Overwork, low back pain, cervical spondylosis...... Can occupational diseases be included?

Work methods such as high work pressure, anxiety, sitting for a long time, and sitting at a desk for a long time have all brought varying degrees of damage to the health of practitioners. "Overwork", low back pain, cervical spondylosis...... These diseases are often derided as "contemporary occupational diseases". Can these diseases be included in the category of occupational diseases? What are the occupational diseases with the highest risk of hazards? What should we do if we get an occupational disease? The period from 25 April to 1 May this year is the 22 nd National Publicity Week for the Law on the Prevention and Treatment of Occupational Diseases in the mainland. The National Health Commission held a press conference on April 25 to answer questions of public concern.

Remarkable results have been achieved in the prevention and treatment of occupational diseases on the mainland

What is the mid-term evaluation of the 14th Five-Year Plan for the Prevention and Control of Occupational Diseases?

Wang Jiandong, deputy director of the Department of Occupational Health of the National Health Commission and a first-level inspector, said that the results of the mid-term evaluation of the "14th Five-Year Plan" national occupational disease prevention and control plan showed that positive progress and remarkable results have been achieved in various key tasks of occupational disease prevention and control.

First, we should adhere to the principle of prevention and increase the intensity of prevention at the source. As of the end of last year, 185,000 enterprises were included in the special governance across the country, and 75,000 have been completed. The theme of this year's National Occupational Disease Prevention and Control Law Publicity Week is "Adhere to Prevention First, Protect Occupational Health", the purpose is to continue to strengthen prevention at the source, consolidate the effectiveness of pneumoconiosis and special treatment of occupational disease hazards, and unswervingly implement the principle of prevention first.

The second is to continuously improve the level of occupational health examination and occupational disease diagnosis and rehabilitation. There are 620 occupational disease diagnosis institutions, 5,670 occupational health examination institutions, and 829 pneumoconiosis rehabilitation stations across the country, basically forming an occupational disease diagnosis and rehabilitation system of "prefecture and city diagnosis, county and district physical examination, and township rehabilitation". From 2021 to 2023, it provided occupational health examinations for 53 million workers, about 90,000 occupational disease diagnosis services for workers, and more than 1.2 million free rehabilitation services for 200,000 pneumoconiosis patients.

The third is to strengthen the construction of the support system and promote scientific and technological innovation. There are 2,059 occupational health and radiation health technical service institutions nationwide, and there are 74,000 professional and technical personnel for the prevention and treatment of occupational diseases. The National Health Commission and 28 provinces have set up technical support institutions for engineering protection. The "National Mine Safety Technology Innovation Center", "National Pneumoconiosis Diagnosis and Treatment Center" and provincial and ministerial key laboratories for pneumoconiosis prevention and control have been established. The Key Laboratory of Dust Hazard Engineering Protection of the National Health Commission has also selected 64 advanced and appropriate technologies for dust and virus prevention in two batches, transformed a number of scientific and technological achievements, and improved the cooperation and linkage mechanism with provincial engineering protection institutions.

Occupational diseases ranked the top three

Noise, dust, chemical poisons

There are 132 diseases in 10 categories under surveillance. Occupational disease hazards are mainly distributed in mining, manufacturing, metallurgy, building materials and other industries

In recent years, everyone has been very concerned about the results of the continuous monitoring of occupational diseases and hazards, what are the current monitoring results, what are the top occupational diseases and hazards, and are there any new changes?

Wang Jiandong replied that since 2019, the number of monitored diseases has been expanded from the original 10 occupational diseases to all occupational diseases, that is, 132 types of occupational diseases in 10 categories. The monitoring of key occupational diseases has been extended to counties (districts), and the types and scope of monitoring diseases have been expanded to all factors and all types of occupational health examinations, such as pre-employment, on-the-job, off-the-job and emergency health examinations. In 560 key counties (districts), the monitoring of occupational disease hazards in the workplace of small, medium and micro enterprises has been carried out, and the current situation of occupational disease hazards in key industries in mainland China and the health status of workers exposed to occupational diseases such as dust, chemical poisons and noise have been basically grasped. This is also the first time since the founding of the People's Republic of China that this base number has been figured out. Therefore, the occupational disease reporting system covers 31 provinces, autonomous regions, municipalities directly under the central government and the Xinjiang Production and Construction Corps, involving more than 2,000 counties (districts).

