What Is Occupational Medicine?

The tasks of occupational medicine are: to prevent workers from causing various harmful diseases caused by their working environment; to protect workers from various hazards caused by unhealthy factors during employment; to place the occupational population in a place Able to adapt to their physiology and

Occupational medicine

Occupational medicine is both a branch of clinical medicine and preventive medicine. It is often collectively referred to as occupational health. In a narrow sense, occupational medicine focuses on individuals and occupational health focuses on people. The scope of work is divided and unified into one goal, that is, to have common preventive medicine concepts, knowledge and skills to achieve the perfect state of promoting and protecting the professional, physical, mental and social adaptation.

Occupational Medicine Occupational Medical Tasks

Doctors Psychological characteristics of the professional environment; even if work can adapt to people, everyone must be able to adapt to their work.

Occupational medical research content

Occupational medicine is part of every specialty in medicine. Occupational diseases caused by biological factors are based on microbiology and parasitology. Diseases caused by physical and chemical factors should be based on toxicology. In the clinical disciplines, the Occupational Diseases Department currently focuses on pneumoconiosis and occupational poisoning. Others such as industrial trauma, dermatitis, noise-induced deafness, and other work-related diseases should still be listed in internal, external, skin, otolaryngology and other departments. Working range. Therefore, occupational medicine should be paid attention to in all medical disciplines.

Founder of Occupational Medicine

Founder of Occupational Medicine in China-Wu Zhizhong

Introduction to Occupational Medicine

Wu Zhizhong, formerly known as Wu Shaotang, was born on March 14, 1906 in a Manchu family in Xinmin County, Fengtian Province (now Liaoning Province). Medical educator and founder of occupational medicine in China. In his early years, he devoted himself to the education of internal medicine. In 1956, he was 50 years old, and he was ordered to establish China's first labor health and occupational disease research institute. He has long been engaged in clinical research on occupational diseases, and has made important contributions to the prevention and control of common occupational diseases such as pneumoconiosis and lead poisoning, as well as the establishment of a national occupational disease prevention network. His most outstanding academic achievement is the pioneering of Chinese occupational medicine. He has edited a 1.3 million-character book "Occupational Diseases".

Occupational Medicine

In 1924, after graduating from Xinmin County Normal School, he was admitted to Fengtian Medical College. In the summer of 1931, Wu Zhizhong graduated from the medical college and spent one year as a clinical postgraduate and assistant resident in the internal medicine of Peking Union Medical College Medical College. 1933

Wu Zhizhong Xia, he returned to work at Shengjingshi Hospital. At the end of the year, he went to the Northern University of Glasgow University School of Medicine to study internal medicine. The following year, he was awarded the honorary title of Glasgow Branch of the Royal College of Physicians after the qualification examination, and then transferred to the University of London's Gai's Hospital . He returned to China in early 1935 and returned to Shengjingshi Hospital to work as a lecturer in Shengjing Medical College. In the spring of 1936, he was arrested and imprisoned for five days by the Japanese and the puppet. He was sentenced to impunity, and after being released from prison on bail, he was admitted to Peking Union Medical College Medical School to teach. In June 1937, he was applied to Changsha Xiangya Medical College (formerly Hunan Medical University) as a lecturer in internal medicine. His teaching content is detailed, logical, rigorous, widely cited, practical, and loved by students. One year later, Associate Professor Li Sheng was hired as a professor of internal medicine another year. In 1941, he was appointed Dean of Medical School and Chief Professor of Internal Medicine. He was in charge of teaching practice at the age of 35. In 1947, Wu Zhizhong was funded by the American Medical Aid Society to visit the United States for new developments in internal medicine. Shortly after the founding of the People's Republic of China, following the dispatch of the Ministry of Health, Wu Zhizhong went to Shenyang China Medical University as Dean and Head of the Department of Internal Medicine. It took him 6 years to transform the China Medical University from a short-term training center to one of the nation's many medical education bases. He trained a large number of talents, wrote a large number of Chinese textbooks, and cooperated with the Anti-American and Aid Korea movements to do a good job in medical treatment of the wounded, and participated in the fight against bacterial warfare, with outstanding achievements. He obtained health at the 2nd National Health Conference in 1952. Medals and awards issued by the Ministry.

