Objective Through the investigation on the implementation of GBZ70-2015 "Diagnosis of Occupational Pneumoconiosis" standard, it provides a basis for the revision of the standard. Methods The questionnaire was formulated and an online survey of qualified diagnosticians for pneumoconiosis was conducted from February 26 to March 15, 2021. Results A total of 923 pneumoconiosis diagnosticians participated in the survey, 76.1% of them diagnosed less than 50 cases of pneumoconiosis in past one year. 84.1% of the institutions were equipped with DR, 73.2% with CT, and 48.7% with medical screen for pneumoconiosis diagnosis. 77.6% of pneumoconiosis diagnosticians believed that the diagnostic criteri ashouldber evised, and the revised opinions mainly focused on "clarifying how CT can be used for auxiliary diagnosis of pneumoconiosis" and "expanding diagnostic methods, medical display can also be used for diagnosis, and electronic standard film should be applied".Conclusion The criteria for the "Diagnosis of Occupational Pneumoconiosis" need to be revised.

Objective To analyze the characteristics of pneumoconiosis patients and the basic status of medical treatment. Methods Research objects were chosen by stratified sampling method and typical survey method from existing pneumoconiosis patients in China. The survey was carried out from March 2017 to January 2018 in nine provinces including provinces from east, medium and western region in China. Source of pneumoconiosis cases were inpatient cases, outpatient or physical-examined cases and household-investigation cases. The survey mainly included demographic and sociological characteristics, economic status, occupational history and dust exposure history, disease status, work-related injury insurance and social security status and related indicators of pneumoconiosis treatment. Results Investigated 1037 pneumoconiosis cases which included 186(19.9%) household-investigation cases, 212(20.4%) outpatient or physical-examined cases and 639 (61.7% ) inpatient cases. Demographic and sociological characteristics, individual monthly income, economic source, occupational history and work-related injury insurance were statistically significant among different source of pneumoconiosis patients (P<0.05). Among all of the household-investigation cases, there were 74 cases (40.2% ) had no income, 117 cases (62.9% ) used to work in private enterprises, 36 cases (19.4%) had work-related injuries insurance, 95 cases (51.1%) were at three phase of pneumoconiosis, 108 cases(59.0%) haven't had any drugs for pneumoconiosis. 65 cases(39.4%) haven't went to the clinic, 53 cases (28.5% ) hadn't seek medical advice although they needed medical treatment very much. Among all of the outpatient or physical-examined cases, there were 95 cases (46.1%) had no income, 36 cases (17.0%) had work-related injuries Insurance, 139 cases (65.6% ) went to the clinic for treatment of pneumoconiosis, 81 cases (38.2%) went to the clinic for more than ten times. Among all the inpatient cases, 310 cases'(49.3%) personal monthly income was above 2000 yuan, 352 cases (55.1%) had work-related injuries Insurance, 588 cases(92.2 %) were taking drugs for treatment of pneumoconiosis, 153 canses(24.2%) had hospitalization for than ten times. Conclusion Household-investigation cases have lower economic conditions, lower rates of In-surance coverage for work-related injuries, severer pneumoconiosis and higher clinical service utilization. Clinical or physical-examined cases have lower economic conditions, lower rates of Insurance coverage for work-related injuries and higher clinical service utilization. Hospitalized cases have better economic conditions, higher rates of insurance coverage for work-related injuries and higher hospitalization service utilization.

职业健康监护是职业卫生服务的重要内容,应根据监护的种类和不同的职业病危害因素及其目标疾病,确定具体的医学检查方法和检查指标.《职业健康监护技术规范》(GBZ188)是对各种职业病危害因素规定的最低检查标准.该标准修订后涵盖了《职业病分类和目录》中所列的全部法定职业病,对保护劳动者健康和规范从事职业健康检查的医疗卫生机构有重要的指导意义.

为指导相关单位做好低温作业人员的职业健康监护,新修订的《职业健康监护技术规范》(GBZ 188)拟在GBZ 188-2014的基础上增加低温作业人员健康监护条款,规定了相应的技术性、规范性意见.针对低温作业人员健康监护的条款、低温作业健康监护的职业禁忌证、低温健康体检应急健康检查条款做一介绍说明,希望对低温作业人员健康监护实施有所帮助.

