Welding fumes in the shipbuilding industry severely threaten workers’ health. This study systematically investigated welding fume exposure in a Chinese shipyard, analyzing mass concentration, particle size distribution, and harmful metal content using data from 2015. Differences were observed across welding sites and processes. Confined spaces and gas metal arc welding (GMAW) were associated with significantly higher exposure levels. Welding fumes were dominated by particles smaller than 1.00 μm, a distribution influenced by welding site, distance from the welding spot, and process. Iron (Fe) and manganese (Mn) were the predominant metal components, with concentrations significantly higher in respirable dust than in total dust. Risk assessment indicated minimal non-cancer hazards for Fe, zinc, and copper. However, Mn posed the predominant risk (Hazard Quotient >> 1), while nickel (Ni) and chromium (Cr) also exceeded safety thresholds at most points. Consequently, confined spaces and GMAW should be prioritized as key control targets in shipyards, as respirable dust rich in metal-bearing particles poses greater health risks. Therefore, China urgently requires the establishment of specific occupational exposure limits for respirable welding fumes. Additionally, personal sampling is more focused and efficient than area sampling for precise occupational health risk assessment due to the greater mobility of welding operations.

Pneumoconiosis patients have a higher prevalence of chronic obstructive pulmonary disease (COPD). While age is a known associated factor, its impact across different populations is unclear. We included 9,964 pneumoconiosis patients from 27 Chinese provinces. Factors were identified using multivariable logistic regression, and the non-linear age–COPD association was examined with restricted cubic spline (RCS) modelling. Stratified analysis and interaction tests assessed sociodemographic heterogeneity. Sensitivity analyses comprised RCS models with varying knots and propensity score matching. The prevalence of COPD among patients with pneumoconiosis was 24.1

BackgroundTuberculosis is the most common complication of pneumoconiosis, which accelerates the progression of pneumoconiosis. Pneumoconiosis combined with tuberculosis is a major health risk. ObjectiveTo understand the outpatient health service utilization for patients of pneumoconiosis combined with tuberculosis and its main influencing factors. MethodsA stratified random sampling combined with non-random sampling was used to select 11181 pneumoconiosis patients in 27 provincial administrative regions (excluding Shanghai, Tianjin, Hainan, Tibet Autonomous Region, Taiwan, Hongkong and Macao Special Administrative Regions) from December 2017 to June 2021. A self-constructed questionnaire, i.e. Health Seeking Behaviors of Pneumoconiosis Patients and Their Influencing Factors, was used, which included basic information, outpatient and inpatient service utilization, and influencing factors of medical treatment behaviors of pneumoconiosis patients. The effective recovery rate of the questionnaire was 90.7%. All patients of pneumoconiosis combined with tuberculosis (n=762) were included as the study subjects. The difference of outpatient utilization in the past two weeks, choosing medical institutions, and the reasons of not seeking medical treatment between urban and rural areas, and the influencing factors of outpatient service utilization were analyzed. ResultsThe study subjects were mainly silicosis combined with tuberculosis (502 cases, 65.9%) and coal workers' pneumoconiosis combined with tuberculosis (232 cases, 30.5%), aged (58.6±12.5) years old. The main region was Western China (45.1%), followed by Eastern China (22.1%), Centeral China (20.2%), and Northeastern China (12.6%). The outpatient utilization rate in the past two weeks was 38.5% (293/762), and the main medical institutions consulted were municipal or provincial hospitals (32.0%), district or county hospitals (28.6%), and township hospitals or health service centers (17.5%). Short distance (20.7%), the availability of specialist outpatient services (16.7%), high level of medical care (14.8%), and low medical cost (12.3%) were the main reasons in choosing medical institutions. Higher proportion of patients seeking medical services due to acute exacerbation in rural areas was reported than in urban areas in the past two weeks (P<0.01). In addition to being hospitalized (113 cases, 41.4%) and self-purchasing medicine (46 cases, 16.8%), the reasons for not seeking medical treatment were self-perceived mild symptoms (15.0%) and high medical cost without reimbursement (9.5%). The multiple regression results showed that outpatient rate for patients of pneumoconiosis combined with tuberculosis in the western region was higher than that in the eastern region (OR=1.66, 95%CI: 1.03, 2.68); patients with an annual personal income of 10000-35500 yuan had a higher outpatient rate than the > 35500 yuan income group (OR=2.54, 95%CI: 1.49, 4.36); the outpatient rate of silicosis patients was higher than that of coal workers' pneumoconiosis (OR=1.83, 95%CI: 1.23, 2.72); the outpatient rate of patients with clinically diagnosed cases (no classified stage of pneumoconiosis) was higher than that of patients with stage I pneumoconiosis (OR=2.32, 95%CI: 1.24, 4.31). Exacerbation of pneumoconiosis-related symptoms in past two weeks (OR=4.26, 95%CI: 2.89, 6.28), occupational injury insurance (OR=0.49, 95%CI: 0.30, 0.80), and hospitalization in past one year (OR=2.37, 95%CI: 1.41, 3.97) were the main factors influencing the outpatient health service utilization among patients of pneumoconiosis combined with tuberculosis.ConclusionThe outpatient rate of patients of pneumoconiosis combined with tuberculosis is higher than that of patients of pneumoconiosis without tuberculosis. The utilization of outpatient services is related with disease factors and socio-economic security factors.