In 1956, the Ministry of Health set up a national research institute for the prevention and treatment of occupational diseases, and transferred Wu Zhizhong to take charge of professional business construction. He was 50 years old. He first went to the Soviet Union to study and study. After returning to Beijing, he served as the deputy director of the Institute of Labor Health of the Chinese Academy of Medical Sciences (renamed the Institute of Health in 1966) and began a new business job. For more than 20 years, he has traveled north and south of the motherland, deepened into mines and factories, and directly served the health of frontline workers. He did not stop working even during the Cultural Revolution and when he was critically ill in his later years. Wu Zhizhong worked hard to promote the international exchange of Chinese and foreign medicine. In 1955, he represented China in India to participate in the International Conference on Internal Medicine; in 1957, he represented the Ministry of Health at the International Industrial Hygiene Conference held in Helsinki, Finland, and participated in the negotiations on scientific and technological cooperation between the Chinese scientific delegation and the former Soviet Union in Moscow; 1958 From September to October, a delegation from the Ministry of Health visited Poland, Democratic Germany, Czech Republic,

Occupational medicine pneumoconiosis Romania and Bulgaria, inspecting the health work of socialist countries in Eastern Europe; October-November 1958, as a member of the expert group of the Chinese Ministry of Health, participated in the first meeting of health ministers of socialist countries held in Prague; in 1964, he went to China Jakarta participated in the Far East Conference on Labor and Hygiene; in the same year, he participated in the organization and academic exchange of the Beijing International Scientific Symposium as the team leader of the Chinese Medical Delegation in Beijing; in December 1965, he was sent to Albania to give a lecture.

Personal Contributions to Occupational Medicine

For the prosperity of the motherland's construction and medical and health services, Wu Zhizhong actively participated in social activities. He has successively served as the representative of the People's Congress of Liaoning Province, the representative of the Second and Third National People's Congresses, a member of the Fifth National Committee of the Chinese People's Political Consultative Conference, a member of the Central Committee of the China Democratic League, a member of the Chinese Medical Association, and a "Chinese Journal of Health" ) Deputy editor-in-chief, editor-in-chief, chairman of the Chinese Academy of Medical Career and Occupational Diseases Society. It has made important contributions to China's medical education and medical development, especially the development of occupational disease prevention.

Occupational medical causes

The human environment is made up of natural factors: air, water, food, climate, and space for human activities. The social and spiritual environment in which people live has a great impact on their physical and mental health.

Mold Most human diseases are caused by or affected by environmental hazards. In order to protect human health, we must first clarify how these factors affect health, collectively referred to as environmental medicine, while occupational medicine only studies environmental factors in the workplace. Specially known as the impact of occupational factors on the health of the professional population.

Environmental factors that can affect health in occupational medicine

envirnmental factor	Include content
biological	Virus, bacteria, parasite
physical	Workload, noise, vibration, weather, air pressure, radiation (radiation or non-ionization), ergonomics
chemical	Chemicals, dust, drugs, tobacco, skin irritants, food additives
Psychological	Stress, shifts, night shifts, relationships
Accidents and injuries	Harmful situations, speeding, alcohol effects, drugs

Disease is caused by environmental and genetic factors, the latter including natural degradation caused by aging. The influence of genetic factors on the occupational population must be prevented by eugenics, and it is difficult to block it the day after tomorrow. The degree of harm to people from environmental hazards is also determined by individual characteristics. This can explain that in the same professional environment, each person is affected differently. These individual characteristics include gender, age, personality, health status, nutrition, and disease. However, the working population is mostly young and middle-aged, and they are relatively healthy. At least they are healthy at the beginning of work, that is, the overall morbidity and mortality in the working population will be lower than the overall population. The "worker effect" should not be ignored in occupational medicine.

Occupational medical environmental factors

1. Physical factors produce biophysical effects on the human body; it can also cause histopathological changes, such as decompression sickness, due to mechanical compression and air embolism in blood vessels.

