[Analysis of suspected occupational diseases cases and subsequent diagnosis follow-up investigation in Hubei Province from 2020 to 2021].

Objective: To understand the epidemiological characteristics of suspected occupational diseases cases, and to track the subsequent diagnosis of suspected cases in Hubei Province from 2020 to 2021, and to provide theoretical basis for the supervision of suspected occupational diseases. Methods: In April 2022, the data of suspected occupational diseases cases and occupational diseases in Hubei Province from 2020 to 2021 were collected by the Occupational Diseases and Health Risk Factors Information Surveillance System. The distribution and diagnosis of suspected occupational diseases cases were analyzed. We investigated undiagnosed suspected occupational diseases by telephone. Results: From 2020 to 2021, a total of 1872 cases of suspected occupational diseases in 6 categories and 18 species were reported in Hubei Province. The top three suspected occupational diseases were suspected occupational noise deafness (36.75%, 688/1872), suspected coal worker's pneumoconiosis (33.07%, 619/1872) and suspected silicosis (20.99%, 393/1872). The diagnosis rate of suspected occupational diseases was 33.60% (629/1872). The rate of confirmed diagnosis was 63.59% (400/629). The diagnosis rate (26.86%, 456/1698) and rate of confirmed diagnosis (55.48%, 253/456) of suspected occupational diseases detected by occupational health examination were the lowest. The diagnosis rate of suspected occupational diseases detected by comprehensive medical institutions and private medical institutions were lower than disease prevention and control institutions and occupational disease prevention center (P<0.05). The main reasons for not entering the diagnostic procedure included that workers were not informed that they were diagnosed as suspected occupational diseases (31.55%, 124/393), workers were unwilling to apply for occupational disease diagnosis (18.56%, 73/393), and some workers planned to apply for diagnosis but had not yet applied (10.69%, 42/393) . Conclusion: Occupational noise deafness, coal worker's pneumoconiosis and silicosis are the main diseases of suspected occupational diseases in Hubei Province. In order to increase the diagnosis rate and confirmed diagnosis rate of suspected occupational diseases, it is suggested to strengthen management and supervision from the aspects of case management, information warning and worker notification.

[Comparative study of surgical effects on patients with mixed deafness and otosclerosis with different air bone conduction differences].

Objective: To analyze the surgical efficacy of patients with mixed hearing loss and otosclerosis with different air bone gap (ABG) before surgery, and to provide reference for the prognosis evaluation of otosclerosis surgery. Methods: The clinical data of 108 cases(116 ears) of otosclerosis who had undergone stapes fenestration technique artificial stapes implantation in Xiangya Hospital of Central South University from November 2013 to May 2020 and had mixed hearing loss before surgery were collected, including 71 women(76 ears)and 37 men (40 ears), with an average age of 38.5 years. According to preoperative pure tone audiometry ABG, they were divided into three groups: group S, 15 dB≤ABG<31 dB, a total of 39 ears; group M, 31 dB≤ABG<46 dB, a total of 58 ears; and group L, ABG≥46 dB, 19 ears in total. The hearing outcomes of three groups of patients at 6-12 months after surgery were compared and analyzed using SPSS 24.0 statistical software. Results: A total of 3 patients (group S: 2 cases; group L: 1 case) experienced severe sensorineural hearing loss after surgery and were not included in the statistical analysis. After surgery, the pure tone hearing threshold of patients with otosclerosis in each group was significantly improved compared to before surgery, with an average air conduction threshold improvement of(21.6±13.4) dB. The difference between before and after surgery was statistically significant(t=17.13, P<0.01). The average bone conduction threshold improved by(3.7±7.6) dB, and the difference was statistically significant before and after surgery(t=5.20, P<0.01). The postoperative ABG was(18.3±9.3) dB, which was significantly reduced compared to preoperative(36.2±8.6)dB. Among the three groups of patients, the L group had the highest improvement in air conduction threshold[(29.9±10.8)dB], while the S group had the lowest improvement[(15.7±11.4)dB]. There was no statistically significant difference in post operative pure tone hearing thresholds between the three groups(P>0.05). The postoperative ABG in group S was the smallest[(16.5±9.0)dB], while in group L, the postoperative ABG was the largest[(20.5±10.0)dB]. Compared with group S, group M and group L still had a large residual ABG at 2 000 Hz after surgery. The bone conduction threshold of both S and M groups improved to some extent after surgery compared to before (P<0.01). Conclusions: Surgery can benefit patients with mixed hearing loss and otosclerosis with different preoperative ABG. Patients with small preoperative ABG have better surgical results and ideal ABG closure at all frequencies after surgery. Patients with large preoperative ABG can significantly increase the gas conduction threshold during surgery, but certain frequencies of ABG may still be left behind after surgery. The improvement effect of surgery on bone conduction threshold is not significant. Patients should be informed of treatment methods such as hearing aids based on their actual situation for selection.

