Occupational Diseases In China Research Articles

Revelation of the list of occupational diseases and diagnostic criteria for occupational diseases

The list of occupational diseases reflecting the latest advances in the identification and recognition of occupational diseases, and providing guidance on the protection of workers' health rights and interests and the prevention, recording, notification and compensation of related occupational diseases. Diagnostic criteria for occupational diseases are an important basis for making diagnoses attributable to occupational diseases, and provide a theoretical basis for health monitoring of occupational groups and occupational hygiene supervision. This thesis starts with the definition of the occupational disease elaborates in detail the development history of list of occupational diseases in International Labour Organization (ILO) , compares the list of occupational diseases in China (2013 version) with the list of occupational diseases in international (2010 version) , and then introduces in detail the latest diagnostic standards of the major occupational diseases. And finally, it puts forward relevant suggestions on the list and diagnostic level of China's occupational diseases, so as to provide certain insights for the further improvement of the list and diagnostic standards of occupational diseases.

Prognostic Nutritional Index Associates with the Severity of Silicosis: A Study from a Tertiary Class A Prevention and Treatment Institute for Occupational Diseases in China

Prognostic Nutritional Index Associates with the Severity of Silicosis: A Study from a Tertiary Class A Prevention and Treatment Institute for Occupational Diseases in China

Research advances in imaging techniques related to the diagnosis of pneumoconiosis

Occupational pneumoconiosis (hereinafter referred to as pneumoconiosis) is the most harmful occupational disease in China. According to the current standard GBZ 70-2015 Diagnosis of Occupational Pneumoconiosis, pneumoconiosis is mainly diagnosed and staged by high kilovolt or digital radiography. Chest radiography in pneumoconiosis is the most widely studied and mature imaging technique in the diagnosis of pneumoconiosis. However, this technique has some limitations in the screening of some early pneumoconiosis and occupational health examination, and there is a certain risk of missed diagnosis and misdiagnosis. With the continuous development of imaging examination technology, computed tomography, magnetic resonance imaging, positron emission tomography-computed tomography and artificial intelligence technology as auxiliary imaging examination methods have shown different diagnostic values in the research of auxiliary diagnosis of pneumoconiosis. This paper summarizes the advantages and problems in the application of various kinds of imaging techniques, which provides a direction for the future research of imaging techniques related to the diagnosis of pneumoconiosis.

Occupational survey-based evidence of health status and welfare problems of workers with pneumoconiosis in China.

Pneumoconiosis is the most dangerous occupational disease in China. According to unofficial records, nearly million migrant workers were affected by pneumoconiosis in 2011, with the number increasing annually. Among them, a large number of migrant workers suffering from pneumoconiosis were not medically diagnosed. Therefore, fundamental questions remain unanswered: what is the background of workers who receive a diagnosis of pneumoconiosis, and how does pneumoconiosis affect their future and well-being? In this study, we identified and surveyed 1,134 workers with pneumoconiosis in seven selected regions in China with substantially high incidences of pneumoconiosis by using a combination of cluster sampling, convenience sampling, and snowball sampling. We used demographic, medical, and rehabilitation conditions and welfare questionnaires to collect the data. The findings highlighted the socioeconomic status of patients with pneumoconiosis. The majority of workers with pneumoconiosis were adult men who had received no higher education, who lived in rural households, and who were employed in mining or manufacturing industries. Among these workers, 52.8% had been exposed to dust at work for more than 10 years, and 53.1% received a diagnosis of stage II or III pneumoconiosis. More than half of the workers (569 workers, 50.2%) did not receive comprehensive, routine treatment; 33.4% (379 workers) visited a doctor when they experienced physical discomfort, and 6.6% (75 workers) never received treatment. Only 156 workers (13.8%) received rehabilitation services, whereas 978 workers (86.2%) never did. The study results also revealed the severe financial difficulties faced by patients with pneumoconiosis. Only 208 workers (18.3%) had access to work-related injury insurance, with the cost of pneumoconiosis treatment being a substantial burden for 668 workers (60.6%). In this study, we explored the existing health and welfare problems faced by workers with pneumoconiosis in China and identified the social injustice and health disparities that these workers experience. We also clarified the primary challenges in implementing safety, health, and welfare policies for these workers and those who are exposed to high-risk environments, such as those working in mining.

