我国中老年人群童年期居住社区质量与认知功能的关联研究

目的探讨我国中老年人童年期居住社区质量与中老年认知功能的关联。方法基于2011年中国健康与养老追踪调查调查数据, 纳入符合标准的≥45岁人群10 940名, 采用标准化调查问卷收集调查对象的一般人口学特征、生活方式、个人疾病史、社区质量和认知功能等信息。社区质量包括社区安全、社区热情及邻里关系, 认知功能评价包括认知完整性和情景记忆能力。采用多因素logistic回归模型分析童年期居住社区质量与中老年期认知功能的关联。结果 10 940名研究对象年龄为(58.3±9.1)岁, 女性占51.5%(5 635名), 认知功能良好者占47.3%(5 174名)。多因素logistic回归模型分析结果显示, 与童年期居住社区很不安全、童年期居住社区很不热情、童年期居住社区邻里关系很不融洽者相比, 童年期居住社区比较安全(OR=0.75, 95%CI:0.57～1.00)和非常安全(OR=0.72, 95%CI:0.55～0.95)、居住社区比较热情(OR=0.69, 95%CI:0.56～0.85)和非常热情(OR=0.70, 95%CI:0.57～0.87)、邻里关系不太融洽(OR=0.57...     

太行山食管癌高发区农村居民高血压风险预测模型构建

目的 剖析太行山食管癌高发区山西平顺农村居民高血压患病的影响因素,为制订防治对策提供根据。方法 通过随机整群抽样方法,抽取调查对象开展问卷调查和体格检查;利用非条件logistic回归模型分析高血压影响因素并建立风险预测模型。结果 调查问卷发放1 121份,有效966(86.1%)份。调查对象女性503名(52.1%),检出336人(粗率34.8%,标化率33.7%)患高血压。分析显示,BMI(OR=1.068,95%CI:1.025～1.112)、习惯性饮茶(OR=1.815,95%CI:1.290～2.555)、喜食腌制食品(OR=1.638,95%CI:1.199～2.239)、被动吸烟(OR=1.535,95%CI:1.135～2.076)、进食较快(OR=1.518,95%CI:1.120～2.058)、高血压家族史(OR=4.197,95%CI:3.080～5.718)、高脂饮食(OR=2.117,95%CI:1.556～2.880)均是高血压患病的危险因素,喜食辣椒(OR=0.621,95%CI:0.425～0.908)则是保护因素;模型检验中C=0.741(95%CI:...     

中山市高尿酸血症的流行概况及其危险因素分析

目的 分析中山市高尿酸血症的流行情况以及其危险因素,并进一步探讨预测高尿酸血症发生的可能的指标因素。方法 于2016年在广东省中山市应用多阶段随机抽样的方法进行现况调查,实际抽取7 174名居民进行问卷调查、体格检查及实验室检测,并采用多因素logistic回归分析各影响因素。结果 中山市总体高尿酸血症患病率为31.91%。多因素logistic回归分析表明,男性(OR = 1.783, 95%CI :1.544～2.059)、偶尔饮酒(OR = 1.198, 95%CI :1.030～1.394)、经常饮酒(OR = 1.388, 95%CI:1.186～1.623)、患高胆固醇血症(OR = 1.267, 95%CI :1.054～1.521)、超重/肥胖(OR = 1.901, 95%CI :1.657～2.181)、患中心性肥胖(OR = 1.311, 95%CI :1.139～1.509)、血压高(OR = 1.321, 95%CI :1.170～1.491)、空腹TG含量≥1.7 mmol/L(OR = 2.016, 95%CI:1.772～2.295)、空腹HDL - C含量＜1.0mmol/L(OR = 1.439, 95%CI: 1.088 ～1.903)等是中山市常住居民患高尿酸血症的独立危险因素。结论 中山市成年居民高尿酸血症患病率已经达到较高水平,应对其危险因素进行干预,减少中山市高尿酸血症发生的风险。     

