China ; Humans ; Occupational Diseases ; classification

OBJECTIVETo investigate the eligibility and main problems for occupational health inspection agencies in China, and to provide technical references for improvement of occupational health inspection.

METHODSA survey was performed in occupational health inspection agencies that obtained eligibility before June 2011 in eight provinces: Zhejiang, Jiangsu, Shandong, Hubei, Guangxi, Shanghai, Chongqing, and Shenzhen. The survey used the General Information Questionnaire for Occupational Health Inspection Agency made by the project of Occupational Health Surveillance and Diagnosis and Identification of Occupational Diseases in China and Australia.

RESULTSA total of 650 agencies obtained eligibility for occupational health inspection in the eight provinces. These agencies contained 343 centers of disease control and prevention (CDC) or health and epidemic prevention stations (52.8%), 219 hospitals (33.7%), 25 institutes or centers for occupational disease prevention and control (3.8%), 29 community health service centers (4.5%), and 34 other agencies (5.2%) including departments of preventive and health care and preventive medicine outpatient departments. Four hundred and fifty-three agencies completed the questionnaire survey with a response rate of 69.7%. The main types of eligible agencies were different among various regions. A majority of occupational health inspection agencies were hospitals in Shanghai and Zhejiang (67.1%, 62.3%), departments of preventive and health care in Shenzhen (70.0%), and CDCs in Chongqing, Jiangsu, Hubei, and Guangxi. Each agency obtained 3.5 occupational health inspection eligibilities on average. Most of agencies could perform eligible health inspection for dust, harmful physical factors, or harmful chemical factors (84.8%, 87.9%, 87.2%). Moreover, 72.8% of agencies were eligible for all the three types of inspections. A few agencies were able to perform eligible health inspection for harmful biological factors or radiation work (22.5%, 23.0%).

CONCLUSIONAn occupational health inspection network has been established in these surveyed regions. CDCs, institutes for occupational disease prevention and control, and hospitals are the main agencies for occupational health inspection. In order to build up a network of occupational disease prevention and control, various agencies should make full use of their own advantages and enhance abilities and technical cooperation.

China ; Hospitals ; Humans ; Occupational Diseases ; epidemiology ; Occupational Health ; Occupational Health Services ; organization & administration ; Organizations ; Surveys and Questionnaires

OBJECTIVE: To understand the research status on living conditions of patients with occupational pneumoconiosis in China. METHODS: The Chinese academic journal database, Wanfang Chinese periodical database and VIP database were used to search the relevant domestic literatures on the survival status of patients of occupational pneumoconiosis. The NoteExpress literature management software, VOSviewer 1.6.10 software and CiteSpace 5.2 software were used to sort out and visually analyze the searched literatures. RESULTS: A total of 4 043 articles were obtained, including 2 745 journal papers, 1 165 degree papers and 133 conference papers. The publication was increasing rapidly in years. The journal papers were published in 766 journals, and the degree papers came from 257 graduate training units. Disease prevention and control institutions, occupational defense institutions, colleges and universities were the supporting units of first authors that published the largest number of periodical papers. Pneumoconiosis was a high-frequency keyword. The emerging key words in this field from 2015 to 2019 include: occupational health examination, nursing intervention, lung function, industrial injury insurance, occupational health monitoring and quality of life. CONCLUSION: The number of literatures published on the survival status of pneumoconiosis patients in China shows a trend of rapid growth. The prominent words in the current and future studies on the living conditions of pneumoconiosis patients in China are occupational health examination, nursing intervention, lung function, industrial injury insurance, occupational health monitoring and quality of life.

