产妇发生医院内呼吸道感染的易患因素观察及对策

目的 探讨产妇发生医院内呼吸道感染相关因素及其护理对策,为临床降低产妇发生医院内呼吸道感染提供依据.方法 对2010年6月-2012年6月321例合并呼吸道感染的产妇临床资料进行了回顾性分析,对产妇发生医院内呼吸道感染的因素采用logistic回归分析进行统计分析.结果 季节(OR=2.634,95％CI:0.453～5.323)、生育高峰期(OR=2.432,95％CI:0.343～4.564)、住院时间(OR=3.453,95％CI:0.644～5.343)是产妇发生上呼吸道感染的危险因素,而室内每天通风(OR=4.453,95％CI:0.563～5.345)是产妇发生上呼吸道感染的保护性因素.结论 应当保持病室内空气流通、减少探视人员、减少产妇住院时间是降低产妇发生呼吸道感染的必要措施.     

公务员人群中脂肪肝患病影响因素的病例对照研究

目的 了解公务员脂肪肝患病情况及其影响因素,探讨预防发病的干预措施.方法 于2008年9～12月,采用整群抽样的方法对天津市某区公务员进行健康状况及影响因素的问卷调查.应用SPSS17.0建立Logistic回归模型,对公务员人群的脂肪肝影响因素进行分析.结果 公务员人群中脂肪肝患病率为17.86％.多因素分析结果显示脂肪肝患病影响因素有:年龄(OR=0.074,95％CI:1.050～1.105)、性别(OR =-1.207,95％CI:0.223～0.402)、体重指数(OR=0.385,95％CI:1.360～1.587)、饮酒(OR=0.990,95％CI:1.459～4.964)、吸烟(OR=0.852,95％CI:1.485～3.707)、睡眠时间(OR=-0.165,95％CI:0.723～0.995)、按时吃饭情况(OR=0.693,95％CI:1.582～2.530)、高血压(OR=1.340,95％CI:3.031～4.817)、高血脂(OR=1.431,95％CI:2.700～6.483)、腰臀比(OR=2.734,95％CI:6.098～18.920)、亚健康分值(OR=-0.048,95％CI:0.936～0.970).结论 公务员人群脂肪肝患病率较高,公务员是各种慢性病发病的高危人群,是今后开展健康管理的重点群体.     

牙周炎与抑郁、焦虑情绪及生活方式的相关性研究

目的 探讨牙周炎与抑郁、焦虑情绪及生活习惯的相关性.方法 从某医院体检人群中选取单纯牙周炎175例(轻、中、重度牙周炎分别为70例、58例和47例)和健康对照组200例为研究对象,以自填式问卷方式调查研究对象的一般情况、心理因素(抑郁和焦虑症状评定量表)及生活方式等内容.结果 轻、中、重度牙周炎组抑郁、焦虑情绪评分及检出率均高于健康组,且差异有统计学意义(均有P ＜0.05);多因素非条件Logistic回归分析结果显示,牙周炎危险因素有抑郁情绪(OR=4.090,95％ CI:1.901 ～8.800)、焦虑情绪(OR =3.311,95％ CI:1.586 ～6.912)、糖尿病(OR=2.543,95％CI:1.387 ～4.665)、高血压(OR=2.505,95％ CI:1.353 ～4.638)、吸烟(OR=2.262,95％ CI:1.622～3.154)、不良口腔习惯(OR=1.838,95％ CI:1.081 ～3.127)和饮酒(OR=1.705,95％ CI:1.225 ～2.374),保护因素有刷牙时间≥3 min(OR =0.318,95％ CI:0.186 ～0.544)、定期牙周检查(OR=0.374,95％ CI:0.203 ～0.689)、使用牙线(OR=0.450,95％ CI:0.262 ～0.772)、积极心理应对方式(OR=0.492,95％ CI:0.288 ～0.840)和饮用绿茶(OR=0.674,95％ CI:0.470～0.966).结论 改善牙周炎患者的不良情绪,控制血糖、血压,养成良好的口腔卫生习惯及生活方式,戒除不良行为等,可降低牙周炎的患病率.     

