Occupational diseases have been mentioned in ancient Chinese medical books. Pliny the elder in ancient Rome described the method of preventing molten ore from smoking with pig bladder for slave workers, and the Swiss doctor Parachelsus put forward the labor hygiene problems in casting and smelting. G. agricola reported that miners have frequent respiratory diseases, and B. Ramazzini wrote a book, which analyzed and recorded the relationship between various harmful factors and occupational diseases in production in detail. With the development of industrial production and natural science, there are more and more occupational diseases.
In 20 13, the National Health and Family Planning Commission, Ministry of Human Resources and Social Security, the State Administration of Work Safety and the All-China Federation of Trade Unions jointly issued the Classification and Catalogue of Occupational Diseases, which classified occupational diseases into 10 and 132. These diseases involve respiratory system, skin, eyes, ears, nose, throat and mouth, which are extremely harmful to the life and health of employees.
By the end of 20 18, 975,000 cases of occupational diseases had been reported nationwide, including 873,000 cases of occupational pneumoconiosis. The results of sampling survey show that there are about120,000 enterprises with occupational hazards in China, and more than 200 million workers are exposed to various occupational hazards.
Today, our theme of occupational disease protection will be shared from the following four aspects:
1. Overview and symptoms of occupational diseases
2. Causes of occupational diseases
3. Treatment and protection of occupational diseases
4. How to care for occupational diseases?
I. Overview and symptoms of occupational diseases:
According to the Law of People's Republic of China (PRC) on the Prevention and Control of Occupational Diseases promulgated on 20 17, "Occupational diseases refer to diseases caused by workers of enterprises, institutions, individual economic organizations and other employers who are exposed to dust, radioactive substances and other toxic and harmful factors in their professional activities." The classification and catalogue of occupational diseases are jointly formulated, adjusted and announced to the whole society by the relevant departments of the State Council. Only medical institutions approved by provincial health administrative departments can issue occupational disease diagnosis reports.
Statutory occupational diseases mainly include:
1. Pneumoconiosis: This disease accounts for the vast majority (about 90%) of occupational disease patients in China. According to the statistics at the end of 20 18, among the 970,000 occupational disease patients in China, as many as 870,000 are occupational pneumoconiosis. It is diffuse fibrosis of lung tissue caused by long-term inhalation of dust in patients' occupational activities, which can cause systemic diseases with the progress of the disease, with a mortality rate of more than 20%. The patient population is mainly distributed in the mining industry, and shows a trend of youthfulness. Common types are trachoma, coal worker's pneumoconiosis, graphite pneumoconiosis, carbon black pneumoconiosis, asbestos pneumoconiosis, talc pneumoconiosis, cement pneumoconiosis, Potter's pneumoconiosis, aluminum pneumoconiosis, welder's pneumoconiosis, etc.
2. Other respiratory diseases: Chronic inflammation and injury of respiratory tract are mainly caused by inhalation of allergens, irritants or metal dust. Disease types include allergic pneumonia, cotton dust disease, asthma, metal and its compound dust pneumoconiosis (such as tin, iron, brocade, Qin, etc. ), chronic obstructive pulmonary disease caused by irritating chemicals, hard metal lung disease, etc.
3. Occupational dermatoses: Chronic inflammation and ulcers are mainly caused by skin contact with allergens, irritating chemicals or light and radiation. The main types are contact dermatitis, mild contact dermatitis, electro-optic dermatitis, melanosis, acne, ulcer, chemical skin burn, leukoplakia and so on.
3. Occupational eye disease: Due to physical and chemical factors, the patient's eye tissue is damaged to varying degrees, even losing normal vision. There are mainly chemical eye burns, electro-optic ophthalmia and cataracts (including radiation cataracts and trinitrotoluene cataracts).
4. Occupational ear, nose, throat and oral diseases: different degrees of structural or functional damage caused by physical and chemical factors. Such as noise deafness, nasal disease, tooth erosion, explosive deafness and so on.
