一起疑似肉毒毒素食物中毒事件的调查

目的调查丁青县甘岩乡38人食物中毒的原因,为预防和处置类似事件提供科学依据。方法采取现场流行病学调查、临床症状分析,对患者血液、粪便及剩余食品进行微生物检测,实验室采用肉毒毒素(A/B/E/F型)核酸检测试剂盒(荧光PCR法)进行检测。结果中毒人员均食用了被肉毒杆菌污染的病死牛肉,从患者的血液、粪便及剩余牛肉样本中检出了A型、B型和E型肉毒毒素。结论本次食物中毒系食用了肉毒杆菌污染的病死牛肉引起,藏区需加强食品卫生知识宣传力度,改变当地居民不良的饮食习惯,预防肉毒毒素中毒的发生。     

新疆巴音郭楞蒙古自治州一起肉毒梭菌食物中毒事件的溯源调查分析

分析新疆巴音郭楞蒙古自治州一起肉毒梭菌食物中毒事件, 探究中毒事件发生原因, 明确诊断, 为临床治疗提供技术支持。应用食品安全事故流行病学方法调查食物中毒事件中病例的基本信息、临床表现, 采集自制腐乳和粪便灌洗液, 经增菌培养后应用实时荧光定量PCR法检测样本中肉毒毒素编码基因, 并进行菌株分离、纯化。对分离到的5株肉毒梭菌经肉毒毒素检测和基因检测验证后, 进一步进行PFGE分型。此次中毒事件中2份自制腐乳和3例患者的粪便灌洗液标本均分离到A型肉毒梭菌, 并得到了毒素检测和基因检测验证, 5株肉毒梭菌的PFGE图谱DNA同源性为100%, 可判定是一起因食用被A型肉毒梭菌污染的自制腐乳而引起的肉毒中毒事件。     

一起麻痹性贝类毒素中毒的实验研究

本文首次对一起食物中毒的可疑食品荔枝螺进行了检测。经小白鼠生物测定,发现该螺肉含有麻痹性贝类毒素,毒力在10～20万 Mu/100g(螺肉),毒素性质为水溶性、耐热,与文献报导的织纹螺毒力相似,证实该起食物中毒系因误食荔枝螺所致。1991年我市某村民一家因食用盐水煮熟的荔枝螺(当地俗称“腊乌螺”)中毒。该螺是当     

一起副溶血性弧菌食物中毒调查处置的思考

目的 对一起发生在企业食堂的食物中毒事件进行调查处置, 分析本次调查处置过程中存在的不足, 提出预防食物中毒的建议。
方法 采用流行病学调查、现场卫生学调查、实验室检测等方法对本次食物中毒发生的原因进行分析, 依据《食品安全法》等法律法规对肇事单位实施行政处罚。
结果 该事件是一起由于食用了某公司食堂提供的受副溶血性弧菌污染的肉面筋引起的食物中毒。
结论 食品安全监管部门应加强对企业食堂的监管, 相关部门要完善食品安全法律法规, 真正做到有法可依, 有效预防食物中毒的发生。
     

一起椰毒假单胞菌酵米面亚种引起的食物中毒调查分析

目的 分析云南省红河州发生的1起因食用玉米面汤圆引起的食物中毒的发生原因,探讨预防控制措施.方法 开展现场流行病学调查,并采集可疑食物和患者呕吐物进行实验室检测.结果 该起事件属于点源暴露,最短潜伏期16h,最长潜伏期27 h,潜伏期中值为23 h.一次进食200 g以上的玉米面汤圆5人,均死亡,从吃剩的玉米面汤圆中检出椰毒假单胞菌酵米面亚种.结论 该起食物中毒是由于食用被椰毒假单胞菌酵米面亚种污染的玉米面汤圆所致,该起中毒事件提示;有关部门应教育群众彻底改变传统的食用方式是防止类似事件发生的有效办法.     

一起肠炎沙门菌引起的食物中毒暴发的调查分析

目的 调查分析一起食物中毒暴发的原因,为治疗和预防食物中毒提供依据.方法 运用流行病学调查、病例资料分析和实验室检测,对食物中毒事件原因进行分析判断.结果 流行病学调查结果提示该次食物中毒与食用糕点制品有关,结合病例资料和实验室检测结果,判定本次事件是由肠炎沙门菌污染糕点所致.结论 为预防食物中毒的发生,需加强食品卫生...     

一起B型肉毒梭状芽孢杆菌毒素食物中毒调查报告与回顾

肉毒梭状芽孢杆菌食物中毒,特别是因食用酥炸、鱼罐头引起的肉毒梭菌B型毒素食物中毒,在锦州地区有史以来的细菌性食物中毒资料中从未见过,在辽宁省内也未曾见过报告.为更好的开展预防工作和掌握中毒特点、规律,对北镇县一农村发生的一起B型肉毒梭菌毒素引起的食物中毒进行了流行病学调查、化验室检验和临床观察,其基本情况回顾如下.     

15例食用泥螺中毒救治体会

为了总结对食用泥螺引起中毒的救治经验 ,对 15例因食用泥螺中毒的病例进行了分析 ,并对其中毒原因、毒理作用及救治方法进行了探讨。毒物鉴定及动物试验证实 ,该螺含有麻痹性贝毒 ;中毒者食剩的残留泥螺中麻痹性贝毒含量高达 8万个小白鼠单位 /10 0g螺肉。贝毒对人体的主要毒作用是麻痹中枢神经及对末梢神经广泛抑制 ,感觉、运动逐渐丧失及强烈的消化道刺激症状。提示 ,处理及时 ,尽早洗胃、催吐 ,大量输液、细胞活化剂 ,维生素C及皮质激素的应用是救治成功的关键。     

多起食用织纹螺中毒的流行病学调查

目的调查分析多起食用织纹螺引起食物中毒事件的原因,探讨预防织纹螺食物中毒的方法,为制定防控措施提供科学依据。方法 2012年7月8日-7月10日共报告食物中毒患者21例,其中重症6例。现场流行病学调查分析,食物中毒与患者发病前食用的织纹螺高度相关。采集剩余织纹螺样品和患者尿样送实验室检测和实验室检测相结合的方法。结果温州市龙湾区和瑞安市两地共报告的21例患者均为食用织纹螺中毒患者,临床表现为呼吸困难、全身乏力、四肢麻痹等症状,经对症治疗,治愈20例,死亡1例。4份患者尿液样本检出河豚毒素(TTX),其含量分别是135μg/L、31μg/L、5μg/L和3μg/L,1份食剩织纹螺样本中检出10.3 mg/kg的TTX。结论根据现场流行病学调查,结合临床表现和实验室检测结果,确定该起食用织纹螺食物中毒事件为河豚毒素中毒。     

健康教育对预防食用织纹螺中毒的作用

织纹螺是沿海常见的螺种之一,为肉食性动物,常以其他动物的腐尸为食,其肉可食。该螺往往通过食物链而带毒。其毒为麻痹性贝毒,此毒对热稳定,有很强的毒性。2 0 0 3年6月2 2日下午至2 3日上午,宁波市镇海区卫生监督所陆续接报食用织纹螺中毒1 5例。临床表现为口唇、四肢、头颈麻木,恶心、头晕,严重的已昏迷、无自主呼吸。在卫生学调查和预防控制中,健康教育成为预防食用织纹螺中毒的最有效措施。预防食用织纹螺中毒的困难1 食用织纹螺的传统性和普遍性　织纹螺广泛分布于浙江省沿海地区,居民很容易从当地滩涂捡拾织纹螺,因其味道鲜美,常被食…     

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.