目的 初步探讨人色素上皮衍生因子(pigment epithelium-derived factor,PEDF)作为正己烷早期神经毒效应标志物的可行性.方法 选取28名职业性慢性正己烷中毒病例作为病例组;按年龄、性别匹配,选取接触正己烷未出现周围神经中毒症状的作业工人56名作为接触组,不接触正己烷等有机溶剂且无周围神经损害症状的作业工人56名作为对照组.采集所有研究对象肘静脉血并检测血清外泌体中PEDF水平.对病例组进行神经肌电图检查.采用方差分析比较病例组、接触组以及对照组PEDF水平的差异,采用Pearson相关分析探讨病例组PEDF与神经肌电图相关指标的相关性.结果 病例组与接触组、对照组间血清外泌体PEDF水平差异具有统计学意义(P＜0.05),且病例组血清外泌体PEDF水平高于接触组(P＜0.05)、而接触组血清外泌体PEDF水平高于对照组(P＜0.05).此外,对病例组血清外泌体PEDF水平与其神经肌电图4项指标进行相关性分析发现,PEDF水平与腓总神经的下肢远端运动潜伏期为正相关(r=0.62,P＜0.001),与腓总神经的运动神经传导速度(r=-0.70,P＜0.001)、下肢感觉神经动作电位波幅(r=-0.61,P=0.001)及感觉神经传导速度(r=-0.61,P=0.001)均为负相关,与正中神经的感觉神经传导速度为负相关(r=-0.53,P=0.004).结论 血清外泌体PEDF可能作为正己烷神经毒效应标志.

目的 研究接触语频噪声对热线电话女性客服人员健康的影响,并提出针对性的防护建议.方法 2017-2019年,对某国有企业人工热线电话岗位工作场所噪声声级进行检测与评价;选择该热线电话岗位60名接触语频噪声的女性客服人员作为接触组,该企业不接触职业病危害因素的60名女性文职人员作为对照组,对两组人员进行职业健康检查,并对结果进行分析.结果 接触组工作场所中噪声声级LEX,8h为55.3～78.6 dB(A),主要集中在500～3 000 Hz;耳机内噪声声级为(62.7～88.9)dB(A),主要集中在500～2 000 Hz,属于非稳态的语频噪声.接触组人员自述乏力、记忆力减退、食欲不振、全身酸痛、入睡困难、听觉迟钝、月经紊乱症状的检出率高于对照组(P＜0.01或P＜ 0.05).接触组高频听阈提高、语频听阈提高、听力下降检出率均高于对照组(P＜ 0.01).接触组工人窦性心动过缓、窦性心律不齐、ST-T改变和心电图异常的检出率均高于对照组(P＜0.01或P＜0.05).接触组低血压、血压异常、血清甘油三酯(TG)、总胆固醇(TC)和血脂异常检出率均高于对照组(P＜ 0.01或P＜0.05).随着工龄增加,接触组听力下降检出率、低血压检出率有增加的趋势(P＜ 0.05).结论 长期接触语频噪声对热线电话女性客服人员可造成以高频听阈提高为主的听力下降和以神经衰弱综合征为主的自觉症状,其心电图、血压、血脂异常检出率均高于正常人群.接触语频噪声的劳动者应注意加强个人防护.

目的 初步在人群中论证外周血红细胞共价交联血影蛋白(Sp)作为正己烷神经毒效应替代标志物的可行性.方法 选取15名职业接触正己烷的工人作为接触组,将其中神经-肌电图异常的5人分类为慢性正己烷中毒前期接触者,其余无神经-肌电图异常的10人分类为一般接触者;选取无正己烷接触史的10名身体健康者作为对照组.采集所有研究对象肘静脉血并提取红细胞膜蛋白.聚丙烯凝胶电泳分离不同相对分子质量的膜蛋白后,分别用考马斯亮蓝和硝酸银染色分析蛋白交联情况,并用免疫印迹实验检测交联蛋白是否为Sp.比较不同组间共价交联Sp阳性率差异.结果 所有膜蛋白样本电泳后经考马斯亮蓝染色均未显示高分子量交联条带,但部分蛋白样本电泳后经硝酸银染色显示交联条带,经免疫印迹实验证实交联条带为Sp.中毒前期接触者共价交联Sp阳性率(100％)高于一般接触者(10.0％)(P＜0.01).结论 外周血红细胞共价交联Sp有可能作为正己烷接触人群神经毒效应替代标志物.