Analysis of the status of occupational disease prevention and control of enterprises in mining and manufacturing industries in China in 2019

Objective: To analyze the status of prevention and treatment of occupational diseases among mining and manufacturing industries in China in 2019, provide the scientific basis for the formulation and revision of policies and standards of prevention and treatment of occupational diseases. Methods: In May 2022, Collecting data of a project named Surveillance of Occupational Hazards in the Workplace in 2019 through the National Surveillance System for Occupational Hazards in the workplace. Compare the status of prevention and treatment of occupational diseases in 63 563 enterprises of mining and manufacturing industries among different dimensions. Results: The training rate of managers was 76.17% and that of occupational health managers was 76.97%. The rate of reporting of occupational diseases hazardous items was 67.58%, the rate of launching of the detection of occupational hazards was 57.16%, and the rate of launching of occupational health examination was 62.42%. Excluding the distribution rate of dust mask, the installation rate of various occupational prevention facilities and the distribution rate of gas mask and hearing protector were less than 80%. The differences in all the indicators among different areas, enterprise scales, economic types were statistically significant (P<0.05) . Conclusion: There are still some enterprises which are relatively weak in the ability of the prevention and treatment of occupational diseases in China. Measures such as special support, guidance and strengthen supervision should be taken towards those enterprises toimprove the awareness of prevention and treatment of occupational diseases and the level of that.

Research progress on the disease burden of pneumoconiosis in China

Pneumoconiosis is the largest and most serious disease among the legal occupational diseases in China, which causes long-term heavy disease burden to individuals, enterprises and society. How to scientifically and reasonably measure and reduce the health impact and economic loss caused by pneumoconiosis has become a key and difficult research topic. In recent years, with the development of global burden of disease (GBD) research, some scholars have adopted disease burden index to evaluate the disease burden of pneumoconiosis, but the research results and data are relatively independent, and there is a lack of systematic evaluation system and framework. This paper summarized the application of disease burden assessment index for pneumoconiosis, epidemiological and economic burden of pneumoconiosis, and the cost-effectiveness of reducing the burden. This paper aims to understand the present situation of pneumoconiosis disease burden in our country, discover the problems and challenges of pneumoconiosis disease burden research in our country now. It provides scientific basis for the research and application of pneumoconiosis and other occupational disease burden in China, as well as the formulation of comprehensive intervention measures, optimization of health resources allocation and reduction of disease burden.

Prevalence and Types of Comorbidities in Pneumoconiosis - China, 2018-2021.

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. 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. This study serves as a reference point for the formulation of treatment strategies and health policy development concerning pneumoconiosis in China.

An Analysis of Targeted Serum Lipidomics in Patients with Pneumoconiosis - China, 2022.

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. 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. 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). 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.

Analysis of project funding in occupational Health and Epidemiology of National Natural Science Foundation of China from 2008 to 2019

Objective: To analysis the projects funded by the National Natural Science Foundation of China in the fields of occupational health (code H2602) and occupational diseases (code H2402) from 2008 to 2019, to provide a reference for the project application of scientific researchers in the field of occupational diseases in China. Methods: In October 2021, the information of all National Natural Science Foundation projects in the field of occupational health and occupational diseases from 2008 to 2019 was collected through LetPub website. It mainly analyzes the types of funded projects, the types of supporting units, the occupational disease hazard factors of the funded projects, the types of occupational injuries and representative research directions. Results: From 2008 to 2019, the National Natural Science Foundation of China funded a total of 282 projects in the field of occupational health and occupational diseases, with a total funding of 113.902 million yuan. Among them, 138 projects (48.94%) were funded, 96 (34.04%) were funded by youth science funds, and 35 projects (12.41%) were funded by regional science funds. 31 (79.93%) funded projects relied on the type of institutions of higher learning, 126 (46.84%) occupational disease hazard factors were chemical factors, and 83 (30.86%) occupational damage types were lung injury and pulmonary fibrosis. Epigenetic regulation is the most important representative research direction of the funded projects. Conclusion: The National Natural Science Foundation of China (NSFC) project funding in the field of occupational health and occupational diseases in China has maintained a stable trend, but there are still problems such as incomplete funding system and late start of some research directions.

