職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫1教學(xué)目標(biāo)拿握內(nèi)農(nóng)◆職業(yè)性致癌因素及職業(yè)腫瘤的概念;◆職業(yè)腫瘤的發(fā)病特點(diǎn)及識(shí)別和確認(rèn)途徑;◆職業(yè)腫瘤的診斷原則◆八種法定的職業(yè)腫瘤。了解內(nèi)容◆職業(yè)性腫瘤的研究進(jìn)展及各種職業(yè)性致癌因素;◆職業(yè)性腫瘤的預(yù)防原則。教學(xué)目標(biāo)2職業(yè)性腫瘤在工作環(huán)境中長(zhǎng)期接觸致癌因素,經(jīng)過(guò)較長(zhǎng)的潛伏期而患某種特定腫瘤。職業(yè)性孜癌因素能引起職業(yè)性腫瘤的職業(yè)性有害因素。職業(yè)性腫瘤3我國(guó)法定職業(yè)病名單中職業(yè)腫瘤有八種聯(lián)苯胺所致膀光癌◆石棉所致肺癌、間皮瘤◆苯所致白血病◆氯甲醚所致肺癌◆砷所致肺癌、皮膚癌◆氯乙烯所致肝血管肉瘤◆焦?fàn)t逸散物所致肺癌◆鉻酸鹽制造業(yè)所致肺癌我國(guó)法定職業(yè)病名單中職業(yè)腫瘤有八種4職業(yè)性致癌因素◆物理因素:電離輻射、紫外線◆化學(xué)因素:在職業(yè)性致癌因素中居多。◆生物因素職業(yè)性致癌因素5FigureINON-IONISING(IONISINGELECTROMAGNETICPARTICLEELFBANDRFBANDBctoRadiowavesMicrowavesintrax-rarsGammaray/s●●·neutrons3:702○原TVRadarMedical一遠(yuǎn)N-wasteReacterN-submarinefabricationNON-NUCLEARNUCLEARTheelectromagnetspectrumshowshowelectromagneticandparticeradiationsareassociatedwithvariousecoltelecommunications,nuclearandotheractivities3(lustrationtakenfromRodiationExposurebylesDaton,oSarbePublication1991)FigureI6化學(xué)性數(shù)癌物Chemicalcarcinogens天然的如石棉(asbestos人造的,如氯乙烯(vinylchloride)◆工業(yè)副產(chǎn)品,如多環(huán)芳烴(polycyclicaromatichydrocarbons)化學(xué)性數(shù)癌物7多環(huán)芳烴和陰囊癌(cancerofthescrotum)Observationofcancerofthescrotum1775,PercivallPott,aLondonsurgeon,describedahighfrequencyofcancerofthescrotum(B4E)amongchimneysweeps,adiseaseknownatthetimeas“soot-war”(煙灰瘤)Acenturylater,otherscientistsnotedsimilarcancersamonggasplant(煤氣車間)workersinGermanyandamongoilshale(油頁(yè)巖)workersinScotland多環(huán)芳烴和陰囊癌(cancerofthescrotu8生物性致癌因素(Biologicalcarcinogens)Someviruseshavebeenimplicatedincausingcancer,eitherbydamagingcellsdirectly,forexample,theHepatitisBvirus,orbydecreasingtheabilityofthebodytocontrolabnormalcells,forexample,thehumanImmunodeficiencyvirus生物性致癌因素9職業(yè)性致因素的作用特點(diǎn)有明確的病因潛伏期及發(fā)病年齡潛伏期通常需要15-20年,最短者要2-5年,長(zhǎng)者可達(dá)3040年。由于職業(yè)性接觸程度較強(qiáng),職業(yè)性腫瘤發(fā)病年齡比非職業(yè)性同類腫瘤提前,如芳香胺引起的泌尿系統(tǒng)癌癥,發(fā)病年齡以40-50歲多見,較非職業(yè)性的早10-15年。好發(fā)部位:多在致癌因素作用最強(qiáng)烈、最經(jīng)常接觸的部位發(fā)生。由于皮膚和肺是職業(yè)致癌物進(jìn)入機(jī)體的主要途徑和直接作用的器官,故職業(yè)性腫瘤也多見于皮膚和呼吸系統(tǒng)職業(yè)性致因素的作用特點(diǎn)10職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤11職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤12職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤13職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤14職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤15職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤16職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤17職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤18職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤19職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤20職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤21職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤22職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤23職