[Analysis of influencing factors of high frequency hearing loss in workers exposed to noise based on multilevel model].

Objective: To understand the current situation of high-frequency hearing loss of workers exposed to occupational noise in Hubei Province and its multi-level influencing factors. Methods: In June 2021, the basic information, occupational history, physical examination results and other relevant information in the "Occupational Health Examinations Case Cards" for noise workers in Hubei Province in 2020 were extracted from the subsystem of the "China Disease Prevention and Control Information System". Multilevel level of logistic model was used to analyze the related factors of high-frequency hearing loss of noise-exposed workers. Results: In 2020, the incidence rate of occupational high-frequency hearing loss in Hubei Province was 8.25% (6450/78152), and the incidence rate in various regions of the province ranged from 1.13% to 19.87%. At the individual level, male, ≥ 30 years of age, 6-10 years of service, small and micro enterprises, as well as construction, mining, manufacturing, transportation and rental services were the risk factors for high-frequency hearing loss (P<0.05). The risk of high-frequency hearing loss among workers in foreign-funded enterprises was significantly lower than that of workers in state-owned/collective enterprises (P<0.05). At the regional level, the younger the age of the employees, the lower the risk of high-frequency hearing loss (P<0.05). There was no significant correlation between the regional economic level and the risk of high-frequency hearing loss (P>0.05) . Conclusion: The incidence rate of occupational high-frequency hearing loss in Hubei Province is low in 2020, but the incidence rate varies greatly in different regions of the province, mainly due to differences in employment age, while the development of regional economic level has not reduced the risk of occupational high-frequency hearing loss.

[Epidemiological characteristics and trend of new cases of occupational pneumoconiosis in Hubei Province from 2011 to 2020].

Objective: The epidemiological characteristics and trend of occupational pneumoconiosis in Hubei Province from 2011 to 2020 were analyzed to provide a theoretical basis for the development of prevention and control strategies for occupational pneumoconiosis. Methods: In March 2021, the data of newly occupational pneumoconiosis in Hubei Province from 2011 to 2020 were collected by the Occupational Diseases and Health Risk Factors Information Surveillance System. Descriptive statistics were adopted to analyze basic situation, region, industry, type of disease, year of diagnosis, age of onset and dust exposureduration of the cases. Results: From 2011 to 2020, a total of 7203 new cases of occupational pneumoconiosis were reported in Hubei Province, including 7125 (98.92%) men and 78 (1.08%) women. The average age of onset was (54.03±10.12) years old. The average duration of dust exposure was (13.80±9.56) years. The mainly types of pneumoconiosis were coal worker's pneumoconiosis (3593 cases, 49.88%) and silicosis (3301 cases, 45.83%). The cases included 4814 cases (66.83%) of stage Ⅰ pneumoconiosis, 1270 cases (17.63%) of stage Ⅱ and 1119 cases (15.54%) of stage Ⅲ. New cases mainly distributed in Yichang City (1586 cases, 22.02%), Shiyan City (1257 cases, 17.45%), Enshi Tujia and Miao Autonomous Prefecture (1050 cases, 14.58%) and Huangshi City (1009 cases, 14.01%), and occurred most frequently in coal mining and washing industry (3743 cases, 51.96%) and nonmetallic mining industry (582 cases, 8.08%). Pneumoconiosis patients of stage Ⅲ were mainly distributed in small enterprises (401 cases, 50.25%) and domestic enterprises (796 cases, 99.75%) . Conclusion: Coal worker's pneumoconiosis and silicosis accounted for the vast majority pneumoconiosis in Hubei Province. The new cases show obvious regions, industries and type of disease distribution. We should strengthen occupational health supervision in small and domestic enterprises.

