Hearing loss and its relationship with blood pressure among workers exposed to noise in a brewery / 公共卫生与预防医学

Objective To investigate the health status of workers exposed to noise in a brewery in Beijing and to analyze the relationship between hearing loss and blood pressure. Methods A total of 949 noise-exposed workers in a brewery who participated in occupational health examination were selected as the investigation subjects. A survey was conducted to investigate the pure tone hearing threshold and abnormal blood pressure of the workers with different characteristics, and to analyze the relationship between the two. Results Among the noise-exposed workers, the detection rates of hearing abnormality, hypertension, and increased systolic and diastolic blood pressure were 73.55%, 52.37%, 43.84% and 46.47%, respectively. The detection rates of hearing abnormality, indicators of hypertension, high frequency hearing threshold abnormality and increased binaural high frequency hearing threshold on average in males were higher than those in females (P 0.05), the detection rates of other hearing abnormality, indicators of hypertension, speech frequency hearing threshold abnormality, high frequency hearing threshold abnormality，increased binaural high frequency hearing threshold on average and the weighted value of the better ear's hearing threshold all increased or had an increasing trend with the increase of age or working years (P< 0.05). The detection rates of hypertension in the groups with high frequency hearing threshold abnormality and increased binaural high frequency hearing threshold on average were higher than those in the normal group (P＜0.05). Conclusion The noise-exposed workers in the brewery have hearing impairment, which is related to the occurrence of hypertension. It is recommended to strengthen the publicity and education on noise protection and take protective measures to reduce the occurrence of occupational noise injury.

Kidney function among male workers of a lithium-ion battery-related enterprise in Shanghai / 环境与职业医学

Background Under the guidance of achieving carbon peaking and carbon neutrality goals, the demand for lithium-ion batteries has increased significantly. However, during the production, use, and maintenance of lithium-ion batteries, workers are inevitably exposed to various occupational hazards, and some chemicals are nephrotoxic. Objective To evaluate the kidney function and potential determinants among male workers in a lithium-ion battery-related enterprise in Shanghai. Methods The data of occupational health examination carried out by an occupational disease prevention and control institution for workers in a lithium-ion battery-related enterprise in Shanghai were collected. The workers participating pre-employment occupational health examination were treated as a control group, and the other group was recruited from those participating periodic health examination. Serum creatinine, urea nitrogen, uric acid, and renal ultrasound were used to assess the kidney function of workers. Kidney function was classified according to the reference range of kidney function indicators in Diagnostics (9th Edition, national planning textbook for high education in medicine). Binary logistic regression and generalized linear regression were used to identify potential determinants of abnormal values in kidney function indicators in workers. Results There were 6184 workers in the control group (pre-employment) with a mean age of (27.40±4.50) years. There were 3526 workers on the job with a mean age of (29.40±4.99) years and the median time of service was 2.00 (1.00, 3.42) years. The prevalence rates of high serum creatinine, high urea nitrogen, and high uric acid, and abnormal kidney ultrasound among the control group were 0.66%, 2.47%, 30.32%, and 10.12%, respectively; the indicators in the on-the-job workers were 0.96%, 3.35%, 38.25%, and 12.68%, respectively, significantly higher than those in the control group (P<0.05). After adjusting for worker age, length of service, smoking status, drinking status, hypertension, and hyperglycemia, the binary logistic regression models showed that regular smokers had a higher risk of high urea nitrogen than nonsmokers (OR=1.411, 95%CI: 1.011, 1.969). The risk of high uric acid was lower in older workers (OR=0.966, 95%CI: 0.953, 0.979), and higher in workers with more years of service (≤1 year, OR=1.295, 95%CI: 1.093, 1.534; >1-3 years, OR=1.747, 95%CI: 1.494, 2.042; >3 years, OR=1.866, 95%CI: 1.511, 2.304), hypertension (OR=1.400, 95%CI: 1.055, 1.859), and hyperglycemia (OR=1.565, 95%CI: 1.221, 2.006). Workers who were older (OR=1.038, 95%CI: 1.022, 1.054) and had longer working years (>1-3 years, OR=1.518, 95%CI: 1.201, 1.920), occasional smoking habits (OR=1.239, 95%CI: 1.039, 1.478), regular drinking habits (OR=1.875, 95%CI: 1.139, 3.087), and hypertension (OR=1.465, 95%CI: 1.075, 1.998) were at a higher risk of renal ultrasound abnormalities. The generalized linear models showed that length of service (>1-3 years, β=1.120, 95%CI: 0.360, 1.880; >3 years, β=1.451, 95%CI: 0.543, 2.358), smoking status (occasional, β=0.818, 95%CI: 0.156, 1.479; regular, β=0.841, 95%CI: 0.066, 1.616), and hypertension (β=2.742, 95%CI: 1.390, 4.094) were the influencing factors of serum creatinine concentration in the workers. Age (β=0.014, 95%CI: 0.009, 0.019) and length of service (>1-3 years, β=0.079, 95%CI: 0.012, 0.146) were the influencing factors of urea nitrogen. Age (β=−1.759, 95%CI: −2.288, −1.231), length of service (≤1 year, β=10.676, 95%CI: 4.035, 17.316; >1-3 years, β=26.117, 95%CI: 19.962, 32.272; >3 years, β=34.558, 95%CI: 26.116, 43.001), hypertension (β=23.162, 95%CI: 11.617, 34.707), and hyperglycemia (β=15.017, 95%CI: 4.853, 25.180) were the influencing factors of uric acid. Conclusion The prevalence of abnormal kidney function of workers in selected lithium-ion battery-related enterprise is varied by age, length of service, smoking status, drinking status, hypertension, and hyperglycemia. There may be a trend that the longer the time working in a lithium-ion battery-related enterprise, the worse the workers' kidney function. Therefore, the enterprise should pay attention to the possible reasons for their changes and take targeted interventions.

