潍坊市气象因素对肾综合征出血热发病影响研究

目的探讨山东省潍坊市气象因素对肾综合征出血热(HFRS)发病的影响,为其防控提供理论依据。方法收集潍坊市2005—2015年肾综合征出血热每日报告发病数据及同期气象数据,利用分布滞后非线性模型分析气象因素与肾综合征出血热发病的剂量-反应关系。结果 2005—2015年潍坊市肾综合征出血热共报告发病2 459例,其中男性多于女性,性别比为2.62∶1;发病集中于20~70岁年龄组(占78.05%);发病人群以农民最多,占81.64%,其次为工人、学生。各气象因素中气温、相对湿度、降水量与HFRS发病数呈负相关关系(P0.05),而平均气压与该发病数呈正相关(P0.05)。HFRS发病风险与气温的反应关系呈倒"U"型,以气温中位数15℃为参照,在日平均气温为10℃时滞后0 d的相对危险度(RR)达到1.06(95%CI:1.03~1.19),HFRS发病风险最高。以相对湿度中位数66%为参照,最大日平均相对湿度(100%)时滞后5 d的HFRS发病风险最高,RR值为1.03(95%CI:1.02~1.09);日平均相对湿度为53%时0~30 d的累积滞后效应的RR值达到1.56(95%CI:1.09~2.48)。结论气象因素对肾综合征出血热发病的影响呈非线性,且存在滞后效应。     

广州地区气象因素对早产影响的时间序列研究

目的研究广州地区气象因素与早产的关系。方法采用时间序列方法,利用广州市白云、越秀、番禺三区2004—2010年早产、气象与空气污染物资料,应用分布滞后非线性模型研究气象因素与早产的关联。结果广州市白云、越秀、番禺三区2004—2010年共活产分娩438 021例,早产儿29973例,早产率为6.84%(95%CI:6.77%~6.92%);日均出生早产儿(11.72±5.63)例,气温均值为(23.41±6.38)℃,相对湿度均值为(67.34±13.84)%,气压均值为(1012.94±6.88)h Pa;风速均值为(6.99±3.70)m/s。气象因素在不同滞后日与早产的关联呈非线性,总体上各气象因素与早产的风险效应呈正向关联。气温、相对湿度、气压和风速分别达到最大值(34℃、100%、1 032.2 h Pa、26 m/s)时,在滞后期(0~26、0~1、0~25、0~24 d)内总体风险效应达到最高,RR值分别为2.01(95%CI:1.28~3.16),1.25(95%CI:1.08~1.45),1.67(95%CI:1.03~2.71)和4.91(95%CI:0.63~38.11)。累积热效应在滞后期0~26 d内最高,RR值为1.47(95%CI:1.16~1.86);累积潮湿风险效应在滞后0 d时最高,RR值为1.12(95%CI:1.05~1.19);累积高气压效应在滞后期0~25 d内最高,RR值为1.34(95%CI:1.01~1.78)。首次怀孕、首次分娩、男婴及孕33~36周的早产亚组对气象因素较为易感,特别是对高温因素。结论广州地区的气温、相对湿度、风速和气压等气象因素可能是早产的重要影响因素。     

天津市气象因素对手足口病发病影响研究

目的研究天津市不同气象因素对手足口病发病的影响,为其防控提供理论依据。方法收集天津市2009年至2018年手足口病日发病数据及气象数据(日均气温、日最高气温、日最低气温、日均相对湿度、日降水量、平均气压、平均风速和最大持续风速),利用分布滞后非线性模型分析气象因素与手足口病发病的关系。结果 2009—2018年天津市手足口病共报告发病167 234例,男女性别比为1.5∶1。发病集中在0～10岁,占全部报告发病的97.74%。散居儿童、托幼儿童与学生发病比为8.7∶4.4∶1。手足口病日报告发病数与日均气温、日最高气温、日最低气温、日均相对湿度、日降水量呈正相关,与平均气压、平均风速和最大持续风速呈负相关。日均气温、日均相对湿度和日降水量作为气象因素纳入分布滞后非线性模型。以气象因素中位数为参照,在滞后0 d、日均气温为36℃时,手足口发病风险最高,相对危险度RR(95%CI)值为1.12(1.06～1.18)。日均相对湿度为73%,滞后12 d时手足口发病风险最高,RR值为1.02(1.01～1.03);降水量为130 mm,滞后0 d时手足口病发病风险最高为1.36(0.91～2.02)。结论气象因素对手足口病的影响呈非线性,且存在滞后效应。     