5. Occupational chemical poisoning: due to contact with heavy metals and their compounds (such as lead, mercury, manganese, brocade, etc. ) or other toxic and harmful substances (such as carbon monoxide, sulfur dioxide, chlorine, benzene, etc. ), causing systemic tissue or organ damage. It may be an acute disease caused by a large amount of one-time contact, or it may be a chronic poisoning caused by long-term micro-contact.
6. Occupational diseases caused by physical factors: These diseases are related to physical factors such as temperature and air pressure, such as heatstroke, frostbite, decompression sickness, altitude sickness and aviation diseases.
7. Radiation-induced diseases: Radiation will cause serious damage to human cells and their genetic material. Depending on the radiation dose, patients may suffer from acute or chronic diseases. Lesions can spread all over the body, such as radiation dermatosis, bone injury, thyroid disease and so on. And even cause malignant tumors.
8. Occupational infectious diseases: The high-risk groups of such diseases are mainly medical personnel, police and field workers. Common diseases are: charcoal, forest encephalitis, brucellosis, Lyme disease, AIDS and so on.
9. Occupational tumor: Due to occupational exposure and exposure to substances that induce gene mutation, the malignant proliferation of local cells in the body is out of control, invading surrounding tissues and even transferring to distant organs. For example, asbestos causes lung cancer and mesothelioma; Benzidine causes bladder cancer; Benzene causes leukemia; The mystery of permethrin, cypermethrin strips, coke oven emissions, monuments and inscriptions lead to lung cancer; Coal tar and asphalt can cause skin cancer.
10. Other occupational diseases:
Metal smog fever is caused by patients inhaling a large number of metal oxide particles released at high temperature during metal casting.
Bursitis is confined to underground workers.
Femoral vein thrombosis syndrome, femoral artery occlusion or lymphatic occlusion are limited to curetters.
Symptoms of occupational diseases:
Occupational diseases can be seen in patients of different ages, regions and jobs. Although all tissues and organs of the body are damaged due to occupational exposure, the symptoms of patients will be very different according to the specific location of the lesion and the severity of the injury.
1. The location of the injury is different:
Some injuries in conspicuous positions, such as face and limbs, can be easily found by patients at an early stage.
Some gene molecular mutations that damage internal organs, even at the genetic level, can not be detected at the early stage of patients; Only when the disease develops to a considerable extent will the symptoms be found.
2. The progress of the disease also shows great differences:
Some patients may be exposed to a large number of toxic substances at one time, or suffer from severe trauma and have an acute attack.
Some patients may have long-term micro-contact, forming chronic injury or chronic poisoning in a subtle way.
3. The main symptoms of pneumoconiosis patients who account for the absolute majority:
When the early injury is mild, the symptoms are not obvious, mainly cough and expectoration.
With the progress of the disease, the patient developed into chronic bronchitis or lung infection, and cough and expectoration increased significantly, resulting in sticky purulent sputum.
I often feel chest pain and dyspnea due to the more and more serious lung tissue damage.
The normal structure of respiratory tract is destroyed, and the patient is weak and prone to various respiratory tract infections.
Eventually, it will form chronic pulmonary heart disease or respiratory failure.
4. Other patients with occupational diseases may have corresponding symptoms due to different degrees of injury:
Damage to the five senses will affect vision and hearing.
Skin or mucosal lesions can cause local color and texture abnormalities (such as redness, blackening, shrinkage and roughness), or surface erosion and ulcers.
Gastrointestinal diseases can lead to abdominal distension, abdominal pain, vomiting, diarrhea, loss of appetite and indigestion.
Urinary system injury can cause hematuria, frequent urination, urgency, urinary incontinence and other symptoms.
Impaired gonads can lead to loss of fertility and infertility.
Impaired hematopoietic function can lead to anemia, leukopenia and thrombocytopenia.
Involvement of the central nervous system can lead to local or systemic sensory abnormalities, muscle weakness, mobility inconvenience, loss of balance and coordination, forgetfulness, and unresponsiveness.
