Objective To investigate the levels of blood lead and zinc protoporphyrin(ZPP),urine lead and δ-aminolevulinic acid(δ-ALA),and the fingerprint characteristics of stable lead isotopes among workers exposed to lead,and to analyze their correlations to provide a foundation for studies and applications of lead stable isotope tracing.Methods Taking 40 lead-exposed workers in a lead-acid battery factory in a city as the research object,the relevant conditions such as working age,smoking,drinking,etc.were recorded by a questionnaire.The levels of blood lead,urine lead,and biomarkers associated with lead exposure were measured,as were the lead isotope ratio(LIR)(207/206Pb,208/206Pb,204/206Pb)in blood,urine,environmental samples(workplace dustfall),and water,and statistical analysis was carried out.Results The blood lead level of the subjects was 56.0-757.6 µg/L,with an average of(300.0±159.8)µg/L,and the abnormality rate of 5.0％;the urine lead level was 2.5-235.3 μg/L,with an average of(40.1±45.2)µg/L,and an abnormality rate of 7.5％;the blood ZPP level was 0.13-7.35 μmol/L,with an average of(1.78±1.86)μmol/L,and an abnormality rate of 17.5％;the urine 8-ALA level was 0.71-7.46 mg/L,with an average of(2.78±1.70)mg/L,and an abnormality rate of 7.5％.Pearson correlation analysis showed positive correlations between overall blood lead and blood ZPP,urine lead and urine 8-ALA,and blood lead and urine 8-ALA(r=0.536,0.728,0.511,P＜0.01).Significant statistical differences were found in blood lead and blood ZPP levels among workers with different employment times(P＜0.05),with the higher levels observed in workers with employment times of 1-4 years;non-drinking workers had higher blood ZPP levels than drinking workers(P＜0.05).Workers exposed to lead had higher levels of 208/206Pb and 207/206Pb in their urine than in their blood(P＜0.01).The tap water from the plant showed lower levels of 208/206Pb and 207/206Pb compared to blood and urine(P＜0.01);the workplace dustfall had a lower level of 208/206Pb compared to blood(P＜0.01),and both 207/206Pb and 208/206Pb were lower than those in urine(P＜0.01).There was a negative correlation between blood 207/206Pb,208/206Pb and blood lead levels(r=-0.562,-0.673,P＜0.01)and between blood 208/206Pb and urine 8-ALA levels(r=-0.416,P＜0.01).Urine 207/206Pb and 208/206Pb also showed a negative correlation with urine lead levels(r=-0.613,P＜0.01;r=-0.331,P＜0.05),and urine 206/206Pb had a negative correlation with blood ZPP levels(r=-0.636,P＜0.01).Conclusions Blood lead levels correlated well with blood ZPP and urine 8-ALA and were consistent with LIR in the environment.The difference in LIR in blood and urine indicated that lead may have"fractionation"after entering the human body.

