江西省居民主要膳食镉暴露风险的初步评估

目的了解江西省主要食品中镉含量状况,对居民膳食镉暴露量及其引起的健康风险进行评估。方法对江西省11类食品中的镉含量进行统计分析,结合居民膳食营养与健康状况调查数据,参考镉的暂定每月可耐受摄入量(PTMI),对居民日常膳食镉暴露量进行评估,同时应用美国环保署(USEPA)的健康风险模型评价其安全性。结果江西省11类食品中镉平均含量为0. 00027~0. 36 mg/kg,总检出率和超标率分别为63. 5%和1. 68%,超标样品主要是动物肾脏、淡水蟹和大米;江西省居民膳食镉的月平均暴露量和偏高暴露量分别为0. 021和0. 054 mg/kg·BW,分别占PTMI的84%和216%,镉暴露的来源主要是大米和蔬菜,二类食品的贡献率占到85. 5%;应用USEPA模型评价,以平均暴露量引起的健康风险值略高于国际辐射防护委员会的推荐标准,但低于USEPA致癌风险评价指南推荐值,而高暴露人群的健康风险较高。结论江西省大部分市售食品镉含量较低,大部分居民通过日常膳食摄入的镉基本上处于可接受水平,但高摄入量人群仍存在一定的健康风险,应引起重视。     

广州市居民膳食镉含量监测及暴露评估

目的了解广州市日常消费食品镉污染状况,评估居民膳食镉暴露风险。方法对2013—2015年广州市11类食品中的镉含量进行监测,结合2011年广州市居民膳食摄入量调查,应用WHO推荐的食品中化学污染物膳食暴露评估方法对广州市居民膳食镉暴露水平进行评估。结果共监测食品样品3 999份,镉平均含量为0.1 889 mg/kg,P50和P95镉含量分别为0.01和0.751 mg/kg,检出值范围为0.000 5~7.83 mg/kg;总检出率为75.04%(3 001/3 999),总超标率为1.50%(60/3 999)。居民主要膳食中镉平均每周暴露量为0.003 3 mg/kg BW,占耐受摄入量(PTWI)的47.14%。稻米、紫菜、蔬菜和水产品是镉摄入的主要来源,从这四类膳食中摄入的镉占总的膳食镉暴露量91.66%;然而对于膳食消费量高(P95)的人群,镉的周总暴露量为0.011 6 mg/kg BW,占PTWI 165.71%。结论大部分广州市居民膳食镉暴露水平位于安全限值以内,但高摄入量人群暴露量超过PTWI,对健康可能存在一定风险,应引起重视。     

深圳市市售水产品中的镉膳食暴露风险评估

目的通过分析深圳市市售水产品中镉污染水平及居民对水产品的消费量,评估食用水产品中镉的膳食暴露风险。方法采用单纯随机抽样方法,在深圳市采集各类水产品样品共1 405份,结合居民水产品消费量调查结果,采用点评估方法评估深圳市居民食用水产品中镉的暴露风险,并对照FAO/WHO食品添加剂联合专家委员会(JECFA)推荐的镉暂定每月耐受摄入量(PTMI)进行评价。结果共检测样品1 405份,总超标率为16.44%(231/1 405),各类水产品中镉含量平均值范围在0.002～1.439 mg/kg之间。镉平均含量较高的是贝类、藻类、头足类,分别为1.439、1.171、0.367mg/kg。深圳市居民食用水产品消费量较高的是淡水鱼、海水鱼和头足类,每天平均消费量分别为0.763、0.595、0.137g/kg Bw。水产品中镉的平均暴露量和P90暴露量分别为5.04μg/kg Bw和11.67μg/kg Bw,分别占PTMI的20.16%、46.68%。贝类、头足类和藻类是深圳市居民摄入水产品中镉暴露的主要来源,从这3类膳食中摄入的镉占深圳市居民每月水产品镉平均暴露量的96.54%。结论深圳市食用水产品中镉有一定的超标情况,但对居民膳食暴露风险低于健康指导值,通过摄入市场上的水产品尚不会对居民的健康产生不利影响。     

