综合性肺康复治疗对煤工尘肺患者的效果评价

目的评价综合性肺康复治疗对煤工尘肺患者的康复效果。方法选取煤工尘肺患者80例,随机分为治疗组40例和对照组40例,治疗组在常规治疗的同时给予运动训练、健康教育、营养指导及心理与行为干预等综合性肺康复治疗措施,疗程6个月;对照组仅予常规治疗,观察治疗前后两组患者呼吸困难评价、生活质量评分、6 min步行距离及肺功能,并做统计学分析。结果治疗组治疗前后呼吸困难评价、生活质量评分、6 min步行距离及肺功能改善比较差异有统计学意义(P0.05);两组患者治疗后呼吸困难评价、生活质量评分、6 min步行距离及肺功能改善比较差异有统计学意义(P0.05)。结论综合性肺康复治疗煤工尘肺患者疗效确切,可明显改善患者症状,提高生存质量,增加运动耐量,且安全性好,未发现不良反应。     

萍乡矿业集团公司员工糖尿病的现况调查

对萍乡矿业集团公司22岁以上的员工进行问卷调查、体格检查及血液生化指标测定。结果显示,糖尿病、糖耐量受损患病率分别为6.44%和7.62%,随年龄的增大、文化程度的降低而升高,且与职业有关。     

云南昭通燃煤中砷的释放规律及其环境效应研究

目的探讨燃煤型氟中毒病区燃煤中砷的实际燃烧释放规律及其环境效应。方法于2005—2010年,在云南昭通系统采集了24户农户的煤、拌煤粘土、煤泥、煤渣以及新鲜玉米和烘烤玉米样品进行砷含量的检测,并计算煤泥中砷元素的燃烧释放量及释放率,分析了煤泥中砷释放量与烘烤玉米中砷增加量的关系。结果煤中砷含量为0.72~14.35 mg/kg,中位数为3.92 mg/kg;拌煤粘土中砷含量为1.66~66.59 mg/kg,中位数为17.22 mg/kg;煤泥中砷含量为1.81~29.52 mg/kg,中位数为7.79 mg/kg;煤泥中砷的释放量为0.09~22.47 mg/kg,中位数为2.00 mg/kg;煤泥中砷的释放率为0.92%~76.10%,中位数为31.76%;新鲜玉米中的砷含量为未检出~0.03 mg/kg,中位数为0.02 mg/kg,远低于GB 2762—2005《食品中污染物限量》中砷限量(0.2 mg/kg);烘烤玉米中的砷含量为未检出~0.34 mg/kg,中位数为0.09 mg/kg,与新鲜玉米相比有了大幅增加,超标率仅为23.8%。粘土与煤泥中砷释放量呈正相关(P=0.001),而砷释放量与烘烤玉米砷增加量间无统计学相关性(P=0.604)。结论拌煤粘土是燃煤中砷污染物释放的重要来源。烘烤玉米中砷污染程度不仅与煤泥中砷释放量有关,而且受到烤房条件、敞炉结构、烘烤时间等多种因素的影响。     

淮南煤矿区蔬菜重金属污染特征及其健康风险

目的探讨和分析煤矿区蔬菜重金属污染水平及其人体健康风险。方法于2014年9月选取淮南煤矿区8类典型蔬菜,共采集56份样品,分析蔬菜As、Cd、Cr、Cu、Hg和Pb蓄积水平,并评估该地区蔬菜重金属污染的人体健康风险。结果部分蔬菜中Cu、Cd和Pb含量超标,但除蒜苗为中度污染(P综=2.96)外,其他蔬菜均属于安全或警戒级(P综1)。成人、儿童摄入蔬菜中Cu的风险值和儿童摄入Cr的风险值(HQ)均1。成人和儿童对6种重金属暴露的总风险值(HQ)均1。结论淮南煤矿区蔬菜重金属污染整体上属于低到中等水平,但多种重金属复合污染的人体健康风险需引起重视。     

