Risk factors for Giardia infection among hospitalized children in Cuba

The risk factors associated with Giardia infection, in children hospitalized in Havana, Cuba, were recently explored. Children aged ≥5?years were more likely to be positive for Giardia infection than the younger children, with an odds ratio (OR) of 3·41 [95% confidence interval (CI) = 1·36-9·69]. The risk factors found to be associated with Giardia infection in univariate analyses were rural residence (OR = 3·01; CI = 1·23-7·35), belonging to a household that did not receive water from an aqueduct (OR = 3·27; CI = 1·21-8·91), drinking unboiled water (OR = 3·64; CI = 2·14-6·26), nail biting (OR = 3·47; CI = 1·97-6·08), eating unwashed vegetables raw (OR = 4·84; CI = 2·33-10·14), and a personal (OR = 3·23; CI = 1·58-6·59) or family history (OR = 3·96; CI = 1·53-10·47) of previous parasitic infection. In multivariate analyses, however, only two (modifiable) risk factors were found to be independently and significantly associated with Giardia infection: nail biting and eating unwashed vegetables raw. It therefore seems that, at least at the individual level, giardiasis-prevention activities in Havana should be focussed on health education to improve personal hygiene and food-related practices. If appropriately managed, the surveillance of drinking water and foodstuffs, for Giardia and other parasites, might also help to reduce the hospitalization of Cuban children.     

Poor food hygiene and housing as risk factors for typhoid fever in Semarang, Indonesia

To identify risk factors for typhoid fever in Semarang city and its surroundings, 75 culture-proven typhoid fever patients discharged 2 weeks earlier from hospital and 75 controls were studied. Control subjects were neighbours of cases with no history of typhoid fever, not family members, randomly selected and matched for gender and age. Both cases and controls were interviewed at home by the same trained interviewer using a standardized questionnaire. A structured observation of their living environment inside and outside the house was performed during the visit and home drinking water samples were tested bacteriologically. Univariate analysis showed the following risk factors for typhoid fever: never or rarely washing hands before eating (OR = 3.28; 95% CI = 1.41-7.65); eating outdoors at least once a week (OR = 3.00; 95% CI = 1.09-8.25); eating outdoors at a street food stall or mobile food vendor (OR = 3.86; 95% CI = 1.30-11.48); consuming ice cubes in beverage in the 2-week period before getting ill (OR = 3.00, 95% CI = 1.09-8.25) and buying ice cubes from a street vendor (OR = 5.82; 95% CI = 1.69-20.12). Water quality and living environment of cases were worse than that of controls, e.g. cases less often used clean water for taking a bath (OR = 6.50; 95% CI = 1.47-28.80), for brushing teeth (OR = 4.33; 95% CI = 1.25-15.20) and for drinking (OR = 3.67; 95% CI = 1.02-13.14). Cases tended to live in houses without water supply from the municipal network (OR=11.00; 95% CI = 1.42-85.2), with open sewers (OR = 2.80; 95% CI = 1.0-7.77) and without tiles in the kitchen (OR = 2.67; 95% CI = 1.04-6.81). Multivariate analysis showed that living in a house without water supply from the municipal network (OR = 29.18; 95% CI = 2.12-400.8) and with open sewers (OR = 7.19; 95% CI = 1.33-38.82) was associated with typhoid fever. Never or rarely washing hands before eating (OR = 3.97; 95% CI = 1.22-12.93) and being unemployed or having a part-time job (OR = 31.3; 95% CI = 3.08-317.4) also were risk factors. In this population typhoid fever was associated with poor housing and inadequate food and personal hygiene.     

Outbreak of norovirus in Västra Götaland associated with recreational activities at two lakes during August 2004

A large community outbreak of norovirus (NV) gastrointestinal infection occurred in V?stra G?taland County, Sweden in August 2004, following attendance at recreational lakes. A frequency age-matched case control study was undertaken of persons who had attended these lakes to identify risk factors. 163 cases and 329 controls were included. Analysis indicates that having water in the mouth while swimming (OR=4.7; 95% CI 1.1-20.2), attendance at the main swimming area at Delsj?n Lake (OR=25.5; 95% CI 2.5-263.8), taking water home from a fresh water spring near Delsj?n lake (OR=17.3; 95% CI 2.7-110.7) and swimming less than 20 m from shore (OR=13.4; 95% CI 2.0-90.2) were significant risk factors. The probable vehicle was local contamination of the lake water (especially at the main swimming area). The source of contamination could not be determined.     

