肥胖和中心性肥胖高血压控制不良患者合并血脂异常、糖尿病和高尿酸血症的分析

目的 研究肥胖与中心性肥胖高血压控制不良患者合并血脂异常、糖尿病与高尿酸血症的情况。方法 采用多阶段分层整群抽样方法，对1 215例患者进行问卷调查、体格检查和实验室检测，比较肥胖、中心性肥胖与非肥胖患者的血压水平，血脂异常、糖尿病与高尿酸血症患病率差异。结果 肥胖与中心性肥胖患者的舒张压水平高于体质量指数正常/体质量指数偏低患者(P<0.05),其血压值随着年龄的增长而降低(P<0.05)。合并血脂异常患病率为45.10%,其中合并低HDL-C血症患病率男性高于女性、合并高TC血症患病率女性高于男性(P<0.05)。合并高尿酸血症、糖尿病单病种或糖尿病与血脂异常2个病种的患病率分别为23.05%、30.95%、60.58%。结论 湖州市肥胖与中心性肥胖的高血压控制不良患者同时合并血脂异常与糖尿病的患病率高，其血脂异常特点为TG升高、HDL-C降低。     

合肥市包河区成人慢性病流行状况及影响因素分析

目的了解合肥市包河区成人慢性病流行状况,分析影响因素。方法采取整群随机抽样的方法抽取2 135名包河区成年人群,通过问卷调查、体格检查和实验室检查了解慢性病患病情况及相关危险因素。结果合肥市包河区成人中心性肥胖患病率为39.5%,高血压患病率为32.1%,血脂异常患病率为17.2%,糖尿病患病率为12.7%,其他慢性病患病率低于2.0%;患病率前4位的慢性病在不同特征人群中的分布存在差异。中心性肥胖的危险因素有女性、年龄、奶制品摄入不足、家族慢病史以及超重或肥胖;成人高血压的危险因素有男性、年龄、奶制品摄入不足、家族慢病史、超重或肥胖以及饮酒;糖尿病的危险因素有年龄以及超重或肥胖;血脂异常的危险因素有年龄、饮酒以及超重或肥胖。结论合肥市包河区成人慢性病患病率较高。年龄、饮酒和肥胖是慢性病的主要影响因素。     

天津市成年居民血脂异常流行特征及影响因素分析

目的了解天津市成年居民血脂异常流行特征及其影响因素,为血脂异常的预防控制提供参考依据。方法于2012年1—12月采用分层随机抽样方法对在天津市抽取的8 968名≥18周岁成年居民进行体格检查和实验室检测。结果天津市成年居民血脂异常患病率为28.88%,标化患病率为26.70%;男性血脂异常患病率为34.63%,高于女性的19.98%(χ2=223.5,P=0.000);18~29、30~39、40~49、50~59、60~69和≥70岁成年居民血脂异常患病率分别为17.55%、24.49%、31.33%、37.40%、32.35%和28.36%,血脂异常患病率随着年龄增加先增高后降低(χ2趋势=105.4,P=0.000);天津市成年居民甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)分别为(1.53±1.23)、(4.91±1.10)、(1.43±0.37)和(2.86±0.80)mmol/L;天津市成年居民高TG血症、高TC血症、高LDL-C血症和低HDL-C血症患病率分别为15.16%、8.95%、6.50%和12.61%,标化患病率分别为14.05%、7.42%、5.36%和12.65%。多因素非条件logistic回归分析结果显示,年龄≥30岁、超重、肥胖、高血压、糖尿病和高尿酸血症是天津市成年居民血脂异常和高TG血症的危险因素,女性和体重过轻是天津市成年居民血脂异常和高TG血症的保护因素;女性、年龄≥30岁、超重、肥胖、高血压、糖尿病和高尿酸血症是天津市成年居民高TC血症的危险因素;女性、年龄≥40岁、超重、肥胖和高血压是天津市成年居民高LDL-C血症的危险因素;超重、肥胖、糖尿病和高尿酸血症是天津市成年居民低HDL-C血症的危险因素,女性和体重过轻是天津市成年居民低HDL-C血症的保护因素。结论天津市成年居民血脂异常患病率较低,但性别、年龄差异较大;性别、年龄、体质指数(BMI)、血压、血糖和血尿酸是天津市成年居民血脂异常的主要影响因素。     

