镉作业工人尿中相关指标的研究

目的:探讨慢性职业性镉中毒的早期诊断指标.方法:以职业接触镉工人144人为接触组和未接触镉且体检未见异常的员工114人为研究对象,分别检测尿中镉(Cd)、α,-微球蛋白(α-MG)、β2-微球蛋白(β2-MG)、视黄醇结合蛋白(RBP)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、碱性磷酸酶(AKP)、Υ-谷氨酰基转移酶(GGT)的含量,应用SPSS10.0软件进行统计学分析.结果:镉作业工人尿镉含量在各接触组中均增高,尿α1-MG、β2-MG、RBP在接触2、3组中增高,与对照组相比有显著性差异(P＜0.05),且随着接触时间的延长呈上升趋势;各接触组尿GGT、NAG活性均明显高于对照组(P＜0.05).结论:尿镉、α1-MG、β2-MG、RBP、GGT、NAG可作为慢性职业性镉中毒的早期诊断指标.     

汞作业人员肾脏早期损伤指标的探讨

[目的]探讨汞作业人员早期肾脏损伤的生物效应指标。[方法]将116名汞作业人员分为尿汞值超标组、尿汞值正常组,并以无汞接触史的50名健康成人作为对照组,分别测定尿中肌酐(UCr)、γ-谷氨酰基转移酶(γ-GT)、α1-微球蛋白(α1-MG)、β2-微球蛋白(β2-MG)、视黄醇结合蛋白(RBP)、N-乙酰-β-D氨基葡萄糖苷酶(NAG),排除肾病史和肾脏疾病患者后对其结果进行分析。[结果]汞作业人员α1-MG、β2-MG、RBP、NAG和对照组相比均有升高趋势,其中RBP和NAG与对照组相比,差异有统计学意义。尿汞值超标组和尿汞值正常组NAG水平均明显高于对照组。[结论]汞作业人员NAG活性增高较尿汞出现得早,建议将尿NAG活性测定作为汞作业人员健康监护指标之一,与尿汞同时检测。     

驱铅对尿β2-MG、NAG、RBP的影响

通过接铅组与对照组及接铅者不同连续驱铅时间分组的PbB,ZPP,尿β2-MG、NAG、RBP检测结果比较,及其各指标在不同驱铅时间的下降程度与恢复至对照组水平的人数分析,表明尿β2-MG、NAG、RBP 3指标在连续驱铅过程中的变化明显,并且不受接铅影响。 更多还原     

空气中铅浓度与尿铅,δ—ALA,尿粪卟啉三项指标的关系

对空气中铅浓度与尿铅、δ-ALA、尿粪卟啉三项指标的关系进行分析。将不同铅接触水平的357名作业工人分为高、中、低铅浓度的三个组。高、中、低浓度接触组的作业环境空气中平均铅浓度结果分别为3.553、0.180、0.022mg/m~3,其尿的三项指标测定结果均比空气中铅浓度为0.0024mg/m~3的对照组高;高浓度组尿的三项指标显著高于其他各组(P<0.01);中浓度组尿铅、尿粪卟啉比低浓度组和对照组显著增高(P<0.01);而低浓度组与对照组各项指标均无显著差异。尿的三项指标间以及它们与空气中铅浓度之间均呈明显正相关,尿铅、δ-ALA、尿粪卟啉与空气中铅浓度的相关系数分别为0.5947(P<0.0005)、0.5038(P<0.0005)、0.7209(P<0.01)。表明铅中毒诊断指示中尿的三项指标仍有其实用价值,但作为低浓度铅接触检测指标,其灵敏度则不够理想。     

铅作业工人尿中N—乙酰—β—D—葡萄糖苷酶活性研究

对某铅冶炼厂262名男性和87名女性作业工人进行了铅对肾功能影响的研究。实验结果表明铅作业工人组尿蛋白显著增高。个别组尿溶菌酶增高;铅作业工人尿NAG显著高于对照组(7.37±2.04U/g.Cr),并与铅中毒指标及肾功能指标(尿LZM和尿Prot)显著相关,提示长期职业性铅接触可造成肾功能的损害。在铅作业工人分组中,NAG并非完全随铅性损害增加而持续上升。从而,提示NAG作为铅性肾损害敏感指标之一,在早期运用较为合适。     

苯暴露对β2-微球蛋白和尿视黄醇蛋白的影响

为了解苯对职业人群肾损伤的影响,寻找作业工人健康监护的早期指标,对某石化公司170名苯接触工人尿中β2-微球蛋白(β2-MG)和尿视黄醇蛋白(RBP)的含量进行了检测。结果显示,低浓度接触组尿β2-MG含量(322.6±235.8pg/L)高于对照组(P<0.05),高浓度接触组尿β2-MG含量(412.9±331.3pg/L)高于对照组(P<0.01)。低浓度接触组尿RBP含量(292.7±172.9pg/L)高于对照组(P<0.05)。提示苯暴露会影响肾小管功能导致尿中β2-MG和RBP含量升高,且尿β-MG含量升高较为显著。建议将尿β-微球蛋白含量作为苯职业人群的健康监护指标。     