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤24職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤25職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤26職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤27職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤28職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤29職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫30教學(xué)目標(biāo)拿握內(nèi)農(nóng)◆職業(yè)性致癌因素及職業(yè)腫瘤的概念;◆職業(yè)腫瘤的發(fā)病特點(diǎn)及識(shí)別和確認(rèn)途徑;◆職業(yè)腫瘤的診斷原則◆八種法定的職業(yè)腫瘤。了解內(nèi)容◆職業(yè)性腫瘤的研究進(jìn)展及各種職業(yè)性致癌因素;◆職業(yè)性腫瘤的預(yù)防原則。教學(xué)目標(biāo)31職業(yè)性腫瘤在工作環(huán)境中長(zhǎng)期接觸致癌因素,經(jīng)過(guò)較長(zhǎng)的潛伏期而患某種特定腫瘤。職業(yè)性孜癌因素能引起職業(yè)性腫瘤的職業(yè)性有害因素。職業(yè)性腫瘤32我國(guó)法定職業(yè)病名單中職業(yè)腫瘤有八種聯(lián)苯胺所致膀光癌◆石棉所致肺癌、間皮瘤◆苯所致白血病◆氯甲醚所致肺癌◆砷所致肺癌、皮膚癌◆氯乙烯所致肝血管肉瘤◆焦?fàn)t逸散物所致肺癌◆鉻酸鹽制造業(yè)所致肺癌我國(guó)法定職業(yè)病名單中職業(yè)腫瘤有八種33職業(yè)性致癌因素◆物理因素:電離輻射、紫外線◆化學(xué)因素:在職業(yè)性致癌因素中居多?！羯镆蛩芈殬I(yè)性致癌因素34FigureINON-IONISING(IONISINGELECTROMAGNETICPARTICLEELFBANDRFBANDBctoRadiowavesMicrowavesintrax-rarsGammaray/s●●·neutrons3:702○原TVRadarMedical一遠(yuǎn)N-wasteReacterN-submarinefabricationNON-NUCLEARNUCLEARTheelectromagnetspectrumshowshowelectromagneticandparticeradiationsareassociatedwithvariousecoltelecommunications,nuclearandotheractivities3(lustrationtakenfromRodiationExposurebylesDaton,oSarbePublication1991)FigureI35化學(xué)性數(shù)癌物Chemicalcarcinogens天然的如石棉(asbestos人造的,如氯乙烯(vinylchloride)◆工業(yè)副產(chǎn)品,如多環(huán)芳烴(polycyclicaromatichydrocarbons)化學(xué)性數(shù)癌物36多環(huán)芳烴和陰囊癌(cancerofthescrotum)Observationofcancerofthescrotum1775,PercivallPott,aLondonsurgeon,describedahighfrequencyofcancerofthescrotum(B4E)amongchimneysweeps,adiseaseknownatthetimeas“soot-war”(煙灰瘤)Acenturylater,otherscientistsnotedsimilarcancersamonggasplant(煤氣車間)workersinGermanyandamongoilshale(油頁(yè)巖)workersinScotland多環(huán)芳烴和陰囊癌(cancerofthescrotu37生物性致癌因素(Biologicalcarcinogens)Someviruseshavebeenimplicatedincausingcancer,eitherbydamagingcellsdirectly,forexample,theHepatitisBvirus,orbydecreasingtheabilityofthebodytocontrolabnormalcells,forexample,thehumanImmunodeficiencyvirus生物性致癌因素38職業(yè)性致因素的作用特點(diǎn)有明確的病因潛伏期及發(fā)病年齡潛伏期通常需要15-20年,最短者要2-5年,長(zhǎng)者可達(dá)3040年。由于職業(yè)性接觸程度較強(qiáng),職業(yè)性腫瘤發(fā)病年齡比非職業(yè)性同類腫瘤提前,如芳香胺引起的泌尿系統(tǒng)癌癥,發(fā)病年齡以40-50歲多見,較非職業(yè)性的早10-15年。好發(fā)部位:多在致癌因素作用最強(qiáng)烈、最經(jīng)常接觸的部位發(fā)生。由于皮膚和肺是職業(yè)致癌物進(jìn)入機(jī)體的主要途徑和直接作用的器官,故職業(yè)性腫瘤也多見于皮膚和呼吸系統(tǒng)職業(yè)性致因素的作用特點(diǎn)39職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤40職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤41職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤42職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤43職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤44職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤45職業(yè)衛(wèi)生與職業(yè)醫(yī)學(xué)課件職業(yè)與腫瘤46職業(yè)衛(wèi)生與職業(yè)醫(yī)