Risk factors for Toxoplasma infection in pregnancy: a case-control study in France.

Each year an estimated 4900 cases of primary Toxoplasma infection occur in pregnant women in France, a country with a high prevalence. Since 1992 all pregnant women at risk of Toxoplasma infection have been required to undergo monthly serological testing. This case-control study, the first of its kind in France, was undertaken to identify risk factors for Toxoplasma infection during pregnancy, with a view to improving primary prevention among non-immune pregnant women. A total of 80 pregnant women who seroconverted to Toxoplasma were matched with 80 pregnant women who had repeatedly negative tests. The women were interviewed by telephone, using a standardized questionnaire, to determine socio-demographic characteristics, exposure to possible risk factors and the type of information on prevention received during pregnancy. The risk factors for Toxoplasma infection included in a multivariate analysis were poor hand hygiene (OR = 9.9; 95%CI: 0.8-125), consumption of undercooked beef (OR = 5.5; 95%CI: 1.1-27), having a pet cat (OR =4.5; 95%CI: 1.0-19.9), frequent consumption of raw vegetables outside the home (OR = 3.1; 95%,CI: 1.2-7.7) and consumption of undercooked lamb (OR = 3.1; 95%CI: 0.85-14). Receipt of documentary advice on prevention was associated with a lower risk of infection. Prevention campaigns among pregnant women in France could be improved and should focus on eating habits, hand hygiene and cats.     

日本血吸虫病肝纤维化的危险因素探讨

[目的 ]探讨日本血吸虫病患者肝纤维化的影响因素。 [方法 ]日本血吸虫病 2级和 3级肝纤维化患者 81例 ,1级肝纤维化患者 6 1例和无肝纤维化的血吸虫感染者 5 0例 ,就可能影响肝脏损伤的因素进行研究 ,对所有因素用有序回归模型分析。 [结果 ]可能与日本血吸虫病肝纤维化有关的危险因素有 :血吸虫病治疗次数(OR =1 75 ) ,血吸虫感染间期 (OR =1 40 ) ) ,经常饮酒 (每天多于 1次 ,5年以上 ) (OR =1 95 )和晚期血吸虫病 (巨脾型和腹水型 )家族史 (OR =2 11)。 [结论 ]血吸虫反复感染、感染间期越长、经常饮酒和有晚期血吸虫病家族史的血吸虫病患者肝组织发生纤维化的危险性也越大。     

Acute hepatitis E of a man who consumed wild boar meat prior to the onset of illness in Nagasaki, Japan.

Zoonotic infection of hepatitis E virus (HEV) has been suggested. To date, pigs, deer, and wild boar have been implicated as reservoirs of HEV in Japan. However, it is not known to what extent zoonotic transmission of HEV play roles of causing HEV transmission. In the present report, we describe a case of acute hepatitis E in which a transmission of HEV by a zoonotic transmission is strongly suggested. The patient had eaten grilled wild boar meat 59 days prior to onset of acute hepatitis. Although the meat was not stored, one of the two people who ate boar meat with the patient at the same time showed high levels of HEV-IgM and -IgG and normal levels of liver enzymes, suggesting a subclinical infection of HEV. Accumulating evidence suggests that eating wild boars is associated with a high risk of acquiring hepatitis E infection.     

Weight cycling in treatment-seeking obese persons: data from the QUOVADIS study

OBJECTIVE: To determine parameters of weight history useful for the assessment of weight cycling and their association with psychological distress and binge eating. DESIGN: Cross-sectional. SUBJECTS: A total of 1889 treatment-seeking obese subjects, enrolled by 25 Italian centers (78% female subject), aged 20-65 y (median 45); 1691 reported previous efforts to lose weight (median age of first dieting, 30 y). MEASUREMENTS: The number of yearly attempts to lose weight, weight gain since age 20 y, cumulative weight loss and gain were checked by a predefined structured interview. Psychological distress was tested by means of Symptom Check-List 90 (SCL-90), Binge Eating Scale (BES) and Three Factor Eating Questionnaire (TFEQ). RESULTS: Differences in anthropometric, clinical and psychological parameters were observed in relation to previous attempts to lose weight. Patients in the upper quartile of parameters of weight history were considered weight cyclers. In multivariate logistic regression analysis, after correction for age, sex and BMI, a high BES score was the only factor systematically associated with a high frequency of dieting (OR, 1.70; 95% confidence interval, 1.22-2.36; P=0.022), with higher cumulative weight loss (1.42; 1.12-1.80; P=0.003) and cumulative weight gain (1.38; 1.06-1.79; P=0.017). However, the sensitivity, specificity and positive predictive value of a high BES score were very low to detect cyclers. Weight cycling did not carry a higher risk of complicating diseases. CONCLUSIONS: Weight cycling is associated with psychological distress, and binge eating independently increases the risk, but cannot be used to predict cycling. Also, obese patients who do not experience overeating as a loss of control discontinue treatment or regain weight following therapy.     

