2007～2008年日照市碘缺乏病调查

[目的]了解日照市碘缺乏病流行现状,评价防治效果,发现可能存在的问题。[方法]2007年10月至2008年6月,在日照市抽取8~10岁小学生进行甲状腺肿大、尿碘、家庭食盐碘含量、饮用水碘浓度及小学生、家庭主妇碘缺乏病防治知识水平调查。[结果]调查儿童3 297名,甲状腺肿大率为3.40%;检测儿童尿340份,尿碘中位数为279.08μg/L;检测居民户食盐703份,碘盐覆盖率为98.43%,碘盐合格率为96.20%;检测饮用水样38份,水碘含量范围为0.10~9.59μg/L,中位数为1.80μg/L。碘缺乏病防治知识及格率,733名五年级小学生为81.45%,186名家庭主妇为86.02%。[结论]日照市已达到消除碘缺乏病的标准,居民碘营养状况处于基本适宜水平,碘缺乏病健康教育工作有待加强。     

云南维西县碘缺乏病防治效果评价

[目的]评价云南省维西县消除碘缺乏病目标实现情况,为持续消除碘缺乏病工作提供科学依据。[方法]按照全国重点地方病防治规划(2004～2010)终期评估方案的要求,将所辖乡(镇)分为东、西、南、北、中5个抽样片区,每个片区随机抽取1个乡(镇),在抽到的乡(镇)中随机抽取1所小学作为调查对象。进行甲状腺肿大调查、尿碘水平测定、家庭食用盐的碘含量检测及碘缺乏病知识知晓率调查。[结果]400名8～10岁儿童未查出甲状腺肿大;100名8～10岁儿童尿碘均大于50ug/L,尿碘中位数为256.13ug/L;100名8～10岁儿童家庭食用盐的碘含量在25.17～43.51mg/kg之间、均数为33.63mg/kg;150名五年级学生碘缺乏病知识知晓率为98.67%;75名家庭主妇碘缺乏病知识知晓率为95.23%。[结论]维西县消除碘缺乏病的各项指标均达到了消除标准,但还存在各成员单位沟通交流少、工作经费不足、健康教育形式单一等问题。应继续加强消除碘缺乏病工作机制,有计划地开展小学生健康教育、甲状腺肿大率调查和尿碘水平监测,并结合碘盐监测等定期对持续消除碘缺乏病的情况做出客观评价,以确保各项措施的落实。     

宛城区碘缺乏病健康教育效果

目的 分析评价宛城区碘缺乏病健康教育效果. 方法 分层随机抽取五年级学生和家庭主妇各150名,采用统一问卷调查表进行碘缺乏病防治认知和行为调查,对抽取的8～10岁儿童和家庭主妇按规定的方法进行盐碘含量、尿碘浓度、儿童甲状腺肿大率监测. 结果 群众知晓率1999-2007年均达80％以上,2008年后均＞90％,2011年与1999年相比显著性提高(P＜0.01).2011年居民购买碘盐行为具有率为72.7％,正确食用碘盐行为具有率74.7％,碘盐合格率98％,饮水水碘中位数4.4 μg/L,儿童甲状腺肿大率3.5％,儿童、孕妇和哺乳期妇女尿碘中位数分别为194.6、235.8、156.0 μg/L. 结论 宛城区健康教育效果显著,提高了群众碘缺乏病防治认知水平,促进了健康行为的形成,促进了实现持续消除碘缺乏病目标.     

2015 - 2016年江苏省镇江市碘缺乏病现状调查

目的 了解2015 - 2016年镇江市居民碘营养状况,为制定有针对性的碘缺乏病防治措施提供依据。方法 采用随机抽样法,在镇江市6个所辖市区中随机抽取共2 700名8～10岁儿童、1 200名孕妇和300名哺乳期妇女,检测儿童、孕妇和哺乳期妇女尿碘含量,家庭食用盐盐碘含量以及学生甲状腺肿大情况;随机抽取900名五年级学生和150名家庭妇女进行健康知识问卷调查,同时监测农村生活饮用水水碘含量。结果 镇江市8～10岁儿童甲肿率为0.44%,尿碘中位数225.00 μg/L,儿童碘营养轻度超标,不同地区、性别间比较差异具有统计学意义（P＜0.05）;孕妇和哺乳妇女尿碘中位数分别为161.50 μg/L和124.50 μg/L,均达碘营养适宜水平。家庭食用碘盐覆盖率为99.71%,碘盐合格率为96.74%,合格碘盐食用率达96.74%,盐碘均数为（22.60±3.39） mg/kg,该地区盐碘质量合格。农村饮用水水碘含量中位数为6.54 μg/L,属缺碘状态。学生和家庭主妇碘缺乏病防治知识知晓率分别为86.62%和87.83%,不同市区间差异无统计学意义（P＞0.05）。结论 镇江市居民碘营养状况符合江苏省持续消除碘缺乏病行动计划与消除碘缺乏病达标考核要求,今后仍需继续加强该市碘营养状况的监测工作。     