目的 观察中药制剂治疗铸工尘肺的疗效.方法 将227例患者按随机数字表法分为治疗组和对照组.两组均常规给予止咳、化痰、平喘等治疗,治疗组同时给予中药治疗.比较两组治疗前后临床症状、肺功能及血清超氧化物歧化酶(SOD)水平的变化.结果 治疗组治疗后临床症状评分较治疗前降低;第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、第1秒用力呼气量占用力肺活量比值(FEV1/FVC)较前增加,差异有统计学意义(P＜0.05);与治疗前及治疗后的对照组比较,治疗组治疗后SOD活力明显升高,差异有统计学意义(P＜0.05).结论 中药制剂不但可以改善患者临床症状和肺通气功能,而且能够减轻氧化应激对肺组织的损伤.

刮研是指用带柄刮刀以人工方法修整工件的表面形状、粗糙度等,刮研作业作为一个重要的工种,在机床生产、精密加工和维修中具有不可代替的位置.目前从事手工刮研作业工人约占行业一线工人的5％,粗略估计全国目前该作业仍有10万余名从业人员. 钳工在刮研操作时,将平面刮刀刀柄顶住腹股沟部位,双手握住刀具,使平面刮刀与被刮表面形成一定的切削角度,并对刀头施加压力,使平面刮刀刀刃吃紧平面.由于刮研工用髂骨和腰部给刀柄以推力,腹股沟长期顶压刮刀致静脉血管回流不畅、下肢瘀血、压力增高、组织缺氧,可造成下肢静脉血栓综合征、股动脉闭塞症及淋巴管闭塞症,相关的疾病主要包括肌肉骨骼系统疾病、外周血管疾病.

Objective To evaluate occupational health risk levels of dust exposed workers in a certain carbide production enterprise with two risk assessment models,thereby provide a scientific basis for the control and management of occupational health risk.Methods A carbide production enterprise in Zhuzhou city was chosen as research object,the field survey about occupational health was conducted in 2015,the concentrations of total dust,respiratory dust and the contents of tungsten and cobalt in main exposure positions were tested.Singapore semi-quantitative risk assessment model and occupational hazards risk assessmnent index method were used to assess the occupational health risk of carbide dust,meanwhile,the classification of the occupational hazards levels at workplaces was made as well.Results The results showed that Singapore semi-quantitative risk assessment method and the occupational hazards risk assessment index method presented consistent assessment results on eight main carbide dust exposed positions.According to total carbide dusts concentrations and tungsten element contents the risks were all at low or mild level,according cobalt element contents the mixing and sieving positions were at high or extremely high risk level,the ball mill drying and further processing,pressing,sintering,sandblasting and packaging positions were at low or mild risk level,while the other dust exposure positions were at relatively harmless level.Conclusion The results suggested that the "occupational hazards risk assessment index method","Singapore semi-quantitative risk assessment model" and "classification of occupational hazards at workplaces" may use for the evaluation of occupational health risks of carbide dusts,but the indicator should be cobalt concentration in workplace air;and the hard metal dusts exposed operation should strengthen the occupational hazards management and control especially some key posts such as mixing,sieving,ball mill drying and further processing etc.

目的 了解我国职业健康检查机构主要仪器设备配置情况及存在的问题.方法 采用典型抽样方法,以浙江、上海、江苏、广西、深圳、重庆、山东和湖北8个省/直辖市/自治区2011年6月前获得职业健康检查资质的职业健康检查机构(以下简称“职检机构”)为调查对象,对其5类共45种常用职业健康检查仪器设备(以下简称“职检仪器”)配置情况进行问卷调查.结果 451家职检机构共配置职检仪器18 891台,平均41.9台/家;医院、疾病预防控制中心(CDC)、职业病防治院所和其他机构配备的设备数量分别占47.1％、38.1％、7.5％和7.3％.CDC职检仪器配置平均数较少(27.1台/家),其中胸部影像学、内外科检查和五官神经科检查仪器配置不足;职防院所仪器配置平均数较多(74.7台/家).职检仪器配置存在明显的机构类型间的差异和地区差异.结论 CDC、医院和职防院所是职业健康检查的3大机构,设备配置各有侧重.应加强对CDC职检仪器的建设,各类职检机构在职检仪器方面应资源共享.

目的 放射卫生技术服务机构质量管理体系的运行和维护能够有效的保证检测工作的规范化、标准化、系统化.方法 概述了本单位质量管理体系的现状和体系文件,在维护体系运行中遇到的问题及如何预防问题的发生.结果 体系运行的维护,需要全方面努力,坚持科学规范的管理理念,全方位提高实验室人员的综合素质,避免一切可能导致检测错误的因素.结论 要从人员、设备、环境等全面考虑维护管理体系的的运行,保障检测工作的科学性和可靠性.