According to the monitoring results, a total of 307,000 employers in key industries were monitored across the country, and more than 53 million occupational health examinations were monitored, of which more than 24 million workers were exposed to various occupational diseases. More than 1.815 million jobs with occupational disease hazards have been monitored, that is, by monitoring the status of workers' exposure to occupational disease hazards and the status of occupational health examinations, it provides a foundation and basis for the prevention and control of occupational disease hazards in the workplace and the strengthening and deepening of the management of occupational disease hazards.

More than 70 million cases of occupational health examinations were reported nationwide, 76,700 suspected occupational diseases were found, and 1,156,000 occupational contraindications were found. Suspected occupational disease mainly refers to the discovery of certain clinical manifestations and symptoms through occupational health examination, and it is suspected to be an occupational disease, but it has not been diagnosed. Occupational contraindications refer to the fact that when a worker is exposed to specific occupational disease hazards, such as exposure to dust or chemical poisons, he is more likely to suffer from occupational diseases than the general occupational population, or he has an underlying disease, such as active tuberculosis, and there are occupational contraindications for posts that are exposed to dust hazards, so he cannot engage in this occupation, and if he engages in this occupation, the risk of pneumoconiosis is greater. Therefore, after discovering these suspected occupational diseases and occupational contraindications, timely diagnosis can be taken, or measures to adjust the job position can be taken to better protect the occupational health of workers.

It has a comprehensive grasp of the risk and development trend of occupational diseases. The monitoring found that the concentration of occupational disease hazards in industries is obvious, and occupational disease hazards are mainly distributed in mining, manufacturing, metallurgy, building materials and other industries. In 2020, the National Health Commission organized a national survey on the status quo of occupational disease hazards in industrial enterprises, and the results showed that 40% of workers in industrial enterprises were exposed to various occupational disease hazards. In first place is noise, second is dust, and third is chemical poisons.

According to the results of the monitoring, the next step will be to further improve the laws, regulations, standards and policy measures for the prevention and treatment of occupational diseases, further deepen the management of occupational disease hazards, and better protect the health rights and interests of workers.

What should a worker do if he or she finds out that he or she is suspected of having an occupational disease?

You can apply for occupational disease diagnosis in three places, and some information will be provided by the employer, and the employee can apply for appraisal if he or she has objections

Sun Xin, director of the Institute of Occupational Health and Poison Control at the Chinese Center for Disease Control and Prevention, said that general health check-ups cannot be used as a substitute for occupational health check-ups. The general health examination and occupational health examination are different from the object, purpose, organizational form and legal basis, the basis of some clinical diagnoses, including the cycle and technical requirements, to the final conclusion, including the treatment of the patient later.

He said that once a worker is found to be suffering from a suspected occupational disease or occupational disease, the worker can apply for an occupational disease diagnosis in three places, one is the place where the employer is located, the other is the place of household registration, and the place of habitual residence. The National Health Commission has increased access to the entire service. It can be diagnosed in the prefecture and the prefecture.

In addition, the diagnosis of occupational diseases requires some information, that is, the occupational history and exposure history of the worker in the workplace, that is, the information of exposure to dust and chemical poisons in the workplace. The other is the concentration intensity, which is provided by the employer. Once the diagnosis institution has made a clear conclusion, after the diagnosis is an occupational disease, the institution shall issue a diagnosis certificate to the worker, and the worker can apply for relevant benefits from the relevant departments, mainly the work-related injury insurance department, with the diagnosis certificate.

Once the diagnosis is made, if the employee feels that he or she has any objections, he or she can apply for an appraisal. If it is a two-level appraisal, you can go to the health administrative department where the prefecture-level city is located for diagnosis. If there is any objection to the municipal diagnosis, you can apply to the provincial health department for diagnosis, and the provincial diagnosis is the final diagnosis.