Objective: To detect of the components and concentration of the metals and metalloids in the lavage fluid of whole-lung lavage (WLL) of the cases of pneumoconiosis, and analyze the characteristics, and explore the method to sample and process the samples of bronchoalveolar lavage fluid (BAL) . Methods: The samples of urine and serum of three cases of pneumoconiosis were collected before WLL, and the samples of BAL were collected during the WLL from the left and right lungs according to the sequence of four pressured gas flow and five negative pressure drainage. Each of 10ml original samples of WLL was collected firstly, and the left was centrifuged to acquire all the sediment samples and each of 10 ml samples from the centrifuge clear liquids, The components and concentration of the metals and metalloids in the samples were measured by Inductively Coupled Plasma mass spectrometer (ICP-MS) . Results: The average volume of BAL from unilat-eral lung for 3 patients was 10 758.3±1518 ml, and the average recovery rate was 89.7%. The average dry weight of sediment samples of BAL of three cases of pneumoconiosis was 0.292 gram with the right lung sam-ples slightly higher than the left lung samples. The detectable elements from the samples included Barium (Ba) , Strontium (Sr) , Calcium (Ca) , Magnesium (Mg) , Manganum (Mn) , Ferrum (Fe) , Cuprum (Cu) , Zinc (Zn) , Kalium (K) , Natrium (Na) , Selenium (Se) , Silicon (Si) and Uranium (U) . Each of concentration dis-tributions of these elements were not normal. Except for Cuprum, Selenium and Uranium, the concentrations of the other ten elements in the supernatant samples, mixture samples and sediments samples were statistical-ly different with the nonparametric test of Kruskal-Wallis. The concentrations of Natrium, Kalium and Barium in supernatant samples were higher, while the others in precipitation samples were higher. The concentration of elements in the sample from the right lung was slightly higher than that from the left lung, but there was no statistically significant difference (P>0.05) . There were statistical difference in term of element concentration of precipitates samples before and after pressured gas flow (P<0.05) . The concentration of K、Ca、Mg、Si and Se in se-rum, urine, supernatant and sediment samples had a good correlation. The correlation coefficient of Silicon between serum and precipitation was 0.676 and that between urine and precipitation was 0.524. Conclusion The concentra-tions of the metals and metalloid in sediment samples were more stable than that of supernatant and mixture samples. The sampling of one-side lung lavage fluid was representative in the detection of metals and metalloid in the BAL. It was the best time for sampling sediment from the BAL after the first pressured gas flow among the WLL.

Objective: To analyze the characteristics of pneumoconiosis patients and the basic status of medical treatment. Methods: Research objects were chosen by stratified sampling method and typical survey method from existing pneumoconiosis patients in China. The survey was carried out from March 2017 to January 2018 in nine provinces including provinces from east, medium and western region in China. Source of pneumoconiosis cases were inpatient cases, outpatient or physical-examined cases and household-investigation cases. The survey mainly included demographic and sociological characteristics, economic status, occupational history and dust exposure history, disease status, work-related injury insurance and social security status and related indicators of pneumoconiosis treatment. Results: Investigated 1037 pneumoconiosis cases which included 186 (19.9%) household-investigation cases, 212 (20.4%) outpatient or physical-examined cases and 639 (61.7%) inpatient cases. Demographic and sociological characteristics, individual monthly income, economic source, occupational history and work-related injury insurance were statistically significant among different source of pneumoconiosis patients (P<0.05) . Among all of the household-investigation cases, there were 74 cases (40.2%) had no income, 117 cases (62.9%) used to work in private enterprises, 36 cases (19.4%) had work-related injuries insurance, 95 cases (51.1%) were at three phase of pneumoconiosis, 108 cases (59.0%) haven't had any drugs for pneumoconiosis. 65 cases (39.4%) haven't went to the clinic, 53 cases (28.5%) hadn't seek medical advice although they needed medical treatment very much. Among all of the outpatient or physical-examined cases, there were 95 cases (46.1%) had no income, 36 cases (17.0%) had work-related injuries Insurance, 139 cases (65.6%) went to the clinic for treatment of pneumoconiosis, 81 cases (38.2%) went to the clinic for more than ten times. Among all the inpatient cases, 310 cases' (49.3%) personal monthly income was above 2000 yuan, 352 cases (55.1%) had work-related injuries Insurance, 588 cases (92.2%) were taking drugs for treatment of pneumoconiosis, 153 canses (24.2%) had hospitalization for than ten times. Conclusion Household-investigation cases have lower economic conditions, lower rates of Insurance coverage for work-related injuries, severer pneumoconiosis and higher clinical service utilization. Clinical or physical-examined cases have lower economic conditions, lower rates of Insurance coverage for work-related injuries and higher clinical service utilization. Hospitalized cases have better economic conditions, higher rates of insurance coverage for work-related injuries and higher hospitalization service utilization.

