汽车驾驶员的高血压危险因素分析

目的了解汽车驾驶员的原发性高血压患病情况及主要危险因素,为该人群制定适宜的防治措施。方法采用现况调查的方法,对重庆市746名20～60岁的男性驾驶员行问卷调查、体格检查和血压测量等。同期检测了884名男性非驾驶员人员的血压值。结果男性驾驶员的高血压标化患病率为28.3%,高于非驾驶员18.26%。驾龄、平均每天开车时间、驾驶车型、工作责任和工作紧张感等职业因素与驾驶员高血压有关。多因素Logistic分析显示驾龄、工作责任和工作紧张感、父母患高血压及体重指数(BMI)>25是驾驶员高血压的主要危险因素。结论职业紧张等因素与驾驶员高血压患病有关,需采取相应的综合防治措施。     

广西居民正常高值血压流行现状及相关危险因素分析

目的 了解广西居民正常高值血压流行状况及相关危险因素,为广西高血压防控工作提供数据支持。方法 2013年在广西10个监测点,采用多阶段整群随机抽样方法抽取5 987名18岁及以上居民,采用问卷调查、身体测量及实验室检测等方法进行调查。剔除有变量缺失及已诊断高血压1 547例,对4 440名研究对象进行分析,采用多因素非条件logistic回归探索正常高值血压及高血压的相关危险因素。结果 人群正常高值血压检出率为36.5%,男性（43.8%）高于女性（30.0%）,男性18～34岁组、35～44岁组检出率分别为44.2%、44.7%。调整年龄、性别后,多因素 logistic 回归分析显示,相对于正常血压,肥胖（OR = 2.356,95%CI:1.609～3.451）、中心性肥胖（OR = 1.594,95%CI:1.364～1.861）、高低密度脂蛋白胆固醇血症（OR = 2.160,95%CI:1.710～2.726）、高血糖（OR = 1.455,95%CI:1.190～1.779）是正常高值血压的危险因素;相对于正常高值血压,肥胖（OR = 2.419,95%CI:1.743～3.357）、中心性肥胖（OR = 1.250,95%CI:1.021～1.529）、高低密度脂蛋白胆固醇血症（OR = 1.312,95%CI:1.023～1.683）、高血糖（OR = 1.600,95%CI:1.291～1.982）也是高血压的危险因素。结论 广西人群正常高值血压检出率接近全国平均水平,并且存在多种危险因素。应加大正常高值血压的筛查,尤其是中青年男性,控制体重,加强多种危险因素的综合干预。     

德州市城镇职工高血压流行特征及影响因素研究

目的 了解德州市城镇职工高血压患病情况,探讨高血压的影响因素及与慢性病的关系.方法 利用德州市城镇职工体检的资料,进行高血压的横断面研究.计算高血压患病率并采用x2检验和Logistic回归模型分析不同人群高血压患病率的差异及不同因素与高血压患病的相关性.结果 德州市城镇职工高血压患病率为23％,男性的高血压患病率高于女性.从年龄分布看,随年龄增加高血压患病率呈上升趋势.不同单位性质人员的高血压患病率差异有统计学意义.Logistic回归分析显示,性别、年龄、BMI、吸烟、饮酒、工作压力、血糖、血脂、胆固醇均与高血压状态相关.高血压患者的脑血管病、冠心病、糖尿病、高脂血症、脂肪肝患病率明显高于非高血压人群.结论 不同人群的高血压分布具有差异,危险因素非常复杂.血压较高人群患各种慢性病的几率比较高.     

2011年旺苍县高血压流行调查

目的调查旺苍县高血压患病情况、流行病学特征及其主要危险因素,为全县高血压病防治提供科学依据。方法采取整群抽样调查方法,抽查全县20岁以上人口1 966人,进行血压测量及相关危险因素调查。结果 20岁以上人口高血压病患病率为31.89%,男性患病率33.14%,女性患病率为30.94%。性别、年龄、体重指数、高钠饮食、吸烟、高血压家族史均与高血压发病有关。结论旺苍县成人高血压患病率很高,应普及高血压知识,加强健康教育,减少危险因素,提高高血压防治水平。     

北海市部分老年健康体检者高血压病调查

目的了解北海地区部分老年健康体检者高血压及相关危险因素患病情况,探讨防治对策.方法对2006年度60岁以上老年健康体检者进行调查分析.结果调查247例,高血压患病率33.6%,知晓率90.48%,控制率25%,治疗率60.71%,心血管疾病危险因素聚集明显.高血压组超重/肥胖、代谢综合征发病率明显高于血压正常组.结论老年人群高血压等慢性非传染性疾病防控工作亟待加强.     

