Occupational exposure to human immunodeficiency virus (HIV)--how can we reduce the risk?

We analyzed occupational exposure to potentially infectious body fluids among health care workers (HCWs). Nurses were the most common exposed category of HCWs. In 73.6% cases needle sticks had been the reason of exposure. Recapping a needle was the cause of exposure in 6.9% accidents. Among 189 registered HCWs, 66 (34.9%) performed invasive procedures without any personal protective equipment. Prophylaxis with antiretroviral drugs was necessary in 43 (22.8%) cases. As many as 60.3% of exposure incidents to potentially infectious material result from non-compliance with the relevant recommendations. Continuous education and training is critically needed to prevent occupational exposure to blood-borne infections among health care workers.     

乡镇工业职业卫生服务与初级卫生保健相结合初探

针对我国乡镇工业职业卫生面临的“高需求、低服务”。以及与农村初级卫生保健(PHC)相脱节问题。提出实施乡镇企业职业卫生与PHC相结合的必要性和迫切性。结合WHO职业卫生合作中心(上海)在华东地区的试点探索,提出两者结合的内容和方式的若干设想,强调从更新观念全面认识PHC和把职业卫生与安全作为PHC组成部分入手,深入实践,共同为卫生部领导下的全国性探索作贡献。     

Needle stick and sharps injuries among health care workers in Gondar city, Ethiopia

Background

All employees in health care settings handling needles or other sharps are at risk for needle stick and sharps injuries (NSSIs). Health care workers in under developed countries are at greater risk of infection from blood borne pathogens because of the lack of safety devices and the high prevalence of these pathogens.

Objectives

The aim of this study was to assess the prevalence of NSSIs and associated factors among health care workers in government health institutions in Gondar city, Ethiopia.

Methods

Institution based cross sectional study was conducted from May-December, 2010. The study included 344 health care workers who were selected from the source population using simple random sampling technique. Data were collected through interviews using structured and pre-tested questionnaire and the collected data were entered and analyzed using SPSS version 16.0.

Results

The prevalence of NSSIs among health care workers in the preceding 12 months was 106 (30.8%), of which 58 (54.7%) was reported by females. Lack of training on occupational health and safety, working more than 48 h/week, dissatisfaction with work environment and work culture, greater than 10 years of work experience and having low and moderate perception of risk were found to be significantly associated with NSSIs.

Conclusion

The study found high prevalence of NSSIs among health care workers. Effective training, ongoing awareness on the risk of hazards, preventive measures such as engineering control, and post-exposure prophylaxis following NSSIs are essential to reduce the risk of such injuries.     

医务人员职业健康危害及其关键控制环节

通过查阅、分析大量文献,结合实际工作经验,系统阐述了医务人员面临的主要职业危害因素,并针对我国医务人员职业危害现状和防治工作中存在的主要问题,提出防治关键环节和措施。分析表明:我国医务人员职业暴露危害严重;医务人员的生命质量和平均寿命低于普通人群;医院职业卫生立法和技术标准滞后;防治措施不力,医务人员职业健康权益得不到有效保护。同时指出对医务人员职业危害防治的关键措施:必须通过加强科学研究、制定法规标准、建设医院安全文化、加强宣传教育和培训、推广免疫接种和防护技术、科学设计工作流程、加强心理疏导等关键措施,有效防治医务人员职业健康危害。     

Hand-arm vibration disorder among grass-cutter workers in Malaysia

Introduction. Prolonged exposure to hand-transmitted vibration from grass-cutting machines has been associated with increasing occurrences of symptoms and signs of occupational diseases related to hand–arm vibration syndrome (HAVS). Methods. A cross-sectional study was carried out using an adopted HAVS questionnaire on hand–arm vibration exposure and symptoms distributed to 168 male workers from the grass and turf maintenance industry who use hand-held grass-cutting machines as part of their work. The prevalence ratio and symptom correlation to HAVS between high and low–moderate exposure risk groups were evaluated. Results. There were positive HAVS symptoms relationships between the low–moderate exposure group and the high exposure group among hand-held grass-cutting workers. The prevalence ratio was considered high because there were indicators that fingers turned white and felt numb, 3.63, 95% CI [1.41, 9.39] and 4.24, 95% CI [2.18, 8.27], respectively. Less than 14.3% of workers stated that they were aware of the occupational hand–arm vibration, and it seemed to be related to the finger blanching and numbness. Conclusion. The results suggest that HAVS is under-diagnosed in Malaysia, especially in the agricultural sectors. More information related to safety and health awareness programmes for HAVS exposure is required among hand-held grass-cutting workers.     

Work ability in ageing workers suffering from chronic diseases.