BackgroundWork-related musculoskeletal disorders (WMSDs) are one of the major occupational health problems in the world. Pharmaceutical industry is an important part of China's national economy. At present, there are few related studies reported at home and abroad. ObjectiveTo investigate the status and influencing factors of WMSDs in chemical pharmaceutical industry. MethodsA cross-sectional epidemiological survey was conducted among all workers from three chemical pharmaceutical enterprises in Guangzhou. The Musculoskeletal Disorders Questionnaire was used to collect information on demographic characteristics, symptoms of musculoskeletal disorders, types of work, work organization, and and work postures. Multiple logistic regression method was used to analyze the risk factors of WMSDs in chemical pharmaceutical workers. ResultsIn this study, 563 workers were selected as subjects. The total prevalence rate of WMSDs symptoms in the chemical pharmaceutical workers was 43.9% (247/563), and the leading body part-specific prevalence rate from high to low was 34.3% in the lower back, 24.3% in the upper back, 24.0% in the shoulders, and 23.8% in the neck. The prevalence rate of WMSDs symptoms in multiple body parts (30.0%) was 2.16 times higher than that in single body part (13.9%), and the prevalence rate of WMSDs symptoms in four body parts was the highest (11.4%). The results of multiple logistic regression analysis showed that age ≥50 years (reference age <30 years) (OR=2.140, 95%CI: 1.054-4.345), often or very often (reference never/rarely) long-time head rotating (OR=2.695, 95%CI: 1.753-4.142) and long-time keeping arms above shoulders (OR=1.902, 95%CI: 1.108-3.265) increased the risk of reporting WMSDs symptoms (P<0.05). Regarding education level, workers with high school and technical secondary school (OR=0.333, 95%CI: 0.175-0.636) or college and above (OR=0.413, 95%CI: 0.216-0.790) education had a lower risk of reporting WMSDs symptoms than those with middle school or below (P<0.05). ConclusionThe prevalence rate of reporting WMSDs symptoms in chemical pharmaceutical industry is high, the involving body parts are lower back, upper back, shoulders, and neck, and reporting simultaneous occurrence of WMSDs symptoms in multiple body parts is common. The chemical pharmaceutical manufacturers can reduce the risk of WMSDs by strengthening the training on workers' ergonomics knowledge, paying attention to the less educated personnel, protecting the elderly workers, and avoiding awkward work postures, like rotating head for a long time and raising arms over shoulders.

目的 掌握汽车制造企业人群的噪声性听力损失(NIHL)的现况,评估使用ISO 1999:2013(E)模型预测发生NIHL的效果.方法 采用横断面调查方法,以某汽车制造企业接触噪声全体工人为研究对象,对其进行噪声接触水平和纯音听阈测试,采用ISO 1999:2013(E)方法对NIHL进行定量风险评价.结果 该汽车制造企业噪声暴露范围在69.3～96.3 dB(A)之间,总超标率为27.44％;噪声作业工人的纯音听阈测试异常率为17.29％,高频NIHL检出率为16.62％;不同工种之间各听力异常检出率比较,差异均有统计学意义(x2值分别为396.03,24.65,23.59和51.59,均P＜0.01);不同工龄之间噪声作业工人高频NIHL的检出率比较,差异均有统计学意义(x2值分别为51.31,29.90和18.39,均P＜0.05).各工种接触噪声30年,高频NIHL的风险开始明显升高,但模型的预测值比该企业噪声作业工人发生高频NIHL的检出率低.结论 该汽车制造企业的工作场所噪声超标率较高,噪声作业工人存在潜在高频NIHL和噪声聋的风险.ISO 1999:2013(E)风险评估模型存在一定局限性,需进一步根据我国人群特征提高模型精确度.

Objective To compare the measured results of arsenic in urine by atomic fluorescence spectrometry（AFS） and inductively coupled plasma-mass spectroscopy（ICP-MS）, and analyze the reasons of the difference. Methods The samples were pretreated according to WS/T 474-2015 Determination of Arsenic in Urine by Hydride Generation Atomic Fluorescence Spectrometry, and digested with mixed acid（nitric acid∶sulfuric acid∶ perchloric acid=3∶1∶1,V/V/V） and then determined by AFS and ICP-MS. The samples were diluted with 0.50% nitric acid and determined by ICP-MS. The samples included urine arsenic quality control samples, inorganic arsenic supplemented samples, and organic arsenic（arsenic choline and arsenic betaine） supplemented samples. Standard curve method was used to compare the results of AFS method and ICP-MS method.Results The results of quality control samples by AFS method（digestion） and ICP-MS method（without digestion） were within the range of reference values, but the values obtained by AFS method were lower than those obtained by ICP-MS method.The recovery of AFS and ICP-MS was 97.79%-100.82% and 99.55%-99.98%, respectively. In the middle and high concentration groups, the measured values of inorganic arsenic by AFS were lower than that by ICP-MS（all P＜0.01）. The recovery of arsenic betaine and arsenic choline by AFS method（digestion） was only 2.17%-2.63%. The values of arsenic betaine and arsenic choline measured by AFS method（digestion） were lower than those measured by ICP-MS method（without digestion） and ICP-MS method（digestion）（all P＜0.01）. Conclusion The result of urine arsenic measured by AFS method was lower than that measured by ICP-MS method, which may be related to the mixed acid digestion of AFS method.

