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Occupational heat-related illness (OHI) is a health threat to workers that can be fatal in severe cases. Effective and feasible measures are urgently needed to prevent OHI. We evaluated the effectiveness of a multifaceted intervention, TEMP, in reducing the OHI risk among outdoor workers in the power grid industry. A cluster randomized controlled trial was conducted with power grid outdoor workers in Southern China from 4 July 2022 to 28 August 2022. Work groups were randomly allocated (1:1) to the intervention or control groups. The multifaceted intervention TEMP comprised mobile application (app)-based education training (T), personal protective equipment [PPE (E)], OHI risk monitoring (M), and educational posters (P). Four follow-ups were conducted every 2 wk after the trial began. The primary outcome was the OHI incidence, and the secondary outcome was PPE usage. The app usage was considered as the compliance of intervention in the intervention group. The primary analysis used was intention-to-treat analysis. Multilevel analyses using random effects logistic regression models were performed to compare the odds of OHI between the two groups, adjusted for individual-level (education and work position) and work-related (including water intake when feeling thirsty, cooling measures, and poor sleep before work) covariates. Of 528 participants, 422 (79.92%) were males, and the age was y. The primary outcome, OHI incidence, was 1.80% in the intervention group and 4.82% in the control group at the end of the whole follow-up. OHI mainly occurred between 1100 and 1500 hours, with nausea, significantly increased heart rate, and oliguria being the top three reported OHI symptoms. Compared with the control group, the adjusted odds ratios between the intervention group and control group were 0.73 [95% confidence interval (CI): 0.30, 1.76] in the first follow-up wave, with 0.38 (95% CI: 0.15, 0.97), 0.29 (95% CI: 0.08, 1.05), and 0.39 (95% CI: 0.13, 1.19) in the following three follow-up waves, respectively. The intervention also significantly improved PPE usage in the intervention group. This multifaceted intervention reduced the OHI risk among outdoor workers in the power grid industry. However, further research is needed to design a more flexible intervention strategy and evaluate its effectiveness in a larger population. https://doi.org/10.1289/EHP14172.

Background Occupational noise has long been recognized as a significant risk factor for hearing loss, particularly among workers. This study aimed to assess the disease burden of hearing loss caused by occupational noise in China from 1990 to 2019, with a focus on differences across sex and age groups, so as to address the existing gaps in the Global Burden of Disease Study (GBD) reports. By analyzing changes in years lived with disability (YLDs) among different sex and age groups over the past 30 years, this study provides valuable insights for the development of occupational noise safety measures in China. Methods We extracted data on the burden of hearing loss attributable to occupational noise from the 2019 Global Burden of Disease study. R software (version 4.12) was used to calculate the YLDs, age-standardized rates (ASRs), and average annual percent change (AAPC), stratified by age and sex. The Joinpoint regression model was used to analyze the trends in the burden of disease attributable to occupational noise exposure from 1990 to 2019. Results In China, the YLDs attributable to occupational noise-induced hearing loss in 2019 were 2.3277 million [95% uncertainty interval (UI): 1.5779–3.3478 million, marking a 70.95% increase compared with that in 1990. Throughout the study period, YLD rates exhibited a declining trend, with rates of 127.7 per 100,000 (95% UI: 87.4–181.4) in 1990 and 119.8 per 100,000 (95% UI: 81.2–182.1) in 2019. Using the Joinpoint regression model, the annual percent change (APC) in age-standardized YLD rates for occupational noise-related hearing loss initially increased from 1990 to 2000, followed by a decline, reaching its lowest point in 2015. From a sex perspective, the burden of YLDs in Chinese males exceeded that in females, although the rate of decline was less pronounced in females. With regard to age, the number and rate of YLDs attributable to occupational noise-induced hearing loss generally increased with age, particularly among middle-aged individuals and older adults. However, from 1990 to 2019, the number of YLDs attributable to occupational noise-induced hearing loss decreased among young people aged 15–19 years, accompanied by a significant reduction in YLDs rates. Conclusion Hearing loss attributable to occupational noise represents a substantial public health concern, especially among middle-aged and older adult workers in China. These findings underscore the importance of implementing effective measures to mitigate occupational noise exposure.

