Associations between maternal occupational exposures and pregnancy outcomes among Chinese nurses: a nationwide study.

BACKGROUND: Several studies have provided evidence about adverse pregnancy outcomes of nurses involved in occupational exposure. However, the pregnancy outcomes among nurses in middle-income countries are not well demonstrated. The main aim of this study is to present the prevalence and influencing factors of pregnancy outcomes among female nurses in China. METHODS: We included 2243 non-nurse health care workers, and 4230 nurses in this national cross-sectional study in China. Information on occupational exposures and pregnancy outcomes was collected using a face-to-face investigation. Odds ratios (ORs) were estimated through logistic regression. RESULTS: The proportion of threatened abortion, spontaneous abortion, and stillbirth of female nurses was 2.6%, 7%, and 2.1%, respectively. We found an increased risk of threatened abortion among nurses with overtime work (OR = 1.719, 95% CI 1.158-2.550). The risk of threatened abortion and spontaneous abortion was elevated among nurses handling disinfectant (OR = 2.293 and 1.63, respectively). We found a nearly twofold increased risk of premature birth (OR = 2.169, 95% CI 1.36-3.459) among nurses handling anti-cancer drugs. CONCLUSIONS: Our findings suggested that maternal occupational exposures might be associated with the risk of adverse pregnancy outcomes among female nurses in China. We recommend that policy-markers and hospital managers work together to reduce exposure to occupational hazards and improve pregnancy outcomes among female nurses.

Integrated mRNA and microRNA profiling in lung tissue and blood from human silicosis.

BACKGROUND: The overwhelming majority of subjects in the current silicosis mRNA and microRNA (miRNA) expression profile are of human blood, lung cells or a rat model, which puts limits on the understanding of silicosis pathogenesis and therapy. To address the limitations, our investigation was focused on differentially expressed mRNA and miRNA profiles in lung tissue from silicosis patients to explore potential biomarker for early detection of silicosis. METHODS: A transcriptome study was conducted based on lung tissue from 15 silicosis patients and eight normal people, and blood samples from 404 silicosis patients and 177 normal people. Three early stage silicosis, five advanced silicosis and four normal lung tissues were randomly selected for microarray processing and analyze. The differentially expressed mRNAs were further used to conduct Gene Ontology and pathway analyses. Series test of cluster was performed to explore possible changes in differentially expressed mRNA and miRNA expression patterns during the process of silicosis. The blood samples and remaining lung tissues were used in a quantitative real-time PCR (RT-qPCR) (RT-qPCR). RESULTS: In total, 1417 and 241 differentially expressed mRNAs and miRNAs were identified between lung tissue from silicosis patients and normal people (p < 0.05). However, there was no significant difference in most mRNA or miRNA expression between early stage and advanced stage silicosis lung tissues. RT-qPCR validation results in lung tissues showed expression of four mRNAs (HIF1A, SOCS3, GNAI3 and PTEN) and seven miRNAs was significantly down-regulated compared to those of control group. Nevertheless, PTEN and GNAI3 expression was significantly up-regulated (p < 0.001) in blood samples. The bisulfite sequencing PCR demonstrated that PTEN had significantly decreased the methylation rate in blood samples of silicosis patients. CONCLUSIONS: PTEN might be a potential biomarker for silicosis as a result of low methylation in the blood.

Characteristics of Diagnosed and Death Cases of Pneumoconiosis in Hubei Province, China, 1949-2019.

OBJECTIVE: This study aims to summarize the characteristics of diagnosed pneumoconiosis and pneumoconiosis death in the Hubei Province of China, between the years 1949 and 2019, and provide clues for the scientific prevention of pneumoconiosis. METHODS: We recruited 23,069 pneumoconiosis cases in Hubei Province, China, from 1949 to 2019. Basic information and occupational surveillance information were obtained from the Hubei Occupational Diseases and Health Risk Factors Information Surveillance System. RESULTS: The annually diagnosed pneumoconiosis cases showed an overall increasing trend from 1949 to 2019 in Hubei Province. The major types of pneumoconiosis were coal workers' pneumoconiosis (CWP, 49.91%) and silicosis (43.39%). Pneumoconiosis cases were mainly engaged in mining (75.32%) and manufacturing (12.72%), and were distributed in Huangshi (35.48%), Yichang (16.16%), and Jingzhou (7.97%). CWP (47.50%) and silicosis (44.65%) accounted for most of the deaths. CONCLUSIONS: The number of pneumoconiosis cases and deaths in Hubei increased in the period of 1949 to 2019. Silicosis and CWP contributed to the predominant types of pneumoconiosis. Prevention and control measures should continue to be taken to reduce the morbidity and mortality of pneumoconiosis.