[Background]Welders'exposure to welding fumes with multiple metals leads to decreased pul-monary function.Previous studies have focused on single metal exposure,while giving little at-tention to the impact of metal mixtures. [Objective]To assess the association between metal levels in urine and blood of welders and pulmonary function indicators,and to identify key metals for occupational health risk assess-ment. [Methods]Questionnaire surveys,lung function tests,urine and blood sampling were conducted among welders and control workers in a shipyard in Shanghai.Inductively coupled plasma mass spectrometry(ICP-MS)was used to detect the concentrations of 12 metals such as vanadium,chromium,and manganese in urine and blood.Spearman correlation was applied to analyze the correlations between the metals in urine and blood.Multiple linear regression,weighted quantile sum(WQS)and Bayesian kernel machine regression(BKMR)were used to analyze the relationships between mixed metal exposure and pulmonary function parameters,such as forced vital capacity(FVC),forced vital ca-pacity as a percentage of predicted value(FVC%),forced expiratory volume in the first second(FEV1),forced expiratory volume in the first second as a percentage of predicted value(FEV1%),and forced expiratory volume in the first second/forced vital capacity(FEV1/FVC). [Results]This study enrolled 445 subjects,including 322 welders(72.36%)and 123 controls(27.64%).The mean age of the 445 participants was(37.64±8.80)years,and 87.19%participants were male.The welders had significantly higher levels of urinary cadmium(0.88 vs 0.58 μg·L-1),blood chromium(5.86 vs 5.06 μg·L-1),and blood manganese(24.24 vs 21.38 μg·L-1)than the controls(P<0.05).The Spearman correlation coefficients between the metals in urine and blood ranged from-0.46 to 0.68.After adjustment for confounders,the multiple linear regression indicted that the urine molybdenum of the welders was negatively correlated with FVC and FEV1.There were also negative correlations between the molybdenum in blood and FVC,FVC%,FEV1,and FEV1%,and between the copper in blood and FEV1/FVC.The WQS model showed that FEV1 and FVC decreased by 0.112 L and 0.353 L with each quartile increase of metal mixture concentrations in urine and blood among the welders respectively,and the leading contributors were copper,zinc,vanadium,and antimony.The BKMR model showed a negative overall effect of metal mixtures in urine and blood among the welders on FVC,FVC%,FEV1,and FEV1%,and the univariate exposure response-relationship between the molybdenum concentration in urine or blood and FVC,FVC%,FEV1,or FEV1%had an approximately linear decreasing trend.Meanwhile,there may be an interaction of cadmium with manganese,nickel,or vanadium,and an interaction of vanadium with iron,molybdenum,zinc,or copper,when different metals in urine among the welders interacted with FEV1%. [Conclusion]Exposure to multiple metals in welders leads to a decline in lung function,with molybdenum,antimony,copper,and zinc as the leading contributors.

