Background The prevalence of chronic diseases among the Chinese occupational population is rising steadily, with hypertension and diabetes becoming important health concerns. Occupational health examinations (OHE) provide stable population coverage, standardized protocols, and fixed follow-up intervals, offering a robust data foundation for risk assessment. However, most existing hypertension prediction studies rely on cross-sectional data and mainly focus on clinic onset, failing to capture the dynamic progression and cumulation of individual risk. Objective To construct a machine learning-based risk prediction model for blood pressure abnormality in occupational populations, providing a reference for health risk stratification and targeted health interventions. Methods Longitudinal data from 2020 to 2023 were extracted from the occupational health examination database of an institution in Shanghai. After excluding individuals with hypertension in any of the first three years, 3710 workers who participated 4 consecutive years of OHE were included. Six categories of blood pressure-related indicators from 2020 to 2022 were selected, including basic information, lifestyles, occupational exposures, cardiovascular indicators, routine blood tests, and biochemical markers, comprising 30 variables in total. For feature engineering, continuous variables were processed to reflect three-year dynamic characteristics: level (mean), variability (variance), and temporal trend (slope). Categorical variables were incorporated using 2022 values. Least absolute shrinkage and selection operator regression was applied to identify variables for inclusion in the machine learning models. Five models (decision tree, logistic regression, random forest, support vector machine, and XGBoost) were employed to predict blood pressure abnormality risk in 2023. And then sensitive analysis was conducted. The optimal model was selected based on the area under the curve (AUC) of receiver operating characteristic. Feature importance and SHAP analyses were applied to interpret the final model. Results Feature engineering transformed 17 continuous variables into 51 secondary variables, combined with 13 baseline variables, resulted in 24 variables screened out by LASSO regression. The logistic regression model achieved the best performance. Feature importance analysis indicated that the dynamic trajectory of blood pressure played a central role in the model, complemented by other biochemical and lifestyle indicators. SHAP analysis further showed that the model’s ability to not only identify risks of high-normal blood pressure and hypertension but also quantify the specific contribution of individual examination indicators to predicted risk, supporting risk-stratified population management in occupational health management. Conclusion Based on an existing occupational health examination database and routinely collected data, this study has developed a risk prediction model for blood pressure abnormalities in occupational populations. By incorporating dynamic change characteristics from longitudinal examinations, the study demonstrates the feasibility of using routine health data for early risk identification and stratified management. However, its applicability is limited by the availability of repeated examination data and the focus on specific occupational groups, requiring further validation across broader populations and diverse clinic scenarios.

Background Long-term occupational health surveillance facilitates the identification of chronic health risks arising from occupational hazard exposures. However, under low-level exposure conditions in chemical enterprises, traditional workplace-centered risk assessment models are insufficient to fully explain the observed health effects among workers, highlighting the need for individual-focused health management strategies that focus on the worker. Objective To characterize long-term health trends among workers in a chemical enterprise and examine the limitations of workplace hazard monitoring and health surveillance under low-level multiple exposure scenarios, thereby providing a scientific basis for more comprehensive worker health protection measures. Methods We analyzed 972 occupational health examination records collected over a 15-year period (2010–2024) from a chemical enterprise, integrating these with enterprise hazard monitoring reports and workshop air monitoring of volatile organic compounds (VOCs). The annual counts and prevalences of abnormalities in liver function tests, metabolic syndrome-related indicators, and liver imaging were summarized. Temporal trends were evaluated using the Cochran-Armitage trend test. Time-related changes in abnormal health indicators among active workers were evaluated by generalized linear mixed-effects models (GLMMs), adjusting for age and sex. Individual longitudinal profiles were described for nine workers with continuous 15-year records. In addition, paired comparisons of health outcomes were conducted for 81 workers with both pre-employment and periodic examinations. Results Workplace hazard monitoring indicated that airborne concentrations of major occupational contaminants including VOCs, acids and bases, dust, and physical factors were below national occupational exposure limits. However, 62 VOC species—including chlorobenzene, chloromethane, and cyclohexane—were detected in workshop air, suggesting complex mixed organic solvent exposure. From 2010 to 2015, occupational health examination records were primarily based on physicians’ qualitative assessment, yielding generally low abnormality detection rates. During 2016–2024, data collection was complete, and the prevalences of abnormalities in liver function, metabolic syndrome-related indicators, and liver imaging among active workers remained relatively high. Trend analysis indicated that only the abnormality rates of total bilirubin (TBIL) and hypertension showed statistically significant temporal trends; other indicators exhibited no significant linear changes despite high prevalences. After adjusting for age and sex, the GLMMs showed that the abnormality rates of aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), TBIL, and hypertension decreased over time, whereas those of total cholesterol, triglycerides, and fatty liver increased. In a subgroup of 9 workers with continuous 15-year follow-up data, the cumulative number of abnormal health indicators increased in several individuals after 2016. Among the 81 workers with both pre-employment and periodic records, abnormalities in total cholesterol, triglycerides, body mass index, and fatty liver were significantly more prevalent after employment over time, whereas changes in liver function enzymes were not statistically significant. Conclusion With increasing age, workers exhibit a gradual deterioration in liver function and metabolic-related health indicators, reaching abnormality rates comparable to those reported in the general population. These findings suggest that both workplace-related and non-occupational factors jointly contribute to the observed health changes. Consequently, occupational health management should shift towards an "individual-centered" approach. Enhancing workers' health literacy, strengthening workplace health promotion, and extending occupational health services beyond the workplace are essential to comprehensively protect workers' health.

