After pneumoconiosis, what is the new "death of the profession"?

"We should be aware that all occupations are hazardous," Professor Zhang Min told students during an occupational health elective class at Peking Union Medical College. Walking into the scene of this class, you will find that most of the "students" in the audience are from different departments of the Cancer Hospital of the Chinese Academy of Medical Sciences and Peking Union Medical College Hospital......

"Occupational health" is a rare professional intersection among many departments. At different intersections, there is pneumoconiosis, which has long topped the list of occupational diseases in mainland China, and there is also contact dermatitis, which points to occupational skin diseases...... And these seemingly difficult to intersect diseases are being connected through the similar occupational environment in which patients live.

Home improvement industry, jewelry polishing, denture processing...... Multiple industries face a "dust threat"

This year, from April 25 to May 1, is the 22nd National Occupational Disease Prevention and Control Law Publicity Week.

Back in 2001, the mainland's first occupational disease prevention and control law was officially passed. Since then, there has been a legal interpretation of occupational diseases: they refer to diseases caused by exposure to dust, radioactive substances and other toxic and harmful substances in the occupational activities of workers in enterprises, institutions and individual economic organizations.

At that time, the secondary industry was growing at a rapid rate of 8.7% in the annual GDP. On the other hand, pneumoconiosis began to appear among migrant workers.

"By the end of 2021, a total of 915,000 cases of occupational pneumoconiosis had been reported in mainland China. Nearly half of occupational pneumoconiosis is coal workers' pneumoconiosis, and these cases mainly occur in the coal, building materials, non-ferrous metals and metallurgical industries. Lei Jie, a deputy to the National People's Congress, chief expert of the Shandong Provincial Center for Disease Control and Prevention, and a member of the Peasants and Workers Party, said that due to the huge demand for coal production in the mainland and the large number of dust collectors in coal mines across the country, today, pneumoconiosis is still a "high-incidence occupational disease" that is "visible" in the mainland.

Lei Jie participated in the drafting of the "Healthy China 2030" planning outline, and during his research, he found that the "high incidence" of pneumoconiosis is closely related to the emergence of new business formats in the industry.

Since the home improvement industry is not a well-known "dust environment", Lei Jie clearly remembers that a young man who has only been engaged in the home improvement industry for one or two years inhaled a lot of dust without knowing it, and when the lesion was found, his life was less than 5 years.

This also suggests that "it is time to focus on the possibility of pneumoconiosis in new industries or processes such as artificial stone processing, denture processing, jewelry polishing and hydraulic fracturing shale gas extraction", mentioned Lei Jie.

The International Labour Organization, the All-China Federation of Trade Unions, and Peking Union Medical College have cooperated to formulate the "Key Points for the Prevention and Control of Dust Hazards in the Workplace".

The guide's editor-in-chief, Min Zhang, is deputy director of the Department of Environment and Occupational Health at the School of Medicine and Public Health, Peking Union Medical College, and deputy director and deputy secretary-general of the Central Committee for Rural Revitalization and Development of the Peasants' and Workers' Party. According to her, if you want to identify, prevent and control the occupational hazards of dust, you can judge by checking the content, concentration, dispersion, and pathogenicity of free silica and asbestos in the workplace.

What are the new "causative" factors?

Like pneumoconiosis, many occupational diseases have a long incubation period, such as asbestos mesothelioma, which can cause musculoskeletal diseases caused by prolonged standing, sedentary and excessive flexion and extension of the body...... As Zhang Min said, all occupations have hazards, and it is not only dust that makes the workplace light up with a "red light".

Nowadays, there is overtime in some industries, and "the mental stress and sleep quality of employees are also occupational hazards that need to be paid attention to," Zhang Min said. "In the future, new occupational disease causative factors may come from completely new physical, chemical or biological agents," says Ray Ger, adding that the large increase in the number of low-dose pollutants will make the work environment more complex than before, and the relationship between disease and work environment will be more difficult to determine.

When practitioners are exposed to biological, chemical, physical and other factors for a long time, these occupational risk factors that may induce cancer and genetic changes are more likely to be overlooked, "and at the same time, the long onset of such diseases makes it difficult to determine the causal relationship between the disease and the occupation, and it is also more difficult to obtain workers' compensation," Lei Jie added.

For a long time, "air quality" has been an important part of the evaluation system of occupational health monitoring. "In the future, we can also consider using 'biomonitoring' to check the actual level of workers' exposure to hazards," Zhang suggested. In this way, the total exposure of the body to hazards can be identified, evaluated and controlled, and the detection results are more comprehensive. ”

Regular occupational health check-ups are important

Zhang Min believes that making medical staff pay attention to occupational hazards is an important step in building an occupational health and safety system, "At present, clinically, medical staff rarely consider that the patient's condition is related to occupational factors."

Front-line medical staff should be aware of the importance of occupational health, and the public should also realize that regular occupational health check-ups are an important way to detect and identify occupational diseases.

"In coal mines, non-ferrous metals, machinery, textiles, building materials, home decoration and other industries, there are dust, noise, chemical and other occupational hazards, workers in these industries should pay more attention to establishing occupational health awareness," Lei Jie said.

Occupational diseases have always been referred to as "work-related injuries that do not bleed", and practitioners generally encounter difficulties such as "difficulty in self-discovery of the disease and difficulty in judging the relationship between the disease and the occupational environment". If an employee wants to specifically identify the hazards of occupational diseases, according to the Law on the Prevention and Treatment of Occupational Diseases, the employee may request to protect the individual's right to know through the labor contract, the employer's bulletin board and the occupational disease hazard warning signs.

When the occupational hazards are identified, workers also need to undergo regular occupational health examinations to detect changes in the symptoms and signs of occupational diseases at an early stage, and prevent the occurrence and further deterioration of occupational diseases through early screening and early prevention. "The first occupational health check-up requires a comprehensive examination, and the follow-up check-up only needs to track the specific indicators in the first physical examination, so that the incidence of occupational diseases can be greatly reduced," says Zhang.

Lei Jie said: "In terms of the occupational disease prevention and control system, we should consider making policy adjustments to the identification and compensation of occupational diseases, so as to truly provide a good 'foundation' for workers' health." ”

(Source: China News Network)