Introduction:Pneumoconiosis is the most prevalent occupational disease in China, with coal worker pneumoconiosis (CWP) demonstrating the highest incidence. Studies have indicated that phospholipids may be associated with CWP. Methods:In this study, serum was obtained from 62 patients with pneumoconiosis, 105 coal dust-exposed workers, and 50 healthy individuals and analyzed via targeted lipidomics using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). After initially identifying phospholipids with significant differences through univariate and multivariate statistical analyses, receiver operating characteristic (ROC) analysis was performed. The differential phospholipids identified in patient samples were then integrated to assess their diagnostic potential for CWP using a support vector machine (SVM). Results:Compared with healthy subjects, the levels of Lyso-PS (18:0) were decreased, while PC (16:0), PC (18:0), PC (16:0/18:1), PI (16:0/18:1), PS (18:1), PG (16:0), and PG (18:0/18:1) were significantly increased in the pneumoconiosis group, with an area under the curve (AUC)>0.7. Moreover, compared with the dust-exposed group, Lyso-PC (16:0), PC (16:0), PC (16:0/18:1), PI (16:0/18:1), and PG (16:0) were significantly elevated in the pneumoconiosis group, with an AUC>0.7. The diagnostic model, including PC (16:0), PC (16:0/18:1), PI (16:0/18:1), and PG (16:0), demonstrated excellent performance with an AUC of 0.956. Discussion:The serum phospholipid profiles of patients with pneumoconiosis differed significantly from those of controls, including differences in PC, Lyso-PC, PI, PS, Lyso-PS, and PG. Among these, a diagnostic model incorporating PC (16:0), PC (16:0/18:1), PI (16:0/18:1), and PG (16:0) demonstrated superior screening efficiency.

Objective: To compare the CT image characteristics of pneumoconiosis large shadow and primary lung cancer mass, and analyze the value of CT image characteristics in the differential diagnosis of pneumoconiosis large shadow and primary lung cancer. Methods: In September 2022, 43 patients with stage Ⅲ pneumoconiosis who were hospitalized in Zibo Occupational Disease Prevention Hospital from January 2020 to June 2021 and 52 patients with primary lung cancer who were confirmed by pathology in the Affiliated Hospital of Jining Medical University during the same period were selected as the investigation objects, and the image characteristics of pneumoconiosis large shadow or lung cancer mass and surrounding tissues in the chest CT images of the two groups were compared. Univariate analysis, cluster analysis and cross analysis were used to screen out statistically significant indicators as independent variables, and pneumoconiosis and lung cancer as dependent variables for logistic regression analysis. Results: There were statistically significant differences between large shadow of pneumoconiosis and primary lung cancer mass in single factor CT imaging, such as irregular shape of lesions, CT attenuation value, calcification, cavitation, spiculation, liquefactive necrosis, satellite lesions, adjacent emphysema, short spicules, and pleural thickening (P<0.05). CT value ≥92 HU (abnormal CT attenuation value), calcification, peripheral satellite lesions, pleural thickening, parapunctal emphysema, spines on the lesion margin, irregular lesion morphology were typical features of stage Ⅲ pneumoconiosis, with multiple features of aggregation. The typical features of lung cancer were liquefaction necrosis, round or quasi-round appearance, cavitation and interlobar pleura. A logistic regression model was constructed using satellite lesions, spiculation, pleural thickening, and lesion abnormal CT attenuation value had an R(2) of 0.880 and an accuracy of 95.3% for differentiation. Conclusion: Abnormal CT attenuation value, calcification, peripheral satellite lesions, pleural thickening, spiculation at the edges, liquefaction necrosis, interlobar pleura involvement, and cavitation can distinguish the large shadow of stage Ⅲ pneumoconiosis from lung cancer mass.