ObjectiveMost of the Chinese occupational population are becoming at risk of noise-induced hearing loss (NIHL). However, there is a limited number of literature reviews on occupational NIHL in China. This study aimed to analyse the prevalence and characteristics of occupational NIHL in the Chinese population using data from relevant studies.DesignSystematic review and meta-analysis.MethodsFrom December 2019 to February 2020, we searched the literature through databases, including Web of Science, PubMed, MEDLINE, Scopus, the China National Knowledge Internet, Chinese Sci-Tech Journal Database (weip.com), WanFang Database and China United Library Database, for studies on NIHL in China published in 1993–2019 and analysed the correlation between NIHL and occupational exposure to noise, including exposure to complex noise and coexposure to noise and chemicals.ResultsA total of 71 865 workers aged 33.5±8.7 years were occupationally exposed to 98.6±7.2 dB(A) (A-weighted decibels) noise for a duration of 9.9±8.4 years in the transportation, mining and typical manufacturing industries. The prevalence of occupational NIHL in China was 21.3%, of which 30.2% was related to high-frequency NIHL (HFNIHL), 9.0% to speech-frequency NIHL and 5.8% to noise-induced deafness. Among manufacturing workers, complex noise contributed to greater HFNIHL than Gaussian noise (overall weighted OR (OR)=1.95). Coexposure to noise and chemicals such as organic solvents, welding fumes, carbon monoxide and hydrogen sulfide led to greater HFNIHL than noise exposure alone (overall weighted OR=2.36). Male workers were more likely to experience HFNIHL than female workers (overall weighted OR=2.26). Age, noise level and exposure duration were also risk factors for HFNIHL (overall weighted OR=1.35, 5.63 and 1.75, respectively).ConclusionsThe high prevalence of occupational NIHL in China was related to the wide distribution of noise in different industries as well as high-level and long-term noise exposure. The prevalence was further aggravated by exposure to complex noise or coexposure to noise and specific chemicals. Additional efforts are needed to reduce occupational noise exposure in China.

This study aimed to understand the health of workers exposed to occupational noise and explore the influencing factors related to workers' health, especially the impact of noise on workers' hearing. This work can provide a basis for formulating relevant measures for occupational noise prevention and control in the future. On the basis of the key occupational disease monitoring project in Chongqing, China, in 2021, the data of 1125 workers exposed to occupational noise were analyzed. Data included demographic information, occupational history, clinical physical examination information, and noise detection information of the working environment. Chi-square test and multifactorial logistic regression were used for statistical analysis. The prevalence rates of abnormal electrocardiogram (ECG), blood pressure (BP), and pure tone audiometry (PTA) were 21.9% (246/1125), 27.8% (313/1125), and 18.0% (202/1125), respectively. Male workers accounted for 78.8%. Compared with male workers, female workers had a lower prevalence of abnormal PTA (OR = 0.28, 95% CI = 0.16-0.50). Workers working in medium enterprises had a lower prevalence of abnormal BP than workers in micro enterprises (OR = 0.36, 95% CI = 0.19-0.66). The prevalence of abnormal BP and PTA of workers increased with age. After adjusting for age, sex, and body mass index, the prevalence of abnormal ECG of mining workers was higher than that of manufacturing workers (OR = 1.54, 95% CI = 1.07-2.24), and the prevalence of abnormal PTA had a rising trend with the increase in noise exposure value. Noise-exposed workers have a high prevalence of abnormal ECG, BP, and PTA, and factors such as age, enterprise size, and workplace noise exposure are correlated with the aberrant health of workers. Governments, enterprises, and individuals need to attach great importance to the possible adverse effects of noise. They must also actively adopt various effective measures to protect the occupational safety and health of workers.

Objective We aimed to examine the efficacy of medical masks and respirators in protecting against respiratory infections using pooled data from two homogenous randomised control clinical trials (RCTs). Methods The data collected on 3591 subjects in two similar RCTs conducted in Beijing, China, which examined the same infection outcomes, were pooled. Four interventions were compared: (i) continuous N95 respirator use, (ii) targeted N95 respirator use, (iii) medical mask use and (iv) control arm. The outcomes were laboratory‐confirmed viral respiratory infection, influenza A or B, laboratory‐confirmed bacterial colonisation and pathogens grouped by mode of transmission. Results Rates of all outcomes were consistently lower in the continuous N95 and/or targeted N95 arms. In adjusted analysis, rates of laboratory‐confirmed bacterial colonisation (RR 0.33, 95% CI 0.21‐0.51), laboratory‐confirmed viral infections (RR 0.46, 95% CI 0.23‐0.91) and droplet‐transmitted infections (RR 0.26, 95% CI 0.16‐0.42) were significantly lower in the continuous N95 arm. Laboratory‐confirmed influenza was also lowest in the continuous N95 arm (RR 0.34, 95% CI 0.10‐1.11), but the difference was not statistically significant. Rates of laboratory‐confirmed bacterial colonisation (RR 0.54, 95% CI 0.33‐0.87) and droplet‐transmitted infections (RR 0.43, 95% CI 0.25‐0.72) were also lower in the targeted N95 arm, but not in medical mask arm. Conclusion The results suggest that the classification of infections into droplet versus airborne transmission is an oversimplification. Most guidelines recommend masks for infections spread by droplets. N95 respirators, as “airborne precautions,” provide superior protection for droplet‐transmitted infections. To ensure the occupational health and safety of healthcare worker, the superiority of respirators in preventing respiratory infections should be reflected in infection control guidelines.