BackgroundThe operation mode of automobile manufacturing industry (AMI) makes workers have different degrees of occupational stress and burnout, which may lead to negative emotions and depressive symptoms. ObjectiveTo study the relationship between occupational stress, job burnout, and depressive symptoms in AMI workers. MethodsIn this study, 1300 workers from a Guangzhou AMI company were selected as subjects by cluster random sampling method. Occupational stress, job burnout, and depressive symptoms of the workers were assessed by using the Effort-Reward Imbalance (ERI) questionnaire, the Maslach Burnout Inventory general survey questionnaire, and the Patient Health Questionnaire-9, respectively. Hierarchical regression was used to analyze the effects of occupational stress and job burnout on depressive symptoms in AMI workers. Mediating effect model was used to analyze the mediating effect of job burnout on the relationship between occupational stress and depressive symptoms. ResultsThere were 1300 questionnaires distributed, 1228 valid questionnaires collected, with a 94.5% recovery rate. The ERI ratio of 1228 AMI workers was 1.06±0.72, and the positive rate of occupational stress was 37.3% (458/1228). The score of job burnout was 2.18±1.37, and the positive rate of job burnout was 62.6% (769/1228). The score of depressive symptoms was 10.27±6.42, and the positive rate of depressive symptoms was 47.1% (578/1228). The dimensional scores of effort and over-commitment in occupational stress as well as emotional exhaustion and depersonalization in job burnout of AMI workers were positively correlated with the depressive symptom scores (rs=0.415, 0.571, 0.573, 0.593, P＜0.05). The dimensional scores of reward and personal achievement were negatively correlated (rs=−0.454, −0.339, P＜0.05). The percentages of variance in depressive symptoms score explained by occupational stress and job burnout were 26.7% and 16.6%, respectively. Job burnout had a partial mediating effect between the three dimensions of occupational stress and depressive symptoms, and the mediating effect values were −0.2832 (95%CI: −0.3250– −0.2434), 0.3553 (95%CI: 0.3071–0.4041), and 0.4193 (95%CI: 0.3681–0.4725), respectively. ConclusionAMI workers' occupational stress affects job burnout, but also indirectly affects depressive symptoms. Job burnout partially mediates the association between occupational stress and depressive symptoms. Reducing occupational stress and burnout levels of AMI workers may alleviate depressive symptoms.

Objective To analyze the prevalence and influencing factors of work-related musculoskeletal disorders（WMSDs） among painters in the manufacturing industry.Methods A total of 639 painters from one shipbuilding enterprise, one automobile manufacturing enterprise and three wooden furniture manufacturing enterprises in Guangdong Province were selected as the research subjects using typical sampling method. The Chinese version of Musculoskeletal Disorders Questionnaire was used to investigate the prevalence of WMSDs in the past one year, and the influencing factors were analyzed. Results The total prevalence rate of WMSDs among painters in the manufacturing industry was 37.4%. The prevalence of WMSDs in different industries from high to low was shipbuilding, automobile and furniture manufacturing（50.0% vs 38.7% vs 29.0%, P＜0.01）. The prevalence of WMSDs in different parts of the body from high to low was neck, ankle/foot, shoulder, low back, upper back, knee,hand/wrist, hip/leg and elbow（20.7% vs 19.2% vs 17.4% vs 15.8% vs 14.1% vs 13.8% vs 13.5% vs 9.5% vs 6.6%, P＜0.01）.Multivariate logistic regression analysis results showed that working in uncomfortable postures was a risk factor for neck, ankle/foot and shoulder WMSDs（all P＜0.01）; long time head turning was a risk factor for neck and shoulder WMSDs（both P＜0.05）;overweight and obesity, and bending and turning frequently at the same time were risk factors for ankle/foot WMSDs（all P＜0.05）;adequate rest time was a protective factor for neck and ankle/foot WMSDs（both P＜0.01）; participated in physical exercise more than once a week was a protective factor of neck and shoulder WMSDs in painters（all P＜0.05）, after excluding the influence of confounding factors. Conclusion The prevalence of WMSDs in manufacturing painters was high, and the main body parts involved were neck, ankle/foot and shoulder. The influencing factors include individual factors, poor ergonomics factors and unreasonable work organization.