BackgroundIn vitro-in vivo extrapolation (IVIVE) is an approach utilizing in vitro experimental data to predict in vivo phenomena. It is a promising tool for chemical risk assessment.ObjectiveTo learn the hotspots, evolution path, and trend of IVIVE in risk assessment by literature search and bibliometric analysis, and provide reference and data support for subsequent research. MethodsPubMed and Web of Science Core Collection were selected as foreign databases to search for literature about IVIVE applied in risk assessment published by December 31, 2023. The number of relevant documents in CNKI and Wanfang database was too small, so the Chinese databases were not included in this study. This study employed bibilometric analysis using VOSviewer and CiteSpace for visualizing networks categorized by author, institution, country, journal, keyword, and co-citation.ResultsA total of 189 articles were included in this study. The first article was published in 2006, and since then the number of publications overall showed an upward trend and increased significantly after 2016. The institution with the most publications was the United States Environmental Protection Agency (28 articles). The United States was the most productive country (87 articles), and had a close cooperation with the United Kingdom. The journal with the most publications and the highest number of citations per article was Archives of Toxicology (19 articles). The keyword co-occurrence analysis suggested that research on IVIVE in risk assessment mainly studied the methods and models of IVIVE and prediction of chemical toxicity, and toxicity, in vitro, and models were the research hotspots in this field. Keyword timeline cluster analysis suggested that the assessment objects gradually expanded from drugs to environmental chemicals, organic chemicals and food additives. The co-citation analysis suggested that articles about IVIVE in risk assessment mostly cited journals in the environment, food, and drug fields, and these articles were mainly methodological studies followed by literature reviews. ConclusionThe research of IVIVE in risk assessment has developed rapidly. With the improvement of prediction models and the expansion of application scope, animal experiments in risk assessment may be greatly reduced and the efficiency of risk assessment can be increased. At present, the United States has a leading position in this field, while China has few relevant studies and needs to actively carry out international cooperation to improve the level of applied research of IVIVE. In the future, it is hoped that the IVIVE method can be further refined to improve its application and expand its research fields.

Objective: To analyze and summarize the trends and hot spots in the field of neurological damage caused by electric welding operations, and to provide ideas for new researches by searching the domestic and international literature. Methods: In December 2022, using Web of Science Citation Index (Web of Science), China Journal Full-Text Database (CNKI) and Wanfang Database as search databases, literature search was conducted on the Chinese and English search terms related to eletrical welding operations and neurological damage. The bibliometric analysis software VOSviewer 1.6.18 and CiteSpace 6.1.6 were used to visualize the publication year, publication quantity, country, research institution and key words of the literature. Results: A total of 309 articles (112 in Chinese and 197 in English) were included in this study. The first domestic and international papers were published in 1976 and 1994 respectively, and the number of papers reached the peak in 2006 and 2018, and then showed a downward trend to varying degrees. In China, Shandong First Medical University (including Shandong Institute of Occupational Health and Occupational Disease Prevention and Shandong Academy of Medical Sciences) and Wuhan University of Science and Technology had the largest number of publications. The 309 articles were from 52 Chinese journals and 86 English journals. The co-occurrence analysis of key words showed that the domestic research mainly focused on eletrical welding operation, welding workers, neurobehavioral function and manganese, and the nervous system damage caused by manganese in welding smoke was the field of international attention. Long term exposure, risk, and performance were key buzzwords in the field. Conclusion: The research focus in the field of nervous system damage caused by electric welding operation has an obvious trend of time evolution, gradually transiting from clinical manifestations to its toxic mechanism and early biomarkers.

Objective: To understand the health-related quality of life for patients of pneumoconiosis combined with tuberculosis and its main influencing factors. Methods: This was a cross-sectional study, and 951 patients of pneumoconiosis combined with tuberculosis from the pneumoconiosis survey in 27 provinces and autonomous regions in China from December 2017 to December 2021 were selected for the study. The nonparametric Mann-Whitney test and the Kruskal-Wallis H test were used to compare the health utility values, and multiple linear regression was used for multifactor analysis. AMOS 24.0 was used to establish a structural equation modeling. Results: The mean age of 951 patients of pneumoconiosis combined with tuberculosis was (59.3±12.4) years. The main types were silicosis combined with tuberculosis (62.2%, 591/951) and coal-worker's pneumoconiosis combined with tuberculosis (34.9%, 332/951), and other type pneumoconiosis-combined tuberculosis was 2.9% (28/951). The proportion of patients with stage Ⅰ, Ⅱ, Ⅲ, and unstaged clinical diagnosis was 27.4% (261/951), 26.6% (253/951), 32.5% (309/951) and 13.5% (128/951), respectively. 63.3% (602/951) of study participants suffered from other chronic diseases, and the percentage of patients combined the number of chronic diseases with 1, 2, and more than 3 respectively were 24.1% (229/951), 16.3% (155/951) and 22.9% (218/951). The median and quartiles of health utility values and the mean±standard deviation of self-rating scores of patients of pneumoconiosis combined with tuberculosis were 0.562 (0.482, 0.766) and (53.7±18.4), respectively, which were lower than patients of pneumoconiosis without tuberculosis (Z=-11.29, P<0.001; t=8.97, P<0.01). The health utility values and self-rating scores for patients of pneumoconiosis combined with tuberculosis were significantly different between urban and rural areas (Z= -2.22, P=0.027; t=4.85, P<0.01). Pain/discomfort was the most frequently reported problem in the five-dimensional distribution of problems, followed by daily activities and anxiety/depression, and the difference in the percentage reported by anxiety/depression between urban and rural areas was significant (χ(2)=30.28, P<0.01). The results of multiple linear regression showed that the survey area, body mass index, education level, age, employment status, annual personal income, stage of pneumoconiosis, number of multi-morbidities, hemoptysis, acute exacerbation of symptoms in two-week, social support and minimum living standard were the main influences on the health utility values of the patients of pneumoconiosis combined with tuberculosis (P<0.05). The results of structural equation model showed that economic security and health status directly affected the health-related quality of life among patients of pneumoconiosis combined with tuberculosis and played a chain-mediating effect in the influence of socioeconomic status on the health-related quality of life among patients of pneumoconiosis combined with tuberculosis. Conclusion: Health-related quality of life was poorer in patients of pneumoconiosis with tuberculosis, with pain and discomfort and anxiety/depression problems being more pronounced, and economic status and health status played multiple mediating roles in the influence of general socio-demographic characteristics on quality of life in pneumoconiosis.

