ObjectiveTo explore the application effect of using the comprehensive index method for occupational health risk assessment in the lead-acid battery enterprises. Methods Convenient sampling method was used to select two lead-acid battery enterprises A and B in Jiangsu Province, with eight key positions including ball grinding, plate casting, pasting, plate coating, plate grinding, plate slicing and brushing, welding and acid charging as the research subjects. Worksite survey of occupational health was conducted in these two lead enterprises, and the levels of lead smoke, lead dust and sulfuric acid in the key positions were detected. The health risk of occupational hazards in the eight key positions was evaluated by a comprehensive index method. Results The time-weighted average concentration (C_TWA) of lead smoke in plate casting and welding positions of enterprise A, the C_TWA of lead dust in plate grinding and plate slicing and brushing positions of enterprise A, the C_TWA of lead dust in plate grinding position of enterprise B, the C_TWA of lead smoke in welding position of enterprise B were exceeded national occupational exposure limits. The risk assessment results of the plate casting, welding, plate grinding and plate slicing and brushing positions were moderate risk, while other positions were low risk in enterprise A. The risk assessment results of the plate grinding and welding positions were moderate risk, while other positions were low risk in enterprise B. Conclusion The results of risk assessment by the comprehensive index method were consistent with the results of occupational hazard factors detection. The comprehensive index method could well evaluate the occupational health risks of lead-acid battery enterprises.

Background Prolonged awkward postures during occupational activities can lead to excessive musculoskeletal load on the wrist of workers and symptoms such as wrist pain or discomfort. Objective To survey the prevalence of wrist pain among workers in 10 key industries and analyze its correlation with wrist working postures. Methods By using stratified cluster sampling method, workers from 10 key industries, such as footwear manufacturing industry, shipbuilding manufacturing industry, and automobile manufacturing industry, were selected from seven regions in North China, East China, Central China, South China, Southwest China, Northwest China, and Northeast China. The demographic information, wrist working postures, pain in wrist of the workers were collected through a cross-sectional survey. Pearson χ² test was used to compare prevalence by selected factors, trend χ² test for between group comparison, and unconditional logistic regression models for the association of wrist working postures with wrist pain. Results There were 64052 workers enrolled in this survey, and 56286 provided valid questionnaires (the effective rate was 87.8%). According to the survey, the prevalence of wrist pain was 23.3% (13112/56286), and the industries with higher prevalences were footwear manufacturing (27.1%, 1927/7106), automobile manufacturing (24.9%, 5378/21560), and shipbuilding and related equipment manufacturing (24.4%, 850/3488) industries. Finger pinching (OR=2.09, 95%CI: 1.95-2.24), frequent wrist bending (OR=2.03, 95%CI: 1.92-2.15), fixed wrist bending (OR=1.77, 95%CI: 1.69-1.85), wrist on hard edge (OR=1.34, 95%CI: 1.28-1.40), and arms over shoulders (OR=1.11, 95%CI: 1.05-1.17) increased the risk of reporting wrist pain. Conclusion Awkward postures are related to wrist pain among workers in selected 10 key industries. The related factors are wrist on hard edge, frequent wrist bending, finger pinching, fixed wrist bending, and arms over shoulders.

Objective: To analyze the current status of work-related musculoskeletal disorders (WMSDs), work fatigue and musculoskeletal pain in Chinese occupational population, and to study the relationship between work fatigue and musculoskeletal pain and WMSDs. Methods: A total of 66 961 employees from 323 enterprises in 15 key industries in China were selected as the study subjects using stratified cluster sampling method. The incidence of WMSDs in the past year was investigated using the Chinese version of the Musculoskeletal Disorders Questionnaire, and the work fatigue and musculoskeletal pain were investigated using Borg 6-20 Rating of Perceived Exertion Scale and visual analogue scale. The data were standardized using the age composition data of 18 to 60 years from the seventh national population census. Results: The standardized annual incidence of WMSDs was higher in the front-line workers than that in the administrative and other supportive staff (38.82% vs 36.30%). The detection rates of work fatigue and musculoskeletal pain in the study subjects were 44.54% and 63.08%, respectively. The result of S-curve fitting showed that the risk of WMSDs increased with the level of work fatigue (P<0.01). Among the front-line workers, the average of monthly fatigue frequency in the neck, shoulder, lower back, upper back, wrist/hand, foot and ankle, knee, leg, and elbow were higher in the group with WMSDs compared to those without WMSDs (all P<0.01). The pain degree of musculoskeletal pain was higher in all nine sites in the fatigued group than in the no-fatigue group (all P<0.01). The standardized detection rate of musculoskeletal pain was higher in the fatigued group than in the non-fatigued group (80.38% vs 25.71%). The work fatigue was moderate and positively correlated with musculoskeletal pain in all seven sites except the lower back and elbow, with Kendall Tau-b correlation coefficients ranging from 0.423 to 0.546 (all P<0.01). Conclusion: There is a good correlation between work fatigue and local musculoskeletal pain, work fatigue and WMSDs in Chinese occupational population. Implementing ergonomic interventions to control the development of work fatigue can be an effective measure for preventing WMSDs.

