The first level of prevention (primary prevention), also known as etiological prevention, is to fundamentally eliminate the role of hazardous factors on people, that is, to improve the production process and production equipment, the rational use of protective facilities and personal protective equipment, in order to reduce the exposure of the worker's chances of exposure and extent. For individuals in the population who are in a high-risk state, they can be examined on the basis of occupational contraindications, and those who have occupational contraindications should not participate in work related to them. It can be seen that the measures of primary prevention are aimed at controlling the health risk factors of the whole population, and therefore belong to the scope of the first level of prevention.
Secondary prevention is the early detection of diseases caused by occupational hazards. Although the first level of prevention is the ideal method, but the realization of the costs required are large, sometimes difficult to fully achieve the desired results, there can still be affected people, so the second level of prevention has become a necessary measure. The main means of prevention is regular monitoring of occupational hazards in the environment and regular physical examinations of those exposed, so as to detect illnesses at an early stage and to prevent and deal with them in a timely manner. In addition, there are inspections before returning to work after a long period of sick leave or trauma and before retirement. The intervals between regular physical examinations can be determined according to the following principles: (1) the natural evolution of the disease, the speed of onset and severity; (2) the degree of exposure to occupational hazards; and (3) the susceptibility of the exposed population. Physical examination programs should encourage the use of specific and sensitive bioassay indicators for evaluation. Lung ventilation function examination or X-ray lung film, commonly used as an indicator of functional and pathological changes in dust-exposed workers; others, such as electrocardiogram, electroencephalogram, and nerve conduction velocity and hearing examination, can be used as an early and specific examination method.
Tertiary prevention is the active treatment and reasonable promotion of rehabilitation after the disease. The principle of tertiary prevention includes: ① the damaged contacts should be transferred away from their original jobs and given reasonable treatment; ② according to the cause of the damage to the contacts, the production environment and process improvement, not only to treat the patient, but also to manage the environment; ③ to promote the patient's recovery and prevent complications. Except for very few occupational poisoning with special detoxification treatment, most of the occupational diseases are mainly based on the damaged target organs or systems, with clinical treatment principles, giving symptomatic integrated treatment. Especially for the lung fibrosis caused by dust exposure, there is no effective method to reverse it. Therefore, the principle of treatment also lies in the full implementation of the three-level preventive measures, so as to achieve timely prevention, early detection and early treatment, promote rehabilitation, prevent complications and improve the quality of life. The first step was to make sure that the people who were exposed to the dust were discouraged from smoking.
The first level of prevention is aimed at whole or selected populations and is more important for healthy individuals. Although the first level can play a fundamental role in the state of health and well-being of the population, but the second and third levels are for the patient, remedial measures, but also indispensable, so the three levels of prevention should be complementary, integrated.
Occupational health and occupational medicine belongs to the field of preventive medicine, which is concerned with the exposure to occupationally harmful factors in the workplace and their impact on the health of workers and the quality of their professional lives. From the exposure to the basic process of disease, workers in the workplace exposure to the amount of production of harmful factors, known as the exposure dose (exposure dose) or external dose (external dose), that is, the amount of production of harmful factors in the production environment; through the distribution of absorption and metabolism of the amount of excretion in the body to become internal dose (internal dose) or body burden (body burden), the amount of exposure in the body. Internal dose (internal dose) or body burden (body burden)? The amount of productive harmful factors in the body that reaches the IE organ (target organ) is called |E dose (target dose) or biological effective dose (biological effect dose). The effect on the health of workers can cause early biological effect or disease, or even death. Occupational health and occupational medicine as a discipline of occupational exposure to hazardous factors and human health effects need to be qualitative and quantitative, through the discovery of the exposure effect dose response (response) effect relationship, in order to determine the causal relationship between the exposure and the effect, and then for the reduction or even elimination of occupational exposure to hazardous factors and to reduce or exempt from the impact of the health of the workers to provide a theoretical basis.
Occupational health and occupational medicine research methods include occupational epidemiology and occupational toxicology. Epidemiology is the scientific basis of preventive medicine, occupational epidemiology is mainly to study the impact of exposure to productive harmful factors on the incidence and distribution of disease (including trauma) in the exposed population, mainly used to investigate the incidence of disease in different laborers, to explore the causal links between the disease and the factors that influence it, and to provide an early warning sign of unknown occupational hazards; test the effects of the human body of the exposure to hazardous factors and evaluation of the intervention measures. Evaluation. A typical occupational epidemiologic study was Pott's 1775 report of scrotal cancer among chimney sweeps. Toxicology is the study of poisons, and information from occupational toxicology can be used as a basis for evaluating and managing productive hazards, particularly to provide information on potential hazards when population effect data are not available.
