化工人群代谢综合征的流行特征

目的：探讨化工人群代谢综合征（MS）的流行特征。方法：利用2000年泸天化集团公司糖尿病（DM）流行病学调查资料，采用中华医学会糖尿病学分会建议的MS诊断标准，分析20岁以上6387名化工企业职工MS及相关组分的患病情况。结果：化工人群MS的患病率为6．1％，男性为6．8％，女性为5．2％，在40岁后明显升高，高发年龄男性在70岁后，女性在60～69岁，分别为18．5％和25．3％；超重／肥胖、高血糖、高血压及血脂异常的患病率分别为26．5％、12．7％、15．0％和18．7％；MS在DM、高血压、血脂异常及超重／肥胖人群中的患病率分别为48．8％、34．0％、18．1％和20．2％。结论：化工人群的MS患病率达到较高水平，男性高于女性，且随年龄增长而升高；超重／肥胖的现象在化工人群中较为普遍；MS与DM、高血压、血脂异常及超重／肥胖密切相关，尤其与DM的关系密切。     

华泾镇干部人群2型糖尿病糖耐量低减与肥胖的关联

目的探讨2型糖尿病、糖耐量低减与肥胖的关系。方法根据1997年美国糖尿病协会（ADA）糖尿病诊断标准，采用随机抽样的方法进行横断面调查研究。随机选取具有干部工作经历的215人开展流行病学调查，针对肥胖因素进行单因素分析。结果该人群总体2型糖尿病的患病率为3．26％，糖耐量低减的患病率为15．35％。体重指数高（BMI≥25）的人群糖尿病的患病率为5．80％，糖耐量低减的患病率为23．2％；肥胖人群中腰臀比大者即向心性肥胖者（男性≥0．9，女性≥0．85）；2型糖尿病的患病率为8．20％，糖耐量低减的患病率为31．15％。结论糖尿病与肥胖相关联，体重指数和腰臀比的增大，可增加2型糖尿病的发病危险性。     

北京市朝阳区成人血压及血脂状况调查

目的了解北京市朝阳区成人血压及血脂的现状，为制定科学合理的防控措施提供资料。方法采用多阶段分层整群随机抽样的方法，共有741名成人接受血压测量（水银柱式血压计测量），其中的256人进行血脂测定（北京市疾病预防控制中心检测）。结果朝阳区成人血压增高的患病率为43．31％，标化患病率为37．12％；血脂异常的患病率为51．56％，标化率为44．19％。男性、女性血压增高的患病率都为双峰型，都在45～50岁、65～70岁时达到高峰。在60岁之前，男性血压增高的患病率大于女性；60岁之后，女性血压增高的患病率大于男性。在50-60岁之前，男性血脂异常的患病率大于女性；50—60岁之后，女性血脂异常的患病率大于男性。血脂异常人群与血脂正常人群的高血压危险因素差异有统计学意义（x^2=21．73，P〈0．01）。结论朝阳区成人血压增高和血脂异常的比例很高，今后应加强对全人群的健康教育和健康促进，通过环境、人群意识及态度的改变来取得良好的防治效果。     

上海松江岳阳社区居民慢性病患病现状及行为危险因素分析

[目的]了解上海市松江区岳阳社区居民慢性非传染性疾病的流行现状及行为危险因素。[方法]采用分层随机抽样的方法，按国家卫生部“中国成人慢性病危险因素调查”的要求，抽取在该社区居住满1年的18～69岁常住居民1984名，进行问卷调查和体格检查。[结果]72．1％的样本人群具有≥1种危险因素，33．1％的样本人群患有≥1种慢性病。吸烟率、饮酒率、超重率、肥胖率分别为24．1％、21．5％、27．5％、6．6％；样本人群中，34．7％缺乏体力活动，49．1％钙质摄入不足，6．9％维生素B、C摄入不足，45．3％蛋白质摄入不足，9．7％嗜腌制品（苯丙胺类致癌物质及高钠食品）；高血压和糖尿病的患病率分别为26．6％、5．5％。Logistic回归分析显示：高血压、糖尿病的共同危险因素为40岁以上人群、高血脂、肥胖。[结论]行为危险因素的持续存在，已导致慢性病的高发。大力开展社区健康教育与健康促进，应采取综合性干预措施，遏止慢性病流行。     