Objective: To evaluate the utilization and influencing factors of whole lung lavage (WLL) for patients with pneumoconiosis. Methods: A total of 10 524 pneumoconiosis patients who sought medical treatment from 2018 to 2021 were selected as the research subjects using a combination of stratified random sampling and non-random sampling methods. The patients were from 27 provincial administrative regions of Chinese mainland (excluding Shanghai City, Tianjin City, Hainan Province and Tibet Autonomous Region). The effects of demographic and sociological characteristics, disease-related factors, and economic and social security status on WLL utilization were analyzed. Results: The WLL rate of pneumoconiosis patients was 17.8% (1 871/10 524). The main reason for promoting WLL in pneumoconiosis patients was “doctor's advice”, accounting for 65.4%； followed by “known-pneumoconiosis-patients had WLL” and “patient's recommendation”, accounting for 24.1% and 18.1%, respectively. Multivariate logistic regression analysis showed that age, body mass index, smoking index, education level, survey area, source of patients, current employment status, nature of dust-exposed unit, stage of pneumoconiosis, type of pneumoconiosis, pneumoconiosis symptoms (coughing up phlegm, chest pain, dyspnea, joint pain), contraindications to WLL (tuberculosis, pulmonary heart disease), family annual income, medical insurance for urban employees, proportion of medical insurance reimbursement, disability benefits, and social assistance were the influencing factors of WLL utilization in pneumoconiosis patients (all P<0.05). Conclusion: A large proportion of pneumoconiosis patients used WLL. The influencing factors of WLL utilization included demographic and sociological characteristics, disease-related factors, economic and social security status, and more. It is necessary to protect the interests of pneumoconiosis patients, strengthen occupational health education and health promotion for pneumoconiosis patients, standardize the use of WLL in medical institutions, and make rational use of WLL.

Objective: To analyze the influencing factors for hospitalization of pneumoconiosis patients, so as to provide reference for improving the timeliness of treatment and quality of life in these patients. Methods: The pneumoconiosis patients in Changshan, Wenling and Changxing ( having mining industry ) of Zhejiang Province were selected by stratified and typical sampling methods. Their demographic features, prevalence of pneumoconiosis and hospitalization status were collected by a questionnaire survey. Logistic regression analysis was conducted to analyze the influencing factors for hospitalization. Results: Among 166 pneumoconiosis patients, 122 ( 73.49% ) chose to be hospitalized. The multivariate logistic regression analysis revealed that the patients who scored higher in ED-5Q ( OR=65.821, 95%CI: 3.831-1130.781 )and who would communicate with other pneumoconiosis patients ( OR=3.744, 95%CI: 1.261-11.115 ) were more likely to be hospitalized; the patients who were under the medical insurance for urban employees were more likely to be hospitalized than those who were under the new rural cooperative medical care system ( OR=0.033, 95%CI: 0.007-0.154 ) and others ( OR=0.038, 95%CI: 0.002-0.960 ) . Conclusion The quality of life, communication with other pneumoconiosis patients and type of medical insurance were the influencing factors for hospitalization of pneumoconiosis patients.

OBJECTIVETo conduct a systematic review of studies reporting the comparison of digital radiography (DR) with conventional film-screen radiograph (FSR) in the screening and recognition of pneumoconiosis worldwide, to evaluate the feasibility of DR in the screening and recognition of pneumoconiosis, to analyze the similarity and difference between DR and FSR, to explore the main challenge to utilize DR in the future.

METHODSThe national and international databases were systematically searched for original articles on DR for screening and recognition of pneumoconiosis published from first Jan 1998 to first Nov 2013, making evaluation and selection of them, and qualitative data and quantitative data were extracted independently from the selected articles and systematically reviewed.