2013年新疆汉族成人城乡居民血脂异常患病率及相关因素研究

目的 了解新疆汉族成人城乡居民血脂异常患病率及相关因素.方法 样本为多阶段分层整群抽取的新疆5个市县3 095名20～80岁的汉族居民,其中城市居民1 970人(63.65％).本文比较了城乡居民血脂总胆固醇(total cholesterol,TC),甘油三酯(triglyceride,TG),低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)和高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)异常患病率及相关因素.结果 血脂异常总患病率为28.11％,城市居民总患病率高于农村居民(30.00％ vs 24.80％,x2=9.58,P=0.002);高TC血症患病率为7.69％,城市高于农村(8.83％ vs 5.69％,x2=9.97,P=0.002);高TG血症患病率为19.97％,城市高于农村(21.47％ vs 17.35％,x2 =7.61,P=0.006);高LDL-C血症患病率为4.52％,城市高于农村(5.33％ vs 3.11％,x2=8.16,P=0.004);低HDL-C血症患病率为7.40％,城市与农村差异无统计学意义(7.56％ vs7.11％,X2=0.21,P=0.644).多因素Logistic回归显示,超重和肥胖是血脂TG、HDL-C异常共同的独立相关因素(均有P＜0.05).结论 新疆五市县汉族成人血脂水平高于全国.城市居民血脂异常水平高于农村.控制超重和肥胖是预防新疆汉族城乡居民血脂异常的重要手段.     

咸阳市秦都区事业单位职工血脂异常流行特征及影响因素

目的了解咸阳市秦都区事业单位职工血脂异常发生率及影响因素,为事业单位职工血脂异常预防和综合防控提供科学依据。方法收集2018年3—12月在某健康检查中心进行检查的咸阳市秦都区事业单位职工资料,分析不同性别、年龄段、各组分血脂异常的检出率及分布情况,采用非条件logistic回归分析其影响因素。结果共调查咸阳市秦都区事业单位职工1 598名,血脂异常总患病率为46.43%,标化患病率为44.86%。男性血脂异常患病率(52.25%)明显高于女性(30.17%),差异有统计学意义(P0.01)。高甘油三酯(TG)血症、高总胆固醇(TC)血症、高低密度脂蛋白胆固醇(LDL-C)血症和低高密度脂蛋白胆固醇(HDL-C)血症患病率分别为25.34%、3.88%、3.50%和28.66%,男性高TG血症(28.12%)与低HDL-C血症(34.41%))患病率明显高于女性(18.22%,12.59%),差异均有统计学意义(均P0.01)。多因素非条件logistic回归分析结果显示,超重(OR=2.31)、肥胖(OR=2.92)和高尿酸血症(OR=1.63)是血脂异常的独立危险因素,女性(OR=0.54)、体重过轻(OR=0.16)是独立保护因素;超重(OR=2.14)、肥胖(OR=2.42)和高尿酸血症(OR=1.88)是高TG血症的独立危险因素;超重(OR=2.56)是高TC血症的独立危险因素;年龄50～59岁(OR=8.34)、超重(OR=3.18)是高LDL-C血症的独立危险因素;超重(OR=1.80)、肥胖(OR=3.07)是低HDL-C血症的独立危险因素,女性(OR=0.34)、体重过轻(OR=0.19)是独立保护因素。结论咸阳市秦都区事业单位职工血脂异常发病水平较高,主要以高TG血症、低HDL-C血症为主,集中在中青年人群,并且与年龄、性别、体质指数(BMI)、高血压和高尿酸血症等密切相关,应根据其工作性质及特点开展预防性知识教育,加强血脂水平管理,提高目标人群生活质量。     

新疆哈萨克族成人血脂异常及其影响因素

目的了解新疆哈萨克族≥18岁居民血脂异常现状及相关影响因素。方法采用分层整群抽样方法,选取新疆新源县、石河子市等地区≥18岁哈萨克族居民3 935人进行调查问卷和身体检查,采集清晨空腹血样检测血脂;采用描述流行病方法和多因素logistic回归分析,分析哈萨克族居民血脂异常分布特征及其相关危险因素。结果新疆哈萨克族居民总血脂异常患病率为40.9%,标化率为40.8%,其中高甘油三酯(TG)血症、高总胆固醇(TC)血症、高低密度脂蛋白胆固醇(LDL-c)血症、低高密度脂蛋白胆固醇(HDL-c)血症的患病率分别为19.4%、14.5%、7.7%、16.1%,标化率分别为18.7%、12.6%、6.3%、18.5%;男性血脂异常患病率为46.5%,高于女性的37.2%(χ2=33.865,P=0.000);血脂异常患病率随年龄增长的差异有统计学意义(χ2=33.682,P=0.000);多因素logistic回归分析显示,男性、超重肥胖是血脂异常的危险因素(分别OR=1.809,95%CI=1.307～2.503;OR=1.835,95%CI=1.329～2.535);饮奶茶量、蔬菜水果类是血脂异常的保护因素(分别OR=0.588,95%CI=0.463～0.746;OR=0.591,95%CI=0.419～0.835)。结论新疆哈萨克族成人各项血脂异常患病率均高于全国平均水平,以高TG血症、低HDL-c血症为主;血脂异常患病率年轻化趋势明显。     