2. Chemical factors Raw materials, intermediate products, finished products, and waste water and waste residues in the production process, which are toxic to humans in a small amount, are called poisons. The poison is dispersed in the air of the workshop in the form of dust, smoke, mist, vapor or gas, and mainly enters the body through the respiratory tract and skin. The degree of harm is related to the volatility, solubility and particle size of solids.

After the poison contaminates the skin, according to its physical and chemical properties and toxicity, some of them have corrosion or irritation, and some have allergic reactions. Although some fat-soluble poisons have no obvious damage to the local skin, they can be absorbed through the skin and cause systemic poisoning.

It is relatively rare to produce poisons that enter the human body through the digestive tract, often caused by poisoning food or smoking.

Toxic substances in the exhaust gas, waste water and waste residue discharged from the workshop, although they do not directly cause workers to suffer from occupational diseases, can harm the residents' health, affect the ecology, and cause great harm.

3. Biological factors Pathogenic microorganisms or parasites present in production materials and operating environments, such as Bacillus anthracis, fungal spores (exogenous allergic alveolitis caused by inhalation of mold dust), forest encephalitis virus, etc.

Socioeconomic factors of occupational medicine

The gross national product (GNP), wealth distribution, cultural and educational level, ecological environment and labor legislation, and medical and health systems can all affect the health of the working population. For example, the level of production management is low, the equipment is rudimentary, more physical work is needed, or the production layout is irrational, which results in ineffective labor or damage to skeletal muscle.

Occupational medical lifestyle

Occupation-related lifestyles include changes in the pace of work, excessive work stress, shift and night shift work, lack of physical exercise, smoking or uncontrolled drinking. Life style is often related to one's own mental state. For example, if individuals ignore the concepts of health and prevention, they ignore safety norms and self-care.

Quality of Occupational Medical Health Services

The professional ability of medical personnel is of paramount importance. Strengthening medical ethics should be an important concept in health services. To this end, the International Occupational Health Association (ICOH) established medical ethics guidelines for occupational medicine in 1992 for members to follow. The most important of the above occupational factors is environmental factors. In a certain environment, there may be several different harmful factors, which play a comprehensive role on people and increase the degree of harm. In addition, the same disease can be caused by harmful factors of different nature, such as rice field dermatitis can be caused by physical, chemical and mechanical stimuli. Exposure to environmental factors that are detrimental to the health of the respiratory tract, such as dust, harmful gases or vapors, and smoking, can aggravate respiratory tract damage.

Preventing mistakes at work and causing occupational damage to health, including work injuries, occupational diseases (including occupational poisoning), and work-related diseases.

Injuries at work are accidents at work, often in the emergency department. But its prevention should be the common task of occupational medicine and labor protection departments, because its occurrence is often related to the imperfections in the organization and protection of labor organizations, machinery, and personal psychological state, lifestyle and other factors.

Occupational medical conditions

The importance of occupational diseases is second only to work injuries. Occupational diseases do not necessarily occur when the human body is exposed to direct or indirect harmful factors in the environment. The onset of occupational diseases also depends on the following three main conditions:

The nature of occupational medicine harmful factors

The physical and chemical properties and the location of harmful factors are closely related to the occurrence of occupational diseases. For example, the penetration depth and harmfulness of electromagnetic radiation mainly depends on its wavelength. The physical and chemical properties of the toxicant are directly related to the affinity and toxic effects of the tissue. For example, gasoline and carbon disulfide have a significant fat-solubility and have a close affinity for neural tissues. Therefore, the nervous system is poisoned first. But sometimes psychological factors can also be the cause of the disease, which cannot be ignored in occupational medicine.

The amount of occupational medicine acting on the human body

Except that the amount of biological factors entering the human body cannot be estimated, physical and chemical factors are harmful to humans. Therefore, when most occupational diseases are diagnosed, the amount (concentration or intensity) must be estimated. First of all, we must know the boundary between the harmful amount and harmless amount of a harmful factor to the human body. The "maximum allowable concentration of harmful gases, vapors and dusts in the workshop air" announced by China refers to the limit of the amount of these chemical substances that generally do not cause disease in the air. At present, the maximum allowable concentration of some chemicals is still under study. Some harmful substances can accumulate in the body, so small amounts and long-term absorption will eventually cause disease. Although some substances cannot be accumulated in the body, the functional changes caused by them can be accumulated. For example, most physical harmful factors can cause adverse effects after prolonged exposure.

