儿童血铅水平与5种微量元素相互关系的研究

目的:探讨儿童铅中毒及血铅水平与5种微量元素锌、铁、钙、镁、铜之间的相互关系。方法:采用放射免疫方法测血铅等5种微量元素,选取杭州师范学院临床医学院附院儿科及学院中心实验室2001年6月~2006年6月3561例3~12岁儿童检测分析。结果:①3561例受检儿童,血铅最低值0·024mg/L,最高值0·186mg/L,几何均值为0·068mg/L,铅中毒发生率15·8%;②线性回归显示锌、铁、钙标准回归系数最大,分别为0·064、0·058、0·051与儿童血铅水平差异显著(P<0·01)。③双因素方差分析显示血铅与血锌、血铁、血钙负相关。结论:儿童铅中毒可导致血锌、血铁、血钙水平下降。     

废旧蓄电池回收加工企业周边居民血铅浓度调查

目的了解某废旧电池回收加工企业周边居民血铅浓度水平。方法于2016年12月,在某废旧电池回收加工企业周边选择1个行政村作为暴露区,同时,选择距离7 km的1个行政村作为对照区,采集2~14岁儿童和15岁以上居民血液样本,采用《血中铅、镉的石墨炉原子吸收光谱测定方法》测定血铅浓度。共采集379份血样。结果暴露区和对照区儿童血铅浓度检出范围分别为28.62~485.01、19.32~89.32μg/L,几何均值则分别为91.30、44.18μg/L。暴露区和对照区成人血铅浓度检出范围分别为6.00~1 066.57、6.00~175.71μg/L,几何均值分别为76.68、51.16μg/L。暴露区儿童和成人血铅浓度均高于对照区(P0.05)。暴露区儿童和成人血铅浓度异常率分别为33.7%和2.4%;对照区则均未出现异常。在暴露区,儿童和成人男性血铅浓度均高于女性,差异有统计学意义(P0.05);在对照区,仅在成人表现为男性高于女性(P0.05)。结论该回收加工企业生产造成的铅污染已导致周边居民尤其是儿童血铅负荷显著增加。     

株洲市2016-2018年门诊儿童血铅水平及影响因素分析

了解株洲市门诊儿童血铅水平及其影响因素,为防治铅暴露提供针对性建议.方法 以2016年2月1日至2018年8月1日检测在湖南中医药高等专科学校附属第一医院儿科门诊进行常规体检的1 600名≤14岁儿童静脉血铅水平和血清钙、铁、锌、镁、铜含量,并对儿童家长进行儿童血铅水平影响因素问卷调查.结果 儿童血铅水平为(95.2 ±46.5)μg/L.血铅水平≥100μg/L者检出率达25.7%,不同性别、年龄组儿童血铅水平差异均有统计学意义(Z值分别为1.85,2.85,P值均<0.05).静脉血铅水平与血清钙、铁、锌、镁、铜含量呈负相关(F=16.80,P<0.01).多因素Logistic回归分析显示.经常饮用罐装或瓶装饮料、进食前经常不洗手、常食爆米花、居室用煤、常吸吮手指/啃手指甲与血铅水平呈正性相关(OR值分别为2.12,1.57,1.46,1.78,3.24,P值均<0.01).结论 株洲市儿童血铅水平较高.应加强环境保护和行为干预,并定期检测血铅水平.     

济宁市5262例体检儿童血铅水平与铜、锌、钙、镁、铁测量结果分析

目的:探讨儿童末梢血血铅水平与铜、锌、钙、镁、铁含量水平的相关性,以及儿童铅中毒率与儿童年龄的相关性。方法:采用钨舟法检测儿童末梢血血铅含量,采用火焰吸收光度法检测血铜、锌、钙、镁、铁水平。结果:5 262例体检儿童中,血铅≥100μg/L者471例,铅中毒发生率为8.95%(471/5 262),以轻中度铅中毒为主。不同性别、不同年龄铅中毒的发生率有统计学差异(P<0.05),男童铅中毒发生率高于女童,以～6岁组儿童铅中毒发生率最高,1～6岁组呈上升趋势,6～12岁组呈下降趋势。铅中毒组与非铅中毒组儿童血锌、铁水平有统计学差异(P<0.05),铅中毒组明显低于非铅中毒组。而铅中毒组与非铅中毒组儿童血钙、镁、铜水平之间无统计学差异。结论:儿童铅中毒可导致血中锌、铁等微量元素水平降低,而铜、钙、镁水平无明显变化。     

