Analysis on the detection of suspected occupational diseases and occupational contraindications for benzene workers in Tianjin / 中华劳动卫生职业病杂志

Objective: To investigate the detection of suspected occupational diseases and occupational contraindications for benzene workers in Tianjin. Methods: In June 2020, the occupational health inspection data of 16113 benzene workers in 514 enterprises with benzene hazards in 16 municipal districts in Tianjin from January to December 2019 were included in the analysis. Enterprise information included the employer's region, economic type, industry classification and enterprise scale. Occupational health inspection data for benzene workers during their on-the-job period included routine inspection indicators and benzene special inspection indicators. Multivariate unconditional logistic regression was used to analyze the relationship between personal general information, occupational history, enterprise information and suspected benzene poisoning and occupational contraindications of benzene workers. Results: There were 16073 benzene workers in the normal group and 24 in the suspected benzene poisoning group. The detection rate of suspected benzene poisoning in females was higher than that in males (χ(2)=8.26, P=0.004) . There was no significant difference in the detection rates of suspected benzene poisoning among different dimensions such as age, length of service, occupational health inspection institution location, employer location, industry classification, economic type, and enterprise scale (P>0.05) . There were 16073 benzene workers in the normal group and 16 in the benzene contraindication group. The detection rate of benzene contraindications for workers in suburban areas where occupational health inspection institutions were located was higher than that in urban areas (χ(2)=9.71, P=0.002) , and there was no significant difference in the detection rates of contraindications for benzene in other dimensions (P>0.05) . Multivariate logistic regression analysis showed that female benzene workers were more likely to detect suspected benzene poisoning (OR=3.53, 95%CI: 1.57-7.94, P=0.002) ; benzene workers who received physical examination in suburban occupational health inspection institutions (OR=5.81, 95%CI: 1.94-17.42, P=0.002) , the employer's area was in the suburbs (OR=9.68, 95%CI: 1.23-76.07, P=0.031) , and female workers (OR=3.07, 95%CI: 1.13-8.37, P=0.028) , it was easier to detect occupational contraindications. Conclusion: Female benzene workers with employers located in the suburbs have a higher risk of detecting occupational contraindications, and women are more likely to detect suspected benzene poisoning. The management of benzene operations in the production environment of enterprises in the suburbs of Tianjin and the occupational health monitoring of female workers should be strengthened.

Analysis on the diagnosis of suspected occupational diseases in Guangzhou from 2014 to 2019 / 中华劳动卫生职业病杂志

Objective: To understand the diagnosis of suspected occupational diseases reported in Guangzhou from 2014 to 2019, so as to provide theoretical basis and technical support for the supervision of suspected occupational disease reports. Methods: By cluster sampling, the suspected occupational disease report card, occupational disease report card and pneumoconiosis report card reported by Guangzhou from January 1, 2014 to December 31, 2019 in the occupational disease and occupational health information monitoring system were collected for matching analysis to understand the diagnosis of suspected occupational disease patients. Results: From 2014 to 2019, a total of 1426 suspected occupational cases in 7 categories and 32 species were reported in Guangzhou. The average number of reported cases per year was about 240. The main diseases of suspected occupational diseases were suspected occupational noise deafness (68.44%, 976/1426) , suspected occupational chronic benzene poisoning (16.48%, 235/1426) , suspected occupational other pneumoconiosis (4.84%, 69/1426) , suspected occupational silicosis (3.23%, 46/1426) and suspected occupational welder pneumoconiosis (1.82%, 26/1426) . The diagnostic rate required to enter the occupational disease diagnostic program is 36.61% (522/1426) , and the diagnostic rate is 59.20% (309/522) . In 2019, the diagnosis rate of suspected occupational diseases was the lowest (23.92%, 61/255) , Huadu District was the lowest (8.33%, 9/108) , suspected occupational pneumoconiosis was the lowest (28.03%, 44/157) , the diagnosis rate of suspected occupational diseases reported by the Centers for Disease control and prevention was the lowest (17.43%, 19/109) , and the diagnosis rate of suspected occupational diseases reported by outpatient treatment was the lowest (22.22%, 2/9) . The suspected occupational diseases reported by institutions outside Guangzhou did not enter the occupational disease diagnosis procedure. Suspected occupational skin diseases, suspected occupational diseases caused by physical factors and suspected occupational tumors were diagnosed, and the diagnosis rate of occupational disease prevention and control institutions was the highest (94.87%, 37/39) . Conclusion: The main types of suspected occupational diseases reported during these six years are noise deafness, chronic benzene poisoning and pneumoconiosis. The overall diagnosis rate and diagnosis rate of suspected occupational diseases are not high. It is suggested to improve the network direct reporting system of suspected occupational diseases and strengthen the follow-up management and supervision of suspected occupational diseases.

