Epidemiological study of multi-site WMSDs in the footwear industry in China.

Objectives. This study aimed to identify the prevalence of multi-site work-related musculoskeletal disorders (WMSDs) in Chinese footwear industry workers from 2018 to 2020 and explore the possible influencing factors of WMSDs. Methods. 7106 subjects from 26 large shoe factories in China were investigated using the epidemiological cross-sectional survey method by using the Nordic musculoskeletal questionnaire (NMQ). Results. The total prevalence of WMSDs in the study subjects was 36.8% (2616/7106). Among them, the prevalence of multi-site WMSDs was 26.1% (1858/7106). The proportion of multi-site WMSDs involving two sites was the largest (31.38%). In addition, the results showed that the risk factors of multi-site WMSDs were gender, marital status, long current job experience, poor health, poor working posture, etc. Conclusions. The prevalence of WMSDs was high in the Chinese footwear industry. Based on the results, therefore, it seems necessary to improve work posture, work organization and workenvironment to prevent WMSDs.

Associations of Occupational Stress and Coping Styles with Well-Being Among Couriers - Three Cities, Zhejiang Province, China, 2021.

What is already known about this topic?: Prior research has primarily concentrated on occupational health concerns, including injuries and heatstroke, among couriers. Nevertheless, there has been a scarcity of emphasis on mental health aspects, with existing studies predominantly addressing the risk factors associated with occupational stress. What is added by this report?: The present study demonstrated a significant association between occupational stress and well-being among couriers, with positive coping strategies acting as a mediating factor. Furthermore, the results indicate that implementing a positive coping style may mitigate the impact of occupational stress on well-being. What are the implications for public health practice?: Future public policy initiatives should focus on promoting the well-being of couriers by fostering improvements in the workplace environment, reevaluating the organization of work, and delivering support to couriers in managing occupational stress.

Characteristics of pneumoconiosis in Zhejiang Province, China from 2006 to 2020: a descriptive study.

BACKGROUND: Pneumoconiosis is the most prevalent occupational disease and displays different patterns in each province of China. Clarifying specific incidence patterns and temporal trends in Zhejiang Province can help provide valuable information on the prevention of pneumoconiosis. METHODS: Annual reports of pneumoconiosis for Zhejiang Province from 2006 to 2020 were extracted from the National Occupational Disease and Occupational Health Information Monitoring System. The information of cases included regions, diagnosis ages, genders, exposure durations, pneumoconiosis categories and stages, the first year of exposure, enterprise industries, scales and ownerships. RESULTS: Totally 6037 new cases of pneumoconiosis were reported between 2006 and 2020, which increased at first and then gradually declined since 2013. Among all pneumoconiosis cases, silicosis accounted for the majority (72.17%). Most of the cases occurred in small-scale and domestic-funded enterprises, which accounted for 71.75% and 96.97%, respectively. When analyzing the industry distribution, the cases were mainly concentrated in mining (37.12%), manufacturing (31.11%) and 'public administration and social organization' (23.94%) industry. The average diagnosis age among the pneumoconiosis cases was 55.44 years, and the median exposure duration was 11.00 years. Significantly older diagnosis age and longer exposure duration were found in females, coal workers' pneumoconiosis cases, cases with higher stages, cases with the first year of dust exposure earlier and cases from large-scale companies. In regional distribution, the top three cities reporting the most pneumoconiosis cases in Zhejiang Province were Taizhou, Quzhou and Hangzhou. CONCLUSION: The current situation of pneumoconiosis in Zhejiang Province was still serious, and government should further strengthen the surveillance of occupational diseases and supervision of enterprises. Moreover, publicity and education regarding pneumoconiosis should be carried out to raise awareness of dust exposure risk and associated health consequences.

Epidemiological characteristics of occupational chemical poisonings in Zhejiang, China from 2006 to 2020: A descriptive analysis.