河北省2018年城乡老年人常见慢性病流行特征及影响因素分析

目的 了解河北省城乡老年人慢性病患病现况及流行特征,为制定公共卫生政策提供客观依据。方法 采用多阶段分层整群随机抽样的方法,抽取河北省石家庄市、唐山市、临城县、沧县4个调查点,每个调查点各抽取1个城市点和1个农村点,对其常住人口进行调查。结果 本次共计调查60岁以上老年人2 772人。其中肥胖的患病率为19.0%;高血压的患病率为56.5%;糖尿病的患病率为16.2%;血脂异常的患病率为34.0%;高尿酸血症的患病率为16.9%。至少患有一种慢性病的人数为2 183人（占78.8%）,其中有1 163人（占42.0%）同时患有两种慢性病,454人（占16.4%）同时患有三种或三种以上慢性病。多因素logistic回归分析结果显示,居住在城市(OR = 0.545,95%CI:0.445～0.668)、低教育程度（OR = 0.556,95%CI:0.392～0.789）、相对低龄（OR = 0.598,95%CI:0.428～0.837;OR = 0.439,95%CI:0.252～0.763）的老年女性（OR = 1.860,95%CI:1.473～2.349）肥胖的风险更高;高年龄（OR = 1.449,95%CI:1.130～1.858;OR = 1.658,95%CI:1.156～2.377）,低教育程度（OR = 0.740,95%CI:0.601～0.911;OR = 0.710,95%CI:0.552～0.914）和每天饮酒（OR = 0.571,95%CI:0.344～0.947;OR = 0.621,95%CI:0.452～0.854）的人患高血压的风险更高。居住在城市(OR = 0.727,95%CI:0.588～0.899)的老年人患糖尿病风险更高;受教育程度高（OR = 1.301,95%CI:1.046～1.618;OR = 1.367,95%CI:1.052～1.777）的女性（OR = 1.407,95%CI:1.172～1.689）血脂症异常的风险更高;城市居民(OR = 0.609,95%CI:0.494～0.752)和几乎每天饮酒（OR = 0.320,95%CI:0.149～0.689;OR = 0.476,95%CI:0.327～0.692）的人患高尿酸血症的风险更高（P＜0.05）。结论 河北省老年人常见慢性疾病患病率仍处于一个较高水平,不同的慢性疾病危险因素不同,应针对不同危险因素积极采取防控措施。     

居民血脂异常影响因素的列线图分析

目的调查杭州市上城区居民血脂异常及影响因素,并建立列线图分析居民血脂异常风险。方法采用多阶段随机抽样方法,从上城区随机抽取5个街道,每个街道各抽取2个社区,每个社区抽取153户家庭,纳入家庭户中≥18岁居民进行问卷调查,体格检查和血糖、血脂检测;采用Logistic回归模型分析血脂异常的影响因素,并采用列线图分析血脂异常风险。结果有效调查3 061人,检出血脂异常536例,患病率为17.51%,标化患病率为13.74%。多因素Logistic回归分析结果显示,年龄≥45岁(OR45岁～=2.623, 95%CI:1.738～3.961; OR65岁～=3.941, 95%CI:2.632～5.900; OR75岁～=3.264, 95%CI:2.095～5.084)、超重/肥胖(OR=1.725, 95%CI:1.390～2.140)、糖尿病(OR=3.103,95%CI:2.369～4.063)、高血压(OR=2.789,95%CI:2.196～3.542)、有冠心病家族史(OR=2.215,95%CI:1.443～3.399)是血脂异常的危险因素;日常锻炼(OR=0.790,95%CI:0.630～0.991)是血脂异常的保护因素。建立的血脂异常风险列线图显示,年龄45～64岁为70分,65～74岁为100分,≥75岁为86分,患高血压为75分,患糖尿病为83分,有冠心病家族史为58分,日常不锻炼为17分,超重/肥胖为40分,总分0～373分,一致性指数C-index为0.790 (95%CI:0.779～0.801)。结论年龄≥45岁、超重或肥胖、患糖尿病、患高血压、有冠心病家族史和缺乏日常锻炼与血脂异常相关,根据上述影响因素建立的列线图对个体血脂异常风险有一定预测作用。     