汞作业者肾脏损害早期指标研究

目的探讨汞作业者肾脏损害的早期指标及其临床意义。方法85名汞作业者分为汞接触正常组、汞接触超标组,并以无汞接触史的65名健康成人作为对照组。分别进行临床体检并测定尿汞（HgU）、血肌酐（BCr）、尿肌酐（UCr）、血尿素氮（BUN）、尿-N-乙酰-β-D葡萄糖苷酶（NAG）、尿β2-微球蛋白（β2-MG）、尿α1-微球蛋白（α1-MG）和尿视黄醇结合蛋白（RBP）,排除肾病史和患有肾脏疾病患者后对结果进行分析。结果汞作业者HgU、BCr、NAG、β2-MG、α1-MG和RBP均显著高于对照组,但BCr、UCr、BUN无显著差别。结论长期汞接触可造成肾小管功能损害,尿NAG、β2-MG、α1-MG、RBP可作为汞作业工人肾脏损害的早期敏感的监测指标。     

排铅后再接铅生物指标的观测

目的：探讨排铅工人再接铅后,某些生物监测指标和卟啉代谢指标的动态变化。方法：110名冶炼厂工人排铅治疗后,回生产岗位2周,7周,24周,分别采样进行血铅（PbB),尿铅（PbU),尿道基酮戊酸（δ－ALA）,血氨基酮戊酸脱水酶 （δ－ALAD）,红细胞游离原卟啉（FEP）,血红蛋白（Hb)的监测,同时进行作业场所空气铅烟的监测。结果：低水平接触组以PbB变化较早和灵敏,其次为δ－ALAD,δ－ALA和FEP的增高出现较晚;中等水平接触组以PbB,PbU和δ－ALAD变化出现最早和敏感,其后变化趋势变缓,但δ－ALA,FEP持续增高;高水平接触组各项指标均出现明显的改变,以δ－ALA变化幅度较大,其次为FEP,PbU,PbB,而δ－ALAD的变化与中等水平组相似,Hb仅在24周出现降低。经相关和聚类分析,PbB,PbU,δ-ALAD活性具有相似变化规律,而EP与δ－ALA具有相似的时间序列变化规律。结论：工人排铅后再接铅,在较短时间内出现铅的毒性效应,应加强一级预防,接铅后各项指标呈现两种不同类型的变化态势。     

云南省某铅锌矿企业227例尿铅超标患者驱铅治疗疗效评价

目的评估云南省某铅锌矿作业工人尿铅超标者的临床诊断类型,探讨在治疗过程中血铅(PbB)、尿铅(PbU)、红细胞锌原卟啉(ZPP)浓度变化规律,评价驱铅治疗的效果。方法治疗结束后,依据《职业性慢性铅中毒诊断标准》(GBZ 37-2002)进行集体诊断。统计驱铅治疗过程中PbB、PbU、ZPP的值,对数据进行t检验和χ2检验,并对两变量相关性进行直线回归分析。结果 227例尿铅超标者诊断为铅中毒临床观察对象、轻度铅中毒、中度铅中毒的百分率分别为3.07%、2.71%、0.13%;驱铅治疗临床观察对象平均治疗1.92个疗程,轻度铅中毒平均治疗2.76个疗程,中度铅中毒平均治疗3.80个疗程后能达到较为满意的效果。结论该矿企尿铅超标的工人驱铅治疗效果良好。     

铅作业人员血铅及肾功能结果比较

目的探讨铅致肾损伤生化指标的变化。方法选择某蓄电池厂60名铅作业工人（接触组）和33名某机关人员（对照组）的血铅含量、尿总蛋白（UTP）、尿β2-微球蛋白（β2-MG）、血清肌酐清除率等指标进行比较分析。结果接触组血铅（0.304±0.05）mg/L、尿UTP（56.78±8.96）mg/gCr、尿β2-MG（98.64±2.06）μg/gCr等指标显著高于对照组（P〈0.05）。结论β2-MG是肾功能早期损害敏感指标之一,将其作为铅接触人群健康监护指标具有实际意义。     

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.     

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.     