When the amount of exposure cannot be estimated, the contact time can be used to roughly estimate the intensity of the effect. Due to the same amount in the environment, long-term and short-term exposures have different consequences. It is of great significance to inquire carefully about the working age and the contact method of a certain factor.

Health status of occupational medical people

The human body's ability to defend against harmful factors is multifaceted. When the effects of physical factors cease, disturbed physiological functions can be gradually restored. The human body eliminates the toxic effects of incoming poisons through detoxification and detoxification processes. Organic poisons can be converted by enzymes in the body, and after being hydrolyzed, oxidized, reduced, and combined, they are mostly excreted as low-toxic or non-toxic. Others undergo transformation to increase their toxicity, and then continue to detoxify and excrete, mainly in the liver. If liver function is impaired, this detoxification process is hindered. Those with renal insufficiency will inevitably affect the excretion of poisons. Therefore, when workers with certain diseases are affected by harmful factors in production, not only can the original diseases be exacerbated, but occupational diseases may also occur. The purpose of pre-employment and regular physical examinations of workers is to find employment contraindications to harmful factors in production in order to more appropriately place their jobs and protect workers' health.

Occupational clinical manifestations

Occupational Medicine Features

From the three main conditions that constitute occupational diseases, these diseases have the following five characteristics:

1. Occupational diseases have specific causes, and controlling the cause can prevent or reduce the incidence.

2. The working conditions include contact time and contact amount. The contact time is related to the production process, production equipment, and labor system. No occupational hazard exists, that is, it causes disease. In particular, exposure to chemical and physical factors is the key to the onset of the disease, and it is often difficult to use absolute numbers for exposure.

"Occupational Diseases Directory" Words can be measured by exposure time or exposure level. Therefore, it is extremely important to determine the dose-response (response) relationship for measuring the presence of occupational diseases in a population. 3. The incidence of an occupational disease is different in different groups, so it is more important for the work of the group.

4. The earlier the disease is found, the easier it is to recover; the later, the worse the treatment effect.

5. For most occupational diseases, there is currently no specific treatment, so in addition to symptomatic treatment of individuals, the focus should be on protecting the health of the population.

From the above characteristics, it can be said that occupational disease is a man-made disease, and its occurrence and prevalence reflect the level of national medical and health work. Therefore, in addition to the medical meaning of occupational diseases, countries in the world also have a certain legislative significance, that is, "statutory occupational diseases" prescribed by the government. The Ministry of Health, Labor and Personnel, Ministry of Finance, and All-China Federation of Trade Unions in November 1987 (87 Weifangzi No. 60) issued the "Provisions on the Scope of Occupational Diseases and Measures for the Treatment of Patients with Occupational Diseases", which divided the list of occupational diseases into 108 categories in 9 categories, including 51 occupational poisonings; 12 pneumoconiosis; occupational diseases with physical factors 6 kinds; 3 kinds of occupational infectious diseases; 7 kinds of occupational skin diseases; 7 kinds of occupational eye diseases; 2 kinds of occupational ENT diseases; 8 kinds of occupational tumors; 7 7 kinds of other occupational diseases. These include accidents such as chemical burns. In order to diagnose correctly, some occupational diseases have been formulated and published in the national "Occupational Disease Diagnosis Standards".

Occupational Medicine Prevention Policy

In order to grasp the incidence of occupational diseases in time to take preventive measures, the Ministry of Health also issued the "Measures for the Management of Occupational Diseases" (88 Weifangzi No. 16) and the Reporting Methods for Occupational Diseases (88 Weifangzi No. 70). The main requirements are: Acute occupational poisoning and acute occupational diseases should be reported within 24 hours after diagnosis. The health and epidemic prevention departments should investigate with the relevant units and submit reports to urge factories and mines to prevent occupational diseases and prevent recurrence of poisoning; Chronic Occupational poisoning and chronic occupational diseases will be investigated with relevant departments within 15 days, reports will be submitted and registered in order to grasp and study the dynamics of occupational poisoning and occupational diseases in a timely manner, and formulate preventive measures.