Epidemiological characteristics of occupational chemical poisonings in Zhejiang, China from 2006 to 2020: A descriptive analysis.

As the second most common occupational disease in China, occupational poisoning is one of the major public health problems that seriously affect workers' health. This study aimed to investigate the epidemiological and occupational characteristics of acute and chronic occupational poisoning cases in Zhejiang Province, so as to provide a scientific basis for proposing intervention measures and preventive strategies of occupational poisoning. The data on occupational poisoning cases in Zhejiang Province from 2006 to 2020 was derived from the National Occupational Disease Network Direct Report System. A descriptive statistical analysis was employed on this data utilizing R software. From 2006 to 2020, 1,008 occupational poisoning cases were reported in Zhejiang Province, with a downward trend since 2007. Of these cases, 81.94% were chronic poisoning and 18.06% were acute poisoning. Ningbo reported the most occupational poisoning cases among the 11 cities in Zhejiang Province, accounting for 20.34% of the total cases. Besides, the occupational poisoning cases in Wenzhou, Jiaxing, and Shaoxing also accounted for 18.15%, 18.06%, and 17.76% of the total number of cases, respectively. Occupational poisoning in male were 693 cases and in female 315 cases. Most of the occupational poisoning cases studied involved people aged between 40 and 49 years (38.19%). The length of work in chronic occupational poisoning cases was significantly higher than that of acute occupational poisoning cases (P < 0.05). Benzene and lead and its compounds (excluding tetraethyl lead) were the major toxicants causing occupational poisoning. More than 60% of occupational poisoning cases were reported in private enterprises. Meanwhile, over 90% of the cases were distributed in medium enterprises and small enterprises. The type of industry with the most occupational poisoning cases was the manufacturing industry. Although the cases of occupational poisoning in Zhejiang Province have declined, more comprehensive and effective prevention and control measures are still needed. More attention ought to be paid to the management of key points according to the epidemiological and occupational characteristics of occupational poisoning cases.

Genetic susceptibility in pneumoconiosis in China: a systematic review.

Pneumoconiosis, encompassing coal workers' pneumoconiosis (CWP), silicosis and asbestosis, is one of the most common occupational diseases in China. Previous studies revealed significant associations between genetic variations and pneumoconiosis risk among individuals in different countries. With the known variability of genetic makeup between ethnicities, susceptibility to pneumoconiosis due to genetic differences is likely to be ethnicity-specific. The present review aimed at providing a comprehensive overview on the association between genetic polymorphisms and susceptibility of pneumoconiosis, specifically among people in China. The literature search was performed in seven English and Chinese databases using keywords related to the review aim. An appraisal of the methodological quality of the included studies was conducted using the assessment tool derived from the Strengthening the Reporting of Genetic Association Studies (STREGA) statement. Forty-five studies were included in this review. Genotypes of specific genes which are associated with the risk of CWP, silicosis and asbestosis were reported. Our findings showed that genes encoding inflammatory cytokines have been examined extensively, and they demonstrated an association between these genes and pneumoconiosis risk. Gene-environment interactions in pneumoconiosis susceptibility were also reported by a number of studies. This review summarised the evidence demonstrating the association between genetic polymorphisms and pneumoconiosis susceptibility among people in China, and that various genotypes could modify their risk to develop pneumoconiosis. The findings prompt that identification of individuals at high pneumoconiosis risk through genetic screening and strategies limiting their exposure to dust could be a potential strategy for the control of this occupational disease in China.

Thalidomide Alleviates Pulmonary Fibrosis Induced by Silica in Mice by Inhibiting ER Stress and the TLR4-NF-κB Pathway.

