Occupational health protection for health workers during the coronavirus disease 2019(COVID-19)pandemic:6P-approach in China

Health workers(HW)are on the frontline fighting against the COVID-19 pandemic,they are exposed to multiple occupational hazards.This article analyzed the comprehensive measures of protecting HWs during the COVID-19 response in China.Occupational health protection of HWs was one of the key strategies of the public health measures adopted against the COVID-19 outbreak from the earliest stage in China.This prioritization of HWs health protection was based on the technical and policy guidance of WHO and International Labor Organization as well as the experiences from previous outbreaks in China.The comprehensive measures in China can be summarized as‘6P-approach’:public health emergency response,prompt learning from lessons,proactive measures of occupational health,precaution strategies against occupational hazards,personal protective equipment and medical devices supply,and professional networking.Through this 6P-approach,China was able to minimize the incidence of COVID-19 infection among HWs,while successfully containing the outbreak dxuing the first quarter of 2020.Although the COVID-19 vaccines have been rolled out,however,the COVID-19 pandemic is still under rapidly evolving situation.Experiences from China may provide other countries with an example of prioritizing and incorporating occupational health protection of HWs in their public health measures responding to the COVID-19 pandemic.

An investigation into the occupational protection status of clinical nursing staff exposed to anti-tumor drugs

Objective:To investigate the occupational protection status of clinical nursing staff vocationally exposed to anti-tumor drugs.Methods:A self-designed questionnaire was used to survey 180 clinical nursing staff vocationally exposed to anti-tumor drugs.Results:Recognition of the need for protection and dependent occupational protection behaviors were very poor in clinical nursing staff vocationally exposed to anti-tumor drugs.The management of the occupational protection of clinical nursing staff vocationally exposed to anti-tumor drugs was also seriously underdeveloped.Conclusion:There is deficiency in the understanding and related protection practices of clinical nursing staff vocationally exposed to anti-tumor drugs in our hospital.The protection measures currently employed in medical practice are inadequate in virtually every aspect considered.It is recommended that all clinical nursing staff should receive full occupational protection training in these matters.The training must raise nursing staff's awareness of the need for occupational protection and standardize their occupational protection behaviors to conform to "best practice" models.These "best practice" models should be quickly established and all staff made cognizant of them forthwith.In addition,where occupational protection systems are already in place,they should be improved to come into line with the new "best practice" models instigated.

Rights Basis and System Building of Occupational Injury Protection for Employers in New Business Forms

Employees in new business forms face higher occupational injury risks and the plight of“falling in the gap in the protection network”of work-related injury insurance.The existing three types of occupational injury protection models are based on the reflection and reform of traditional occupational injury insurance.The readjustment path of occupational injury insurance is the most desirable among them.Occupational injury protection for employees in new forms of business is based on the concept of human rights protection,with the right to equality,social insurance and occupational safety and health as the direct basis.The top-level design of the system should be based on the appropriate“decoupling”of work-related injury insurance and labor relations,and rely on the technological empowerment of the digital age to explore the establishment of a work-related injury insurance system that is both mandatory and flexible.For the specific system building,in the dimension of mandate,the commercialization of benefits payment should be realized while expanding the statutory coverage of work-related injury insurance;while in the dimension of flexibility,it should be based on the characteristics of employees.Corresponding rules and regulations should be adjusted in terms of management model,work-related injury identification,and treatment calculation and payment.

The Effect of Evidence-based Management on Occupational Protection of Nurses Who Perform Chemotherapy

Objective:The study was to explore the effect of evidence-based management in occupational protection for nurses who perform chemotherapy.Methods:40 chemotherapy nurses were selected,20 of them were included in the experimental group for evidence-based management,and the other 20 were included in the control group for routine management.Results:Compared with the control group,there were significantly fewer adverse nursing events in the experimental group,and P<0.05.Conclusion:The effect of evidence-based management in occupational protection of nurses who perform chemotherapy is significant.

Research Progress on the Occupational Hazards and Protective Measures of Emergency Department Nurses

The emergency department is a department that is crucial for medical institutions.It is mainly responsible for rescuing critically ill patients and dealing with all kinds of public health emergencies.There are significant differences in the working environment and working mode between the nurses in emergency departments and those of other departments.They tend to come into contact with various occupational risk factors,resulting in high incidence of occupational hazards and accidental injuries.Therefore,it is necessary to analyze the common occupational risk factors of nurses in the emergency department and propose protective measures to ensure that these nurses are able to provide nursing services safely and effectively.

