[Application and comparison of three occupational health risk assessment methods in an automobile manufacturing industry].

Objective: Three occupational health risk assessment methods were used to assess the occupational health risk of noise exposed posts in an automobile manufacturing enterprise. According to the results, the selection of risk assessment methods and risk management of such occupational noise enterprises were provided. Methods: Form April to November 2021, The occupational health field survey was carried out in an automobile manufacturing industry in Tianjin. The occupational health MES risk assessment method, occupational health risk index risk assessment method and Australian occupational hazard risk assessment method were used to evaluate the occupational health risk of noise-exposed posts in this enterprise, and the evaluation results of different methods were analyzed and compared. Results: The average value of L(Aeq, 8 h) in the four workshops of automobile manufacturing industry was 82.95 dB (A) , and the noise detection exceeding rate was 22.41% (26/116) . The LAeq, 8h and exceeding rate noise of welding workshop were higher than those of other workshops (χ(2)=23.56, 32.94, P<0.01) . The three occupational health risk assessment methods have the same risk assessment results for the four major workshops. The assembly and painting workshops are level 4 risk (possible risk) , and the stamping and welding workshops are level 3 risk (significant risk) . Conclusion: Occupational noise has certain potential hazards to workers in automobile manufacturing enterprises. Therefore, in the future work, corresponding organizational management measures should be taken to improve the working environment and reduce the actual exposure level of workers in order to protect the health of occupational workers.

[Construction of Tianjin occupational disease prevention and control ability assessment system based on Delphi method].

Objective: To establish a systematic, scientific, reasonable, feasible and reliable evaluation system for occupational disease prevention and control capability, in order to provide reference for occupational disease prevention and control work in Tianjin City. Methods: In August 2022, literature review was conducted to propose indicators for the evaluation system. Two rounds of anonymous consultation with occupational health experts were conducted using the Delphi method to form expert opinions. According to the boundary value method and expert opinions, eliminate, screen, and modify the evaluation system indicators to ultimately determine the system indicators. Use Cronbach's alpha to test the reliability of the system indicators and form a Tianjin occupational disease prevention and control capability evaluation system. Results: It showed that the effective response rates of the two rounds of consultation conducted by experts in this study were 92.3% and 100.0%, respectively. The expert authority coefficients were 0.84 and 0.82, respectively. The Kendall coordination coefficient was tested for differences, and the differences were statistically significant (P<0.05). The Tianjin occupational disease prevention and control capability evaluation system includes 7 primary indicators, 17 secondary indicators, and 54 tertiary indicators. The Cronbach's alpha of the primary, second, third level indicators and all indicators were 0.91, 0.98, 0.98, 0.98 (>0.7) . Conclusion: The preliminary evaluation system for occupational disease prevention and control capacity in Tianjin City has been established, providing a reference basis for the investigation of occupational disease prevention and control capacity in Tianjin City.

[Evaluation effect of COMPERA 2.0 risk assessment model on prognosis of Chinese patients with pulmonary arterial hypertension].

Objectives: To clarify the evaluation effect of COMPERA 2.0 risk assessment model on prognosis of pulmonary arterial hypertension (PAH) in China. Methods: Patients with newly diagnosed PAH admitted in Fuwai hospital between April 2019 and March 2022 were enrolled retrospectively and divided in low, intermediate-low, intermediate-high and high strata by scores of COMPERA 2.0 risk assessment model. All the patients were followed up by clinic or telephone. The primary endpoint was defined as a composite of all-cause mortality, exacerbated heart failure and aggravated symptoms. Kaplan-Meier analysis and log-rank trend test were used to determine the risk of endpoints among the 4 groups. Multivariate Cox proportional hazards regression were used to analyze the association between COMPERA 2.0 scores and prognosis in patients with PAH. Results: A total of 951 patients with PAH were enrolled in this study. The age [M (Q1, Q3)] of the patients was 35 (28, 47) years, of which 706 cases (74.2%) were females. A total of 328 cases (34.5%) were assigned in low strata, 264 cases (27.8%) in intermediate-low strata, 193 cases (20.3%) in intermediate-high strata, and 166 cases (17.5%) in high strata. During the duration [M (Q1, Q3)] of follow-up after discharge of 1.8 (1.0, 2.8) years, the primary endpoint was occurred in 12.8% (42/328), 21.2% (56/264), 28.5% (55/193) and 42.8% (71/166) of low, intermediate-low, intermediate-high and high strata, respectively. The rates of primary endpoint were significantly increased with strata rising (P<0.001). Multivariate Cox proportional hazards regression showed that COMPERA 2.0 risk scores were associated with the primary endpoints in PAH patients (HR=1.801, 95%CI: 1.254-2.588, P=0.001) after adjusting confounders. Conclusion: COMPERA 2.0 risk assessment model is a simple and effective tool for evaluating the prognosis of newly diagnosed PAH patients in China.