目的 了解油库作业工人的健康状况,更好地保护劳动者职业健康,提出针对性的防护建议.方法 2019年12月,以深圳市3家油库的344名接触有毒有害因素的作业工人为调查对象,对其进行职业健康检查并对结果进行综合分析.结果 职业健康检查共检出职业禁忌证4人,分别为人工性荨麻疹1人、贫血2人、慢性阻塞性肺病1人;疑似职业病4人,分别为疑似汽油致职业性皮肤病2人、疑似电光性皮炎1人、疑似慢性苯中毒1人;与目标疾病无关的其他疾病或异常289人.主要自述症状有头晕(22.09％)、头痛(18.90％)、乏力(15.41％)、记忆力减退(12.21％)和食欲不振(1 1.63％)等.主要检出异常项目为肝功10项(25.87％)、心电图(23.84％)、肝胆脾胰B超(20.06％)、血脂4项(19.77％)和纯音听阈测试(19.05％)等;主要检出病症或异常有脂肪肝(26.45％)、总胆固醇(TC)偏高(25.58％)、三酰甘油(TG)偏高(22.24％)、高密度脂蛋白胆固醇(HDL-CH)偏低(20.64％)和丙氨酸氨基转移酶(ALT)偏高(17.62％)等.结论 油库作业工人的健康状况有待改善,工人应重视改变个人的生活方式和饮食习惯.作业工人应积极了解本人接触的职业病危害因素的健康损害,加强对职业病危害因素的劳动防护,减少汽油的吸入或皮肤直接接触.管理者应改善作业环境,定期组织工人进行职业健康检查,加强职业卫生培训和健康教育.

目的 分析船员血液生化指标检查结果,探讨主要的异常指标,提出针对性的预防保健措施.方法 选择深圳市某能源集团船舶作业公司的241名男性船员作为观察组,选择某医院的236名男性医生作为对照组,对两组人员进行血液生化指标检查,并对结果进行分析.结果 观察组人员总胆固醇(TC)偏高(占21.58％)、甘油三酯(TG)偏高(占19.92％)、低密度脂蛋白胆固醇(LDL-C)偏高(占17.84％)、直接胆红素(DBIL)偏高(占19.92％)、总胆红素(TBIL)偏高(占21.16％)、肌酸磷酸激酶(CK)偏高(占12.86％)、血尿酸(BUA)偏高(占19.92％)的检出率均高于对照组(分别为9.75％、10.59％、7.20％、11.02％、10.17％、4.24％、7.63％,P＜0.01);两组人员的高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBG)、餐后2h血糖(PBG)、血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、间接胆红素(IBIL)、肌酐(Cr)、尿素氮(BUN)、乳酸脱氢酶(LDH)、肌酸磷酸激酶同工酶(CK-MB)、α-羟丁酸脱氢酶(α-HBDH)异常检出率的差异均无统计学意义(P＞0.05).结论 船员血液生化指标检查结果表现出以血脂代谢紊乱、胆红素增高、CK增高和BUA增高为主的改变,这些改变是船员的膳食结构、职业性噪声接触、心理健康状况较差、轮班作业和不良生活习惯(例如吸烟、饮酒、缺乏必要的健身运动)等多种因素共同作用的结果.船员应注意调整膳食结构,加强对噪声的个人防护,保持积极乐观的心态,养成良好的生活习惯,并定期进行健康监护,以改善个人健康状况.

目的 了解加油站主要化学性危害因素及分布特征,为职业病防治策略制订提供依据.方法 采用分层随机抽样法抽取广东省某市124家加油站,并对这些加油站进行职业卫生调查,检测作业场所有害化学物,组织124家加油站的860名作业人员进行职业健康检查;用两独立样本t检验比较加油工与收银员接触的各化学性有害因素的差异;用偏相关分析检验销售量与化学物浓度的相关性;用Pearson相关分析分析作业人员苯接触浓度与血液指标的相关性;不同性别作业人员体检结果的职业相关异常率差异用Fisher确切检验分析.结果 加油工接触的正己烷(t=-5.899,P＜0.05)、正戊烷(t=-7.942,P＜0.05)、异戊烷(t=-9.805,P＜0.05)、正庚烷(t=-2.672,P＜0.05)、溶剂汽油(t=-3.551,P＜0.05)的浓度高于收银员;95#汽油销售量与现场作业人员接触的苯(r=0.161,P=0.002)、正己烷(r=0.114,P=0.029)、正庚烷(r=0.102,P=0.049)浓度存在显著相关;98#汽油销售量与现场作业人员接触的苯(r=0.143,P=0.006)、正己烷(r=0.136,P=0.009)、正戊烷(r=0.144,P=0.006)、异戊烷(r=0.117,P=0.027)浓度存在显著相关;职业健康检查结果显示12.9％的作业人员出现职业相关异常,职业禁忌证发生率为1.9％,且不同性别的作业人员体检结果的职业相关异常率差异有统计学意义(P＜0.05).结论 加油站作业人员存在不同程度的苯、正己烷、正戊烷、异戊烷、正庚烷、溶剂汽油接触,接触化学物的浓度与岗位、油品销售量相关,且各化学危害因素对不同性别的作业人员的职业危害可能存在差异.