Objective: As the second most common occupational disease in China, occupational poisoning is one of the major public health problems that seriously affect workers' health. This study aimed to investigate the epidemiological and occupational characteristics of acute and chronic occupational poisoning cases in Zhejiang Province, so as to provide a scientific basis for proposing intervention measures and preventive strategies of occupational poisoning. Methods: The data on occupational poisoning cases in Zhejiang Province from 2006 to 2020 was derived from the National Occupational Disease Network Direct Report System. A descriptive statistical analysis was employed on this data utilizing R software. Results: From 2006 to 2020, 1,008 occupational poisoning cases were reported in Zhejiang Province, with a downward trend since 2007. Of these cases, 81.94% were chronic poisoning and 18.06% were acute poisoning. Ningbo reported the most occupational poisoning cases among the 11 cities in Zhejiang Province, accounting for 20.34% of the total cases. Besides, the occupational poisoning cases in Wenzhou, Jiaxing, and Shaoxing also accounted for 18.15%, 18.06%, and 17.76% of the total number of cases, respectively. Occupational poisoning in male were 693 cases and in female 315 cases. Most of the occupational poisoning cases studied involved people aged between 40 and 49 years (38.19%). The length of work in chronic occupational poisoning cases was significantly higher than that of acute occupational poisoning cases (P < 0.05). Benzene and lead and its compounds (excluding tetraethyl lead) were the major toxicants causing occupational poisoning. More than 60% of occupational poisoning cases were reported in private enterprises. Meanwhile, over 90% of the cases were distributed in medium enterprises and small enterprises. The type of industry with the most occupational poisoning cases was the manufacturing industry. Conclusion: Although the cases of occupational poisoning in Zhejiang Province have declined, more comprehensive and effective prevention and control measures are still needed. More attention ought to be paid to the management of key points according to the epidemiological and occupational characteristics of occupational poisoning cases.

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

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

Epidemiological characteristics and survival analysis on patients with occupational pneumoconiosis in Zhejiang Province from 1987 to 2019.

Objective: To evaluate risk factors affecting survival in patients diagnosed with pneumoconiosis and propose strategies to improve the quality of life in these patients. Methods: The basic patient information was obtained from the pneumoconiosis report card. Disease types, regions, and industry distribution of pneumoconiosis were analyzed. The Kaplan-Meier survival curves and the Cox proportional risk regression model was used for survival analysis. Results: A total of 13,812 patients were diagnosed with pneumoconiosis in Zhejiang province from 1987 to 2019. The overall survival rate at the end of life table analysis was 83%. Kaplan-Meier analyses showed that there were significant differences between survival curves depending on the stage of first diagnosis, age at first diagnosis, type of pneumoconiosis, industry, and duration of dust exposure (P < 0.05). The results of Cox proportional hazards regression analysis showed that pneumoconiosis stage of first diagnosis, age at first diagnosis, industry, and duration of dust exposure were risk factors affecting patient survival (P < 0.05). Conclusions: The patients with high stage of pneumoconiosis at first diagnosis, older age, and long duration of dust exposure should be followed up and monitored as key population, and the industries with high incidence of pneumoconiosis such as mining and construction should be supervised as key industries.

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

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

The Influence of Long Working Hours, Occupational Stress, and Well-Being on Depression Among Couriers in Zhejiang, China.

Objective: This study aimed to examine the association between long working hours, occupational stress, depression, and well-being, and to explore the intermediary effect of occupational stress and well-being between working hours and depression among couriers in Zhejiang, China. Methods: The study used a cluster random sampling method to select 1,200 couriers from mainstream express companies in Zhejiang, China. The data were collected and analyzed using the Core Occupational Stress Scale (COSS) to measure occupational stress, the Patient Health Questionnaire-9 (PHQ-9) scale to evaluate depression, and the World Health Organization five-item Well-Being Index (WHO-5) scale to assess well-being. Structural equation modeling (SEM) was used to test the hypothesized relationship among the variables. Results: The phenomenon of long working hours (75.1%) was quite common among couriers in Zhejiang, China. Working hours had a direct positive effect on depression (ß = 0.008, p < 0.001) and on occupational stress (ß = 0.009, p < 0.001), and working hours had a negative effect on well-being (ß = -0.013, p < 0.001). Occupational stress had a direct positive effect on depression (ß = 0.272, p < 0.001), but well-being had no significant direct effect on depression. Working hours had an indirect effect on depression through the mediating effect of occupational stress while the mediating effect of well-being was not found. Conclusion: Long working hours is associated with occupational stress, well-being, and depression. Our results confirmed that working hours, occupational stress, and well-being were strong predicators of depression. Working hours had a significant indirect effect on depression via occupational stress. The result of this study showed that decreasing working hours and reducing occupational stress would be effective for couriers to prevent depression. However, more studies are needed to verify the relationship between working hours and depression.

