Evaluation of Attitudes of Family Physicians toward Occupational Health and Occupational Diseases in Türkiye

Background/Aim: This study evaluated family physicians’ attitudes toward occupational health and disease in Türkiye. Materials and Methods: The study is cross-sectional and descriptive in a quantitative research design. The “Attitude Scale for Physicians toward Occupational Health and Occupational Diseases” developed by Kolcu et al. was used in the study (Cronbach’s α 0.94). Our study aimed to sample the entire country using the stratified sample selection based on geographical region. 349 family physicians were included in the study according to sample size (n: 349). Results: The mean age of the participants in the study was 37.77 ± 8.96 (min: 27, max: 65 years). Of the participants, 65.2% were male. Of the physicians, 33.8% were family medicine specialists, and 38.8% had occupational physician certificates. It was determined that the level of attitude of family physicians toward occupational diseases was insufficient. It was also found that awareness increased as age increased, and awareness and attitude levels did not change according to gender. No significant difference was found in the scale total scores and subdimensions of family physicians’ occupational health and occupational disease attitudes according to the regions they worked in Türkiye. Conclusion: It has been concluded that there is no difference in awareness among family physicians in regions where it is much more important to diagnose an occupational disease, especially in industrial regions. The number of family physicians with occupational physician certificates was very insufficient, and a significant number of those who had occupational physician certificates did not practice occupational medicine.

Application of coal mine dynamic safety management and occupational health and safety management system

A method system was put forward based on the occupational health and safety management system to develop the dynamic safety management of coal mine. It aimed at the problems in the mining safety management and was put in practice in Lingxin coal mine of Ningxia Coal Industry Group Co., Ltd.. And good effect was obtained in safety work. It developed the mining dynamic safety management based on the building of occupational health and safety management system of mining enterprise and its main contents are as follows： timely identification and dynamic control of accident risk, persistent improvement of safety management performance according to the ＂PDCA＂ circle.

Improving the law on the prevention and control of occupational diseases in China: an employer-supporting management perspective

A healthy workforce is fundamental for China to pursue its Healthy China 2030 strategy and the UN Sustainable Development Goals.The Law of the People’s Republic of China on the Prevention and Control of Occupational Diseases(the Chinese OD Law),which has been amended four times since its adoption in 2002,is the core and cornerstone of the entire regulatory system for occupational health.In addition to discussing the new institutional reforms,which are relevant to China’s regulatory system for occupational diseases(ODs)because of their marked impact on healthcare system reform,we present further evidence,mainly drawn from desk and field research.Our study focuses on the barriers that employers face in complying with the Chinese OD Law and explores the optimized employer-initiated management system,which requires further amendments to the Chinese OD Law,as the State Council of China has prioritized this issue as a top challenge.We first summarize the key characteristics of the Chinese OD Law and illustrate employers’essential obligations,and then analyze the critical challenges that employers face regarding OD prevention and control.We demonstrate good practices and experiences in China,and,finally,propose recommendations for further amendments to the Chinese OD Law in the near future.These recommendations can be achieved only through integrating the healthcare system reform with mechanism innovation.

Occupational Health Risk Assessment of Benzene,Toluene,and Xylene in Shanghai

Objective This study was designed to conduct a retrospective and systematic occupational health risk assessment(OHRA)of enterprises that used benzene,toluene,and xylene(BTX)in Shanghai,China.Methods All data for the study were obtained from 1,705 occupational health examination and evaluation reports from 2013 to 2017,and a semiquantitative model following Chinese OHRA guidelines(GBZ/T 298-2017)was applied for the assessment.Results The selected enterprises using BTX were mainly involved in manufacturing of products.Using the exposure level method,health risk levels associated with exposure to BTX were classified as medium,negligible,or low.However,the risk levels associated with benzene and toluene were significantly different according to job types,with gluers and inkers exhibiting greater health risks.For the same job type,the health risk levels assessed using the comprehensive index method were higher than those using the exposure level method.Conclusion Our OHRA reveals that workers who are exposed to BTX still face excessive health risk.Additionally,the risk level varied depending on job categories and exposure to specific chemicals.Therefore,additional control measures recommended by OHRA guidelines are essential to reduce worker exposure levels.

