WHO流行病学调查第一阶段技术报告

The industrialization process of women of childbearing

age youth occupational environment on reproductive

health effects in the epidemiology

Technical report of first stage

1) Introduction

According to WHO

’

s prediction, in the 21 Century, infertility will

be the second only to tumors and cardiovascular disease in the first three

major

average

incidence

rate

around

the

world

is

7%

~

46%.

Despite

differences

in

different

regions,

the

present

acceptable

incidence in research field is 8% ~ 15%. In China, the incidence rate of

infertility is relatively low before 1970s, but it begun to rise from early

1980s. Entering the 21

st

century, it shows clear ascendant trend, reaching

as high as 8%-10% and even more than 15% in some regions.

The

decline

of

reproductive

capacity

has

become

an

important

problem

facing

the

rapid

development

of

economic

construction

currently.

It

is

proved

by

medical

reports

that

infertility

patients

is

increasing,

and

the

number

in

urban

areas

is

higher

than

that

in

rural

areas. In highly-industrialized and densely-populated cities, the number

of infertility is the highest. According to a large number of documents,

the most influential acquired factor lies in the environment that we live

by.

The

higher

the

region

is

industrialized,

the

higher

the

patients

of

infertility

are.

Environment,

particularly

the

production

environment,

affects

people's

reproductive

capacity.

At

present,

over

100

chemicals

which mankind has a close contact with have been proved to have such

effect. Nowadays, mankind activities, professional production activities

in particular, can not continue without these chemical materials.

These

materials in human body,

mainly plays an estrogenic effect (estrogen),

directly

affecting

men

and

women's

reproductive

capacity.

Other

physical

and

chemical

factors

in

workplaces

effecting

reproductive

capacity should

also be concerned now. But a comprehensive research

on occupational factors is rare.

Occupational

analysis

shows

that

the

exposed

occupational

environment

is

an

important

trigger

of

infertility.

Nowadays,

with

our

economy

developing

rapidly,

traditional industry

changing continually,

and

n

ew

industries

emerging,

new

occupational

hygienic

problem

is

becoming salient. The incidence rate of infertility is increasing in China.

Apart

from

the

currently-

known

related

factors,

the

other

factors

like

whether the emerging occupational environment will pose threat to the

reproductive

capacity

of

human

beings

have

not

aroused

people

’

s

attention.

People

in

the

child- bearing

age

are

the

main

labor

resource,

and

the

physical

factors

in

many

occupational

environments

will

pose

threat

to

people

’

s

reproductive

capacity

in

different

degrees.

The

problem of the reproductive capacity exerts influence not only in healthy

condition

and

the

stability

of

a

whole

family,

but

also

in

the

next

generation, even in our nation

’

s great rejuvenation. We need economic

development as well as employment rate, but what we need desperately

is the healthy life of our generation and our next generation.

How can

we

avoid

the

influences

on

our

reproductive

capacity

by

occupational

environments, and how can we evaluate the potential danger posed by

these

emerging

occupational

environments

and

the

dangerous

factors

resulting in infertility as soon as possible. These questions should be the

focus that needs our attention in today

’

s world, and there is a long way

ahead.

It

is

a

meaningful

and

urgent

work

to

pay

much

attention

to

reproductive health from the perspective of epidemiology.

2) Work in the first stage

(1)

Complete

bibliographic

search,

and

consult

600

pieces

of

literature.

From December 2010, we hyperlinked CNKI, WanFang database,

Sinomed,

PUBMED

etc.

from

library

of

Capital

Medical

University.

More than 600 pieces of literature can be found by the key words such

as

“

infertil ity

”

.

（

2

）

Write a summary of these literature having 3000 letters.

We have summarized these literature, finishing a report called

“

A

current situation of infertility

”

which has about 3000 letters. We in our

report elaborated the occupation distribution of the infertility patients by

doing a separate research between women and men, and also

influence

by

the

main

occupation

factors.

In

addition,

we

discussed

initially

the

reasons

causing

infertility

and

gave

a

simple

analysis

about

these

reasons.

(3) Finish a questionnaire. Appendix 1

Through

a

comprehensive

summary

about

infertility,

we

have

a

further

understanding

about

the

research

and

have

finalized

important

questions in our questionnaire.