The aim of this study was to investigate the work ability in ageing workers suffering from osteoarthritis (OA), coronary heart disease (CHD) or hypertension (H). One hundred and sixty-six OA and 355 CHD/H outpatients were evaluated. The Work Ability Index (WAI) served for work ability assessment. Patients' results were compared with the results of a control group of 225 healthy young workers. Statistical analysis was performed with ANOVA tests. WAI in female and male CHD/H patients was higher than in OA patients (p < .01), better work ability was related to better education (p < .01), white-collar work (p < .01) and better recreation (p < .01); subjective work ability was determined mostly by the objective health status. The promotion of work ability among workers suffering from advanced age-related diseases should be closely related to the promotion of health. It is indicative to improve occupational education and skills, already at an early stage of a disease.     

Occupational Safety and Health in Finland

In Finland, occupational safety is the responsibility of the employer, while the occupational safety and health laws are enforced by the Labour Inspection Service, an organization of the state. The Labour Inspection is divided in 11 administrative districts, and it employs 360 professionals. They are mandated to carry out site visits without prearranged appointments to inspect safe work situations, working hours, construction safety, or any aspect of accident risks. The inspectors are also mandated to verify the existence of sufficient occupational health services as prescribed by the Occupational Health Services Act for all employees. The occupational health services are typically provided by enterprise-owned medical departments, by mutually owned health care centers, by private practitioners, or by municipal health care centers. The latter are required by law to provide all services as prescribed by the legislation to anyone who comes to the facility. This situation is prevalent in the countryside, where there are very few private caregiving centers. Declaring occupational accidents and disease cases is mandatory, and the Inspection districts examine all accidents to establish causes and consequences, and to initiate prosecution in case of criminal negligence. Labour Inspection Districts are also notified of the new occupational disease cases as they are declared to insurance companies. Insurance for occupational disease, accidents, and death is an obligation of the employer, although they can choose the insurance company. The medical confidentiality between the workers and their occupational health care providers is very strict. Official statistics are maintained by the state Statistics Finland organization, and they may be used, for example, for research purposes by scientific institutes like the Finnish Institute of Occupational Health. Construction industry accounts for 25% of all fatal accidents (120 cases per 1 million working hours), followed by mechanical, wood, metal, machinery, and pulp and paper industry (10% each of fatal accidents) with rates ranging from 100–160 cases per 1 million working hours. There are some 5,000 occupational disease cases per year (rate 22/10,000 employed). The major disease categories include repetitive strain injuries (1,300 cases), respiratory allergies (600 cases), occupational skin diseases (1,000 cases), and 900 cases of noise-caused hearing loss. In 1998, 589 cases of asbestos-related diseases were reported.     

Nanotechnologies,engineered nanomaterials and occupational health and safety – A review

The significance of engineered nanomaterials (ENM) and nanotechnologies grows rapidly. Nanotechnology applications may have a positive marked impact on many aspects of on human every day life, for example by providing means for the production of clean energy and pure drinking water. Hundreds of consumer nano-based products are already on the market. However, very little is known of the risks of ENM to occupational safety and health (OSH), even though workers are likely to be at extra risk, as compared with other potentially exposed groups of people, because the levels of exposure are usually higher at workplaces than in other environments. However, knowledge of the exposure to, or effects of, ENM on human health and safety in occupational environments is limited and does not allow reliable assessment of risks of ENM on workers’ health. Several issues related to ENM in the workplaces require marked attention. The most topical issues include: (1) improved understanding of ENM metrics associated with ENM toxicity; (2) development of monitoring devices for ENM exposure assessment; (3) understanding the changes of ENM structure and state of agglomeration at different concentrations in aerosols; (4) understanding translocation of ENM in the human body; (5) identifying the key health effects of ENM including pulmonary toxicity, genotoxicity, carcinogenic effects, and effects on circulation; (6) development of tiered approaches for testing of safety of ENM; and (7) utilizing these data for health risk assessment, with a special emphasis on occupational environment. Available data on several ENM – ability to enter the body and reach almost any organ, to cause pulmonary inflammation and fibrosis, and even to cause increased risk of mesotheliomas in animal models, call for immediate action. It is crucial to identify those ENM that may cause occupational health and safety risks from those ENM which are innocent, hence allowing prioritization of regulatory and preventive actions at workplaces at national, regional and global levels.     

