In the past 10 years, the number of newly reported cases of occupational diseases nationwide has dropped by 43.8%, and the problems of difficult diagnosis and investigation have been gradually solved. At the same time, new occupational health problems have attracted attention.

Can occupational stress and low back pain be included in occupational diseases?

  Our reporter Ji Wei

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  In recent years, my country has achieved remarkable results in the prevention and control of occupational diseases. The diagnosis, monitoring and screening of occupational diseases have been continuously improved, and the protection of workers' health rights and interests has been strengthened.

With the increase of people's health awareness, work-related diseases other than occupational diseases have also received increasing attention. Experts said that whether such diseases can be included in the occupational disease catalogue needs comprehensive consideration.

  This year marks the 20th anniversary of the promulgation and implementation of the Law on the Prevention and Control of Occupational Diseases. The reporter of "Workers Daily" learned from the press conference on the theme of "Everything is for the Health of the People - Our Ten Years" held by the National Health Commission. In recent years, my country's occupational disease risk monitoring and assessment The work has been continuously strengthened, and all occupational diseases have been included in the monitoring scope of occupational diseases and occupational disease hazard factors, and the coverage rate of monitoring counties and districts has reached more than 95%.

  Wu Zongzhi, director of the Occupational Health Department of the National Health and Health Commission, said that since the 18th National Congress of the Communist Party of China, my country's occupational health cause has developed rapidly, and occupational disease prevention and control work has achieved remarkable results.

The number of new cases of occupational diseases reported nationwide dropped from 27,420 in 2012 to 15,407 in 2021, a drop of 43.8%.

Occupational disease prevention and control has been included in basic public health service items, and the overall situation of occupational disease hazards in industrial enterprises across the country, as well as the survival and security of occupational pneumoconiosis patients, have been basically figured out.

Why Occupational Diseases Are Difficult to Diagnose

  Li Tao, chief expert of occupational health at the Chinese Center for Disease Control and Prevention, believes that the diagnosis of occupational diseases is not difficult in medical technology, but it is difficult to confirm the labor relationship between sick workers and employers, and to determine the causal relationship between exposure to occupational disease hazards and the disease.

  Different from general disease diagnosis, occupational disease diagnosis is essentially an attributive diagnosis of a disease. In addition to determining whether a patient is sick, it is also necessary to determine in which employer the worker has been exposed to occupational disease hazard factors, and what type of occupational disease hazards have been exposed to. Occupational disease hazard factors, whether the degree of exposure to occupational disease hazard factors is sufficient to cause workers to become ill.

  Taking pneumoconiosis as an example, Li Tao said that due to the relatively long incubation period of pneumoconiosis, an average of 10 to 20 years, it takes a long time for workers to start to be exposed to dust and find that their health is damaged.

However, a considerable number of workers, especially migrant workers, are highly mobile, often working in multiple employers, and many may not have signed labor contracts with employers, which makes it difficult to clarify labor relations, and it is impossible to provide a clear occupation in the diagnosis of occupational diseases. History of exposure to occupational disease hazards.

Therefore, some workers cannot be diagnosed with occupational pneumoconiosis despite their clinical manifestations of typical pneumoconiosis.

  However, it is worth noting that at present, many provinces and cities have carried out comprehensive statistics on pneumoconiosis.

Since 2017, Hunan Province has implemented basic medical treatment and assistance for pneumoconiosis of migrant workers, and has implemented medical expense subsidies for pneumoconiosis patients of migrant workers who are not responsible. So far, 27,000 patients with pneumoconiosis of migrant workers have been clinically diagnosed and obtained. Rescue and rescue.

  The survey results show that by the end of 2021, a total of 915,000 occupational pneumoconiosis patients have been reported nationwide, and 450,000 existing occupational pneumoconiosis patients.

Li Tao said that in the next step, we will continue to carry out active monitoring and screening of pneumoconiosis, and gradually find out the base of pneumoconiosis patients.

Monitor nearly 200,000 employers in 3 years

  According to Su Xu, chief radiation protection expert of the China Center for Disease Control and Prevention, occupational disease hazards mainly include 459 types of 6 categories: dust, chemical factors, physical factors, radioactive factors, biological factors and other factors.

Since 2019, the monitoring of occupational diseases and occupational disease hazards in my country has covered all districts and counties from prefectures and cities.

  In the past three years, a total of 194,242 employers have been monitored, involving 33.51 million workers, of which the number of workers exposed to occupational disease hazards is 14.39 million. The reporting rate of employers' occupational disease hazards projects has increased year by year.

  Su Xu said that in response to the problems found in monitoring and investigation, the National Health and Health Commission has focused on five aspects: promoting local governments to implement occupational disease prevention and control responsibilities; deepening the special governance of occupational disease hazards; strengthening supervision and law enforcement; Implementation of the main responsibility of micro-enterprises; further improvement of relevant policies and measures.

  In order to facilitate the diagnosis and identification of occupational diseases, Li Tao introduced that according to the revised Law on the Prevention and Control of Occupational Diseases, the National Health and Health Commission organized the revised management measures for the diagnosis and identification of occupational diseases, which will be promulgated and implemented in 2021.

The new method clarifies the certification standards for occupational disease diagnosis certificates, and simplifies the materials required by workers for occupational disease diagnosis. The workers only need to provide the occupational disease diagnosis materials that they have mastered. The occupational disease diagnosis and identification materials are mainly provided by the employer.

The measures also clarified the time limit for occupational disease diagnosis for the first time, which greatly shortened the time for occupational disease identification.

  According to the Law on the Prevention and Control of Occupational Diseases, if there is no evidence to deny that there is an inevitable connection between the occupational disease hazard factors and the clinical manifestations of the patient, it should be diagnosed as an occupational disease.

According to reports, relevant departments will continue to promote the revision of the Law on the Prevention and Control of Occupational Diseases to facilitate the diagnosis and identification of occupational diseases.

The adjustment of occupational disease catalogue should be adapted to the level of development

  Occupational stress, low back pain and other diseases caused by work pressure are considered occupational diseases?

Li Tao made it clear that occupational stress and low back pain are not occupational diseases at present, but work-related diseases.

  "Occupational stress, as the name suggests, is the mental and psychological stress caused by occupational activities. Low back pain does not refer to a general disease, but a work-related disease caused by long-term overloading of the lower back due to work or poor work styles."

Li Tao said.

  Li Tao emphasized that since it is a work-related disease, the employer should take active measures to prevent it.

The fifth paragraph of Article 15 of Chapter II of the Law on the Prevention and Control of Occupational Diseases stipulates that the equipment, tools, utensils and other facilities of the employer shall meet the requirements of laborers' physical and mental health.

  Regarding whether work-related diseases such as occupational stress and low back pain will be included in the occupational disease catalogue in the future, Li Tao said that for the revision of occupational disease classification and catalogues, he will adhere to the principle of doing his best and doing what he can.

The adjustment of the classification and catalogue of occupational diseases must be in line with the national economic and social development level and the affordability of work-related injury insurance, and scientific and rigorous diagnostic standards must be formulated.

  According to reports, according to the national occupational disease prevention and control plan, during the "14th Five-Year Plan" period, the National Health Commission will work closely with the Ministry of Human Resources and Social Security to promote the revision of occupational disease classification and catalogues on the basis of full research and demonstration.