KJ06-职业环境与健康-双语课件(1).ppt

occupational health and occupational medicine,department of preventive medicine of medical college of guangzhou wu jianjun,concept of occupational health and occupational medicine？,occupational:,referring to the workplace occupational hazards occupational disease,content of occupational health and occupational medicine,occupational hazards risk assessment acceptable level of risk prevent(ion) and control,section 1：occupational hazards and occupational adverse effects section 2： occupational toxicant and poisoning,section one,occupational hazards and occupational adverse effects,1、occupational hazards 2、occupational adverse effects 3、prevention and control of occupational adverse effects,occupational hazards,what is occupational hazards？ what does occupational hazards include？,what is occupational hazards？(definition),any existing or potential workplace condition that, by itself or by interacting with other variables, can result in death, injury, property damage, or other loss.,content of hazards definition:,include substandard conditions, practices, and/or procedures. are defined as the potential for harm or damage to people, property, or the environment. include the characteristics of objects and the actions or lack of actions by people.,work（or occupational） conditions,production procedure（technique，equipment，material，technical flow，etc） working course （organization，layout，posture and working manner，etc） workplace environment （indoor， air environment and outdoor）,occupational hazards in production procedure,1、chemical agents occupational toxicant modality：gas，vapor，dust，smog form： raw material，semifinished product，product，accessorial material and waste，etc.,familiar occupational toxicant in work environment, metal and metalloid such as lead，mercury，manganese，phosphor，arsenic，sulfur，etc. organic solvent such as benzene，toluene， carbon tetrachloride ，etc., irritative gas and asphyxiating gas chlorine，ammonia，sulfur dioxide，etc. carbon monoxide，hydrogen cyanide，hydrogen sulfide，etc.,familiar occupational toxicant in work environment,amino- and nitro- benzene compounds such as trinitrotoluene（三硝基甲苯），aniline macromolecule compound chloroethylene（氯乙烯） etc. pesticide organophosphate pesticides， organochlorine pesticides， pyrethroid pesticides etc.,familiar occupational toxicant in work environment, occupational dust crystalline silica dust asbestos dust coal dust cement dust organic dust etc.,occupational hazards in production course,2、physical agents, abnormal weather air temperature，air humidity，airflow etc. abnormal air pressure decompression sickness mountain sickness，aircraft disease, noise，vibration nonionization radiation ultraviolet，infrared，visible light，laser etc. ionization radiation x ray， ray， particle etc.,physical agents,1、unreasonable labor organization and system 2、labor intensity 3、improper work tool or adverse posture,occupational hazards in work course,work environment the work environment is defined as the employers establishment and other locations where employees are engaged in work-related activities or are present as a condition of their employment.,occupational hazards in work environment,1、layout of workshop is unreasonable 2、hazards in natural environment high temperature，hot radiation， low temperature etc.,occupational hazards in work environment,occupational adverse effects,1、mode of occupational adverse effects 2、effects on health,1、mode of occupational adverse effects,worker,occupational adverse effects,conditions,occupational disease workrelated disease occupational injury,2、effects on health of occupational hazards,occupational disease workrelated disease occupational injury,occupational illness,any abnormal condition or disorder other than one resulting from an occupational injury caused by exposure to environmental factors related to employment. it includes acute and chronic illnesses or diseases that may be caused by inhalation, absorption, ingestion, or direct contact.,occupatinal disease,a disease, such as byssinosis or black lung, resulting from the conditions of a persons work, trade, or occupation. 1、generalized occupational diseases 2、prescribed occupational diseases,list of the prescribed occupational diseases（put into effect since may first 2002）,10 kinds and 115 varieties 1、pneumoconiosis （13） 2、ionizing radiation-induced occupational illness （11） 3、occupational poisoning （56） 4、physical agents-induced occupational diseases （5） 5、biological agents-induced occupational diseases （3）,6、occupational dermatoses （8） 7、occupational eye diseases （3） 8、occupational ear，nose and throat diseases （3） 9、occupational cancers （8） 10、other occupational diseases （5）,list of the prescribed occupational diseases（put into effect since may first 2002）,character of occupational disease,specific pathogeny most pathogeny can be detected quantificationally, dose-effect relation the number of a disease is great prognosis are better specific remedy is not found to most occupational diseases,diagnosis of occupational disease,occupational history survey and evaluation of occupational spot clinical symptom and test,work-related,if an event in the work environment either caused or contributed to the case or aggravated a