[Current status and research progress of occupational health monitoring in welding fume operations].

Welding operations are widely present in the manufacturing production process, involving a large number of occupational groups, and are the key occupations where work injuries and occupational diseases occur in China. For different welding processes and welding materials, the content and focus of occupational health monitoring are different. At present, the item of occupational health examination in welding operation is in poor consistency with the on-site exposure of occupational hazard factors, and it is mainly concentrated in the stage of disease development, which can not reflect the early health damage caused by welding dust exposure in time. The emergence of biomarkers of welding dust can make up for this defect. Therefore, it is of great significance to describe the current situation of occupational health monitoring of welding dust and summarize the research progress of related biomarkers for the early prevention of diseases caused by welding dust and the practice of occupational health monitoring.

[Analysis of project funding in occupational Health and Epidemiology of National Natural Science Foundation of China from 2008 to 2019].

Objective: To analysis the projects funded by the National Natural Science Foundation of China in the fields of occupational health (code H2602) and occupational diseases (code H2402) from 2008 to 2019, to provide a reference for the project application of scientific researchers in the field of occupational diseases in China. Methods: In October 2021, the information of all National Natural Science Foundation projects in the field of occupational health and occupational diseases from 2008 to 2019 was collected through LetPub website. It mainly analyzes the types of funded projects, the types of supporting units, the occupational disease hazard factors of the funded projects, the types of occupational injuries and representative research directions. Results: From 2008 to 2019, the National Natural Science Foundation of China funded a total of 282 projects in the field of occupational health and occupational diseases, with a total funding of 113.902 million yuan. Among them, 138 projects (48.94%) were funded, 96 (34.04%) were funded by youth science funds, and 35 projects (12.41%) were funded by regional science funds. 31 (79.93%) funded projects relied on the type of institutions of higher learning, 126 (46.84%) occupational disease hazard factors were chemical factors, and 83 (30.86%) occupational damage types were lung injury and pulmonary fibrosis. Epigenetic regulation is the most important representative research direction of the funded projects. Conclusion: The National Natural Science Foundation of China (NSFC) project funding in the field of occupational health and occupational diseases in China has maintained a stable trend, but there are still problems such as incomplete funding system and late start of some research directions.

[Analysis on disease burden and trend of occupational lung disease in Tianjin from 2010 to 2019 based on disability adjusted life years].

Objective: To analyze the level and trend of occupational pneumoconiosis disease burden in Tianjin from 2010 to 2019, and to provide scientific basis for making prevention and control countermeasures and suggestions. Methods: In June 2021, the data of occupational pneumoconiosis cases in Tianjin from 2010 to 2019 were selected from Follow-up survey of occupational pneumoconiosis patients in Tianjin and occupational "Health Hazardous Surveillance Information System", the subsystem of China Disease Control and Prevention Information System. Disability-adjusted life year (DALY) , years of life lost (YLL) and years lost due to disability (YLD) were used to comprehensively measure the disease burden of occupational pneumoconiosis by region, year, disease type, industry, sex and age; Kruskal-wallis H test was used for univariate analysis of DALY loss in pneumdo-niosis occupational. Results: A total of 43089 person-years of DALY due to pneumoconiosis in Tianjin from 2010 to 2019, of which the YLD accounted for about 2/3 (28277 person-years) , the YLL accounted for about 1/3 (14812 person-years) , and the average DALY was 7.34 person-years. The industrial distribution of pneumoconiosis burden in Tianjin was mainly concentrated in the manufacturing industry accounting for 90.6% of the whole industry. The disease types were mainly concentrated in silicosis, foundry pneumoconiosis, asbestosis and cement pneumoconiosis accounting for 34.4%, 16.9%, 13.3% and 10.5%, and the age distribution was mainly concentrated in the 50~<85 years old age group, accouling for 83.6%. The median DALY of occupational pneumoconiosis patients with different pneumoconiosis stages, disability grades and years of service exposed to dust were statistically significant (P<0.05) . Conclusion: The disease burden of occupational pneumoconiosis in Tianjin was still serious. It is necessary to take targeted intervention measures for key industries and population.