Prevalence status and associated factors of wrist postural injury in the Chinese occupational population.

Objective: This study investigated the prevalence of wrist injuries in 15 industries and different types of work in China. Study on the associated factors of wrist injuries provides a scientific basis for prevention and treatment of wrist diseases in occupational workers. Methods: A cross-sectional study of musculoskeletal symptoms of related practitioners in 15 industries, including automobile manufacturing, was conducted to retrieve worker demographic information, working wrist posture, and pain conditions. Multivariable binary logistic regression analyses were performed to identify factors associated with work-related musculoskeletal disorders (WMSDs). Results: The prevalence of wrist injuries among the study population was 13.2%. Toy manufacturing, animal husbandry, automobile manufacturing, shoe manufacturing, and biopharmaceutical manufacturing had the highest wrist injury rates at 29.1, 19.1, 14.9, 14.9, and 14.0%, respectively. Among the types of jobs, enamel workers (63.0%), butchers (43.6%), combers (32.5%), welders (31.3%), and scaffolders (26.5%) had the highest prevalence rates. Based on the final multivariate logistic regression analysis: female [odds ratios (OR) = 1.24; 95% confidence interval (CI), 1.15-1.35], 6-10 years of service (OR = 1.11; 95% CI, 1.03-1.18), >10 years of service (OR = 1.15; 95% CI, 1.06-1.25), frequent upward and downward flexion in wrist posture at work (OR = 1.81; 95% CI, 1.84-2.11), and frequent wrist placement on the edge of angular objects increased the OR of injury (OR = 1.52; 95% CI, 1.44-1.61). Need to squeeze objects tightly while working (OR = 1.72; 95% CI, 1.57-1.89), prolonged wrist flexion (OR = 1.86; 95% CI, 1.75-1.97), and work hand position above the shoulder for prolonged periods (OR = 1.11; 95% CI, 1.04-1.19) also suggested the relationship between these factors and the higher prevalence of wrist injury in the workers. The associated factor was physical activity (OR = 0.86; 95% CI, 0.80-0.94). Conclusion: This study suggested the relationship between these factors and the higher prevalence of wrist injury in the toy manufacturing, animal husbandry, automobile manufacturing, and shoe-making industries, enamel workers, butchers, and combers. And are work types that require special attention. Females, working age, physical activity, and abnormal posture of the wrist were factors significantly associated with WMSDs.

Shoulder work-related musculoskeletal disorders and related factors of workers in 15 industries of China: a cross-sectional study.

BACKGROUND: Changes in modern industrial production practices can easily lead to shoulder work-related musculoskeletal disorders (WMSD). The current reports on shoulder WMSD are limited to some industries are less well studied, and the sample size is usually small. This study aimed to describe the prevalence and severity of shoulder WMSD in a large sample of Chinese workers from 15 industries, analyze the possible correlations with sociodemographic and work-related variables, and compare the differences between industries. METHODS: A cross-sectional study was conducted among a sample of 55,749 participants from 252 enterprises in 15 industries throughout China. A Chinese version of the musculoskeletal disease questionnaire was used to collect the demographic factors, shoulder symptoms in past 12 months, and work-related factors including posture-related factors, repetition, vibration, work organization, job control, and environmental factors as independent variables. Descriptive statistics were used, and the binary logistic regression analysis was performed to explore the association between shoulder WMSD and potential demographic and work-related factors. RESULTS: Nearly 35.5% of participants reported shoulder pain and discomfort in the previous 12 months. Biopharmaceutical manufacturing (56.2%), medical services (54.4%), and aviation services (50.1%) were the three industries with the highest prevalence of shoulder WMSD. The pain score of aviation services workers was the highest. The related factors for shoulder WMSD varied among the different industries. CONCLUSION: Our study found a relatively high prevalence of shoulder WMSD in China. There were large differences in the prevalence of shoulder WMSD among industries, and the related factors were particular to each industry. Such information is useful to help occupational health practitioners and policymakers conduct preventive programs to reduce shoulder disorders in these working populations.