目的 调查广州市某造船厂工人工作相关肌肉骨骼疾患(work-related musculoskeletal disorders,WMSDs)患病情况,探讨影响颈部WMSDs的主要因素.方法 以广州市某造船厂工作人员为研究对象,采用《北欧肌肉骨骼疾患问卷(修改版)》调查其WMSDs患病情况,运用多因素logistic回归分析颈部WMSDs的影响因素.结果 148名造船厂工作人员的WMSDs总患病率为45.9％,其中患病率最高的部位是颈部(31.1％),其他依次为肩部(27.0％)、下背部(21.6％)、上背部(16.2％)、腿部(14.9％)、膝部(14.9％)、肘部(14.9％)、踝部(13.5％)和手部(13.5％).各工种中打磨工和电焊工颈部WMSDs患病率较高,分别为50.0％和41.7％.多因素logistic回归分析结果显示,颈部WMSDs的独立危险因素是每天从事同样的工作(OR = 9.65,95％CI:1.77～52.61)和上肢用力(OR = 2.43,95％CI:1.06～5.60),休息时间充足是颈部WMSDs的保护因素(OR = 0.38,95％CI:0.16～0.92).结论 造船厂工人WMSDs患病率较高.其中颈部较为常见,其危险因素主要包括不良工作姿势及不合理的劳动组织.

目的 了解饮料制造企业噪声暴露情况,探讨该行业作业工人噪声性听力损失(noise-induced hearing loss,NIHL)的影响因素.方法 选择广州市某饮料制造企业符合条件的182名接触噪声的作业工人为调查对象,对其进行纯音听阈测试,并对工作场所进行噪声检测,分析工人NIHL影响因素.结果 该饮料制造企业工作场所噪声超标率为70.59％,超标岗位主要集中在瓶装饮料线以及纯净水线.84名(46.15％)接触噪声作业工人被检出NIHL.logistic回归分析结果显示:作业人员年龄＞35岁发生NIHL的危险度是20～30岁的2.647倍(P＜0.05);接触噪声工龄＞10年发生NIHL的危险度是接触噪声工龄＜5年的2.853倍(P＜0.05);所在岗位为纯净水线发生NIHL的危险度是辅助设施岗位的9.000倍(P＜0.05).结论 该饮料制造行业噪声水平较高,企业应采取工程控制措施控制噪声危害,加强职业卫生管理.

目的 了解某化学制药行业的职业病危害情况,评估其职业健康风险,探讨其防控对策.方法 选择广州某化学制药厂作为本次研究对象,运用新加坡半定量风险评估法对其进行职业健康风险评估.结果 该制药厂主要存在的职业病危害因素为丙酮、二氯甲烷、盐酸和其他粉尘(药尘)等;离心间和蒸馏塔作业位的丙酮和二氯甲烷浓度超标,其中丙酮最高检测浓度达2 456.6 mg/m3,二氯甲烷的最高检测浓度达925.0 mg/m3;离心间作业位和蒸馏塔作业位接触的二氯甲烷风险等级为高风险,而离心间作业位和蒸馏塔作业位接触的丙酮、液体原料装卸作业位接触的二氯甲烷均为中等风险.结论 该制药厂存在职业健康高风险岗位,使用轴流风机的全室通风设计不能满足离心间和蒸馏塔等高风险作业位的职业病防护要求,应引起重视,并加强职业病防护设施和个体防护的管理.