What are the occupational health risks faced by "white-collar workers"?

Work stress leads to some cardiovascular diseases, including stroke and ischemic heart disease, and sedentary lifestyle, which leads to obesity, hypertension, diabetes and other chronic diseases

In addition to the traditional front-line "blue-collar" workers, what other occupational health risks do "white-collar" workers face, and how can these occupational health risks be prevented?

Sun Xin replied that "blue-collar" workers are mainly exposed to dust, chemical poisons, and noise caused by some traditional problems such as pneumoconiosis and poisoning, including the problem of noise concentration. When it comes to "white-collar workers", the first impression is given to everyone, the appearance is glamorous, and they are mainly engaged in some office buildings. However, our survey found that in reality, "white-collar workers" are often one of the people with greater work pressure and anxiety. This has something to do with the way of working, often working overtime, including now working remotely, requiring 24-hour on, which virtually increases the pressure at work. Work stress leads to a number of cardiovascular diseases, including stroke, ischemic heart disease, and some mental health problems. Therefore, once white-collar workers do not manage their physical and mental health, it will bring varying degrees of damage. In addition, there is another feature, long-term desk work, frequent use of computers, mobile phones, may lead to some neck, shoulder, wrist damage.

In addition, work styles, such as frequent sedentary lifestyle, lead to chronic diseases such as obesity, high blood pressure, and diabetes, which are common health problems faced by white-collar workers. How can it be prevented?

From the perspective of employers, first of all, there are some service industries that do require long hours of work, and employers should reasonably arrange working hours, including rest periods, in accordance with the law to protect the health rights and interests of workers. Personally, there are a lot that can be done, for example, some workers work long hours, it is recommended to take a five-to-10-minute break for one hour of work, do some outdoor activities, and you can also do some stretching activities in the office.

In addition, there is some desk work, try not to work in one position for a long time, you can rest for five to ten minutes an hour to relieve yourself.

In addition, the occupational health protection action in the Healthy China Action clearly states that the health protection of fixed-position workers should be strengthened, one is the long-term desk work with their heads bowed and the long-term forward-leaning sitting posture, including teachers, doctors, nurses, and the other type of drivers, mainly the health protection of people in the fixed position sitting posture.

Talents in the directory are called occupational diseases

Low back pain, cervical spondylosis, and varicose veins caused by prolonged standing are collectively referred to as work-related diseases

What is the progress of the adjustment of the "Classification and Catalogue of Occupational Diseases" and what are the principles and working ideas for selecting the types of diseases to be included in the catalogue of occupational diseases?

Wang Jiandong introduced that according to the relevant regulations of the International Labour Organization and the world's common practice, occupational diseases generally have a legal definition. According to the relevant regulations of the mainland, occupational diseases refer to diseases caused by exposure to dust, radioactive substances and other toxic and harmful substances in the occupational activities of workers in enterprises, public institutions and individual economic organizations.

"There are three elements here, one is that the worker must be a worker in enterprises, institutions and individual economic organizations, the second is in professional activities, and the third is exposure to toxic and harmful substances. Wang Jiandong said, but meeting these three elements does not necessarily mean that it can be defined as an occupational disease. It can only be called an occupational disease in the list of occupational diseases. The catalogue of occupational diseases in mainland China was published in 2013, and the current catalogue of occupational diseases has 132 kinds in 10 categories, and these 132 diseases are the legal occupational diseases in mainland China. In other words, a statutory occupational disease must have the above four elements.

In the professional population, it is often said that low back pain, cervical spondylosis, and varicose veins caused by long-term standing may be caused by poor working methods or poor sitting postures at work, but they may also be caused by bad lifestyle behaviors in our lives.

