游泳场所卫生状况综合评价方法的应用和比较

[目的]应用综合评价方法评价游泳场所卫生状况,并对各方法的合理性进行比较,并验证其一致性。[方法]以2009年上海市长宁区30家游泳场所的卫生监督检查和水质检测两大类资料作为研究对象。对卫生监督检查资料应用量化分级管理评分法综合评价游泳场所卫生状况;对水质检测资料分别应用合格率法、综合指数法、模糊数学法和人工神经网络法构建水质综合评价模型并进行水质等级判断。最后,对五种综合评价方法的结果进行一致性检验。[结果]相比于其他评价方法,人工神经网络法有其方法学的优势,经其构建的水质综合评价模型评价的游泳场所水质平均等级为2．27级,各水质等级的游泳场所单位数的分布呈“两头少,中间多”的纺锤形结构,且显示出体育场馆内设游泳场所的等级达标率较高（100．0％）和小区会所内设游泳场所的等级达标率较低（68．2％）,这些结果与历年来的游泳场所卫生监督检测结果基本相符。经综合指数法、合格率法和模糊数学法构建的水质综合评价模型评价的游泳场所水质平均等级分别为3．23级、2．87级和2．20级。经量化分级管理评分法评价的游泳场所卫生平均等级为2．27级。五种综合评价方法的结果间的Kappa系数在-0．134～0．173之间。[结论]五种综合评价方法结果的一致性较低,应用人工神经网络法构建的游泳场所水质综合评价模型相对合理。     

2006-2008年龙岩市城区游泳场所水质卫生状况分析

[目的]了解龙岩市城区游泳场所基本卫生状况。[方法]按GB／T 17220—1998《公共场所卫生监测技术规范》,对龙岩市城区2006－2008年游泳场所的游泳池水质进行检测。[结果]2006～2008年合计检测水样46份,合格率为34．8％。不同年份间合格率的差异有统计学意义（P〈0．05）。pH值、浑浊度和尿素指标均合格,合格率为100．00％。不合格项目分别为池水温度（67．4％）、游离性余氯（50．0％）、细菌总数（50．0％）、大肠菌群（80．4％）。不同指标间合格率的差异有统计学意义（P〈0．01）。学校内设游泳场所水质合格率低于社会性游泳场所（P〈0．01）,大池水质合格率低于小池（P〈0．05）。[结论]龙岩市城区游泳池水的卫生状况不容乐观,特别是校内游泳池,应加强游泳场所的监管力度,加大卫生健康的宣传,强化消毒措施。     

上海市某区游泳池水质卫生状况

目的通过监测上海市某区游泳池水质,评价泳池水质状况,探讨泳池管理存在的问题.通过加强管理,改善现有状况。方法依据《公共场所卫生监测技术规范》（GB/17220—1998）采集并检测水样,按《游泳场所卫生标准》（GB9667—1996）进行评价。结果不同游泳场馆池水的合格率分别为健身会所35.71%、公共游泳馆57.14%、宾馆酒店75.32%,所有水样各指标合格率分别为细菌总数98.05%、浑浊度100%,大肠菌群96.75%,尿素60.39%,游离余氯98.70%,pH值100%。结论该区游泳池需要增加换水频率,加强消毒卫生管理,提高游泳者卫生意识和公共道德。     

2011年青岛市崂山区游泳场馆卫生现状调查

[目的]了解青岛市崂山区游泳场所卫生管理状况及水质监测结果,为制定探索监管措施提供依据。[方法]2011年7、10月,按照《公共场所卫生监测技术规范》(GB 17220-1998)对崂山区9家游泳场所进行卫生管理状况及水质监测。[结果]崂山区9家游泳场所均有卫生许可证,有池水净化消毒设备的有9家,有应急处置预案的有8家,有消毒产品索证的6家。2011年合计监测水样216份,合格的186份,合格率为86.11%。样品合格率,7月份为85.19%,10月份为87.04%(P>0.05);健身场所的为95.83%,体育场馆的为95.83%,公司会所的为79.17%,酒店的为80.56%(P>0.05)。pH值、浑浊度、尿素、游离性余氯、细菌总数、大肠菌群合格率分别为100.00%、100.00%、77.78%、72.22%、83.33%、83.33%。[结论]崂山区游泳场所卫生状况总体较好,健身场所、酒店类游泳场所卫生状况有待提高。     