What is already known about this topic?The application of whole lung lavage (WLL) for the clinical treatment of pneumoconiosis is prevalent in China. Several scholars have reported success in the treatment of early-stage pneumoconiosis. Nonetheless, the overall efficacy of WLL in the management of pneumoconiosis remains ambiguous.What is added by this report?The preliminary evaluation of the effects of WLL on pneumoconiosis patients was conducted using follow-up data from 2020 to 2022, after controlling for confounding factors via propensity score matching. While the study found that WLL may improve some pneumoconiosis symptoms, no significant enhancements were observed in overall health status or quality of life.What are the implications for public health practice?The findings of this research indicate limited efficacy of WLL in treating patients with pneumoconiosis, thereby suggesting that it should not be utilized as a standard treatment procedure for this condition.

目的 了解尘肺病患者全肺灌洗(WLL)利用情况及其影响因素.方法 采用分层随机抽样和非随机抽样相结合的方法,选择2018-2021年中国27个省级行政区(不含上海市、天津市、海南省、西藏自治区)尘肺病患者就医行为调查中的10524例尘肺病患者为研究对象,分析其人口社会学特征、疾病相关因素和经济与社会保障情况对于WLL利用情况的影响.结果 尘肺病患者WLL率为17.8%(1871/10524).促使尘肺病患者利用WLL的主要原因以"医生建议"为主,占65.4%;其次为"周围有尘肺病患者进行WLL"和"病友推荐",分别占24.1%和18.1%.多因素logistic回归分析结果显示,患者年龄、体质量指数、吸烟指数、文化程度、调查地区、患者来源、目前就业状态、粉尘作业单位性质、尘肺病期别、尘肺病病种、尘肺病相关症状(咳痰、胸痛、呼吸困难、关节疼痛)、WLL禁忌证(肺结核、肺源性心脏病)、家庭年收入、城镇职工医保、医保报销比例、伤残补助、社会资助等均是尘肺病患者利用WLL的影响因素(P值均<0.05).结论 尘肺病患者对WLL的利用比例较大;WLL利用的影响因素包括人口社会学特征、疾病相关因素、经济与社会保障情况等.应最大程度地以保证尘肺病患者的利益为主导,加强对尘肺病患者的职业健康教育与健康促进,规范医疗机构使用WLL行为,以合理利用WLL.