Objective To analyze the coverage of chronic disease-related indicators and the distribution of positive detection rates in occupational medical examinations (OME). Methods A total of 872 862 currently employed workers who underwent OME from 2015 to 2023 were selected as the study participants using a convenience sampling method. According to the year of OME, the study period was divided into three periods: 2015-2017, 2018-2020, and 2021-2023. The examination rates and positive detection rates of five chronic disease-related indicators, including obesity, high blood pressure, hyperglycemia, dyslipidemia, and hyperuricemia, were analyzed. Results Regarding the routine medical examination indicators in OME, the examination rates for systolic and diastolic blood pressure were both 97.4%, while those for body height and weight were both 6.8%. Among the mandatory or optional examination items for specific occupational groups in OMEs, the examination rates of fasting blood glucose, triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were 35.2%, 18.5%, 18.5%, 7.8%, and 7.9%, respectively. Regarding items not included in OMEs, the examination rates of glycated hemoglobin and uric acid were 0.2% and 19.2%, respectively. The examination rates for systolic and diastolic blood pressure consistently exceeded 95.0%, the examination rates for fasting blood glucose, triglycerides, and uric acid ranged from 32.9% to 37.0%, 16.8% to 21.4%, and 16.9% to 24.1%, respectively, while the rates for body height and weight remained below 10.0% across these three periods. Among workers who completed corresponding OME items, dyslipidemia and hyperuricemia showed relatively higher positive detection rates, with rates of 23.2% and 23.0%, respectively. The positive detection rates of obesity, high blood pressure, and hyperglycemia were relatively lower, at 9.6%, 3.5%, and 1.4%, respectively. Across the three periods, the positive detection rates of dyslipidemia, hyperuricemia, obesity, high blood pressure, and hyperglycemia ranged from 18.0% to 33.7%, 7.0% to 28.5%, 7.8% to 10.9%, 3.3% to 3.9%, and 1.4% to 1.5%, respectively, all showing increasing trends with advancing OME periods (all P<0.01). Conclusion Current OME practices show a mismatch between the coverage of chronic disease-related indicators and the actual health risks among occupational worker populations. Although blood pressure monitoring is well implemented, basic physical indicators (body height and body weight) and key metabolic indicators (blood glucose, blood lipids, and uric acid) are insufficiently covered, limiting comprehensive assessment of occupational health risks. Optimization of monitoring strategies is urgently needed to improve data completeness.