寄生虫病综合防治示范区鞭虫感染影响因素分析

目的了解寄生虫病综合防治示范区鞭虫感染的主要影响因素,为改进鞭虫感染防治措施提供依据。方法应用非条件Logistic回归分析,对寄生虫病综合防治示范区基线调查数据库中的相关数据进行单因素和多因素分析。结果单因素分析显示,饮用水源类型、家庭厕所类型、农田用肥方式、菜地用肥方式、便后洗手、生吃蔬菜瓜果、检查前服用过驱虫药等7个因素均有统计学意义（P〈0.05）,其中,生吃蔬菜瓜果具有高度危险作用（OR=2.302）;便后洗手和检查前服用过驱虫药具有保护作用（OR值分别为0.904和0.664）;农田和菜地施用化肥（或混合肥）较施人畜粪肥保护作用明显（OR值分别为0.864和0.854）;饮用井水和泉水具有一定的保护作用（OR值分别为0.843和0.567）;室内简易厕和沼气池对鞭虫感染也具有保护作用（OR值分别为0.576和0.687）。多因素分析显示,鞭虫感染的主要影响因素包括生吃蔬菜瓜果、农田用肥方式、菜地用肥方式和检查前服用过驱虫药4个因素。结论寄生虫病综合防治示范区人群鞭虫感染的主要影响因素是生吃蔬菜瓜果和农田（菜地）用肥方式,服用驱虫药可以降低鞭虫感染率,改水和改厕措施可在一定程度上降低人群感染风险。     

Associations of appetitive behaviors in 7-year-old children with their cardiometabolic health at 10 years of age

Background and AimsAtherosclerosis begins early in life, thus optimal cardiovascular health needs to be promoted early. We investigated whether appetitive behaviors among 7 year olds are associated with their cardiometabolic health years later.Methods and ResultsA sample of 2951 children from a Portuguese birth cohort was analyzed. The Children's Eating Behavior Questionnaire assessed eating behaviors, and a measure of cardiometabolic risk (higher risk group: those in the upper quartile of triglycerides, homeostatic model assessment-insulin resistance, waist circumference and systolic blood pressure and in the lower quartile of high-density lipoprotein cholesterol z-scores) was created. Linear and logistic regressions were run. Children with more food avoidant behaviors had lower cardiometabolic risk (Satiety Responsiveness – boys: OR = 0.39, 95% CI 0.16; 0.93, girls: OR=0.37, 95% CI 0.17; 0.82 and Slowness in eating – boys: OR = 0.49, 95% CI 0.25; 0.95, girls: OR = 0.49, 95% CI 0.27; 0.91). Food approach behaviors (Food responsiveness (CEBQ-FR), Enjoyment of food (CEBQ-EF) and Emotional overeating (CEBQ-EOE)) increased cardiometabolic risks (e.g. CEBQ-FR: boys: OR = 2.50, 95% CI 1.45; 4.32, girls: OR = 2.33, 95% CI 1.46; 3.71). CEBQ-EF had stronger effects in boys, while CEBQ-EOE was positively associated with cardiometabolic risk among girls. When adjusting for BMIz at 7y, associations did not remain significant. Appetitive behaviors were also associated with isolated cardiometabolic parameters; the strongest association being with waist circumference.ConclusionsAppetitive behaviors at 7-years are associated with cardiometabolic risk at age 10. While ‘food avoidant’ behaviors protect against cardiometabolic risk and ‘food approach’ behaviors increase cardiometabolic risk, these associations are largely dependent of child's adiposity.     

