辽宁省2004-2010年洪涝灾害对细菌性痢疾发病影响的分析

目的 研究辽宁省洪涝灾害对细菌性痢疾发病的影响。方法 收集辽宁省2004-2010年细菌性痢疾月发病数据、洪涝灾害、气象和人口数据,运用面板Poisson回归模型定量分析洪涝灾害对细菌性痢疾发病的影响。结果 研究期间细菌性痢疾月平均发病率为2.17/10万,病例主要分布于7-9月。Spearman相关分析显示,洪涝灾害对细菌性痢疾的发病不存在滞后效应。在调整了气象因素对疾病发病的影响后,面板数据分析显示,洪涝灾害对细菌性痢疾发病存在影响,IRR=1.4394(95%CI:1.4081~1.4714)。结论 研究期间辽宁省洪涝灾害可使灾后人群细菌性痢疾的发病风险升高。     

成都市暴雨洪涝与儿童手足口病关联分析及脆弱人群亚组识别

目的 刻画成都市2011—2017年暴雨洪涝与儿童手足口病(Hand, foot and mouth disease,HFMD)之间的短期滞后关系,并进一步量化在不同性别、年龄亚组中的效应,识别脆弱人群。方法 收集整理成都市2011年1月1日—2017年12月31日的15岁以下HFMD日发病数、气象因子和暴雨洪涝发生情况数据。以暴雨洪涝为关键自变量,运用准泊松分布滞后模型,探讨了暴雨洪涝发生后0~14天的滞后效应。结果 研究发现暴雨洪涝与儿童手足口病呈正相关关系。0~7天和0~14天的累积滞后效应分别为1.11(95% CI:1.01~1.22)和1.21 (95% CI:1.04~1.41)。性别和年龄亚组分析分别表明,男童和3岁以下儿童（<1岁婴儿和1~2岁幼儿亚组）存在单日滞后统计显著的正相关关系,且0~7天和0~14天的累积滞后均显著;女童的单日滞后没有统计学意义,仅0~14天累计滞后统计显著,且效应略低于男童（女童: RR =1.23(1.00~1.51),男童: RR =1.26(1.06~1.51)）;<1岁婴儿0~7天和0~14天的累积滞后效应最强,分别为1.26(95%CI:1.02~1.57)和1.68(95%CI:1.20~2.34)。结论 暴雨洪涝会增加儿童患HFMD的风险,尤其是男童和3岁以下的婴幼儿（对1岁以下的婴儿的影响最大）。利益相关者应充分意识到暴雨洪涝的健康风险。家庭、社区、学校和政府应共同努力,减少暴雨洪涝相关的儿童HFMD。     

Increased incidence of cutaneous Staphylococcus aureus infections after the 2010 floods in the Var department of France: Rumour or reality?

BackgroundNatural disasters are typically associated with the emergence of infectious diseases. On 15 June 2010, severe storms caused flooding in the Var department (France). A rumour about increased risk of Staphylococcus aureus skin infections after bathing in the sea began to circulate on Internet a few days after the floods. The aim of this study was to compare the rumour with the true incidence of cases of infection.MethodsSince 1999, we have been conducting a prospective survey of S. aureus skin infections in our hospital to study their clinical, laboratory and epidemiologic features. We compared data on cases of Staphylococcus skin infection recorded in our institution from 2008 to 2012.ResultsWe found that there was no increase in S. aureus skin infections after the floods compared to the previous and subsequent years.ConclusionWe had a unique opportunity to check the rumoured increase in incidence of infectious disease with the true incidence. In our study, the fear of S. aureus skin infections following flooding proved to be unfounded.     

洪水事件对人群健康影响的研究进展

洪水是发生最频繁的自然灾害之一,可能会导致广泛的生理和心理健康问题.该文综述了洪水事件对人群健康的影响,发现以溺水为主要方式的直接死亡,以粪-口和虫媒传播为主要途径的传染病,增加的伤害病例以及创伤后应激障碍(PTSD)、抑郁和虐待倾向等心理问题是洪水期间易发生的人群健康危害.积极改善灾区卫生条件,加强灭鼠控蚊工作有利于防治灾后疫情,同时,加强对易感人群(老弱病残、低收入人群等)的保护,积极进行暴露人群的心理疏导也有十分重要的意义.     

湖南省暴雨洪涝对细菌性痢疾的滞后效应及脆弱地区

目的 研究湖南省暴雨洪涝对细菌性痢疾(菌痢)的滞后效应,找出脆弱地区。 方法 收集2004~2011年菌痢周发病资料及同期气象资料。采用两阶段模型,首先建立基于时间序列的分布滞后非线性模型,分析洪水对菌痢发病的滞后效应;然后利用分层线性模型筛选脆弱地区。 结果 研究期间湖南省总共上报菌痢患者53 439例。在全省水平上,暴雨洪涝发生后2周其累积效应有统计学意义(RR=1.19, 95%CI: 1.05~1.36),效应值在滞后1周时达到最大(RR=1.12, 95%CI: 1.05~1.20)。西部地区(RR=1.66, 95%CI: 1.09~2.55)、经济发展水平低的地区(RR=1.43, 95%CI: 1.02~2.02)相较于其他地区更加脆弱。 结论 暴雨洪涝可以增加菌痢的发病风险,相应的干预措施应至少持续2周;针对经济发展水平较低的脆弱地区,应加大救灾力度,降低菌痢的发病风险。     

