黄山市2019—2021年围生儿出生缺陷分析

目的 分析2019—2021年黄山市围生儿出生缺陷变化趋势及相关因素。方法 根据2019—2021年黄山市17家医院上报的31 534名围生儿出生缺陷监测资料,分析围生儿出生缺陷发生水平。结果 2019—2021年共监测围生儿31 534人,上报出生缺陷儿683例,核实确认674例,全孕周出生缺陷发生率213.73/万(674/31 534),围生儿出生缺陷发生率143.65/万(453/31 534),并呈逐年上升趋势(χ²_趋势=5.137,P=0.023)。围生儿出生缺陷发生率城市高于农村(χ²=24.096,P<0.001)、不同年龄产妇出生缺陷发生率有差异(χ²=7.698,P=0.006)。全孕周出生缺陷中35岁以上的高龄组染色体异常缺陷儿是适龄组的3.286(95%CI:1.802～6.024)倍。全孕周出生缺陷顺位前五分别是:先天性心脏病、外耳其他畸形、多指(趾)、染色体异常、总唇裂。先天性心脏病位居全孕周出生缺陷顺位首位,<28周出生缺陷顺位中染色体异常居首位。结论 黄山...     

2013—2019年广西地区围生儿出生缺陷监测结果分析

目的分析2013—2019年广西地区围生儿出生缺陷监测结果,及时发现影响出生缺陷的可疑因素,为制定出生缺陷的预防措施提供依据。方法本研究采用回顾性研究的方法,监测2013—2019年在广西地区1174家医院怀孕满28周到出生后7 d的围生儿(包括活产、死胎、死产、7 d内死亡的新生儿及计划内引产的围生儿),并在此基础上分析这几年广西出生缺陷的三间分布及发生率变化情况。结果2013—2019年广西地区共有5640807名围生儿,出生缺陷患儿65224名,平均年发生率约为115.63/万。城镇地区出生缺陷的总发生率为198.28/万,乡村地区出生缺陷的总发生率为97.58/万,城镇地区高于乡村地区(χ²=7147.778,P<0.01);男性出生缺陷发生率为128.00/万,女性出生缺陷发生率为100.33/万,男性出生缺陷发生率远远高于女性(χ²=924.316,P<0.01);产妇年龄主要集中在25~30岁这一阶段(平均占比33.31%)。出生缺陷发生率顺位表前5位为先天性心脏病、总唇裂、多指(趾)、马蹄内翻足和外耳其他畸形。2013-2019年多指(趾)发生率从20.69/万增加到25.48/万(P<0.01);先天性心脏病从15.79/万增加到35.82/万(P<0.01);神经管缺陷由1.64/万下降至0.60/万(P<0.01);胎儿水肿综合征由7.56/万降至2.39/万(P<0.01)。结论广西地区出生缺陷的发生率总体较高,近7年来,围生儿部分出生缺陷发生率发生变化,且存在一定的地区、性别、母亲年龄差异,故使用新的诊断技术、提高监测能力、加强健康教育对降低出生缺陷的发生率具有重要意义。     

2015-2019年余姚市围生儿不同性别 户籍出生缺陷发生率及转归情况分析

目的分析2015-2019年余姚市围生儿不同性别、不同户籍出生缺陷发生率及转归情况,为制定相应干预措施提供依据。方法收集2015-2019年度余姚市医疗保健机构上报的出生缺陷监测资料,并进行统计分析。结果不同性别围生儿出生缺陷发生率比较差异无统计学意义(P0.05);不同户籍围生儿出生缺陷发生率比较差异有统计学意义(P0.01);围生儿出生缺陷主要有先天性心脏病、唇腭裂、先天性脑积水、无脑畸形、脊柱裂及多指(趾);与2019年相比,围生儿死胎、死产构成比明显下降,存活构成比明显上升(P0.001)。结论余姚市本地户籍围生儿出生缺陷发生率呈稳定下降趋势,非本地户籍围生儿出生缺陷发生率呈上升趋势,应重点加强流动人口围生儿出生缺陷的监测、预防及科学干预,以降低出生缺陷发生率、改善转归结局。     