哈尔滨市机关职员非酒精性脂肪性肝病流行病学调查

目的 了解哈尔滨市机关职员非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)的患病率及其主要危险因素.方法 采用自制调查问卷,对2010年10月～2011年7月到哈尔滨医科大学第一临床附属医院体检的哈尔滨市区机关职员进行拦截式访问调查,问卷内容包括一般情况、生活方式、饮食习惯、疾病既往史、血液学及生物化学检查结果等资料,分析NAFLD的危险因素.结果 哈尔滨市机关职员NAFLD患病率为49.4％.单因素分析显示,病例组和对照组在性别、婚姻、学历、午餐地点、是否按时就餐、是否常吃坚果、碳水化合物摄入量、油脂摄入量等26个变量上的差异均有统计学意义(均有P＜0.05).多因素非条件Logistic回归分析显示,女性(OR =0.349,95％ CI:0.217 ～0.561)、研究生及以上学历(OR=0.581,95％ CI:0.380 ～0.888)、常饮茶(OR=0.535,95％ CI:0.336～0.854)是NAFLD的保护因素;而腰围粗(OR=5.735,95％ CI:2.992 ～ 10.990)、午餐地点在外( OR=1.649,95％ CI:0.433～0.974)、谷丙转氨酶升高(OR=3.254,95％ CI:1.401～7.560)、高血压(OR=1.678,95％ CI:1.041～2.705)、高甘油三酯(OR=3.020,95％ CI:1.793～5.088)是NAFLD的危险因素.结论 哈尔滨市机关职员NAFLD的患病率高于目前国外及我国其他地区的报道,不良的饮食习惯和生活方式是影响NAFLD患病率的重要因素.     

中国五城市流动育龄妇女围孕保健服务满意度影响因素研究

目的 了解流动育龄妇女围孕保健服务现状和满意程度,分析其满意度的影响因素,为改善流动育龄妇女的优生健康质量提供依据. 方法 利用2005年北京、南京、厦门、深圳和重庆五城市流动人口生殖健康抽样调查数据,描述分析流动育龄妇女围孕保健服务利用及满意程度分布情况,对影响满意度的有关因素进行多因素分析. 结果 5 399例有效调查问卷中,流动育龄妇女在流入地的围孕保健服务利用率为41.1％,其中对服务满意者占63.3％.多因素Logistic回归分析发现,流动育龄妇女对围孕保健服务的满意度在调查地区间存在差别,差异有统计学意义;自评健康状况一般(OR=1.79,95％ CI:1.43 ～2.25)或身体状况差(0R=1.87,95％CI:1.10～3.16)、检查婚育证明(OR=1.63,95％ CI:1.20～2.22)、未参加计生部门宣教活动(OR=1.28,95％ CI:1.04～1.57)、自行前往参与服务(OR=1.54,95％CI:1.22～1.94)、付费检查(OR=1.36,95％ CI:1.08 ～ 1.72)、服务态度差(OR =2.33,95％ CI:1.81 ～2.99)、设施环境差(OR=1.54,95％CI:1.20～1.97)与较高的不满意度存在统计学关联. 结论 自评健康状况一般或差、无婚育证明、未参加计生部门宣教活动、自行前往孕检、付费检查、服务态度差、设施环境差与较高的不满意度有关,建议将计生服务与围孕保健相结合、积极促进流动育龄妇女社会融入、提供优惠、专业的保健服务,提高流动育龄妇女对围孕保健服务满意度,有助于降低不良妊娠结局发生风险.     