Background Hexavalent chromium [Cr(VI)] can induce malignant transformation of lung epithelial cells, but its molecular mechanism is still unclear. Objective This study aims to explore the key genes of Cr(VI)-induced malignant transformation of lung epithelial cells and the mechanism of the transformation by bioinformatics analysis. Methods High-throughput gene expression profile data related to Cr(VI)-induced toxic effect was downloaded from the Gene Expression Omnibus(GEO) database, and the co-expressed genes were obtained by the intersection of differentially expressed genes in each dataset. DAVID 6.8 was used to analyze the function enrichment of gene ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathways of the selected differential expression genes. STRING, and Cytoscape 3.8.2 were applied to construct and visualize the protein-protein interaction network. The expressions of Hub genes in lung tumor were obtained by GEPIA2. Results A total of 234 differentially expressed genes were screened out from the GSE24025 and GSE36684 datasets, among which 99 genes were up-regulated while 135 genes were down-regulated. The results of GO and KEGG analyse were mainly concentrated in cell adhesion, negative regulation of cell proliferation, and transcription disorders. A rotein-protein interaction network was generated by STRING database and Cytoscape software. Four functional modules with high scores and 6 Hub genes were finally retrieved. The expression trend of FBLN1 in lung cancer subtypes was consistent with the results of transcriptome screening. Conclusion Cr(VI) exposure causes the differential expression of multiple genes in lung epithelial cells, involving cell morphology, movement, survival fate, phenotype function and signal pathway related to cancer development. FBLN1 may be the critical gene related to malignant cytopathy.

Objective To investigate the micronucleus rate of peripheral blood lymphocytes in radiation workers exposed to chronic low dose ionizing radiation in Jiangsu province to adopt corresponding protective measures. Methods From January to December 2019, 504 in-service radiation workers were taken as the radiation group, 105 healthy adults who were to be engaged in radiation work by pre-job occupational health examination were served as the control group. We compared the micronucleus rate of peripheral blood lymphocytes measured by conventional culture. Results The micronucleus rate in the radiation group was significantly higher than that in the control group (P < 0.001) and the micronucleus rate in the female radiation workers was higher than that in the male (P < 0.01); The difference of micronucleus rate in different age groups was statistically significant (P < 0.05), among which aged 41～50 years being higher than that of those aged 21～30 years. Besides, The difference of micronucleus rate between different working age groups was statistically significant (P < 0.05), with higher rates in the 21～30 year range than in the 0～10 year range. (P < 0.05). Differential micronucleus rates among different types of work were statistically significant (P < 0.01), with the highest rate of micronucleus among staff in radiotherapy positions compared to other positions. What’s more, the highest rate of micronucleus among radiology staff in units of different levels was found in municipal hospitals, with statistically significant differences in micronucleus rates between provincial hospitals, enterprises (P < 0.05) and municipal hospitals (P < 0.01). Conclusion The micronucleus rate of radiation workers was significantly higher than that of non-contact personnel, and the micronucleus rate of female radiation workers is higher than that of men. Moreover, the highest rate was found among radiation workers. Therefore, radiation protection and daily management of this population should be strengthened.

