山东省风疹流行现状分析

为了解风疹发病现况 ,进一步做好控制风疹和先天性风疹综合征 (CRS)工作 ,对近年来山东省风疹流行现状进行了分析。结果显示 :自 1995年山东省推广风疹疫苗免疫接种以来 ,风疹发病得到了有效控制。但部分地区风疹疫苗免疫接种存在漏洞 ,风疹仍在局部地区以爆发形式呈小规模周期性流行。 1999年全省共报告风疹 114例 ,2 0 0 0年报告 2 13例 ,2 0 0 0年比 1999年上升 86 84 % ;高峰季节为春季 ,病例主要集中于学龄儿童 ,1999年 7岁发病最高 ,2 0 0 0年为 10～ 12岁。免疫史分析发现 ,山东省风疹发病主要与风疹疫苗实际接种率不高有关。因此 ,今后应加强风疹疫苗的常规免疫接种 ,以降低风疹和CRS的发生 ,提高麻疹监测工作的质量。     

一起中学生风疹爆发的流行病学调查

2003年2～6月南京市某中学发生一起风疹爆发流行,我们进行了流行病学调查和血清学检测,积极采取消毒措施,同时使用国产减毒风疹疫苗和进口麻风腮疫苗进行应急接种,有效控制了疫情.现对本次风疹流行特点进行分析如下.     

济南市1998-2006年风疹爆发疫情的流行病学特征分析

目的分析济南市1998-2006年风疹爆发疫情的流行病学特征,预测风疹流行趋势,判定高危人群,预防和控制风疹爆发和流行。方法根据济南市法定传染病报告系统和风疹监测系统资料,对1998-2006年风疹爆发疫情进行描述流行病学分析。结果济南市1998-2006年报告风疹爆发疫情74起、1212例,占全部风疹病例数的73．10％（1212／1658）。爆发疫情中本市人口病例占94．14％（1141／1212）;中学爆发疫情43起,占爆发总起数的58．11％;5-14、15-19、20-29岁病例分别占50．50％、45．21％、3．80％。爆发疫情病例中有风疹减毒活疫苗（Rubella Attenuated Live Vaccme,RubV）免疫史的仅占0．49％,无RubV免疫史和免疫史不详的分别占93．65％和5．86％。结论预防和控制风疹爆发的重点在5-19岁人群。高质量的RubV常规预防接种是减少风疹发病,控制风疹爆发的重要手段。     

单县某小学风疹爆发流行的调查报告

目的查明单县某小学风疹爆发流行的原因和传播特征,采取有效措施尽快控制疫情.方法利用流行病学调查方法,结合临床特征和实验室检查等进行统计分析.结果该次风疹爆发流行共发生76例风疹病人,罹患率2.96%;流行高峰在1月15～24日,发病53例,占69.74%;病例以8～10岁学生为多,占75.10%.主要以二、三年级为主,占72.31%.76例病人中有67.11%未接种过风疹疫苗.结论免疫空白和疫情迟报是该次爆发流行的主要原因.加强对重点人群传染病知识的宣传,广泛开展风疹疫苗接种是控制风疹疫情最有效的手段.     

蚌埠市中小学校风疹爆发疫情分析

目的剖析学校风疹爆发疫情的原因,提出针对性的预防和控制措施.方法对2001和2002年蚌埠市部分中小学校的风疹爆发疫情进行流行病学分析.结果 2 a间共有13所中小学发生风疹爆发,平均每起爆发累及13.2人;首例病例出现24 h内报告疫情的只有1起,仅占全部爆发学校的7.7%;实验室确诊病例占全部报告病例的43.6%.所有爆发均发生于3～6月,农村报告的病例少于城市,病例均为学生,其中96.5%的患者年龄在6～14岁,男女发病比例基本相近.结论学校风疹爆发的原因主要是中小学生风疹抗体阳性率低,应用风疹疫苗预防和控制风疹爆发是最有效的途径.     

