Radiation-induced chromosomal aberrations and haematological alterations in hospital workers

Long-term exposure to low doses of ionizing radiation may affect cells and tissues and result in various adverse health effects. The purpose of this study was to investigate whether chromosome aberrations and haematological alterations could be used as biomarkers of possible radiation injury in workers exposed to ionizing radiation. Groups totalling 323 medical professionals handling X-ray equipment and 160 control subjects were examined for incidence of chromosome aberrations and changes in leukocyte, lymphocyte and thrombocyte counts. The incidence of all types of chromosome aberrations was higher in the exposed groups than in controls, yet no significant difference was found between the exposed groups. A many-fold increase in chromosome aberration frequency in all exposed groups was not followed by a corresponding haematological depression. This suggests that chromosome aberrations are a significantly more sensitive indicator of changes caused by low doses of ionizing radiation than haematological alterations.     

Mortality studies of dockyard workers (longshoremen) in Italy

A polycentric mortality study was performed in five Italian harbours: Savona, Marina di Carrara, Livorno, Civitavecchia, and Ravenna. The cohort included active and retired workers (longshoremen), who had been employed between 1960 and 1981. Causes of death were ascertained from death certificates; expected numbers of deaths were generated from age, sex, calendar year, and cause-specific national mortality rates. A low overall mortality was found, which is in agreement with procedures of health selection, typical of physically demanding jobs; an excess of lung cancer was, however, found in four out of five harbours.     

Mortality of workers at a nuclear materials production plant at Oak Ridge,Tennessee, 1947–1990

The Y-12 plant at Oak Ridge, Tennessee, produced nuclear materials for the U.S. government's nuclear weapons program beginning in 1943. Workers at Y-12 were exposed to low dose, internal, alpha radiation and external, penetrating radiation, as well as to beryllium, mercury, solvents, and other industrial agents. This paper presents updated results from a long-term mortality study of workers at Y-12 between 1947 and 1974, with follow-up of white men through 1990 and data reported for the first time for women and men of other races. Vital status was determined through searches of the National Death Index and other records, and the workers' mortality was compared to the national population's using standardized mortality ratios (SMRs). Total mortality was low for all Y-12 workers and total cancer mortality was as expected. Among the 6,591 white men, there were 20% more lung cancer deaths than expected (95% confidence interval /CI/ 1.04–1.38). Death rates from brain cancer and several lymphopoietic system cancers were also elevated among white men, with SMRs of 1.28 and 1.46. Mortality from cancer of the pancreas, prostate, and kidney was similarly elevated. There was evidence of excess breast cancer among the 1,073 female workers (SMR 1.21, 95% CI 0.60–2.17). Lung cancer mortality among these workers warrants continued surveillance because of the link between internal alpha radiation exposure and this disease, but other agents, notably beryllium, also merit consideration as potential causes of lung cancer. Other cancers and agents should also be investigated as part of a comprehensive study of the health consequences of the production of nuclear weapons. © 1996 Wiley-Liss, Inc.     

Musculoskeletal diseases in lumber and wood products workers as identified through hospital records surveillance

Currently available computerized hospital records from four hospitals in Southwest Oregon were utilized for occupational health surveillance by administering brief occupational questionnaires to hospitalized male patients. Patients with occupational exposure to the lumber and wood products industries showed statistically significant increased risks of hospitalization for diseases of the musculoskeletal system and connective tissue. The technique of using routine hospital records for occupational health surveillance has utility as a simple, inexpensive, but systematic tool for monitoring occupational populations.     

甘肃省武威市2011-2013年暗娼HIV哨点监测分析

目的 了解2011-2013年甘肃省武威市暗娼（female sex workers,FSWs）人群艾滋病（acquired immunodeficiency syndrome,AIDS）知识知晓率、高危性行为及其影响因素,为武威市暗娼人群艾滋病行为干预提供依据。方法 2011-2013年,对武威市暗娼人群进行分层抽样调查,血清学检测人类免疫缺陷病毒（ human immunodeficiency virus,HIV）、丙型肝炎病毒（hepatitis C virus,HCV）和梅毒抗体。结果 3年共完成1 200人调查,艾滋病知识总体知晓率为89.8%（1 077/1 200）;2011-2013年监测人群的艾滋病知识知晓率分别是97.0%（388/400）、90.8%（363/400）、81.5%（326/400）（χ²=52.88,P<0.001）。2011-2013年,暗娼人群“最近1个月安全套坚持使用率”分别为93.0%（372/400）、83.0%（332/400）和75.0%（300/400）（χ²=47.61,P<0.001）。血清学监测未发现HIV阳性者,梅毒、HCV抗体阳性率分别是2.9%（35/1 200）和2.3%（27/1 200）。多因素Logistic回归分析发现,艾滋病知识的知晓、文化程度、娱乐场所等级、年龄、最近1年被诊断性病是影响暗娼“最近1个月每次商业行为都坚持使用安全套”的因素。结论 2011-2013武威市暗娼人群艾滋病知晓率和安全套坚持使用率有下降的趋势,武威市应将中、低档娱乐场所暗娼作为重点人群,强化艾滋病知识宣教和行为干预。     