RESULTSFive hundred and twenty articles were found and evaluated and nine of them met the inclusion criteria of systematic review. The research time started from 2002 to 2011 whose objects mainly came from pneumoconiosis cases and dust-exposed workers and control population examined with DR and FSR using the high kV radiography from 120 to 130 kV. The chest radiographs were read at blind and random and standard control method. There were only two papers compare the validity of DR and FSR for recognition and classification of pneumoconiosis using gold standards. There were still some diversity of imaging processing and imaging reading without design and assessment using Standards for Reporting of Diagnostic Accuracy (STARD) in these researches. The evaluation index of the nine articles include detection rate of small opacities, crude agreement, Kappa value of Kappa Consistency Test, Area Under the Curve of ROC, etc. Seven of the nine selected articles estimated DR has generally produced superior image qualities compared to FSR. Four papers had a conclusion that DR could be equivalent to FSR in identification of shapes and profusion of small opacities and in classification of pneumoconiosis. Five papers considered DR had higher presence of pneumoconiosis comparing with FSR especially in recognition the pneumoconiosis of category 1. The variation between different film formats of DR and FSR were smaller than that within and between readers for classification of pneumoconiosis.

CONCLUSIONAlthough there are still some imperfections in the existent researches to solve, DR can be equivalent to FSR in screening and recognition of pneumoconiosis. It is necessary to develop technical specifications of DR and standard digital chest radiographs for pneumoconiosis including both hard copy and soft copy, and develop an evaluation criterion on chest images of DR.

Humans ; Mass Screening ; Pneumoconiosis ; diagnostic imaging ; Radiographic Image Enhancement ; methods

Objective: To develop a rapid detection method for 21 elements in urine with inductively coupled plasma mass spectrometry (ICP-MS) . Methods: The urine samples were directly diluted 20 times by 1% HNO₃, and detected by ICP-MS, Indium, Yttrium, and Lutecium were used as on-line internal standard. Fe was analyzed by Dynamic Reaction Cell (DRC) mode, As, Cr, V and Zn were analyzed by collision cell technology (CCT) mode, and Be, Mn, Ni, Cd, Sn, Bi, Pb, Re, Sb, W, Li, Cu, Se, Sr, Mo were analyzed by standard mode. Dynamic band-pass tuning (DBT) was used to eliminate interference for Fe. Results: All the elements have good linearity in their determination range, with the correlation coefficient r>0.999 5. The limits of detection of the 21 elements were in the range of 0.017-11.14 μg/L. The inter-precision (relative standard deviation, RSD) was less than 9.96%, and the intra-precision was less than 13.90% (except As RSD<18.91%) . The spike recovery of all elements fell within 81.1%-116.4%. Conclusion The method was proved to be simple, fast, and accurate, and met the needs of testing requirements of large amounts of specimens.

To revise GBZ 188 Technical Specification for Occupational Health Surveillance based on national laws, regulations, standards, specifications and legal documents of occupational disease, and combination with the actual situation in China. The main modifications are as follows: the occupational health surveillance for workers exposed to toluene (xylene may implement by reference), bromopropane, methyl iodide, ethylene oxide, chloroacetic acid, indium and its compounds, coal tar, coal tarasphalt, asphalt, β-naphthylamine, dust of metal and its compounds(tin, iron, antimony, barium and its compounds), hard metal dust, erionite dust, low temperature, laser, tick-borne encephalitis virus, Borrelia burgdorferi, and human immunodeficiency virus, for scraper or grind operators, and underground workers using squatting or kneeling position, crawling position, side-lying position, or shoulder position for a long period of time are included. The emergency health screening for workers exposed to arsenic, fluorine and its inorganic compounds, and acrylamide are included. The occupational medical examination (OME) for workers exposed to amino and nitro compounds of benzene, phosgene, monomethylamine, organic fluorine and dimethyl sulfate has been adjusted and made mandatory, with corresponding assessments required upon leaving the job. The special occupational health surveillance for workers exposed to mycobacterium tuberculosis and hepatitis virus is removed. The OME conclusion of reexamination is removed, and standardize recheck/additional inspection requirements. The optional items in OME performed before, during and after leaving post are removed, but the optional items in emergency medical examination are retained. Additional OME items are added. The Guideline for OME Summary Reports is added as informative appendix, and so on. The revised GBZ 188 Technical Specification for Occupational Health Surveillance is more scientific and practical.