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.

Research Progress in Occupational Health Risk Assessment Methods in China

Traditional occupational disease control and prevention has remained prevalent in China over recent decades. There are appropriately 30,000 new case reports of occupational diseases annually. Although China has already established a series of occupational disease prevention programs, occupational health risk assessment （OHRA） strategies continue to be a limitation.

A Methodology to Develop the Integration of the Environmental Management System with Other Standardized Management Systems

Traditionally the global management system of an organization is frequently split into a number of individual management systems that are defined and implemented according to specific management systems standards (MSSs) as well as managed independently. The individual implementation of MSSs is an option that leads to several inefficiencies and sub-optimization of the global management system of an organization. As referred by ISO [1] the interested parties’ requirements increase. A more effective and efficient option for an organization is to integrate, into an integrated management system (IMS), the implementation and management of requirements of multiple MSSs. Certain difficulties are associated to the structuring process, implementation, verification, evaluation, improvement and progressive development of an IMS in the organizations. Several scholars have proposed various theoretical approaches regarding the integration of individual management systems (MSs) leading to the conclusion that there is not a common practice for all organizations as they encompass different characteristics. This paper aims to present and justify a designed methodology to be used by organizations to support the integration of various MSs. Among them are highlighted: the Environmental Management System (EMS) according ISO 14001 [2], the Quality Management System (QMS) according ISO 9001 [3], and the Occupational Health and Safety Management System (OH & SMS) according OHSAS 18001 [4]. The methodology was designed in the context of a Portuguese company, on sequence of an organizational diagnosis and a research that was performed through a questionnaire. The strategy and the research methods took into consideration the case study.

Study on Occupational Health Surveillance System Usedduring Construction of Qinghai-Tibet Railway

To prevent the occupational altitude disease and other occupational disease during construction, occupational health surveillance system is established used for the Qinghai-Tibet railway construction. This system is composed of three parts, labor environment monitoring system, occupational disease monitoring system and information managing system for health surveillance. The objective disease of surveillance is altitude disease, pneumoconiosis, occupational poisoning, ultraviolet radiation damage and occupational hearing damage. The surveillance period is 3 month. In addition, two systems, including information managing system and evaluation reporting system used for health surveillance, and a computer information managing software of health surveillance used during Qinghai-Tibet railway construction is developed. The computer managing software has three main functions, basic database, statistics database and output of evaluating report.

Effects of occupational stress on the gastrointestinal tract

The aim of this review is to provide a general overview of the relationship between occupational stress and gastrointestinal alterations. The International Labour Organization suggests occupational health includes psychological aspects to achieve mental well-being. However, the definition of health risks for an occupation includes biological, chemical, physical and ergonomic factors but does not address psychological stress or other affective disorders. Nevertheless, multiple investigations have studied occupational stress and its physiological consequences, focusing on specific risk groups and occupations considered stressful. Among the physiological effects of stress, gastrointestinal tract(GIT) alterations are highly prevalent. The relationship between occupational stress and GIT diseases is evident in everyday clinical practice; however, the usual strategy is to attack the effects but not the root of the problem. That is, in clinics, occupational stress is recognized as a source of GIT problems, but employers do not ascribe it enough importance as a risk factor, in general, and for gastrointestinal health, in particular. The identification, stratification, measurement and evaluation of stress and its associated corrective strategies, particularly for occupational stress, are important topics to address in the near future to establish the basis for considering stress as an important risk factor in occupational health.