Silicosis is the most prevalent occupational disease in China. It is a form of pulmonary fibrosis caused by the inhalation of silicon particles. As there is no cure for the potentially lethal and progressive condition, the treatment of silicotic fibrosis is an important and difficult problem to address. Thalidomide, a drug with anti-inflammatory and immunoregulatory properties, has been reported to have lung-protective effects. The purpose of this study was to observe the therapeutic effect of thalidomide on silicotic mice and to determine the protective mechanism. By using silicotic mice models and MH-S cells, we found the expression of endoplasmic reticulum stress (ER stress) and Toll-like receptor 4 (TLR4)-nuclear factor kappa-B (NF-κB) pathway as well as inflammation-related factors were upregulated in the macrophages of silicotic mice. The same indexes were detected in silica-stimulated MH-S cells, and the results were consistent with those in vivo. That is, silica activated ER stress and the TLR4-NF-κB pathway as well as the inflammatory response in vitro. Treating both silicotic mice and silica-stimulated MH-S cells with thalidomide inhibited ER stress and the TLR4-NF-κB pathway as well as the inflammatory response. The present study demonstrates thalidomide as a potential therapeutic agent against silicosis.

Cost-effectiveness of comprehensive preventive measures for coal workers\u2019 pneumoconiosis in China

BackgroundCoal workers’ pneumoconiosis (CWP) remains one of the most severe occupational diseases in China. Despite the implementation of CWP comprehensive preventive measures, the unreasonable allocation of investment by coal enterprises limits the effect of preventing CWP, especially when the health resources are inadequate. This study aims to evaluate the cost-effectiveness of comprehensive measures for CWP from the perspective of coal enterprises.MethodsComprehensive measures and two primary interventions (engineering controls and individual protective equipment) were selected. A time-dependent Markov model was developed to evaluate cost and quality-adjusted life-years (QALYs). The input data were collected from the survey and literature. A hypothetical null situation, in which the currently implemented interventions were eliminated, was used as a comparator based on the generalised cost-effectiveness analysis (GCEA) recommended by the World Health Organization (WHO). The primary outcomes of the model were reported in terms of incremental cost-effectiveness ratios (ICERs). Uncertainty was verified using one-way and probabilistic sensitivity analyses.ResultsThe QALYs of the comprehensive measures, engineering controls, and individual protective equipment were 17.60, 17.50, and 16.85 years, respectively. Compared with null, the ICERs of the interventions were 65,044.73, 30,865.15, and 86,952.41 RMB/QALY, respectively. Individual protective equipment was dominated by an ICER of -11,416.02 RMB/QALY compared to engineering controls. Sensitivity analysis suggested the robustness of the results.ConclusionsThe comprehensive preventive measures for CWP that are currently implemented in Chinese state-owned mines are cost-effective. In comprehensive measures, engineering controls are more cost-effective than individual protective equipment. Investment in engineering controls should be increased to improve the cost-effectiveness of preventing CWP.

Socioeconomic Status, Occupational Disease, and Psychological Well-Being: Evidence from People with Pneumoconiosis in China

Background: Pneumoconiosis is one of the most prevalent occupational diseases in China. The present study aims to examine the status, needs, and challenges of people with pneumoconiosis from a socioeconomic perspective and to reveal the mechanisms by which the disease is linked to their psychological well-being. This study also examines the association of the social security subsidy to such mechanism. Methods: A questionnaire survey of 1134 respondents from seven cities or districts in China was conducted from 2014 to 2016. Generalized Structural Equation Modeling (GSEM) was employed to complete the analysis using Stata 16. Results: Respondents with poor socioeconomic status engaged longer in dusty work and had higher stages of pneumoconiosis, complications, and aggravation. These, in turn, were linked to their socioeconomic status due to high treatment expenditure and loss of the ability to work, which were negatively associated with their psychological well-being. Social security assistance and subsidies could help improve their socioeconomic status. Conclusions: This study provides evidence for the mechanism of social factors linking to physical health and further to psychological well-being among people with pneumoconiosis. Social security assistance and subsidies should be urgently provided for them to improve their socioeconomic status and their psychological well-being.

Discussion on the evaluation of occupational disease diagnostic criteria

Occupational disease diagnosis standards are an important basis for occupational disease diagnosis, occupational health surveillance, occupational health supervision, occupational disease treatment, occupational disease disability assessment, and handling of occupational disease diagnosis disputes in conjunction with the "Occupational Disease Prevention and Control Law of the People's Republic of China". With the successive promulgation of the "Standardization Law of the People's Republic of China" and the "Administrative Measures on Health Standards", the establishment of a mandatory standard implementation evaluation mechanism has gradually been paid attention to. However, there is still a lack of systematic research on the evaluation of diagnostic criteria for occupational diseases. Therefore, this article combines the current status of the diagnostic standards for occupational diseases in China, and proposes reasonable suggestions on how to carry out the evaluation of the implementation of this type of standard in terms of evaluation methods and content.