Objectives This study aimed to investigate the synergistic effects of co-exposure to occupational heat and noise on multi-system health outcomes among Chinese workers, and to examine the mediating role of systemic inflammation, indicated by white blood cell (WBC) count. Methods A cross-sectional analysis was conducted using data from the Fujian Workplace Occupational Hazards Comprehensive Surveillance Program (2020–2022), encompassing 10,275 workers from the manufacturing, petrochemical, mining, and construction industries. Multivariate logistic regression, relative excess risk due to interaction (RERI), random forest with SHAP values, and mediation analysis were used to explore interaction effects and mediating pathways. Results Co-exposure to heat and noise in the workplace was associated with increased risks of hypertension (OR = 1.94, 95%CI:1.61–2.36; RERI = 0.26, P interaction <0.001) and abnormal ECG (OR = 1.81, 95%CI:1.48–2.12; RERI = 0.16, P interaction <0.001), indicating synergistic effects beyond individual exposures. WBC partially mediated the effects of occupational heat and noise exposure on hypertension (heat: 9.2%; noise: 7.4%; co-exposure: 15.3%), liver dysfunction (heat: 5.4%; noise: 13.2%; co-exposure: 11.5%), and abnormal ECG findings (heat: 7.0%; noise: 6.4%; co-exposure: 8.7%). Machine learning models further confirmed that interaction between heat and noise was a stronger predictor of adverse health outcomes than either exposure alone. Conclusion Co-exposure to occupational heat and noise significantly exacerbates health risks across multiple organ systems, with systemic inflammation playing a partial mediating role. These findings highlight the importance of integrated occupational hazard assessments and targeted interventions that consider multiple concurrent occupational hazards.

Objectives To describe the prevalence of self-reported musculoskeletal disorders among workers in the electronics manufacturing industry and to investigate the relations between work-related musculoskeletal disorders (WMSDs) and work-related variables. Methods An interview-based questionnaire survey was carried out in thirty electronics manufacturing factories in China in 2018. The prevalence of WMSDs was estimated using the modified Nordic Musculoskeletal Questionnaire (NMQ). A multivariate logistic regression model was applied to evaluate the effects of risk factors on WMSDs on multiple body parts. Results The 12-month prevalence of WMSDs among participants was 40.6%, and the common body sites affected were the neck (26.8%), shoulder (22.8%), upper back (14.9%), and lower back (14.8%). The results of logistic regression showed that female adults, > 5 job tenure and work-related factors (including awkward posture, lifting or carrying weights, excessive repetition, prolonged sitting, monotonous work and working under conditions of cold or temperature variations) led to a higher risk of WMSDs on most body parts. Upper back, wrist/hand and elbow pain levels were significantly higher for workers with vibration. However, more frequently, physical exercise was a protective factor against WMSDs on most body parts except the upper back, leg and knee. Conclusions The study indicates a high prevalence of musculoskeletal pain among the electronics manufacturing industry in China. Different personal and work factors are related to the occurrence of WMSD on different body parts. Preventive measures should be implemented based on the characteristics of WMSD in the electronic manufacturing industry. Furthermore, the training and intervention guidance of ergonomic hazards in the workplace need to be strengthened by understanding the impact of bad posture, avoiding long-term sitting posture and increasing physical activities.

In order to study the relationship between China's safety production indicators and economic and social indicators, the development trend of indicator data in the past 20 years was statistically analyzed, and qualitative and quantitative research was conducted using grey relational analysis and multiple linear regression analysis methods. In the past two decades, there has been a significant improvement in the number of deaths, work-related injuries, and occupational patients in China's safety production, and the country's three categories of 14 economic and social indicators have achieved rapid development. Using the grey relation analysis method, the grey correlation degree between the number of deaths, work-related injuries, and occupational patients in China over the past twenty years and 14 economic and social indicators was obtained. The ranking of economic and social indicators that affect the number of deaths, work-related injuries, and occupational patients varies greatly. A multiple linear regression model was established for the number of deaths, work-related injuries, occupational diseases, and 14 economic and social indicators. The rationality of the model was verified from four aspects: R 2 , F-value, P-value, and deviation between actual and fitted values. Provide guidance for the development of safety production indicators and economic and social indicators in China through research.

[...]by 2020, 95% of workers who are exposed to occupational risks for pneumoconiosis must have health checks, and 80% of workers in the coal, metal, and construction industries should be covered by work-related injury insurance. To achieve these targets, the Chinese Government has committed to revise and improve occupational laws as well as occupational health regulations; investigate and promote new technologies and facilities that would benefit workers' health; strengthen the surveillance and reporting systems for preventing and controlling occupational diseases; and monitoring other occupational conditions such as work-related mental health and musculoskeletal diseases. China's rapid global economic progress is a double-edged sword for occupational health, exposing workers, particularly the poor and the disenfranchised, to unprecedented injuries and risks but also providing an opportunity to promote workplace health and safety standards for the country's working population.