Objective:To analyze and compare the detection level and actual detection of suspected occupational diseases of lead exposed workers in the network report of occupational disease and occupational health information monitoring system, so as to provide a basis for formulating and improving relevant laws and regulations on occupational disease monitoring in the future.Methods:From January 2016 to December 2018, the network report occupational health examination data of lead exposed workers in Jiangsu Province were selected, the network report detection rate of suspected occupational diseases of lead exposed workers was counted and compared with the actual detection rate judged in the early stage, and the distribution characteristics of the network report detection rate of different years, regions and occupational health examination institutions and the reasons for the difference with the actual detection rate were analyzed.Results:Network report detection rate of suspected occupational disease in Jiangsu Province from 2016 to 2018 (0.042%, 30/71810) was significantly lower than the actual detection rate of 1.12% (805/71810) , and the difference was statistically significant (χ 2=723.518, P<0.01) . The network report detection rates of suspected occupational chronic lead poisoning showed an increasing trend year by year, and the difference were statistically significant (χ 2trend=7.627, P<0.01) . All the 30 network report cases were male, and 28 cases (93.33%) were from small and medium-sized enterprises. Among the 805 cases of suspected occupational chronic lead poisoning, 689 cases (85.59%) came from small and medium-sized enterprises. The three cities with more cases were Huai'an 222 cases (27.58%) , Suzhou 208 cases (25.84%) and Changzhou 138 cases (17.14%) . Compared with the actual detection, the number of network reports in Yangzhou accounted for 85.29% (29/34) of the actual detection from 2016 to 2018, that in Suqian accounted for 10.00% (1/10) , and that in other prefecture level cities was 0. From 2016 to 2018, 46.22% (33191/71810) of the occupational health examinations of lead exposed workers were undertaken by Centers for Disease Control and prevention at all levels (referred to as "CDC") . The 30 suspected cases of occupational chronic lead poisoning reported network came from CDC, accounting for 4.89% (30/614) of the actual detection, and the rest were 0. Conclusion:There are great differences between the network report and the actual detection rate of suspected occupational chronic lead poisoning among lead exposed workers, mainly due to the differences in the judgment level of suspected occupational diseases in different regions, the nature of institutions and the level of professional technicians.

Objective:To understand the occupational health status of a lead-acid battery enterprise in Jiangsu Province, to observe the results of blood lead and bone mineral density (BMD) of the workers exposed to occupational lead, and to explore the effect of occupational lead exposure on BMD, so as to provide basis for the prevention and treatment of occupational lead poisoning and osteoporosis.Methods:An occupational health survey was conducted in a lead-acid battery enterprise in Jiangsu Province in January 2019. Basic information and occupational health examination results of 402 persons exposed to occupational lead were collected, and BMD was measured. Spearman rank correlation test was used to analyze the relationship between blood lead and BMD, and logistic regression analysis was used to analyze the influencing factors of BMD.Results:The blood lead level M ( P25, P75) of 402 occupational lead exposure workers was 220.5 (118.0, 307.0) μg/L, 46 workers (11.4%) had blood lead value ≥400 μg/L, and 5 workers (1.2%) ≥600 μg/L. 124 workers (30.8%) had abnormal BMD. The concentrations of lead dust and lead smoke in the workplace were <0.004-0.027 and <0.021-0.045 mg/m 3, respectively. The positions exceeding the standard point were mainly concentrated in the casting and welding group (44.4%, 4/9) of lead smoke positions. There was a statistically significant difference in the overall distribution of blood lead levels among lead exposure workers with different BMD levels, and there was a positive correlation between blood lead and BMD ( P<0.01) . The results of univariate analysis showed that there were statistically significant differences in the distribution of abnormal BMD among workers exposed to different genders, positions and blood lead levels ( P<0.01) . The results of multivariate logistic regression analysis showed that the risk of abnormal BMD in male workers was 5.069 times of that in female worker (95% CI: 2.906-8.840, P<0.01) . Conclusion:Occupational lead exposure personnel have a high blood lead level and a high abnormal BMD rate. Exposure to lead working environment is an influencing factor for the abnormal BMD of workers, so enterprise managers should pay attention to health protection, occupational health monitoring and supervision of working environment of front-line workers.