The relationship of occupational injury and use of mental health care

Introduction: Symptoms of depression and anxiety are a common consequence of occupational injury regardless of its cause and type. Nevertheless, mental health care is rarely covered by workers’ compensation systems. The aim of this study was to assess the use of mental health care post-injury. Methods: We used a subsample of patient-care workers from the Boston Hospital Workers Health Study (BHWHS). We matched one injured worker with three uninjured workers during the period of 2012–2014 based on age and job title (nurse or patient-care associate) and looked at their mental health care use pre- and post-injury using medical claims data from the employer sponsored health plan. We used logistic regression analysis to assess the likelihood of mental health care use three and six months post-injury controlling for any pre-injury visits. Analyses were repeated separately by job title. Results: There were 556 injured workers between 2012 and 2014 that were matched with three uninjured workers at the time of injury (n = 1,649). Injured workers had a higher likelihood of seeking mental health care services than their uninjured counterparts during the six months after injury (OR = 1.646, 95% CI: 1.23–2.20), but not three months post-injury (OR = 0.825, 95% CI: 0.57–1.19). Patient-care associates had a higher likelihood to seek mental health care post-injury, than nurses (OR: 2.133 vs OR: 1.556) during the six months period. Conclusions: Injured workers have a higher likelihood to experience symptoms of depression and anxiety based on their use of mental health care post-injury and use is more predominant among patient-care associates; however, our sample has a small number of patient-care associates. Practical Applications: Treating depression and anxiety as part of the workers’ compensation system has the potential of preventing further physical ailment and improving the return to work process regardless of nature of injury.     

工作场所超细颗粒物暴露评估与风险评估研究进展

纳米技术产业的快速发展促使纳米材料需求量不断增长,纳米材料的规模化生产及使用,增加了暴露于超细颗粒物的职业人群数量,且工种复杂多样,尤其在自动化程度低、工人职业卫生防护意识薄弱的作业场所,对接触者有潜在的职业暴露风险.从现场暴露评估策略、检测方法、接触限值以及风险评估手段,综述针对超细颗粒物这一新型职业危害因素的研究进...     

燃煤发电职业危害暴露健康负担评价方法*

为评估煤电行业从业人员因遭受职业危害暴露引起的健康负担大小,根据工作暴露矩阵法对燃煤发电职业暴露程度进行估算,利用健康效应分析和伤残调整寿命年指标构建燃煤发电职业暴露健康负担评价体系,实现职业暴露健康负担的量化评价。将所构建的评价体系应用于3个燃煤电厂进行对比分析,结果表明:各类危害因素中,粉尘所致健康危害最大,人均健康负担约为8.861 a;各生产环节中,运输煤系统所致健康影响最大,约占整个生产过程的45.53%。     

Hepatitis B virus infection among health care workers in Public Teaching Hospitals in Khartoum State, Sudan

Background

Hepatitis B virus (HBV) infection is a global public health problem. It is estimated that there are more than 300 million HBV carriers in the world.

Aim

The study aimed to examine the sero-prevalence of hepatitis B virus (HBV) markers among health care workers (HCWs) in Public Teaching Hospitals in Khartoum State, in the year 2004.

Methods

The study is an observational, cross sectional, facility-based study. It was conducted on stratified two-stage cluster random sample of 843 subjects. The study followed non-parametric statistical methods, using Z-test for single proportion.

Results

Among the 843 subjects tested for all HBV markers (Anti-HBc, HBsAg, HBsAb, and HBeAg), the prevalence of Anti-HBc, HBsAg, HBsAb, and HBeAg was found to be 57% (CI 95%:53-60%), 6% (CI 95%:4.0-8.0%), 37% (CI 95%:34-40%) and 9% (CI 95%:7-11%) respectively. P < 0.05.

Conclusion

Seroprevalence of all HBV markers (P < 0.05) was found to be significantly high, while the rate of immunity against HBV infection was low among health care workers In Public Teaching Hospitals in Khartoum State, Sudan.     

对乡镇企业职工的职业安全卫生知识、态度、行为的调查

从对某市部分乡镇企业职工的职业安全卫生知识、态度、行为所进行的调查看,不同状况的人群对职业安全卫生知识、态度、习惯有显著性差异。为此,提示职业安全卫生监督管理部门及企业的有关职能部门在职工的职业安全卫生教育中,要加强对文化程度低、年轻、工龄较短的职工的教育,并采用形式多样化手段。另外,职业安全监督管理部门还要加强监督外资企业做好职工的职业安全卫生教育。从职工对职业安全卫生的态度及行为结果看,提出在进行职业安全卫生教育时,要有针对性。不仅要给职工配备劳保用品,更重要的是监督职工经常和正确地使用劳保用品,并养成良好的卫生习惯     

钢铁冶炼厂焦化生产中的呼吸防护

为提高钢铁冶炼厂焦化作业时的职业健康呼吸防护水平、降低焦化作业中致癌性因素对人体的危害,本文分析了焦化生产中危害呼吸系统的主要职业因素,并以国内外职业健康呼吸防护相关标准和规章制度为评估依据,提出了正确选用、使用和维护呼吸防护用品的方法。相关成果可为相关行业提供指导和借鉴。     

Comparative assessment of respiratory and other occupational health effects among elementary workers

