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The right of occupational disease diagnosis is a worker's right to occupational health protection, and a procedural right to protect substantive rights. Its contents include the submission of occupational disease diagnosis, the application for occupational disease diagnosis and appraisal, as well as the cooperative obligation of the parties. The right of occupational disease diagnosis and appraisal is the embodiment and extension of the right of occupational disease diagnosis. For workers, the right of occupational disease diagnosis is private, and waiving the diagnosis of occupational diseases is a personal right. For employers, there is no legal right to request initial occupational disease diagnosis, but there is a right to apply for occupational disease diagnosis appraisal and to request re-diagnosis of occupational diseases. The cooperative obligation in occupational disease diagnosis is to guarantee the initiation and smooth progression of the right to occupational disease diagnosis. After workers request occupational disease diagnosis, if they unreasonably refuse to cooperate in health examinations or medical examinations during the diagnosis process, it can be considered as waiving the right to occupational disease diagnosis. If the employers apply for appraisal of occupational disease diagnosis without paying the appraisal fee, it can be handled as waiving their rights or withdrawing their appraisal applications. When workers apply for occupational disease diagnosis or appraisal of occupational disease diagnosis, but the employer refuses to pay the corresponding fee, it does not affect the progress of occupational disease diagnosis and appraisal work. In this case, the employer should bear the corresponding administrative responsibilities according to law.
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Background According to the Classification and Catalogue of Occupational Diseases, brucellosis is one of the notifiable occupational infectious diseases, which occurs from time to time in the occupational population. Objective To compare the work-related injury appraisal process and results of 13 cases of brucellosis at both provincial and municipal levels, analyze and summarize the bias in the practical work of labor capacity identification for occupational diseases such as brucellosis by appraisal management departments and experts, and propose suggestions for optimizing appraisal work. Methods A comparative study was conducted on the objective examination results and labor capacity appraisal conclusions based on the occupational contact history, clinical diagnosis, occupational disease diagnosis staging, and labor capacity appraisal of 13 patients with brucellosis. The reasons for the inconsistency between the initial appraisal conclusion by institutions at the municipal level and the final appraisal conclusion by institutions at the provincial level were compared and analyzed. Results All of the 13 patients with brucellosis applied for municipal-level labor capacity identification after being identified as work-related injuries, 11 of which did not receive a disability level, and 2 were rated as level 10 disability. Four of those who did not receive the disability rate applied for provincial-level labor capacity identification. As a result, 2 cases were maintained original appraisal conclusions, while the other 2 changed the conclusions to level 9 disability and level 10 disability respectively. It was the first time in Shijiangzhuang municipal-level primary labor capacity appraisal and Hebei provincial-level labor capacity re-appraisal that the work-related injury caused by occupational brucellosis was rated as level 9 disability or level 10 disability. Hence, the lessons learned from this comparative analysis are that the degree of target organ damage and (or) organ dysfunction are the direct basis for work-related injury appraisal; an objective and scientific labor capacity identification for occupational brucellosis should base on the each case of disability evaluation, identify the relevant target organ damage and the degree of dysfunction, and rate the disability level after a comprehensive appraisal. Conclusion This analysis would be a guidance to the identification of labor capacity for occupational brucellosis in Hebei Province and the whole country. There is a hysteresis issue in the occupational disease provisions in the national standard GB/T 16180—2014 Standard for identify work ability—Gradation of disability caused by work-related injuries and occupatiaonal diseases. In current situation, appraisal experts should not only search for clauses that directly correspond to the occupational diseases and injuries, but also target conditions not covered in the clauses and conduct assessment based on the characteristics of occupational diseases, with scientific, accurate, and flexible application of the clauses in the standard and appendix, so as to make fair, just, and professional appraisal conclusions.