A few patients with occupational diseases may die in a short time due to serious illness or untimely treatment. More patients may cause irreversible damage to the body due to toxic and harmful substances, accompanied by lifelong sequelae.
Second, the causes of occupational diseases:
External damage is the direct cause of occupational diseases, mainly including chemical factors, dust organisms, physical stimulation, pathogen infection and so on.
1. Chemical factors:
Various chemical hazards of heavy metals such as lead, mercury, manganese, cadmium, thallium and arsenic. According to the statistics of relevant departments, there are as many as 374 kinds of chemicals that can cause occupational diseases.
Such as lung cancer and mesothelioma caused by asbestos. Leukemia caused by benzene, skin cancer caused by coal tar and petroleum asphalt are all fatal to health.
2. Dust creatures:
Dust is a very familiar state of matter.
Dust is divided into:
Inorganic dust (mineral dust, metal dust, synthetic inorganic dust);
Organic dust (animal dust, plant dust, synthetic organic dust;
Mixed dust.
Total dust refers to dust that can enter the whole respiratory tract (nose, pharynx, larynx, trachea, bronchus, bronchioles, respiratory bronchioles, alveoli).
There are as many as 5/kloc-0 kinds of dust, such as silica dust, coal dust, talcum powder dust, cement dust, etc., which all cause damage to human lungs and are difficult to reverse.
3. Physical stimulation:
According to statistics, there are 14 kinds of occupational diseases caused by physical factors such as noise, high temperature, high altitude hypoxia and high frequency electromagnetic field.
Long-term exposure to noise, which seriously damages hearing, is harmful to health or has other hazards, belongs to noise. Noise can cause deafness. The main clinical symptoms are hearing loss, tinnitus, earache, headache and dizziness.
There are also injuries caused by long-term local oppression. Long-term exposure to sunlight, ultraviolet rays or radiation can lead to occupational diseases such as skin cancer.
4. Pathogen infection:
Biological factors of occupational diseases caused by various bacterial, fungal, parasitic and viral infections.
The most common fungal (mold) infections are onychomycosis and tinea pedis. Normal people's internal organs are usually not infected. However, some surgical patients, organ transplant recipients (taking immunosuppressants) and patients with chronic bacterial diseases (taking antibiotics for a long time) may also cause deep fungal infection. Because antifungal drugs are relatively simple, once drug resistance occurs, patients may die!
I'm afraid the most common human parasite is ascaris lumbricoides. However, there are two kinds of parasitic diseases that are terrible, one is malaria and the other is schistosomiasis. At present, malaria is rare in China, and schistosomiasis occurs from time to time in the surrounding areas of rivers and lakes in China. At present, artemisinin is the only effective drug to treat malaria, and artemisinin can also be used for schistosomiasis.
Three. Treatment and protection of occupational diseases
Doctors will formulate individualized treatment plans according to the types and specific conditions of patients with occupational diseases, and strive to control the disease as soon as possible, maintain the stability of the disease, reduce complications and sequelae, and improve the quality of life of patients in the future.
1. Stay away from poisons immediately and wash your skin thoroughly.
Take off the contaminated clothes and immediately move to the outdoor with good air circulation.
Wash the skin contact area with warm water or soapy water.
Benzene substances can be washed with alcohol.
Acid poisons such as Australia and formaldehyde can be washed with sodium bicarbonate solution.
Alkaline poisons, such as concentrated ammonia water and quicklime, can be washed with acetic acid or abscisic acid solution.
2. First aid and supportive treatment
Dehydration and electrolyte disorder require fluid replacement to maintain the balance of water, electrolyte and acid-base in the body.
Vomiting patients need to clean up vomit and keep the respiratory tract unobstructed.
People who have difficulty breathing can be given oxygen, and those who are seriously ill need auxiliary ventilation.
People with abnormal heartbeat or cardiac arrest need manual pressing or electric shock defibrillation to restore normal heartbeat.
People with eating difficulties can supplement the necessary nutrition through nasal feeding tube or intravenous infusion.