Objective. This study was conducted to assess hazards faced by elementary workers. Methods. A questionnaire survey and a respiratory function test (spirometry) were carried out on 150 respondents. Results. Major hazards identified related to sharp objects, heavy weight lifting, thermally harsh conditions, working at height, whole body vibration, chemicals, pathogens, increased noise levels and confined space entry. Workers suffered from upper and lower respiratory disorder symptoms, digestive problems, optical and musculoskeletal issues, etc. Spirometric measurement showed obstructive lung disorders to be highest among construction workers (CW) (48%) followed by sanitation workers (SW) (32%) and solid waste pickers (SWP) (28%). Restrictive lung pattern was dominant among SW (56%) followed by SWP (46%) and CW (42%). The observed FEV₁/FVC in diseased SWP, SW and CW ranged from 51 to 96%, from 52 to 98% and from 31 to 99% respectively while observed mean FEV₁ was 2.15, 1.79 and 1.70 L, respectively. Conclusion. The study findings show that occupational exposure can significantly influence respiratory system impairment and contribute to other ailments among elementary workers. The study recommends use of appropriate protective equipment and regular medical examination for early recognition of any health risk so that timely interventions for effective management may be undertaken.     

Do fixed-term workers have a higher injury rate?

One of the most remarkable changes in the labour markets of industrialised countries has been the increase of fixed-term employment. Naturally, the ways in which this development impacts on the quality of working life has awoken increasing scientific discussion. The aim of this paper is to examine these connections from the perspective of occupational injury. The majority of research literature in this field has shown that fixed-term workers have a risk of occupational injury that is several times higher than permanent workers.The analysis presented here is based on three large independent statistical data sets. In the Work and Health Study 10.9% of fixed-term and 10.0% of permanent workers experienced occupational injury during the previous 12 months. In The Victim Survey of Finland 5.4% of fixed-term and 6.5% of permanent workers were injured at work. In The Quality of Working Life Survey 3% of fixed-term and 5% of permanent workers were involved in occupational injury. These three data sets showed unanimously that fixed-term workers did not have a higher occupational injury rate than permanent workers. The most important explanatory factor was that in Finland fixed-term contracts are concentrated in public services such as education and health care with a predominance of female workers. Still, the connection remained after adjusting the basic background variables of age, socio-economic status and industry.     

中国职业安全的现实问题

中国职业安全现实引起社会关注,特别是务工农民伤亡事故的数字背后,隐含着对职业安全的认识,职业人群的安全健康理念,职业安全健康的法规基础等深层次问题。笔者指出了现代职业安全存在的现实状况;提出需要关注的难点;强调人的安全健康是职业安全的实质;给出了职业安全与安全生产的差异,分析了务工农民的安全意识与安全文化冲突,呼吁职业安全需要法律保障,建立一体化的职业安全健康法律法规体系,以《宪法》为基础,以人为本,保护从业人员的安全健康。     

铅与噪声对蓄电池制造作业工人健康影响的联合作用

探讨铅与噪声对蓄电池制造作业工人的联合作用,为职业危害联合作用健康管理提供科学依据。依据蓄电池厂作业工人的职业史调查、环境检测和生物检测资料,将研究对象分为铅与噪声联合暴露组、单纯铅暴露组、正常组,分析比较3组作业工人的听力损伤、神经系统和消化系统症状、贫血结果。结果显示在4 000 Hz和6 000 Hz频率段,联合组听力异常率及听阈均值高于单纯铅暴露组和正常组(P0.05),与单纯铅暴露组和正常组比较,联合组的神经系统和消化系统症状率明显增多(P0.05)。表明铅和噪声联合作用可增加作业者的听觉系统、神经系统和消化系统症状患病,并提出相应管理对策。     

Respiratory Impairment in Cotton-Ginning Workers Exposed to Cotton Dust

Dust generated during the handling and processing of cotton causes ill health of ginning workers. The purpose of this study was to determine the prevalence of respiratory symptoms among cotton-ginning workers. This study involved 188 workers of 10 cotton-ginning factories. Forced vital capacity (FVC), peak expiratory flow rate (PEFR), and forced expiratory volume in 1 s (FEV1) declined significantly with increasing duration of exposure (p < .001) of the cotton-ginning workers. Results of a standard respirator medical evaluation questionnaire indicated that, depending on duration of exposure, 51%–71% of cotton-ginning workers suffered from chest tightness, 55%–62% experienced chest pain, while 33%–42% of the workers reported frequent cough. Blood tests of the workers showed higher values of erythrocyte sedimentation rate, eosinophils, and white blood cells when exposure was longer. Byssinosis symptoms were observed among the workers. We recommend regular periodical medical check-ups, compulsory use of personal protective equipment, and proper ventilation at the workplace.