Human health and occupational exposure to pesticides among smallholder farmers in cotton zones of Côte d'Ivoire

While precautionary efforts are being made to minimize human health problems associated with agricultural pesticides, the continued occurrence of occupational poisoning from these chemicals raises major concerns among stake- holders. Information gap on human health problems associated with pesticides poses major obstacles to making informed policy decisions, particularly in developing countries where most of the poisonings occurs. In this study, we identified acute human health symptoms associated with pesticide use in cotton zone of C?te d’Ivoire and, documented the response of rural households to the symptoms. The results show that cotton farmers in Cote d’Ivoire suffer from different occupational health hazards from exposure to agricultural pesticides. Key health symptoms reported by pesticide applicators are headache, rheum, cough, skin rash and sneezing. Pesticide applicators reported four times higher symptoms of ill health than other household members who do not normally handle pesticides. Although, households recognized pesticides as an important cause of ill health, some of the symptoms have been accepted as norm by individuals who apply pesticides. Official data on pesticide poisoning in the country is most likely to be seriously under-estimated as applicators visited formal health centers for medical assistance in only 2% of poisoning cases reported. There is a high likelihood that households in the study area under-estimated pesticide-related health costs in making farm production decision-making. Approaches to use economic instruments for reliable monitoring and reporting procedures to formulate appropriate policies and regulations to minimize exposure to pesticides are recommended. Health planners and policy makers should aim at reducing the risks posed by pesticide to farm households by, improving awareness of farmers;promote complementary approach (e.g. Integrated Pest Management) and, use of economic instruments and improved surveillance to bridge the gap in the documentation of pesticide poisoning cases among farmers.

Health care worker occupational experiences during the COVID-19 outbreak:A cross-sectional study

BACKGROUND Health care workers treating coronavirus disease 2019(COVID-19)patients experience burnout and stress due to overwork and poor working conditions.AIM To investigate the work experiences of frontline health care workers in Wuhan city and Qinghai province,China,during the COVID-19 outbreak.METHODS In this cross-sectional descriptive study,a self-reported questionnaire was designed to evaluate work experiences of medical staff throughout the course of the COVID-19 pandemic.A total of 178 health care workers responded to the questionnaire between February 19 and 29,2020.Higher questionnaire dimensional score confirmed dimensional advantage.RESULTS Of all dimensions evaluated by this questionnaire,the occupational value dimension had the highest mean score of 2.61(0.59),followed by the support/security dimension score of 2.30(0.74).Occupational protection scored lowest at 1.44(0.75),followed by work environment at 1.97(0.81).The social relationships dimension had an intermediate score of 2.06(0.80).Significant differences in working conditions were observed across hospital departments,with the fever ward scoring lowest.Total scores also differed significantly across workplaces;the fever outpatient department scored lowest(P<0.01).This phenomenon was likely due to the fact that work in the fever outpatient department,where many patients present to hospital,necessitates constant contact with a large number of individuals with insufficient provision of resources(such as protective equipment and social support).Medical workers in the fever outpatient department were burdened with a fear of COVID-19 infection and a lower sense of professional value as compared to workers in other hospital departments.Medical staff in Wuhan worked longer hours(P<0.01)as compared to elsewhere.The mean support/security dimension score was higher for tertiary hospital as compared to secondary hospital medical staff as well as for Wuhan area as compared to Qinghai region staff(P<0.01).Staff in Wuhan had a lower mean work environment score as compared to staff in Qinghai(P<0.05).CONCLUSION Medical staff treating COVID-19 patients in China report poor occupational experiences strongly affected by work environment,occupational protection and social relationships.Health care managers must address the occupational needs of medical staff by ensuring a supportive and safe work environment.