[Health hazards and hearing loss risk assessment of workers exposed to noise in an automobile manufacturing enterprise].

Objective: To investigate the current situation of occupational exposure to noise among noise workers in an automobile manufacturing enterprise in Tianjin, understand the impact of noise on workers＇ nervous system and hearing, and assess the risk of hearing loss among noise workers. Methods: In May 2021, 3516 workers in an automobile manufacturing enterprise were investigated by using a self-made questionnaire＂Noise Workers Questionnaire＂ and cluster sampling method. The occupational noise hygiene survey and occupational hazards detection were carried out in their workplaces. They were divided into noise exposure group and non-noise exposure group according to whether they were exposed to noise or not. The general characteristics, hearing and nervous system symptoms of the two groups of workers were compared, and the risk of hearing loss was assessed. Results: There were 758 workers in the noise exposure group, aged (26±5) years old, with a working age of 3.0 (2.0, 6.0) years exposed to noise. 2758 workers in the non-noise exposure group, aged (25±6) years old, with a working age of 2.0 (1.0, 4.0) years. There were statistically significant differences in the distribution of workers＇education level, working age and memory loss between the two groups (χ(2)=37.98, 38.70, 5.20, P<0.05). The workers in the noise exposure group showed a decreasing trend of insomnia, dreaminess, sweating and fatigue with the increase of working age (χ(2trend)=6.16, 7.99, P<0.05). The risk classification of binaural high-frequency hearing loss for workers in all noise positions until the age of 50 and 60 was negligible, the risk of occupational noise deafness was low for workers in stamping and welding noise positions until the age of 60. Conclusion: The occupational noise exposed to automobile manufacturing workers may cause certain harm to their nervous and auditory systems. Noise protection measures should be taken to reduce the risk of hearing loss and occupational noise deafness.

Quantitative Collateral Assessment on CTP in the Prediction of Stroke Etiology.

BACKGROUND AND PURPOSE: Patients with stroke etiology of large-artery atherosclerosis were thought to have better collateral circulation compared with patients with other stroke etiologies. We aimed to investigate the association between stroke etiology and collateral circulation with a new quantitative collateral assessment method. MATERIALS AND METHODS: This retrospective study reviewed data from consecutive patients with proximal anterior artery occlusion who underwent CTP before reperfusion therapy. CBF maps were derived from CTP. A new indicator, maximum CBF of collateral vessels within the Sylvian fissure (cCBFmax), was applied to quantitatively assess the collateral status. The relationship between collateral status and stroke etiology was investigated. RESULTS: A total of 296 patients were finally analyzed. The median cCBFmax was significantly higher in patients with large-artery atherosclerosis than in those without it (92 [interquartile range, 65-123] mL/100 g/min versus 62 [interquartile range, 46-82] mL/100 g/min; P < .001). Multivariable analysis revealed that a higher cCBFmax score was independently associated with large-artery atherosclerosis etiology (OR, 1.010; 95% CI, 1.002-1.018; P = .017) after adjustment. The area under the curve, sensitivity, and specificity of the final model in predicting the etiology of large-artery atherosclerosis were 0.870, 89.7%, and 75.2%, respectively. CONCLUSIONS: Patients with large-artery atherosclerosis had a more adequate collateral perfusion supply with the new quantitative collateral assessment. The new quantitative collateral measurement might contribute to the prediction of stroke etiology in the acute clinical scenario for patients with acute ischemic stroke.

[Research progress on the human health risks assessment of radionuclides in water environment].

The quality of the water environment is one of the most important factors that can directly affect the health of human beings and other non-human species. The levels of the radionuclides in water environment are the key indicator while assessing the quality of water environment. Recently, with the development of the nuclear energy in China, the public people have paid a focus attention on the levels and the health risks of the radionuclides. This paper introduced the sources, the health effects, the health risk assessment methods and the current status of the health risk assessment study about the radionuclides, in order to provide basis for the health risk assessment of radionuclides in water environment and the protection of human health.

[Application of five methods in the occupational health risk assessment of workers exposed to welding fumes].