Psychopathological features of a patient population of targets of workplace bullying

BACKGROUND: A strong association between workplace bullying and subsequent anxiety and depression, indicated by empirical research, suggests that bullying is an aetiological factor for mental health problems. AIMS: To evaluate levels of stress and anxiety-depression disorder developed by targets of workplace bullying together with outcome at 12 months and to characterize this population in terms of psychopathology and sociodemographic features. METHODS: Forty-eight patients (36 women and 12 men) meeting Leymann Inventory of Psychological Terror criteria for bullying were included in a prospective study. Evaluations were performed at first consultation and at 12 months using a standard clinical interview, a visual analogue scale of stress, the Hospital Anxiety and Depression (HAD) scale, the Beech scale of stress in the workplace and a projective test (Picture-Frustration Study). RESULTS: At first consultation, 81% of patients showed high levels of perceived stress at work and 83 and 52% presented with anxiety or depression, respectively. At 12 months, only 19% of working patients expressed a feeling of stress at work. There was a significant change in symptoms of anxiety while there was no change in symptoms of depression. Stress at work and depression influenced significatively capacity to go back to work. At 12-month assessments, workers showed a significantly better score on the HAD scale than non-workers. Over half the targets presented a neuroticism-related predominant personality trait. CONCLUSION: Workplace bullying can have severe mental health repercussions, triggering serious and persistent underlying disorders.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.     

Organophosphate toxicity and occupational exposure

The ubiquitous organophosphates present a continuing health hazard in agriculture, public health eradication programmes and as chemical warfare agents. Despite significant progress in understanding the potential mechanisms of toxicity far beyond the commonly accepted mechanism of cholinesterase inhibition in intentional exposures, the precise health effects following occupational exposures are yet to be completely defined. A much greater understanding exists of the clinical features of organophosphate poisoning. These are characterized by a triphasic response involving an initial acute cholinergic phase, an intermediate syndrome (both associated with high mortality) and a disabling but non-lethal delayed polyneuropathy. The delayed polyneuropathy may occur in the absence of the cholinergic or intermediate phases. However, progress is still required in order to improve the quantification and assessment of occupational exposures and the implementation of appropriate preventive measures. Finally, evidence-based guidelines for appropriate or optimal therapeutic interventions following poisoning are required urgently and collaborative work with colleagues in developing countries, where the occurrence of organophosphate exposures is more frequent, may provide the answers.     

Miliaria rubra of the lower limbs in underground miners

This report documents a case series of miliaria rubra of the lower limbs in miners at a deep underground metalliferous mine in tropical arid Australia. During the summer months of February and March 1999, all cases of miliaria rubra of the lower limbs in underground miners seen at the mine's medical centre were clinically examined and administered a questionnaire. Twenty-five patients were seen, an incidence of 56.4 cases per million man-hours. Miliaria rubra was most often located between the ankle and knee (88% of cases). Twenty-four percent had concurrent folliculitis and 20% had concurrent tinea. Thirty-two percent had a personal history of asthma. Walking through ground-water and splashing of the legs was common. Three to 4 weeks of sedentary duties in air conditioning was generally required to achieve resolution of miliaria rubra. The incidence of miliaria rubra of the lower limbs is 38% of the incidence of heat exhaustion at the same mine. The length of disablement is greater, however. Atopics may be at increased risk of miliaria rubra. Control measures are discussed.     

Planning research

The starting point for any research project should be a question.Once this has been defined and the relevant scientific literaturereviewed, a protocol should be drawn up. This will be used notonly as a guide to the conduct of the study and in the preparationof the final report, but also in seeking any financial supportand approvals that are required for the investigation. A protocolis normally arranged in sections covering the background tothe study, the question(s) that it will address, the methodsthat will be used for the collection and analysis of data, thestatistical power of the investigation (where relevant), anyethical considerations, and the financial input that will beneeded. A pilot study is often helpful where aspects of thestudy method are untried or of uncertainvalidity.     

Stress in the Norwegian police service

BACKGROUND: High levels of stress have been attributed to the conditions of police work, but there is little empirical evidence for this. AIMS: To develop a new instrument to measure job stress in the police; to assess the most severe and frequent police stressors; to compare levels of stress according to the demographic and organizational factors; and to study stress in relation to personality traits, work locus of control and coping strategies. METHODS: A comprehensive nationwide questionnaire survey of 3272 Norwegian police at all hierarchical levels, including the Norwegian Police Stress Survey (NPSS), the Job Stress Survey, the Basic Character Inventory, the Work Locus of Control Scale, and the Coping Strategies Scale. RESULTS: Work injuries were appraised as the most stressful but least frequent stressor and job pressure was reported the least severe but most frequent stressor. Females experienced job stressors less frequently, but appraised them as more severe than men did. Older police officers reported more job pressure severity and fewer work injuries. The police in districts where peer support was planned but not implemented, and who worked in districts with more than 50,000 inhabitants, perceived the lack of support more severely than others. The correlations between stress and personality traits, work locus of control, and coping were moderate. CONCLUSIONS: The NPSS captures police-specific stressors that are not adequately measured by global stress instruments. The study of stress in police work should preferably involve a nationwide use of police-specific stress instruments.