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Objective To explore the application effect of quality control circle in the quality management improvement of the occupational disease diagnostic and code.Methods To established across departmental team of medical record QCC,we Select 132 cases of the occupational disease departmentin specialized Hospital from May 1,2022 to June31,2022,Analyze the reasons of inaccurate that main diagnosisselection and code mapping.After formulating a series of improvement measures,we Se-lect 71 cases of occupational disease department from November 1,2022 to December 31,2022.To compared effect that before and after the implementation of QCC.Results After6 months of improvement,The utilization rate of main diagnosis mapping Z-code was decreased from 36.3%to 12.7%,goal achievement rate of 106.3%,improvement rate of 65.0%.Enrollment rate of major diagnostic was increased from 53.0%to 86.3%,goal achievement rate of 116.4%,Improvement rate of 62.8%.Conclu-sion We have changed the quality control management mode of diagnosis and coding by the QCC,implement targeted feedback,supervision,and training,establish a reward and punishment mechanism that matches indicators to improved accuracy of enroll-ment.Upgrading the quality management level of medical records and medical safety at the same time.Should continue to pro-mote theimplementation.
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In order to accurately master and understand the national occupational health standard Diagnosis for Occupational Radiation Thyroid Disease(GBZ 101-2020), the significance of the publication of this standard, the relevant background, the basic principles of the revision, the main basis for technical content revision, and the application of the standard are described. To provide guidance for t the physcians for occupational disease diagnosiss to understand the diagnostic principles, make correct diagnosis and avoid confusion in using the standard, so as to better protect the occupational health rights of radiation workers.
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Objective@#To investigate the quality of life among patients with occupational pneumoconiosis in Jinhua City, Zhejiang Province, so as to provide insights into improving the quality of life among patients with occupational pneumoconiosis.@*Methods@#Patients with occupational pneumoconiosis in Jinhua City from 2009 to 2021 were retrieved from the National Occupational Disease and Health Risk Factors Monitoring Information System. Participants' demographics, diagnosis of pneumoconiosis, stage of pneumoconiosis, pulmonary function and medical expense were collected through questionnaire surveys, and the quality of life was measured using a Chinese version of the Short-Form Health Survey (SF-36). The quality of life was descriptively analyzed among patients with occupational pneumoconiosis by disease stage, pulmonary function, expense for disease diagnosis and treatment and educational level. @*Results@#A total of 244 patients with occupational pneumoconiosis were enrolled, including 225 men (92.21%). The participants had a mean age of (75.20±9.42) years, and mean duration from dust contact to pneumoconiosis onset of (13.11±9.89) years. The scores for physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health were (64.03±31.22), (45.14±44.22), (56.34±26.60), (40.80±19.80), (59.14±17.35), (68.41±19.67), (47.03±44.08) and (61.15±17.06) points among patients with occupational pneumoconiosis, which were all lower than the national constant (P<0.05). Lower scores were measured for physical functioning [(31.17±23.40) points], bodily pain [(45.21±19.50) points] and vitality [(47.00±20.70) points] among patients with stage Ⅲ occupational pneumoconiosis, for physical functioning [(32.27±24.24) points], role-physical [(12.88±30.70) points], bodily pain [(37.44±20.43) points], general health [(14.76±17.17) points], vitality [(38.79±19.33) points], social functioning [(53.33±17.08) points], role-emotional [(9.09±26.71) points], and mental health [(53.21±17.25) points] among occupational pneumoconiosis patients with severe pulmonary function damages, and for physical functioning [(30.97±27.40) points], bodily pain [(37.77±24.34) points], general health [(19.10±18.62) points], vitality [(38.39±23.78) points], social functioning [(55.89±21.00) points] and mental health [(55.35±20.35) points] among occupational pneumoconiosis patients that had personal payments for pneumoconiosis diagnosis and treatment expenses exceeding 30% of annual household incomes, while higher scores were measured for physical functioning [(66.36±17.33) points] and role-physical [(59.09±45.10) points] among occupational pneumoconiosis patients with an educational level of high school and above (all P<0.05). @*Conclusions @#The quality of life was low among occupational pneumoconiosis patients in Jinhua City from 2009 to 2021. Stage of pneumoconiosis, pulmonary function, medical expenses and educational level were identified as factors affecting the quality of life among occupational pneumoconiosis patients in Jinhua City.
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The National Disease Control and Prevention Bureau and the National Health Commission jointly issued an announcement on Notice on Carrying out Pilot Work of Occupational Health Classification Supervision and Law Enforcement, which presented a method of comprehensive risk assessment method of occupational disease hazards of employers. This method embraces relevant factors at full scale and is simple in operation, but its applicability and accuracy of assessment results need further practical study. Based on the steps of occupational health risk assessment and proven occupational health risk assessment methods available at home and abroad, this paper proposed improvements and discussed the comprehensive risk assessment method of occupational disease hazards of employers, so as to provide a technical basis to implement the occupational disease hazard classification management of employers for relevant government supervision departments.