2018年湖南省成人中心性肥胖现状及影响因素分析

目的 了解湖南省2018年成人中心性肥胖现状及影响因素,为政府制定肥胖防控措施提供理论依据。方法 数据来自2018年湖南省常住居民慢性病与危险因素调查项目,采用多阶段分层整群随机抽样方法选取湖南省≥18岁常住居民7 464名为研究对象。进行问卷调查、体格检查和实验室检测。利用SAS 9.4软件进行加权,并进行χ²检验、秩和检验和多因素logistic回归分析。结果 加权后,2018年湖南省成人中心性肥胖率为26.3%,男性和女性分别为28.4%和24.2%,差异无统计学意义(P>0.05)。多因素logistic回归分析结果显示,60～岁年龄组(与18～40岁相比OR=1.90,95%CI:1.01～3.57)、居住城市(OR=1.62,95%CI:1.12～2.34)、超重(OR=21.52,95%CI:15.55～29.79)、肥胖(OR=845.69,95%CI:564.01～999.99)、患高血压(OR=1.65,95%CI:1.29～2.10)、患糖尿病(OR=1.69,95%CI:1.33～2.15)与中心性肥胖高风险相关,均有统计学意义(P&...     

中国中老年妇女吸烟、饮酒行为与抑郁症状相关性分析

目的探索吸烟、饮酒行为对中国中老年妇女抑郁症状的影响,为改善中老年妇女抑郁状况提供政策依据和干预措施。方法选用2013和2015年中国健康与养老追踪调查(CHARLS)数据,采用10项流调中心抑郁量表(CES-D10)评估中老年妇女的抑郁症状,运用logistic模型分析吸烟、饮酒行为对中老年妇女抑郁症状的影响。结果本研究中基线5 532名无抑郁症状的中老年妇女2年后出现抑郁症状1 405例,抑郁症状发生率为25.40%,农村(29.25%)高于城镇(19.93%)。Logistic分析结果显示,与不吸烟的中老年妇女相比,吸烟者(OR=1.23,95%CI=0.95～1.60)和戒烟者(OR=0.70,95%CI=0.47～1.08)发生抑郁症状的风险无显著增加;与不饮酒的中老年妇女相比,每周饮酒者(OR=1.16,95%CI=0.90～1.52)与偶尔饮酒者(OR=1.03,95%CI=0.83～1.29)发生抑郁症状的风险无显著增加。按居住地对中老年妇女进行分层后发现,居住在城镇的中老年妇女,吸烟者(OR=1.53,95%CI=1.01～2.32)发生抑郁症状的风险高于不吸烟者;居住在农村的中老年妇女,相比不吸烟者,吸烟者(OR=1.10,95%CI=0.78～1.57)和戒烟者(OR=0.77,95%CI=0.46～1.29)发生抑郁症状的风险无显著性差异。无论是居住在农村还是城镇,相比不饮酒者而言,每周饮酒和偶尔饮酒的中老年妇女发生抑郁症状的风险无显著变化。结论中国中老年妇女抑郁症状发生率较高,农村高于城市。应加强中老年妇女的健康教育,告诫其减少吸烟,同时加强中老年妇女的心理干预,为提高中老年妇女的身心健康提供保障。     

上海市成年双生子健康生活方式与肥胖的关联研究

目的分析上海市成年双生子健康生活方式的数量与超重/肥胖及腹型肥胖的关联。方法使用2017-2018年上海市双生子项目第二轮调查数据, 通过病例对照的研究设计分析健康生活方式与肥胖的关联, 并进一步利用双生子配对控制遗传等混杂因素。结果共纳入7 864名(3 932对)成年双生子。同卵双生子配对病例对照分析显示, 与0～2种健康生活方式者相比, 有3种和4～5种健康生活方式者患超重/肥胖的风险分别降低49%(OR=0.51, 95%CI:0.28～0.93)和70%(OR=0.30, 95%CI:0.13～0.69), 患腹型肥胖的风险分别降低17%(OR=0.83, 95%CI:0.44～1.57)和66%(OR=0.34, 95%CI:0.14～0.80);并且每增加1种健康生活方式, 患超重/肥胖的风险降低41%(OR=0.59, 95%CI:0.42～0.85), 患腹型肥胖的风险降低37%(OR=0.63, 95%CI:0.44～0.90)。结论健康生活方式的数量与超重/肥胖及腹型肥胖均相关, 数量越多, 患病风险越低。     