乌拉盖管理区高血压流行现状及影响因素分析

目的 了解乌拉盖管理区高血压患病、治疗与控制及相关危险因素,为内蒙古地区高血压社区防治策略的改进提供依据.方法 随机抽样抽取乌拉盖年龄≥10岁的1103名居民进行问卷调查及体格检查,采用多因素logistic回归分析高血压患病、治疗与控制的影响因素.结果 1103人中,高血压患病率为44.8％(标化率43.6％),知晓率为59.7％(标化率48.5％),治疗率为48.6％(标化率38.5％),控制率为14.6％(标化率11.7％).多因素logistic回归分析结果显示,男性(OR=1.67,95％CI:1.25～2.23,P＜0.01)、高年龄(35～＜55岁:OR=3.08,95％CI:2.10～4.52,P＜0.01;≥55岁:OR=5.43,95％CI1:3.55～8.30,P＜0.01)、中心性肥胖(OR =2.57,95％CI:1.92～3.45,P＜0.01)为高血压患病的危险因素,奶制品摄入200～＜300 g/d(OR=0.55,95％CI:0.35～0.85,P＜0.01)为保护因素;高年龄(35～＜55岁:OR=0.13,95％CI:0.05～0.40,P＜0.01;≥55岁:OR=0.08,95％CI:0.03～0.25,P＜0.01)、中心性肥胖(OR=0.61,95％CI:0.39～0.97,P＜0.05)、合并糖尿病(OR=0.37,95％CI:0.17～0.80,P＜0.05)、合并血脂异常(OR=0.38,95％CI:0.22～0.65,P＜0.01)为高血压治疗的保护因素,经常吸烟(OR=3.10,95％CI:1.80～5.33,P＜0.01)为危险因素;经常吸烟(OR=5.35,95％CI:1.88～15.15,P＜0.01)为高血压控制的危险因素,合并糖尿病(OR=0.34,95％CI:0.18～0.66,P＜0.01)为保护因素.结论 内蒙古乌拉盖管理区高血压患病率较高,知晓率、治疗率与控制率仍有待提高.     

苏州市沧浪区老年轻度认知功能损害患病率及其危险因素

目的 了解苏州沧浪区老年轻度认知功能损害患病率及其危险因素.方法 采用整群分层抽样的方法,抽取苏州沧浪区4个社区60岁以上老年人群进行蒙特利尔认知功能量表调查.结果 不同年龄、性别、文化程度、收入状况、性格人群的患病率存在明显差异,性别(OR=1.853,95％ CI:1.360～2.460)、年龄(OR=1.616,95％ CI:1.429～1.828)、文化程度(OR=1.940,95％ CI:1.669～2.256)、居住状况(OR=-1.301,95％ CI:1.115 ～1.517)、体育锻炼(OR=0.879,95％ CI:0.779 ～0.992)和邻居交往(OR=1.380,95％ CI:1.026 ～1.855)对老年轻度认知功能损害存在显著性影响.结论 女性、高龄、低文化程度、独居、体育锻炼少、邻居交往少是老年轻度认知功能损害的危险因素.     

女性系统性硬皮病发病影响因素的病例对照研究

目的 探讨月经生育因素、日常生活方式和环境因素与女性系统性硬皮病(systemic sclerosis,SSc)患病的关联.方法 2012年8月～2015年12月,收集来自于安徽医科大学附属医院的100例女性SSc患者和来自于合肥市社区的400例女性对照的相关信息,用单因素和多因素非条件Logistic回归分析影响SSc患病的因素.结果 单因素Logistic回归分析发现11个因素与SSc的患病有关.多因素Logistic回归分析显示,肥胖(0R=0.464,95％ CI:0.229～0.939)为SSc的保护因素,而农民(OR=4.458,95％ CI:2.379～8.352)、教师/会计/文员(OR=9.740,95％ CI:3.153 ～30.909)、制鞋/服装/纺织工人(OR=16.150,95％ CI:4.933 ～ 52.873)、偏瘦(OR=3.733,95％ CI:1.440 ～9.636)、服用避孕药(OR=3.994,95％ CI:1.291 ～ 12.361)、流产(OR =4.679,95％ CI:2.365 ～9.258)、其他接触的人吸烟(OR =5.059,95％ CI:2.582～9.913)、噪声暴露(OR =2.184,95％ CI:1.018～4.685)、有机溶剂暴露(OR =4.432,95％ CI:1.158～16.965)、药物过敏史(OR =3.564,95％ CI:1.425～8.916)为SSc患病的危险因素.结论 多个环境因素与SSc的患病有关,应针对性加强SSc的预防和患者康复工作.     

