绍兴市5岁以下儿童意外死亡分析

目的分析2009—2018年绍兴市5岁以下儿童意外死亡情况及变化趋势,为制定儿童意外死亡干预方案提供依据。方法通过绍兴市5岁以下儿童死亡监测系统收集2009—2018年绍兴市5岁以下儿童意外死亡资料,分析意外死亡率、死因谱,计算年度变化百分比(APC)分析意外死亡率变化趋势。结果 2009—2018年绍兴市5岁以下儿童意外死亡662例,年平均意外死亡率为14.31/万。本地儿童意外死亡333例,年平均意外死亡率为10.51/万,流动儿童意外死亡329例,年平均意外死亡率为22.53/万,流动儿童意外死亡率高于本地儿童(P0.05)。2009—2018年绍兴市5岁以下儿童意外死亡率的APC为-56.00%,呈逐年下降趋势(P0.05),其中本地儿童意外死亡率的APC为-55.43%,呈逐年下降趋势(P0.05);流动儿童意外死亡率未见明显变化趋势(P0.05)。意外死亡原因前四位依次为溺水、意外窒息、交通意外和意外跌落,死亡率依次为6.16/万、4.54/万、1.92/万和0.99/万,流动儿童溺水、意外窒息和交通意外死亡率均高于本地儿童(P0.05)。结论 2009—2018年绍兴市5岁以下儿童意外死亡率呈下降趋势,流动儿童意外死亡率高于本地儿童,溺水和意外窒息为主要死因。     

2005—2014年上海市闵行区脑卒中死亡流行病学特征及时间趋势分析

目的分析2005—2014年上海市闵行区脑卒中死亡的流行病学特征和时间变化趋势,为脑卒中的防治提供可靠的基础信息和科学依据。方法计算2005—2014年总人群、男性和女性脑卒中的粗死亡率、标化死亡率和年龄别死亡专率,以及不同类型、不同季节脑卒中的标化死亡率。应用U检验进行年龄别死亡专率之间的比较。采用时间趋势分析APC(annual percent change,年度变化百分比)法描述脑卒中死亡的变化趋势。结果 2005—2014年,全人群、男性和女性的脑卒中粗死亡率和标化死亡率均呈现下降趋势(P0.05)。男性年平均标化死亡率是女性的1.13倍。全人群中除50岁~59岁组外,其他年龄组死亡专率均呈下降趋势(P0.05)。男性在30岁~79岁各年龄组的年均死亡专率均显著大于女性(P0.01)。闵行区脑卒中死亡以缺血性脑卒中为主。全人群和女性出血性脑卒中的标化死亡率呈下降趋势(P0.05)。各季节脑卒中标化死亡率均呈下降趋势(P0.05),冬季是脑卒中死亡的高发季节。结论近10年,闵行区脑卒中死亡率呈下降趋势,可能与政策的推动和迅速发展的社区慢性病管理体系有关,建议进一步应用信息化技术,实现对居民健康的精细化管理,有针对性地加强健康教育,提高人群的健康意识。     

上海市浦东新区王港社区居民2009—2018年心脑血管疾病死亡趋势及影响因素分析

目的了解上海市浦东新区王港社区居民心脑血管疾病(CCVDs)死亡流趋势及其影响因素对疾病死亡率变化的贡献率。方法收集上海市浦东新区王港社区2009年1月1日—2018年12月31日户籍人口死因监测数据库中CCVDs相关数据,采用死亡率、标化死亡率、年均变化百分比(APC)等指标对CCVDs死亡情况进行分析,并采用率的差别分解法分析人口因素和非人口因素对CCVDs死亡率差异的贡献率。结果上海市浦东新区王港社区居民2009—2018年因CCVDs死亡857例,粗死亡率为245.23/10万,标化死亡率为78.91/10万;其中因脑血管病死亡460例,粗死亡率为131.63/10万,标化死亡率为42.84/10万;因缺血性心脏病死亡338例,粗死亡率为96.72/10万,标化死亡率为29.18/10万。2009—2018年CCVDs粗死亡率呈明显上升趋势(APC=3.55,Z=2.32,P=0.049),标化死亡率无明显变化趋势(APC=0.08,Z=0.06,P=0.952);脑血管病及缺血性心脏病粗死亡率和标化死亡率均无明显变化趋势(均P 0.05)。以2009年为基准,2014—2018年CCVDs死亡率人口因素增加值和贡献率分别为48.66/10万和63.10%,均高于2009—2013年CCVDs死亡率人口因素增加值和贡献率的15.48/10万和39.08%。结论上海市浦东新区王港社区居民2009—2018年CCVDs粗死亡率呈明显上升趋势,人口老龄化是CCVDs死亡率上升的主要原因。     

宣威肺癌高低发区危险因素的研究

云南省宣威县是我国农村肺癌高发地区。研究宣威肺癌高发的原因已引起了国内外有关学者的极大兴趣。据1973～1975年全国恶性肿瘤死亡回顾性调查表明,宣威肺癌调整死亡率男性为27.95/10万,女性为24.49/10万。不同地区间肺癌死亡率差异悬殊,可分为高、中、低发区。调查表明,在高、中、低发区苯并(a)芘浓度与肺癌的死亡率存在有明     