Epidemiological characteristics and diagnosis of reported cases with suspected occupational diseases in Huzhou City from 2016 to 2020 / 预防医学

Objective@#To investigate the epidemiological characteristics of suspected cases with occupational diseases and analyze the quality of occupational diseases report in Huzhou City from 2016 to 2020, so as to provide insights into supervision and early warning of occupational diseases.@*Methods@#The epidemiological data pertaining to suspected cases with occupational diseases reported in Huzhou City from 2016 to 2020 were retrieved from the Occupational Disease and Health Risk Factors Monitoring Information System of China Disease Prevention and Control Information System, including gender, age, type of job, industry category, enterprise size and diagnosis. The percentages of identification, diagnosis and definitive diagnosis were calculated, and the distribution and diagnosis of suspected cases with occupational diseases were descriptively analyzed among different regions, industry categories and enterprise sizes.@*Results@#A total of 264 398 people underwent occupational health examinations in Huzhou City from 2016 to 2020, and 322 suspected cases with occupational diseases were detected (12.18/104), including 179 cases with suspected pneumoconiosis (55.59%), 78 cases with suspected occupational ear, nose, throat and oral diseases (24.22%), 54 cases with suspected occupational poisoning (16.77%), 6 cases with suspected occupational skin diseases (1.86%), 3 cases with suspected occupational diseases caused by physical factors (0.93%) and 2 cases with other suspected respiratory diseases (0.62%). The 322 cases with suspected occupational diseases included 290 men (90.06%) and 32 women (9.94%), and had a mean age of (53.28±9.20) years. A total of 207 cases underwent occupational diseases diagnosis (64.29%), and 155 cases were definitively diagnosed with occupational diseases (74.88%). Among different counties (districts) in Huzhou City, the highest number of suspected cases with occupational diseases was reported in Changxing County (101 cases, 31.37%), with a diagnostic rate of 88.12%, and among all enterprises, the highest number of suspected cases with occupational diseases was reported in small enterprises (220 cases, 68.32%), with a diagnostic rate of 68.64%, while among all industry categories, the highest number of suspected cases with occupational diseases was reported in manufacture industry (228 cases, 70.81%), with a diagnostic rate of 56.14%. In addition, there was no suspected case with occupational diseases detected in agriculture, forestry, animal husbandry, fishery, wholesale/retail trade industry, or public administration, social security or social organizations.@*Conclusion@#Pneumoconiosis was the predominant type of suspected occupational diseases in Huzhou City from 2016 to 2020, and a low diagnostic rate was found. Improved supervision of occupational diseases control is strongly recommended among small enterprises to standardize the reporting system of suspected occupational diseases.

Occupational health surveillance in Xiacheng District of Hangzhou from 2014 to 2017 / 上海预防医学

Objective To investigate the status of occupational health surveillance in Xiacheng District of Hangzhou City from 2014 to 2017, and to provide basis for occupational hygienic supervision Methods Data on occupational health surveillance in Xiacheng District from 2014 to 2017 were collected, and the trend of occupational health surveillance was analyzed.The differences of occupational health surveillance among different hazardous agents, economic types, industries and scales were compared. Results There was no significant difference in rates of pre-job and on-job occupational medical examination from 2014 to 2017, and the rate of off-job occupational medical examination showed an increasing trend.There were statistical difference in on-the-job occupational medical examination rates among empolying units of different economic types, industries and scales.There were statistical differences in the detection rates of occupational contraindication among empolying units of different economic types, hazardous agents.There was no significant difference in the detection rates of suspected occupational diseases among empolying units. Conclusion The occupational health surveillance showed a phenomenon of "emphasizing on-the-job, neglecting pre-job and off-the-job" in Xiacheng District.Supervision department should pay more attention on manufacturing, collective and private economic.It is necessary to focus on the protection of staff contacts with chemical and physical agents. It is suggested that relevant departments should strengthen the propaganda and supervision of occupational health surveillance, according to the nature, characteristics of the employing units and types of their hazardous agents.