Clinical and epidemiological features of patients with clonorchiasis

AIM:To study the clinical and epidemiological features of patients with clonorchiasis so as to provide scientific evidences for the diagnosis and prevention of clonorchiasis. METHODS:Stools from 282 subjects suspected of having clonorchiasis were examined for helminth eggs with modified Kato's thick smear and sedimentation methods,and their sera were tested for HAV-DNA,HBV-DNA,HCV-RNA,HDV- RNA and HEV-RNA with polymerase chain reaction (PCR). Clinical symptoms of patients with clonorchiasis only were analyzed,and their blood samples were tested for circulating antigen (CAg) with Dot-ELISA,esoinophilic granulocyte count, and alanine aminotransferase (ALT).Meanwhile,they were asked to provide data of occupation,eating habit,hygienic habit and knowledge of donorchiasis.In addition,the ecosystem of the environment in epidemic areas was surveyed. RESULTS:Among the 282 patients,61 (21.43%) were infected with clonorchis sinensis only,97 (34.64%) were co-infected with clonorchis sinensis and other pathogens, 92 (32.86%) were infected with hepatitis virus only and 31 (11.07%) neither with clonorchis sinensis nor hepatitis virus. Among the 61 patients with clonorchiasis only,there were 14 (22.95%) subjects with discomfort over hepatic region or epigasfrium,12 (19.67%) with general malaise or discomfort and inertia in total body,6 (9.84%) with anorexia,indigestion and nausea,4 (6.56%) with fever,dizziness and headache (6.56%),and 25 (40.98%) without any symptoms;sixty one (100%) with CAg (+),98.33% (59160) with eosinophilic granulocytes increased and 65.00% (39/60) with ALT increased.B-mode ultrasonography revealed 61 cases with dilated and thickened walls of intrahepatic bile duct,and blurred patchy echo acoustic image in liver.Twenty-six cases had stones in the bile duct,39 cases had slightly enlarged liver with diffuse coarse spots in liver parenchyma.Twenty cases had enlarged gallbladder with thickened coarse wall and image of floating plagues,9 cases had slightly enlarged spleen.By analysis of epidemiological data,we found that the ecologic environment was favorable for the epidemiology of clonorchiasis.Most patients with clonorchiasis were lack of knowledge about the disease.Their living environment, hygienic habits,eating habits and their occupations were the related factors that caused the prevalence of the disease. CONCLUSION:The clinical symptoms of clonorchiasis are non-specific,and the main evidences for diagnosis of clonorchiasis should be provided by etiologic examination, B-mode ultrasonography and clinical history.The infection of clonorchis sinensis is related to occupations,bad eating habits and lack of knowledge about prevention of the disease.

Integration of Individualized Management Systems （MSs） as an Aggregating Factor of Sustainable Value for Organizations An Overview Through a Review of the Literature

Nowadays, there exist various standards for individual management systems （MSs）, at least, one for each stakeholder. New ones will be published. An integrated management system （IMS） aims to integrate some or all components of the business into one coherent and efficient MS. Maximizing integration is more and more a strategic priority in that it constitutes an opportunity to eliminate and/or reduce potential factors of destruction of value for the organizations and also to be more competitive and consequently promote its sustainable success. A preliminary investigation was conducted on a Portuguese industrial company which, over the years, has been adopting gradually, in whole or in part, individualized management system standards （MSSs）. A research, through a questionnaire, was performed with the objective to develop, in a real business environment, an adequate and efficient IMS-QES （quality, environment, and safety） model and to potentiate for the future a generic IMS model to integrate other MSSs. The strategy and research methods have taken into consideration the case study. It was obtained a set of relevant conclusions resulting from the statistical analyses of the responses to the survey. Globally, the investigation results, by themselves, justified and prioritized the conception of a model of development of the IMS-QES and consequent definition and validation of a structure of an IMS-QES model, to be implemented at the small- and medium-sized enterprise （SME） where the investigation was conducted.