Objective:To analyze the protective effect of dust masks worn by super absorbent polymer (SAP) dust-exposed workers and the influence of each test exercise on the protective effect of mask.Methods:In March 2017, forty nine SAP dust-exposed workers in a large chemical enterprise were selected as subjects. The respirator fitness tester was used to test the protective effect of dust mask before and after training, and the influence of each test exercise on the protective effect of dust mask was analyzed.Results:After training, the qualified rate of dust mask protective effect of SAP dust-exposed workers was 95.92% (47/49) , which was significantly higher than that before training [63.31% (32/49) ], and the difference was statistically significant (χ 2=14.69, P<0.01) . When the total protective effect was qualified, the fit factor ( FF) decreased significantly when speaking aloud and bending down ( Z=-2.59, -4.20, P<0.01) . The qualified rates of protective effect of each exercise were significantly different (χ 2=42.70, P<0.01) , among which the qualified rates of deep breath was the highest (100.00%) , and the qualified rate of bending down was the lowest (70.21%) . Conclusion:Strengthening the training of workers to wear masks correctly is helpful to improve their respiratory protection efficiency. Under the condition that the total protective effect of dust masks is qualified, workers should try to avoid unnecessary actions, especially speaking aloud and bending down frequently.

Occupational disease diagnosis standards are an important basis for occupational disease diagnosis, occupational health surveillance, occupational health supervision, occupational disease treatment, occupational disease disability assessment, and handling of occupational disease diagnosis disputes in conjunction with the "Occupational Disease Prevention and Control Law of the People's Republic of China". With the successive promulgation of the "Standardization Law of the People's Republic of China" and the "Administrative Measures on Health Standards", the establishment of a mandatory standard implementation evaluation mechanism has gradually been paid attention to. However, there is still a lack of systematic research on the evaluation of diagnostic criteria for occupational diseases. Therefore, this article combines the current status of the diagnostic standards for occupational diseases in China, and proposes reasonable suggestions on how to carry out the evaluation of the implementation of this type of standard in terms of evaluation methods and content.

Objective:To analyze and compare the detection level and actual detection of suspected occupational diseases of lead exposed workers in the network report of occupational disease and occupational health information monitoring system, so as to provide a basis for formulating and improving relevant laws and regulations on occupational disease monitoring in the future.Methods:From January 2016 to December 2018, the network report occupational health examination data of lead exposed workers in Jiangsu Province were selected, the network report detection rate of suspected occupational diseases of lead exposed workers was counted and compared with the actual detection rate judged in the early stage, and the distribution characteristics of the network report detection rate of different years, regions and occupational health examination institutions and the reasons for the difference with the actual detection rate were analyzed.Results:Network report detection rate of suspected occupational disease in Jiangsu Province from 2016 to 2018 (0.042%, 30/71810) was significantly lower than the actual detection rate of 1.12% (805/71810) , and the difference was statistically significant (χ 2=723.518, P<0.01) . The network report detection rates of suspected occupational chronic lead poisoning showed an increasing trend year by year, and the difference were statistically significant (χ 2trend=7.627, P<0.01) . All the 30 network report cases were male, and 28 cases (93.33%) were from small and medium-sized enterprises. Among the 805 cases of suspected occupational chronic lead poisoning, 689 cases (85.59%) came from small and medium-sized enterprises. The three cities with more cases were Huai'an 222 cases (27.58%) , Suzhou 208 cases (25.84%) and Changzhou 138 cases (17.14%) . Compared with the actual detection, the number of network reports in Yangzhou accounted for 85.29% (29/34) of the actual detection from 2016 to 2018, that in Suqian accounted for 10.00% (1/10) , and that in other prefecture level cities was 0. From 2016 to 2018, 46.22% (33191/71810) of the occupational health examinations of lead exposed workers were undertaken by Centers for Disease Control and prevention at all levels (referred to as "CDC") . The 30 suspected cases of occupational chronic lead poisoning reported network came from CDC, accounting for 4.89% (30/614) of the actual detection, and the rest were 0. Conclusion:There are great differences between the network report and the actual detection rate of suspected occupational chronic lead poisoning among lead exposed workers, mainly due to the differences in the judgment level of suspected occupational diseases in different regions, the nature of institutions and the level of professional technicians.