发热伴血小板减少综合征重症及死亡危险因素的Logistic回归分析

目的 分析发热伴血小板减少综合征(SFTS)患者的临床特征和危险因素.方法 收集2011年5月至2012年7月解放军第一五四医院就诊的273例SFTS患者的相关信息,采用RT-PCR检测新布尼亚病毒(SFTSV),通过ELISA检测SFTSV-IgM和IgG抗体,采用Human BioPlex ProTM Assays 17-Plex Panel方法测定细胞因子.对确诊病例采用单因素、多因素Logistic回归模型分析SFTS病例重症和死亡发生的危险因素.结果 273例SFTS患者中180例SFTSV核酸阳性.主要临床表现为发热、乏力、肌肉酸痛和胃肠道症状.多因素Logistic分析显示,年龄≥60岁(OR=1.08,95％CI:1.03～1.13)、淋巴结肿大(OR =3.75,95％CI:1.45～9.66)、下呼吸道感染(OR=3.57,95％CI:1.40～9.11)、肌酐(Cr)＞97 mmol/L(OR=4.10,95％CI:1.55～10.82)及意识障碍(OR=3.35,95％CI:1.21～9.29)与重症病例发生显著相关.年龄≥60岁(OR=1.06,95％CI:1.00～1.12),下呼吸道感染(OR=4.33,95％CI:1.35～13.93),Cr＞97 mmol/L (OR=10.14,95％CI:3.19～32.21)及意识障碍(OR=3.47,95％CI:1.03～11.72)与死亡病例发生显著相关.结论 年龄≥60岁、合并下呼吸道感染、Cr＞97 mmol/L、意识障碍是SFTS患者预后不良的危险因素,应予重点治疗.     

维吾尔族和汉族人群非酒精性脂肪肝相关危险因素分析

目的 探讨维吾尔族和汉族非酒精性脂肪肝(NAFLD)的危险因素,为NAFLD的预防和治疗提供科学依据.方法 采用横断面研究方法对4 318名维吾尔族和汉族健康体检人群进行问卷调查,同时对其体质指数、腰围、血压、血糖、血脂、血尿酸(SUA)等生化指标进行检测.采用多因素非条件logistic回归分析NAFLD的相关危险因素.结果 维吾尔族和汉族人群NAFLD检出率分别为45.2％(716/1 584)、36.1％(986/2 734)；高尿酸血症检出率分别为9.5％(150/716)、17.2％(470/2 734)；SUA水平分别为(288.98±90.46)、(326.49±98.43) μmol/L；上述指标差异均有统计学意义(P＜0.01).多因素非条件logistic回归分析显示,男性(OR=1.476,95％CI:1.149～1.898)、年龄(OR=1.036,95％CI:1.028～1.044)、维吾尔族(OR=1.337,95％CI:1.114～1.604)、肥胖(OR=5.682,95％CI:4.731～6.823)、高血压(OR=1.260,95％CI:1.036～1.531)、淋巴细胞计数升高(OR=1.404,95％CI:1.221～1.613)、血红蛋白浓度升高(OR=1.018,95％CI:1.010～1.026)、高尿酸血症(OR=3.059,95％CI:2.278～4.107)、高甘油三酯血症(OR=2.328,95％CI:1.946～2.786)、低高密度脂蛋白胆固醇(OR=1.401,95％CI:1.119～1.755)以及高血糖(OR=2.004,95％CI:1.496～2.685)是发生NAFLD的危险因素.结论 维吾尔族人群发生NAFLD的危险较汉族高,SUA水平与NAFLD密切相关.     

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.     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

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.