我国金属矿山采—装—运过程中粉尘职业危害防控技术进展与展望

在高温、噪声、粉尘、有毒有害气体等金属矿山主要的职业病危害因素中,由粉尘引起的尘肺病在职业病病例中占比最大,为不断推进粉尘职业健康防护研究,保障金属矿山人员、生产与环境安全,概述了金属矿山尘源与扩散理论以及粉尘职业健康职业防护研究现状,基于安全工程系统性原理,分别从源头治理、过程控制以及个体防护3个维度分析了我国金属矿山采—装—运过程中粉尘职业危害防控技术进展。在此基础上,剖析了目前存在的不足,并展望了未来发展方向。认为现阶段存在的不足在于金属矿山粉尘控制理论体系尚未成熟,金属矿山粉尘智能化监测预警技术研究有待加强,不同粉尘治理技术交叉性、协同性研究与应用较薄弱,以及以现场人员舒适性为导向的个体呼吸防护设备研发需要进一步加强,未来可从完善金属矿山粉尘控制理论体系,开发适用于金属矿山产尘特性的智能化防尘监测预警技术,注重粉尘治理技术的交叉性、协同性研究与应用,以及研发更符合人体工程学的个体防护设备等方面进一步开展工作。

某冶金制造企业噪声暴露对听力水平的影响

目的探讨冶金制造业噪声暴露对听力水平的影响。方法对某企业245名噪声暴露工人及51名行政人员进行双耳0.5~8 kHz纯音气导听阈测试,检测工作场所噪声8 h等效声级,统计分析不同工种工人听力阈值。结果噪声暴露工人0.5~8 kHz听力阈值均显著高于行政人员;听力受损主要发生在4、6 kHz;听力阈值与工龄、年龄正相关,40岁以上、6年以上工龄,工人双耳4、6 kHz听力阈值均高于40 dB HL。结论噪声暴露工人4、6 kHz听力损伤最明显,年龄、工龄、噪声暴露强度是听力受损的危险因素。应加强噪声源的控制,重视耳塞等防护措施,并减少噪声暴露时间。

2018—2022年某三级口腔专科医院工作人员职业暴露情况调查

目的:探讨口腔专科工作人员职业暴露危险因素和职业伤害情况,为制定针对性职业防护措施提供依据。方法:回顾性分析2018年1月1日—2022年12月31日某三级口腔专科医院工作人员的职业暴露现状,探讨口腔专科医护工作人员职业暴露的风险因素。结果:5年职业暴露率分别为9.65%、6.54%、4.96%、5.38%、3.96%。151名职业暴露人员中,84.77%的职业暴露源不明;以女性[128人(84.77%)]、护士[63人(41.72%)]为主;暴露科室主要以综合门诊科/部(21.85%)和牙周黏膜科(17.22%)为主;主要发生于口腔诊疗操作(48.34%);08:00~11:59(51.66%)是1 d中发生职业暴露次数最多的时间;手部(87.42%)是最主要的暴露部位;暴露器械多为根管锉、牙科钻、洁治器头(38.41%)及注射针头(33.11%);2020年后工作人员职业防护考核得分有大幅度提升(P<0.05)。结论:口腔专科职业暴露风险较综合医院有其专科特色,建议在推广安全器具使用的基础上,进行喷溅操作多、诊疗次数多的操作之前开展病人血源性检测,同时在进行职业安全防护、标准操作规程、职业暴露处置等相关培训时要结合人群特点,培训形式应与受训者群体特征相适应。

某医院放射工作人员3年个人剂量检测及职业健康数据分析

目的分析某医院放射工作人员3年个人剂量检测及职业健康数据,探讨不同职业类别受照剂量的差异以及放射工作人员防护效果。方法本研究对2020年1月—2022年12月山东省某3家医院所有放射工作人员共7440人次个人剂量水平、职业健康数据进行分析。结果从事介入医学工作人员其个人有效剂量分布区间明显高于其他从业人员,特别在>3.0 mSv区间介入医学3名,而核医学及诊断放射学各1名。但总体分析显示,从事核医学的放射工作人员个人剂量要高于其他职业类别,差异有统计学意义(P<0.05)。从事介入医学专业放射工作人员,其腹部B超异常率为42.31%,远高于平均水平的31.13%。核医学专业在血压、腹部B超等项目异常检出率显著高于其他职业类别(P<0.05)。结论2020—2022年,放射工作人员接收辐射剂量较多的是介入医学,其有效剂量分布区间相对较高,而核医学人均年有效剂量最高。同时,介入医学专业腹部B超异常率远高于平均水平,而核医学专业则在血压、腹部B超等项目异常检出率显著高于其他职业类别。