Objective: To assess the health risks of welding fume jobs with five occupational health risk assessment methods, and to compare the advantages, disadvantages and applicability of these methods in the health risk assessment of welding fume. Methods: The International Commission for Mining and Metals (ICMM) occupational health risk assessment method, MES method, the qualitative method and comprehensive index method in GBZ/T 298-2017 "Technical Guidelines for Occupational Health Risk Assessment of Chemical Hazardous Factors in the Workplace" were used to assess the risk of welding fume exposure positions in four manufacturing enterprises in Tianjin in March, 2020. The assessment results of different methods were standardized by risk ratio (RR) . Results: After the results were standardized, the results of enterprises 1, 2 and 4 were negligible risks, enterprise 3 was medium risk in the ICMM matrix method and MES method, and the results of ICMM quantitative method for each enterprise were negligible risk, low risk, extremely high risk and low risk, respectively. The results of the qualitative assessment of the guidelines for all companies were negligible risks, and the comprehensive index method were medium risks. Conclusion: The five models are all suitable for occupational health risk assessment of welding fumes, but they all have certain shortcomings. They should be combined with qualitative and semi-quantitative assessment results for comprehensive analysis.

[Research progress of occupational disease assessment and application on burden of disease].

Burden of disease (BOD) refers to the pressure on the entire social economy and health caused by disease, disability and premature death, and the resulting economic and social impacts. It includes epidemiological burden and economic burden. BOD is widely used in the analysis and research of various chronic diseases, infectious diseases and cancers. With the rapid development of economy and industrialization, the health effects of occupational diseases on workers and the resulting disease burden have become a major public health and social problem, which has caused widespread concern. However, in the field of occupational disease burden research, domestic and foreign scholars have little research on it, and lack of systematic research and framework construction. Therefore, this paper is intended to summarize the occupational disease assessment and applied research of BOD, in order to provide data support for occupational disease monitoring, health promotion and optimal allocation of health resources, and to provide theoretical basis and reference basis for the reform of occupational health work and the formulation of health policies.

[A cost-benefit analysis of occupational disease reporting in China].

Objective: To perform a cost-benefit analysis of the occupational disease reporting system in China, and to provide a basis for effective resource allocation. Methods: The data on the cost of occupational diseases were collected from China Health Statistics Yearbook 2013, the estimated benefit data were collected from published articles in China and foreign countries, and the probability data were collected from the occupational diseasereports published by health and family planning administrative departments. Adecision-making tree was used for the cost-benefit analysis. Results: The estimated cost of occupational disease reporting was about 102.47 million yuan/year, consisting of a cost of reporting in national medical institutions of 1.25 million yuan/year, a management cost of 30.35 million yuan/year, a management cost in local public health institutions of 69.80 million yuan/year, a management cost in national public health institutions of 370 thousand yuan/year, and a cost of construction and maintenance of reporting system of 700 thousand yuan/year. The results of the decision tree analysis showed that when an occupational disease monitoring system was established, the incremental input for occupational disease monitoring and prevention/control was 2.1 billion yuan/year, the output was 6.5 billion yuan/year, and the benefit of occupational disease reporting system was 4.4 billion yuan/year. Conclusion: The benefit of occupational disease reporting system depends on the cost-benefit of occupational disease prevention and control measures, and proper prevention and control measures are extremely important for improving the benefit of occupational disease reporting system.

A method for the non-invasive assessment of chest wall growth in pectus excavatum patients.

INTRODUCTION: Various scales and measurement methods including X-rays and computed tomography (CT) have been used to quantify the degree of deformity in pectus excavatum. This study describes a non-invasive method for recording the deviation of the anterior chest wall (ACW) in pectus excavatum (PE) patients. Data obtained using this non-invasive method were compared with CT data. MATERIALS AND METHODS: Twenty-one patients treated at our institutions between June 2008 and February 2009 were enrolled in this study. All patients underwent CT and thermal plastic strip measurement. A thermal plastic strip was positioned and taped to the supine patient's ACW at the skin level from the posterior axillary line, over the depressed sternum, to the contralateral posterior axillary line and used to create a casting of the ACW. RESULTS: The funnel index (FI) was defined as the width of the ACW divided by its height; the concave index (CI) was defined as the breadth of the depressed area of the funnel chest divided by its depth. Pearson's correlation coefficient was used to compare the FI and CI obtained with the thermal plastic strip method and with CT; measurements obtained with both methods were found to correlate well (FI: r (2)=0.965; CI: r (2)=0.947). CONCLUSIONS: The thermal plastic strip measurement method provides a two-dimensional record of the shape of the anterior chest wall. The measurement can be repeated, does not involve the patient being exposed to radiation, and offers a good longitudinal assessment of chest wall growth in PE patients.

Epidemiological and morbidity assessment of Schistosoma japonicum infection in a migrant fisherman community, the Dongting Lake region, China.