According to Wang Jiandong, these diseases are generally referred to as work-related diseases, which are related to work, life, and may also be related to other factors. From the perspective of relevance, statutory occupational diseases are diseases that are selected from work-related diseases, which are easy to be attributed and diagnosed and included in the classification and catalogue of occupational diseases. That is to say, the 132 occupational diseases are some of the work-related diseases, which are easy to diagnose by the attribution of occupational diseases, and they are diseases caused by workers' exposure to occupational disease hazards in occupational activities, which is the difference and connection between work-related diseases and occupational diseases.

"All sectors of society are highly concerned about the adjustment of the catalogue and look forward to expanding the types of diseases and including more diseases of occupational groups in occupational activities into the classification and catalogue of occupational diseases. Wang Jiandong said that since 2020, the National Health Commission has organized relevant units to carry out relevant preliminary research on the adjustment to understand the progress of the formulation of the directory of foreign and international labor organizations, and through visits to employers, occupational disease diagnosis institutions and relevant departments and experts such as the Ministry of Human Resources and Social Security, to listen to the opinions of all parties on the adjustment of the catalog, on this basis, the organization of professional institutions to study and compile the diagnostic criteria for the proposed new diseases, and the adjustment of the catalog is being accelerated and orderly in accordance with the procedures.

"The new occupational diseases should be commensurate with the level of economic and social development of our country, focus on key occupational groups, and make up for the shortcomings of the current catalog. Wang Jiandong stressed that the formulation or adjustment of the classification and catalogue of occupational diseases is for prevention. For the diseases included in the catalogue, the employer shall implement the corresponding responsibility for the prevention and control of occupational disease hazards in accordance with the law, do a good job in the occupational health management of workers, and avoid or reduce the suffering of occupational diseases to the greatest extent. For work-related diseases that are not included in the classification and catalogue of occupational diseases, the focus is to encourage employers to carry out regular health examinations for workers, improve the working environment and conditions, carry out health guidance and health management for workers, do a good job in popularizing the knowledge of work-related disease prevention, improve workers' awareness and skills of disease prevention, and achieve the goal of not getting sick and getting sick less.

Judging by the number of reported cases

Pneumoconiosis is the number one occupational disease

The difficulty in diagnosing occupational diseases that everyone talks about is not actually the difficulty of diagnosis, but the difficulty of confirming labor relations and obtaining diagnostic evidence

Pneumoconiosis is the number one occupational disease in mainland China, why is it difficult for many patients with pneumoconiosis to be diagnosed with occupational pneumoconiosis?

Wang Jiandong replied that pneumoconiosis has been the largest and most reported occupational disease in mainland China for many years, accounting for about 90% of all reported occupational diseases. In terms of the number of workers exposed to occupational disease hazards, noise hazards are now the first occupational disease hazard factor, and dust hazards are the second, but pneumoconiosis is still the largest occupational disease in terms of the number of reported occupational disease cases. According to the provisions of the current Law on the Prevention and Treatment of Occupational Diseases, the diagnosis of occupational diseases is an attributive diagnosis, that is, on the basis of clinical diagnosis, the occupational history of the worker, the history of exposure to occupational disease hazards, the test results of occupational disease hazards in the workplace, and the results of clinical examination.

In response to these problems, the Standing Committee of the National People's Congress revised the Law on the Prevention and Treatment of Occupational Diseases three times in 2011, 2017 and 2018, all of which involve the improvement of the diagnosis and appraisal system of occupational diseases, and strive to facilitate the diagnosis and appraisal of occupational diseases by workers. At the same time, in 2021, the National Health Commission made a comprehensive revision of the Administrative Measures for the Diagnosis and Appraisal of Occupational Diseases in accordance with the law, requiring the employer to bear the main responsibility for providing the materials required for the diagnosis of occupational diseases by the employee. The civil affairs department applies for medical assistance and livelihood assistance.

In response to the problem of assistance for patients with pneumoconiosis who cannot be clearly identified, in recent years, the state has actively carried out monitoring to prevent the return to poverty due to illness, and included pneumoconiosis in 30 special treatment categories for monitoring serious diseases, so as to maintain the continuity and stability of relevant treatment policies. According to the Health China WeChat public account