某市三甲综合医院工作人员血源性职业暴露监测分析

目的进一步了解玉林市红十字会医院的医院血源性职业状况与特点,重点分析乙型肝炎、艾滋病职业暴露情况,进一步了解玉林市红十字会医院医院血源性职业状况与特点,为制定有效的职业暴露防护措施提供参考。方法基于2018年1月—2022年12月某市三甲综合医院院感科登记的医院工作人员血源性职业暴露资料,对发生职业暴露人群的职业分布、暴露发生场所、暴露方式、暴露环节、职业暴露病原体分布、预防用药情况分别进行统计分析。结果共上报职业暴露403例,职业暴露发生人群以护士占首位,202例,占50.12%;发生职业暴露较多的场所为内科病房168例,占41.69%;发生职业暴露较多的方式是针刺伤320例,占79.40%;发生职业暴露较多的环节是拔针158例,占39.21%;暴露源是乙型肝炎病毒的94例,20例未产生有效血清保护性抗体,接种乙肝疫苗并注射乙肝免疫球蛋白,占21.28%;暴露源是获得性免疫缺陷综合征(acquired immune deficiency syndrome,AIDS)的22例,经艾滋病职业暴露事故处理小组评估,有12例启用基础预防用药。结论医院要结合自身实际情况,规范操作流程,加强医务人员职业安全培训,建立完善的职业防护措施体系,才能有效地降低职业暴露风险。

强化儿科护理人员风险防范意识的管理策略分析

目的探讨强化儿科护理人员风险防范意识的管理策略及效果。方法将2021年1—12月、2022年3月—2023年2月这2个阶段在山东大学附属儿童医院小儿呼吸内科从事护理工作的30名护士作为研究对象,分别设为对照组、研究组。对照组阶段实施常规护理管理,研究组阶段在护理管理中实施风险管理。对2组护士的职业暴露伤害发生率进行统计和对比,调查并对比2组护士对于自身安全防护的满意度,并对于2组护士的自我防护知信行评分、疲劳评分、工作压力评分、职场正念评分、职业满意度评分作比较。结果研究组护士的职业暴露伤害总发生率为6.67%,低于对照组的26.67%(P<0.05)。研究组护士对于自身安全防护的总满意度高于对照组(P<0.05)。研究组护士的自我防护知信行评分、职场正念评分、职业满意度评分均高于对照组(P<0.05);研究组护士的疲劳评分、工作压力评分均低于对照组(P<0.05)。结论在小儿呼吸内科护理管理中实施风险管理,可提高护士的自我防护认知、信念,有利于减少护士在护理工作中的职业暴露伤害风险,使其对于自身安全防护更加满意,还可减轻护士的疲劳感、压力,增强其职场正念和职业满意度。

新业态劳动群体参保社会保险问题研究

随着新就业形态的迅速发展,我国新业态从业者数量激增,如何促进此类从业者参保社会保险,成为亟需解决的问题。2021年,人力资源和社会保障部等联合发布《关于维护新就业形态劳动者劳动保障权益的指导意见》,将新业态劳动者划分为三类,新增“不完全符合确立劳动关系情形”这一劳动形态,开启了新业态社保在劳动关系保障的新篇章。近年来,我国各地政府对新业态劳动者的社保政策逐步放宽,对提高社保待遇及权益进行了积极探索和实践,但仍面临劳动关系缺乏划分经验、新业态劳动者以及新经济组织对社保缴纳存在缴费压力大、社保转移接续手续繁琐、参保面窄、维权工作难等问题。基于劳动三分法,分析政府、劳动者、用人单位等各方主体参与的新业态劳动群体社保参与路径,提出尽快完善适合新业态灵活就业人员劳动关系划分的顶层设计;优化社保转移接续手续,提高参保扩面的精准性;解决社保制度中政策、缴费激励、逆向选择问题;落实监管政策,做好维权工作等政策建议。

护理实习生职业防护意向与行为量表的研制及信效度检验

目的研制适用于护理实习生调查的职业防护意向与行为量表,并进行信效度检验。方法基于计划行为理论,依据职业防护行业相关规范、文献及访谈结果,构建量表条目池;采用Delphi专家咨询法、条目分析法、条目与维度相关系数法等筛选量表条目,并进行信效度检验。结果职业防护意向与行为量表共37个条目,意向分量表和行为分量表均通过探索性因子分析提取了3个公因子;各目标分布与维度间的联系符合理论构想。结论护理实习生职业防护意向与行为量表具有良好的信效度,符合问卷的心理学测量要求,可用于评估护理实习生职业防护意向和行为。