广东河源地区22554例0～8岁儿童微量元素检测分析

目的:了解目前广东河源地区儿童体内钙、铁、镁、锌、铜、铅6种微量元素含量情况,为儿童科学合理补充微量元素提供依据。方法:采用原子吸收光谱法对22554例儿童进行钙、铁、镁、锌、铜、铅6种微量元素检测,并按0~1岁、1~2岁、2~3岁、3~4岁、4~5岁、5~6岁、6~7岁、7~8岁八个年龄组对检测结果进行统计比较、分析。结果:广东河源地区儿童钙、铁、镁、锌、铜5种微量元素缺乏率分别为0.16%、37.35%、42.66%、26.76%、0.33%,其中血铅的中毒率为1.60%。除镁外,钙、铁、锌、铜缺乏率和铅中毒率在不同性别间比较,均无统计学意义(P0.05);钙、铁、镁、锌、铜5种元素各年龄组间比较差异有显著性(P0.05)。血铅的含量在5~6岁年龄组检出率最高,为2.60%。结论:河源地区儿童镁缺乏最为严重,其次为铁和锌,铅中毒较少。提示各级政府医疗卫生保健单位应加强儿童保健,加大儿童微量元素监测力度,做到科学合理补充微量元素,以保证儿童健康成长。     

环境铅镉联合暴露对儿童智力及神经行为的影响

目的探讨南方某工业区环境铅、镉联合暴露对儿童智力及神经行为的影响。方法选取南方某金属污染重点防治区所在镇为暴露区,相邻上风侧的镇为对照区,按照年龄分层分别抽取暴露区和对照区镇一级小学9~11岁在校学生为调查对象,采用联合型瑞文智力测验量表中国第2次修订版(CRT-C2)对学生进行智力测试,采用天津医科大学编制的津医精神运动成套测验(JPB)对学生进行神经行为测试;同时采用ICP-MS方法检测血铅、血镉含量。结果共调查530名9~11岁在校学生,其中暴露区266人,对照区264人。暴露区儿童血铅、血镉几何均数分别为65.89、1.93μg/L,对照区儿童血铅、血镉几何均数分别为37.21、1.07μg/L,暴露区儿童血铅、血镉水平均高于对照区(均P0.01)。暴露区和对照区儿童IQ值分别为103.38±10.76、106.23±12.84,暴露区儿童IQ值低于对照区(P0.01)。暴露区儿童划消数字、连接数字、目标追踪3个测试项目得分均低于对照区儿童(均P0.01)。多因素线性回归分析结果显示,血铅不仅与IQ值呈负相关(β=-4.16,P0.01),而且与划消数字(β=-0.96,P0.05)、连接数字(β=-1.54,P0.01)、目标追踪(β=-11.85,P0.01)均呈负相关;血镉仅与目标追踪呈负相关(β=-31.21,P0.01)。血铅和血镉的交互作用与IQ值以及5个神经行为测试项目的相关性均无统计学意义(均P0.05)。结论环境铅、镉暴露能分别影响儿童智力和神经系统发育,尚未发现铅、镉联合暴露的影响。     

2703名儿童体内元素检测结果分析

目的了解商丘地区学龄前儿童体内铁、锌、钙、铜、镁5种元素水平,为儿童合理补充元素和临床治疗儿童元素缺乏提供依据。方法 2013年8月-2014年8月使用原子吸收光谱仪检测商丘地区2 703名学龄前儿童末梢血铁、锌、钙、铜、镁水平。按0~1岁、1~2岁、2~3岁、3~4岁、4~7岁将儿童分为5个年龄组。结果铁、锌、钙、铜、镁缺乏发生率分别为38.40%(1 038名)、34.67%(937名)、19.68%(532名)、1.07%(29名)、0.00%(0名),铁与锌同时缺乏发生率为24.08%(651名)。元素缺乏情况在5个年龄组儿童中较常见,不同年龄组儿童锌、钙、铜缺乏发生率比较差异均有统计学意义(P0.05),不同年龄组儿童铁缺乏发生率比较差异无统计学意义(P0.05)。不同性别儿童铁、锌、钙、铜缺乏发生率比较差异均无统计学意义(P0.05)。结论商丘地区儿童铁、锌、钙、铜、镁5种元素缺乏较普遍,缺乏铁、锌、钙3种元素的儿童较多。应加强儿童保健,加大宣传、监测及防治力度,做到合理膳食、合理补充及膳食结构科学合理,以保障儿童健康成长。     