Industry Distribution Characteristics of Benzene-Induced Leukemia - 7 PLADs, China, 2005-2019.

What is already known about this topic?: In the 1980s. benzene-induced leukemia (BIL) mainly occurred in shoemaking and painting industries. Now the industry distribution of benzene-induced leukemia may have changed over time. What is added by this report?: BlL cases mainly occurred in the manufacturing industry from 2005-2019, especially in private enterprises and small/medium-sized enterprises. The industry with the largest number of new cases of BIL was the general and special equipment manufacturing. The number of leukemia cases in emerging industries such as computer/electronic product manufacturing was found to be increasing. What are the implications for public health practice?: Strengthening supervision and regulation of manufacturing, especially of small/medium-sized enterprises and emerging manufacturing industry, may be effective in reducing BIL.

Industry Distribution Characteristics of Benzene-Exposed Workers with Cytopenia - Four Provinces, China, 2020.

What is already known about this topic?: Benzene is harmful to the hematopoietic system and can cause leukemia. However, benzene is still being used in various industries including furniture, rubber, plastic products, and metal product manufacturing. What is added by this report?: The white blood cell count of workers in general equipment, special equipment, chemical raw materials, and chemical products manufacturing decreased significantly. The enterprises in which benzene concentration exceeded the occupational exposure limit were small enterprises and private enterprises. What are the implications for public health practice?: Regular health examinations are necessary for benzene-exposed workers. In addition, the monitoring of benzene concentration in small enterprises and private enterprises should be strengthened.

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

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

Influence of Prolonged Visual Display Terminal Use and Exercise on Physical and Mental Conditions of Internet Staff in Hangzhou, China.

To examine the effects of prolonged visual display terminal (VDT) working hours and exercise frequency on VDT-related symptoms, we recruited 944 Chinese internet staff for the study. A self-administered questionnaire survey was used to obtain the hours of daily VDT work, exercise frequency, and the physical and mental health of the participants. The daily VDT working time of participants was 8.7 hours. Musculoskeletal pain and eye complaints were prevalent, and the participants had poor mental health status. When daily VDT operation time was more than 11 hours, VDT-related symptoms, including backache (odds ratios (OR) = 3.59), wrist pain (OR = 1.88), hip pain (OR = 2.42), dry eyes (OR = 2.22), and ocular soreness (OR = 2.16) were more likely to occur, and an increased risk of serious occupational stress (OR = 6.75) and job burnout (OR = 2.66) was found in internet workers. Compared with those who never exercised, appropriate exercise frequency (three times per week) was helpful to relieve pain in the shoulders (OR = 0.28), neck (OR = 0.45), back (OR = 0.30), lower back (OR = 0.25), and wrists (OR = 0.38), as well as to prevent vision loss (OR = 0.33) and job burnout (OR = 0.42). Therefore, avoiding excessive VDT exposure and performing moderate exercise could protect the physical and mental health of internet staff from the adverse effects of VDT.

Childhood pesticide poisoning in Zhejiang, China: a retrospective analysis from 2006 to 2015.