Analysis of occupational health examination data of 215 radiation workers from hospitals in Jiayuguan, China / 中国辐射卫生

Objective To understand the effects of long-term exposure to ionizing radiation on the health of radiation workers. Methods A total of 215 radiation workers were randomly selected and assigned to the exposure group and 197 non-radiation workers were assigned to the control group. The occupational health examination results of the two groups were compared and analyzed. Results The WBC count of the exposure group was lower than that of the control group (P＜0.05), while the abnormality rates of ocular lens, ECG, liver function, and thyroid function were significantly higher in the exposure group than in the control group (P＜0.05). In the exposure group, the abnormality rate of liver function was lower in females than in males, and the abnormality rate of hemoglobin level was higher in females than in males (P＜0.01). The abnormality rate of ocular lens increased with age (P＜0.01). The abnormality rate of hemoglobin level was different among different age groups (P＜0.01). The abnormality rate of ocular lens increased with increasing years of service. The abnormality rates of RBC count and hemoglobin level in the general radiotherapy group were higher than those in the interventional radiotherapy group (P＜0.01). Sex was the influencing factor for abnormal liver function (P＜0.01). Conclusion Prolonged exposure to low doses of ionizing radiation can adversely affect the health of radiation workers in medical institutions.

Study on the Oral Health Status in Middle-aged and Elderly Population in Wuhan / 华中科技大学学报(医学版)

Objective To analyze the current oral health status of middle-aged and elderly people in Wuhan,and to provide clinical evidence for preventing and promoting oral health among middle-aged and elderly people.Methods The data was col-lected from the annual health examination data system of Wuhan,which included 1994 patients aged 45～95.According to the World Health Organization(WHO)"Basic Methods of Oral Health Survey"(5 th edition),the data of caries,periodontal disease,dentition defect,dentition loss and denture restoration was mainly studied.Statistical methods such as Chi-square test and vari-ance analysis were used for data analysis.Results Among the 1994 subjects,1613 people(80.89％)were male and 218 people(10.93％)were older than 75 years old.The average numbers of caries and teeth loss were 2.68 and 2.03,respectively.The mean number of caries and tooth loss increased with age.The mean numbers of caries and tooth loss in 45～,55～,65～,75～,and 85～95 years old groups were 0.98 and 0.54,1.82 and 1.39,3.21 and 2.48,7.65 and 6.04,12.65 and 9.91,respective-ly.The difference among different age groups was statistically significant(P＜0.01).The proportion of restoration of teeth loss was also elevated with the increase of age(P＜0.01),and the difference of community periodontal index(CPI)among different age groups was also statistically significant(P＜0.01).The proportion of people in CPI1 group(shallow periodontal pocket)was decreased with the increase of age,while the proportion of people in CPI2 group(deep periodontal pocket)was increased with the increase of age(P＜0.01).Conclusion The overall oral health examination results of middle-aged and elderly people in Wuhan shows that the oral health status is slightly better when compared with the result of urban area in the 4th National Oral Health Examination.But caries,periodontal disease,tooth loss and unrepaired dentures are still serious in the elderly population.It is necessary to improve the prevention awareness of oral diseases in the elderly through regular oral examination,timely detection and treatment.At the same time,attention should be paid to dental restoration in the elderly population to improve the quality of life.