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Objective@# To investigate the disease burden of occupational pneumoconiosis from 2009 to 2021 in Jinhua City, Zhejiang Province, so as to provide insights into formulating occupational pneumoconiosis prevention and control measures.@*Methods@#Data on occupational pneumoconiosis in Jinhua City from 2009 to 2021 were collected through Occupational Disease and Health Hazard Monitoring Information System including demographic characteristics, disability level, age, pneumoconiosis type and stage, and analyzed years live dwith disability (YLD), years of life lost (YLL) and disability adjusted life years (DALY) by different genders, pneumoconiosis stages, pneumoconiosis types, ages and disability levels. @*Results@#A total of 244 occupational pneumoconiosis cases were diagnosed in Jinhua City from 2009 to 2021, of which 225 cases were male, accounting for 92.21%. The median age of onset was 44.50 (interquartile range, 23.00) years. There were 229 deaths, with a median age of 78.00 (interquartile range, 13.00) years. The DALY was 3 791.88 person-years, YLD was 2 428.21 person-years (64.04%) and YLL was 1 363.67 person-years (35.96%). The YLD was 3 647.8 person-years in men, which was higher than 144.08 person-years in women (P<0.05). The YLD of asbestosis cases was lower than that of silicosis, coal workers' pneumoconiosis and other pneumoconiosis (P<0.05). The YLL was not statistically significant in the stage and type of occupational pneumoconiosis (P>0.05). The YLD was higher among cases at ages of less than 40 years, and lower among cases at ages of 60 to 69 years and 70 years and over (P<0.05); the YLL was lower among cases at ages of 70 years and over (P<0.05). The cases with second/third level of disability had the highest YLD, followed by the cases with fourth/fifth level of disability, and the cases with sixth/seventh level of disability had the lowest YLD (P<0.05). @*Conclusions@#The disease burden of occupational pneumoconiosis in Jinhua City from 2009 to 2021 is mainly induced by disability, and the disease burden caused by silicosis is the highest. With the progress of pneumoconiosis stages and disability levels, the life loss continues to increase.
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Unclear labor relationship is the most common challenging issue in occupational disease diagnosis. At present, there are three main errors in the understanding regarding labor relationship in the process of occupational disease diagnosis. Firstly, labor relationship does not need to be considered in occupational disease diagnosis. Secondly, labor relationship must exist in order to initiate the occupational disease diagnosis procedure. Lastly, there is an overreach in handling labor relationship issues beyond one's authority. Labor relationship is the basic and antecedent problem which cannot be avoided in occupational diseases diagnosis. While officially, labor relationship issue should be considered in occupational disease diagnosis, they are not a necessary condition. The occupational diseases diagnosis requires actual labor and employment relations. If the workers with actual labor-relation are suspected to have health injuries caused by occupational hazards in the workplace, they are eligible for occupational diseases diagnosis. But it is not the responsibility of health department to judge the labor relationship. When a dispute arises between a worker and an employer regarding labor relationship, the resolution of the relevant dispute shall be submitted to the human resources and social services department or the labor and personnel arbitration committee, or submitted to the court for adjudication according to law. In the process of occupational disease diagnosis, the two reasonable disposal procedures for verifying actual labor and employment relationship involve workers submitting evidence of their labor relationship with the employer, and the employer's verification. If the employer disputes the labor relationship as presented by the worker, the occupational disease diagnosis institution should inform the worker to apply for labor dispute arbitration. However, it is important to note that arbitration or mediation documents from the court cannot be used as evidence in occupational disease diagnosis.