Occupational disease clinical manifestations

Occupational Medicine Classification

Occupational diseases are generally divided into acute and chronic. Acute occupational disease usually refers to the onset of exposure to harmful factors in production within one or one working day. For example, a single inhalation of high concentration of hydrogen sulfide immediately caused coma; spraying with organophosphorus pesticides caused poisoning within hours after absorption through the skin; inhalation of phosgene, nitrogen oxides, dimethyl sulfate, or organic fluoride cracking gas took only a few hours Acute pulmonary edema occurred; after inhalation of high concentrations of methyl bromide, triethyltin, and tetraethyl lead, although the symptoms were not obvious that day, and acute cerebral edema symptoms appeared after 1 to 2 days, all belonged to the category of acute poisoning.

Chronic occupational diseases are caused by long-term exposure to harmful factors. It often takes several months to contact, even after several years, symptoms gradually appear. For example, regular exposure to benzene vapor or radioactive substances exceeding the maximum allowable concentration can cause leukopenia or inhibit bone marrow hematopoietic function. Silicosis often occurs in high-concentration silica dust environments. After working for several years to more than ten years, he developed symptoms.

Tumors caused by occupational factors generally require decades of contact time. For example, -naphthylamine and benzidine cause bladder tumors for about 16 years.

Occupational disease is a systemic disease, and its clinical manifestations can be determined according to the nature of the causative factor, the location of the contact, and the fate into the body. Occupational diseases caused by biological factors are subject to the incidence of infectious and parasitic diseases. According to the physical, chemical and biochemical properties of chemicals entering the human body, most of them are the most severe damage to an organ, called "target organs". A few harmful substances have no specific target organs but have systemic affinity. Occupational diseases caused by physical factors, some of which are obvious at the contact site, such as conjunctival keratitis (electrooptic ophthalmitis), dermatitis caused by ultraviolet rays; some are systemic, such as adverse weather conditions; most of the contact sites and systemic reactions Both, such as damage to the hearing organs caused by noise, can also cause systemic effects on the cardiovascular system. Therefore, occupational diseases are scattered in various clinical departments and have different performances according to the main damaged system.

Occupational medical work related illness

Broadly speaking, occupational diseases are also work-related diseases. However, the so-called work-related illnesses in the past have been called occupational morbidity, which is different from occupational diseases. Occupational disease refers to a disease caused by a specific occupational hazard, and work

Occupational disease comics Relevant diseases refer to multi-factor diseases, which are related to work, and are also found in the non-professional population. Therefore, not every case and case must have a history of occupation or exposure. When this type of disease occurs in workers, occupational exposure will exacerbate, accelerate or relapse the original disease, or significantly reduce the patient's labor force. The scope of work-related diseases is actually wider than occupational diseases. Therefore, this kind of disease should be listed as an important part of protecting and promoting workers' health in primary health institutions.

Examples of common work-related illnesses are:

(1) Behavioral (mental) and physical and mental illnesses such as mental anxiety, depression, neurasthenia syndrome, often due to heavy work, night work, eating disorders, excessive drinking, smoking and other factors. Sometimes the fear of a certain occupational hazard causes psychological stress and organ dysfunction.

(2) Chronic non-specific respiratory diseases include chronic bronchitis, emphysema, and bronchial asthma, which are multifactorial diseases. Smoking, air pollution, and repeated respiratory infections are often the main causes. Patients can develop severe chronic non-specific respiratory diseases even if the air pollutants are below the maximum allowable concentration.

(3) Other diseases such as hypertension, peptic ulcer, and back pain are often related to certain tasks, such as the relationship between carbon disulfide exposure and arteriosclerosis.