[Investigation on high-frequency hearing loss of noise workers in an automobile factory].

Objective: To investigate the high-frequency hearing loss (HFHL) of workers in an automobile factory and its influencing factors, so as to provide a scientific basis for occupational health management of noise workers. Methods: From March to July 2019, 2647 workers from an automobile factory were selected as the research objects by cluster sampling method. The basic personal information (such as gender, age, education level, height, weight, etc.) , history of ear disease, the history of detonation, history of exposure to ototoxic drugs, history of exposure to occupational noise, etc., were investigated by questionnaire and occupational health examination. Chi-square test was used to compare the detection rates of HFHL in different populations, and multivariate logistic regression model was used to analyze the influencing factors of HFHL. Results: The noise level of 2647 individual workers ranged from 75.0 dB (A) to 92.0 dB (A) , with an average of (84.14±2.47) dB (A) . The detection rate of HFHL was 17.2% (456/2647) . There were significant differences in the the detection rate of HFHL among workers of different gender, age, educational level, working age, noise exposure level, diabetes history, detonation history, smoking and drinking workers (P<0.05) . Multivariate logistic regression analysis showed that male, age ≥30 years old, smoking and noise exposure were risk factors for HFHL (P<0.05) . Conclusion: The detection rate of HFHL in automobile factory workers is high. Gender, age, smoking and noise are the influencing factors of HFHL. It is necessary to strengthen the noise control in the workplace and guide workers to choose healthy lifestyle.

[Validation and analysis of Goldengate high-throughput deafness gene chip in detecting the patients with enlarged vestibular aqueduct syndrome].

Objective: To verify the accuracy and effectiveness of Goldengate high-throughput deafness gene chip in detecting the patients with enlarged vestibular aqueduct syndrome(EVAS), and to provide a reference for genetic detection strategy of EVAS. Methods: From August 2016 to February 2018, 15 patients with EVAS and 60 normal controls were detected by Goldengate high-throughput deafness detection chip developed by our team, and the results were verified by Sanger sequencing. SLC26A4 gene sequencing was carried out in all the patients with EVAS. Results: 12/15 of patients with EVAS were detected mutations of SLC26A4 gene. Nine mutations were detected by chip detection and SLC26A4 gene direct sequencing, seven of which were detected by both methods. The chip could detect 93.33%(28/30) of the allele information provided by SLC26A4 gene direct sequencing. In addition to SLC26A4 gene, mutations of GJB2, PCDH15, TMC1, MYO6 and mitochondrial genes were detected in 15 patients with EVAS. These results were verified by Sanger sequencing. Conclusion: Goldengate high-throughput deafness gene chip possesses the traits of wide coverage and high accuracy, which can be used as a preliminary detection method for patients with EVAS.

[Application value of high-throughput gene copy number variation detection in the diagnosis of enlarged vestibular aqueduct].

