic chemicals.</p>

Characterization of severe acute occupational poisoning accidents related to metal and metalloid in China between 1989 and 2003 / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the characteristics of severe acute occupational poisoning accidents related to metal and metalloid and provide scientific evidences for prevention and control strategies.</p><p><b>METHODS</b>The data from the national occupational poisoning case reporting system were analyzed with descriptive methods.</p><p><b>RESULTS</b>(1) There were 39 severe acute occupational poisoning accidents related to metal and metalloid for 15 years, which showed that there were 2.6 accidents occurred each year. Thirteen chemicals were reported to cause poisoning directly with 609 workers poisoned and 32 workers died. On average, there were 15.6 workers poisoned and 0.8 workers died of poisoning in each accident. The total poisoning rate was 52.9%, and the total mortality was 5.3%. The average poisoning age was (29.2 +/- 9.08) years old and the average death age was (32.3 +/- 9.9) years old. (2) The number of accidents related to metal and metalloid had been rising since 1997, and 43.6% of the accidents were caused by hydrogen arsenide. (3) The accidents mainly occurred in manufacture and chemical industry and easily occurred in some jobs, such as cleanout and porterage. (4) The main causes of the accidents were poor ventilation (22.5%), lack of personal protection equipment (19.8%), lack of safety education (19.8%), and lack of safety work practice (15.3%).</p><p><b>CONCLUSION</b>(1) The accidents related to hydrogen arsenide and arsenide should be highly emphasized. (2) It is important to strengthen the safety education and personal protection.</p>