泉州某煤矿2009-2014年尘肺发病分析

目的 分析泉州某煤矿2009-2014年新发尘肺发病规律,探讨发病特点,为制定防治措施提供依据.方法 对矿区2009-2014年所有新发尘肺病例资料进行分析.结果 2009-2014年共受检4157人,检出新发尘肺病175例,检出率4.2％.各年度检出率类似.患者平均发病年龄(51.6±10.8)岁,各年发病年龄总体上年轻化趋势;平均发病工龄(17.2±9.8)年,各年度发病工龄整体呈缩短趋势.新发尘肺病1 75例中,工期占65.7％;Ⅰ期检出率(2.8％)高于Ⅱ期(0.8％)和Ⅲ期(0.7％).结论 泉州某煤矿尘肺病平均发病年龄呈年轻化趋势、发病工龄呈缩短趋势.应根据发病特征,加强尘肺病的综合防治.     

淮南煤矿接尘职工尘肺患病状况调查

目的研究淮南煤矿尘肺病发病规律,探讨尘肺病防治对策。方法用流行病学调查方法,对淮南矿区接尘作业职工50年来尘肺病发病情况进行调查、统计分析。结果1954年至2003年,共诊断各期尘肺病6 115例,其中合并肺结核1 109例,合并率18.14%。Ⅰ期尘肺5 578例,综合防尘前接尘发病5 196例(93.15%),综合防尘后接尘发病382例(6.85%)。现患尘肺病3 140例,其中合并肺结核327例,合并率10.41%。Ⅰ期尘肺平均发病工龄22.1±7.7年,平均发病年龄52.2±10.0岁;尘肺平均晋期年限,0 ~Ⅰ5.7±4.3年,Ⅰ~Ⅱ7.2±5.3年,Ⅱ~Ⅲ8.0±5.5年;死亡尘肺病2 975例,病死率48.65%,尘肺平均死亡年龄64.27±10.9岁。1991~2003年,平均每年新诊断尘肺病114例。结论粉尘危害产生了严重的后果。由于采取有效的防尘措施,尘肺病的发病工龄、年龄逐渐延长。应继续加强粉尘治理,直至消除尘肺病。     

某地区不同管理体制煤矿的尘肺发病分析

目的 探索安徽省淮北地区不同管理体制煤矿尘肺发病现状,为防治尘肺病提供依据.方法 对1963年1月至2007年12月确诊的9237例尘肺病例,进行回顾分析.结果 国有煤矿尘肺检出率为5.57%,明显低于地方煤矿(9.59%).国有煤矿Ⅰ期尘肺平均发病工龄为(23.0±7.7)年,比地方煤矿的(20.0±9.0)年明显延长;Ⅰ期尘肺病平均发病年龄为(50.6±8.4)岁,比地方煤矿的(46.1±8.2)岁明显后移;国有煤矿Ⅰ期晋Ⅱ期平均年限为(8.7±6.0)年.比地方煤矿的(7.2±6.9)年明显延长;上述差异均有统计学意义(P<0.05).结论 地方煤矿尘肺检出率明显高于国有煤矿,Ⅰ期尘肺病平均发病工龄和年龄地方煤矿比国有煤矿明显缩短.地方煤矿应加大综合防尘力度.     

煤矿在职接尘工人煤工尘肺的发病情况

目的 探讨煤矿在职接尘工人煤工尘肺病发病特点,为指导煤工尘肺防治工作提供依据.方法 选择某矿业集团坚持定期健康检查、资料保存完整的3个煤矿,以调查前一年进行过尘肺病检查,但未诊断为尘肺的全部在岗接尘工人为调查对象,共8535人,收集调查对象的一般情况和职业史,对其进行尘肺健康检查,由具有尘肺病诊断资质的尘肺诊断组按GBZ 70-2002<尘肺病诊断标准>做出尘肺诊断.比较煤工尘肺的发病率,分析煤工尘肺患者发病年龄、发病工龄及不同工龄、不同工种人群煤工尘肺发病率的分布.结果 共8527人受检,受检率为99.9%(8527/8535).新发现Ⅰ期煤工尘肺49人,发病率为0.57%;平均发病年龄为(44.4±2.7)岁,平均发病工龄为(26.1±4.7)年.掘进工煤工尘肺病的发病率为0.92%(21/2282),高于采煤工(0.35%,5/1430)和辅助工(0.35%,5/1430),差异有统计学意义(P＜0.05).掘进工和混合工的平均发病工龄分别为(21.7±4.8)和(22.3±5.1)年,明显低于采煤工(27.8±4.6年)和辅助工(29.4±4.7年),各工种煤工尘肺平均发病工龄比较,差异具有统计学意义(F=6.42,P=0.001).煤工尘肺发病工龄多在20～30年,发病年龄多集中在45～55岁.结论 煤矿在职接尘工人煤工尘肺发病率为0.57%,掘进工的发病率高于采煤工和辅助工.掘进工和混合工的平均发病工龄较采煤工和辅助工短.     