2008-2017年兰州市气象因子与流感发病关系的时间序列研究

目的探讨兰州市气象因子与流感发病的关系。方法利用兰州市2008—2017年流感逐日发病数据,结合同期气象资料,采用Spearman相关分析和分布滞后非线性模型(DLNM)分析气象因子对流感发病的影响。结果 2008—2017年兰州市共报告流感4 866例,男女性别比为1.21∶1;以6～14岁儿童发病例数最多,占34.03%;流感发病高峰主要在冬、春季。Spearman相关分析显示,流感日发病例数与气温、相对湿度、降水量呈负相关(rs值分别为-0.232,-0.066,-0.087,P0.05),与风速呈正相关(r=0.056,P0.05)。DLNM拟合结果显示,以日均气温11.22℃为参照,气温为33℃、lag 1时RR值最高,为2.70(95%CI:0.41～17.66),但差异无统计学意义(P0.05);以日均相对湿度50%为参照,相对湿度为0%、lag 0时RR值最高,为7.70(95%CI:1.33～10.42),差异有统计学意义(P0.05);以日均风速1.25 m/s为参照,风速为0 m/s、lag 14时RR值最高,为3.24(95%CI:0.86～5.24),但差异无统计学意义(P0.05)。气象因子与流感发病风险关系的总体效应显示,日均气温在-6～0℃和12～20℃时的RR值均1(P0.05),日均相对湿度在26%～39%和51%～69%时的RR值均1(P0.05),日均风速在0～2 m/s时的RR值均无统计学意义(P0.05)。结论气象因素是影响兰州市流感发病的重要因素,流感发病风险在低温和低湿环境时相对较高。     

北京市手足口病流行特征分析及气象因素对其发病的影响

目的研究北京市手足口病的流行特征以及气象因素对手足口病发病的影响,为其预警预测以及防控提供科学依据。方法采用R 4.0.2软件对2010—2019年北京市手足口病的流行特征进行描述性统计,同时利用分布滞后非线性模型分析2015—2019日均气温、日均相对湿度、日均降水量、日均气压、日均风速等气象资料与手足口病发病的效应关系。结果 2010—2019年北京市手足口病共报告发病324 864例,平均发病率为155.10/10万。5～7月是每年手足口病发病高峰期。日均气温、日均相对湿度和日均降水与手足口病发病均呈正相关(r_s分别为0.66、0.45和0.24,P值分别为0.000 0、0.000 0和0.000 0);日均风速、日均气压与手足口病发病均呈负相关(r_s分别为-0.14和-0.3,P值分别为2.22×10~(-9)和0.000 0)。当日均气温为25.5℃,滞后10 d时RR值最大,为1.41(95%CI:1.12～1.77)。当相对湿度为84.5%,滞后15d时RR值最大,为1.51(95%CI:1.34～1.70)。日均风速为3m/s,滞后14d时RR值最大,为1.22(95%CI:0.86～1.73)。日均气压为842.5百帕,滞后5d时RR值最大,为1.20(95%CI:0.66～2.07)。日均降水为166.5mm,滞后7d时RR值最大,为4.37(95%CI:1.61～11.84)。当符合上述气象因素条件则手足口病发病风险最高。结论日均气温、日均相对湿度、日均降水量、日均气压、日均风速等气象因素与手足口病的发病密切相关,呈非线性且有一定的滞后性,可用于预测手足口病发生风险和流行强度,为传染病的防控、预警预测提供科学依据。     

长沙市气象因素与手足口病发病的关联研究:基于分布滞后非线性模型北大核心CSCD

目的分析长沙市气象因素与手足口病发病的关联及其滞后效应。方法收集2016-2019年长沙市手足口病日发病数据及同期气象数据,对其进行关联性分析,采用分布滞后非线性模型分析气象因素对手足口病发病的滞后效应。结果2016-2019年长沙市共报告手足口病122788例,年平均发病率为395.09/10万,4~7月和11~12月是每年手足口病发病高峰期。以中位数18.2℃为参考值,日均气温在28.5℃时对手足口病发病的总体效应最高(RR=2.70,95%CI:2.04~3.58),低温(P_(5)=3.2℃)情况下滞后2d时RR最大,为1.19(95%CI:1.09~1.30),高温(P_(95)=30.7℃)情况下滞后0d时RR最大,为1.14(95%CI:1.04~1.26)。以中位数1002.10hPa为参考值,日均气压在991hPa时对手足口病发病的总体效应最高(RR=2.35,95%CI:1.84~3.02),低压(P_(5)=988.7hPa)情况下滞后5d时RR最大,为1.10(95%CI:1.06~1.13),高压(P_(95)=1015.8hPa)情况下滞后2d时RR最大,为1.10(95%CI:1.05~1.16)。结论日均气温、日均气压与手足口病发病呈非线性关系,并存在明显的滞后效应,高温、低压对手足口病发病的影响更为显著。     