目的 为申请放射卫生技术服务资质审定或延续的机构提供帮助.方法 对放射卫生技术服务甲级机构资质审定或延续申请材料、整改报告的技术审查和现场评审过程中常见问题进行分析.结果 申请机构应建立完善的管理体系,并保证其系统性、全面性、有效性和适应性;申请资质审定或延续前应对人员、设备和环境设施等全部要素进行内部审核;按相关要求编写申请材料及整改报告,有助于放射卫生技术服务资质许可的通过,减少不符合项的发生.结论 为放射卫生技术服务机构申请资质提供帮助.

目的 了解全国放射卫生机构设置、独立设置的放射卫生部门以及专业技术人员结构状况,分析存在的问题,为放射卫生机构设置及人才队伍建设提供依据.方法 由原卫生部组织,全国31个省、自治区、直辖市及新疆生产建设兵团卫生监督部门组织开展调查,并上报数据,获取全国放射卫生机构情况,岗位设置以及专业技术人员基本资料,按照监督、疾控、职防和其他划分机构类别,按照省、市、县和其他划分机构级别,分别对不同类别和级别放射卫生机构的统计数据进行分析.结果 在全国放射卫生机构31个省级机构中,30个省设有独立的放射卫生部门,市(地)级机构放射卫生机构大部包含在职业卫生技术服务机构中,县(区)级机构与公共卫生在一起;全国放射卫生机构中的平均从业人员为1.6人,省级机构平均从业人员为6.5人,市(地)级机构平均从业人员为3.1人,县(区)级机构从业人员平均数量最低仅为1.2人,监督县(区)级机构平均1.4人;专业人员的职称以中级和初级为主,分别占总人数的42.6％和38.2％;学历构成以大中专为主,分别占总人数的36.6％和34.5％;所学专业以公共卫生为主,占总人数的45.7％,放射卫生和放射医学专业人员较少,分别占5.4％和6.7％,其他专业占39.7％.结论 全国放射卫生市县级大部分机构没有设置独立的放射卫生部门,存在人员不足,专业结构不合理的问题.需尽快制定各级机构的任务要求、人员配置标准,省市级需设置独立的放射卫生机构,要进一步加强各级机构的人才队伍和能力建设,定期参加全国放射卫生检测比对或考核,打造一支技术过硬的专业队伍.

目的 测试中国疾病预防控制中心辐射防护与核安全医学所的实验室信息管理系统(LIMS),以初步检验该系统对放射卫生质量管理工作各个环节的合理、有效控制.方法 概述了实验室信息管理系统的定义,通过对5个测试模块进行研究分析,找出问题,分析并提出相应的对策,使得LIMS系统更加适应工作流程的需要.结果 LIMS系统能够更加清晰的将“人,机,料,法,环”等质量管理体系中的重要影响因素系统化、条理化、可操作化.结论 通过进一步加强对实验室信息管理系统的重视、改进和提高,努力实现质量管理体系的科技化、效率化、统一化和规范化管理.

标准作业程序(SOP)是将某一事件的标准操作流程、要求和注意事项等以统一的格式描述出来,用以指导和规范日常的工作,是对一个过程的描述,是某个流程关键点如何来规范操作的依据程序[1],其核心就是使得流程的细节更加精确,对某一流程的关键之处进行细化、量化和优化.中国疾控中心辐射安全所依据相关要求和准则[2-4],对质量管理体系和SOP提出了系统的管理要求和管理标准.

目的：分析2006—2012年全国放射卫生技术服务机构检测能力考核过程中存在的问题，提出对策。方法对2006—2012年参加全国放射卫生服务机构检测能力考核的资料进行分析。结果经趋势性礸2检验，放射工作人员个人剂量监测和生物剂量估算考核合格率随年份的增加而增加（ P＜0.01）；放射性核素γ能谱分析和水中总α总β放射性测量考核合格率随年份的增加而下降（ P＞0.05）。放射工作人员个人剂量监测、放射性核素γ能谱分析、水中总α总β放射性测量和生物剂量估算考核2011年优秀率分别为35.6％、8.0％、18.9％和0.0％；2012年优秀率分别为29.6％、25.0％、27.3％和18.2％。2009—2012年参加考核的放射卫生技术服务机构总数逐年增加，70.0％以上的机构仅参加1项考核项目；除2009年有16.0％的机构参加3项考核项目外，其余各年份参加3或4项考核项目的机构参加率均低于9.0％。结论组织放射卫生技术服务机构参加检测能力考核对规范放射卫生技术服务工作，提高服务水平具有重要意义，可为行政部门制订政策，宏观监督管理提供科学、客观的数据。