Health status of photovoltaic module production workers in Shanghai / 环境与职业医学

Background Photovoltaic (PV) cells can convert solar energy into electricity and alleviate the dilemma of energy supply shortage. Shanghai's PV module industry is booming, but there are few reports on the health status of the workers and there is an urgent need for health risk assessment. Objective To evaluate the health status of PV module production workers and the association between work and health status, in order to provide a direction for the health management of the workers. Methods Among the PV module production workers who completed prescriptive occupational health examination by a designated medical institution in 2021, 2453 workers with more than one year of working age were selected as the exposure group and 538 newly hired workers as the control group. On the basis of the Technical specifications for occupational health surveillance (GBZ 188−2014), the health examination included physical examination and laboratory examination and information such as sociodemographics, living habits, and disease history. We compared the indicators of pure-tone hearing test, blood routine examination, electrocardiogram (ECG), liver function, and kidney function between the two groups. The blood routine results included erythrocyte-related indicators, leukocyte-related indicators, and platelet-related indicators, and the results of liver function included hepatocyte injury indicators, hepatic secretory function indicators, and hepatic synthesis function indicators. The workers were divided into four groups by quartiles of working age. Trend chi-square test was used to analyze differences in health status between the four working age groups. Multiple logistic regression models were used to evaluate the association between working age and health indicators. Results Among the exposure group workers, 2035 (83.0%) were male and 418 (17.0%) were female. The median (P25, P75) age was 34.0 (30.0, 39.0) years and the median (P25, P75) working age was 6.0 (3.0, 10.0) years. The abnormality rate of blood routine was 61.7%. Among them, the abnormality rates of platelet-related indicators and liver secretory function indicators were 39.8% and 48.1% respectively. The risks of abnormal hepatocyte injury-related indicators, fatty liver, and platelet-related indicator abnormalities among the exposure group were 1.471 (95%CI: 1.060, 2.054), 1.691 (95%CI: 1.208, 2.385), and 7.576 (95%CI: 4.967, 11.994) times higher than those in the control group respectively. The single-factor analysis demonstrated a positively linear trend between working age and hypertension prevalence, electrical audiometry abnormality rate, or liver secretory function indicator abnormality rate. Corrected for gender, age, smoking status, hypertension, etc., the results of logistic analysis showed that quartile working age was positively related to abnormal liver secretion function and abnormal platelet-related indicators respectively (OR=1.047, P=0.005; OR=1.037, P=0.014), and inversely associated with the abnormal rate of renal function (OR=0.953, P=0.044). Conclusion Negative associations between health status and working age are identified in PV module production workers. The target PV module production employees are in younger age, and with the increase of working age, the abnormalities of liver function and platelets may increase. Therefore, the enterprises should extend occupational health work from workplace to workers.

Helicobacter pylori infection factors and immunological typing in community health examination population / 公共卫生与预防医学

Objective To investigate and analyze the risk factors of Helicobacter pylori (Hp) infection and the immunological classification of Hp-infected people in community health examination population. Methods Among of the 2 475 residents in a community who underwent health examination in Guangyuan First People's Hospital were selected between July 2022 and April 2023. Western blotting was used to detect and type the Hp antibodies. The risk factors of Hp infection in the community residents were analyzed by binary logistic regression analysis, and the results of immunological typing were compared among patients with different upper digestive tract diseases and chronic diseases. Results The Hp infection rate among of the 2 475 residents who underwent physical examination was 35.64% (882/2475), and the positive rates of type I Hp antibody and type II Hp antibody were 23.72% (587/2 475) and 11.92% (295/2 475) , respectively. There were significant differences in Hp infection rates in gender, age, smoking history, and whether or not people had diabetes (P<0.05). Multivariate logistic regression analysis showed that male, age ≥60 years old, drinking history and diabetes were risk factors of Hp infection in the community health examination population (P<0.05). The positive rate of type I Hp antibody in men and patients with coronary heart disease was higher than that in women and patients without coronary heart disease (P<0.05). Conclusion The infection rate of Hp among health examination population in this community is low, mainly type I. Hp infection is affected by gender, age, drinking history and diabetes. There are more males in the population with type I Hp antibody positivity, and the risk may be higher in patients with coronary heart disease. Clinically, it is necessary to take susceptible population as the focus of prevention and treatment, and take targeted monitoring and diagnosis and treatment measures.