According to the principle of tertiary prevention, occupational diseases and injuries are different from general diseases with unknown causes or pathogenesis, so if they have preventive benefits, the following three aspects should be done:
1. Identification, evaluation and control of productive hazardous factors Environmental monitoring
In order to identify potential occupational hazardous factors in the environment, and their intensity (e.g., the number of occupational hazards in the environment, and their impacts), it is necessary to do a good job. Identification of potential occupational hazards in the environment, and its intensity (exposure) and exposure opportunities, and should be announced to the workers, in order to provide a basis for improving the production environment; biological monitoring (biological monitoring) refers to the regular, systematic and continuous detection of human biological materials in the content of poisons and/or metabolites, or the level of biological susceptibility or effect caused by them, and compared with the reference value to evaluate the degree of exposure to toxicants and the possible effect on the human body. The level of toxicant exposure and potential health effects can be evaluated by comparing the levels with reference values.
2. Occupational health services and health promotion Occupational health services (occupational health services) are comprehensive interventions aimed at providing and maintaining safe and healthy working conditions and work environments that are conducive to the physical and mental health of workers and to the realization of their work performance, thereby promoting workers' health, improving their quality of life and contributing to sustainable economic growth. The aim is to promote workers' health, improve their quality of life and promote sustainable economic development. Health surveillance focuses on the early detection of the health status of workers in specific production environments, and through pre-employment and regular health checks, workers should be informed of any illnesses they find, and early treatment should be provided to prevent contact in a timely manner. For those whose ability to work has been impaired, an assessment of their ability to work should be made and they should be dealt with in accordance with the provisions of the labor insurance regulations. Personnel training and health education training of occupational health and labor protection business and management personnel, so that directly involved in the production of knowledge of occupational hazards damage to the health of the disease-causing links and knowledge of protection, self-care, but also the implementation of mass supervision of enterprise managers.
3. Occupational health regulations and supervision and management of the above two aspects of the work in addition to the direct services necessary, the information accumulated, but also for the formulation of relevant laws and regulations to provide a scientific basis. Occupational health standards and diagnostic standards for occupational diseases are the most important part of occupational health-related regulations, health administrative departments should follow the spirit of the Occupational Disease Prevention and Control Act, the implementation of occupational health supervision and management, to help and supervise the implementation of employers to implement the "Act" and related regulations, and with the relevant government departments such as labor and economic departments, industry departments, trade unions, etc. *** with close cooperation, to ensure that the occupational hygiene regulations and supervision and management. It also works closely with relevant government departments such as labor and economic departments, industrial departments, trade unions, etc.**** In order to implement health policies and laws, the Ministry of Health has a Department of Health Law and Supervision, as well as local health supervision departments. In the planning and design of enterprises, construction and acceptance, etc., the implementation of the three simultaneous, in order to implement preventive health supervision; enterprises into production, to implement regular health supervision.
The above three aspects of work, need to have three aspects of power: first, the power of the administrative leadership, that is, leaders at all levels should be responsible for the people's health, serious planning of occupational health work; second is the power of the medical and health personnel, medical and health care, should be according to the World Health Organization's 1994 "occupational health for all" recommendations, the occupational health of the World Health Organization, the occupational health of the people's health, the occupational health of the people's health. Secondly, it is the power of medical and health personnel. In medical and health work, occupational health should be included in primary health care according to the recommendation of the World Health Organization in 1994 "Occupational health for all". In health management, medical and health personnel (including the Center for Disease Control, the Health Supervision Office, occupational disease prevention and control agencies, enterprise employee hospitals and health stations, township and community health units, and hospitals responsible for occupational health personnel, etc.), in close collaboration with engineers and technicians, and professionals in the field of labor protection sciences and other areas, work hard to do a good job of first-level prevention, and early detection of problems and timely control measures, so that workers can work in a safe and sanitary environment. The workers will be able to work in a safe and hygienic environment. If prevention is neglected and occupational disease patients are simply treated, more and more patients are bound to be cured, and it is only by taking into account the "management" of unhealthy environments at the same time that the vicious circle can be broken and diseases caused by occupational factors can be effectively controlled (Figure 1-1-2). Occupational health and occupational medicine work closely together in a division of labor. Occupational medicine can often act as a scout at the first sign of an unusual cluster of illnesses. The clinician first contacts the individual patient and accumulates and synthesizes the individual phenomena; without the concept of prevention and without concern for the safety of the group, the meaning of tertiary prevention cannot be further understood in a comprehensive manner. Therefore, the "prescription" in occupational medicine is not only to treat the patient, but also needs to work closely with other health departments, and work closely with professionals in labor protection, industrial hygiene and chemistry, engineering and technology, as well as workers, **** with the management of "production processes" that do not meet health standards. "in order to more effectively protect the health of workers, effective prevention and treatment of diseases and injuries.