目的 分析核电系统工作人员的健康状况,为制定科学合理的管理制度提供一定的健康资料.方法 选择2011-2017年在我院进行职业健康检查的部分核电系统工作人员为研究对象,分析7年间员工的健康状况.结果 2011-2017年期间首次职业健康检查的核电系统工作人员中未检出疑似职业病人员,检出职业禁忌证人员共527人,全部结论均未见异常人员170人,每年95％以上的工作人员均检出其他疾病或异常结果,且7年内的变化差异均有统计学意义.职业禁忌证检出人数中构成比最高的为放射线作业人员,但检出率最高的为高气压作业人员.异常率比较高的体检项目主要有眼科、血常规、心电图、肝胆胰脾B超、纯音测听、肝功能、血脂及耳鼻喉常规检查.结论 核电系统工作人员的健康状况确实存在着一定的问题,应该引起行业管理部门的高度重视,进一步加强对该系统工作人员的健康监护.

[目的]观察职业性镉作业观察对象尿镉及肾小管损伤效应标志物水平的变化,比较脱离镉作业6年后镉作业观察对象尿肾小管损伤分子-1(KIM-1)的水平.[方法]选取8例职业性镉作业观察对象,对2009-2014年度的尿镉、尿β2-微球蛋白及尿维生素A结合蛋白(即视黄醇结合蛋白)水平进行跟踪观察.2014年用ELISA法检测观察对象及正常对照组尿肾小管损伤分子-1(KIM-1)的水平.[结果]停止镉作业后,观察组的尿镉平均水平略有下降趋势,但各年度间差异无统计学意义(P＞0.05).停止镉接触后,观察组尿β2-MG水平和尿视黄醇结合蛋白水平一直维持在正常范围.观察组各年度尿β2-MG水平、尿视黄醇结合蛋白水平差异均无统计学意义(P＞0.05).停止镉接触6年后,观察组尿KIM-1的水平(1.37±0.61) ng/mL,对照组为(0.62±0.35)ng/mL,两组差异有统计学意义(P＜0.05).[结论]镉作业观察对象脱离镉接触后,尿镉水平下降不明显,传统的肾小管功能损害标志物尿β2-MG及尿视黄醇结合蛋白水平无明显变化,但尿KIM-1仍存在异常.

OBJECTIVE:To investigate the prevalence of metabolic syndrome (MS)in 259 professional automobile drivers, and to put forward targeted suggestions on protection.METHODS:In October 2014, 114 male bus drivers and 145 male taxi drivers in a transportation service company were enrolled as investigation group, and 121 non-operating male staff were enrolled as control group. Physical examination and a questionnaire survey were conducted for both groups, and the results were analyzed.RESULTS:The bus drivers and taxi drivers had significantly higher prevalence rates of MS than the nonoperating staff(17.5%/13.1% vs 3.3%, P<0.05). The results of univariate logistic analysis showed that smoking(OR=2.58, 95%CI 1.14~5.88), exercise (OR=0.21, 95% CI 0.10~0.43), meal time (OR=0.27, 95% CI 0.13~0.59), and a family history of chronic diseases (OR=2.26, 95% CI 1.13~4.50)were associated with MS, and each independent variable showed significant differences between groups (P<0.05). Multivariate logistic regression analysis showed that with age remaining the same, smoking was the risk factor for MS in professional automobile drivers (OR=5.25, 95%CI 2.00~13.80), and meal time (20~40 min)(OR= 0.20, 95%CI 0.09~0.44)and exercise (OR=0.13, 95% CI 0.06~0.30)were protective factors against MS.CONCLUSION:Professional automobile drivers have a higher prevalence rate of MS than non-operating staff, which should be taken seriously by working personnel.

目的 了解某市加油站加油工的职业危害因素接触情况以及健康状况.方法 通过对广东省某市石油公司的113家加油站进行职业卫生调查,分析该企业生产过程中存在的职业病危害因素情况;对现场作业工人进行职业健康检查,进一步分析存在的职业病危害因素对工人健康的影响.结果 该石油公司的油品中含有苯、甲苯、二甲苯、乙苯、正己烷、环己烷、正辛烷、正庚烷、异戊烷、正戊烷、壬烷等职业病危害因素,工作场所检测结果显示所有检测项目均未超过职业卫生接触限值,但工作场所空气中苯的检出率为64.88％.健康检查结果显示,目标疾病相关异常率为6.08％.结论 长期接触汽油和柴油可能对加油作业工人造成健康损害,应加强对加油作业工人的职业健康监护和职业卫生宣传.