A Report on the Exercise Habits of Elderly People Aged 75 and Over Living at Home in Japan Comparison before and after the Spread of COVID-19 Infection

The purpose of the research was to investigate the actual exercise practices before and after the spread of COVID-19 infection among elderly persons aged 75 years or older living at home. Public health nurses conducted infection control measures, visited their homes, interviewed them and conducted case studies. Results showed that there was no change in exercise habits or health examination data before and after the spread of Corona infection.

Results of occupational health examination for gas station workers / 公共卫生与预防医学

Objective To understand the occupational health status of gas station workers, to analyze the characteristics of early health damage, and to provide a reference for the occupational health monitoring of workers in this industry. Methods The gas station workers who underwent occupational health examination in an occupational health examination institution in Tianjin in 2021were selected as the research subjects. The examination results were statistically analyzed. Results A total of 381 gas station workers were included in this study, with a sex ratio of male to female of 1.40:1. The top three tests with abnormal results from high to low were abdominal color Doppler ultrasound (39.63%), urine routine (29.13%), and blood pressure (23.62%). The detected fatty liver accounted for 74.83% of abnormal abdominal color Doppler ultrasound. Analysis of abnormal results of different genders showed that the detection rate of abnormal blood pressure, fatty liver and liver function in males was higher than that in females (χ2=16.40, 25.40, 15.98，P＜0.05), the detection rate of high GGT in males was significantly higher than that in females (χ2=16.04，P＜0.05）. The detection rate of abnormal urine routine in females was higher than that in males (χ2=12.85，P＜0.05), and the positive rate of urine white blood cells and blood in urine were significantly higher I women than those in men (χ2 =16.80, 11.66，P＜0.05). The abnormal detection rate of electrocardiogram of gas station workers increased with age (χ2=28.02，P＜0.05), and the abnormality of high blood pressure showed an increasing trend with age and working years（χ2=25.00, 15.26，P＜0.05). Conclusion The long-term exposure of gas station workers to chemical toxic substances such as organic solvents and benzene series and physical factors such as high temperature in summer and low temperature in winter will have a certain impact on health. It is suggested that employers should reasonably arrange their work systems and carry out occupational health monitoring in a targeted manner.

Influencing factors of metabolic syndrome in community patients with schizophrenia / 四川精神卫生

BackgroundPatients with schizophrenia are at high risk of suffering from metabolic syndrome. Most previous studies on the influencing factors of metabolic syndrome focused on the inpatients and limited ones on patients dwelling in community. ObjectiveTo explore the influencing factors at different risk levels of metabolic syndrome in community-dwelling patients with schizophrenia in Guangzhou， so as to provide references for future interventions on metabolic syndrome in this patient population. MethodsIn November 2021， 3 339 patients with schizophrenia who were registered in and administered by Guangzhou Mental Health Information System were included. All these patients had finished the physical examination in 2020， and whether they had metabolic syndrome was assessed basing on Guideline for the prevention and treatment of type 2 diabetes mellitus in China （2020 edition）. Patients were divided into high-risk group （n=423）， critical group （n=1 524） and metabolic syndrome group （n=1 392） according to the Chinese expert consensus on the management of metabolic syndrome in patients with schizophrenia. Multiple logistic regression analysis were performed on the risk factors of metabolic syndrome in community-dwelling patients with schizophrenia. ResultsThe prevalence rate of metabolic syndrome in community-dwelling patients with schizophrenia was 41.69%. Univariate analysis showed that the results in gender （χ2=44.610）， age （χ2=55.992）， marriage status （χ2=30.755）， illness course （χ2=25.913） and body mass index （χ2=829.265） were significantly different among the three groups （P<0.01）. Kruskal-Wallis H test showed that the levels of waist circumference （H=920.331）， systolic blood pressure （H=436.673）， diastolic blood pressure （H=393.337）， fasting blood glucose （H=807.304）， triglyceride （H=1 134.125） and high-density lipoprotein cholesterol （H=593.615） among the three groups were significantly different （P<0.01）. Logistic regression analysis showed that age ≥50 （OR=1.761， 95% CI： 1.087~2.853）， overweight （OR=2.418， 95% CI： 1.862~3.140） and obesity （OR=57.903， 95% CI： 14.340~233.802） were risk factors contributing to high-risk patients becoming critical population （P<0.05 or 0.01）. Female gender （OR=1.295， 95% CI： 1.034~1.622）， aged 40~49 （OR=2.597， 95% CI： 1.582~4.263）， age ≥50 （OR=4.392， 95% CI： 2.609~7.395）， overweight （OR=7.844， 95% CI： 6.018~10.223） and obesity （OR=426.785， 95% CI： 105.724~1 722.839） were risk factors for high-risk patients developing into metabolic syndrome population （P<0.05 or 0.01）. ConclusionThe prevalence rate of metabolic syndrome is higher in community-dwelling patients with schizophrenia. Female gender， older age， overweight and obesity would increase the risk of metabolic syndrome in schizophrenic patients. ［Funded by Health Science and Technology Project in Guangzhou （number， 20221A010028）］