2007年西平县小学生碘营养水平调查结果分析

目的为全面落实地方病防治措施,了解西平县8岁-10岁小学生的碘营养状况及其碘的主要来源,为下一步碘缺乏病防治工作提供科学指导。方法2007年冬在全县范围内按东西南北中5个方位抽取5个乡镇,每个乡随机抽取1个村小学,每个小学抽取8岁-10岁学生50人,共250名小学生分别进行甲状腺触诊,并采集其尿样及家庭食用盐样做碘含量测定。150名小学5年级学生进行健康教育问卷调查,50名家庭主妇进行问卷调查。结果甲状腺1度肿大患者6名,肿大率小于5%;碘盐中位数为275 mg/L;尿碘中位数279.6μg/L;水碘中位数10.6μg/L;家庭主妇知识各晓及格率90.4%,学生健康知晓及格率89.4%。结论调查结果说明我县小学生碘营养水平保持良好,碘缺乏病防治工作已走向良性轨道,只有食用合格碘盐,才能获得人体代谢所获得的碘。     

天水市碘缺乏病防治现状调查分析

目的了解碘缺乏病的消长趋势和防治现状。方法在全市范围内随机抽取监测点开展儿童甲状腺和智商检查,盐碘和尿碘含量测定,健康教育知识问卷调查。结果儿童甲状腺肿大率为10.0%,居民户合格碘盐食用率为98.1%,儿童和育龄期妇女尿碘中位数分别为353.86μg/L和212.99μg/L,儿童智商均值为98.9,碘缺乏病知识问卷五年级学生和家庭主妇及格率分别为6.8%和57.8%。结论天水市儿童甲状腺肿大率、居民户合格碘盐食用率和儿童尿碘中位数3项指标达到了基本实现消除碘缺乏病的标准,但碘缺乏病防治知识的宣传不够深入,重点人群知晓率低,碘缺乏病对重点人群的危害仍未完全消除。     

2011年广州市碘缺乏病监测结果分析

目的:分析广州市碘缺乏病(IDD)监测结果,了解碘缺乏病流行现状,评价防治效果,为制定策略提供依据。方法:采用现况流行病学调查方法,随机抽取广州市十二个区(县)8岁～10岁在校儿童进行调查。分别采用直接滴定法、分光光度法检测盐碘和尿碘含量,B超法检测甲状腺大小。结果:1188名儿童家庭食用盐碘合格率为96.7%,盐碘的中位数为31.5 mg/kg;1146名儿童尿碘的中位数为198μg/L;120名儿童B超诊断甲状腺肿大率为3.3%。结论:广州市盐碘合格率较高,尿碘含量合格,儿童甲状腺肿大率偏低,通过食盐加碘为主导的综合性措施,使碘缺乏病防治工作取得了显著效果。     

延安市消除碘缺乏病监测结果

[目的]监测消除碘缺乏病状况,提供可持续的防治对策. [方法]抽样监测10个县8～10岁小学生甲状腺大小、家中食盐碘含量、监测尿碘,对抽取学生和学生家庭主妇进行问卷调查,对安塞学生进行智商测定,测定安塞中心小学周围环境水中碘含量. [结果]各县甲状腺肿大率分布在1.90%～9.52%,女生高于男生;尿碘为24.5～993.5μg/L,各县中位数均达到100μg/L以上,低于50μg/L的小于20%;碘盐合格率和合格碘盐食用率均为91.4%;智商抽查中等及以上级别低于非病区儿童;问卷调查儿童和家庭主妇的及格率分别为98.8%和97.5%;抽查学校周围环境的水碘含量均低于10μg/L.[结论]抽查各县达到了消除碘缺乏病标准,但病情有所回升,需要政府和广大群众共同努力,使碘缺乏病持续消除.     

2009年黔东南州8～10岁儿童尿碘与居民食盐碘含量调查

[目的]了解黔东南州8～10岁儿童碘营养状况和居民食用盐碘含量,为制定有效的防治措施提供科学依据。[方法]2009年,在黔东南州所辖16县（市）抽取80所小学的8～10岁小学生进行尿碘测定与碘缺乏病知识调查;抽取4680户居民食盐检测碘含量。[结果]检测小学生尿样1600份,尿碘中位数为344.15μg/L,尿碘≥100μg/L、≥300μg/L、≤50μg/L的分别占96.88%、60.88%、0.63%。检测4680户居民的食用盐,碘盐覆盖率为99.83%,碘盐合格率为98.14%,合格碘盐食用率为97.97%,盐碘中位数为31.70mg/kg,碘盐中碘含量超标的占0.15%。[结论]黔东南州各县（市）已经达到消除碘缺乏病标准,部分儿童碘营养水平偏高,碘盐浓度仍有下调空间。     

2012年许昌县消除碘缺乏病目标评估

目的了解许昌县碘缺乏病防治现状,为制定防治策略和措施提供依据。方法 2012年5～6月,在许昌县抽取9个乡镇、36个行政村的288户居民的食用盐检测碘含量,抽取5个乡镇5所小学的99名8～10岁学生进行尿碘检测,抽取150名小学生进行碘缺乏病防治知识调查。结果检测食用盐288份,碘盐覆盖率为98.96%,碘盐合格率为98.25%,合格碘盐食用率为97.22%。检测99名8～10岁小学生尿样,尿碘中位数278μg/L,〉50μg/L的占96.97%。调查150名8～10岁小学生,碘缺乏病基本知识普及率为96.93%。结论许昌县已经达到消除碘缺乏病目标要求。     

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.