pre-existing condition, then it is considered work-related,character of work-related diseases,factor not only one potential illness is exposed or pre-existing illness is aggravated the cases will decrease obviously by taking measure are not an attribute of prescribed occupational diseases,familiar work-related diseases,pulmonary disease related to occupation chronic bronchitis，emphysema etc. damage of bones and parenchyma low back pain，shoulder or neck pain cardiovascular diseases coronary heart disease genital dysfunction diseases of digestive system ulcer（stomach or intestines）,occupational injury,physical harm or damage to the body such as a cut, fracture, sprain, amputation, etc. in the work setting. an injury results from an exchange, usually acute, of mechanical, chemical, thermal, or other environmental energy that exceeds the bodys tolerance.,prevention and control of occupational adverse effects,basic principle 1、three class prevention primary prevention secondary prevention tertiary prevention 2、safety first，prevention central,measure of prevention and control,law the occupational diseases prevention and control act，p.r.china organization set up reasonable occupational health system etc. technology reform technique etc. hygiene occupational health surveillance etc.,section 2： occupational toxicant and poisoning,occupational toxicant some chemical existing in workplace which have adverse effect on human health occupational poisoning poisoning result from contacting occupational toxicant during occupation,modality and approach of occupational toxicant, modality：gas，vapor，dust，smog approach of absorption：respiratory tract，skin，alimentary tract,familiar occupational toxicant,lead（pb），mercury（hg） cadmium（cd），maganese（mn），chromium（cr） organic solvent（ benzene） amino- and nitro- benzene compounds（trinitrotoluene，aniline） irritative gases and asphyxiating gases,1、lead（pb）,（1）properties： lead is a soft, heavy, blue-gray metal; mw: 207.19 (pb) d 11.3 g/cm3; mp 327.5 bp：1525 valences +2, +4 in salts 400-500 vapor smoke of lead,（2） lead exposures,occupational lead exposures may occur in the following workers (examples): lead mining, refining, smelting, and manufacturing industry employees printers plastic manufacturers steel welders or cutters construction workers rubber product manufacturers gas station attendants battery manufacturers bridge reconstruction workers battery recyclers,lead exposure for children,（3）toxicology,absorption inhale by respiratory tract ingest by alimentary tract skin,（2）distribution and excretion,most of the lead that is absorbed into the body is excreted either by the kidney (in urine) or through biliary clearance (ultimately, in the feces) studies indicate that adults excrete the majority (50%60%) of an absorbed fraction of lead on a short-term (several weeks), adults may ultimately retain only 1% of absorbed lead, but children tend to retain more than adults,absorbed lead that is not excreted is exchanged primarily among three compartments: blood; soft tissue (liver, kidneys, lungs, brain, spleen, muscles, and heart); and mineralizing tissues (bones and teeth), which typically contain the vast majority of the lead body burden.,（2）distribution and excretion,lead in the blood,the half-life of lead in adult human blood has been estimated to be from 28 days to 36 days approximately 99% of the lead in blood is associated with red blood cells (erythrocytes); the remaining 1% resides in blood plasma it is blood plasma which transfers lead between the blood and the soft and mineralizing tissues,lead in soft tissues,the blood distributes lead to various organs and tissues autopsies of exposed workers revealed that lead had built up in these soft-tissue organs (in decreasing order): liver, kidney, lungs, and brain lead in soft tissues has an approximate half-life of 40 days,lead in mineralizing tissues (bones and teeth),most retained lead in the human body is ultimately deposited in bones. the bones and teeth of adults contain about 94% of their total lead body burden,4、clinical symptoms,（1）acute poisoning occupational poisoning is rare，nausea，vomit，bellyache etc.,（2）chronic poisoning,neurologic effects effects include forgetfulness; irritability; impaired concentration; depression and mood changes; increased nervousness; headache; fatigue; impotence; dizziness; weakness; and paresthesia（感觉异常）; lead encephalopathy（铅性脑病）, digestive system general symptoms include inappetence（食欲不振）； nausea（恶心），windy（腹胀的），bellyache（腹痛） etc. if it is serious，lead colic（铅绞痛）will occur a purplish line on the gums (lead line) is rarely seen today,（2）chronic poisoning,hematologic and hematopoietic system effects lead inhibits the bodys ability to make hemoglobin by interfering with several enzymatic steps in the heme pathway. specifically, lead decreases heme biosynthesis by inhibiting -aminolevulinic acid dehydratase （ala脱水酶）and ferrochelatase （亚铁络合酶）activity.,（2）chronic poisoning,lead can induce anemia（microcytic小红细胞的 and hypochromic低血色素的）, often accompanied by basophilic stippling of the erythrocytes（嗜碱性红细胞、点彩红细胞），reticulocytosis（网织红细胞）,（4）others： renal effects endocrine effects cardiovascular (hypertension) effects reproductive and developmental effects,5、diagnosis a