女性静脉注射吸毒感染HIV危险因素的病例对照研究

目的探讨女性静脉注射吸毒（IDus）感染艾滋病病毒（HIv）的危险因素,为制定针对这一人群的干预措施提供理论依据。方法通过1：1配对50对女性IDUs病例对照研究,探索其感染HIV的危险因素。结果对各个变量进行单因素条件Logistic回归分析后发现,与HIV感染有显著相关的因素有：无固定居所、共用针具史、过去1年有多性伴或以性换钱／毒品、有HIV阳性固定性伴、有IDU性伴、有暴力虐待史、曾感染梅毒、认为自己有很大／一定感染HIV危险。HIV感染的危险因素为：有HIV阳性的固定性伴（OR=28．05;95％CI=2．34,335．67）,过去一年曾以性换钱鹰品（OR=5．89;95％CI=1．12,31．09）,以及无固定居所（OR=10．77;95％CI=1．21,96．06）。结论广东省的女性IDUs中,性行为较注射行为对于HIV传播更为危险,干预重点应该放在如何减少在吸毒情况下经性途径传播HIV的危险因素上。     

Urban/rural differences in prevalence and risk factors for intestinal helminth infection in southern Malawi

Urbanization may increase the risk of human infection with intestinal helminths. A cross-sectional survey was conducted to investigate the prevalence, intensity and potential risk factors of acquiring such infection, among children aged 3-14 years in similar urban and rural communities in southern Malawi. Stool samples were collected from 553 children (273 urban and 280 rural). The overall prevalence of helminth infection was significantly higher in the urban subjects than in the rural (16.5% v. 3.6%; P < 0.001), mostly because of differences in the prevalence of Ascaris lumbricoides infection. Living in an urban community was associated with a significantly higher risk of infection [odds ratio (OR) = 5.3; 95% confidence interval (CI) = 2.6-12.1], even after controlling for potential confounding factors. In the urban community, risk factors included having pools of water/sewage around houses (OR = 3.0; CI = 1.4-6.5), not wearing shoes (OR = 7.1; CI = 2.7-19.2), not attending school (OR = 2.8; CI = 1.2-6.5), having mothers with 4-8 years of education (OR = 5.2; CI = 2.0-14.0), and having mothers below 35 years of age (OR = 4.09; CI = 1.39-16.28). In this part of Africa, efforts to reduce helminth infections may best be focused on reducing geohelminth burden in urban areas.     

经内镜逆行胰胆管造影术后高淀粉酶血症的危险因素分析

目的探讨经内镜逆行胰胆管造影(ERCP)术后高淀粉酶血症(PEPH)发生的危险因素。方法对2012年1月-2014年12月在新疆维吾尔自治区人民医院行治疗性ERCP并符合纳入标准的233例患者的临床资料进行回顾性分析,提取患者年龄、性别、饮酒史、单发结石、甘油三酯、民族等基本信息并详细录入ERCP术中操作、术中诊断以及并发症等情况。计数资料组间比较采用χ2检验,采用Logistic回归分析寻找PEPH发生的危险因素。结果 PEPH发生率为26.6%(62/233)。单因素分析显示女性(χ2=3.320,P=0.045)、有饮酒史(χ2=6.108,P=0.010)、胆总管狭窄(χ2=5.767,P=0.012)、单发结石(χ2=9.121,P=0.020)、十二指肠乳头憩室(χ2=28.170,P0.001)、异常的甘油三酯(χ2=54.717,P0.001)为PEPH发生的影响因素。多因素Logistic回归分析显示女性[比值比(OR)=1.616,P=0.025]、饮酒史(OR=2.360,P=0.010)、胆总管狭窄(OR=2.163,P=0.012)、十二指肠乳头憩室(OR=5.502,P0.001)、甘油三酯异常(OR=12.924,P0.001)为PEPH发生的独立危险因素。结论女性、有饮酒史、胆总管狭窄、十二指肠乳头憩室、异常的甘油三酯是PEPH的独立危险因素。对这一类高危人群进行针对性的预防可有效降低PEPH及ERCP术后胰腺炎的发生。     

Toxoplasmosis in military personnel involved in jungle operations

Tropical diseases, mainly leishmaniasis and malaria, increased among Colombian military personnel due to intensive operations in the jungle in the last ten years; as a result the Colombian army developed important preventive strategies for malaria and leishmaniasis. However, no knowledge exists about toxoplasmosis, an emergent disease in military personnel. We compared the prevalence of IgG anti-Toxoplasma antibodies by ELISA and of parasitaemia by a real time PCR assay, in 500 professional soldiers that operated in the jungle with a group of 501 soldiers working in an urban zone (Bogotá). We found that the prevalence was significantly different between both groups of soldiers (80% in soldiers operating in jungle vs. 45% in urban soldiers, adjusted OR 11.4; CI 95%: 3.8-34; p<0.0001). All soldiers operating in the jungle drink unboiled and chlorine untreated lake or river water. In urban soldiers, these risk factors along with eating wild animal meat or eating tigrillo (little spotted cat) were significantly associated with a higher prevalence. Characteristic toxoplasmic choriorretinal lesions were found in 4 soldiers that operated in the jungle (0.8%) and in one urban soldier (0.19%). All soldiers before being deployed in jungle operations should be tested for Toxoplasma antibodies and to receive adequate health information about the routine use of personnel filters to purify their water for consumption.     