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@#Introduction: Dust is one of the chemical substances that cause occupational disease, especially among stone crafters. Its deposition for a long period can lead to various health problems, hence, there is a need for early detection. Therefore, this study aims to assess the occurrence of lung function disorder in headstone and stone mortar crafters. Methods: A cross-sectional design was used and the sample population consists of all headstone and stone mortar crafters in Allakuang Village, Sidrap Regency, Indonesia. They were selected using a purposive sampling method, and 33 out of 148 people met the criteria. Subsequently, their lung function was measured once using spirometry as well as FVC and FEV1 parameters. The data obtained were then analyzed using Chi-Square. Results: 18 of 33 respondents with lung function disorders. They had a long tenure, a normal working time, bad exercise habits, as well as a normal and overweight nutritional status based on their BMI category. The statistical test results showed that tenure, working time, and exercise habits had an effect on the disease condition with p=0.000. Meanwhile, other factors, such as age and nutritional status had no effect with p-values of 0.981 and 0.14, respectively. Conclusion: Based on the results, the majority of headstone and stone mortar crafters have lung function disorders, and the influential factors include tenure, working time, and exercise habits.
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The surveillance of occupational disease has entered a new stage ofdevelopment, with the implementation of the national health informatization project. To improve the efficiency and quality of occupational disease monitoring information reporting in this paper, the system architecture and related management regulations, as long as the major changes and achievement of "surveillance system of occupational disease and health hazards information" under the framework of National Health Insurance Informatization Project were elaborated. The deficiencies existing in the system were analyzed, and expectation for the construction of the occupational disease surveillance system was addressed.
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Humans , Occupational Diseases , Occupational HealthABSTRACT
To provide in-depth information and guidance on ergonomics, the International Labour Organization (ILO) had issued a series of conventions, recommendations, and resolutions on human factors/ergonomics (HFE) and had published HFE guides and toolkits. In 2021, the ILO and the International Ergonomics Association released an international guideline on HFE entitled Principles and Guidelines for Human Factors/Ergonomics (HFE) Design and Management of Work Systems (hereinafter referred to as the HEF Guidelines), aiming to improve the occupational safety, health, and the well-being of workers from the perspective of work system sustainability. There are currently 112 national health standards in China related to HFE, of which 79 (accounting for 71%) are equivalent to relevant standards from the International Organization for Standardization. Most of the recommended standards do not meet the applicability requirements of HFE for the Chinese workforce, as they are different from the national occupational health standard system. At present, China's HFE capability cannot meet the needs of the workforce, and there is still a gap between occupational diseases related to HFE included in the Occupational Disease List of China and those compared to the ILO. In the future, China needs to pay attention to the application of the HEF Guidelines, further improve the technical services for occupational health, include diseases caused by poor ergonomics in the national occupational disease list, strengthen the HFE standard system in the national occupational health standard system, actively promote the application of action-oriented HFE tools, enhance “human-machine coordination” and “person-job matching”, and focus on physical and cognitive HFE design to promote equality in workplace and reduce the occurrence of occupational and work-related diseases.
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Objective To analyze the diagnosis cases of occupational benzene poisoning in gas station industry, and to explore the application of GC-MS technology in occupational disease diagnosis. Methods The epidemiological method was used to describe and analyze the occupational disease diagnosis of 15 gas station workers , and qualitative screening of occupational hazard factors was performed by GC-MS. Results All the 15 workers had more than one year's occupation history of oil refueling and unloading. The clinical manifestations were consistent with the characteristics of chronic benzene poisoning in diagnosis of occupational benzene poisoning. However, due to lack of evidence of occupational exposure to benzene and incomplete diagnostic data, occupational chronic benzene poisoning was not diagnosed. GC-MS technology was used to screen the occupational hazard factors in the gas station workplace, and benzene, n-pentane, n-hexane and so on were found. Conclusion GC-MS is recommended for qualitative screening of organic solvents such as benzene when diagnosing occupational diseases for gas station workers , so as to accurately identify occupational hazard factors in workplaces and provide reliable basis for diagnosis of occupational diseases.