不同实习医务人员职业防护能力知信行现况调查

目的 对不同实习医务人员职业防护知信行能力进行横断面调查研究。方法 2021年3-9月采取方便整群抽样方法选取山东省2所医学院校正在临床实习的护士及医生进行职业防护知信行能力问卷调查,采取问卷星方式进行线上调查,共收集有效问卷452份,其中实习护士187名(本科64名、专科123名),实习医生265名(本科221名、专科44名)。应用SPSS25.0统计软件进行数据分析。结果 实习医务人员职业防护知识与防护态度、防护知识与防护行为总体分布比较,差异均有统计学意义(P<0.05);不同类别实习医务人员职业防护知识、态度、行为总体分布比较,差异均有统计学意义(H=33.733、29.158、28.740,P<0.001);专科实习医生与本科实习护士及专科实习护士职业防护知识5个维度、职业防护态度2个维护及职业防护行为4个维护的总体分布比较,差异均有统计学意义(P<0.05)。结论 管理者应加强对实习医务人员职业防护知识的培训,尤其是加强对实习医生职业防护能力的培训,从而降低其职业暴露发生率。

深圳地区手术室护理人员艾滋病职业防护分析

目的调查深圳地区手术室护理人员艾滋病职业防护知识掌握情况并分析相关影响因素。方法采取调查问卷方式收集2020年8—10月深圳地区60例手术室护理人员艾滋病职业防护知识掌握情况,并分析其影响因素。结果60例护理人员对于艾滋病基础知识掌握相对较好,其各项基础知识完全掌握人数为52例,占比86.67%,而对于艾滋病职业防护知识掌握程度相对薄弱,其各项职业防护知识完全掌握人数为43例,占比71.66%;不同文化程度、职称、工作年限及是否发生过职业暴露的护理人员对于艾滋病职业防护知识掌握情况比较,差异有统计学意义(P<0.05);经多因素分析,较高的文化程度、工作年限、职称及发生过职业暴露是影响艾滋病职业防护知识掌握情况的保护因素(P<0.05)。结论深圳部分地区护理人员艾滋病职业防护掌握情况较差,文化程度、工作年限、职称及是否发生过职业暴露是影响手术室护理人员艾滋病职业防护知识掌握情况的重要因素,应针对性加强其职业防护技能和意识的培训。

医务人员职业安全与健康促进的国际经验及启示

通过检索国内外文献,运用归纳法和比较研究法,分析国际组织和典型国家医务人员职业安全与健康促进经验。结合我国卫生系统现状,建议政府主导立法和施策,医疗机构加强职业安全与健康教育,医务人员提升职业健康素养,融合多学科多部门优势,兼备生理心理及软硬件服务,不断促进我国医务人员职业安全与健康水平提升。

护士职业暴露和防护情况调查研究

目的 分析护士职业暴露和防护情况。方法 选取2021年1月至2023年12月晋江市医院182名有职业暴露经历护士开展研究,其中2021年80名,2022年39名,2023年63名,开展回顾性问卷调查,分析职业暴露原因、自我防护情况、针刺伤情况和知晓防护知识情况。结果 182名护士中有142名为针刺伤,占比78.02%,有40名为其他,占比21.98%,年人均刺伤次数为1.52次,针总刺伤名数为216次,出现刺伤后有92.00%报告,低于100%报告率;182名护士总暴露次数为284次,常见职业暴露原因有90人次操作不规范/个人疏忽,占比31.69%,有64人次从橡皮或其他阻体中拔出针头,占比22.54%,有29人次在输液、采血时被刺伤,占比10.21%;实施标准预防措施情况:实施率较高的标准预防护措施有用锐器盒存放废弃针头、锐器利器刺伤后从远心端向近心端边挤血边流动水冲洗5 min后彻底消毒和采取消毒剂消毒处理被患者体液/血液污染的物品等;标准化防范策略实施后的职业暴露比率低于标准化防范策略实施前(P <0.05);防护知识来源:182名护士中93名为外出培训班学习交流,占比51.10%,37名为学校教育,占比20.33%,121名为院内学习培训,占比66.92%,84名为同事间交流,占比46.15%,93名为工作经验,占比51.10%。结论 护士工作时可能出现职业暴露,原因较多,应加强自我防护意识,采取适宜预防措施,维护自身安全。