Introduction: Pneumoconiosis emerges as the most critical and prevalent occupational disease in China at present, according to research. Studies indicate that pneumoconiosis may indeed impact the body's phospholipid metabolism. Methods: In this study, serum samples were taken from 46 paired participants, which included patients with pneumoconiosis and dust-exposed workers. We employed ultra-performance liquid chromatography- tandem mass spectrometry (UPLC-MS/MS) technology in targeted lipidomics to investigate serum target phospholipids. Initially, a pilot study was conducted with a selection of 24 pneumoconiosis patients and 24 dust-exposed workers, using both univariate and multivariate statistical analyses to preliminarily identify significant differences in phospholipids. Subsequent to this, the remaining subjects were engaged in a validation study, wherein receiver operating characteristic (ROC) analysis was performed to further substantiate the screening potency of potential lipid biomarkers for pneumoconiosis. Results: The pilot study revealed significantly reduced serum levels of 16:0 lysophosphatidylcholines (Lyso PC), 18:0-18:1 phosphatidylglycerol (PG), 18:0-18:1 phosphatidylethanolamine (PE), 18:0 PE, and 18:1 lysophosphatidylethanolamine(Lyso PE) in the case group in comparison to the control group. Additionally, 18:0 PE, 18:0-18:1 PE, and 18:1 Lyso PE emerged as significant phospholipids with superior diagnostic values [area under the curve (AUC)>0.7]. A diagnostic model was established, built on 16:0 PC and 18:0 PE (AUC>0.8). In the ROC analyses of validation studies, the 18:0-18:1 PE and this diagnostic model demonstrated excellent screening efficiency (AUC>0.7). Discussion: A significant divergence in phospholipid metabolism has been observed between pneumoconiosis patients and dust-exposed workers. The 18:0-18:1 PE present in serum could potentially function as a lipid biomarker for pneumoconiosis. Additionally, diagnostic models were developed relying on 16:0 PC and 18:0 PE, proving to have superior screening efficiency.

Background: Pneumoconiosis is the most widely distributed occupational disease worldwide. China is currently the largest coal producer and consumer and the country with the most coal miners and cases of coal workers' pneumoconiosis (CWP). Despite more than 70 years of effort, the problem of CWP and silicosis remains serious. There is a lack of analysis of direct data on coal miners' pneumoconiosis from all over the country. This study aimed to describe the epidemiology of coal miners' pneumoconiosis and reveal some important clues regarding its social determinants. Methods: The annual incidence rate, 20-year prevalence rate, and incidence rate of coal miners' pneumoconiosis per million tons in China from 1949 to 2021 were calculated by using the data of annual number of coal miners' pneumoconiosis diagnosed and reported from the coal mining and dressing industry, the number of coal miners, and the raw coal production, and the relationship between the incident cases of coal miners' pneumoconiosis and the death toll from coal mine safety accidents was analyzed using Pearson correlation analysis, with the aim of exploring the relationship between the incident cases of coal miners' pneumoconiosis and its social determinants with an ecological study. Results: From 1949 to 2021, there have been more than 462,000 patients with coal miners' pneumoconiosis in China, showing double U-shaped distributions with an increasing trend, accounting for about 50.5% (462,000/915,000) of all diagnosed pneumoconiosis in China, while the incidencet rate of coal miners' pneumoconiosis presents a large W shaped distribution with three peaks over a time span of more than 50 years. From 1949 to 1986, there was a strong correlation between the incident cases of coal miners' pneumoconiosis and raw coal production, the number of coal miners, and the number of deaths from coal mine accidents ( r = 0.849, P < 0.001; r = 0.817, P < 0.001; r = 0.697, P < 0.001, respectively), but there was no such correlation found from 1987 to 2006. It was estimated that the annual incidence rate of coal miners' pneumoconiosis in China from 2016 to 2020 was 3.4 %o (95% CI: 2.6-4.3 %o ), and the prevalence rate across the recent 20-year observation period was 4.8% (95% CI: 4.6-4.9%), both measured at the peak or around the peak over the 70 years. In particular, 1963, 1986, 2006, and 2009 were the four important turning points in time. Conclusion: There was a sustained high level of incident cases of coal miners' pneumoconiosis with double U shaped curve in China, which may be affected by a variety of social determinants and risk factors.

What is already known about this topic?Pneumoconiosis, recognized as one of the most detrimental occupational diseases in China, exhibits a multimorbidity profile due to a plethora of comorbidities and complications. These factors significantly influence the treatment outcomes, progression, prognosis, and overall quality of life of the afflicted patients.What is added by this report? The present study examined the prevalence and types of comorbidities, encompassing 13 common diseases or conditions, within cases of pneumoconiosis across 27 provincial-level administrative divisions (PLADs) in China. Distinctions in multimorbidity distribution by gender, urban vs. rural areas, stages of pneumoconiosis, and the smoking index were considered. Furthermore, the study investigated the patterns of multimorbidity.What are the implications for public health practice? This study serves as a reference point for the formulation of treatment strategies and health policy development concerning pneumoconiosis in China.