COVID-19 vaccination and associated factors in Turkish healthcare workers practicing chest medicine

Objective: To evaluate the COVID-19 vaccination status and related characteristics of Turkish healthcare workers practicing chest medicine.Methods: A cross-sectional online survey was conducted among the Turkish Thoracic Society members. The survey was started on May 17, 2021, and kept open for seven weeks. The 39-item survey included the COVID-19 vaccination status and demographic, clinical, and occupational characteristics. Results: Of 378 healthcare workers participated in the survey, 354(93.7%) reported receiving at least one dose of the COVID-19 vaccine. A total of 323(91.2%) healthcare workers received CoronaVac vs. BioNTech/Pfizer in 31(8.8%). In the CoronaVac group, 77(23.8%) contracted COVID-19 when not fully vaccinated, and 13(4.0%) when fully vaccinated;however, 16(51.6%) healthcare workers in the BioNTech/Pfizer group got COVID-19 when not fully vaccinated, but any fully vaccinated participants did not contract COVID-19(P=0.003). Regarding vaccine dosing, 328(86.8%) were fully vaccinated, while 50(13.2%) were not. Multiple regression analysis for being a non-fully vaccinated healthcare worker demonstrated a significant relationship with having any SARS-CoV-2 infection history(adjusted OR 9.57, 95% CI 3.93-23.26, P<0.001) and being a non-physician healthcare worker(adjusted OR 5.86, 95% CI 2.11-16.26, P=0.001), but a significant negative relationship with full-time working at the time of survey(adjusted OR 0.13, 95% CI 0.03-0.56, P=0.006). Conclusions: Although a majority of healthcare workers were fully vaccinated, occupational and non-occupational characteristics were related to being non-fully vaccinated. Active surveillance regarding the COVID-19 vaccination in healthcare workers is necessary to address specific parameters as barriers to vaccination.

Organization：A new focus on mine safety improvement in a complex operational and business environment

The daily operations in the mining industry are still a significant source of risk with regard to occupational safety and health(OS & H). Various research studies and statistical data world-wide show that the number of serious injuries and fatalities still remains high despite substantial efforts the industry has put in recent years in decreasing those numbers. This paper argues that the next level of safety performance will have to consider a transition from coping solely with workplace dangers, to a more systemic model taking organizational risks in consideration. In this aspect, lessons learned from the nuclear industry may be useful, as organizational learning processes are believed to be more universal than the technologies in which they are used. With the notable exception of major accidents, organizational performance has not received all the attention it deserves. A key element for reaching the next level of performance is to include organizational factors in low level events analyses, and approach the management as a risk control system. These factors will then appear not only in the event analysis,but in supervision activities, audits, change management and the like. Many recent event analyses across various industries have shown that organizational factors play a key role in creating conditions for triggering major accidents(aviation, railway transportation, nuclear industry, oil exploitation, mining, etc.).In this paper, a perspective that may be used in supervisory activities, self-assessments and minor events investigations, is presented. When ingrained in an organizational culture, such perspective has the highest potential for continuous safety improvement.

Tuberculosis in the mines of Zambia:A case for intervention

Zambia is among the sub-Saharan countries highly burdened with tuberculosis(TB) and has an estimated prevalence rate of 638 per 100 000 population in those aged 15 years and above.The mining industry is the main contributor to the country's gross national product,although it is associated with public health challenges,with TB in the mines being among the occupational health diseases having a negative economic impact and threatening to delay the control of TB in the country.We reviewed available evidence on the extent of the burden of TB in the mines so as to inform the development of targeted interventions for the post-2015 End TB Strategy.This was a review of published data from Medline/Pubmed,Cochrane Library and Embase,including unpublished "grey"literature on the burden of TB and the risk factors of TB in the mines of Zambia.There is limited research in Zambia to fully understand the burden of TB and risk factors associated with TB in the mines.However,the few studies and data available have shown that TB is a significant health problem requiring interventions to improve the quality of life of miners,ex-miners and surrounding communities.TB is a potential problem in the mines of Zambia and the actual burden needs to be determined.Exposure to silica as a risk factor needs further investigation.