Simulated downwind coal combustion emissions for laboratory inhalation exposure atmospheres

Exposure atmospheres for rodent inhalation toxicology studies were generated to enable the evaluation of biological responses to a simulated downwind coal combustion atmosphere. A composition representing a single test case of emissions components as they may exist tens to hundreds of miles from a coal-fired power plant was developed. The particulate matter (PM) was 99% sulfate (partially neutralized) and 1% ash. Sulfate was present in equimolar concentrations to sulfur dioxide (SO₂). Gaseous nitrogen species included nitrogen monoxide (NO), nitrogen dioxide (NO₂), and nitric acid (HNO₃). At the high-exposure level, the gaseous species target concentrations were 0.2?ppm SO₂, 0.6?ppm NO, 0.3?ppm NO₂, and 0.1?ppm HNO₃. The test atmosphere was produced by combining effluent from a laboratory coal combustor with sulfate generated through an evaporation–condensation generator. These atmospheres were used to conduct inhalation toxicology studies that have been previously reported.     

燃煤污染型砷中毒患者外周血中丝裂酶原活化蛋白激酶信号通路相关基因mRNA转录表达情况

目的 检测燃煤污染型砷中毒患者外周血淋巴细胞中丝裂酶原活化蛋白激酶(MAPK)中ERK1、ERK2、JNK1、P38基因mRNA的转录表达情况.方法 2006年12月在贵州省燃煤型砷中毒病区兴仁县交乐村选择燃煤污染型砷中毒患者70例,其中轻、中、重度患者分别为31、25、14例,同时选取12 km以外有相似生活习惯、无燃用高砷煤史、经健康体检无异常、年龄性别匹配的大果朵村村民30名作为对照组.检测环境介质、粮食和观察对象尿、发中砷含量；采集外周血,Trizol法提取外周血淋巴细胞中总RNA,反转录获得cDNA.采用实时荧光定量PCR(QT-PCR)检测外周血淋巴细胞中MAPK信号通路中相关基因(ERK1、ERK2、JNK1、P38)mRNA转录表达.结果 燃煤型砷中毒病区环境介质中室内空气、室外空气、煤、辣椒和玉米中砷含量[中位数(四分位数)]分别为0.079(0.053 ～0.117) mg/m3、0.007(0.002～0.015) mg/m3、93.010(39.460 ～ 211.740) mg/kg、3.460(0.550～ 16.760)mg/kg和1.500(0.300 ～4.140) mg/kg,均超出国家卫生标准.土壤、大米和饮用水中砷含量分别为12.130(4.230 ～24.820)、0.650 (0.300～0.980)和0.043 (0.012～0.089) mg/kg,砷含量均在国家卫生参考标准之内.与对照组[(26.97±9.71)μg/g肌酐]相比,燃煤污染型砷中毒患者尿砷含量[(71.48±22.74)μg/g肌酐]较高,差异有统计学意义(F=90.38,P＜0.01)；与对照组[(1.58±1.07) μg/g]相比,砷中毒患者发砷含量[(4.45±2.78) μg/g]增高,差异有统计学意义(F =48.22,P＜0.01)；砷中毒患者外周血淋巴细胞中ERK2、JNKl mRNA相对表达量[中位数(四分位数)]分别为0.0667(0.0378 ～0.1371)、0.0013 (0.0009～0.0025),低于对照组[0.1744(0.1009 ～0.1985)和0.0022(0.0017 ～0.0030)],差异有统计学意义(x2值分别为15.10,14.25,P＜0.01).轻、中、重度砷中毒患者外周血淋巴细胞中ERK2mRNA相对表达量分别为0.0818(0.0408 ～0.1509)、0.0582(0.0154～0.1699)、0.0588(0.0399～0.1034),低于对照组0.1744 (0.1099～0.1985),差异有统计学意义(Z值分别为-2.89,-3.19,-2.67,P＜0.01)；JNKl mRNA相对表达量分别为0.0012(0.0007～0.001 57)、0.0019 (0.0011 ～0.0035)、0.0013(0.0010 ～0.0026),与对照组0.0022(0.0017～0.0030)相比,轻度组表达量减少,差异有统计学意义(Z=-3.72,P＜0.01).结论 砷可致中毒患者外周血淋巴细胞中MAPK信号通路中ERK2和JNK1 mRNA转录水平发生改变,表明MAPK信号通路参与了燃煤污染型砷中毒的发生和发展过程.     

