粤北地区慢性阻塞性肺疾病患病率调查

目的　调查广东省粤北地区40岁以上人群慢性阻塞性肺疾病(COPD)的患病率及其危险因素。方法　采用统一的流行病学调查表格,以整群随机抽样方法,在韶关北部山区共调查 40 岁以上居民1498人,并进行肺功能检测,有支气管阻塞者行扩张试验。结果　资料完整的 1468 人,男性640人,女性828人,平均年龄54.3岁。COPD总患病率为12.0%(176/1468),男性患病率18.3%(117/640),显著高于女性患病率7.1%(59/828),P<0.01。只有80.7%COPD患者有咳嗽、咯痰、呼吸困难或气短等症状之一。该地区COPD诊断率过低,只有26.1%的 COPD病例曾诊断过慢性支气管炎、肺气肿或COPD。吸烟是极为重要的危险因素,78.4%COPD患者有吸烟史。该地区居民生物燃料暴露与COPD患病的关系尚待进一步研究。结论　粤北农村地区 COPD患病率远高于预期,吸烟是极为重要的危险因素。肺功能在COPD的诊断,尤其是早期诊断中非常重要。     

湖北省部分农村地区人群慢性阻塞性肺疾病患病率及危险因素研究

目的了解湖北省南部（鄂南）农村地区慢性阻塞性肺疾病（COPD）患病率及危险因素。方法采用统一的流行病学调查表格，以多阶段抽样方法，抽取鄂南农村居民1883人进行调查，并进行体检和肺功能检测。结果共检出COPD患者186例，总患病率为9．88％，病例中男性占13．68％，女性占6．46％，男性高于女性（X2=27．48，P〈0．001）。随年龄增高患病率逐渐上升（X2=79．22，P〈0．001）。单因素分析表明，性别、年龄、吸烟、做饭频率、用生物燃料做饭、家族史、14岁以前经常咳嗽、体重指数降低、近5年房屋装修等9项因素与COPD有关。多因素logistic分析发现，性别、年龄、吸烟、做饭频率、家族史、14岁以前经常咳嗽为COPD的危险因素。结论鄂南农村地区COPD患病率较高，应针对危险因素采取综合干预措施来控制COPD的发生。     

无症状慢性阻塞性肺疾病患者相关特征分析

[目的]了解鄂南农村居民无症状慢性阻塞性肺疾病(COPD)患病状况及患者的流行病学特征,为防治COPD提供科学依据。[方法]以多阶段抽样方法,抽取鄂南农村居民1883例进行问诊、体检和肺功能检测,并采用统一的问卷进行调查。[结果]共检出COPD患者186例,总患病率为9.88%,其中无症状者71例,占38.17%;有症状者115例,占61.83%。无症状COPD的患病率为3.77%。无症状组和有症状组患者年龄、性别、职业、受教育程度、行饮情况,使用燃料情况和吸烟史比较,差异均无统计学意义(P﹥0.05)。两组吸烟指数差异有统计学意义(P﹤0.01),肺功能检测显示,有症状组第1s用力呼气容积(FEV1)、第1s用力呼气容积占预计值百分比(FEV1占预计值%)与无症状组比较,差异均有统计学意义(P﹤0.05或P﹤0.01)。[结论]该地区COPD患病率较高,其中无症状COPD的比例也较高。如果单凭症状,易造成COPD的漏诊和对疾病危害的低估。     

陕西省部分地区慢性阻塞性肺疾病流行情况及相关危险因素

  目的  了解陕西省部分地区40岁及以上人群慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）的患病情况及影响因素。  方法  采用多阶段分层整群抽样的方法,在陕西省3个项目县区抽取了1 800名40岁及以上常住居民进行问卷调查、身体测量及肺功能检测,采用χ2检验和二分类Logistic回归分析模型对影响COPD患病率的相关因素进行分析。  结果  共获得有效样本1 638例,陕西省部分地区COPD的患病率为13.8%。其中男性患病率（18.5%）高于女性（9.6%）（χ2=27.399,P < 0.001）;70岁及以上年龄组患病率最高,占22.5%,其次为60~岁、50~岁和40~岁,患病率分别为20.4%、12.9%和8.5%,且随着年龄的增长患病率逐渐上升（χ_趋势2=31.970,P < 0.001）。多因素Logistic回归分析模型得出,年龄（OR=2.86,95% CI:1.52~5.39,P=0.001）,吸烟（OR=1.60,95% CI:1.12~2.27,P=0.031）,有呼吸系统疾病家族史（OR=1.83,95% CI:1.05~3.18,P=0.008）是居民患COPD的危险因素。  结论  陕西省部分地区居民COPD患病率较高,高龄、吸烟、有呼吸系统疾病家族史是患COPD的危险因素。     