Background::Patients with pneumoconiosis have an elevated risk of contracting pulmonary tuberculosis (PTB) and need particular attention. However, extensive population-based studies on the prevalence of PTB in patients with pneumoconiosis have not been reported in China since 1992. This study aimed to investigate the epidemiological characteristics of PTB in patients with pneumoconiosis based on its social determinants and risk factors in China.Methods::Based on the Commission on Social Determinants of Health (CSDH) framework, data were obtained from a questionnaire survey of patients with pneumoconiosis from China’s 27 provinces (autonomous regions, municipalities) from December 2017 to June 2021. By chi-square and multivariate logistic regression analyses, the epidemiological characteristics of PTB in the patients were identified based on its prevalence and odds ratio (OR) and associated social determinants and risk factors. The population attributable fractions (PAFs) of significant risk factors were also calculated.Results::The prevalence of PTB in patients with pneumoconiosis ( n = 10,137) was 7.5% (95% confidence interval [CI]: 7.0-8.0%). Multivariate logistic regression analysis showed that risk factors included in-hospital exposure to patients with PTB (OR = 3.30, 95% CI: 2.77-3.93), clinically diagnosed cases (OR = 3.25, 95% CI: 2.42-4.34), and northeastern regions (OR = 2.41, 95% CI: 1.76-3.31). In addition, lack of work-related injury insurance (WRII), being born in a rural area, being unemployed, living in western regions, household exposure to patients with PTB, smoking, being underweight, complications of pulmonary bullae or pneumothorax, hospitalization history, and former drinkers among the rural patients were also statistically significant risk factors. Being born in a rural area, lack of WRII and in-hospital exposure to patients with PTB had higher PAFs, which were 13.2% (95% CI: 7.9-18.5%), 12.5% (95% CI: 8.3-16.7%), and 11.6% (95% CI: 8.8-14.3%), respectively. Conclusion::The prevalence of PTB in pneumoconiosis remains high in China; it is basically in line with the CSDH models and has its characteristics.

BackgroundMetallic nickel and nickel compounds are classified as possibly carcinogic and carninogic to humans respectively, but the exact carcinogenic mechanism has not been clarified.ObjectiveTo analyze the carcinogenic research trend and hotspots of nickel and nickel compounds, and provide research directions for this topic.MethodsLiterature search on the carcinogenesis of nickel and nickel compounds was conducted through authoritative databases at home and abroad: Wanfang, China National Knowledge Infrastructure, PubMed at the US National Library of Medicine, and Elsevier’s biomedical research database EMBASE. VOS viewer 1.6.17 visual analysis software was applied to perform the bibliometric analysis and present results with charts on annual number of publications, distribution of author’s affiliations, country/region distribution, journal distribution, and keywords of literature that meet a predetermined inclusion criteria.ResultsA total of 242 Chinese documents and 878 foreign documents (languages included English, German, and Japanese) related to the carcinogenic research of nickel and nickel compounds were found. In terms of Chinese articles, the earliest publication of relevant research was in 1974; Guangzhou Medical University (including Guangzhou Medical College and Institute of Chemical Carcinogenesis of Guangzhou Medical College) was the institution that published most articles in this field (35 articles); Industrial Health and Occupational Diseases was the journal that published the most articles (19 articles). In terms of foreign articles, the earliest publication was in 1950; the United States ranked the country having the highest number of published articles (304 articles), and China took the second place (83 articles); Cancer Research was the journal that published the most articles (40 articles). The keyword co-occurrence analysis showed that the domestic studies on the carcinogenesis of nickel and nickel compounds mainly focused on nickel smelting fume, nickel sulfate, nickel chloride, and other nickel and its compounds in association with DNA damage, DNA methylation, induction of human bronchial epithelial cell transformation, and other carcinogenic mechanisms. The international studies focused on population epidemiological studies on occupational risk factors, incidence, and mortality on carcinogenesis of nickel and nickel compounds, and studies on histone modification, oxidative stress, DNA damage, cell transformation, and other carcinogenic mechanisms.ConclusionStudies have shown that the hotspots of carcinogenic research on nickel and nickel compounds involved studies on carcinogenic mechanisms related to DNA damage, DNA methylation, histone modification, oxidative stress, and induction of human bronchial epithelial cell transformation, and population epidemiological studies on occupational risk factors, incidence, and mortality. In recent years, the number of published articles on the carcinogenesis of nickel and its compounds in China has been decreasing. In view of the large number of occupational nickel-exposed population in China, more efforts should be made to study the carcinogenesis of nickel and nickel compounds in the future.