Current status and influencing factors of hearing loss in suspected occupational noise-induced deafness among electric welders in Nantong City / 中国职业医学

OBJECTIVE: To analyze the current status and influencing factors of hearing loss in the suspected occupational noise-induced deafness(ONID) among welders in Nantong City. METHODS: A total of 3 265 noise-exposed welders who underwent the occupational health examination in Nantong City in 2017 were collected as the study subjects by judgment sampling method. The data of occupational medical examination of these welders was collected. The incidence and influencing factors of suspected ONID were analyzed. RESULTS: A total of 159 cases of suspected ONID were detected and the detection rate was 4.87%. The suspected ONID was mainly mild noise-induced deafness, accounting for 82.39%(131/159). The abnormal rates of 4 000 Hz hearing threshold in the left and right ears of suspected ONID cases were higher than that of 3 000 Hz in the corresponding ears(100.00% vs 93.08%, 98.11% vs 92.45%, P<0.05). The multivariate logistic regression analysis showed that age and length of service during noise exposure were risk factors for suspected ONID(P<0.05). The risks of suspected ONID among welders in general equipment manufacturing industry, metal products industry, other industries, electrical machinery and equipment manufacturing industry, and manufacturing of equipment of railways, ships, aerospace and other transportations were lower than that in computer, communication and other electronic equipment manufacturing industry. The odds ratio(OR) and 95% confidence interval(95%CI) were 0.341(0.155-0.752), 0.264(0.112-0.620), 0.149(0.038-0.582), 0.110(0.035-0.341), 0.418(0.179-0.972), respectively. The risk of suspected ONID among welders in state-owned enterprises was lower than that in private enterprises(OR=0.254, 95%CI 0.116-0.559,P<0.01). CONCLUSION: The age, service length of noise exposure, type of enterprise industry and economy of enterprise are all influencing factors of suspected ONID in electric welding workers in Nantong City.

Suspected occupational diseases report and diagnostic situation follow-up in Guangdong Province,2014-2017 / 中国职业医学

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.

Influencing factors of suspected occupational noise-induced deafness in noise-exposed workers / 中国职业医学

OBJECTIVE: To analyze the influencing factors of suspected occupational noise-induced deafness( ONID) in noise-exposed workers. METHODS: A total of 38 770 noise-exposed workers engaged in occupational health examination were collected as the study subjects from 2012-2016 by judgment sampling method. The data of workers' occupational medical examination was collected,and the incidence and influencing factors of suspected ONID were analyzed. RESULTS: A total of 125 cases of suspected ONID were detected and the detection rate was 0. 32%. The result of multivariate Logistic regression showed that male workers exposed to noise had a higher risk of suspected ONID than female workers( P <0. 01). The odds ratio( OR) and 95% confidence interval( CI) were 1. 98( 1. 22-3. 19). The older the age and the longer service length of workers exposed to noise,the higher the risk of suspected ONID( P < 0. 01). The ORs and 95% CIs were 1. 79(1. 43-2. 25) and 1. 84( 1. 47-2. 30) respectively. The noise-exposed workers had a higher risk of suspected ONID in foreign-funded enterprises than domestic-funded enterprises( P < 0. 01). The noise-exposed workers had a higher risk of suspected ONID in metal manufacturing industries than in non-metal manufacturing industries( P < 0. 01). The ORs and 95% CIs were 1. 83(1. 19-2. 82) and 2. 02(1. 40-2. 94) respectively. CONCLUSION: The incidence of suspected ONID is affected by factors of gender,age,length of service,economy type of enterprises and industry type.

Discussion on the determination of suspected occupational disease / 中国职业医学

OBJECTIVE: To explore the essential conditions and principles of conclusion for suspected occupational disease in order to protect the rights and interests of worker. METHODS: In reference to the legal concept interpretation and the principle of rights remedy,suspected occupational disease was defined,and the related judging organizations,decision criteria and reporting procedures were analyzed. RESULTS: Suspected occupational disease might be defined as the disease state in a specific time period when the preliminary diagnosis of suspected occupational disease was made by the occupational health examination institutions or occupational disease diagnosis organizations,without definite diagnosis by the occupational disease diagnosis organizations and no conclusion of occupational disease diagnosis( identification). We recommended that the conclusion of suspected occupational disease should be made by the occupational health examination institution and occupational disease diagnosis organization according to the criteria of occupational disease diagnosis. The suspected occupational disease should be reported based on the regulation and standard of occupational disease diagnosis.CONCLUSION: The determination of suspected occupational diseases should be strict,and the medical institutions which can make diagnostic conclusion of suspected occupational disease and the relevant requirements should be clear. The diagnostic criteria of suspected occupational disease and reporting procedures should be standardized.