Take an antidote
(1) Poisoning by metals and their compounds: commonly used drugs such as calcium sodium edetate and sodium disulfonate.
(2) Methemoglobinemia: Methylene blue is commonly used.
(3) Chloride poisoning: commonly used as nitrite drugs. Methanol and ethylene glycol poisoning: commonly used mesalazine.
4. Promote the toxins absorbed in the body to be discharged as soon as possible.
Intensive diuretic: diuretics are used simultaneously with a large amount of infusion.
Hyperbaric oxygen chamber: Carbon monoxide combined with hemoglobin is replaced by high concentration oxygen.
Blood purification: hemoperfusion or hemodialysis to remove toxic substances from blood.
5. Long-term follow-up to monitor the condition.
Many patients with occupational diseases suffer from chronic injuries for a long time. Even after treatment, they may still have some sequelae or functional defects, so they need long-term follow-up.
Through regular follow-up, doctors can understand the progress trend of the disease and adjust the treatment plan in time; It is also beneficial for patients to obtain a complete medical record as a reference for future treatment or the basis for claims.
The key to occupational disease prevention lies in taking necessary protective measures according to industry norms. In the process of work, we should concentrate on protecting our own safety and avoid possible dangerous situations in time.
Fourth, how to care for occupational diseases?
Primary prevention, also called etiological prevention, is to fundamentally eliminate and control occupational hazards and prevent occupational diseases.
1. Technical measures to replace toxic substances with non-toxic substances; Adopt remote control operation or automatic and semi-automatic operation to prevent harmful substances from running, running, dripping and leaking; Strengthen ventilation, dust removal and detoxification measures.
2. Organize measures, reasonably organize and arrange the labor process, establish and improve the labor system, and implement the health regulations formulated by the state.
3. Health care measures Do a good job in pre-employment physical examination and find susceptible groups and employment contraindications; Do a good job in health promotion and health education; Pay attention to the balance between diet and health food supply. I strengthen my exercise and improve my body's resistance.
Secondary prevention is also called preclinical prevention. Early detection, early diagnosis and early treatment can prevent the development of lesions.
1. Conduct general survey, screening, regular health examination, definite diagnosis and timely treatment for occupational contacts.
2. Monitor the production environment regularly and take preventive measures immediately when problems are found.
Tertiary prevention is also called clinical prevention. So that patients can get timely and reasonable treatment after diagnosis, prevent the deterioration and recurrence of the disease and prevent the loss of labor ability. For patients with chronic occupational diseases, medical monitoring can prevent complications and disability. Through functional and psychological rehabilitation treatment, we can achieve the goal of not being disabled, not being disabled, and prolonging life.
Patients with occupational diseases must follow the doctor's advice and review regularly; At the same time, we should give up smoking and drinking immediately, pay attention to supplement nutrition and enhance physical fitness.
1. Patients must leave their original jobs immediately:
Avoiding further stimulation will further aggravate the condition.
Those who are seriously ill had better rest at home or arrange rest.
2. Quit smoking and drinking:
Quit smoking immediately and stay away from second-hand smoke. There are many harmful components in cigarette smoke.
Alcohol can also damage cells and may interact with drugs, affecting curative effect and even causing toxic and side effects.
3. Matters needing attention in family therapy:
Patients must follow the doctor's advice and take enough drugs for a course of treatment to ensure the long-term stability of their condition.
If there are intolerable serious adverse reactions, it is necessary to return to the doctor in time so that the doctor can adjust the dose or change the medication plan.
Don't add other drugs and health products at will, so as not to cause adverse reactions.
4. Supplement nutrition and enhance physical fitness:
Ensure that there are fresh fruits, vegetables, nuts and high-quality protein, such as eggs, fish and lean meat, every day.
Exercise every day promotes blood circulation and contributes to physical and mental health.
Ok, the sharing of occupational disease prevention and control is over. If you are engaged in high-risk work or friends, you can learn from the contents of the article to protect your health and prevent occupational diseases.