Occupational medical diagnostic instructions

The diagnosis of occupational diseases is related to whether workers can enjoy the state's labor insurance treatment. Therefore, it is not only a medical problem, but also involves the correct implementation of national labor protection policies. Generally speaking, the correct diagnosis depends on the following three conditions:

Occupational Medicine Occupational History

Includes information such as type of job, opportunity and degree of exposure to occupational hazards (the simplest is professional service life), and environmental conditions. In order to understand the cause in depth, in addition to verbal inquiries, sometimes it is necessary to go directly to the scene to observe in order to make a correct judgment. The qualitative data of contact history is not enough. It should also be quantitative, that is, environmental monitoring data or records of working age.

Occupational medical examination

It is similar to the general clinical method. However, for diseases caused by a certain occupational factor, if the occupational history is relatively clear, certain items can be selected for examination according to the characteristics of the disease.

Occupational medical laboratory examination

There are some occupational diseases, clinical manifestations are not obvious, and often rely on laboratory inspections, mainly the following: Determining harmful substances in biological materials to detect the amount absorbed by the body, such as urine, hair, nails and other heavy metals; In the body, after metabolism

Occupational disease The amount of excreted metabolites, such as benzene, can be measured separately in urine urine phenol, hippuric acid or methyl hippuric acid; determine the body's biochemical or cell morphological changes after occupational hazards, such as contact Check the blood routine, check the bone marrow picture if necessary. Based on the data obtained in the above three aspects, a comprehensive analysis was performed to arrive at a diagnosis conclusion. For chronic occupational diseases, long-term dynamic follow-up is often required to make a final judgment. For some clinical manifestations whose cause is not determined, it is important to exclude diseases other than occupational factors, which is an important method in the diagnosis of occupational diseases. At this time, in addition to comprehensive analysis using the above three data, occupational epidemiological methods can also be used for identification.

Occupational medical treatment instructions

According to the four-level prevention principle, occupational injuries are different from diseases of unknown etiology or onset. For prevention benefits, excellent health services include:

1.Environmental monitoring and health surveillance. The former is to identify potential occupational hazards in the environment, their intensity (amount of exposure), and opportunities for exposure, and should be announced to employees.

Occupational Disease Research Occupational Disease Research

Provide the basis for entering the production environment; health monitoring focuses on early detection of the health status of workers in a specific production environment, and through pre-employment and regular health inspections, workers should be informed of the illness and deal with it as soon as possible to prevent contact in time. Those whose work ability has been damaged shall be assessed for work ability and shall be dealt with in accordance with the provisions of the Labor Insurance Regulations.

2. Occupational epidemiology The diseases caused by occupational factors are relatively easy to identify and diagnose clinically. However, some diseases such as occupational tumors and other work-related diseases; or long-term exposure to trace occupational hazards, the causal relationship between the disease and environmental factors is difficult to confirm, and occupational epidemiological methods need to be used to "diagnose" the contact population.

3. Provide scientific basis for the formulation of relevant policies and laws. In addition to the work necessary for direct service in the above two aspects, the accumulated information can also be used as a scientific basis for the formulation of relevant laws and regulations. Health standards and diagnostic standards for occupational diseases are the most important parts of the occupational health decree. The health department needs to negotiate and implement them with relevant government departments such as labor departments, industrial departments, and trade unions.

arsenic 4. Health Supervision In order to implement health policies and laws, the Ministry of Health has a Department of Health Supervision and a local health supervision department. In the aspects of planning, design, construction, and acceptance of the enterprise, implement the three simultaneous measures to implement preventive health supervision. After the enterprise is put into production, it is necessary to implement regular sanitary supervision.

5. Personnel training and health education rotation training of occupational health and labor protection business and management personnel. The protection knowledge will be used to directly involve producers in understanding the pathogenic links in which occupational hazards harm health, implement self-care, and implement mass supervision of enterprise managers.

The above five aspects of work require three aspects of strength, including the strength of administrative leadership, that is, leaders at all levels should be responsible for the health of the people, and do a good job of occupational health; followed by the strength of medical personnel, in medical and health work, According to the World Health Organization's 1994 "Occupational Health for All" recommendation, occupational health should be included as part of primary health care; the third force is self-care for workers.