儿童贫血与血铅及微量元素水平的关系

目的:研究儿童贫血与血铅、铁、铜、钙、镁、锌水平之间的关系。方法:随机选择武汉市妇女儿童医疗保健中心就诊儿童90例,采集静脉血分别检测血常规及血铅的含量,采集末梢血检测铁、铜、钙、镁、锌的浓度。根据血常规的结果将研究对象分为贫血组和对照组,贫血组又进一步分为轻度、中度、重度3组。同时,根据血铅的检测结果将研究对象分为低铅组和高铅组。结果:血铅范围在100~200μg/L范围与轻度贫血有明显的相关性。低铅组和对照组与高血铅组和贫血组相比较,铁和锌的水平明显偏低,但钙、镁、铜含量无统计学差异。血铅的水平与Hb、Hct、MCV、MCH呈现明显的负相关性,与RDW-CV呈现正相关性。结论:血铅水平>100μg/L明显与贫血相关,高血铅降低铁和锌的吸收,从负面影响血液学参数。     

银川吴忠中小学生血清微量元素与生长发育指标的关系

了解银川、吴忠市7~ 17 岁儿童青少年血清微量铁、锌、铜、钙、镁元素水平及其与体格发育指标的关系,为儿童青少年合理补充微量元素提供依据.方法 采用分层整群抽样方法,在银川(兴庆区、西夏区、金凤区) 和吴忠两市抽取小学6 所、初中5 所、高中2 所.根据相关纳入和排除标准,共抽取研究对象1 860 名.进行体格测定、静脉采血,采用电感耦合等离子体发射光谱仪测定离心血清中微量元素铁、锌、铜、钙、镁水平.结果 儿童青少年铁、锌、铜、钙、镁元素总体水平中位数分别为20.23,2.98,0.76, 72.57, 13.59 mg /L,四分位数间距分别为21.67,2.98,0.38, 38.42,6.89 mg /L.不同年龄组儿童青少年铁、锌、铜、镁元素水平差异均有统计学意义(Z 值分别为20.12,89.93,55.23,55.76,P 值均<0.01),不同性别之间5 种血清微量元素总体水平差异均无统计学意义(Z 值分别为- 0.16,- 0.77,- 1.88,- 0.95,- 2.06,P 值均> 0.05).铁、锌与身高、体重呈正相关,铜、镁与身高、体重呈负相关; 锌与体质量指数(BMI) 呈正相关,铜、镁与BMI 均呈负相关; 锌与年龄别身高(HAZ) 呈正相关,铜、镁与年龄别体重(WAZ) 和年龄别BMI(BAZ) 呈负相关,铁与BAZ 呈负相关(P值均<0.05).结论 微量元素铁、锌、铜、钙、镁对儿童生长发育有重要的意义.应通过学校和家长的互动,提高儿童青少年健康保健意识.     

6～12岁多动症儿童体内元素水平分析

目的:探讨儿童多动症(ADHD)与体内微量元素和钙、镁水平的关系,为ADHD的预防、诊断和治疗提供科学依据。方法:通过病例对照研究,选取2013年9月~2014年6月在乌鲁木齐儿童医院儿保门诊就诊的维吾尔族、汉族、哈萨克族6~12岁ADHD儿童150名(ADHD组)和同岁同民族健康儿童150名(对照组),应用BH5100原子吸收光谱仪对两组儿童血液样品中铜、铁、锌、铅、镉、钙和镁含量进行测定。结果:ADHD组儿童血铅和血镁水平显著高于对照组,血锌水平显著低于对照组,差异均有统计学意义(P<0.05);血铁、钙、镉、铜水平与对照组比较,差异无统计学意义(P>0.05)。结论:ADHD的发生可能与高铅、高镁和低锌水平有一定的关系。     

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.     

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.     

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.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

The risk of heat exhaustion at a deep underground metalliferous mine in relation to surface temperatures

The risk of heat exhaustion at a deep underground metalliferous mine was assessed in relation to thermal conditions prevailing on the surface. For each day of a 1-year prospective case series of heat exhaustion, surface 24-h mean wet and dry bulb temperatures were recorded. From this data, 24-h mean wet bulb globe temperatures were derived using certain assumptions. The three surface temperature variables were significantly higher on those days on which heat exhaustion occurred, compared to those days on which it did not occur (P < 0.001). The relative risk of heat exhaustion on days when the 24-h mean wet bulb globe temperature was in the range 26.0-28.0 degrees C was 4.82 (95% confidence interval 2.12-10.96). Surface temperature data could be used at this mine to warn miners about the risk of heat exhaustion.