Objective To understand the lens opacities of Shenzhen airport radiation workers during 2008—2013.Methods The results of the lens opacities of Shenzhen airport radiation workers in the last 6 years were counted and analyzed.Results The rate of lens opacities of 536 radiation workers in 2008 in Shenzhen airport was 2.80%.The 6-year follow-up showed that the rate of lens opacities respective was 2.87%, 2.85%, 2.88%, 2.90%, 2.89%, there was not a significant difference(P >0.05).The rate of lens opacities of radiation workers in 2013 in Shenzhen airport was 2.77% and 1.92% in the controlled, there was not a significant difference(P>0.05).Conclusions Radiation workers who use exactly the x-ray luggage inspection system according to relevant national standards can work safely.According to Management Method of Occupation Health for Radiation Workers, we suggest that individual dose radiation workers should be monitored.

Objective To explore the effect of cadmium chloride on the morphology of human renal tubular epithelial cell ( HK2-cell) and survival rate.Methods The HK-2 cells cultured with DMEM medium were randomly divided into six groups when they reached 70%to80%fusion.Groups A,B,C,D,E were given 5,10,20,50,100μmol/L of cadmium chlorine,respectively,with two parallel cell bottles in each group,and the culture lasted for 24 hours.Group F( control group) wasn′t given cadmium chlorine.The changes in cellular morphology were observed after 24 hours of incubation.Methyl thiazol tetrazolium( MTT) assay was used to detect the optical density( OD) value in each group,and the survival rates of the cells were calculated.Results The morphology of HK-2 cells showed no significant difference among control group,group A and group B.The HK-2 cells appeared morphological changes in group C ,with the decreasedcell viability.The survival rates of HK-2 cells in groups C,D,E were significantly lower than that in the control group (P<0.01).The survival rates of HK-2 cells in groups A, B showed no statistically difference compared with control group(P>0.05).Conclusion Cadmium chloride with the concentration of 20μmol/L or more might lead to HK-2 cell injury,damages to cellular morphology and decreased cell viability.

目的 分析某核电站放射工作人员的职业健康损害情况,为评价放射卫生防护工作提供依据.方法 对某核电站放射工作人员进行连续5年(2010-2014年)外周血淋巴细胞微核率检测.比较不同年份、不同工龄放射工作人员外周血淋巴细胞微核率的变化情况.结果 该核电站1822名放射工作人员总的微核率为0.09％,总的微核异常检出率为1.01％.各年度微核率、微核异常检出率均呈现逐年下降趋势(趋势x2=125.89、15.77,P＜0.01).未发现微核率、微核异常检出率随工龄增大而增高的趋势(趋势x2=3.67、3.89,P＞0.05),但各工龄组间差异有统计学意义(x2=275.58、27.09,P均＜0.01).结论 外周血淋巴细胞微核率明显高于国外报告数据,应加强对放射工作人员的防护.

目的：调查2010—2012年深圳市职业健康检查复查工作完成情况，提出落实职业健康检查复查工作的建议性措施。方法分析2010—2012年在深圳市职业病防治院进行职业健康检查的135947名员工职业健康检查及复查受检情况。结果2010—2012年发现需排除目标疾病的复查人员共12598人，检出率9.27％，实际复查人数7310人，复查率为58.03％。2012年在岗期间职业健康检查复查率高于2010年（71.41％ vs 46.95％，P ＜0.05）。结论2010—2012年深圳市职业健康检查复查率总体较低，应加大职业健康检查复查工作的监督与落实，建立完善的复查跟踪措施，制定复查工作紧急预案方案，切实做到及时发现职业健康损害、疑似职业病和职业禁忌证。

目的 了解消防员目前健康状况,为相关部门制定加强消防员健康保护及消防作业防护措施提供参考依据.方法 针对我市2011年1084名消防员职业健康检查结果进行综合分析与评价.结果 本次消防员职业健康检查受检率93.45％,检查项目异常人数检出率高达99.54％,消防员职业禁忌证检出率8.12％,不符合消防员体格标准检出率26.66％,消防员患病率高达83.67％,与对照组比较差异有统计学意义x2＝9.46,P＜0.01).结论 消防员健康状况应引起管理层高度重视,采取积极有效措施加以保护。