In health management, medical and health personnel include health and epidemic prevention stations, occupational disease prevention and control institutions, enterprise staff hospitals and health stations, township and street health units, and personnel in charge of occupational health in hospitals. They actively participate in engineering, labor protection science, and other aspects. The close collaboration of personnel provides scientific basis for relevant legislation, and strives to do first-level prevention, and early detection of problems and timely control measures to enable workers to work in a safe and healthy environment. If prevention is neglected, treating patients with occupational diseases alone will inevitably make them more cured. Only by treating the unsanitary environment at the same time can we break the vicious circle and effectively control the diseases caused by occupational hazards.

Occupational Medicine Prevention Instructions

Occupational injury is a type of man-made disease, and the health of exposed people should be protected in accordance with the four-level preventive measures.

Primitive prevention Primitive prevention aims to prevent certain diseases by using legislative means, economic policies, changing lifestyle habits, and avoiding social, economic, and cultural factors that are known to increase the risk of disease. If smoking is known to cause a variety of chronic diseases and exacerbate occupational diseases (pneumoconiosis), change national economic policies, ban adolescents from smoking, and establish prevention strategies such as smoke-free schools and factories. For the prevention of occupational injuries, promulgate labor laws and formulate regulations on occupational disease prevention (such as passed by Shanghai Municipal People's Congress Standing Committee in January 1996).

Occupational Medicine Primary Prevention

Also known as cause prevention, is to fundamentally eliminate the effects of hazards on people, that is, to improve production processes and equipment, to rationally apply protective facilities and personal protective equipment to reduce the opportunity and degree of worker exposure. Regarding chemical and physical factors, the design hygienic standards for industrial enterprises formulated by the state (published separately after 1979, 1983-1989, and after 1989) should be used as a common adherence to the exposure limit or "line of defense" and guidelines for preventive measures. Prevention often plays an effective role. Individuals at high risk in the crowd can be inspected on the basis of occupational contraindications, and those who have the occupational contraindications are not allowed to participate in the work.

Occupational medicine secondary prevention

Also known as disease prevention, is the early detection of diseases caused by occupational hazards in the human body. Although the first-level preventive measures are the ideal method, they require a large amount of cost to achieve, sometimes they are not ideal, and they can still cause disease. Therefore, the second-level preventive measures have become necessary measures. The main method is to regularly monitor occupational hazards in the environment and regular physical examination of contacts to detect diseases early and prevent them in a timely manner. In addition, there are inspections before returning to work after long-term sick leave or trauma, and inspections before retirement. The interval of regular physical examination can be determined according to the following principles: the natural evolution of the disease, the speed and severity of the disease; the degree of occupational hazards in contact; the susceptibility to contact with the population. Physical examination items can be evaluated using special biological testing methods. Examination of pulmonary ventilation function or X-ray lung imaging is often used as an indicator of functional and pathological changes to dust-exposed workers; other such as electrocardiogram, electroencephalogram, and nerve conduction speed and hearing tests can be used as early stages Specific check method.

Occupational Medicine Tertiary Prevention

After getting sick, recover reasonably. The principles are as follows: Contacts who have been damaged should be removed from their original jobs and treated reasonably; Promote the reform of the production environment and working conditions based on the reasons for the damage to the contacts; Promote the rehabilitation and prevention of patients complication. Except for a very small number of occupational poisonings, which have special detoxification treatment, most occupational diseases are based on damaged target organs or systems, and the principle of medical treatment is used to provide symptomatic comprehensive treatment. In particular, there is no reliable way to reverse the lesions of pulmonary fibrosis caused by dust exposure. Therefore, the countermeasures also lie in the comprehensive implementation of four-level preventive measures to achieve early detection, timely prevention, early treatment, and reasonable remediation. Discourage smoking when exposed to dust.

Both primary and primary prevention target the entire or selected population, the latter of which is more important for healthy individuals. Although these two levels can play the most important role in the health and happiness of the population, the second and third levels are for patients, and timely remedies are still important, so the four levels need to complement each other. ^[1]