Rui-Sheng Wang

Glutaraldehyde exposure and its occupational impact in the health care environment.

Despite the search for effective and less toxic substitutes, glutaraldehyde (GA) remains one of the few substances capable of high-level instrument disinfection in modern health care. Workers commonly affected include operating room nurses, radiographers, x-ray technicians and cleaners. Widespread hospital usage combined with its well-known irritant properties, has ensured an increase in occupationally-related illnesses during recent years. Operating room nurses, laboratory workers and x-ray technicians frequently contact GA in both the liquid and vapor form. Workplace exposure is usually dependent on job tasks, ventilation levels and the use of protective equipment. GA is a relatively potent irritant and sensitizer, with a well-documented history of symptoms following occupational exposure. Although mechanisms for GA toxicity have been postulated, research on the toxicological, teratogenic, and carcinogenic potential of this chemical has shown inconsistent results. Reducing workplace exposure to its lowest possible level represents the most important hazard reduction strategy. This may be achieved by keeping GA containers tightly sealed when not in use, maintaining adequate ventilation levels and the rigid adherence to appropriate personal protective equipment. Substitution with automated cold sterilization machines may be another appropriate measure, while banning unnecessary practices such as GA fogging and its use as a surface disinfectant may also be helpful in reducing occupational exposure in the health care environment.

Contemporary smoking habits among nurses in Mainland China

Abstract Although China is the world’s largest consumer of tobacco and tobacco-related products, the epidemiology of smoking has not been well studied among nurses. Given this serious gap in the literature, we considered it necessary to investigate tobacco smoking habits among a large cross-section of contemporary Chinese nurses, by means of a questionnaire survey. A total of 509 replies were obtained from 520 nurses (response rate: 97.9%). The overall prevalence of smoking was 2.6% (95%CI 1.5 – 4.3). When stratified by gender, the prevalence rate among male nurses was 52.2% (33.0 – 70.8). Of those who smoked, the median number was 11 smokes per day for a period of 25.0 years. When categorized by severity, 15.4% were light smokers, 69.2% moderate smokers and 15.4% heavy smokers. When stratified by age there were no smokers under 25 years, with the prevalence between 25 and 34 years similarly low, at 1.1%. The highest smoking rate was seen among nurses aged 45 to 50 years (10.1%), even though they only comprised 9.8% of the total workforce. Although our study suggests that tobacco usage is relatively uncommon among Chinese nurses overall, the rate among male nurses was alarmingly high. The distribution of smoking by age was not uniform however, with a high proportion being concentrated in the older age ranges. As such, future preventive measures will need to consider the individual situation of Chinese nurses who smoke, particularly those who occupy the older age groups.

Occupational stress and psychosomatic complaints among health professionals in Beijing, China

OBJECTIVE To investigate the prevalence, distribution and correlates of occupationally-related psychosomatic complaints among a previously understudied workforce. PARTICIPANTS A selection of 336 public health professionals working in Beijing, China. METHODS A self-reporting questionnaire survey was used (99% response rate). RESULTS The incidence of ocular discomfort was relatively high for health professionals aged below 60 years, headache or dizziness was mostly reported by the older age groups, insomnia or sleep disorders were common among those aged 30-39 years, while self-reported depression or emotional instability were concentrated in younger staff. Regression analyses revealed that age, personal life habits, family status, work conditions and occupational environment were related to eye discomfort, headache, dizziness, insomnia, sleep disturbance, depression or emotional instability. Moreover, undertaking a busy work schedule of long duration and work-induced stress were major correlates for illness and other subjective symptoms. On the other hand, having a friendly working atmosphere and a high interest in ones work were negatively correlated with psychosomatic symptoms. CONCLUSIONS Overall, our study suggests high-intensity work and various other occupational factors may be strongly related to psychosomatic symptoms among health professionals in China.

Work Environment and Hand Dermatitis among Nurses in a Chinese Teaching Hospital

ObjectiveThe aim of this study was to investigate the effects of the working environment on hand dermatitis (HD) prevalence among nurses in a Chinese teaching hospital.MethodsWe utilised a previously validated, self-reporting survey which was translated into Chinese.ResultsThe prevalence of HD among nurses was 18.3%, although this rate varied between departments, ranging from 9.4% in gynaecology to 26.7% in intensive care (P for Trend=0.3167). Logistic regression indicated that wet work was the most important HD risk factor, with a 9-fold increase (OR 9.0, 95% CI 1.2–74.9, P=0.0342). Allergic disease was also related to HD, with a 4.6-fold increase noted (OR 4.6, 95% CI 1.4–15.0, P=0.0096).ConclusionsOverall, the prevalence of HD among Chinese hospital nurses appears to be less than that of their foreign counterparts. Nevertheless, the burden of this disease does seem to vary with respect to depertment of employment within the hospital.

HIV/AIDS prevention in China: A challenge for the new millennium

China’s first HIV infection was officially reported in 1985 and by the end of 1996, there may have been up to 200,000 people affected nationwide. In 2001, this figure probably exceeded 600,000. By 2003, the predicted number of HIV cases had reached 1.5 million. At least 80,000 individuals now have fullblown AIDS. China may soon have the largest HIV-infected population in the world, possibly 6 million cases by 2005. With infection rates rising at about 30% per year, it is feared this figure might exceed 10 million by 2010. Although the Chinese government was initially slow to accept the problem, in the late 1990s definite changes began occurring. In 2003 Premier Wen Jiabao publicly shook the hand of an AIDS patient and his government promised to introduce a range of free HIV-related services. Large preventive education campaigns are now underway. Unfortunately, there will still be many obstacles in controlling the epidemic and preventing further spread of this disease. Without doubt, China faces a serious predicament in the new millennium, and one which will pose numerous challenges for preventive medicine.

Tobacco use among public health professionals in Beijing: the relationship between smoking and education level.

All researchers Smoking rate Never smoked 86.3% <5 per day 26.5% Current smoker 10.5% 5-15 per day 55.9% Previous smoker 3.2% >15 per day 17.6% Males onlye Smoking duration Never smoked 68.0% <20 years 46.4% Current smoker 24.4% 20-30 years 17.9% Previous smoker 7.6% >30 years 35.7% Smoking by educationd Brinkman Indexc Technical diploma 16.3% Light smoker 67.9% Bachelor degree 11.5% Medium smoker 25.0% Postgraduate degree 5.5% Heavy smoker 7.1% Smoking by age ranged Median values <30 years 7.2% Smokes per day 10.0 30-50 years 9.5% Years of smoking 20.0 >50 years 23.1% Years since quitting 7.5 Smoking by careerd <5 years 6.2% 5-20 years 10.4% >20 years 19.7%

Infection control practices among Chinese physicians

Although sound infection control practices are essential within hospital settings, compliance rates among physicians may be suboptimal and this latter issue has rarely been studied in mainland China. Therefore, we surveyed a complete cross-section of physicians from a large teaching hospital in Shijiazhuang City, Hebei Province. Of the respondents, 54.1% said they never wore protective gloves whilst taking blood samples. Regular glove usage during gastric lavage, endotracheal intubation and indwelling urinary catheter insertion or removal was reported by 65.6%, 63.5% and 95.8% respectively. Most physicians (61.5%) washed their hands less than 10 times per work shift, with domestic soap being the most common method (71.1%). A complete course of Hepatitis B virus (HBV) vaccinations was reported by 64.3%, although 24.1% had not been vaccinated at all. Overall, our study suggests that infection control practices may be suboptimal among Chinese physicians. As such, a greater priority must be urgently directed towards improving compliance during clinical procedures in mainland China.