上海市2008年临床核医学的医疗照射水平分析

[目的]掌握上海市临床核医学诊断与治疗的医疗照射水平现状及其发展趋势。[方法]设计统一调查表格,普查上海市开展临床核医学诊疗的43家医疗机构的有关基本现状,具体调查2008年43家医疗机构的临床核医学诊疗工作量及其分布,以及受检者与患者的性别、年龄组分布。[结果]2008年上海市拥有各类核医学相关设备169台,从事临床核医学的工作人员为342人。全市核医学诊断年频率为6．63人次／千人口,居多的检查类型为骨显像、PET肿瘤显像、甲状腺显像等,男性比女性高25．6％。核医学诊断年频率随受检者年龄增长（0～15岁、16～40岁、〉40岁组）而增加。临床核医学的放射性药物治疗频率为0．41人次／千人口,女性比男性高62．5％。多数显像和功能检查的常用放射性核素为^99mTc;PET检查常用的放射性核素为^18F。甲状腺癌和甲亢治疗常用的放射性核素为^13I,二者典型放射性活度分别是5088MBq和237MBq。上海市临床核医学诊断的应用频率比1998年增加了91.8％;是1998年我国大陆平均水平的11．4倍。全市核医学的放射性核素治疗频率比1998年增加了182．8％;是1998年我国大陆平均水平的6．8倍多。[结论]上海市临床核医学诊断和治疗的发展速度很快,应切实加强临床核医学的医疗照射防护工作。     

秀丽线虫中铝暴露导致的多重毒害在世代间具有可转移特性

目的 研究铝暴露可能导致的多重毒性是否在世代间具有可传递特性.方法 利用模式生物秀丽线虫对于铝(2.5、75、200 μmol/L)暴露导致的寿命、发育、生殖、运动行为、行为可塑性等多种毒性及其在世代间的可传递性进行了研究.每个参数进行4组平行试验分析,寿命、发育、生殖与运动行为的分析每组20条线虫,行为可塑性的分析每组100条线虫.实验结果 都用SPSS 13.0软件进行分析.结果 数据显示,铝暴露能导致线虫出现多种表型和行为缺陷.与0 μmol/L浓度处理[平均存活天数,24 d;体长(1.30±0.05)mm;后代数目(278士20)个;世代时间(64.0±1.2)h;身体弯曲频率(45.8±3.0)次;头部摆动频率(109.33±7.30)次;行为可塑性(3±4)%]相比,低浓度铝(2.5 μmol/L)暴露即可导致平均存活天数(20 d)、体长[(1.12±0.02)mm;t=14.55,P＜0.01]、后代数目[(145±23)个;t=30.62,P＜0.01]、运动行为[身体弯曲频率(29.8±3.0)次;t=20.31,P＜0.01.头部摆动频率(95.8±6.2)次;t=16.43,P＜0.01]等严重缺陷,而高浓度的铝暴露还可以导致世代时间[75μmol/L,(67.0±1.7)h;t=8.92,P＜0.01.200 μmol/L,(70.7±1.5)h;t=15.13,P＜0.01]与行为可塑性[75 p,μmol/L,(16.5±3.0)%;t=27.11,P＜0.05.200 μmol/L,(23.5±4.0)%;t=16.43,P＜0.01]等的严重缺陷.而且,大部分高浓度铝暴露导致的缺陷可以从暴露当代传递到后代,使后代仍然呈现出严重表型与行为缺陷.在这些后代中,各表型与行为缺陷只能得到有限的恢复(如体长、后代数目与运动行为),或没有明显的恢复(如高浓度铝暴露引起的寿命缺陷).尤其是,铝引起的世代时间缺陷在子代中会变得更为严重.结论 在秀丽线虫中,铝暴露导致的针对表型与行为的多重毒害在很大程度上可以从当代动物传递到后代个体中.     

Comparison between exhaled breath condensate analysis as a marker for cobalt and tungsten exposure and biomonitoring in workers of a hard metal alloy processing plant

Objective  Cobalt (Co), Tungsten (W) and Tungsten Carbides (WC) are major constituents of hard metal alloys. Whereas little is known about potential health hazards due to tungsten carbide exposure, occupational exposure to cobalt has been shown to induce a variety of respiratory diseases. Since the concentration of a potentially hazardous substance in the target organ is the most meaningful risk indicator in occupational medicine, the detection of hard metals in exhaled breath condensate (EBC) has been proposed to be a valuable instrument. The present study examines the correlation of Co and W concentrations in EBC and urine with one another and various spirometrical and clinical parameters to scrutinize this potential. Methods  A total of 62 subjects (90.3% males, age 40.6 ± 9.2 years) were recruited from a hard metal processing plant in Germany. Examinations included the airborne workplace exposure, a complete spirometry, measurements of Co and W concentrations in EBC and urine with high resolution inductive coupled plasma mass spectrometry (HR ICP-MS) and graphite furnace atomic absorption spectrometry (GFAAS). Results  Air concentrations ranged between 0.0019 mg/m3 and 0.074 mg/m3 for Co and 0.012 mg/m3 and 0.021 mg/m3 for W. Median urine concentrations and interquartile ranges of the exposed subjects ranged from 0.81 (0.0–1.46) μg/l for Co and 30.5 (14.5–57.7) μg/l for W. Median breath condensate metal concentrations and interquartile ranges ranged from 8.4 (5.0–13.9) μg/l for Co and 8.8 (4.4–18.5) μg/l for W. Urine concentrations of Co and W were closely related to the airborne workplace exposure that had been assessed by air monitoring. EBC concentrations of Co and W showed no correlations to urinary W and Co concentrations and the ambient monitoring results of the individual workplace, respectively. Cobalt EBC concentration was elevated in subjects who reported to have suffered from respiratory disease; both Co and W concentrations in EBC, however, decreased with increasing spirometrical signs of obstruction. Conclusion  According to our study, urinary concentrations of Co and W seem to be more reliable indicators of current workplace exposure than EBC concentrations. As far as new methods and exposure matrices for valid concentration measurements in respiratory organs and possible hazardous effects—especially of cobalt—in the lung are concerned, the present results are less clear-cut, and further research is required.     