Objective: To explore the application value of high-throughput gene detection method of copy number variations (CNV) in the diagnosis of enlarged vestibular aqueduct (EVA). Methods: A total of 46 nonsyndromic hearing loss patients with EVA were recruited between May 2014 and December 2016 from Department of Otolaryngology of Xiangya Hospital, Central South University. A high-throughput multiplex analysis method based on double ligation and multiple fluorescent PCR was designed and performed to detect CNV in the three EVA-related genes (SLC26A4, FOXI1 and KCNJ10). The data were analyzed by GeneMapper v4.1. Healthy volunteers (n=100) were selected as normal controls. Results: A total of 46 EVA patients were detected (32 males, 14 females, aged 1 to 26 years). In 4 EVA patients, deletions of exons 1-3 of SLC26A4 gene (4/46, 8.7%) were detected, which were not reported in the database of genomic variants (DGV), and were absent in 100 normal controls. There was no CNV detected in FOXI1 and KCNJ10 in the study. Conclusions: In the current study, three known EVA-related genes were designed as the target area for CNV detection by high-throughput ligation-dependent probe amplification (HLPA) analysis. This method can be used as a supplementary analysis of point mutation detection of hearing loss, which helps achieve the accurate genetic diagnosis of EVA.

[Cumulative noise exposure and the risk of high-frequency hearing loss relationships].

Objective: To explore the dose-response relationship between cumulative noise exposure and high-frequency hearing loss, and further to provide a basis for the control of occupational hazards of noise. Methods: A Meta-analysis of dose-response relationships was performed on the data of eligible literatures published in China from January 2000.1 to December 2019.12. Results: The initial combined Odds Ratio (OR) and its 95%CI in the Meta-analysis were 1.10 (1.08-1.12) . As the Begg's funnel plot and Egger's test indicated publication bias (t=5.97, P<0.01) , the Trim-and-Fill Method was used for OR value adjustment. The adjusted-OR was 1.09 (1.07-1.12) ; sensitivity analysis showed that the results of this Meta-analysis have high stability; subgroup analysis indicated that the ORs of the steady-state noise group and the non-steady-state noise group were 1.10 (1.08-1.12) and 1.14 (1.07-1.21) , the ORs of the old standard group and the new standard group were 1.10 (1.08-1.12) and 1.11 (1.00-1.24) , respectively. The nonlinear dose-response relationship curve demonstrated that the risk of high-frequency hearing loss increases rapidly after CNE reaches 95 dB (A) ·years. Conclusion: There is a definite dose-response relationship between CNE and high-frequency hearing loss, which can be used to predict the risk of high-frequency hearing loss in noisy workers.

[Study on the effects of noise on hypertension and hyperglycemia among occupational workers].

Objective: To study the effect of noise on hypertension and hyperglycemia among occupational workers. Methods: Total 670 workers in an automobile manufacturing company were selected as the subjects of physical examination in 2017. According to the noise exposure or not, the subjects were divided into control group (no noise exposure) 143 and contact group (noise exposure) 527. Questionnaire survey and physical examination were conducted. The measurement data were analyzed by t-test, and the count data and grade data were analyzed by χ(2) test. The influence of noise on blood glucose, heart rate, blood pressure and other indicators was analyzed by logistic regression, and the OR and 95%CI of each risk factor were calculated. Results: The average age of the control group and the contact group was no significant difference (P>0.05) . There were 139 (20.7%) cases of high systolic pressure, 154 (23.0%) cases of high diastolic pressure, 63 (9.4%) cases of hyperglycemia, 29 (4.3%) cases of tachycardia. Compared with the control group, there were significant differences in systolic blood pressure, diastolic blood pressure and blood glucose in the contact group (P<0.05) . Compared with the control group, the systolic blood pressure, diastolic blood pressure and blood glucose of the subjects in the corresponding age contact group increased significantly (P<0.05) . The years of noise exposure were protective factors for systolic and diastolic blood pressure (OR=0.970, 0.973) . Conclusion: Noise exposure may increase blood pressure and blood sugar of occupational workers, but the effect on heart rate can not be determined.

[Application of the real-time fluorescence PCR melting curve method in gene screening of non-syndromic hearing loss].