贵州省40岁及以上人群慢性阻塞性肺疾病流行及影响因素

  目的  分析研究贵州省40岁及以上不同性别人群慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)流行状况及其影响因素,为COPD预防提供依据。  方法  采用多阶段分层整群抽样方法,抽取贵州省COPD监测地区2 599名40岁及以上常住居民,进行问卷调查、体格及肺功能检查。  结果  贵州省监测地区COPD患病率为10.7%,男性患病率(13.0%)高于女性(7.6%)(χ2=16.951, P＜0.001)。Logistic回归分析模型分析结果显示,在男性人群中,年龄、吸烟、肺结核、慢性支气管炎病史与COPD患病密切相关;而女性人群中,年龄、脑血管、肺气肿病史、慢性支气管炎病史、鼻炎与COPD患病密切相关。  结论  贵州省监测地区COPD患病率及影响因素存在性别差异,为降低COPD患病率,男性以控烟和采取呼吸系统疾病筛查为主要措施,女性重点加强呼吸系统疾病筛查。     

宁夏监测点居民慢性阻塞性肺疾病流行特征及危险因素调查分析

目的 了解宁夏监测点居民慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）的流行特征及危险因素。方法 采用多阶段分层整群随机抽样方法,在宁夏3个监测县（区）的18个村（居）委会抽取40岁及以上人群进行询问调查、身体测量和肺功能检查,并进行危险因素分析。结果 共检出COPD患者154例,总患病率为8.56%,男性患病率（12.53%）高于女性（3.87%）（χ2=42.76,P<0.001）;40~岁、50~岁、60~岁、≥ 70岁COPD患病率分别为5.07%、6.69%、15.04%、17.35%,随年龄增高患病率逐渐上升（χ_趋势2=40.63,P<0.001）。多因素Logistic回归分析示,COPD的主要危险因素有男性（OR=2.832,95%CI:1.443~5.559）、高龄（OR=4.887,95%CI:2.058~11.608）、地区（OR=2.510,95%CI:1.222~5.156）、吸烟（OR=2.261,95%CI:1.370~3.733）、有害气体接触史（OR=2.006,95%CI:1.096~3.670）、木材家具加工及装饰房修职业暴露史（OR=2.660,95%CI:1.271~5.566）。结论 宁夏监测点居民COPD患病率较高,主要危险因素是男性、高龄、地区、吸烟、有害气体接触史、木材家具加工及装饰房修职业暴露史。     

重庆城市社区慢性阻塞性肺疾病流行病学调查

目的 获得重庆市城市地区慢性阻塞性肺疾病(COPD)患病率及其影响因素,为COPD早期防治提供依据.方法 2007年12月- 2008年1月,采用多级整群随机抽样方法,对重庆市南岸区城区南湖社区和裕华社区≥40岁常住居民2 133人进行问卷调查和肺功能检查,筛查其中的COPD患者,采用修订后的阻塞性肺疾病负担研究(BOLD)问卷进行调查.结果 2 024人调查问卷和肺功能检查合格,COPD患病率为7.9％( 160/2 024),男性患病率15.5％ (123/792),女性患病率3.0％ (37/1 232);吸烟者COPD患病率达15.9％ (118/743),COPD患者73.8％(118/160)有吸烟史;男性、高龄、低体质指数、有吸烟史、吸烟指数高、14岁以前经常咳嗽史、采用煤或生物燃料烹饪时无通风设备是COPD的重要危险因素,均OR＞1,差异均有统计学意义(均P＜0.01);COPD患者中,仅58.8％曾经被诊断为COPD等呼吸气流受限疾病,仅24.4％曾经进行过肺功能检查,23.1％ COPD患者无症状.结论 重庆市城区COPD患病率高,漏诊多,肺功能检查率低;吸烟是COPD主要危险因素;应重视COPD的早期诊断,早期防治.     