暴雨洪涝与人类健康关系的研究进展

暴雨洪涝已成为世界范围内频繁发生的自然灾害之一。20世纪以来,伴随全球气候的巨大变化,多种极端气候事件出现的频率及强度均与之增大/强,其中包括暴雨洪涝。在暴雨洪涝效应期,灾区居住条件恶劣、洁净水源及服务设施匮乏,为多种疾病的流行及播散提供了适宜条件。大量研究显示,暴雨洪涝会对人类身体健康造成严重危害,且这种危害在未来相当长的时期内将持续存在。基于文献回顾,从暴雨洪涝与人类健康关系的研究现状、研究方法学以及研究方向等方面进行了综述,从而为认识和应对暴雨洪涝灾害的健康风险提供理论依据。     

Carbon monoxide exposures in New York City following Hurricane Sandy in 2012

Abstract

Context. On October 29, 2012, Hurricane Sandy made landfall and devastated New York's metropolitan area, causing widespread damage to homes and the utility infrastructure. Eight days later, snow and freezing temperatures from a nor'easter storm delayed utility restoration. Objective. To examine carbon monoxide (CO) exposures in the 2 weeks following Hurricane Sandy. Methods. This was a retrospective review of prospectively collected, standardized, and de-identified data sets. CO exposures and poisonings identified from two electronic surveillance systems, the New York City Poison Control Center (NYCPCC) and New York City's Syndromic Surveillance Unit, were compared with CO exposures from identical dates in 2008–2011. Data collected from the poison center included exposure type, CO source, poisoning type, treatment, and outcomes. Data collected from the Syndromic Surveillance Unit cases, which were identified by CO-related chief complaints presenting to NYC hospitals, included visit date and time, and patient demographics. Results. Four hundred thirty-seven CO exposures were reported to the NYCPCC, 355 from NYC callers, and the remainder from surrounding counties, which represented a significant increase when compared with CO exposures from identical dates in the preceding 4 years (p < 0.001). The total cases that were reported to the NYCPCC in 2008, 2009, 2010, and 2011 were 18, 13, 24, and 61, respectively. Excluding a single apartment fire that occurred (n = 311), the more common sources of CO were grilling indoors (26.2%) and generators (17.5%). Syndromic surveillance captured 70 cases; 6 cases were captured by both data sets. Conclusions. CO exposures following weather-related disasters are a significant public health concern, and the use of fuel-burning equipment is a clear source of storm-related morbidity and mortality. Multiple real-time epidemiologic surveillance tools are useful in estimating the prevalence of CO exposure and poisoning and are necessary to assist public health efforts to prevent CO poisoning during and after disasters.     

Climate change and the new normal for cardiorespiratory disease

Climate change is already affecting the cardiorespiratory health of populations around the world, and these impacts are expected to increase. The present overview serves as a primer for respirologists who are concerned about how these profound environmental changes may affect their patients. The authors consider recent peer-reviewed literature with a focus on climate interactions with air pollution. They do not discuss in detail cardiorespiratory health effects for which the potential link to climate change is poorly understood. For example, pneumonia and influenza, which affect >500 million people per year, are not addressed, although clear seasonal variation suggests climate-related effects. Additionally, large global health impacts in low-resource countries, including migration precipitated by environmental change, are omitted. The major cardiorespiratory health impacts addressed are due to heat, air pollution and wildfires, shifts in allergens and infectious diseases along with respiratory impacts from flooding. Personal and societal choices about carbon use and fossil energy infrastructure should be informed by their impacts on health, and respirologists can play an important role in this discussion.     

Community-based flood disaster management for older adults in southern of Thailand: A qualitative study

ObjectiveThis study explored the approaches for community-based flood disaster management for older adults in Southern Thailand. It sought to understand community culture for supporting older adults and promoting community strength in case of flood disaster.MethodThis was a qualitative content analysis study using data from observation, in-depth interviews, secondary data, and focus group discussion. One hundred and twenty-seven people in total were selected specifically for the study, including Local Administration Organization (LAO), community leaders, public sector officers, civil groups, and older adult groups and family caregivers.ResultsThe results of this study were two main themes, focusing on 1) approaches to community-based flood disaster management for older adults as follows: eight approaches in the phase of prevention and preparedness in flood disaster management for older adults, eight approaches in the phase of response in flood disaster management for older adults, and six approaches in the phase of recovery and rehabilitation in flood disaster management for older adults; and 2) factors contributing to success in flood disaster management for older adults has four factors, including the human factor, the work factor, the data factor, and the resource factor.ConclusionThe findings showed significant roles in improving the potential and strength in community-based flood disaster management for older adults and providing suggestions for community nurses and health practice personnel involving in flood disaster management to mitigate the potential influence on older adults in the community.     

2005—2011年四川省洪涝事件敏感传染病的初步筛选

目的分析2005—2011年四川省洪涝事件发生期间传染病发病情况,筛选洪涝敏感的传染性疾病,为洪涝多发时期传染病预防控制提供科学依据。方法根据《中国气象灾害年鉴》的记载,四川省2005—2011年共发生20次洪涝事件。基于39种法定传染病进行筛选,其中各地级市(州)每旬发病数≥20的有病毒性肝炎、乙型病毒性肝炎、细菌性痢疾、感染性腹泻、麻疹、流行性腮腺炎、肺结核7种,采用服从Poisson分布的两个样本均数的Z检验(正态近似法)比较洪涝事件暴露期及相应对照期传染病罹患率,并计算相对危险度。结果细菌性痢疾、感染性腹泻在各洪水暴露期罹患率明显高于未发生洪水的对照期(P0.05)。病毒性肝炎、乙型病毒性肝炎、肺结核、流行性腮腺炎、麻疹等在暴露期与对照期罹患率之间的差异不明显。结论 2005—2011年四川省洪涝事件敏感的传染性疾病是细菌性痢疾和感染性腹泻。