目的 调查119家煤矿企业肺结核体检管理和煤矿工人肺结核发病情况,探讨我国煤矿工人肺结核纳入职业健康体检情况和存在的主要问题.方法 对全国9省54家国有重点煤矿、24家地方国有煤矿和41家乡镇煤矿共119家煤矿企业开展问卷调查,对资料进行统计分析.结果 国有重点煤矿、地方国有煤矿肺结核体检的主要管理部门为企业附属医院(33.3％和41.7％),乡镇煤矿为企业行政管理部门(68.3％).51.9％的国有重点煤矿和41.7％的地方国有煤矿制定了肺结核体检管理制度,乡镇煤矿均未制定相关制度.109家煤矿(91.6％)无肺结核专职管理人员,31家(26.1％)无肺结核兼职管理人员.2010-2012年,17.3％的国有重点煤矿、33.3％的地方国有煤矿和62.6％的乡镇煤矿未开展岗前职业健康体检,国有重点煤矿岗前肺结核检出率年均47.53/10万人,其他煤矿均未检出病例.国有重点煤矿、地方国有煤矿和乡镇煤矿工人年均在岗体检率分别为51.7％、37.4％和25.0％,肺结核检出率分别为134.86/10万人、472.27/10万人、1 816.75/10万人,未开展在岗体检的企业比例分别为9.3％、27.8％、47.2％.结论 乡镇煤矿缺乏结核病管理制度及管理人员,与地方结核病防治机构缺乏业务联系,工人体检率低,但肺结核检出率高,是煤矿企业肺结核防控的最薄弱之处.相关部门需加强对煤矿工人肺结核的防治管理.

In this work, untargeted lipidomics was employed to analyze the effects of coal dust exposure on serum metabolite profiles. Furthermore, the potential of differential metabolites as novel biomarkers for diagnosis was investigated by binary logistic classification model. Nineteen differential metabolites were found among the three groups. The compounds were enriched in pathways associated with linoleic acid metabolism and pyrimidine metabolism. Fifty-three differential metabolites were found in coal dust–exposed people and CWP patients, and they were mainly enriched in glycerophospholipid metabolism. Three differential metabolites were correlated with lung function values. The diagnostic model, composed of lysoPI (16:0/0:0), bilirubin, and lysoPC (24:1/0:0), showed strong discrimination ability between dust-exposed people and CWP patients. The sensitivity, specificity, and AUC values of the model were 0.869, 0.600, and 0.750, respectively. The results suggest that coal worker’s pneumoconiosis causes abnormal lipid metabolism in the body. A diagnostic model may aid current CWP diagnostic methods, and lysoPI (16:0/0:0), bilirubin, and lysoPC (24:1/0:0) can be used as potential CWP biomarkers. Further study is warranted to validate the findings in larger populations.

Prolonged exposure to hard metal dust results in hard metal lung disease (HMLD) characterized by respiratory symptoms. Understanding the pathogenesis and pathological process of HMLD would be helpful for its early diagnosis and treatment. In this study, we established a mouse model of hard metal-induced acute lung injury through one-time intratracheal instillation of WC-Co dust suspension. We found that WC-Co treatment damaged the lungs of mice, leading to increased production of IL-1β, TNF-α, IL-6 and IL-18, inflammatory cells infiltration and apoptosis. In vitro, WC-Co induced cytotoxicity, inflammatory response and apoptosis in macrophages (PMA-treated THP-1) and epithelial cells (A549) in a dose-dependent manner. Moreover, RNA-sequence and validation experiments verified that Pentraxin 3 (PTX3), an important mediator in the regulation of inflammation, was elevated both in vivo and in vitro induced by WC-Co. Functional experiments confirmed the PTX3, which was located on the membrane of apoptotic cells, promoted macrophage efferocytosis efficiently. This progress could help block the lung inflammation and contribute to the rapid recovery of WC-Co-induced acute lung injury. These observations provide a further understanding of the molecular mechanism of WC-Co-induced pulmonary injury and disclose PTX3 as a new potential therapeutic approach to relieve WC-Co-induced acute lung injury via efferocytosis.