目的 总结首届全国卫生监督技能竞赛放射工作人员个人剂量监测盲样考核工作的经验,并应用到实际监测工作中,规范监测技术,不断提高监测水平,推动全国外照射个人剂量监测质量保证工作的持续改进.方法 科学制定《放射工作人员个人剂量监测盲样考核方案》；制备发放考核样品；检测结果分析,对考核全过程进行质量控制.结果 考核工作科学、公正、公平、有效的开展,圆满完成了全国卫生监督技能竞赛的任务,达到了预期目的.结论 通过在全国范围内开展技能竞赛活动,可以检验全国省级疾病预防控制机构或职业病防治机构的个人剂量监测水平.能够激励广大卫生监督、疾控和职防机构工作人员钻研业务、加强岗位练兵,切实提高技术支撑和监测能力.

目的分析放射卫生技术服务甲级机构资质评审和检测能力考核过程中存在的问题,提出对策。方法 对2008—2013年4月14家放射卫生技术服务甲级机构的资质评审现场考核和参加全国放射卫生技术服务机构检测能力考核的资料进行分析。结果 资质评审现场考核显示,评审项目出现不符合和基本符合情况居前4位的为检测工作、仪器设备、质量管理和建设项目评价能力的项目。2012年14家甲级机构参加比对的放射工作人员个人剂量监测、放射性核素γ能谱分析、水中总α总β放射性测量和生物剂量估算等4个考核项目的总体合格率均达100.0%,但优秀率仍有进一步提升的空间。结论 放射卫生技术服务甲级机构资质评审现场考核与检测能力考核相结合,对规范放射卫生技术服务工作,提高服务水平具有重要意义。

Pneumoconiosis is a pulmonary fibrosis disease caused by inhaling industrial dust.The high voltage chest Roentgenography is presently the main means for diagnosing pneumoconiosis.Digital radiography technology has developed rapidly in recent years and is hopefully to supersede the traditional Roentgenography.Through comparing the different imaging techniques,this article summarized the pneumoconiosis imaging diagnostic techniques and made some prospects.

目的探讨转化生长因子-β(TGF-β)和肿瘤坏死因子-α(TNF-α)基因多态性与煤工尘肺发生的关系。方法选择234名汉族男性煤工尘肺患者为病例组,440名接触煤尘无尘肺及其他肺部疾病者为对照组,采集外周静脉血,采用聚酶链反应-限制性片段长度多态性(PCR-RFLP)技术检测TGF-β(+869)位点和TNF-α(-238)位点基因多态性。结果煤工尘肺病例组TGF-β(+869)位点基因型、等位基因分布频率与对照组比较,差异均无统计学意义(P>0.05)。TNF-α(-238)位点为G/A基因型者患Ⅰ期煤工尘肺的危险度是G/G基因型的1.74倍(95%CI:1.01～3.01,P<0.05),调整年龄、接尘工龄和工种后为1.58倍(95%CI:0.89～2.78,P>0.05)。Ⅰ期煤工尘肺患者C、A等位基因频率分别为93.10%和6.90%,对照组G、A等位基因频率分别为95.80%和4.20%,两组比较,x 2 =3.828,P=0.05。结论TNF-α(-238)位点和TGF-β(+869)位点的多态性对煤工尘肺的发生不起主要作用。

[Objective] To study the effects of transforming growth factor(TGF)-β and tumor necrosis factor(TNF)-α gene polymorphism on genetic susceptibility of silicosis.[Methods] Total of 259 silicosis patients(case)and 341 workers exposed to silica dus(tcontrol)was selected.Each object were asked to fill a uniformed questionnaire.A chest high-voltage X-ray film was taken for each one.Blood sample from each object was analyzed using the polymerase chain reaction restriction fragment length polymorphisms(PCR-RFLP)technique for gene polymorphisms of TGF-β(+869)and TNF-α(-238).[Results] No significant difference was found between silicosis patients and controls in distribution of TGF-β(+869)and TNF-α(-238)allelic frequency.Of the 259 selected cases,129 were 1:1 pair-matched with controls by type of work,length of dust exposure,and age to evaluate the risk of silicosis.It was found that persons with GA genotype of the TNF-α(-238)gene had a reduced risk for silicosis(OR=0.27,95%CI:0.10-0.75,P 0.02).[Conclusion] While TGF-β(+869)gene polymorphism showed no correlation with silicosis,the TNF-α(-238)gene polymorphism with the specific GA genotype demonstrated silicosis risk reduction.