Objective: To detect 20 common deafness gene mutations in non-syndromic hearing loss patients in China using the melting curve method, and analyze and summarize the mutation data to explore the clinical value of this method. Methods: The real-time fluorescence PCR melting curve method was used to detect 20 common mutations of four deafness genes(GJB2,GJB3,SLC26A4 and mtDNA) in 492 patients with non-syndromic hearing loss recruited between March 2014 and September 2016 from the Otolaryngology Department of Xiangya Hospital, Central South University(283 males and 209 females, the age ranged from 1 to 48 years old). The Sanger sequencing method was used to compare the sensitivity, specificity, positive predictive value, negative predictive value, and total coincidence rate of the deafness mutation detected by the real-time fluorescence PCR melting curve method. Results: A total of 492 samples were detected. 193 wild-type samples, 93 homozygous mutant samples, 145 heterozygous mutant samples, 59 composite heterozygous mutant samples and 2 samples with unknown mutations were detected using the real-time fluorescence PCR melting curve method within the range of 20 gene mutations, whichwere identical to the Sanger sequencing results.The two samples were detected as unknown mutations by the real-time fluorescent PCR melting curve method were confirmed by Sanger sequencing, including a composite heterozygous mutant sample and a homogenous mutation sample. GJB2 c.235delC and SLC26A4 c.919-2 A>G were the most common hotspot mutations in this study, followed by mtDNA m.1555 A>G. Compared with the Sanger sequencing method, the sensitivity, specificity, positive predictive value, negative predictive value, and total coincidence rate of the real-time fluorescence PCR melting curve method were 100%, the Youden's index was 1.0, and the Kappa value was 1. Conclusions: The real-time fluorescence PCR melting curve method is suitable for the detection of deafness gene mutations. It has the advantages in terms of simple, rapid, high sensitivity and strong specificity and can accurately detect the 20 gene mutations of 4 common deafness genes in Chinese population, which is expected to be used for the clinical detection of deafness genes in the future.

[An investigation of reproductive health in female workers engaged in administrative management].

Objective: To investigate the reproductive health status of female workers engaged in administrative management, and to provide a reference for protecting the reproductive health of female workers. Methods: From April to November, 2016, a cross-sectional survey was performed for 2717 female workers aged 18-60 years and engaged in administrative management from 13 cities and provinces in China, and a questionnaire was used to investigate their general information, occupational hazards in workplace, and reproductive health status, and the reproductive health status of female workers was analyzed. Results: Of all 2 717 female workers, 1 170 had gynecological diseases or symptoms, resulting in an incidence rate of 43.06%, and among these workers, 11.15% had abnormal menstruation, 34.64% had infertility, and 38.76% had a history of abortion. There were significant differences in the rates of abnormal results of gynecological examination, abnormal menstruation, abortion, and infertility between the female workers in different age groups (P<0.01) . Unhealthy living habits and major events were risk factors for gynecological diseases, abnormal menstruation, and abortion (P<0.05) ; bad working status was a risk factor for gynecological diseases and abortion (P<0.05) ; exposure to harmful factors was a risk factor for gynecological diseases and abnormal menstruation (P<0.05) . Conclusion: Living habits, major events, working status, and occupational harmful factors have certain influence on reproductive health of female workers engaged in administrative management. Occupational health protection should be strengthened, working patterns should be improved, self-protection awareness should be raised, and health protection should be enhanced for women of childbearing age to protect and promote the reproductive health of female workers.

[Influencing factors for reproductive health of female workers in petrochemical industry].

Objective: To investigate the reproductive health status of female workers in petrochemical industry, and to provide a reference for improving reproductive health status and developing preventive and control measures for female workers in petrochemical industry. Methods: A face-to-face questionnaire survey was performed from January to October, 2016. The Questionnaire on Women's Reproductive Health was used to investigate the reproductive health of female workers in petrochemical industry. The multivariate logistic regression model was used to identify the influencing factors for reproductive health of female workers in petrochemical industry. Results: Among the 7485 female workers, 1 268 (40.9%) had abnormal menstrual period, 1 437 (46.4%) had abnormal menstrual volume, 177 (28.5%) had hyperplasia of mammary glands, and 1 807 (24.6%) had gynecological inflammation. The reproductive system diseases in female workers in petrochemical industry were associated with the factors including age, marital status, education level, unhealthy living habits, abortion, overtime work, work shift, workload, video operation, occupational exposure, positive events, and negative events, and among these factors, negative events (odds ratio[OR]= 1.856) , unhealthy living habits (OR=1.542) , and positive events (OR=1.516) had greater impact on reproductive system diseases. Conclusion: Many chemical substances in the occupational environment of petrochemical industry can cause damage to the reproductive system, which not only affects the health of the female workers, but also poses potential threats to the health of their offspring. Occupational exposure, unhealthy living habits, overtime work, and work shift have great influence on reproductive system diseases in female workers.