武汉口岸出国劳务人员高血压患病情况分析

目的掌握武汉口岸出国劳务人员的高血压患病情况,从而能够为有针对性地提出防控对策通过依据。方法对武汉口岸2012年7月1日—2014年6月30日24 165名出国劳务人员的血压监测结果进行统计分析。结果共检出血压升高者5462例,总检出率为22.6%。其中,男性检出率25.7%,女性检出率6.6%,高血压检出情况男女差异明显(P0.01),且高血压检出率随年龄、体重指数等危险因素的增长而增加。结论武汉口岸出国劳务人群的高血压检出率较高,应加强对高血压危险因素的监控,加大宣传教育力度。     

安徽省农村地区成年人群高血压流行及其危险因素知晓率调查

目的了解安徽省农村地区成年人群高血压的流行和分布情况及对高血压危险因素的知晓情况,为我省农村地区防治高血压工作提供依据。方法2 091名年龄在35岁以上的农村成年人参加了此次调查。经过培训的调查员用标准水银血压计对参加者进行了血压测量。被调查者的人口统计学资料和对高血压危险因素的知晓情况由调查员用统一的调查表调查后获得。结果总的高血压患病率为36.1%。35~44岁、45~54岁、55~64岁、65~74岁、75岁以上年龄组男性、女性的患病率分别为20.7%、30.6%、41.6%、62.8%、71.7%和15.2%、27.3%、36.8%、56.5%、62.7%。在参加者中,对高血压7种危险因素(遗传、肥胖、年龄、缺乏锻炼、吸烟、饮酒、高盐摄入)的知晓率分别为7.0%、8.7%、21.8%、9.4%、1.3%、7.3%、1.5%。21.5%的高血压患者和15.1%血压正常者知道他们自己的血压值,仅有3.1%的高血压患者和2.2%的血压正常者知道正常血压值。结论本次调查的结果表明,安徽省农村地区成年人群高血压的患病率非常高,对高血压危险因素和高血压相关知识的知晓率非常低。应该采取全面的高血压预防控制措施,并提高对高血压危险因素和相关知识的知晓率。     

上海市成人自报高血压患者治疗控制情况及其影响因素

【目的】分析上海市18岁及以上自报高血压患者治疗控制情况及其影响因素。【方法】使用2013年上海市慢性病及其危险因素监测数据。分析接受治疗的自报高血压患者血压控制情况及其影响因素。【结果】对6 768名接受高血压治疗的自报高血压对象进行分析,60岁及以上年龄占67.46%,男性40.93%。治疗控制率为37.69%。影响血压控制的相关因素包括男性、年龄大、文化程度低、农业职业人群以及农村人口等社会因素,超重/肥胖、腰围超标、有高血压家族史、患有糖尿病等疾病因素,饮酒频率高、蔬菜摄入不足,以及血压监测频率低等行为因素。【结论】上海市自报高血压患者治疗控制率低,在疾病管理中应当细分对象需求,加强生活方式的干预,大力推广血压自我监测。     

河北省某医学院学生高血压前期检出情况分析

目的了解河北省某医学院学生高血压前期检出情况,分析其影响因素,为制定防治策略提供科学依据。方法采取整群抽样方法抽取河北省某医学院1040名学生,对其进行血压、身高、体重等指标的测量,同时进行了高血压前期相关因素的问卷调查。结果该校学生高血压前期检出率33.40%,其中男生为48.34%,高于女生的22.99%,差异有统计学意义(χ~2=66.523,P0.05)。Logistic回归分析发现男性(OR=3.361,95%CI:2.497～4.523)、自我健康评价较好(OR=1.367,95%CI:1.048～1.785)、超重/肥胖(OR=1.907,95%CI:1.531～2.375)与高血压前期有显著正关联,具备慢性病防治素养(OR=0.487,95%CI:0.316～0.751)与高血压前期有显著负关联。结论该校学生高血压前期检出率较高,男性、自我健康评价较好、超重/肥胖为高血压前期的危险因素,具备慢性病防治素养为高血压前期的保护因素。     

广州市某转型社区成人高血压影响因素分析

目的了解广州市萝岗区九龙镇九佛片区在社区转型过程中高血压流行的相关影响因素,为制定预防控制措施提供科学依据。方法采用多阶段整群随机抽样方法确定调查样本,通过问卷调查深入了解15岁及以上调查对象的一般状况、吸烟、饮酒和高血压家族史等情况,体检获得血压值。采用Logistic回归方法分析高血压相关影响因素。结果共调查2980人,其中高血压患病者为610人,高血压粗患病率为20.5%,标化患病率为17.6%。Logistic回归分析显示,年龄大、职业、丧偶、戒酒、向心性肥胖和家族史是高血压的独立危险因素;女性、文化程度高、禽类及制品摄入少和中等工作强度为保护因素。结论该地区应以年龄大、男性和离退休人员或公务事业人员为高血压重点防治对象,针对吸烟、饮酒和肥胖等危险因素开展各种健康干预,提高居民健康意识,减少高血压的发生。     

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.     

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.     

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.