开滦矿区2005-2012年煤工尘肺发病情况分析

目的浅析近8年开滦煤矿尘肺发病特点。方法对2005年1月1日-2012年12月31日开滦职业病防治所尘肺诊断组新诊尘肺患者的检出数、检出率、构成比、发病年龄、接尘工龄及接尘工种等方面进行调查。结果 8年来开滦煤矿共有46 091人受检,受检率28.52%(46 091/161 624),检出尘肺病人827例,尘肺检出率1.79%(827/46 091);2008年开滦尘肺病人检出率最高,2009年开滦尘肺病人检出率最低,2010、2011、2012年尘肺病人检出率趋于平稳,略有下降;尘肺病人平均发病工龄为(35.86±9.92)年,平均发病年龄(57.76±10.08)岁;主要接尘工种中,平均发病年龄以纯掘进工为最短,主掘进工与纯掘进工两者之间差异有统计学意义(P0.05),主采煤工与纯采煤工之间差异有统计学意义(P0.05);新发尘肺检出率以Ⅰ期煤工尘肺居多,占尘肺总数的94.56%(728/827);Ⅱ期占煤工尘肺总数的4.72%(39/827);Ⅲ期占煤工尘肺总数的0.72%(6/827),新发尘肺中Ⅰ期与Ⅱ期比较,Ⅰ期与Ⅲ期比较,Ⅱ期与Ⅲ期比较差异有统计学意义。结论近8年来开滦煤矿尘肺检出率1.79%,新发尘肺中以Ⅰ期轻症为主;尘肺平均发病年龄超过工人退休年龄;众多工种中发病以煤矿混合工最多,以纯掘进工的发病工龄最短,辅助工种发病人数有上升趋势。     

2011 - 2015年衡阳市新诊断尘肺病例发病特征分析

目的 通过对2011 - 2015年衡阳市新诊断的尘肺病例数据分析,了解尘肺病发病特征,为该市尘肺病防治工作的开展提供参考依据。方法 通过中国疾病预防控制系统子系统“健康危害因素监测信息系统”获取近5年衡阳市新诊断的尘肺病例数据,用描述统计法对尘肺发病特征进行相关分析。结果 共收集尘肺病例522例,行业分布主要集中在煤矿开采与洗选业,占整个尘肺病例总数的67.05%（350例）;病例工种以主采煤工、主进掘工、凿岩工为主,分别占整个尘肺病例数的53.64%（280例）、16.48%（86例）、12.26%（64例）;企业规模分布以小型企业为主,占整个尘肺病例数的79.10%（413例）。尘肺患者平均接尘工龄为（17.77±9.01）年,平均发病年龄为（51.53±7.06）岁;接尘工龄主要集中在5～25年,占70.69%（369例）;发病年龄主要集中在45～60岁,占69.54%（363例）;随着接尘工龄和发病年龄的增大,尘肺患病期别有晋升的趋势。结论 衡阳市新诊断尘肺病例主要集中在煤矿开采业,以主采煤工发病最为严重;企业分布主要集中在小企业。应加强煤矿企业和小规模企业的卫生管理工作,尽可能的减少尘肺病的发生。     