广东省云浮市2015—2019年出生缺陷监测结果分析

目的探讨广东省云浮市出生缺陷的发生率、种类及变化趋势,为制定云浮市出生缺陷干预措施提供科学依据。方法按《中国出生缺陷监测方案》及《广东省妇幼卫生监测方案》,对2015—2019年云浮市出生缺陷监测数据进行回顾性描述和趋势χ~2检验分析。结果 2015—2019年云浮市出生缺陷发生率平均为90.84/万(1 729/190 339),出生缺陷发生率呈逐年上升趋势,各年份间出生缺陷发生率比较差异有统计学意义(χ~2=32.40,P0.05);男性出生缺陷发生率(104.18/万)高于女性(74.96/万),差异有统计学意义(χ~2=45.05,P0.05);居住地在城市的围产儿的出生缺陷发生率(101.79/万)高于居住地在农村者(88.59/万),缺陷儿母亲常住地城乡之间比较差异有统计学意义(χ~2=5.18,P0.05);母亲年龄20岁及≥35岁组的出生缺陷发生率明显高于20～、25～、30～岁组;2015—2019年5年间出生缺陷首位均为多指(趾)或并指(趾),2016年先天性心脏病取代2015年的胎儿水肿综合征,并为第5顺位。结论多指(趾)或并指(趾)、唇腭裂为云浮市高发的出生缺陷,每年的出生缺陷发生率均有明显上升趋势,需要加强三级防控措施,减少围产儿出生缺陷,提高出生人口素质。     

佛山市南海区407例出生缺陷监测资料分析

目的分析广东省佛山市南海区出生缺陷发生的种类及相关因素,了解出生缺陷变化趋势,探讨干预措施。方法对2002年10月1日～2006年9月30日在佛山市南海区市级2家医院住院分娩的孕满28周至出生后7天的围生儿进行出生缺陷监测,分析出生缺陷发生率、类别、构成比及相关因素。结果 2003～2006年期间监测医院共出生围生儿21593例,其中有出生缺陷407例,出生缺陷发生率呈逐年增高趋势。在407例出生缺陷儿中,单发畸形369例,多发畸形38例。出生缺陷前5位畸形依次为：多指（趾）、先天性心脏病、唇腭裂、尿道下裂、并指（趾）。出生缺陷的发生率农村明显高于城市（χ2=22.25,P〈0.001）;出生缺陷发生的性别分布为男性高于女性,经检验有显著性差异（χ2=13.88,P〈0.01）。结论佛山市南海区出生缺陷发生率呈逐年上升的趋势,且农村高于城市,男性高于女性。     

成都市温江区2009—2012年出生围生儿情况分析

目的分析成都市温江区2009—2012年出生的围生儿报表数据,揭示产妇的年龄、死胎死产、出生缺陷构成比的变化趋势,为相应的干预提供可靠有效的依据。方法对2009—2012年温江区围生儿年报表进行回顾性分析,通过两样本率的χ2检验,了解各指标的变化趋势。结果温江区2009—2012年共出生17 421名围生儿,其中高龄产妇1 152名,比率为6.61%,近4年整体变化不明显,但城镇高于农村(χ2=8.669,P<0.05),呈逐年上升趋势(χ2=3.969,P<0.05);低龄产妇664名,比例为3.81%,整体呈下降趋势,农村高于城镇(χ2=153.088,P<0.05);死胎死产145名,比率为8.32‰,整体呈下降趋势,农村高于城镇(χ2=4.606,P<0.05);出生缺陷儿126名,比率为7.23‰,整体呈上升趋势。结论加强优生优育的宣传,降低低龄产妇的比率,寻找可能的干预方式,避免出生缺陷上升的趋势。     

深圳市福田区2009-2013年围产儿出生缺陷发生情况分析

目的 掌握围产儿出生缺陷的发生情况,为制订及完善出生缺陷预防对策及干预措施提供科学依据。方法 按照国家所规定的出生缺陷监测方案,对2009-2013年深圳市福田区围生儿出生缺陷监测资料进行统计分析。结果 5 年间出生缺陷平均发生率为26.80‰,各年度出生缺陷发生率经χ²趋势检验结果 显示有逐年增高趋势（χ²=43.623,P<0.0005）,其中流动人口出生缺陷发生率为28.37‰,各户籍类型出生缺陷发生率比较有统计学意义（χ²=15.398,P=0.001）,出生缺陷前五位例数共2258例,占全部出生缺陷发生的53.58%,先天性心脏病在各年度均是出生缺陷第一位,各年度出生缺陷儿的存活率经χ²趋势检验结果 显示有逐年增高趋势（χ²=7.281,P=0.007）。结论 2009-2013年深圳市福田区出生缺陷率高于全国水平,且呈逐年上升趋势,流动人口出生缺陷发生率较高;先天性心脏病持续居于出生缺陷第一位;出生缺陷儿的存活率有逐年增高趋势。     