Do Ramadan fasting restrictions alter eating behaviours?

During Ramadan month, Muslims should refrain from drinking, eating and smoking from dawn to sunset. Ramadan fasting can be considered as a kind of dietary restriction. Eating restriction is a risk factor for later development of eating disorders. The purpose of this study is to evaluate whether Ramadan fasting changes the eating behaviours of young people, especially girls who are known as the most vulnerable group for eating disorders. Our sample consisted of 79 healthy volunteers from a high school (63 females; mean age = 16.29; 16 males; mean age = 16.31) who fasted during the Ramadan month. No statistically significant differences were found between the scores of EAT (Eating Attitude Test) and BITE (Bulimic Investigatory Test, Edinburgh) which were administered within the weeks before and after Ramadan. According to our results Ramadan fasting restrictions do not seem to change the eating behaviours of young girls and boys. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association.     

Hepatitis E virus antibody prevalence among persons who work with swine.

Prevalence of antibody and risk factors to hepatitis E virus (HEV) infection were determined in a cross-sectional study of 2 group-matched populations: swine farmers (n=264) and persons without occupational exposure to swine (n=255) in Moldova, a country without reported cases of hepatitis E. The prevalence of HEV infection was higher among swine farmers than among the comparison group (51.1% vs. 24.7%; prevalence ratio, 2.07; 95% confidence interval [CI], 1.62-2.64). In multivariate analysis, HEV infection was associated with an occupational history of cleaning barns or assisting sows at birth (odds ratio [OR], 2.46; 95% CI, 1.52-4.01), years of occupational exposure (OR, 1.04 per year; 95% CI, 1.01-1.07), and a history of drinking raw milk (OR, 1.61; 95% CI, 1.08-2.40). HEV infection was not associated with civilian travel abroad or having piped water in the household. The increased prevalence of HEV infection among persons with occupational exposure to swine suggests animal-to-human transmission of this infection.     

Risk factors for anemia in Vietnam

Anemia is a significant public health problem in Vietnam, but representative national data and comprehensive risk factors analysis are lacking. The objectives of this study were to: 1) determine the distribution and severity of anemia in Vietnam, and 2) to assess potential risk factors for anemia. Nine thousand five hundred fifty households in 53 provinces were covered using a stratified two-stage cluster survey carried out in 1995. Selected household members were interviewed; intestinal helminthes were tested in non-pregnant women by Kato-Katz technique; hemoglobin concentrations were measured with Hemocue. Data were weighted and analyzed by survey procedures using SAS 9.0. Overall, 60% of children under 2 years old, 53% of pregnant women, 40% of non-pregnant women and 15.6% of men were anemic. Hookworm infection was the strongest factor associated with anemia (OR = 1.7; 2.9 and 4.5 for 11,999, 2,000-3,999 and > or = 4,000 hookworm egg counts, respectively) and accounted for 22% of anemia. Hookworm intensity was significantly associated with hemoglobin level; for each 1,000 egg increase, hemoglobin was reduced by 2.4 g/l. Living in different ecological zones, eating < 1 serving of meat/ week, and farming were significantly associated with anemia in women and children. Other risk factors in women included having > 3 children and having a child < 24 months old. In men, no variables were found significantly associated with anemia.     

Risk factors for primary liver carcinoma in Chinese population

AIM: To evaluate the risk factors for primary liver carcinoma (PLC) in Chinese population. METHODS: Chinese Biomedical Literature Database, China Hospital Knowledge Database and MEDLINE were searched. All the related literatures were screened, and the risk factors for PLC in Chinese population were studied. Heterogeneity was evaluated by odds ratio (OR) q test. Combined OR and its 95% confidence interval (95%CI) were calculated, the association between the investigated risk factors and PLC was determined. Validity and bias of the findings were evaluated by sensitivity analysis and funnel plot analysis respectively. RESULTS: Fifty-five of one hundred and ninety identified studies were accepted according to the inclusive criteria. Ten factors related to PLC were demonstrated by sensitive analysis and funnel plot analysis. They were cirrhosis (OR = 11.97, P=0.000), HBV infection (OR = 11.34, P=0.000), HCV infection (OR = 4.28, P= 0.000), family history of liver cancer (OR = 3.49, P=0.000), unstable emotion (OR = 2.20, P=0.000), depressed characters (OR = 3.07, P= 0.000), aflatoxin (OR = 1.80, P= 0.000), alcoholic (OR = 1.88, P= 0.000), intake of musty food (OR = 1.87, P = 0.000) and drinking contaminated water from pond (OR= .77, P=0.003). CONCLUSION: The main risk factors for PLC in China are liver diseases, family history of liver carcinoma, poor psychic status, aflatoxin, and some unhealthy behaviors.     