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Objective To analyze the epidemiological characteristics of occupational diseases caused by physical factors in Guangdong Province from 2013 to 2022, and to evaluate the key risk points of its incidence. Methods The data of newly diagnosed and suspected occupational diseases caused by physical factors in Guangdong Province from 2013 to 2022 were collected from the Occupational Diseases and Hazards Monitoring Information System under China Disease Prevention and Control Information System, and were analyzed retrospectively. The key risk points of occupational diseases caused by physical factors were evaluated. Results A total of 661 cases of occupational diseases caused by physical factors were reported in Guangdong Province from 2013 to 2022, showing an overall increasing trend, with an average annual growth rate of 29.6%. The major occupational diseases caused by physical factors were occupational hand-arm vibration disease and occupational heat stroke, accounting for 59.5% and 39.6%, respectively. The nine prefecture-level cities of Pearl River Delta region accounted for 98.5% of the new cases. The cases were distributed mainly in the manufacturing industry (77.0% of the cases). A total of 294 enterprises were involved in the analysis of newly diagnosed occupational diseases caused by physical factors. Occupational hand-arm vibration cases appeared to be significantly aggregated in specific enterprises, and other disease cases were mostly sporadic. The types of enterprise registration were mainly Hong Kong-, Macao-, and Taiwan-invested enterprises and domestic-funded enterprises, accounting for 53.1% and 41.4%, respectively. In terms of enterprise size, large-scale and small-scale enterprises accounted for 56.5% and 21.4% of cases, respectively. A total of 27.4% of workers with occupational diseases caused by physical factors were identified as suspected occupational diseases before be diagnosed as occupational diseases, all of which were hand vibration disease and heat stroke In the future, attention should be paid to the risks of mass events of occupational hand-arm vibration disease, outbreaks of occupational heat stroke, and missed diagnosis of suspected occupational hand-arm vibration disease. Conclusion Among all occupational diseases caused by physical factors in Guangdong Province, attention should be paid on occupational hand-arm vibration disease and occupational heat stroke. Occupational hand-arm vibration disease has a high risk of group morbidity. Construction workers and sanitation workers have a high potential risk of occupational heat stroke.
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Objective@#To investigate the epidemiological characteristics of suspected cases with occupational diseases and analyze the quality of occupational diseases report in Huzhou City from 2016 to 2020, so as to provide insights into supervision and early warning of occupational diseases.@*Methods@#The epidemiological data pertaining to suspected cases with occupational diseases reported in Huzhou City from 2016 to 2020 were retrieved from the Occupational Disease and Health Risk Factors Monitoring Information System of China Disease Prevention and Control Information System, including gender, age, type of job, industry category, enterprise size and diagnosis. The percentages of identification, diagnosis and definitive diagnosis were calculated, and the distribution and diagnosis of suspected cases with occupational diseases were descriptively analyzed among different regions, industry categories and enterprise sizes.@*Results@#A total of 264 398 people underwent occupational health examinations in Huzhou City from 2016 to 2020, and 322 suspected cases with occupational diseases were detected (12.18/104), including 179 cases with suspected pneumoconiosis (55.59%), 78 cases with suspected occupational ear, nose, throat and oral diseases (24.22%), 54 cases with suspected occupational poisoning (16.77%), 6 cases with suspected occupational skin diseases (1.86%), 3 cases with suspected occupational diseases caused by physical factors (0.93%) and 2 cases with other suspected respiratory diseases (0.62%). The 322 cases with suspected occupational diseases included 290 men (90.06%) and 32 women (9.94%), and had a mean age of (53.28±9.20) years. A total of 207 cases underwent occupational diseases diagnosis (64.29%), and 155 cases were definitively diagnosed with occupational diseases (74.88%). Among different counties (districts) in Huzhou City, the highest number of suspected cases with occupational diseases was reported in Changxing County (101 cases, 31.37%), with a diagnostic rate of 88.12%, and among all enterprises, the highest number of suspected cases with occupational diseases was reported in small enterprises (220 cases, 68.32%), with a diagnostic rate of 68.64%, while among all industry categories, the highest number of suspected cases with occupational diseases was reported in manufacture industry (228 cases, 70.81%), with a diagnostic rate of 56.14%. In addition, there was no suspected case with occupational diseases detected in agriculture, forestry, animal husbandry, fishery, wholesale/retail trade industry, or public administration, social security or social organizations.@*Conclusion@#Pneumoconiosis was the predominant type of suspected occupational diseases in Huzhou City from 2016 to 2020, and a low diagnostic rate was found. Improved supervision of occupational diseases control is strongly recommended among small enterprises to standardize the reporting system of suspected occupational diseases.