Balanced Convolutional Neural Networks for Pneumoconiosis Detection.

Pneumoconiosis remains one of the most common and harmful occupational diseases in China, leading to huge economic losses to society with its high prevalence and costly treatment. Diagnosis of pneumoconiosis still strongly depends on the experience of radiologists, which affects rapid detection on large populations. Recent research focuses on computer-aided detection based on machine learning. These have achieved high accuracy, among which artificial neural network (ANN) shows excellent performance. However, due to imbalanced samples and lack of interpretability, wide utilization in clinical practice meets difficulty. To address these problems, we first establish a pneumoconiosis radiograph dataset, including both positive and negative samples. Second, deep convolutional diagnosis approaches are compared in pneumoconiosis detection, and a balanced training is adopted to promote recall. Comprehensive experiments conducted on this dataset demonstrate high accuracy (88.6%). Third, we explain diagnosis results by visualizing suspected opacities on pneumoconiosis radiographs, which could provide solid diagnostic reference for surgeons.

Progress in epidemiological studies on pneumoconiosis with comorbidities

Pneumoconiosis is one of the most serious and common occupational disease in China at present, there are a variety of complications, which seriously affect the disease treatment, disease progress and prognosis, but also the direct cause of death. Therefore, the prevention and treatment of various comorbidities of pneumoconiosis is a major public health problem in our country. This article outlines the epidemiological characteristics of different comorbidities of pneumoconiosis, analyze and summarize its research status and existing problems, and put forward relevant thoughts, in order to provide reference for the prevention and treatment of pneumoconiosis comorbidities.

Analysis of Health Service Utilization and its Influencing Factors among Patients with Pneumoconiosis in China

Pneumoconiosis, an interstitial lung disease that occurs from breathing in certain kinds of damaging dust particles, is a major occupational disease in China. Patients diagnosed with occupational pneumoconiosis can avail of free medical treatment, whereas patients without a diagnosis of occupational diseases cannot not claim free medical treatment in most provinces from the government before 2019. This study aimed to analyze the priority of medical facility selection and its influencing factors among patients with pneumoconiosis. A total of 1,037 patients with pneumoconiosis from nine provinces in China were investigated. The health service institutions most frequently selected by the patients were county-level hospitals (37.5%). The main reason for the choice was these hospitals' close distance to the patients' homes (47.3%). The factors for the choice of health care institutions were living in the eastern region ( OR = 2.91), living in rural areas ( OR = 2.10), silicosis diagnosis ( OR = 2.44), employment in private enterprises ( OR = 2.91), smoking ( OR = 2.69), and quit smoking ( OR = 3.98). The diagnosis, treatment, and rehabilitation therapy of pneumoconiosis should be enhanced in primary medical institutions.

The Role of the Kurtosis Metric in Evaluating the Risk of Occupational Hearing Loss Associated with Complex Noise - Zhejiang Province, China, 2010-2019.

What is already known about this topic?Occupational noise-induced hearing loss (NIHL) has been the second most common occupational disease in China. Noise energy is the main risk factor for occupational NIHL. Evidence shows the temporal structure of noise (as indicated by kurtosis metric) contribute to the development of NIHL. However, the role of the kurtosis metric in evaluating the risk of occupational NIHL associated with complex noise has been rarely reported.What is added by this report?Noise temporal structure (as indicated by kurtosis) is an important risk factor for occupational NIHL in addition to noise energy. Kurtosis can be used to quantify complex noise exposure. A combination of noise kurtosis and noise energy can effectively evaluate the risk of occupational hearing loss associated with complex noise.What are the implications for public health practice?Considering the effect of noise temporal structure on occupational NIHL, the existing international noise exposure standards (e.g. measurement method and noise exposure limit) for complex noise should be modified based on noise temporal structure. More effort is needed to reduce noise exposure, improve health screening, and monitor occupational NIHL.

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

Abstract 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.