Prevalence and risk factors of intestinal parasites in Cuban children

OBJECTIVES: To determine the prevalence of intestinal parasite infections and their risk factors in children in urban and rural settings in two Cuban municipalities. METHODS: A total of 1320 Cuban schoolchildren aged 4-14 were tested by stool examination for intestinal parasite infections and evaluated by parental questionnaire for a number of common environmental, sanitary, socioeconomic and behavioural risk factors. Multivariate regression was applied to examine the relationship between the respective parasite infections and the risk factors. RESULTS: Prevalences of intestinal parasite infections were 58% in Fomento and 45% in San Juan y Martínez; for helminth infections, these were 18% and 24% and for protozoa infections, 50% and 29%, respectively. Helminth infections were associated with high parental education (maternal: OR 0.68, CI 0.50-0.93; paternal: OR 0.71, CI 0.52-0.96), absence of toilet (OR 1.57, CI 1.12-2.19), consumption of water from a well or river (OR 0.56, CI 0.41-0.77) and eating unpeeled/unwashed fruit (OR 1.37, CI 1.01-1.87); protozoa infections were only associated with high maternal education (OR 0.72, CI 0.57-0.91). CONCLUSIONS: Paediatric intestinal parasite infections are still prevalent in certain areas in Cuba and associated with a number of common environmental, socioeconomic and sanitary risk factors.     

Infective tricuspid valve endocarditis with pulmonary emboli caused by Campylobacter fetus after tooth extraction

We describe a case of infective endocarditis caused by Campylobacter fetus accompanied by pulmonary emboli. A 52-year-old man was referred to our hospital due to febrile temperatures with a history of dental treatment followed by eating raw meat. Computed tomography revealed multiple infiltrations and a nodule with low attenuation area and feeding vessels. A mobile mass, possible vegetation, attached to the tricuspid valve was detected by transthoracic echocardiography. Two blood cultures disclosed Campylobacter fetus. Long-term antibiotic therapy was given, curing the infection with valvuloplasty. We presented the possibility that infective Campylobacter fetus endocarditis after dental treatment was caused by eating raw meat.     

内蒙古饮水型地方性砷中毒病区人群皮肤损伤危险因素分析

目的 探讨内蒙古饮水型地方性砷中毒病区人群皮肤损伤(角化和色素异常)的危险因素.方法 采用整群抽样方法对内蒙古巴彦淖尔市临河区、杭锦后旗、五原县的5个乡10个社中902名居民进行问卷调查,并进行体检,观察皮肤改变情况.采集所有调查对象的手指甲、饮用水水样,利用电感耦合等离子质谱仪(ICPMS)测定水砷,中子活化分析(INAA)法测定指甲含砷、硒量.对数据进行单因素和多因素非条件Logistic回归分析.结果 单因素Logistic回归分析显示皮肤角化的危险因素为年龄、使用农药、指甲含砷量、吸烟、吸烟时间、饮酒、水砷、氟中毒和饮含砷水时间,保护因素为职业、指甲含硒量和维生素;色素异常的危险因素为年龄、使用农药、指甲含砷量、吸烟、吸烟时间、吸烟量、饮酒、氟中毒、水砷和饮含砷水时间,保护因素为性别、职业和指甲含硒量;多因素Logistic逐步回归分析结果显示年龄、使用农药和水砷为皮肤角化的危险因素(OR值分别为1.387、1.583、1.321,P均＜0.05),职业和维生素为其保护因素(OR值为0.307、0.260,P均＜0.05);年龄、使用农药、指甲含砷量、氟中毒和水砷为皮肤色素异常的危险因素(OR值分别为1.724、2.636、2.741、3.699、1.863,P均＜0.05),而性别是其保护因素(OR值为0.255,P＜0.05).结论 慢性砷中毒患者皮肤损伤的发生与多种因素有关,可以采取改水除砷、健康宣教、合理摄入营养素等综合措施进行防治.