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Objective: To analyze the pattern and characteristics of occupational diseases in Weihai City from 2009 to 2020, and to provide scientific basis for the formulation of occupational disease prevention. Methods: In February 2021, retrospective analysis was performed on the cases of occupational diseases diagnosed from 2009 to 2020 in Weihai City. The relevant information and data were collected to analyze the types of occupational diseases, onset age, working age, diagnosis time, industry distribution, economic type and enterprise size distribution. Results: From 2009 to 2020, a total of 453 cases of new occupational diseases were reported in Weihai City. There were 431 males (95.14%) and 22 females (4.86%) . The average onset age was (49.16±8.51) years, and the average working age was (17.89±9.30) years. The incidence of pneumoconiosis and other respiratory diseases (322 cases, 71.08%) , occupational otolaryngology and oral diseases (71 cases, 15.67%) and occupational chemical poisoning (36 cases, 7.95%) were the top 3 cases, of which 313 cases were pneumoconiosis and 69 cases were noise deafness. The cases were mainly concentrated in the 40-59 years age group (357 cases, 78.81%) and the 10-19 years working age group (175 cases, 38.63%) . There were significant differences in the incidence of occupational diseases in different ages and different working ages (χ(2)=97.64, 80.74, P<0.001) . The new cases were mainly in mining industry (134 cases, 29.58%) , shipbuilding or maintenance industry (97 cases, 21.41%) , and private enterprises (350 cases, 77.26%) . Conclusion: Pneumoconiosis and noise deafness are the main emerging occupational diseases in Weihai City. Occupational disease prevention and control in private enterprises such as mining and shipbuilding or maintenance industry should be strengthened.
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Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , China/epidemiology , Incidence , Industry , Occupational Diseases/epidemiology , Pneumoconiosis/epidemiology , Retrospective StudiesABSTRACT
Objective: To understand the diagnosis of suspected occupational diseases reported in Guangzhou from 2014 to 2019, so as to provide theoretical basis and technical support for the supervision of suspected occupational disease reports. Methods: By cluster sampling, the suspected occupational disease report card, occupational disease report card and pneumoconiosis report card reported by Guangzhou from January 1, 2014 to December 31, 2019 in the occupational disease and occupational health information monitoring system were collected for matching analysis to understand the diagnosis of suspected occupational disease patients. Results: From 2014 to 2019, a total of 1426 suspected occupational cases in 7 categories and 32 species were reported in Guangzhou. The average number of reported cases per year was about 240. The main diseases of suspected occupational diseases were suspected occupational noise deafness (68.44%, 976/1426) , suspected occupational chronic benzene poisoning (16.48%, 235/1426) , suspected occupational other pneumoconiosis (4.84%, 69/1426) , suspected occupational silicosis (3.23%, 46/1426) and suspected occupational welder pneumoconiosis (1.82%, 26/1426) . The diagnostic rate required to enter the occupational disease diagnostic program is 36.61% (522/1426) , and the diagnostic rate is 59.20% (309/522) . In 2019, the diagnosis rate of suspected occupational diseases was the lowest (23.92%, 61/255) , Huadu District was the lowest (8.33%, 9/108) , suspected occupational pneumoconiosis was the lowest (28.03%, 44/157) , the diagnosis rate of suspected occupational diseases reported by the Centers for Disease control and prevention was the lowest (17.43%, 19/109) , and the diagnosis rate of suspected occupational diseases reported by outpatient treatment was the lowest (22.22%, 2/9) . The suspected occupational diseases reported by institutions outside Guangzhou did not enter the occupational disease diagnosis procedure. Suspected occupational skin diseases, suspected occupational diseases caused by physical factors and suspected occupational tumors were diagnosed, and the diagnosis rate of occupational disease prevention and control institutions was the highest (94.87%, 37/39) . Conclusion: The main types of suspected occupational diseases reported during these six years are noise deafness, chronic benzene poisoning and pneumoconiosis. The overall diagnosis rate and diagnosis rate of suspected occupational diseases are not high. It is suggested to improve the network direct reporting system of suspected occupational diseases and strengthen the follow-up management and supervision of suspected occupational diseases.