2013 - 2015年青海省哨点医院食源性疾病病例监测结果分析

目的 对2013 - 2015年青海省哨点医院食源性疾病病例监测结果分析,掌握该省食源性疾病发病本底资料,为食源性疾病及食源性疾病的暴发防控提供科学依据。方法 按照《全国食源性疾病监测工作手册》要求,选择该省二级甲等以上10家哨点医院,收集以腹泻症状为主诉的就诊病例,并采集粪便或肛拭子标本进行病原学分析。结果 2013 - 2015年10家哨点医院共监测腹泻病例3 298例,采集病例生物标本2 846份,检出沙门菌、志贺氏菌、副溶血性弧菌、致泻大肠埃希氏菌共114株,总检出率为4.01%,其中沙门菌46株,志贺氏菌65株,副溶血性弧菌2株、致泻大肠埃希氏菌1株。8 - 11月为发病高峰,5岁以下年龄组,60岁以上年龄组为高发病人群;可疑食品以肉与肉制品所占比例最大,其次为水果类及其制品、粮食类及其制品;可疑进食场所以家庭为主,其次为路边摊点。结论 沙门菌、志贺氏菌是目前青海省食源性疾病的主要致病菌;需进一步加强青海省食源性疾病监测网络体系建设,加强对人群特别是儿童、老年人食源性疾病的知识宣传教育,加强可疑食品的监督管理,积极开展有效的防控措施。     

2013 - 2017年烟台市哨点医院食源性疾病监测结果分析

目的 分析烟台市2013 - 2017年食源性疾病监测结果,掌握该市食源性疾病主要致病菌类型和流行病学特征,为疾病预防和控制提供依据。方法 2013 - 2017年烟台市哨点医院报告的食源性疾病病例均纳入分析,采集部分病例粪便或肛拭子进行病原学分析。 结果 2013 - 2017年间,烟台市30所监测哨点医院共报告疾病18 269例,病例主要发生在6 - 9月份（56.54%）,以14～34岁（40.59%）为主,农村居民的发病率高于城市,职业以农民为主（23.96%）,可疑暴露食品以水产动物及其制品比例最大（21.97%）,家庭是主要可疑进食场所。共采集病例生物标本1 079份,检出阳性标本152份 （11.98%）,以沙门菌阳性（83例,占54.61%）和副溶血性弧菌阳性（32例,占21.05%）为主,其次为诺如病毒（22例,占14.47%）、致泻性大肠埃希菌（10例,占6.58%）和志贺菌（5例,占3.29%）。结论 加强烟台市食源性疾病的监测能力,加快医院信息化建设步伐,提高居民健康素养,养成健康生活方式,是预防和控制食源性疾病发生的有效措施。     

2001—2013年十堰市某医院放射工作人员个人剂量监测及职业健康检查结果分析

目的通过分析十堰市某医院放射工作人员2001—2013年健康监护资料,为进一步做好放射防护工作提供参考依据。方法采用回顾性分析方法,收集2001—2013年该院放射工作人员个人剂量监测和职业健康检查结果并进行统计、分析。结果 2001—2013年的13年期间,该院共完成5 059人次个人剂量监测,年人均有效剂量为（0.84±0.51）mSv/a;不同岗位中介入岗位人员高于其他岗位,平均为1.45 mSv/a;在7次共708人次职业健康检查中,有112人次放射敏感指标异常,异常率为15.8%,其中血常规异常较常见;异常率呈现下降趋势,女性、介入岗位和放射工龄长的人员异常率较高。结论该医院仍应进一步做好放射防护,要重点做好女性、介入岗位和放射工龄长的员工的健康监护工作。     

Vaccination against the 2009 pandemic influenza A (H1N1) among healthcare workers in the major teaching hospital of Sicily (Italy)