BACKGROUND: Pesticide poisoning in children has been a serious public health issue around the world, especially in the developing countries where agriculture is still one of the largest economic sectors. The purpose of this study was to analyze epidemiological characteristics of acute pesticide poisoning in children from Zhejiang province, China. METHODS: The pesticide poisoning cases for children were retrieved from Occupational Disease Surveillance and Reporting System, Zhejiang Provincial Center for Disease Control and Prevention, China. The incident cases, deaths, and fatality rate of child pesticide poisoning from 2006 through 2015 were calculated. RESULTS: During the study period, totally 2952 children were poisoned by pesticides, with 66 deaths, resulting in a fatality rate of 2.24%. Among them, there were 1607 male cases with 28 deaths, and 1345 female cases with 38 deaths. Most of the cases occurred in preschool children (1349) and adolescent age group (1269). Organophosphate and carbamate insecticides were the cause of most poisonings (1130), leading to 34 deaths. The highest fatality rate (3.13%) was due to poisoning by herbicides and fungicides, causing 14 deaths out of 448 cases. Poisoning occurred mostly in rural areas (78%). And most pesticide poisoning occurred in the summer (896) and fall (811), while fewest poisoning cases in the winter (483) but with the highest fatality rate (3.52%). CONCLUSIONS: This study shows that pesticide poisoning of children is a major health problem in Zhejiang, suggesting preventive strategies should be conducted to control childhood pesticide poisoning.

Pesticide poisoning in Zhejiang, China: a retrospective analysis of adult cases registration by occupational disease surveillance and reporting systems from 2006 to 2010.

OBJECTIVE: Despite the rapid industrialisation and urbanisation over the past 30 years, agriculture is one of the largest economic sectors in China and the unregulated use of pesticides result in extensive pesticide poisoning. The objective of this study was to analyse pesticide poisoning cases registration received by Zhejiang Provincial Center for Disease Control and Prevention, China. DESIGN: Register-based study. SETTING: Cases registered regarding pesticide poisoning. Data were obtained from the Occupational Disease Surveillance and Reporting Systems in Zhejiang province from 2006 to 2010, which contains anonymous records representing general population of Zhejiang province, China. PARTICIPANTS: All cases registered as pesticide poisoning were identified. PRIMARY OUTCOME: Monthly and age-group pesticide poisoning death rates were calculated. RESULTS: A total of 20 097 pesticide poisoning cases with 1413 deaths were recorded during the study period. There were 10 513 male pesticide poisoning cases with 782 deaths, and 9584 females with 631 deaths. Pesticide poisoning occurred mostly in non-occupational exposure (79.86%), in which the majority (85.77%) of the cases was of intentional pesticide poisoning. The occupational exposure was most common in men during the farming season. The death rate increased stepwise with age, and the pesticide suicide rate was higher in the older age group. CONCLUSIONS: Pesticide poisoning remains a major health problem in China, and further recommendations to reduce the pesticide poisoning are required.

Genetic damage and lipid peroxidation in workers occupationally exposed to organic bentonite particles.

OBJECTIVES: It has been found that bentonite particles (BPs) could induce the cyto-genotoxicity and oxidative stress in vitro, but these effects on population exposed to BPs remain unclear. The aim of the present study was to investigate whether the genetic damage and lipid peroxidation can be detected in workers occupationally exposed to organic BPs. METHODS: Sixty subjects were divided into three groups: (i) exposure group I consisted of 20 workers exposed to high concentrations of organic BPs in air; (ii) exposure group II were composed of 20 workers exposed to moderate concentrations of organic BPs in air; (iii) control group included 20 healthy unexposed subjects. Genetic damage was examined by comet assay and cytokinesis-block micronucleus cytome (CBMNcyt) assay. Lipid peroxidation was detected by malondialdehyde (MDA) assay. RESULTS: The % tail DNA, MDA, the frequencies of micronucleus (MNF), micronucleated cell (MCF), nucleoplasmic bridges (NPBs), nuclear buds (NBUDs), apoptotic cell rate (ACR) and necrotic cell rate (NCR) in two exposure groups were significantly higher than those in control group (P<0.01 or P<0.05). Moreover, the % tail DNA, MDA, MNF, MCF, NPBs, NBUDs, ACR and NCR in exposure group I with higher exposure level of organic BPs in air were significantly higher than those in exposure group II with lower level of organic BPs (P<0.01). The order of nuclear division index (NDI) was: exposure group I

[Analysis of monitoring results of occupational hazard factors in workplaces in Zhejiang Province, China in 2006 - 2010].