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Humans , China/epidemiology , Noise, Occupational , Occupational Diseases/epidemiology , Physical Examination , Pneumoconiosis/epidemiology , SilicosisABSTRACT
Objective: To investigate the detection of suspected occupational diseases and occupational contraindications for benzene workers in Tianjin. Methods: In June 2020, the occupational health inspection data of 16113 benzene workers in 514 enterprises with benzene hazards in 16 municipal districts in Tianjin from January to December 2019 were included in the analysis. Enterprise information included the employer's region, economic type, industry classification and enterprise scale. Occupational health inspection data for benzene workers during their on-the-job period included routine inspection indicators and benzene special inspection indicators. Multivariate unconditional logistic regression was used to analyze the relationship between personal general information, occupational history, enterprise information and suspected benzene poisoning and occupational contraindications of benzene workers. Results: There were 16073 benzene workers in the normal group and 24 in the suspected benzene poisoning group. The detection rate of suspected benzene poisoning in females was higher than that in males (χ(2)=8.26, P=0.004) . There was no significant difference in the detection rates of suspected benzene poisoning among different dimensions such as age, length of service, occupational health inspection institution location, employer location, industry classification, economic type, and enterprise scale (P>0.05) . There were 16073 benzene workers in the normal group and 16 in the benzene contraindication group. The detection rate of benzene contraindications for workers in suburban areas where occupational health inspection institutions were located was higher than that in urban areas (χ(2)=9.71, P=0.002) , and there was no significant difference in the detection rates of contraindications for benzene in other dimensions (P>0.05) . Multivariate logistic regression analysis showed that female benzene workers were more likely to detect suspected benzene poisoning (OR=3.53, 95%CI: 1.57-7.94, P=0.002) ; benzene workers who received physical examination in suburban occupational health inspection institutions (OR=5.81, 95%CI: 1.94-17.42, P=0.002) , the employer's area was in the suburbs (OR=9.68, 95%CI: 1.23-76.07, P=0.031) , and female workers (OR=3.07, 95%CI: 1.13-8.37, P=0.028) , it was easier to detect occupational contraindications. Conclusion: Female benzene workers with employers located in the suburbs have a higher risk of detecting occupational contraindications, and women are more likely to detect suspected benzene poisoning. The management of benzene operations in the production environment of enterprises in the suburbs of Tianjin and the occupational health monitoring of female workers should be strengthened.
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Female , Humans , Male , Benzene/analysis , Industry , Occupational Diseases/epidemiology , Occupational Exposure/analysis , Occupational HealthABSTRACT
Objective: To understand the survival status and its influencing factors of occupational pneumoconiosis patients in Shizuishan City, and to analyze the disease burden of occupational pneumoconiosis and its trend, so as to provide scientific basis for formulating comprehensive prevention and treatment measures of occupational pneumoconiosis. Methods: A retrospective survey was conducted during July to December 2020 to explore the survival status of occupational pneumoconiosis patients who had been reported from 1963 to 2020 in Shizuishan City. The Kaplan-Meier method and Life-table method were used for survival analysis, and Cox proportional hazards regression model was used to analyze the influencing factors of survival time. The disability adjusted life years (DALY) was applied to analyze the disease burden of occupational pneumoconiosis and its temporal trend. Results: From 1963 to 2020, a total of 3263 cases of occupational pneumoconiosis were reported in Shizuishan City, of which 1467 died, so that the fatality rate was 44.96%. The median survival time was 26.71 years, average age of death was (70.55±10.92) years old. There were significant differences in the survival rates of occupational pneumoconiosis patients among different types, diagnosis age, exposure time, industry, initial diagnosis stage and whether upgraded (P<0.05) . As the survival time increased, the survival rate of patients decreased gradually. When the survival time was ≥50 years, the cumulative survival rate of patients was 4.20%. Cox regression analysis suggested that the type of pneumoconiosis, industry, diagnosis age, exposure time, initial diagnosis stage and whether upgraded were the influencing factors for the survival time of patients with occupational pneumoconiosis (P<0.05) . The total DALY attributable to occupational pneumoconiosis from 1963 to 2020 in Shizuishan City was 48026.65 person years, of which the years of life lost (YLL) was 15155.39 person years, and the average YLL was 10.33 years/person, and the years lost due to disability (YLD) was 32871.26 person years, and the average YLD was 10.07 years/person. The DALY attributed to coal worker's pneumoconiosis and silicosis were 39408.51 person years and 6565.02 person years, respectively, and they accounted for 82.06% and 13.67% of the total disease burden in Shizuishan City, respectively. The DALY caused by occupational pneumoconiosis in the age group of 40-49 years old and the first diagnosis of stage I occupational pneumoconiosis were higher, which were 20899.71 and 36231.97 person years, respectively. The average YLL and average YLD showed a volatility downtrend over time. Conclusion: The disease burden of occupational pneumoconiosis cannot be ignored in Shizuishan City, and timely targeted measures should be taken for key populations and key industries. It is recommended that life-cycle health management and hierarchical medical should be taken to improve the life quality of patients and prolong their lifes.