2013－2016年南京市民膳食中镉暴露风险评估

目的 了解南京市居民主要膳食消费量及市售食品中镉含量,对居民通过膳食镉暴露健康风险进行初步评估。 方法 2013－2016年监测全市10大类共计1 181份样品镉含量,结合2012年南京市居民膳食消费量调查,应用食品中化学污染物膳食暴露点评估法,初步评估南京市居民主要食品的镉暴露风险。 结果 市售食品中镉含量较高的食品是茶叶、面粉、菌藻类、水产品和动物内脏, 镉含量的中位数分别为:0.0300、0.0249、0.0203、0.0285、0.0327 mg/kg;各类蔬菜中叶菜类平均镉含量最高(中位数为0.0100 mg/kg),镉含量最低的食品是新鲜水果(0.0003 mg/kg)和畜肉(0.0024 mg/kg)。居民平均每月膳食镉暴露量为0.0087 mg/(kg·bw),占每月可耐受摄入量的34.6%;膳食摄入量采用P₅₀时,膳食中镉的每月暴露量为0.0027 mg/(kg·bw),占每月可耐受摄入量的10.8%,膳食摄入量采用P₉₀时,膳食中镉的每月暴露量为0.0188 mg/kg·bw,占PTWI的75.0%。大米、菌藻类、蔬菜和水产品是镉摄入的主要来源,从粮谷类食品、蔬菜、水产品中摄入的镉分别占膳食镉暴露量(膳食摄入量采用P₉₀时)的35.91%、13.98%、19.10%。居民膳食中每月镉暴露量均值占PTMI百分数的顺序依次为6~17岁年龄组(45.3%)、18~44岁年龄组(36.0%)、45~60岁年龄组(34.4%)和60岁以上年龄组(32.2%)。 结论 南京市居民膳食镉暴露水平总体安全,但仍有必要加强食品中镉含量监测,从源头上控制镉污染,进而减少居民膳食中镉暴露水平。     

襄阳市部分食品镉污染状况及膳食暴露评估

目的了解近年来襄阳市部分食品中镉的污染水平,评估居民的镉膳食暴露量。方法 2011-2013年通过食品安全风险监测网络,随机采集市售的8类食品,用石墨炉原子吸收法测定各类食品中镉含量,采用点评估的方式,计算居民的实际镉摄入量水平。根据FAO/WHO食品添加剂联合专家委员会(JECFA)推荐的暂定每月可耐受摄入量(PTMI),评价襄阳市居民膳食摄入镉的安全性。结果 2011-2013年采集8类共740份食品检测镉含量,镉含量超标率4.05%,超标率较高的食品种类有食用菌、动物内脏、蔬菜;襄阳居民镉摄入月暴露总量为11.33μg/kg·bw,占PTMI的45.32%,膳食摄入量P97.5月暴露量为20.14μg/kg·bw,占PTMI的80.56%。结论目前襄阳市居民在一般食物消费水平下,镉膳食暴露风险不大,但高消费人群存在潜在的风险。应加强相关产品中镉的监测及膳食指导工作。     

广东省食品中镉的危险性评估

目的了解广东省居民膳食中镉的实际摄入量情况。方法通过2004-2005年对各类食品中镉含量的检测,同时结合2002年广东省居民城市及农村居民营养与健康状况调查中各类食物的消费量数据,计算出广东省居民膳食中镉的实际摄入量,并与FAO/WHO推荐的每人每日镉的允许摄入量(ADI)60μg进行比较,分析其危险性。结果广东省居民每人每日膳食中镉的实际平均摄入量为65.00μg,其中城市居民膳食中镉的实际平均摄入量为63.48μg,农村居民膳食中镉的实际摄入量为65.42μg,无论是城市居民还是农村居民,通过膳食实际摄入的镉都略高于ADI。结论目前广东省居民膳食中镉的摄入量偏高,对健康可能存在一定的危害,应加强对人群健康的监测。     

2019—2021年杭州市居民主要膳食的镉暴露风险评估

目的 了解杭州市居民主要消费食品中镉（cadmium,Cd）的污染状况,对居民膳食镉暴露的健康风险进行评估。 方法 对2019—2021年采集的588份市售食品样品,采用微波消解-电感耦合等离子体质谱法（ICP-MS法）进行Cd含量的测定,并对居民主要膳食的镉暴露风险进行评估。 结果 杭州市居民每月膳食Cd的平均总暴露量为8.32 μg/（kg·BW）,为PTMI的33.3%。高暴露水平下,居民每月主要膳食Cd的总暴露量（P90值）为18.2 μg/（kg·BW）,为PTMI的72.8%。膳食Cd暴露的主要来源为主食类、蔬菜类、鱼虾类食品,其对居民主要膳食Cd平均暴露量的贡献比值依次为57.7%、22.6%、10.2%。结论 杭州市居民主要消费的8类食品的Cd污染程度相对较低,膳食Cd暴露风险总体处于可接受水平,而高暴露水平下的居民膳食Cd的暴露风险仍需引起关注。     