Status analysis of radiation occupational health inspection institutions in Zhejiang Province, China / 中国辐射卫生

Objective To investigate the operation status and service level of radiation occupational health inspection institutions in Zhejiang Province, China, and to provide a basis for administrative departments and quality management departments to develop policies. Methods The investigation data of radiation occupational health inspection institutions in Zhejiang Province were collected for descriptive analysis of the regional distribution, nature, and service qualification of the institutions. Results There were 27 radiation occupational health inspection institutions in Zhejiang Province. These institutions were located in 11 cities, of which 85.18% were public institutions and 14.72% were private institutions. For the physical examination workload of radiation workers in Zhejiang Province in 2021, general hospitals accounted for 75.90%, private institutions accounted for 4.51%, and occupational prevention and treatment hospitals accounted for 19.59%. In the radiation occupational health inspection institutions, the stand-alone and online software installation rates were 33.33% and 37.04%, respectively. A total of 26 986 individuals (82.97%) underwent chromosome aberration examination. The examination rates of thyroid color Doppler ultrasound examination and eye lens examination were 41.24% and 82.97%, respectively. Pre-job, on-job, and off-job physical examination accounted for 25.81%, 70.52%, and 3.67%, respectively. For radiation workers who underwent on-job physical examination, diagnostic radiology workers accounted for the highest proportion of 34.90%. The excellent, qualified, and unqualified rates of 27 radiation occupational health inspection institutions were 7.41%, 88.89%, and 3.70%, respectively. Conclusion The network of radiation occupational health inspection institutions in Zhejiang Province is well-established and located mainly in general hospitals, occupational prevention and control institutions, and private institutions. To enhance the quality and proficiency of occupational health examinations, it is imperative to prioritize self-improvement and management, reinforce law enforcement supervision, actively engage in blind sample assessments, and advance the application of information technology and standardized services.

Effect of respiratory filter on pulmonary function in occupational health examination / 中华劳动卫生职业病杂志

Objective: To explore the influence and significance of respiratory filter on the judgment of pulmonary function and the conclusion of occupational health examination in occupational health examination. Methods: From August to November 2020, 252 occupational health examinees were randomly selected as the research objects, and the lung function was examined with the respiratory filter bite and the straight cylinder bite without filter, respectively. The lung function examination indexes and the qualification rate of lung function examination were analyzed and compared between the two groups, and the diagnostic criteria of lung function examination was corrected. Results: 252 subjects were 36 (30, 42) years old. The qualified rate of lung function examination with respiratory filter bite (28.17%, 71/252) was lower than that with straight cylinder bite (34.92%, 88/252) , the difference was statistically significant (P<0.05) . The percentage of forced vital capacity in normal predicted value (FVC%) , percentage of forced expiratory volume in the first second in normal predicted value (FEV(1)%) , and percentage of forced expiratory volume in the first second in forced vital capacity (FEV(1)/FVC%) of subjects using respiratory filter bite were lower than those using the straight cylinder bite (P<0.05) . The corrected diagnostic criteria of pulmonary function were FVC%>78%, FEV(1)%>77%, FEV(1)/FVC%>68%. There was no significant difference between the qualified rate of the respiratory filter bite lung function test calculated according to the corrected diagnostic criteria (35.71%, 90/252) and the qualified rate of the straight cylinder bite lung function test calculated according to the original diagnostic criteria (34.92%, 88/252) (P>0.05) . Conclusion: In occupational health examination, the use of respiratory filter may affect the results of pulmonary function examination. The diagnostic criteria of pulmonary function can be corrected according to different filtering effects to ensure the accuracy of the conclusions of occupational health examination.