The relationship between malignant mesothelioma and an asbestos cement plant environmental risk: a spatial case–control study in the city of Bari (Italy)

Objectives  To estimate the mesothelioma risk and environmental asbestos exposure (EAE) due to an asbestos-cement plant. Methods  A spatial case–control study including 48 malignant mesothelioma (MM) cases occurred in the period 1993–2003 selected from the regional mesothelioma register (RMR) and 273 controls. The disease risk was estimated by means of a logistic-regression model, in which the probability of disease-occurrence is expressed as a function of the classes of distances. A non-parametric method was applied to estimate the full relative risk surface. Results  Significant MM odds ratio of 5.29 (95 CI: 1.18–23.74) was found for people living within a range up to 500 m centered on the plant. The non-parametric estimation of relative risk surface unveiled a marked peak near the plant not paralleled by the spatial distribution of controls. Conclusion  Evidence of an association between mesothelioma risk and EAE is highlighted. The role played by the RMR in increasing the public health local authorities awareness is stressed.     

Occupational paraquat exposure of agricultural workers in large Costa Rican farms

Objective  Paraquat is an herbicide widely used worldwide. This study determined the extent of occupational exposure to paraquat among farm workers in Costa Rica and identified determinants of occupational exposure. Methods  Twenty-four hour urine samples were collected from 119 paraquat handlers and 54 non-handlers from banana, coffee and palm oil farms. Information about herbicide handling operations was also collected. The urinary paraquat levels were determined by an enzyme-linked immunosorbent assay (ELISA) with a limit of quantification (LOQ) of 2 ng/mL. Inhalable dust and airborne paraquat levels were simultaneously measured for a subset of the participants. Results  Urinary paraquat measurements were non-detectable or very low when workers did not handle paraquat. For handlers, 83.3, 47.1 and 63.9% of the samples were below the LOQ on before-, during- and after-paraquat spray days, respectively. The arithmetic mean (±SD) of urinary paraquat level on days when workers handled paraquat was 6.3 (±10.45) μg/24 h. Paraquat exposures among handlers on spray day were significantly associated with the type of crop. Conclusion  Non-handlers had negligible urinary paraquat, while detectable paraquat exposures were observed among handlers on spray day. Urinary paraquat levels were different by crop.     

Environmental tobacco smoke and its effect on the symptoms and medication in children with asthma

Environmental tobacco smoke (ETS) worsens asthmatic symptoms. We analyzed the relationship between levels of ETS and asthmatic symptoms and medication. We asked parents of 282 asthmatic children about the general condition, smoke exposure and medication. Patients were classified into three groups: no-ETS (no smoking), mild-ETS (smoking in the house but not in the same room as patient), and heavy-ETS (smoking in the same room as patient). We classified 116 children in no-ETS group, 124 children in mild-ETS group and 42 children in heavy-ETS group. The symptoms were worst and prevalence of leukotriene receptor antagonist and long-acting β₂-agonist use were highest in heavy-ETS group. However, there was no statistical difference between no-ETS and mild-ETS groups in prevalence of anti-asthmatic drug use and symptoms. We conclude that a smoking ban in rooms used by asthmatic children is an easy way to reduce ETS, asthmatic symptoms and the use of anti-asthmatic drugs.     

Mercury exposure in a high fish eating Bolivian Amazonian population with intense small-scale gold-mining activities

Methylmercury exposure in Amazonian communities through fish consumption has been widely documented in Brazil. There is still a lack of data in other Amazonian countries, which is why we conducted this study in the Bolivian Amazon basin. Simple random sampling was used from a small village located in the lower Beni River, where there is intense gold mining and high fish consumption. All participants were interviewed and hair samples were taken to measure total mercury concentrations. The hair mercury geometric mean in the general population was 3.02 μg/g (CI: 2.69–3.37; range: 0.42–15.65). Age and gender were not directly associated with mercury levels. Fish consumption showed a positive relation and so did occupation, especially small-scale gold mining. Hair mercury levels were lower than those found in Brazilian studies, but still higher than in non-exposed populations. It is necessary to assess mercury exposure in the Amazonian regions where data is still lacking, using a standardized indicator.     

胎儿宫内多环芳烃暴露水平及其母婴暴露关系研究

目的了解胎儿宫内多环芳烃(PAHs)暴露水平,并探讨母婴暴露关系。方法于2006年10月至2008年1月在太原市两所二级甲等医院中随机调查符合条件的347名孕产妇,进行流行病学调查和生物样品的收集,其中母婴匹配的有271对用于本次分析。采用改进的高效液相色谱法测定母亲外周静脉血及新生儿脐带血中7种PAHs水平。结果可供检测的271对血清样本中,芘及苯并(a)蒽的检出率分别为母90.94%和脐79.34%;母95.97%和脐85.03%,其余4种致癌性PAHs的检出率均在50%～70%左右。脐带血苯并(k)荧蒽(P=0.002)、苯并(a)芘(P=0.002)、二苯并(a,h)蒽(P<0.001)水平均高于母血清,差异有统计学意义。此外,新生儿血清中苯并(b)荧蒽浓度要稍高于母亲,但差异没有统计学意义(P=0.075)。结论新生儿脐带血中可检出多种致癌性多环芳烃,并且脐带血中PAHs水平与母体相当甚至高于母体水平。