上海市某区市售动物性水产品中镉污染及膳食暴露风险评估

【目的】了解上海市某区市售水产品中重金属镉的污染状况,评估居民经由市售水产品的膳食镉暴露风险水平。【方法】2018—2019年,采用多阶段抽样方法随机抽取该区11个乡镇/街道农贸市场/超市的动物性水产品397份。按照国家标准进行镉含量检测,利用单因子污染指数(Pi)法评价水产品中镉的污染状况,结合2013年该区居民膳食调查数据,采用点评估法评估居民膳食镉摄入状况,并计算各类水产膳食镉安全限值(MOS)来评价人群镉摄入健康风险。【结果】该区397份市售动物性水产品中镉的检出率为75.06%,其中镉超标10份,均为蟹类(2.25%)。397份样品中蟹类、双壳类中镉平均水平P_(50)分别为140.0、90.0μg/kg,高于虾类、腹足类、海水鱼类的11.0、7.6、3.8μg/kg(χ~2=186.41,P<0.005),淡水鱼类中均未检出镉。市售蟹类水产中镉的Pi值为0.280,其余均小于0.100,说明除甲壳蟹类属于轻污染外,其余不同种类的水产品均属于未污染级。该区居民动物性水产品消费量以淡水鱼最高,其次是虾类、海水鱼、蟹类,膳食暴露评估结果显示各类水产MOS均大于1,即通过市售动物性水产摄入镉对居民健康风险可以接受。【结论】该区居民通过市售动物性水产品膳食摄入镉风险水平较低,但对市售甲壳蟹类镉污染状况应提高警惕,尽量减少蟹类的摄入,相关部门也应当引起重视,加强监测管理。     

2013—2014年南丹县矿区周边主要食品中锑的含量及暴露评估

目的了解广西南丹县矿区周边常住居民主要食品中锑(Sb)的污染水平,评估矿业活动影响区居民膳食中Sb暴露安全性。方法于2013年7—8月和2014年11—12月,采用称重法和化学分析法对矿业影响区和对照区居民膳食痕量元素Sb的每日摄入量进行调查和测算,获得居民膳食中Sb暴露量,采用世界卫生组织(WHO)规定的Sb每日耐受摄入量(TDI值)来评价居民通过膳食摄入Sb的安全性健康风险。结果所采集14类食品共864份样品中,Sb检出率为97.2%,食品中Sb含量的范围、中位数及几何平均值分别为未检出~1.750、0.007和0.008μg/g。对照区和矿业影响区居民对Sb的膳食平均摄入量均低于TDI值(6μg/kg),肉类是膳食中Sb暴露的主要来源,其平均贡献率分别为64.4%和61.2%。锑暴露对人体的健康风险评估结果表明,对照区和矿业影响区居民通过膳食途径摄入的Sb无健康风险,但矿业影响区的潜在健康风险高于对照区,对男性的潜在健康风险高于女性。结论南丹县矿区周边居民膳食中Sb暴露水平总体处于安全水平,但膳食中肉类对Sb暴露的贡献较大。     

吉林省居民主要膳食镉暴露风险评估

目的为了解吉林省食品中镉的污染状况,对吉林省居民主要膳食镉暴露进行风险评估。方法利用吉林省居民膳食消费量数据和2015-2016年食品安全风险中1 379份食品中镉含量的检测数据,结合联合国粮农组织和世界卫生组织设立的食品添加剂联合专家委员会(JECFA)制订的食品中镉的暂定每月可耐受摄入量(PTMI),采用点评估和概率评估2种方法对居民主要膳食中镉的暴露进行评估。结果吉林省主要食品中镉含量平均值为0.001927 mg/kg,检出率为48.6%,其中水产及其制品中的镉检出率最高,为98.3%,其次是谷类及其制品,为70.1%。主要食品每月膳食镉暴露量为0.000746 mg/(kg·BW),远远低于JECFA规定的PTMI标准,并且安全限值(MOS)均大于1。吉林省居民主要膳食镉的主要来源为蔬菜类及其制品(48.8%)、肉类及其制品(25.2%)和谷类及其制品(9.92%)。结论吉林省居民消费的食物中镉的污染程度较轻,吉林省居民主要膳食摄入的镉对人体健康的风险是可以接受的。     

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.     

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.     

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.