An analysis of occupational health examination results of 450 radiation workers in a steel mill / 中国辐射卫生

@#<b>Objective</b> To investigate the occupational health status of 450 radiation workers in a steel mill when they resigned, and to provide references and suggestions for the occupational health monitoring of the enterprise employees and for the workers’ proper arrangement after their resignations. <b>Methods</b> Occupational health examinations were performedon 450 steel workers who were about to resign in accordance with the applicable laws and regulations. And the examination results were statistically analyzed. <b>Results</b> Among the 450 radiation workers, 82% had abnormal examination results which included chromosome aberration in peripheral blood lymphocytes (4.89%), lens opacity (44.44%), pinguecula (25.33%), hypertension (28.22%), thyroid dysfunction (9.59%), and abnormal liver ultrasound findings (30.89%). Compared with the normal population, these steel workers had a significantly higher chromosome aberration rate in peripheral blood lymphocytes and a significantly higher incidence rate of ocular disorders. <b>Conclusion</b> It is important to effectively manage the occupational health of radiation employees in steel mills, and to regularly provide training on occupational health protection. To avoid radiation damage, workers should pay close attention to radiation protection at work, especially eye protection, to avoid eye disorders.

Analysis of occupational health examination results of radiation workers in Dezhou, China / 中国辐射卫生

Objective To investigate the occupational health status of radiation workers in Dezhou, China, explore the effects of low-dose ionizing radiation on the health of radiation workers, and provide a basis for improving the health of radiation workers. Methods A total of 1101 radiation workers in Dezhou who underwent occupational health examination in 2021 were selected. The effects of physical examination type, type of work, sex, length of service, and age on the health status of radiation workers were compared and analyzed. Results The abnormal rates of abdominal color Doppler ultrasound and eye lens were significantly higher in pre-post radiation workers than in radiation works (P < 0.05). The abnormal rates of eye lens increased with the length of service in radiation workers (P < 0.05). The abnormal rate of abdominal color Doppler ultrasound in male workers was higher than that in female workers, while the abnormal rates of blood routine and thyroid function were higher in female workers than in male workers (P < 0.05). Conclusion The abdominal rates of color Doppler ultrasound and eye lens are relatively high among radiation workers in Dezhou. It is necessary to improve the protection awareness and strengthen the level of radiation protection, so as to ensure the occupational health of radiation workers.

Application status and trends of health examination data: visualization research based on Citespace / 中华健康管理学杂志

Objective:To explore the application status and trends of the health examination data.Methods:Relevant literatures on health examination data were retrieved from Web of Science from 1 January 2007 to 30 June 2022 and China Knowledge Network Infrastructure from 1 January 1992 to 30 June 2022; and the literature and research contents were visually analyzed by using CiteSpace 6.1 bibliometrics software.Results:Total of 5 517 Chinese articles and 18 563 English articles were selected. The publication volume of health examination data in China increased year by year since 1992, and the international publication volume also showed an increasing trend. The Chinese literature focused on health management, osteoporosis, overweight, and physical examination subjects such as pilots, while the English literature focused on the study of obesity, care and functional cognition after the formation of a cohort of physical examination data. More co-citation papers related to health examination data were published in the journals from developed countries mainly in the United States and the United Kingdom, and the contents of the co-cited journals highly covered disease research on chronic diseases, such as cardiovascular disease, functional cognition and rehabilitation.Conclusions:The number of articles published on health examination data is increasing year by year, and in the future, more studies will use big data algorithms such as machine learning to measure the association between the risk of chronic diseases and related influencing factors.

Relationship between cardiometabolic index and hyperuricemia in health examination population / 中华健康管理学杂志