[Objective] To understand the influencing factors of level changes of urinary cadmium and serum sex hormone of female workers exposed to cadmium,and explore its mechanism. [Methods]A total of 100 female workers with cadmium exposure were selected from a cadmium battery factory as the exposure group in November 2010,which was furthermore partitioned into 2 smaller exposure groups according to the air cadmium levels in workplace.Another 50 female workers from the same factory were selected as the control group.Urine samples were collected for the measurement of urinary cadmium,and blood samples for the levels of serum FSH,LH and E2. [Results]Urinary cadmium level and abnormal rate of the 2 exposure groups were significantly higher than those of the control group P0.05,P0.01).The level of serum FSH,LH and E2 of high dose exposure group was significantly lower than that of the control group in menstrual phase(P0.01);serum LH level of high dose exposure group was significantly lower than that of control group in follicular phase of menstrual cycle(P0.01);while serum LH and E2 were significantly lower than those of control group in luteal phase of menstrual cycle(P0.01). [Conclusion]Under the conditions of this study,the over standard cadmium oxide concentration in the workplace air is the major risk factor for the increasing of urinary cadmium level.Cadmium exposure may influence the sex hormone secreting function of hypothalamus-hypophysis-ovary hormone axis,thus causes endocrine disrupting effects on the reproductive system of female workers.

[Objective]To evaluate the levels of blood lead and urinary lead and among lead-exposed male workers and the influencing factors,and study the variation of serum sex hormone and its related mechanism.[Methods]A total of 120 male workers that engaged in lead-exposed operation were selected from a lead storage battery manufacture plant as the exposed group in January 2011,which was furthermore partitioned into high,medium and low-dose exposed-groups.Another 40 male workers without lead exposure from the same plant were selected as the control group.Urine samples were collected for the measurement of urinary lead,and blood samples for measurements of blood lead,serum testosterone,FSH and LH.[Results]The average lead concentration in the workplace air was 0.29 mg/m3,and 90% samples' concentration were higher than the national occupational health standard.Blood and urinary lead level and abnormity rate of 3 exposed-groups were all increased significantly compared with the control group,and differences of blood lead level and abnormity rate between the 3 exposed-groups were also significant(all P0.01).With the growth of the length of service,blood and urinary lead level and abnormity rate of 3 exposed-groups represented a increasing tendency.Serum testosterone concentration of the medium and high dose exposed-groups were decreased significantly compared to the control group and the low dose exposed-group,to which the results of serum FSH concentrations were contrary(all P0.01).[Conclusion]Under the conditions of this study,the growth of service length and high concentration of lead in the work place are both major risk factors for the increasing of blood and urinary lead.Lead-exposure can influence the sex hormone secreting function of hypothalamus-hypophysis-testicle axis,which will make interference effect on internal secretion of male workers' reproductive system.

为了规范职业健康监护工作,我国相继出台了<职业健康监护管理办法>和<职业健康监护技术规范>(GBZ188-2007),通过3年实际运行,职业健康监护工作体系不断得到完善并取得一定成效.现结合实际初步探讨职业健康监护工作中存在的问题并提出几点建议.

Objective To evaluate the concentration of urinary cadmium and serum sex hormone in cadmium-exposed male workers and explore the affecting factors and related mechanism.Methods The individuals exposed to cadmium from three workshops 40 in each, in a cadmium rechargeable battery manufacture plant were selected as the exposure groups according to concentrations of cadmium oxide in the workplace in November 2008, namely assembly, charging and butt-weld workshop for low, moderate and high dosage group.Another forty male workers without cadmium exposure of the same plant were selected as the control group.Urinary cadmium, serum testosterone,FSH and LH concentrations were measured and urinary cadmium concentration abnormity rate was calculated for the following analysis.Results Compared with the control group, the urinary cadmium concentration and its abnormity rate of the low and high dosage groups were all significantly increased(P0.01),while serum testosterone concentrations of medium and high dosage groups were both significantly decreased(P0.01).With the growth of aerial cadmium concentration in workplace, urinary cadmium concentration and its abnormity rate, serum FSH and LH concentrations of the exposure groups all presented an increasing tendency, while serum testosterone concentration presented a decreasing tendency.Compared with3 service years group, the urinary cadmium concentration and its abnormity rate of 6～9 years and 9 years groups were all significantly increased(P 0.01).With the growth of service length, the urinary cadmium concentrations and its abnormity rate of the exposure groups both presented an increasing tendency.Conclusion Under the conditions of this study,the increased service length of workers and high concentration of cadmium oxide in the workplace were the major risk factors for the increase of urinary cadmium concentration.Cadmium-exposure may cause endocrine disrupting effect on the reproductive system of male workers.