Prevalence and risk factors analysis for low back pain among occupational groups in key industries of China.

BACKGROUND: With the acceleration of industrialization and population aging, low back pain (LBP) has become the leading cause of life loss years caused by disability. Thus, it places a huge economic burden on society and is a global public health problem that needs urgent solution. This study aimed to conduct an epidemiological investigation and research on a large sample of workers in key industries in different regions of China, determine the incidence and distribution characteristics of LBP, explore the epidemic law, and provide a reference basis for alleviating global public health problems caused by LBP. METHODS: We adopted a modified epidemiological cross-sectional survey method and a stratified cluster sampling method. All on-duty workers who fulfill the inclusion criteria are taken as the research participants from the representative enterprises in key industries across seven regions: north, east, central, south, southwest, northwest, and northeast China. The Chinese version of the musculoskeletal disease questionnaire, modified by a standardized Nordic questionnaire, was used to collect information, and 57,501 valid questionnaires were received. Descriptive statistics were used, and multivariate logistic regression analysis (p < 0.05) was performed to explore the association between musculoskeletal disorders and potential risk factors. RESULTS: LBP annual incidence among workers in China's key industries is 16.4%. There was a significant difference in LBP incidence among occupational groups across different industries (p < 0.05). The multivariate regression model showed the following as risk factors for LBP: frequent repetitive movements with the trunk, working in the same positions at a high pace, trunk position, frequently turning around with your trunk, often working overtime, lifting heavy loads (i.e., more than 20 kg), education level, staff shortage, working age (years), cigarette smoking, use of vibration tools at work, body mass index, lifting heavy loads (i.e., more than 5 kg), and age (years). Physical exercise, often standing at work, and absolute resting time were protective factors. CONCLUSION: LBP incidence among key industries and workers in China is high. Thus, it is urgent to take relevant measures according to the individual, occupational, and psychosocial factors of LBP to reduce the adverse impact of LBP on workers' health.

Incidence and Risk Factors of the Upper-Limb Musculoskeletal Disorders Among Occupational Groups in Key Industries - China, 2018-2021.

What is already known about this topic?: The burden of illness and economic losses due to upper-limb work-related musculoskeletal disorders (UL-WMSDs) is high; thus, they have become a major global public health problem. At present, the epidemiological characteristics of UL-WMSDs in China's occupational population are still unknown. What is added by this report?: The incidence of UL-WMSDs among key occupational groups in China is 22.5%, with distinct occupational characteristics. What are the implications for public health practice?: This study has primarily determined the occurrence and potential risk factors of UL-WMSDs in key industries in China and provided data support for recommending prevention and control of the occurrence of such diseases in key industries in China, and in facilitating the addition into the China's List of Legal Occupational Diseases.

Epidemiological Data of Work-Related Musculoskeletal Disorders - China, 2018-2020.

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: In recent decades, work-related musculoskeletal disorders (WMSDs) have become increasingly prominent and have become an important issue that is of universal concern and an urgent need to be solved in all countries of the world. WHAT IS ADDED BY THIS REPORT?: The top three industries or occupational groups with the highest standardized prevalence rate of WMSDs were flight attendants, medical staff, and vegetable greenhouses in that order. Women workers were 1.5 times more likely to suffer from WMSDs than men workers. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: This study has found the prevalence and distribution characteristics of WMSDs in key industries in China. It is urgent to draw up relevant measures to prevent and control occupational populations with WMSDs.

Investigation on Work-Related Musculoskeletal Disorders - China, 2018-2019.

What is already known about this topic? Work-related musculoskeletal disorders (WMSDs) have a high prevalence and seriously harmful, which has attracted extensive attention in various countries in the world. Currently, the occurrence and rules of WMSDs in key industries are not known in China. What is added by this report? The prevalence of WMSDs is relatively high among professional populations in key industries in China, with the most commonly affected body parts concentrated in neck, shoulders, and low back and increasing with age and working years. What are the implications for public health practice? This study determined the prevalence and distribution characteristics of WMSDs in key industries in China and provided scientific evidence to recommend for inclusion of WMSDs in the new revision of the list of occupational diseases in China.