安徽省1998～2001年麻疹流行病学特征和控制策略分析

为了解安徽省加速控制麻疹进展,对1998～2001年麻疹流行病学特征和控制策略进行了分析.自采取加速控制麻疹措施后,麻疹发病率下降显著,1996～2000年年平均发病率比1991～1995年下降了67.72%;麻疹仍每隔2年流行1次,持续2年;每年3～6月是发病高峰季节;平均发病年龄逐年增大,2001年为11.06岁,但仍属小年龄发病模式;爆发病例占总病例数的60%以上,主要集中在中小学生.建议继续采取以下控制麻疹的策略①提高和维持高水平2剂麻疹疫苗接种率;②有必要在中小学生中开展麻疹疫苗强化免疫活动;③进一步加强麻疹及其它出疹性疾病监测.     

风疹爆发应急接种的预防效果研究

目的　探讨风疹应急性预防接种的效果 ,为控制风疹爆发疫情提供依据。方法　对某市 8所小学风疹爆发流行进行流行病学调查 ,首先利用 1所小学自然爆发至终止的数据建立本次风疹爆发的Reed -Frost模型 ,以此模型预测其它 7所经应急性预防接种的小学的理论风疹发病人数 ,进而预测应急性预防接种的预防效果。结果　 7所小学风疹的理论显性发病例数 1 0 0 0例 ,应急性预防接种减少风疹发病 92 5例。结论　在发生风疹爆发的小学应尽早进行风疹疫苗的应急接种 ,以控制风疹爆发疫情的蔓延     

重庆市2000年麻疹实验室监测结果分析

为进一步提高麻疹监测工作质量 ,对重庆市 2 0 0 0年麻疹实验室监测结果进行了分析。共检测了 186份疑似麻疹病例血清标本 ,其中爆发病例标本 16 6份 ,散发病例标本 2 0份 ,麻疹IgM抗体阳性数分别为 92份和 14份。两起爆发病例的 2 0份麻疹IgM抗体阴性标本中 ,11份风疹IgM抗体阳性 ,确证为风疹爆发。 6个年龄组 5 2 9份标本麻疹IgG抗体平均阳性率为 85 0 7% ,8～ 2 3月龄阳性率为 81 16 %。从 10份咽拭子标本中分离出 5株麻疹病毒 ,经核酸序列分析鉴定 ,均为H1基因型。建议对疑似麻疹爆发病例同时进行麻疹和风疹的血清学诊断 ;麻疹疫苗的第 2次接种应提前至 18月龄 ;在加速控制麻疹阶段实验室诊断显得更为重要。     

一起学校风疹爆发的调查和控制效果评价

20 0 1年 4月 ,加祥县黄垓、老僧堂乡部分中小学发生发热、出疹性疾病爆发 ,两周时间内由最初报告的 8例迅速扩展到 4 2 2例 (调查时 )。为明确诊断 ,及时控制疫情 ,我们开展了现场流行病学调查 ,并采血进行血清学检测。结果证实是一次风疹爆发流行 ,立即开展了以风疹疫苗应急免疫为主的综合性防制措施。现将本次调查结果及风疹疫苗应急免疫效果报告如下。1　方法与诊断标准1.1　发病情况和接种率调查　来源于现场流行病学调查、风疹病例个案调查表和当地防保站风疹应急接种报表。1.2　诊断标准　按照卫生部 1990年下发的《规定管理的传染病…     

松阳县2004年风疹流行病学分析

目的了解松阳县2004年风疹流行情况,指导风疹预防控制工作。方法对松阳县2004年报告的风疹病例进行流行病学分析。结果松阳县2004年共报告风疹195例,报告发病率为84．42／10万。病例中学生180例,占92．31％。1-6月均有发病,发病高峰为4月,占64．10％。共发生12起农村学校风疹爆发,181例爆发病例中,无风疹减毒活疫苗（Rubella Attenuated Live Vaccine,RubV）免疫史者占48．07％,免疫史不详者占51．93％。农村风疹爆发学校学生RubV接种率（20％）明显低于城区学校学生（92％）。结论松阳县2004年风疹发病率高的主要原因,与农村学校学生RubV接种率低及生活住宿条件差有关。采取RubV应急接种为主的综合措施可有效控制风疹爆发。     

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.