邻苯二甲酸酯健康影响流行病学研究进展

邻苯二甲酸酯是一种常见室内空气污染物。作为典型的环境内分泌干扰物,其健康危害受到了国内外研究者日益广泛的关注。目前,我国在邻苯二甲酸酯暴露与健康影响方面的数据相对缺乏,本文从过敏性疾病、甲状腺功能紊乱、糖尿病以及生殖发育异常等方面总结了邻苯二甲酸酯暴露对人群的健康影响,有利于加深公众对邻苯二甲酸酯健康危害的认识。     

邻苯二甲酸酯对儿童青少年健康的影响

作为常见环境污染物,邻苯二甲酸酯类(PAEs)对儿童青少年健康产生了广泛影响。本文综述了在生命早期,PAEs暴露与肥胖、胰岛素抵抗、哮喘等过敏症状、神经系统发育乃至注意缺陷多动症的关联,以及PAEs暴露对心血管、甲状腺、性发育、肾脏、免疫系统的影响。     

儿童哮喘与邻苯二甲酸酯暴露关系的研究

在过去30年里儿童哮喘的发病率快速增长,而在同一时期包括邻苯二甲酸酯在内的环境化学物质的污染状况也越来越严重,这提示,邻苯二甲酸酯的暴露可能与儿童哮喘的高发有关.本文概述邻苯二甲酸酯的儿童内暴露状况与儿童哮喘发病情况之间的关系.其中,邻苯二甲酸酯儿童暴露与过敏性疾病的流行病学研究,为儿童哮喘的环境归因研究提供了一定的线索和研究方向;相关的动物实验和体外细胞实验,为探索邻苯二甲酸酯暴露所致包括过敏性哮喘在内的健康损害及可能的机制提供了一定的科学依据.虽然目前的研究显示,邻苯二甲酸酯暴露在哮喘发作过程中起到了佐剂的作用,但对于研究结果存在不一致性未得到明确结论.因此,在未来的研究中仍需要继续探索邻苯二甲酸酯对儿童罹患哮喘的影响,并进一步分析其可能的作用机制.     

邻苯二甲酸酯类化合物的环境污染及人体暴露水平

邻苯二甲酸酯，主要用作增塑剂，是一类环境内分泌干扰物。本文综述了邻苯二甲酸酯在我国环境中的污染水平、迁移转化规律及人体暴露途径和暴露水平。     

邻苯二甲酸酯代谢研究进展

邻苯二甲酸酯主要用作塑料增塑剂,普遍存在于环境中。动物实验表明邻苯二甲酸酯具有内分泌干扰作用,已在尿液、血液和精液等体液中检测到邻苯二甲酸酯。邻苯二甲酸酯在体内的代谢研究是内暴露评价的基础,该文对邻苯二甲酸酯的代谢研究进展进行了综述,指出了邻苯二甲酸酯主要代谢路径和在尿液中的代谢产物,比较了不同人群尿液中邻苯二甲酸酯代谢物的浓度水平。     

邻苯二甲酸酯雌性生殖毒性研究进展

邻苯二甲酸酯是一类产量大、用途广而且严重污染环境的化合物,流行病学调查证实了邻苯二甲酸酯的暴露与女性生殖功能损害的关系。本文就邻苯二甲酸酯对雌性生殖功能损害的体内、体外实验及毒性的机制进行了回顾。     

邻苯二甲酸酯毒性及健康效应研究进展

该文对邻苯二甲酸酯毒性及健康效应的研究进展进行了综述,并对相关研究的前景进行了展望。重点介绍的内容包括动物毒理学研究、人群流行病学研究、人体对邻苯二甲酸酯的暴露、现行的邻苯二甲酸酯的安全标准以及作者对进一步研究的若干思考。     

邻苯二甲酸酯类胚胎生殖毒性研究进展

邻苯二甲酸酯类(phthalate esters,PAEs)是目前普遍使用的增塑剂,常用于生产医疗制品、塑料玩具和食品包装等.它是一种典型环境内分泌干扰物,具有生殖毒性.动物实验发现,产前以及发育早期暴露PAEs的雄性动物,其生殖道会表现出特殊毒性症状,如尿道下裂、隐睾症等,类似于人类胎儿期性腺发育异常引起的睾丸发育不全综合征(testicular dysgenesis syndrome,TDS).     

生命早期邻苯二甲酸酯暴露与儿童青春发动时相提前关联研究进展

儿童青春发动时相提前对儿童身心健康造成了不小的影响, 也与成年时期多种慢性非传染性疾病有关, 其病因复杂, 主要包括环境因素及遗传学因素。邻苯二甲酸酯(PAEs)作为一类常见环境污染物, 暴露于人体后其代谢物可作为内分泌干扰物影响身体的内分泌系统稳态。生命早期更是疾病易感时期, 很多研究发现, 围生期及发育关键时期暴露于PAEs可促进青春期发展。本文从PAEs暴露与青春发动时相提前关联的流行病学研究和相关机制方面进行阐述。     

邻苯二甲酸酯致雌性生殖系统毒性及其机制的研究进展

邻苯二甲酸酯(phthalate esters,PAEs)作为塑化剂广泛用于聚氯乙烯(PVC)塑料产品中,在环境中普遍存在,现已被确定为环境内分泌干扰物,主要通过食物、水、皮肤等途径进入机体.流行病学调查显示,邻苯二甲酸酯暴露与女性生殖系统损伤有关.邻苯二甲酸酯可干扰雌性啮齿类动物的排卵和卵巢颗粒细胞激素的分泌,并且可影响受精卵的着床及生长发育.该文综述了邻苯二甲酸酯类对雌性卵巢颗粒细胞、卵泡和子宫的影响及其可能的作用机制,并对目前存在的问题和未来研究的方向进行了展望.     

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.