Objective To investigated the effects of occupational exposure to N,N-dimethylformamide (DMF) on sterol regulatory element-binding protein (SREBP) and iron metabolism among workers. Methods A total of 20 workers occupationally exposed to DMF were selected as the exposure group, and 15 healthy workers without DMF exposure from the same factory were selected as the control group using the purposive sampling method. DMF exposure levels were assessed in individual samples of the workers. The urinary N-methylformamide (NMF) levels were measured by gas chromatography. The mRNA expression of SREBP-1a, SREBP-1c, and SREBP-2 in peripheral blood was measured by real-time quantitative polymerase chain reaction. Enzyme-linked immunosorbent assay was used to detect serum transferrin, soluble transferrin receptor (sTfR), and ferritin levels. Results The DMF exposure levels among the workers in the control group were below the detection limit, and urinary NMF was undetectable. The median DMF exposure level was 13.30 mg/m³, and the mean urinary NMF level was (9.72±1.78) mg/g Cr among the workers in the exposure group. Compared with the control group, the relative mRNA expression of SREBP-1a, SREBP-1c, and SREBP-2 in peripheral blood of workers in the exposure group increased (all P<0.05), while the levels of transferrin and sTfR decreased (both P<0.01). However, there was no statistically significant difference in serum ferritin levels between the two groups (P>0.05). In the exposure group, urinary NMF level of workers was negatively correlated with the relative mRNA expression level of SREBP-1c in blood [correlation coefficient (r)=-0.50, P=0.03], and positively correlated with the levels of serum transferrin, sTfR, and ferritin (r = 0.63, 0.58, and 0.52, respectively; all P<0.05). Conclusion Occupational exposure to DMF can upregulate the expression of the SREBP family and disrupt iron metabolism, with a potential association between these effects.

ObjectiveTo explore the effects of mechanical pressure regulation on the migration and bone-promoting ability of suture dural cells （S-DCs） and non-suture dural cells （NS-DCs）. MethodsDural cells （S-DCs）， non-cranial suture dural cells （NS-DCs） and cranial suture mesenchymal stem cells （CS-MSCs） of 5-day-old SD rats were isolated and cultured. Four experimental conditions， namely S-DCs-Normal， S-DCs-Stress， NS-DCs-Normal and NS-DCs-Stress， were set according to the source of the cells and whether mechanical pressure （1.07 kPa， 24 hours） was applied. The migration ability of dural cells was detected by cell scratch test. Four experimental condition culture media were collected and co-cultured with CS-MSCs for osteogenic induction. Calcium salt deposition was detected by alizarin red staining， and the expression of osteogenesis-related proteins was detected by Western blot. ResultsCompared with the Normal group， the migration abilities of both S-DCs and NS-DCs decreased after Stress treatment （P<0.05）. Compared with S-DCs， NS-DCs has a weaker migration ability under the same processing conditions （P<0.05）. The conditioned medium experiment showed that Stress treatment reduced the osteogenic ability of CS-MSCs （P<0.05）， and the osteogenic effect of the conditioned medium derived from NS-DCs was weaker than that of S-DCs （P<0.05）. The Western blot results were consistent with the trend of alizarin red staining. Both Stress treatment and NS-DCs sources could down-regulate the expression of osteogenesis-related proteins （P<0.05）. ConclusionMechanical stress can significantly inhibit the migration of dural cells and the osteogenic differentiation process of CS-MSCs mediated by it. The mechanical tolerance and osteogenic regulation ability of S-DCs are significantly better than those of NS-DCs.

As a primary approach to safeguarding workers' occupational health in China, the work-related injury insurance still has insufficient preventive measures for occupational groups. By reviewing the preventive measures embedded in Germany’s statutory accident insurance (Gesetzliche Unfallversicherung) and Japan’s workers’ accident compensation insurance, this study summarized their best practices and then proposed the following policy directions based on China’s specific context: strengthening the prevention-oriented institutional framework, increasing financial investment in occupational injury prevention, improving the incentive mechanisms of floating premium rate, and promoting data integration and intelligent applications in occupational health management. These measures are expected to shift China’s work-related injury insurance system from a compensation-oriented model to one that emphasizes comprehensive prevention and health promotion, thereby providing useful insights for better safeguarding the health of Chinese workers.