基于FMEA方法的射线检测实验室风险管理

射线检测是无损检测的主要方法,广泛应用于产品缺陷检测。X射线、γ射线是能量较高的电磁辐射,这使得射线检测实验室的管理不同于一般的实验室。基于此,应用故障模式及影响分析(FMEA)方法,参考质量、环境、职业健康安全国际管理体系标准的要求,对射线检测实验室的质量、环境、职业健康安全三大风险进行识别、分析、评价及控制。通过设计适用于三大风险的FMEA表和评分表对射线检测实验室的质量因素、环境因素、危险源开展识别及评价,通过计算风险优先数(RPN)获得重要质量因素、环境因素、危险源,并提出有效控制措施。研究结果对高等院校射线检测实验室的风险分析、评价及管理具有一定的参考价值。

警察职业安全与健康风险因素分析评估及对策研究——基于风险管理标准建设

警察①是高风险职业,因公伤亡高发或罹患重大疾病源于警察职业特殊性,预防警察职业伤害发生,保证警察健康从警是公安工作高质量发展前提和基础。在明确危险源、危险和有害因素及其与风险因素本质联系基础上,对可能导致警察职业伤害的风险因素分类辨析,依据国家标准,从人、物、环境、管理不同维度,对警察职业安全与健康风险因素进行评估,基于LEC法结合警务特点,将警察职业伤害类型分为心理健康问题、生理性疾病和人身安全危险,确立取值标准并形成风险清单,提出风险管理流程和对策,为建立警察职业安全与健康风险管理标准提供理论支撑和实践指导。

脑卒中患者夫妻心理资本干预方案的构建

目的 构建脑卒中患者夫妻心理资本干预方案,为提升脑卒中患者夫妻的心理资本水平提供参考。方法 以心理资本干预模型与二元疾病管理理论为指导,参考国内外相关文献构建脑卒中患者夫妻心理资本干预方案,对18名专家开展2轮德尔菲专家咨询。结果 2轮问卷有效回收率均为100%,专家权威系数为0.885。最终干预方案包括8次干预,23条干预措施。结论 构建的脑卒中患者夫妻心理资本干预方案具有科学性和较好的专家认可度。后续将在康复期脑卒中患者及配偶中应用,评估实施效果,验证干预方案的有效性和可行性。

基于行为研究法的健康管理在脊柱外科围术期患者中的应用

目的:探讨基于行为研究法的健康管理在脊柱外科围术期患者中的应用效果。方法:选取2021年1月1日~2022年12月31日脊柱外科收治的88例患者作为研究对象,按照单双号法随机分为管理组和常规组各44例,常规组采用脊柱外科常规围术期护理,管理组在常规组基础上采用基于行为研究法的健康管理。比较两组深静脉血栓形成(DVT)发生率、DVT风险[采用Caprini风险评估量表]、血栓相关指标[包括D-二聚体(D-D)、纤维蛋白原(Fg)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)]、疾病认知(采用骨科手术患者深静脉血栓认知水平问卷)、生活质量[采用生活质量综合评定问卷(GQOL-74)]。结果:管理组DVT发生率低于常规组(P<0.05);术后1、3 d,两组Caprini风险评估量表评分均低于术后即刻(P<0.05),且管理组低于常规组(P<0.01);术后3 d,两组D-D、Fg、PT、APTT均低于术后1 d(P<0.05),且管理组低于常规组(P<0.05);干预后,两组疾病认知水平、GQOL-74评分均高于干预前(P<0.05),且管理组高于常规组(P<0.05)。结论:基于行为研究法的健康管理能降低脊柱外科手术患者围术期DVT发生风险,提升患者疾病相关知识认知水平,改善生活质量。

电力建设企业本质安全度评价方法及应用

融合《职业健康安全管理体系要求及使用指南》(GB/T 45001—2020)的要求及本质安全的内涵,建立一套适用于电力建设企业的本质安全度评价方法。综合考虑人、物、环境、管理本质安全,结合PDCA的大循环及小循环,构建全面的本质安全度评价指标体系。根据本质安全度得分,分为初始、基础、符合、成熟及稳定5个等级。以电力建设公司为实例,利用电力建设企业本质安全度评价方法进行评价。结果表明,该方法适用于对电力建设企业进行全面多维度的本质安全评价;根据评价结果,采用权重-得分图锁定企业本质安全体系的薄弱环节,从而对该企业本质安全建设工作提出有针对性的建议。