A. The gender of the questioned person

B.

The

occupation

of

questioned

people.

As

for

the

specific

occupational

classifications,

we

adopt

the

2010

sixth

national

population

census

occupational

classification

standards.

Occupation

can

be

classified

into

3

categories,

that

are

large,

medium

and

small.

There

are

8

large

occupations,

65

medium,

and 410 small occupations. Our research is target at the 7

th

, 8

th

,

9

th

large occupation.

Instruction: (1) As for the personnel who at the same time is engaged in

more than one occupation, the one spending longer working time is his

or

her

occupation.

If

the

time

cannot

be

determined,

the

one

earning

more

money is his or her occupation.

As for the personnel who at the

same time is engaged in more than one occupation at he same workplace,

the

one

possessing

a

higher

tech

is

his

or

her

occupation.

(2)

As

for

apprentice, they should be classified according to their work types and

study fields. (3) The personnel who is engaged in

technical occupation

as

well

as

in

administration

should

be

classified

according

to

his

administrative

occupation.

(4)

The

personnel

who

is

engaged

in

communist

party

as

well

as

in

administration

should

be

classified

according to his main occupation.

C.

Work

kinds

of

the

questioned

person:

according

to

the

description of work types, we have to research the work types of

questioned people as assistance. In our research form, we need a

detailed

record

of

work

nature,

work

time,

and

work

types

of

questioned people. As for researchers, we need our researchers to

analyze

and

research

the

occupation

contacts

of

questioned

people.

D.

Work nature of questioned people: sedentary or the opposite

E.

Work time of questioned people:

the working hours of day and

night and the total working days in one week

F.

Work

types:

brain

work,

manual

work,

brain-based

work,

or

physical-based work.

G.

The

condition

of

marriage

and

fertility

of

the

surveyed

people.

According

to

the

latest

diagnostic

criteria

of

infertility,

the

couple who have normal sexual life without conceptive measures

cannot bear child should be counted as infertility.

According to

the

criteria,

we

can

conclude

the

related

resulted

result

from

some projects in our questionnaire.

H. Other projects in the questionnaire. Other projects are mainly for

physiology and reproductive heath of both men and women. As

an assisted project, the content bears no clear relation with our

investigation conclusion, but it can be used in our next stage to

analyze the potential causes leading to infertility.

(4) Finish the handbook of implementing projects

According the analysis of this research, the target of the research

is the related exposed factors affecting infertility. We explore the danger

posed

by

key

occupational

environments

on

reproductive

capacity,

particularly

on

infertility.

We

also

do

a

research

on

the

occupation

distribution

and

potential

influence

of

occupational

environment

of

infertility patients. We set up a information platform which analyzes the

influence of

occupational

environment

on

reproductive health.

We

can

put forward some possible preventative measures.

Our handbook of implementing projects is very specific, because

it

includes

the

object

of

the

research,

research

contents,

methods,

detailed

procedures,

and

the

administration

and

evaluation

system

of

projects.

(5)Finish

the

handbook

of

researchers,

and

train

dozens

of

researchers.

In the handbook of researchers, we target the labor forces working

in

newly-industrialized

environment

and

other

workers

in

related

environment as our research object.

The research can be divided into the following steps.

Firstly,

distribute

the

questionnaire

into

surveyed

regions.

The

principle:

under

the

principle

of

random

sample,

we

position

our

surveyed

people

in

pearl

river

delta

and

around

Beijing

area

which

posses many new industries.

Secondly,

distribute

the

questionnaire

into

surveyed

units.

The

principle:

under

the

principle

of

random

sample,

we

should

select

different

factories

and

different

occupational

personnel

in

the

same

factory as our target.

Thirdly,

distribute

the

questionnaires

to

the

person

under

investigation.

The

operation

principle:

under

the

principle

of

random

sampling,

strictly

selecting

the

samples

under

investigation

through

questionnaires: people who are married, and plan to have children, but

do not use contraception.

Specific operation in the process of investigation:

(1) The preparation before filling the questionnaire

Before

asking

the

respondent

to

fill

the

questionnaire,

the

investigator should first make clear his intention, and lay stress on the

point

that

this

investigation

is

conducted

in

an

anonymous

way.

The