OBJECTIVE: To analyze the monitoring results of the occupational hazard factors in workplaces in Zhejiang Province, China in 2006 - 2010. METHODS: Descriptive analysis was performed on the monitoring results of the occupational hazard factors in workplaces in Zhejiang Province from 2006 to 2010. RESULTS: From 2006 to 2012, the number of monitored objects for each occupational hazard factor increased gradually, and the qualified rate for each factor remained unchanged or rose slightly. The qualified rates for silica dust and asbestos dust were less than 60%. The qualified rates for benzene, toluene, and xylene, which were always the factors highlighted in the monitoring of toxic chemicals, were all above 85%. The numbers of monitored objects for hexane, hydrogen sulfide, and cyanide grew significantly in recent years. However, the qualified rates for physical factors, which mainly included high temperature and noise, were less than 70%, lower than those for chemical factors. CONCLUSION: The qualified rate is as important as the number of monitored objects in the monitoring of the occupational hazard factors in workplaces in Zhejiang Province, China. The acute and chronic factors, physical and chemical factors, and traditional and new factors should be balanced in monitoring.

[Analysis of new pneumoconiosis cases during 2006-2009 in Zhejiang province].

OBJECTIVE: To analyze the characteristics of pneumoconiosis cases in Zhejiang province and to provide the evidence for pneumoconiosis control and prevention measures in Zhejiang province. METHODS: The data of new pneumoconiosis cases were from national surveillance system of occupational disease in Zhejiang province during 2006-2009, and were analyzed for distribution, age, exposure duration, pneumoconiosis phases and enterprise types. RESULTS: During 2006-2009, 819 new pneumoconiosis cases (173, 157, 209 and 280 cases, respectively) were reported, 86.9% cases suffered from silicosis. Most of pneumoconiosis cases were distributed in Ningbo, Wenzhou areas and in building materials, machinery, coal, geological and mining, light industries and construction enterprise. The average ages of new pneumoconiosis cases were (47.8 +/- 10.0), (52.5 +/- 13.1), (55.5 +/- 11.2) and (55.9 +/- 12.2) years old, respectively and showed a significant increase trend (P<0.05). The average exposure duration of new pneumoconiosis cases were (12.4 +/- 8.6), (12.9 +/- 9.4), (12.4 +/- 8.6) and (15.7 +/- 10.0) years. The average exposure duration of phase I, phase II, phase III new pneumoconiosis cases were (14.3 +/- 9.87), (12.4 +/- 8.7) and (11.4 +/- 7.1) years, respectively and there were significant differences (P<0.05). CONCLUSION: New pneumoconiosis cases in Zhejiang province are increasing year by year, the main type of pneumoconiosis is silicosis, the distribution of pneumoconiosis cases is associated with the areas and enterprises, and the exposure duration of new pneumoconiosis cases is relatively shorter.

Studying the genotoxic effects induced by two kinds of bentonite particles on human B lymphoblast cells in vitro.

The aim of the present study was to evaluate the genotoxic effects induced by native and active bentonite particles (BPs) on human B lymphoblast cells using comet assay and cytokinesis-block micronucleus (CBMN) assay in vitro. The cells were exposed to BPs at the concentrations of 30, 60, 120 and 240µg/ml for 24, 48 and 72h, respectively. The quartz contents of native and active BPs were 6.80±0.20 and 6.50±0.10%, respectively. Gypsum and DQ-12 quartz served as negative and positive controls. The results of comet assay showed that DNA damage induced by native and active BPs was significantly higher than that induced by gypsum control (P<0.05 or <0.01), and increased with exposure concentration and duration. When the cells were exposed to BPs at the doses of 120 and 240µg/ml for 72h, DNA damage induced by active BPs and native BPs was significantly higher than that induced by DQ-12 quartz (P<0.01), and DNA damage induced by active BPs enhanced significantly, as compared with native BPs (P<0.01). The results of CBMN assay demonstrated that both native BPs and active BPs could induce significant micronuclei, as compared with gypsum control (P<0.05 or <0.01). However, there was no significant difference of micronucleus frequency (MNF) among native BPs, active BPs and DQ-12 quartz. The water-soluble fractions from two kinds of BPs did not induce significant DNA damage and micronuclei. These findings indicated that the genotoxicity induced by active BPs and native BPs could be detected in comet assay and CBMN assay in vitro, the insoluble particle fractions from BPs may play a main role in the genotoxic effects induced by BPs.