ABSTRACT
Objective To study the applicability of two different occupational health risk assessment methods for noise positions in a beer manufacturing enterprise. Methods An occupational health investigation along with the detection of occupational hazard factors were carried out in the workplace of a beer manufacturing enterprise in Wuhan. Workers with 8-hour working day equivalent sound level (LEX,8 h) ≥ 80 dB (A) were selected as research subjects. The “Guidelines for Noise Occupational Disease Risk Management” method and occupational hazard risk index method were used to assess the risk of noise jobs in the beer manufacturing company. The assessment results of the two methods were compared. Results The noise exposure level of the enterprise was between 81.2 and 91.2dB(A). The guideline method predicted that the risk of high-frequency hearing loss and noise deafness for wine bottling workers and labelers on the bottling production line was high after 35 years exposure to noise. Washing，inspection and boxing on the bottling production line and bottling up on the canning production line were at medium risk, and others were at low risk. The evaluation results of the occupational hazard risk index method showed that the bottlers, bottling workers, wine inspectors, labelers and boxers on the bottling production line were at medium risk, and other positions were at low risk. Conclusion The occupational hazard risk index method is more comprehensive to consider all the factors of health risk, and the evaluation results are close to the “Guidelines for Noise Occupational Disease Risk Management” method. The guideline method can quantitatively predict the risk of high-frequency hearing loss and noise deafness, and the risk of hearing loss increases with the extension of years of noise exposure.
ABSTRACT
OBJECTIVE@#To evaluate the efficacy and safety of proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) for unstable intertrochanteric fractures using meta-analysis.@*METHODS@#The PubMed, Embase, Cocharane Central Register of Controlled Trials, Google Scholar, China Science and Technology Papers and Citation Database (CSTPCD) and China Journal Full-text Database (CNKI) were searched for published randomized controlled trials before January 1, 2019. Two researchers independently screened the literature in the light of the inclusion and exclusion criteria, evaluated the quality of the studies and extracted the data which were consisted of clinical efficacy indexes, such as incision length, operation time,intraoperative blood loss, weight-bearing time,fracture-healing time, Harris hip score and safety indicators like complications. Meta-analysis was performed with the Revman 5.3 software provided by Cochrane Community in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) standard.@*RESULTS@#Nine randomized controlled trials met the requirement with a total of 779 patients, of whom 383 were fixed with PFNA and 396 with DHS. Meta-analysis demonstrated that PFNA was associated with smaller surgical incision length [MD=-7.43, 95%CI (-9.31, -5.55), P<0.05], shorter operation time [MD=-22.76, 95%CI (-29.57, -11.95), P<0.05], less intraoperative blood loss [MD=-216.34, 95%CI (-275.18, - 157.49), P<0.05], earlier weight bearing after surgery [MD=-12.34, 95%CI (-17.71, -6.97), P<0.05], shorter fracture healing time [MD=-5.00, 95%CI (-7.73, -2.26), P<0.05], higher postoperative Harris hip score [MD=12.22, 95%CI (3.88, 20.55), P<0.05], higher rate of excellent Harris hip score [OR=3.56, 95%CI (1.44, 8.81), P<0.05] and lower incidence rate of postoperative complications [OR=0.48, 95%CI (0.33, 0.70), P<0.05], such as hip varus, wound infection, urinary tract infection, pulmonary infection, pressure sore, deep vein thrombosis, pulmonary embolism, heart failure and cerebral infraction when compared with DHS. No statistical difference was shown between the groups when it came to subgroup analysis by age. However, there was no significant difference (P>0.05) in the duration of hospitalization and the complications resulting in the occurrences of internal fixation loosening, such as femoral shaft fracture (during or post operation), internal fixation fracture, cut-out, displacement or retraction.@*CONCLUSION@#Current published evidence supports the superiority of PFNA to DHS for unstable intertrochanteric fractures in terms of clinical efficacy. The conclusion was limited because of the relatively low quality of evidence with low strength of confidence. Large scale and high-quality randomized controlled trials are required to validate the safety of PFNA and DHS for unstable intertrochanteric fractures.