We assessed the epidemiology and morbidity related to Schistosoma japonicum infection by both parasitological (Kato-Katz method and miracidium hatching test) and ultrasound examination in a migrant fisherman community (n = 106) from the Dongting Lake region in China in 2001. A prevalence of 69.8% and a mean infection intensity of 66.5 eggs per gram (epg) were recorded for this group. Males had a higher level of infection (77%) and intensity (92.2 epg) compared with females (58% and 28.6 epg, respectively). Subjects aged 11-20 years had the highest prevalence of infection (91%) and the heaviest infection intensity (85.3 epg) among all age groups. Twenty-six percent of the subjects had not been treated previously for schistosomiasis. Parenchymal fibrosis (> or = stage II) detected by ultrasound and spleen enlargement (or splenectomy) occurred in 37% and 9% of subjects, respectively. Portal vein dilation was detected in 18% subjects, and 58% (11/19) of those patients with portal vein enlargement were shown to have parenchymal fibrosis (> or = stage II). These results indicate that S. japonicum infection and related morbidity in mobile fisherman is still unacceptably high despite the fact that China has implemented a Schistosomiasis Control Project financed by a World Bank Loan for a period of 8 years since 1992. Clearly, new approaches for schistosomiasis control, especially in communities like these mobile fishermen, should be explored.

[Evaluation of Schistosoma japonicum tegumental membrane antigen (SjMAg) in immunodiagnosis and efficacy assessment].

OBJECTIVE: To evaluate the specificity and sensitivity of SjMAg in detecting specific antibodies in sera of patients with schistosomiasis japonica and in assessing therapeutic efficacy. METHODS: SjMAg-ELISA was used to determine the specific IgG and IgG4 in sera of patients with schistosomiasis japonica at different time points after chemotherapy. RESULTS: SjMAg-ELISA was as sensitive and specific as SEA-ELISA. The negative conversion rate of IgG detected by SjMAg-ELISA 12 months after treatment was 80.0%, being significantly higher than 43.3% by SEA-ELISA. The negative conversion rate of IgG4 detected by SjMAg-ELISA 12 months after treatment was 93.3%, being significantly higher than 60.0% by SEA-ELISA. The negative conversion rates of IgG and IgG4 2 yr after treatment were 92.9% and 97.6% respectively. CONCLUSION: SjMAg-ELISA is comparable to SEA-ELISA in diagnosing schistosomiasis japonica and is more effective in assessing therapeutic efficacy.

Testing homogeneity of intra-run variance parameters in immunoassay.

A common assumption in the analysis of immunoassay data is a similar pattern of within-run variation across runs of the assays. One makes this assumption without formal investigation of its validity, despite the widely acknowledged fact that accurate understanding of intra-run variation is critical to reliable calibration inference. We propose a simple procedure for a formal test of the assumption of the homogeneity of parameters that characterize intra-run variation based on representation of standard curve data from multiple assay runs by a non-linear mixed effects model. We examine the performance of the procedure and investigate the robustness of calibration inference to incorrect assumptions about the pattern of intra-run variation.

Calibration inference based on multiple runs of an immunoassay.

Several authors have documented the poor performance of usual large-sample, individual calibration confidence intervals based on a single run of an immunoassay. Inaccuracy of these intervals may be attributed to the paucity of information on model parameters available in a single run. Methods for combining information from multiple runs to estimate assay response variance parameters and to refine characterization of the standard curve for the current run via empirical Bayes techniques have been proposed. We investigate formally the utility of these techniques for improving the quality of routine individual calibration inference.

Towards patient collaboration in cognitive assessment: Specificity, sensitivity, and incremental validity of self-report.

The present work addressed the specificity and sensitivity of patient-reported cognitive ability using both cross-sectional and longitudinal data, and the incremental validity of patient self-report in addition to knowledge gained through neuropsychological tests. We examined a sample of individuals with multiple sclerosis (N=130) as a model of chronic illness where neuropsychological deficits are relatively common. Results revealed that 64% of the sample reported noticing some problems with memory or confusion. Very high levels of reported problems were not consistent with objective testing, whereas moderate levels of noticing problems were congruent with test results. This pattern suggests a curvilinear relationship between self-reported and objective assessment. The moderate reporters seem to be attending to subtle increases in deficits over time. Results also supported the incremental validity of combining subjective and objective indices, but only when the high reporters were excluded. We conclude that patients can provide important complementary data which may promote preventive care.