中国煤矿职业病防治现状调查分析

目的为国家制订具有针对性的政策提供科学依据,促进和提升煤炭企业尘肺病防治工作,降低尘肺病的发生。方法采用现场调查、资料研究、抽检等方法,对华北、东北、华东、西南4个地区的5个国有重点煤炭集团(共有47对矿井)、14个地方国有煤矿以及26个乡镇煤矿职业病防治现状进行研究。结果 5个国有重点煤炭集团综采工作面和机掘工作面粉尘浓度平均分别为66.8、65.5 mg/m3,尘肺病平均发病工龄为21.5 a。尘肺患者的平均发病年龄为51.6岁,在职职工平均尘肺病检出率为6.6%,离退休人员尘肺病平均检出率为13.7%;11个地方国有煤矿采煤工作面的平均总粉尘浓度为64.17 mg/m3,超标10.7倍,采煤工作面平均呼吸性粉尘浓度为16.08 mg/m3,超标4.6倍,尘肺病平均发病工龄18.5 a,Ⅰ期尘肺平均发病年龄43.8岁,尘肺病检出率7.4%;26个乡镇煤矿尘肺病的检出率7.5%,平均发病工龄6.8 a。结论煤炭企业尘肺病危害较严重;适应市场经济条件的尘肺病防治体系亟待建立。     

皖北地区尘肺流行病学调查

目的探讨本地区尘肺发病规律、综合防尘效果及预防措施。方法对确诊8985例尘肺病患者按全国尘肺流行病学调查办公室设计的统一方案填写“尘肺病例卡”所有内容,用SQLSERVER2000建立数据库,SPSS10.0统计软件包进行统计学处理。结果①该地区尘肺发病率6.94%,病死率29.88%,肺结核合并率18.99%,平均病程12.56年,前10位死因肺结核居首位,其次是尘肺和肺癌;②发病工龄(21.64±7.09)年,发病年龄(49.71±7.99)岁,晋期年限Ⅰ→Ⅱ(8.29±6.56)年,Ⅱ→Ⅲ(9.96±5.88)年;③随着尘肺期别增加,尘肺结核合并率和病死率明显上升。结论该地区尘肺病检出率和病死率较高,防治重点是建井公司和乡镇煤矿,防痨工作应加强。     

闽西矿区2005-2011年尘肺病发病情况分析

目的分析闽西矿区2005-2011年尘肺病发病情况及特点,为龙岩市职业健康监护体系制定尘肺病预防策略提供依据。方法选取2005-2011年龙岩市CDC上报《中国疾病预防控制信息系统》的587例尘肺病例为研究对象,采用SPSS 17.0软件包统计分析相关的报告信息。结果闽西矿区2005-2011年累计尘肺病587例。其中新发尘肺病449例,占总病例数的76.49%;晋期病例138例,占总病例数的23.51%。煤炭开采和洗选业尘肺病的平均发病年龄和平均发病工龄〔(50.48±11.06)岁,(27.28±11.69)年〕大于(或长于)其他行业尘肺病的平均发病年龄和平均发病工龄〔(45.05±6.52)岁、(10.27±5.85)〕年,差异具有统计学意义(P0.05或0.01)。不同行业壹期、贰期、叁期尘肺病例的平均发病年龄比较差异无统计学意义(均P0.05)。矽肺平均发病年龄和平均发病工龄〔(53.52±12.25)岁,(28.76±13.70)〕年大于(或长于)煤工尘肺的平均发病年龄和平均发病工龄〔(49.50±10.45)岁,(26.26±11.35)年〕,具有统计学意义(P0.05或0.01)。尘肺病合并肺TB的合并率为3.07%。结论闽西矿区尘肺发病情况严重,职业健康监护覆盖面有待提高。     

泉州市2007—2014年尘肺病流行趋势分析

目的了解泉州市尘肺病流行趋势,为制定防治措施提供依据。方法收集泉州市2007—2014年新发尘肺病例资料,对发病年龄、工龄和尘肺期别等指标进行统计分析。结果泉州市2007—2014年共诊断尘肺病331例,以矽肺(84.0%)和煤工尘肺(13.6%)为主;发病年龄31.7~79.0岁(49.7±10.7)岁,工龄1~45年(14.6±9.3)年,二者均有逐年降低趋势。≥40岁占82.2%,40~49岁和≥60岁组、发病工龄≥20年和Ⅰ、Ⅱ期尘肺发病数均呈上升趋势。随发病年龄的增加Ⅰ、Ⅱ期尘肺比重逐渐降低,Ⅲ期尘肺比重逐渐升高;发病工龄与尘肺期别无关联。结论泉州市尘肺病高年龄发病数、高工龄发病数、Ⅰ期和Ⅱ期尘肺发病数呈上升趋势,发病年龄与尘肺期别有关。应有针对性地加强健康筛查,预防尘肺病高发。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.