北京市昌平区百善镇居民主要慢性病患病情况

目的掌握北京市昌平区百善镇居民主要慢性病患病率情况，为防治工作提供科学依据。方法采取等比例多阶段整群随机抽样的方法确定170人为监测对象，进行问卷调查，数据用Epidate3．02软件进行双录入核查，采用SPSS10．0进行统计学分析。结果该镇18周岁以上调查人群高血压患病率为55．9％、糖尿病患病率为9．4％，超重占38．2％，肥胖占31．2％，血脂异常占38．8％，心肌梗死患病率为1．8％，脑卒中患病率为7．1％。结论昌平区百善镇居民主要的慢性病是糖尿病、高血压、超重肥胖和血脂异常，依据当前慢性病患病及相关危险因素现状，应立即采取综合防治措施，以减少慢性病对居民的危害。     

集安市慢性病及其危险因素调查分析

目的全面掌握集安市不同地区居民慢性病危险因素及主要慢性病的流行状况和发病趋势,为慢性病干预策略和措施提供科学依据。方法通过问卷调查、身体测量、实验室检测等方法进行调查研究。结果主要慢性病患病情况高血压患病率24.16%、糖尿病9.83%。在主要慢性病危险因素中,男性吸烟率50.88%、女性吸烟率27.66%;男性饮酒率21.20%、女性饮酒率13.00%。结论集安市男性吸烟率未见明显下降,总体烟民规模仍呈扩大态势;青壮年人群饮酒行为不容乐观;18岁以上居民中接近一半的人蔬菜水果摄入不足,特别是60岁以上的老年人;成人超重与肥胖处于高流行水平;成人高血压患病率较高;糖尿病男性发病高于女性,并随年龄增长增高。     

北京市东城区494名超重和肥胖成人健康状况及相关知识、态度、行为调查

目的了解北京市东城区成人肥胖和超重人群与肥胖有关的疾病患病率，生活、饮食习惯以及与肥胖有关的知识、态度和行为。方法采用两阶段随机抽样方法，在北京市东城区肥胖和超重人群中随机抽取494人进行调查，调查采用一次性回顾性问卷调查并测量了被调查对象的身高、体重、腰围、臀围等指标。结果在494例被调查对象中，男性148人，占30％；女性346人，占70％。超重者占38％，肥胖者占62％。418人患有与肥胖有关的慢性非传染性疾病，患病率为84．6％；排在疾病谱第一位的是高血压，患病率63．6％。77．5％的人未采取任何减肥措施，59．5％的人日平均蔬菜摄人量低于250g，55．7％的人没有吃水果的习惯。调查对象对肥胖者易患高血压、高血脂和糖尿病有较高的知晓率，但对每人每天食用油适宜摄人量和每天应该进行多长时间的锻炼的知晓率较低。结论超重和肥胖与饮食习惯、运动等因素密切相关，超重和肥胖者有慢性非传染性疾病的比例显著增高。     

糖尿病肾病患者如何合理降糖

糖尿病的发病呈逐年升高的趋势。最新的一项流行病学的调查结果显示：中国成人糖尿病患病率已达9．7％，约为9000万人，糖尿病前期人群高达15．5％，约为1．4亿人。有资料表明，糖尿病肾病是成人慢性肾功能不全病因中最重要的单一因素。1型糖尿病患者糖尿病肾病患病率为30％-40％，2型糖尿病患者的患病率可达20％。     

社区成年人腹型肥胖与2型糖尿病的现况调查

目的研究社区成年人2型糖尿病的患病率与分布，以分析腹型肥胖与2型糖尿病关系。方法以社区为单位，开展20岁以上成年人2型糖尿病普查。结果2689人中糖尿病患病率为6．32％，空腹血糖受损者2．79％；人群中腹型肥胖的分布为66．05％。结论糖尿病的发生与性别无关，随年龄增长糖尿病患病率增高：腹型肥胖是糖尿病发生的危险因素。     

老年人体重指数与心血管危险因素关系的分析

目的了解老年人群体重指数分布特点及与心血管疾病危险因素的关系。方法对参检的1343例60岁以上的离退休职员，检测收缩压、舒张压、血清甘油三酯、总胆固醇及空腹血糖，并计算不同性别不同体重指数（BMI）各组的患病率。结果受检1343人中BMI不足、正常、超重和肥胖各组检出率分别为6．18％、51．67％、35．52％和6．63％。但老年人不同性别体重指数分布差异无统计学意义（P〉0．05）。高血压、高血脂及糖尿病患病率分别为46．09％、46．91％和7．45％。男性高血压和高血脂患病率显著高于女性（P〈0．05），高血压、高血脂及糖尿病患病率伴随体重指数增加而升高。与BMI正常组比较，超重肥胖组高血压、高血脂和糖尿病患病率明显升高（P〈0．05）。心血管病危险因素检出率伴随BMI升高而升高。结论BMI升高是老年人群心血管病相关危险因素聚类的重要因素。     

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.