Objective:To investigate the relationship between cardiometabolic index (CMI) and hyperuricemia (HUA) in the health examination population.Methods:It was a cross-sectional study. A total of 21 720 individuals who received health examinations in Xiangya hospital, Central South University between 2020 and 2021 were recruited in this study. Multivariate logistic regression analysis was used to determine the independent correlation between CMI and HUA, and stratified analysis was applied to check whether there were population differences. Then the predictive value of CMI for hyperuricemia in the health examination population was evaluated with the area under the receiver operator characteristic (ROC) curve.Results:Among the 21 720 subjects, 4 418 (20.34%) were detected with HUA. In the HUA group, the body mass index (BMI), waist-to-hip ratio, CMI, total cholesterol, triglyceride, systolic blood pressure, diastolic blood pressure, fasting blood glucose, 2-hour postprandial blood glucose, and blood creatinine levels were all significantly higher than those in the normal uric acid group, while high-density lipoprotein and epidermal growth factor receptor (eGFR) were significantly lower (all P<0.05). Multiple logistic regression analysis showed that after adjusting for relevant factors, CMI was significantly positively correlated with HUA ( OR=1.16, 95% CI: 1.129-1.192); and with the increase of CMI, the risk of HUA increased gradually. Stratified analysis and interaction test according to gender, age, BMI, hypertension, abnormal blood glucose and glomerular filtration rate indicated that CMI was positively associated with the occurrence of HUA in all populations. Compared with that in people with abnormal blood glucose, the correlation between CMI and HUA was more obvious in people with normal blood glucose. The area under the ROC curve (AUC) for CMI to predict HUA was 0.723(95% CI: 0.715-0.731), with a specificity of 0.636 and a sensitivity of 0.698, and the cut-point was 0.693. Conclusion:There was a significant positive correlation between CMI and HUA in the health examination population, which has good predictive value for HUA.

Analyzing the influencing factors of quality control assessment of pure tone audiometry among noise exposed personnel in Guangzhou City from 2021 to 2022 / 中国职业医学

{L-End}Objective To explore the status of quality control assessment of pure tone audiometry (PTA) and to analyze its influencing factors in occupational medical examination (OME) institutions in Guangzhou City. {L-End}Methods A total of 41 OME institutions in Guangzhou City were selected as the research subjects from 2021 to 2022 using random sampling method, and its status of on-site quality and PTA quality for individuals exposed to noise were assessed. {L-End}Results A total of 205 rectification items were identified among the 41 OME institutions from 2021 to 2022. Among them, 19, 28, 30, and 28 OME institutions did not meet the requirements of organizational structure, quality management system, quality control of OME, and health examination information reporting, respectively. A total of 1 095 OME reports for individuals exposed to noise were assessed, with 820 reports having correct results and conclusions, resulting in an accuracy rate of 74.9%. The results of the multiple logistic regression analysis showed that OME institutions without meeting the requirements for the quality management system had a higher risk of failing the PTA quality control assessment and having inaccurate hearing test results compared with those meeting the requirements (all P<0.05). OME institutions with a filing period less than one year had a higher risk of having inaccurate hearing test results than those with a filing period of one year or more (P<0.05). OME institutions not meeting the requirements for quality control of OME had a higher risk of having abnormal OME conclusions than those meeting the requirements (P<0.05). OME institutions not meeting the requirements for health examination information reporting had a higher risk of having abnormal conclusions in suspected occupational disease than those meeting the requirements (P<0.05). OME institutions not meeting the requirements for the quality management system had a higher risk of having abnormal conclusions of occupational contraindications than those meeting the requirements (P<0.05). {L-End}Conclusion The quality of PTA in OME institutions in Guangzhou City needs to be improved. And a well-established quality management system for OME is beneficial for improving the quality of PTA.

Analysis and optimization of the record management practice in occupational health examination institutions / 中国职业医学

The Prevention and Control of Occupational Diseases Law revised in 2017 abolished the qualification test and approval for occupational health examination institutions, and replaced it with record management. The record does not belong to any type of administrative permit and does not require the premise of “general prohibition”. Its core idea is that “the public law actively acts as an obligation”, which does not prohibit administrative counterpart from carrying out specific tasks, mainly information collection, supervision and management of follow-ups, and emphasizes on simplifying procedures, improving working efficiency and stimulating market vitality. It is a strategic measure of the government's reform on “release, control and service”. It has the functional significance of alleviating information asymmetry, cultivating market credit mechanism and reflecting the government's flexible supervision and management mechanisms. However, China has not yet unified legislation on record management, and individuals on the theoretical and practical circles have different understandings on the concept, operation principle, and management effectiveness of the record management. There are practical dilemmas in the record management of occupational health examination institutions, such as alienation of record management into licensing, insufficient regulation of record management procedures, and weak in-process and post-process supervision and management capabilities. It is suggested to clarify the legal nature of record management, unify and improve the record management procedures, and improve in-process and post-process supervision and management capabilities. By building a legal, scientific and systematic regulation for the record management of occupational health examination institutions, adhering to the unity of “discharge” and “control”, it could effectively safeguard the legitimate rights and interests of occupational health examination institutions, workers and employers.