北京市石景山区居民血尿酸水平与慢性病关系探讨

目的了解人群血尿酸水平和高尿酸血症(Hyperuricemia,HUA)患病状况及与性别、年龄等慢病危险因素的关系。方法对北京市石景山区居民进行成人HUA患病及危险因素调查,测定血尿酸、血糖、血脂水平,测量身高、体重、腰围,分析血尿酸水平与慢性病及危险因素之间的关系。结果血尿酸水平各年龄段男性均高于女性,血尿酸随年龄升高而升高,差异有统计学意义;血尿酸水平与高血压、血脂异常、心脑血管病、TG、TC、HDL-C、和超重肥胖相关。HUA患病率为11.1%,其中男性患病率18.2%,女性患病率6.7%,男性高于女性,差异有统计学意义(χ2=121.789,P=0.000);主要患病年龄在40～49岁,50岁以上患病率低;HUA患病率与吸烟、饮酒密切相关,logistic回归分析,男性、饮酒、高TG、低HDL是HUA危险因素。结论血尿酸水平与血脂异常、高血压、肥胖等慢病相关,而且与吸烟、饮酒等生活方式有关,改善生活方式和饮食习惯,对降低血尿酸水平,预防心脑血管病是有益的。     

上海市嘉定区糖尿病高危人群血脂异常患病情况及影响因素研究

目的调查上海市嘉定区糖尿病高危人群血脂异常患病情况及影响因素。方法在上海市嘉定区13个街镇随机抽取3个街镇,再在抽中的街镇抽取3个居委作为研究现场,选取年龄30岁以上的常驻居民为调查对象。通过问卷调查和实验室检测收集调查对象的一般资料和实验室数据。结果本研究共调查糖尿病高危人群2 526人,其中男性1 055人,女性1 471人;糖尿病高危人群血脂异常患病率为31.43%(1项及以上血脂指标异常),高TC血症、高TG血症、低HDL-C血症和高LDL-C血症患病率分别为11.56%、13.42%、9.11%和14.89%。分层分析发现,不同年龄、性别、超重肥胖、腹型肥胖、血压异常的患者血脂异常比较,差异有统计学意义;血脂异常组的空腹静脉血糖和糖化血红蛋白值高于正常组,差异有统计学意义;logistic回归分析显示,超重肥胖、腹型肥胖、空腹静脉血糖和糖化血红蛋白是糖尿病高危人群血脂异常的危险因素。结论糖尿病高危人群应控制血糖和体重,以减少血脂异常和心血管事件的发生风险。     

中国18岁及以上人群血脂异常流行特点研究

目的 掌握我国城乡及不同地区居民血脂异常及高胆固醇血症、高甘油三酯血症、低高密度脂蛋白血症流行情况及其差异。方法 调查时间为2002年8至12月。采用酶法对49252名调查对象空腹血浆总胆固醇、甘油三酯、高密度脂蛋白胆固醇进行测定。结果 按年龄和地区调整后,我国18岁及以上成人血脂异常患病率为18．6％,18-44岁、45-59岁和≥60岁人群的患病率分别为17．0％、22．9％和23．4％;男性为22．2％,女性为15．9％;城市为21．0％,农村为17．7％。我国18岁及以上成人高胆固醇血症患病率为2．9％,胆固醇边缘性升高率为3．9％;高甘油三酯血症患病率为11．9％;低高密度脂蛋白血症患病率为7．4％。结论 血脂异常已成为威胁我国人民健康的重要危险因素;18岁及以上人群血脂异常以高甘油三酯、低高密度脂蛋白胆固醇血症为主;中、老年人血脂异常患病率相近,城乡差别不大。作好人群早期综合防治工作十分重要。     

石河子中小学生血脂异常患病率及危险因素分析

了解石河子地区在校中小学生血脂异常患病情况及其危险因素,为青少年血脂异常的防控提供科学依据.方法 采用分层随机整群抽样的方法调查石河子市12所学校l 764名在校中小学生,对其进行问卷调查、体格检查和实验室检查,分析其血脂异常流行病学特征及危险因素.结果 石河子地区在校学生血脂异常总患病率为13.04%;高三酰甘油(TG)血症、高总胆固醇(TC)血症、高低密度脂蛋白胆固醇(LDL-C)血症和低高密度脂蛋白胆固醇(HDL-C)血症患病率分另为5.67%,8.73%,5.78%,10.32%.男生血脂异常患病率(14.29%)高于女生(11.75%)(x2=2.498,P=0.114).多因素Logistic回归分析显示,年龄(OR=1.204,95%CI=1.011~ 1.433,P=0.037)、肥胖(OR=1.723,95%CI=1.205~2.465,P=0.003)和高脂饮食(OR=1.535,95%CI=1.073~ 2.196,P=0.019)是血脂异常的危险因素.结论 石河子在校中小学生血脂异常患病率较高且以低HDL-C血症为主,年龄、肥胖和高脂饮食是血脂异常的危险因素.     

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.