Objective:To evaluate spinal-pelvic mobility and sagittal spinal-pelvic alignment characteristics in patients with developmental dysplasia of the hip (DDH), and to investigate differences in sagittal spinal-pelvic parameters between patients with DDH and those with osteonecrosis of the femoral head (ONFH).Methods:A total of 55 patients with DDH who underwent primary total hip arthroplasty (THA) at the Affiliated Hospital of Xuzhou Medical University between April 2021 and March 2024 were retrospectively analyzed. The cohort included 8 males and 47 females, with a mean age of 56.16±10.82 years (range: 26-76 years). Among them, 18 patients had bilateral DDH and 37 had unilateral DDH. Fifty-five age- and sex-matched patients with ONFH were selected as the control group. Unilateral DDH cases were classified according to the Hartofilakidis classification: 18 cases of type A, 13 cases of type B, and 6 cases of type C. Lateral spinal-pelvic radiographs were used to measure pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and lumbar lordosis (LL) in both standing and sitting positions. Changes in sagittal spinal-pelvic parameters between standing and sitting positions were analyzed to assess spinal-pelvic mobility. Spinal-pelvic mobility was considered abnormal if △SS was outside the range of 10°-30°. Abnormal mobility was further categorized as stiffness (△SS<10°) or hypermobility (△SS>30°).Results:The PI (52.37°±12.43°), standing PT (12.13°±9.50°), and sitting PT (36.49°±13.43°) of DDH patients were significantly higher than those of ONFH patients (44.88°±11.38°, 7.80°±11.36°, and 28.91°±11.38°, respectively), with statistically significant differences ( P<0.05). Abnormal spinal-pelvic mobility, including both stiffness and hypermobility, was observed in 53% of DDH patients, with stiffness accounting for 20%. These proportions were significantly higher than those in ONFH patients, which were 24% and 6%, respectively ( P<0.05). The prevalence of abnormal spinal-pelvic mobility in Hartofilakidis type C DDH patients was 83%, significantly higher than the 30.8% observed in type B patients (χ 2=4.550, P=0.033). The standing LL (54.37°±11.59°) and sitting LL (28.56°±15.51°) in unilateral DDH patients were significantly greater than those in bilateral DDH patients (46.88°±15.30° and 20.42°±9.77°, respectively), with statistically significant differences ( P< 0.05). Conclusions:Compared with patients with ONFH, those with DDH demonstrate a higher prevalence of abnormal spinal-pelvic mobility, particularly a greater incidence of spinal stiffness. Among DDH subtypes, Hartofilakidis type C patients exhibit a higher proportion of abnormal mobility compared to types A and B. Additionally, patients with unilateral DDH present with greater lumbar lordosis than those with bilateral involvement.

ObjectiveTo investigate the chemical hazards in the production line of lithium batteries, so as to provide a scientific basis for the management of occupational-health risk and to promote the healthy and sustainable development of the lithium battery industry. MethodsAn on-site survey on the process flow of the production of lithium battery was conducted in an enterprise. Volatile organic compounds (VOCs) in the occupational environment were collected by Summa canisters, carbonates and N-methyl pyrrolidone (NMP) were collected using activated carbon tubes, and airborne metals were collected using filter membranes. VOCs, carbonates and NMP were detected by gas chromatography-mass spectrometry (GC-MS), and airborne metal elements in the dust samples were analyzed by inductively coupled plasma mass spectrometry (ICP-MS). ResultsNon-targeted environmental monitoring results indicated that NMP was detected in the negative /positive electrode coating, assembly and drying filling workstations, dimethyl carbonate (DMC) was detected in the assembly, drying and electrolyte injection workstations, and ethyl methyl carbonate (EMC) was detected solely in the electrolyte injection workstation. Semi-quantitative analyses of VOCs identified 136 pollutants, including acrylonitrile and halohydrocarbons. Quantitative targeted environmental monitoring results revealed the highest geometric mean (GM) concentration of EMC (31.450 mg·m^-3) was found in the assembly and drying workstations, diethyl carbonate (DEC) was detected in all workstations. While vinylene carbonate (VC) and ethylene carbonate (EC) were detected only in electrolyte injection, assembly and drying workstations. NMP was detected in all positive electrode coating samples, with a GM concentration of 5.68 mg·m^-3 (concentration range: 4.0‒ 7.4 mg·m^-³). Lithium was exclusively detected in dust samples from the liquid injection workstation (GM: 0.014 μg·m^-³). ConclusionNMP, EMC, DEC, and other chemicals are identified at the key workstations such as the positive electrode coating, electrolyte injection, assembly and drying in the lithium production line. Furthermore, semi-quantitative VOCs analyses identified 136 pollutants, demonstrating a characteristic of multicomponent chemical exposure.