Natural radioactivity in lignite samples from open pit mines “Kolubara”, Serbia – risk assessment

Coal as fossil fuel mainly contains naturally occurring radionuclides from the uranium and thorium series and ⁴⁰K. Use of coal, primarily in industry, as a result has dispersion of radioactive material from coal in and through air and water. The aim of this study was to determine the activity concentrations of natural radionuclides in coal samples from open pit mines “Kolubara” and to evaluate its effect on population health. The results showed that all measured and calculated values were below the limits recommended in international legislation.     

江西省燃煤污染型地方性氟中毒防治考核验收结果评价

目的评价江西省燃煤污染型地方性氟中毒病区控制和消除情况。方法按国家地病中心项目方案要求,在燃煤污染型地方性氟中毒所有病区村,县级对改良炉灶及使用情况和病区所有8-12岁儿童氟斑牙病情进行自评,省级依据方案进行复核,结果按《地方性氟中毒病区控制标准》(GB17017-2010)和《燃煤污染型地方性氟中毒病区消除标准》进行判定。结果县级自评结果显示两县区合格改良炉灶率和合格改良炉灶正确使用率均在90%以上,儿童氟斑牙检出率为15.99%。省级复核合格改良炉灶率、合格改良炉灶正确使用率分别为99.83%、96.33%;儿童氟斑牙检出率为14.15%,县级自评和省级复核结果一致率为86.21%。江西7个燃煤污染型氟中毒病区县,达到消除标准的3个县,其他达到控制标准。结论江西燃煤污染型氟中毒防治效果明显,病情得到有效控制。     

Limitations and plausibility of the Pliocene lignite hypothesis in explaining the etiology of Balkan endemic nephropathy

Background:

Balkan endemic nephropathy (BEN) is a chronic, tubulointerstitial renal disease often accompanied by urothelial cancer that has a lethality of nearly 100%.

Introduction:

One of the many factors that have been proposed to play an etiological role in BEN is exposure to organic compounds from Pliocene lignite coal deposits via the drinking water in endemic areas.

Objectives:

The objective of this study was to systematically evaluate the role of the tenets of the Pliocene lignite hypothesis in the etiology of BEN in order to provide an improved understanding of the hypothesis for colleagues and patients alike.

Methods:

A comprehensive compilation of the possible limitations of the hypothesis, with each limitation addressed in turn is presented.

Results:

The Pliocene lignite hypothesis can best account for, is consistent with, or has the potential to explain the evidence associated with the myriad of factors related to BEN.

Conclusions:

Residents of endemic areas are exposed to complex mixtures containing hundreds of organic compounds at varying doses and their potentially more toxic (including nephrotoxic) and/or carcinogenic metabolites; however, a multifactorial etiology of BEN appears most likely.     

合川区煤矿工人职业病防治知识知晓调查分析

目的了解合川区煤矿工人的人群特征和对职业病防治知识知晓情况,评价《职业病防治法》实施以来职业病健康促进工作对煤矿工人的影响,为今后进一步加强职业病防治健康教育和健康促进提供科学依据。方法使用统一设计的调查问卷对合川辖区内煤矿生产企业在岗的从业人员进行了抽样调查。结果绝大多数煤矿工人的文化程度为文盲或小学,对职业病防治知识知晓少,获取职业病防治知识的主要途径是人际传播。结论应将煤矿工人作为重点人群进行宣传教育,将职业病防治知识及相关政策作为重点内容,提高煤矿工人的职业病防治意识。