凤城市居民伤害死亡趋势分析及预测

目的分析2009—2017年凤城市居民伤害死亡趋势并预测2018—2021年情况,为伤害防控提供依据。方法收集2009—2017年凤城市全死因监测资料和人口学资料,统计伤害死亡率、标化死亡率和年度变化百分比(APC),建立GM (1,1)灰色模型预测2018—2021年凤城市伤害死亡率。结果 2009—2017年凤城市居民伤害死亡率为52.68/10万,标化死亡率为46.50/10万,标化死亡率的APC为-5.10%,呈逐年下降趋势(P0.05)。男性伤害死亡率和标化死亡率均高于女性(P0.05)。65岁～组居民伤害死亡率最高,为108.13/10万。伤害前五位死因依次为交通事故、自杀、中毒、跌落和溺水,死亡率分别为27.03/10万、7.84/10万、5.62/10万、5.08/10万和2.36/10万。男性交通事故死亡率呈逐年下降趋势(P0.05);女性自杀死亡率呈逐年下降趋势(P0.05);总跌落死亡率呈逐年上升趋势(P0.05)。GM (1,1)模型预测2018—2021年凤城市居民伤害死亡率将逐年下降,分别为48.00/10万、44.15/10万、40.61/10万和37.35/10万。结论 2009—2017年凤城市居民伤害死亡率呈逐年下降趋势,2018—2021年仍可能继续下降。男性和65岁以上老年人是高危人群,交通事故和跌落为主要死因。     

2006-2020年苏州市前列腺癌死亡时空流行状况分析

目的:了解苏州市前列腺癌死亡的流行趋势和空间分布特征。方法:利用2006—2020年前列腺癌死亡数据分析年度变化趋势,运用地理信息技术开展空间自相关分析,寻找高发、低发地区。结果:2006—2020年苏州市前列腺癌年平均粗死亡率为6.87/10万,标化死亡率为3.03/10万;2006—2020年前列腺癌粗死亡率年度变化百分比为9.25%,标化死亡率年度变化百分比为4.07%。空间分布研究发现,苏州市前列腺癌存在高发、低发地区。结论:苏州市前列腺癌死亡风险呈现上升趋势;主要高发年龄段为≥60岁的男性,应针对前列腺癌高发区域开展基于高危人群风险分层的肿瘤筛查工作。     

舟山市居民溺水死亡及潜在寿命损失分析

目的了解2009—2018年舟山市居民溺水死亡特征及溺水死亡导致的寿命损失,为舟山市制定溺水死亡预防控制措施提供依据。方法通过浙江省慢性病监测信息管理系统收集2009—2018年舟山市居民死亡监测资料,统计死亡率、标化死亡率、早死指数、潜在减寿年数(PYLL)和潜在工作损失年(WPYLL)等指标,分析舟山市居民溺水死亡的人群特征、溺水原因,以及溺水死亡导致的寿命和劳动力损失。结果 2009—2018年舟山市居民溺水死亡率为7.97/10万,标化死亡率为4.68/10万,溺水死亡率呈逐年下降趋势(P0.05)。男性溺水标化死亡率为8.03/10万,高于女性的1.33/10万(P0.05)。职业以渔业生产人员为主,322例占41.44%。0岁～组、15岁～组和65岁～组居民溺水死亡原因均以意外失足/跌坠为主,分别为13例、11例和47例,占36.11%、23.91%和29.38%;30岁～组和45岁～组居民以船舶事故溺水死亡为主,分别为58例和130例,占33.33%和36.01%。溺水死亡导致的PYLL为22 511人年,WPYLL为11 911人年,其中30～65岁居民的PYLL和WPYLL分别为73.33%和70.55%;早死指数为28.97。结论 2009—2018年舟山市居民溺水死亡率呈下降趋势,男性及渔业生产人员溺水死亡风险较高;30～65岁居民溺水死亡导致的寿命损失严重。     

龙游县肺癌死亡及减寿趋势分析

目的了解衢州市龙游县居民肺癌死亡特征和变化趋势,为加强肺癌综合防治工作提供依据。方法收集整理龙游县居民2010—2016年肺癌死亡监测资料,计算肺癌粗死亡率、标化死亡率(采用2010年全国人口普查数据为标准人口进行标化)、减寿率和标化减寿率等指标,对肺癌死亡病例的性别、年龄分布及肺癌导致的潜在寿命损失进行描述性分析。结果 2010—2016年龙游县累计报告肺癌死亡1 555例,死亡率为48.17/10万,标化死亡率为38.05/10万,居恶性肿瘤死亡首位。肺癌死亡率呈逐年上升趋势(P0.01)。男性肺癌年均死亡率为72.05/10万,高于女性的23.45/10万(P0.001)。男性肺癌死亡率呈逐年上升趋势(P0.01),年平均增长速度为4.69%;女性肺癌死亡率年平均增长速度为2.49%,但未见明显上升趋势(P0.05)。肺癌死亡率随着年龄增加而上升(P0.001),其中60岁以上人群肺癌死亡1 243例,占肺癌死亡总数的79.94%。2010—2016年肺癌导致的潜在寿命损失为12 471人年,减寿率为4.41‰,标化减寿率为3.72‰。其中男性肺癌标化减寿率为5.31‰,女性为1.95‰。结论龙游县居民肺癌死亡率呈上升趋势,主要危及60岁以上人群,男性肺癌死亡率及减寿率均高于女性。     