株洲市气象因子对手足口病发病的滞后效应研究

目的 分析株洲市气象因子对手足口病发病的影响,为手足口病预防控制工作提供科学依据。 方法 收集2010-2016年株洲市手足口病日发病数据及日气象数据,在描述其数据特征的基础上,采用分布滞后非线性模型,分析气象因子与手足口病发病的关系及其滞后效应。 结果 2010-2016年株洲市共报告手足口病病例53 877例,其中2016年报告病例最多,为12 355例;发病呈现双高峰状态。株洲市气温、风速和日照时数与手足口病发病呈正相关(P<0.05),气压、相对湿度与手足口病发病呈负相关(P<0.05)。以气温18.18 ℃为参照,日平均气温在30.6 ℃,滞后0 d时相对危险度(relative risk,RR)值最高,为1.28(95%CI:1.12~1.46),且有统计学意义(P<0.05);以最低气压1 003.58 hpa为参照,日最低气压在1 032.2 hpa,滞后25 d时RR值最高,为1.68(95%CI:0.97~2.93);以风速3.8 m/s为参照,日均最大风速在0 m/s,滞后0 d时RR值最高,为1.17(95%CI:0.92~1.49);以相对湿度74.8%为参照,日均相对湿度在28%,滞后2 d时RR值最高,为1.61(95%CI:0.81~3.17);以日照时数4.18 h为参照,日均日照时数在13 h,滞后0 d时RR值最高,为1.06(95%CI:0.97~1.17),以上四项均无统计学意义(P>0.05)。 结论 气象因子是影响株洲市手足口病发病的重要因素,对手足口病发病的影响呈非线性且具有滞后性。     

气温与儿童肺炎住院量的关系研究

目的分析不同气温指标与儿童肺炎患者住院量的关系。方法收集2015—2017年宁波市某综合性三甲医院0～14岁儿童肺炎患者住院资料和同期宁波市气象资料,采用广线义性模型结合分布滞后非线性模型分别定量评估日平均气温、日最低气温和日最高气温(各气温指标的第1百分位数为低温,第99百分位数为高温)与儿童肺炎住院量的暴露-反应关系。结果纳入儿童肺炎住院患者4 542例,住院量分布具有明显季节性,夏季较低而冬季较高。排除相对湿度、PM2.5、长期趋势、季节趋势等混杂因素后,高温和低温时儿童肺炎住院量均呈增加趋势;分别采用日平均气温和日最低气温为暴露指标时,高温效应均有统计学意义,累积滞后0～7 d儿童肺炎住院量增加的RR值分别为1.52(95%CI:1.04～2.23)和1.59 (95%CI:1.08～2.34);采用日最高气温为暴露指标时,低温效应在累积滞后0～5 d和累积后0～7 d时有统计学意义,累积滞后0～7 d儿童肺炎住院量增加的RR值为1.30 (95%CI:1.02～1.66)。结论高温和低温均可能造成儿童肺炎发病风险升高。     

手足口病流行与暴发的气象因素预警界值研究

目的探讨气象因素与手足口病(hand foot and mouth disease,HFMD)流行和暴发的相关性,并提出预警界值。方法选取广州市为研究现场,分别以2010-2017年HFMD流行和暴发情况为结局变量,以平均气温、总和降雨量和相对湿度为解释变量,经交叉相关分析后应用分类和回归树(classification and regression trees,CART)模型进行预警界值分析。结果 2010-2017年广州市共报告494 359例HFMD病例,平均每年报告(61 795±15 232)例,其中24个月疫情呈现暴发状态。月平均气温滞后0期(0.64,P0.05)和月平均相对湿度滞后1期(0.59,P0.05)与月发病数的相关系数最高。月发病例数的气象预警界值回归树分析中,月平均气温滞后0期≥22.3℃且月平均相对湿度滞后1期≥82.37%时RR值最大,为2.06(95%CI:1.99～2.13)。月度暴发的气象预警界值分类树分析中,月平均气温滞后0期≥24.6℃且月平均相对湿度滞后1期≥83.92%时RR值最大,为3.54(95%CI:3.03～4.03)。结论基于CART模型分析HFMD流行与暴发的气象因素预警界值,可有效提升监测和预警的质量。     

广州地区日均气温与早产关系的时间序列研究

目的量化评估广州地区日均气温与早产的关联性。方法采用时间序列方法,利用广州市白云与越秀2个区2005—2011年的早产、气象与空气污染物资料,应用分布滞后非线性模型研究日均气温与早产的关联性,并评估高低气温对早产的冷热效应及累积冷热效应。结果广州市白云与越秀2个区2005—2011年共活产分娩263 322名,早产儿22 903例,早产率为8.70%(95%CI:8.59%~8.81%);日均出生早产儿(9.01±5.61)例;日均气温为(23.35±6.51)℃;日均相对湿度为(66.98±13.98)%;日均SO2浓度为(43.48±28.88)μg/m3;日均NO2浓度为(50.60±50.14)μg/m3;日均PM10浓度为(80.46±61.61)μg/m3。日均气温在不同滞后日与早产的关联呈非线性,暴露—反应关系近似U形,根据累积相对危险度最小的值对应确定参照气温为25.9℃。在滞后期第0~21天内,日均气温的累积风险效应从31℃开始显现出统计学意义,RR值为1.280 3(95%CI:1.014 9~1.615 1),并在34℃时达到最大,RR值为1.689 9(95%CI:1.076 7~2.652 6)。对于冷效应及累积冷效应,在整个滞后期内均无统计学意义。对于热效应,高温(日均气温为32℃),滞后1 d时风险效应最大,RR值为1.052 8(95%CI:1.014 2~1.092 9);对于累积热效应,在滞后期为第0~14天内达到最大,RR值为1.511 7(95%CI:1.210 5~1.887 8)。结论在广州地区,高温是造成早产的重要影响因素,可增加早产的发生风险。     

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.     

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.     

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.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.