密切值法评价无锡市2类游泳场所水质卫生状况

目的验证密切值法在游泳池水质卫生状况评价中的应用。方法应用多因素系统优选法——密切值法对无锡市2类游泳场所（星级宾馆室内游泳池和对社会公众开放的游泳场馆）6项指标的监测结果进行综合评价。结果星级宾馆室内游泳池的水质卫生状况优于对社会公众开放的游泳场馆，优劣顺序与实际情况符合。结论密切值法计算简便，容易理解，能充分利用原始数据信息，用于游泳池水质卫生状况评价更为全面。     

2006年安阳市游泳池水水质卫生状况分析

[目的]了解安阳市游泳场所在卫生管理软件和硬件方面存在的问题,并提出相应的管理对策.[方法]2006年1～12月对安阳市9家游泳场所水质采样检验, 6～7月对每家游泳场所进行了一次性10项卫生管理检查.[结果]全年共采水样204份,合格138份,合格率为67.4%.6～9月采样135份,合格84份,合格率为62.2%;其他月份采样69份,合格54份,合格率78.3%.6～9月的水样合格率低于其他月份水样,两者差异有统计学意义(P＜0.05).卫生管理、卫生设施齐全并正常运转等卫生状况较好的单位,水质合格率高于相应较差的单位,差异有统计学意义(P＜0.01).[结论]游泳场所的卫生管理是动态的过程,重视软件的落实和硬件的运转,加强水质检测是保证游泳场所卫生达标的关键.     

2012-2016年肇庆市端州区泳池水水质监测结果分析

目的 了解肇庆市泳池水水质卫生现状,为优化泳池场所卫生管理提供科学依据.方法 对肇庆市端州区各开放的游泳场所进行水样采集,检测pH值、浑浊度、大肠菌群、细菌总数、尿素、泳池水余氯、浸脚池余氯,按GB9667-1996对泳池水质进行评价.结果 2012-2016年间共检测水样264份,合格204份,合格率为77.27％,各年度水样合格率差异无统计学意义.不合格指标主要为游离余氯和微生物指标.住宅(小区)内泳池、酒店内泳池、社会经营性公共泳池、学校内泳池这4类游泳场所中,社会经营性的泳池水质合格率比其它3类低,其中山泉水泳池合格率最低,仅为37.78％.结论 5年间端州区泳池水的卫生状况有所改善,游离余氯、微生物指标是影响泳池水水质的重要因素,部分泳池,特别是山泉水泳池存在卫生隐患.应继续加强对游泳场所的监督管理.     

2008～2009年南京市鼓楼区游泳池水质资料分析

[目的]了解鼓楼区游泳场所卫生状况,为监督管理提供科学依据。[方法]对2008～2009年鼓楼区游泳场所游泳池水质进行分析。[结果]2008～2009年对相同15家游泳池共采集280份水样,合格181份,合格率为64.64%。检测合格率,2008年为60.77%,2009年为68.00%(P>0.05)。2008～2009年平均合格率,室内水样为81.43%,室外水样为60.00%(P<0.01);菌落总数为73.93%,大肠菌群为91.41%,池水温度合格率为99.29%,pH值、浑浊度、尿素、游离性余氯均为100%。[结论]鼓楼区游泳场所池水卫生状况较差,存在微生物污染。     

2008-2009年南京市鼓楼区游泳池水质资料分析

[目的]了解鼓楼区游泳场所卫生状况,为监督管理提供科学依据。[方法]对2008～2009年鼓楼区游泳场所游泳池水质进行分析。[结果]2008～2009年对相同15家游泳池共采集280份水样,合格181份,合格率为64.64%。检测合格率,2008年为60.77%,2009年为68.00%（P〉0.05）。2008～2009年平均合格率,室内水样为81.43%,室外水样为60.00%（P〈0.01）;菌落总数为73.93%,大肠菌群为91.41%,池水温度合格率为99.29%,pH值、浑浊度、尿素、游离性余氯均为100%。[结论]鼓楼区游泳场所池水卫生状况较差,存在微生物污染。     

2007年-2010年某市游泳池水质检测结果分析

目的:了解某市游泳池水质卫生状况,为游泳场所的卫生质量管理提供依据。方法:对游泳池水的卫生指标pH值、浑浊度、尿素、游离性余氯、细菌总数、大肠菌群进行检验,并对检测结果进行分析。结果:四年共检测186份水样,99份水样合格,总合格率为53.2%,不同年份合格率无显著差异。不同游泳场所的合格率依次为:社会性场所>酒店宾馆>专业游泳馆>学校,以学校内设泳池水质的卫生合格率最低,仅为50%。主要不合格项目是游离余氯、尿素、细菌总数。结论:游泳场所水质卫生状况不容乐观,有关部门仍需加大对游泳场所的监督管理力度。     

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.     

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.     

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.     

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.     

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.