2014—2019年中山市心血管病死亡状况及寿命损失分析

目的分析2014—2019年中山市户籍居民心血管病死亡现状及寿命损失情况,为制定科学有效的心血管病防治策略提供依据。方法收集2014—2019年中山市死因监测数据,按照ICD-10对疾病编码和分类,利用Excel-2010计算不同性别、年龄组的心血管病粗死亡率和标化死亡率,死亡率的时间变化趋势分析采用Cochran-Armitage趋势检验。计算去心血管病期望寿命、潜在减寿年数(PYLL)、潜在减寿率(PYLLR)和平均减寿年数(AYLL)等寿命损失指标并比较。结果 2014—2019年中山市心血管病平均粗死亡率为227.91/10万(标化死亡率189.30/10万)。男性死亡率高于女性;无论男性还是女性,粗死亡率和标化死亡率均呈下降趋势(P0.01)。心血管病死亡随着年龄增长而增加(P0.01),死亡主要集中在45岁及以上年龄组,15～44岁组、65岁及以上年龄组的死亡率呈下降趋势(P0.01)。脑血管病、缺血性心脏病和高血压性心脏病占心血管病死因的95.63%。全死因期望寿命为80.00岁,去心血管病死因后,男性和女性寿命分别增加3.50岁和2.75岁。因心血管病死亡导致的PYLL为137 845人年,PYLLR为14.02‰,AYLL为5.95年。PYLLR呈现总体逐年下降趋势,而AYLL总体逐年上升。男性PYLL、PYLLR和AYLL明显高于女性。结论中山市心血管病死亡率呈下降趋势,但心血管病导致的疾病负担仍然严重,其中男性和45岁及以上年龄组人群是心血管病死亡的高危人群,应对不同人群采取有针对性的预防措施,以减少心血管病的发生和死亡,提高居民健康生命质量。     

上海市静安区1976—2015年病毒性肝炎死亡率和潜在寿命损失年变化趋势分析

【目的】分析上海市静安区病毒性肝炎死亡长期趋势,为开展相关防控和研究工作提供参考依据。【方法】计算1976—2015年上海市静安区病毒性肝炎的死亡率、标化死亡率和潜在寿命损失年(PYLL)、减寿率(PYLL‰),应用Joinpoint回归分析病毒性肝炎死亡率、减寿率(PYLL‰)的变化趋势和年度变化百分比(APC)。【结果】1976—2015年静安区因病毒性肝炎死亡1 342人,其中男性832人,女性510人;平均粗死亡率8.31/10万,平均标化死亡率5.45/10万;男性病毒性肝炎死亡率、标化死亡率、PYLL‰均高于女性(χ~2=107.34,112.93,39.15,均P0.01),男性主要集中在35~64岁(占62.62%),而女性主要集中在65岁及以上(占55.49%),男性死亡年龄早于女性(Z=-8.879,P0.01);1990年以后(除2002年)病毒性肝炎死亡病例中,主要以乙型肝炎为主,占比75.00%~100%,其他及未分型比例逐渐减少;1976-2015年病毒性肝炎死亡率总体呈明显下降趋势(APC=-2.0%,P0.05),2002年为转折点,2002—2015年病毒性肝炎死亡率下降趋势更加明显(APC=-8.1%,P0.05);1976—2015年病毒性肝炎减寿率总体呈明显下降趋势(APC=-3.7%,P0.05),1992年为转折点,1992—2015年的病毒性肝炎减寿率下降趋势更加显著(APC=-6.5%,P0.05)。【结论】2002—2015年,上海市静安区病毒性肝炎死亡率和减寿率呈下降趋势,以乙型肝炎死亡为主。     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Hydrazine inhalation hepatotoxicity

Abstract Hydrazine is a hazardous chemical commonly used as a reactant in rocket and jet fuel cells. Animal studies have demonstrated hepatic changes after hydrazine inhalation. Human case reports of hydrazine inhalation hepatotoxicity are rare. We report a case of mild hepatotoxicity following brief hydrazine vapour inhalation in a healthy young man, which resolved completely on expectant management.     

Fitness standards in airline staff

Employers have a legal duty to manage safety and to meet this duty it is necessary to control risks arising from pre-existing medical conditions. Such conditions can be identified at the time of job placement, but there is little published information about the approach to fitness standards by most airlines. This review is therefore limited to the practice of one major airline. It is illustrated by reference to various occupations within the airline, with the associated rationale.