[目的]动态掌握广州市重点行业职业病危害因素的种类和分布情况,为该市职业卫生监管工作提供科学依据.[方法]选择广州市职业病危害重点行业的36家企业为监测对象,对其工作场所职业病危害因素接触水平进行动态监测,并对职业病危害因素的超标情况进行分析.[结果]2014-2016年共对36家哨点企业进行了工作场所职业病危害因素的连续性监测,覆盖487个岗位1 588个检测点.36家企业职业病危害因素超标率为11.34％(180/1 588),涉及的主要职业病危害因素有粉尘、多种化学因素和噪声.不同行业的企业、岗位、检测点超标率差异均有统计学意义(P＜0.01),其中均以化工行业的超标率为低,船舶修造行业、木质家具制造行业超标率较高.3类超标率在不同年份间比较,差异均无统计学意义(P＞0.05).不同职业病危害因素的企业、岗位、检测点超标率均不同,差异均有统计学意义(P＜0.01),其中均以物理因素(主要为噪声)最高.[结论]广州市典型制造企业职业病危害情况不容忽视,其中噪声危害比较严重.船舶修造行业、木质家具制造行业目前仍是广州市职业病危害防控的重点行业,开展重点行业职业病危害哨点监测是工作场所职业卫生状况监管的重要措施.

目的 了解广州市皮革箱包制鞋行业的职业病危害情况,为职业卫生监管工作提供科学支持.方法 采用分层抽样的方法选择研究对象,以自填调查问卷的形式调查企业的职业卫生管理状况,通过现场采样和原辅材料挥发性有机成分分析的方法检测并分析该行业工作场所的职业病危害因素.结果 共调查87家皮革箱包制鞋企业,以小型企业为主(占81.61％),调查的应答率均在90％以上,调查项目达到要求的比率(符合率)为41.52％;工作场所有害因素检测发现,企业超标率为35.19％,岗位超标率为14.98％,检测项次超标率为4.02％;其中2家企业的2个样品中检出1,2-二氯乙烷.结论 广州市皮革箱包制鞋企业职业卫生管理状况不容乐观,含有1,2-二氯乙烷等高毒化学物质的有机溶剂仍存在一定范围的使用,应加强该行业的职业卫生监管.

目的 分析职业卫生技术服务机构服务质量,探讨其监管方式.方法 搜集某市2014年职业卫生监督检查中96家企业提交的工作场所职业病危害因素检测报告结果数据,分析不同类型职业卫生技术服务机构服务内容、不合格检出率.结果 大型公立机构、区县疾病预防控制中心、民营/外地机构每家企业职业病危害因素平均检测项次分别为48.65、20.54、29.76,三者差异有统计学意义(F=3.98,P＜0.05);检测项目的不合格率分别为16.78％、20.97％、9.57％,三者差异有统计学意义(x2=43.88,P＜ 0.01).结论 应加强对职业卫生技术服务机构服务行为的监管,通过抽样监督检测对机构实施的企业定期检测结果的可信度进行评估,督促机构的规范服务.

OBJECTIVE:To provide data for the occupational health supervision by analyzing the occupational health status in manufacturing industry in Guangzhou, China.METHODS:The occupational health investigation was performed in 280 enterprises randomly selected from 8 industries based on industry stratification. According to the occupational health standards, 198 out of the 280 enterprises were supervised and monitored. Sample testing was performed in 3~5 workplaces where workers were exposed to the highest concentration/intensity of occupational hazard for the longest time. Comparative analyses of the overproof rates of hazard were performed among enterprises, workplaces, and testing items from different industries.RESULTS:The concentrations of occupational hazard in 42.93% (85/198) of enterprises and 22.96% (200/871) of workplaces were above the limit concentration. The most severe hazards were the noises in shipbuilding and wooden furniture industries and the welding fumes in shipbuilding industry. Less than 30% of enterprises were able to provide occupational health examination and periodic test reports of occupational hazard in workplaces. The rate of the workers with abnormal occupational health examination results and the need for reexamination reached 6.63% (832/12 549), and they were mostly from shipbuilding, wooden furniture, and chemical industries.CONCLUSION:The occupational health supervision should be strengthened in enterprises, and hazard from noises and dusts should be selectively controlled or reduced. The publication of relevant data and information of occupational health in enterprises should be promoted to enhance social supervision.