Subject(s)
Adult , Aged , Aged, 80 and over , Humans , Middle Aged , Anthracosis , China/epidemiology , Coal Mining , Cost of Illness , Pneumoconiosis/epidemiology , Retrospective StudiesABSTRACT
@#Improving the efficiency of occupational disease diagnosis and verification is conducive to protecting the rights and interests of workers, better realizing the legislative value pursuit of the Law of the People's Republic of China on the Prevention and Control of Occupational Diseases, and truly demonstrating the spirit of legal fairness and justice. In 2021, the Administration Measures for the Diagnosis and Verification of Occupational Disease was revised and implemented. The working procedures of occupational disease diagnosis are adjusted and optimized, and the efficiency of diagnosis of occupational disease is greatly improved. They include items such as new provisions specifying working time limits; optimize the working mode; the diagnosis of occupational disease attribution applies to presumptive causality is emphasized and the logical thinking of inversion of burden of proof is carried out. However, the work efficiency of occupational disease diagnosis does not make a great breakthrough in quality, mainly manifests in three aspects: difficult to confirm labor relationships, raising the threshold of occupational disease diagnosis, the administrative field investigation is empty and the diagnosis of occupational disease is complicated. There are many pre-procedures in occupational disease diagnosis, which restrict the efficiency of diagnosis. In the future, attention needs to be paid to promote the independent work of occupational disease diagnosis institutions, and through the revision of the Law of the People's Republic of China on the Prevention and Control of Occupational Diseases. Occupational disease diagnosis institutions should be empowered to confirm labor relationship, so as to lower the threshold of diagnosis of occupational disease and maximize the protection of the rights and interests of workers.
ABSTRACT
Objective To analyze the incidence of occupational diseases in Dandong from 2015 to 2019, discuss the characteristics and rules of occupational diseases, and provide theoretical basis for the formulation of occupational disease prevention measures. Methods The occupational disease report data of Dandong from 2015 to 2019 were collected and analyzed by using Excel and SPSS statistical software. Results From 2015 to 2019, a total of 112 new cases of occupational diseases were reported in Dandong, including 108 cases of occupational pneumoconiosis, accounting for 96.43%. Four patients with other occupational diseases, accounting for 3.57% . Among the newly reported cases of occupational diseases, 111 cases were male, accounting for 99.10%, and one case was female, accounting for 0.89%. There were statistically significant differences in the reported conditions of different types of occupational diseases according to gender (P 0.05). The length of contact at the onset of the disease was mainly concentrated in 11-20 years, and there was no statistical significance in the comparison of the length of contact at the onset of different types of occupational diseases (P > 0.05). In terms of industry distribution, the mining industry reported the most cases (87 cases, accounting for 77.68%). The private enterprises were more concentrated, accounting for 68 cases, 60.71%. Small and medium-sized enterprises reported the most new cases of occupational diseases, with 107 cases, accounting for 95.54%. There was statistical significance in the new cases of occupational diseases with different industry distribution (P 0.05). Conclusions Occupational pneumoconiosis accounted for the majority of new cases of occupational diseases in Dandong city from 2015 to 2019, indicating that occupational pneumoconiosis is still the focus of occupational disease prevention and control in Dandong City. In the future occupational disease prevention work, we should actively standardize the implementation of the “Law of the People's Republic of China on the Prevention and Control of Occupational Diseases”, do a good job in the supervision and management of key groups and positions, and effectively protect the health of workers.