Menstrual disorders and occupational exposures among female nurses: A nationwide cross-sectional study.

BACKGROUND: The regularity of menstrual cycles is one of the important indicators of female reproductive health. However, the current evidence on the association of occupational exposures and menstrual disorders is scarce. OBJECTIVES: This study aims to elucidate the relationship between occupational hazards and menstrual characteristics in female nurses and non-nurse health care workers in China. DESIGN: We conducted a national cross-sectional study on the reproductive health of female nurses in China. SETTINGS: A total of 1, 300 medical institutions in 15 provincial administrative regions in China participated in the study. PARTICIPANTS: There were 8, 904 nurses and 3, 977 non-nurse health care workers who were selected using simple random sampling method. METHODS: All participants were administered a face-to-face standardized questionnaire, including personal socio-demographic information, occupational activities, and self-reported menstrual characteristics. Univariate and multivariate logistic regressions were used for statistical analyses. RESULTS: The results demonstrated that 41% of nurses experienced menstrual disorders. We found handling disinfectants was the most significant risk factor for menstrual disorders (OR = 1.53, 95% CI: 1.39-1.68), followed by abnormal workload (OR = 1.28, 95% CI: 1.19-1.39), and occupation as a nurse (OR = 1.28, 95% CI: 1.18-1.40). Noise, prolonged standing or frequent heavy lifting, night work, anti-cancer drug exposure, and overtime work were moderately associated with the occurrence of menstrual disorder (OR > 1). CONCLUSIONS: This national-wide cross-sectional study has revealed the significant association between menstrual disorders and occupational hazards among female nurses in China.

Global DNA methylation and PTEN hypermethylation alterations in lung tissues from human silicosis.

BACKGROUND: Silicosis is a respiratory disease caused by long-term silica dust exposure. Our previous study has demonstrated that silica mediates the activation of phosphatidylinositol 3-kinase (PI3K)/phosphatase and tensin homolog deleted on chromosome 10 (PTEN)/serine or threonine kinase (AKT)/mitogen-activated protein kinases (MAPK)/AP-1 pathway in human embryo lung fibroblasts (HELFs). The purpose of this study is to identify genome-wide aberrant DNA methylation profiling in lung tissues from silicosis patients. METHODS: We performed Illumina Human Methylation 450K Beadchip arrays to investigate the methylation alteration in formalin-fixed, paraffin-embedded (FFPE) lung specimens, immunohistochemistry to detect the level of c-Jun and PTEN proteins; methylation specific PCR (MS-PCR) to identify PTEN and c-Jun promoter methylation in HELFs. RESULTS: We found 86,770 CpG sites and 79,660 CpG sites significantly differed in methylation status in early-stage and advanced-stage compared with GEO normal lung methylation data. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis revealed the methylated status of MAPK signaling pathway was considered changed. The number of PTEN and c-Jun CpG promoter methylated-sites were increased in advanced-stage. Early-stage showed the positive expression of c-Jun and PTEN protein and negative or mild expression in advanced-stage. PTEN promoter was no differentially methylated and c-Jun promoter differed at 12 and 24 h in HELFs. CONCLUSIONS: Abnormal DNA methylation on genome-scale was implicated in silicosis, and PTEN promoter hypermethylation might be associated with decrease of PTEN protein.

A survey of occupational health hazards among 7,610 female workers in China's electronics industry.

To investigate the occupational hazards among Chinese female workers in the electronics industry, the authors systematically sampled a total of 8,300 female workers at random across 4 provinces in a variety of electronics factories. A detailed questionnaire was used to collect information on occupational hazards and the occurrence of occupation-related diseases. The results show that 4,283 female workers (51.9%) were exposed to 1 or more occupational hazards. The most common chemical hazard was organic solvent, and the second most common was heavy metals. The ergonomic hazards included repetitive movements, poor standing posture, and the lifting of heavy goods. More than 60% of the female workers self-reported occupation-related diseases. These results showed that occupational health hazards were common in the electronics industry in China and that they caused serious occupation-related health problems for the female workers therein.