[Occupational health status of electronics manufacturing female employees in China].

Electronics industry is a typical labor-intensive industry in China. There are a lot of female workers and various occupational hazard factors in the workplace. This article reviewed the characteristics of employment of women in electronics industry, occupational hazards of exposure, protective measures, occupational disease situation, influence of reproductive health and mental health, and occupational health management. Electronics female emplyees have the priority in reproductive health and mental health. Besides, this group has poor protective measures, occupational health management and policy should be taken to enhance the level of women health in electronics industry.

[Clinical and genetic investigation of families with Waardenburg syndrome type 2].

Objective:To investigate the clinical chacteration and molecular pathology of Waardenburg syndrome type 2 in seven families, and provide genetic diagnosis and hereditary counseling for family members. Method:Clinical data of seven families with WS2（14 patients）were collected. Peripheral blood samples of the probands and related family members were collected and genomic DNA was extracted. The coding sequences of microphthalmia associated transcription factor (MITF), sex-determining region Y-box 10(SOX10), snail family zinc finger 2 (SNAI2) and endothelin receptor type B（EDNRB）were analyzed by polymerase chain reaction and DNA sequencing. Then the raw data was analyzed. Result:The most common manifestations of WS2 are sensorineural hearing loss(10/14,71.4%), freckle(7/14, 50.0%)，heterochromia iridis(6/14, 42.9%) and premature greying(5/14,35.7%). All the deafness phenotype is congenital, bilateral profound sensorineural hearing loss. Freckles phenotype is different from cutaneous pigment abnormalities of WS in Westerners. The heterozygous mutation, c.328C>T in exon 3 of the MITF gene was detected in the proband and all patients of pedigree 2. However, no pathological mutation of the relevant genes (SOX10,SNAI2 and EDNRB) was detected in other pedigrees. Conclusion:There are obvious variations in clinical features of WS, while freckles may be a special subtype of cutaneous pigment disturbances. The MITF gene mutation, R110X,is therefore considered the disease causing mutation in pedigree WS02.However, there are novel disease causing genes or copy number variations in Waardenburg syndrome type 2, which require further research.

[The diversity analysis of spontaneous cerebrospinal fluid otorrhea between young children and adults].

Objective:To assess the diversity of spontaneous cerebrospinal fluid（CSF）otorrhear in clinical manifestation，CT，leakage sites and surgical operation between young children and adults．Method:We conducted a retrospective study of 6 consecutive patients who were all underwent the surgery through the transmastoid approach，including 4 adults patients and 2 children．In the 4 adults patients，two patients' bony defects lay on the tegmen mastoideum，one lay on the tegmen tympani，and another one lay on the sinus meningioma angle．None of the 4 adults patients had abnormal inner ear structures．Materials used in repair included free muscle graft，temporalis fascia，and fibrin glue of the 4 adults patients．The 2 children patients were diagnosed with congenital abnormalities of the lateral inner ear，who had bony defects of the foot plate or fenestra vestibule．Materials used in repair included free muscle graft，temporalis fascia,and musclein sequence. Result:No CSF leaks recurred after the operation except one adults patient，who's left ear recurred two times and experienced three operations. Conclusion:The clinical manifestations of spontaneous CSF otorrhea between young children and adults are different，the HRCT scan on temporal bone before the operation is very important．Especially foradults patients，making sure of theleakagesites and numbers isvaluable and significance for thesurgical procedure selection．.