云南省农村居民慢性阻塞性肺疾病患病现况及基于结构方程模型的影响因素

  目的  分析云南省农村居民慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患病现况及其影响因素。  方法  采用多阶段分层随机抽样方法抽取云南省农村地区7 572名≥35岁常住居民进行现场问卷调查和体格检查,采用主成分分析法(principal component analysis,PCA)构建个体社会经济地位(socioeconomic status,SES),运用结构方程模型(structure equation modeling,SEM)分析COPD患病的影响因素。  结果  云南省农村居民COPD患病率为12.60%,男性患病率高于女性(χ2 =57.973,P＜0.001);COPD患病率随年龄的增加而升高(χ_趋势2=165.616,P＜0.001);少数民族居民COPD患病率高于汉族居民(χ2=33.785,P＜0.001);SES越低,COPD患病率越高(χ_趋势2=10.751,P＜0.001)。SEM分析结果显示,性别、年龄、民族和SES对COPD患病具有直接和间接作用,其总路径系数分别为0.09、0.15、0.06和-0.05,而COPD家族史、低BMI、现在吸烟和被动吸烟对COPD患病只有直接作用, 其路径系数分别为0.06、0.03、0.08和0.08。  结论  云南省农村居民COPD患病率较高,应加强对男性、高龄、吸烟、低BMI、有COPD家族史和SES较低人群的COPD健康教育和干预工作。     

海安地区≥65岁人群慢性阻塞性肺疾病患病现状及相关因素

目的 调查海安地区≥65岁人群慢性阻塞性肺疾病（COPD）患病现状及相关因素,为制定COPD防控措施提供科学依据。方法 于2021年8月采用整群随机抽样的方法抽取海安地区≥65岁居民进行问卷调查及肺功能检查,采用描述性分析方法对COPD患病情况进行分析,并采用单、多因素分析方法对COPD患病影响因素进行分析。结果 本研究共完成832名海安地区≥65岁人群的资料收集及肺功能检查。年龄65~86岁,以70~79岁所占比例较高,为50.60%,男性占56.97%。检出COPD患者310例,患病率为37.26%,其中轻、中、重度与极重度分别占26.97%、30.91%、27.88%、14.24%。多因素Logistic回归分析,结果显示年龄（OR=1.495）、文化程度（OR=1.939）、吸烟（OR=1.876）、家庭有患哮喘者（OR=1.390）、家族有COPD患者（OR=1.539）均为≥65岁人群COPD患病的影响因素。结论 海安地区≥65岁人群COPD患病率较高,中、重度占比较大,应引用医疗卫生部门对老年人群COPD患病情况的重视,并针对相关因素开展预防控制工作。     

中北大学老年人慢性阻塞性肺疾病整群抽样调查

目的了解中北大学65岁以上教职工及家属(以下简称"老年人")的吸烟及慢性阻塞性肺疾病(COPD)患病情况。方法采取整群抽样的方法,选取全校812名老年人为研究对象,用自制问卷对其进行一般资料、吸烟情况、呼吸道症状的调查,并对204名有慢性呼吸道症状的老年人进行肺功能检测,对所得数据进行统计学分析。结果研究人群中,男性老年人COPD患病率为12.1%(52/430),女性COPD患病率为3.1%(12/382),男性老年人COPD患病率明显高于女性,差异有统计学意义(χ~2=22.33,P=0.000)。65岁组老年人COPD患病率为5.3%(19/356),75岁组老年人COPD患病率为8.2%(31/380),85岁组老年人COPD患病率为18.4%(14/76)。COPD患病率随着患者年龄的增大而增加,且不同年龄段老年人COPD患病率差异有统计学意义(χ~2=14.842,P=0.001)。男性老年人吸烟率为88.6%(381/430),女性老年人吸烟率为1.3%(5/382),男性老年人吸烟率明显高于女性,差异有统计学意义(χ~2=618.13,P=0.000)。结论我校老年人COPD患病率较高,且既往确诊率较低,应逐渐推广肺功能检测,力争做到COPD的早发现、早诊断、早治疗;同时应积极开展健康教育,帮助更多吸烟者戒烟,切实保障老年人的身体健康。     

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.     

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.     

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.     

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.     

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.