2005-2017年宜昌市夷陵区出生缺陷变化趋势分析

目的了解宜昌市夷陵区围生儿出生缺陷发生状况及变化趋势,为临床提供依据。方法对夷陵区内医疗保健机构2005-2017年出生缺陷监测数据进行整理,分析出生缺陷的发生率、城乡差异、缺陷类型、发现时间变化情况。结果 13年间共监测57 279例围生儿,出生缺陷651例,缺陷平均发生率为11. 37‰,其中,2005-2013年为波动性升高,2014年起稳定逐年升高,2017年升高至25. 32‰(χ~2=43. 214,P<0. 001);男性缺陷发生率高于女性(χ~2=6. 217,P=0. 013); 2005-2013年农村高于城镇(χ~2=70. 931,P=<0. 001),但在2014-2017年城镇显著高于农村(χ~2=207. 230,P<0. 001);排前5位的缺陷疾病依次为:先天性心脏病、多指(趾)、外耳畸形、唇腭裂和马蹄内翻足,其中,先天性心脏病以检出率35. 94%居首位,且2014-2017年发生率呈上升趋势(χ~2=71. 250,P<0. 001);缺陷儿的产前确诊率为26. 72%,2014-2017年更低,仅为14. 71%。结论应着力加强健康教育、遗传咨询、优生优育知识普及;着力提升婚前、孕前、产前检查率;指导城、乡孕妇防范社会环境因素对胎儿的不利影响,适时接受产前筛查;强化医师专项技术培训,提升缺陷儿产前诊断水平是减少夷陵区出生缺陷发生率的关键。     

2004～2008年深圳市龙岗区出生缺陷监测情况分析

目的 了解近年深圳市龙岗区围产儿出生缺陷发生率及其变化情况,为制定干预措施提供参考依据.方法 按照国家出生缺陷监测方案,对2004～2008年深圳市龙岗区26家产科医院出生的围产儿进行监测,并对监测资料进行统计分析.结果 2004～2008年共计监测围产儿138 188例,出生缺陷共1 829例,出生缺陷发生率为13.24‰,2004～2007年出生缺陷发生率呈逐年上升趋势,但差异无统计学意义(χ2=5.21,P=0.16);流动人口的出生缺陷发生率高于常住人口的发生率,其差异有统计学意义(χ2=11.71,P<0.01);前5位出生缺陷依次为先天性心脏病(15.42%)、多指(趾)(15.25%)、唇裂并腭裂(6.23%)、马蹄内翻足(6.18%)、外耳畸形(6.12%);出生缺陷中的死胎、死产导致死亡构成比呈下降趋势(χ2=31.24,P<0.01),新生儿存活构成比则呈上升趋势(χ2=25.04,P<0.01).结论 加强出生缺陷监测工作,采取综合干预措施,有效降低出生缺陷的发生率.     

丽水市围产儿出生缺陷变化趋势分析

目的分析丽水市出生缺陷发生现状及变化趋势,探讨减少本地区出生缺陷发生的有效干预措施。方法对2006年10月1日—2016年9月30日丽水市3个监测县(市、区)8家出生缺陷监测医院住院分娩的孕28周至产后7d内的围产儿和28周的出生缺陷儿报表资料进行分析。结果共监测围产儿92 543人。报告出生缺陷2 907例,其中围产儿出生缺陷2 234例,28周出生缺陷儿673例;围产儿出生缺陷发生率为24.14‰,呈逐年上升趋势(P0.05)。围产儿出生缺陷发生率男婴(25.57‰)高于女婴(22.52‰),城镇(27.04‰)高于乡村(22.62‰)(均P0.05);不同年龄组母亲分娩出生缺陷围产儿的概率不同(P0.05),20岁(37.21‰)和≥35岁(30.21‰)女性娩出出生缺陷围产儿的风险较高。围产儿出生缺陷发生率前五位为先天性心脏病、多指/趾、唇腭裂、并指/趾和小耳。围产儿和出生缺陷围产儿死亡率分别为9.09‰和15.49%,均呈逐年下降趋势(P0.05);出生缺陷儿死亡占围产儿死亡的41.14%。结论丽水市围产儿出生缺陷发生率呈逐年上升趋势,以先天性心脏病为主,围产儿性别及其母亲的年龄和居住地区与出生缺陷的发生密切相关。     

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.     

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.