综合ICU多重耐药菌医院感染的风险模型构建

目的构建重症监护病房（ICU）多重耐药菌医院感染的风险模型。方法对2012年10月—2015年9月入住ICU＞48 h的836例患者进行回顾性分析,构建医院感染logistic回归模型,对模型进行拟和优度检验、ROC曲线下面积（AUC）分析。结果3年入住ICU＞48 h的患者共836例,多重耐药菌医院感染发病率为14.23%(119例)。15个单因素分析有意义的自变量纳入logistic多因素分析,结果显示,ICU住院时间（OR=2.493;95%CI：1.816～3.494）、基础疾病种类(OR=1.536; 95%CI：1.243～1.898)、低蛋白血症(OR=87.211;95%CI：36.165～210.304)、呼吸机插管日数(OR=1.723;95%CI=1.399～2.121)、发热（OR=20.639;95%CI：3.462～123.043）、原发肺部感染(OR=0.295;95%CI：0.133～0.664)变量进入logistic回归方程。评价模型效果：灵敏度95%,特异度87.9%,模型ROC的AUC为0.973。结论logistic回归模型对ICU患者医院感染预测风险拟合度较好。     

中国中老年人群和高个成年人中心型肥胖的腰围界值点验证

目的 探讨中国中老年人群和高个成年人的适宜腰围界值点及其对糖尿病患病危险的预测价值.方法 利用2002年中国居民营养与健康状况调查数据,分析≥45岁人群和身高在全人群第85百分位数(P85)以上成年人的腰围分布特征,分析不同的腰同界值点与体重指数(BMI:kg/m2)≥24的诊断一致性,采用多元logistic回归分析不同腰围水平的调查对象患糖尿病和空腹血糖受损的相对风险,并以ROC曲线最短距离确定上述人群的适宜腰围界值点.结果 中国中老年人腰围男性均值为80.8 cm,女性均值为79.4 cm;高个男性腰围均值为84.1 cm,女性为77.9 cm.中老年人腰围以男性85 cm、女性80 cm作为界值点,与BMI≥24的诊断一致性最好,预测糖尿病的ROC曲线距离最短.与腰围<85 cm组相比,85 cm～组、90 cm～组和95 cm～组的中老年男性患糖尿病[OR值分别为2.1(95%CI:1.6～2.8)、3.0(95%CI:2.3～4.0)和4.5(95%CI:3.4～5.8)]和空腹血糖受损[OR值分别为1.6(95%CI:1.2～2.2)、2.6(95%CI:1.9～3.5)和3.5(95%CI:2.6～4.6)]的相对风险明显增加.与腰围<80 cm组相比,80 cm～组、85 cm～组和90 cm～组中老年女性患糖尿病[OR值分别为1.9(95% CI:1.4-2.6)、3.2(95%CI:2.4～4.3)和4.8(95%CI:3.7～6.1)]和空腹血糖受损[OR值分别为2.5(95%CI:1.8～3.4)、3.2(95%CI:2.4～4.4)和4.2(95%CI:3.2～5.6)]的相对风险明显增高.高个成年人腰围以男性90 cm、女性85 cm作为界值点,预测糖尿病患病的ROC曲线距离最短.与腰围<85 cm组相比,95cm～组高个男性患糖尿病和空腹血糖受损的相对风险明显增高[OR值分别为3.6(95%CI:2.1～6.4)和5.5(95%CI:3.0～10.1)].与腰围<80cm组相比,85 cm～、90 cm～组高个女性患糖尿病的相对风险明显升高[OR值分别为5.0(95%CI:2.7～9.4)和8.0(95%CI:4.6～14.1)],90 cm～组患空腹血糖受损的相对风险OR=3.7(95%CI:2.0～6.9).结论 男性85 cm和女性80 cm是中老年人群的适宜腰围界值点;对于高个成年人,此腰围界值点对于空腹血糖受损有预测价值;人群中心型肥胖预防指标建议使用男性85 cm和女性80 cm作为腰围界值点.     

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.     

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.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

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.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.