Index design of core elements of health examination report and pilot data analysis / 中华健康管理学杂志

Objective:To analyze the core elements′ index design of physical examination reports and pilot data.Methods:We searched and analyzed the core element indexes of the physical examination report in databases such as CNKI and Wanfang through the literature analysis method, forming the initial core element indicator set. Special working meetings were organized to discuss revisions and improvements. The core elements′ index set was formed using a mixed research method combined with the quantitative analysis results of pilot data and expert opinions. Six hundred and thirteen cases from five hospitals were included in this study, including Anzhen Hospital, Peking University Third Hospital, Beijing Physical Examination Center, Beijing Tongren Hospital, China-Japan friendship hospital.Results:The subjects were (49.5±17.6) years old, including 302 males (49.3%) and 311 females (50.7%). The physical examination conclusion indicates that the number of health problems is between five and eight, with no significant difference between men and women. The health history data analysis of different sexes showed that hypertension in men was significantly higher than in women (17.9% vs. 10.6%, P=0.010). The lifestyle and eating habits survey showed that men had significantly higher incidences of smoking and drinking than women (24.8% vs. 2.2%, P?0.001; 9.9% vs. 1.3%, P?0.001). The exercise habits and sleep survey showed that the proportion of men who did not exercise was lower than that of women (13.2% vs. 22.8%, P=0.022). There was no statistically significant difference in sleep duration between the sexes. Conclusions:The core elements of health examination reports can standardize the collection of physical examination data and improve its sharing and application. This can allow the reports to better assist the decisions based upon physical examination report data.

Application of radiation-sensitive indicators in health monitoring of radiation workers in China / 中国辐射卫生

Health monitoring of radiation workers is an important part of the radiation protection system. Occupational health examination is very important for the safe use of nuclear energy technology. This article analyzes the detection results of radiation-sensitive indicators reported in the literature to investigate the health status of radiation workers and to provide a reference for the further study of sensitive indicators in health monitoring of radiation workers.

Association between serum electrolyte concentrations and the risk of cardiovascular events in physical examination population / 中华健康管理学杂志

Objective:To analyse the relationship between serum electrolyte concentrations and risk of cardiovascular events in physical examination population.Methods:A cross-sectional study design was applied to survey 8 445 adults whose serum high-sensitivity cardiac tropon Ⅰ (hs-cTnⅠ) and serum electrolytes (chloride, phosphorus, calcium, sodium, potassium and magnesium) concentrations were measured at the health examination center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 1, 2018 to February 28, 2022. The risk of cardiovascular events was classified into three levels according to the serum hypersensitive cardiac troponin Ⅰ(hs-cTnⅠ) concentration: low, middle or high risk group. One-way analysis of variance was applied to compare the differences in serum electrolyte concentrations of participants with different risk levels of cardiovascular events. Ordered multi-category logistic regression was performed to analyze the correlation between serum electrolyte levels and the risk of cardiovascular events.Results:The concentration of potassium and magnesium ion in the subjects with low risk of cardiovascular events were both higher than those in the middle and high risk group [potassium ion (4.28±0.29) vs (4.24±0.34), (4.23±0.36) mmol/L, magnesium ion (0.88±0.06) vs (0.87±0.07), (0.87±0.07) mmol/L](both P<0.05), while the concentration of sodium ion was lower [(140.54±1.75) vs (140.88±1.73), (140.81±2.20) mmol/L]( P<0.001); the concentration of phosphorus ion in the high-risk group was lower than those in the middle and low risk groups [(1.04±0.17) vs (1.08±0.16), (1.05±0.15) mmol/L]( P=0.001); no significant difference was found in the concentrations of chloride and calcium ion among the three groups (both P>0.05). Compared to subjects with normal concentrations of electrolyte, the risk level of cardiovascular events in subjects with hypokalemia ( OR=6.96, 95% CI: 3.67-13.10) and hypomagnesemia ( OR=5.00, 95% CI: 1.01-24.50) was higher(both P<0.05). Within the normal range, sodium concentration was positively correlated with the risk of cardiovascular events ( OR=1.08, 95% CI: 1.03-1.14; P<0.001). Conclusions:The serum sodium, potassium and magnesium concentrations in health examination subjects are correlated with the risk of cardiovascular events. Maintaining the balanced concentration of serum potassium and magnesium, as well as low sodium levels within normal limits may help prevent cardiovascular events.