Objective:To evaluate spinal-pelvic mobility and sagittal spinal-pelvic alignment characteristics in patients with developmental dysplasia of the hip (DDH), and to investigate differences in sagittal spinal-pelvic parameters between patients with DDH and those with osteonecrosis of the femoral head (ONFH).Methods:A total of 55 patients with DDH who underwent primary total hip arthroplasty (THA) at the Affiliated Hospital of Xuzhou Medical University between April 2021 and March 2024 were retrospectively analyzed. The cohort included 8 males and 47 females, with a mean age of 56.16±10.82 years (range: 26-76 years). Among them, 18 patients had bilateral DDH and 37 had unilateral DDH. Fifty-five age- and sex-matched patients with ONFH were selected as the control group. Unilateral DDH cases were classified according to the Hartofilakidis classification: 18 cases of type A, 13 cases of type B, and 6 cases of type C. Lateral spinal-pelvic radiographs were used to measure pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and lumbar lordosis (LL) in both standing and sitting positions. Changes in sagittal spinal-pelvic parameters between standing and sitting positions were analyzed to assess spinal-pelvic mobility. Spinal-pelvic mobility was considered abnormal if △SS was outside the range of 10°-30°. Abnormal mobility was further categorized as stiffness (△SS<10°) or hypermobility (△SS>30°).Results:The PI (52.37°±12.43°), standing PT (12.13°±9.50°), and sitting PT (36.49°±13.43°) of DDH patients were significantly higher than those of ONFH patients (44.88°±11.38°, 7.80°±11.36°, and 28.91°±11.38°, respectively), with statistically significant differences ( P<0.05). Abnormal spinal-pelvic mobility, including both stiffness and hypermobility, was observed in 53% of DDH patients, with stiffness accounting for 20%. These proportions were significantly higher than those in ONFH patients, which were 24% and 6%, respectively ( P<0.05). The prevalence of abnormal spinal-pelvic mobility in Hartofilakidis type C DDH patients was 83%, significantly higher than the 30.8% observed in type B patients (χ 2=4.550, P=0.033). The standing LL (54.37°±11.59°) and sitting LL (28.56°±15.51°) in unilateral DDH patients were significantly greater than those in bilateral DDH patients (46.88°±15.30° and 20.42°±9.77°, respectively), with statistically significant differences ( P< 0.05). Conclusions:Compared with patients with ONFH, those with DDH demonstrate a higher prevalence of abnormal spinal-pelvic mobility, particularly a greater incidence of spinal stiffness. Among DDH subtypes, Hartofilakidis type C patients exhibit a higher proportion of abnormal mobility compared to types A and B. Additionally, patients with unilateral DDH present with greater lumbar lordosis than those with bilateral involvement.

Chronic obstructive pulmonary disease(COPD),as a global health challenge,brings heavy economic and psychological burdens to patients and their families.Accurately identifying the risk factors for COPD and excluding false associations are crucial for understanding its pathogenesis and formulating prevention strategies.Mendelian randomization(MR),as a supplementary method,has shown great potential in reducing the interference of confounding factors,lowering the cost of experimental research,and avoiding experimental ethical issues.This article focuses on MR and its main derivative methods,discusses their basic principles and applicable conditions,and analyzes their application effects and limitations in COPD research in combination with specific cases,enabling MR to be more widely applied in the study of influencing factors of COPD.