The aim of the study was to investigate factors involved in vaccination acceptance among healthcare workers (HCWs) and adverse reactions rates associated with pandemic influenza vaccination. The study was carried out in the major teaching hospital of Sicily from November 2009 to February 2010 on 2267 HCWs. A total of 407 (18%) HCWs were vaccinated against the 2009 pandemic influenza A (H1N1). A logistic regression analysis indicates an increased risk of non-vaccination against pandemic influenza in females (OR = 1.6; 95% CI = 1.3-2.1) compared to males, in nurses/technicians/administrative workers (OR = 1.7; 95% CI = 1.3-2.2) compared to doctors/biologists, and in HCWs who were non-vaccinated against seasonal influenza in 2008-2009 (OR = 4.9; 95% CI = 3.7-6.5) compared to vaccinated HCWs. Overall, 302 (74.2%) out of 407 questionnaires distributed to vaccinated HCWs were returned within the observation period. One hundred fifty-two workers (50.3%) experienced at least one adverse reaction (30.1%, local reactions; 6.6% systemic reactions and 13.6% both of them). The most frequent side effect of vaccination was pain at the injection site (43.4%). Twelve (3.9%) out of 302 HCWs stated they experienced influenza-like illness episodes during the follow-up period. The use of an adjuvanted vaccine against pandemic influenza A (H1N1) appears to be an effective and safe preventive strategy, showing a prevalence of both local and systemic adverse reactions not very different from that seen after vaccination with non-adjuvanted seasonal influenza vaccine. Despite this finding, vaccination coverage among HCWs remains very low, suggesting the need to implement educational campaigns directed to groups with lower coverage rates.     

Morbidity and mortality associated withsurgical site infections: results from the 1997–1999 INCISO surveillance

Since 1997, a surgical-site infections (SSI) surveillance network (INCISO) has been implemented in volunteer general surgical units in Northern France. For three months each year, all patients who undergo a surgical procedure are consecutively reviewed for their peri-operative condition and traced for outcome with a 30-day follow-up. Of the 38973 surgical patients included over a three-year period, 1344 (3.4%) developed SSI and 568 died (1.5%) including 78 with an SSI. Organ-space and deep incisional SSI were associated with a higher mortality and required re-operation more frequently than did superficial incisional SSI. SSI incidence and mortality varied according to the surgical procedure. SSI was a significant predictor of mortality, independently of NNIS risk index and other survival predictors. Thirty-eight percent of deaths in SSI patients were attributable to infection. Hence, the significant impact of SSI on mortality and morbidity in surgical patients is now an additional reason to reinforce compliance of surgical staff with preventive measures and hygiene practices.     

Cancer in ex‐asbestos cement workers in Israel, 1953–1992

A cohort of 3,057 male workers employed in an asbestos‐cement plant using 90% chrysotile‐10% crocidolite, located in Northern Israel, was followed from 1953–1992 for incidence and mortality from cancer. In the years 1978–1992, the cohort had an elevated risk for all malignant neoplasms combined (n > 153, SIR > 117, ns), lung cancer (n > 28, SIR > 135, ns), mesothelioma (n > 21; SIR >5000, p > .0001), unspecified pleural cancer (n > 5; SIR > 278 , P > .0001), and liver cancer (n > 7, SIR 290, ns). Risks for colo‐rectal (n > 19; SIR > 79, ns), bladder (n = 12, SIR 69) and renal cancers (n > 5, SIR 104) were less than expected. Risk for mesothelioma showed a sharp risk gradient with duration of exposure, increasing from 1 per 625 for those employed less than 2 years to 1 per 4.5 workers employed over 30 years. The ratio of mesothelioma to excess lung cancer cases was 2.9 to 1, or 3.6 to 1, if pleural cases of unspecified origin were included; the pleura to peritoneum ratio of verified mesothelioma cases was 20 to 1. This atypically high ratio of mesothelioma to excess lung cancer cases is suggested to be the combined result of high past asbestos exposures in the workers and their low prior risk for lung cancer, and possibly, relatively early smoking cessation in relation to asbestos exposure. Am. J. Ind. Med. 35:1–8, 1999. © 1999 Wiley‐Liss, Inc.     

Evidence for an increase in trisomy 21 (Down syndrome) in Europe after the Chernobyl reactor accident

The objective of this study is to investigate the prevalence of Down syndrome (DS) associated with Chernobyl fallout. Maternal age-adjusted DS data and corresponding live birth data from the following seven European countries or regions were analyzed: Bavaria and West Berlin in Germany, Belarus, Hungary, the Lothian Region of Scotland, North West England, and Sweden from 1981 to 1992. To assess the underlying time trends in the DS occurrence, and to investigate whether there have been significant changes in the trend functions after Chernobyl, we applied logistic regression allowing for peaks and jumps from January 1987 onward. The majority of the trisomy 21 cases of the previously reported, highly significant January 1987 clusters in Belarus and West Berlin were conceived when the radioactive clouds with significant amounts of radionuclides with short physical half-lives, especially (131)iodine, passed over these regions. Apart from this, we also observed a significant longer lasting effect in both areas. Moreover, evidence for long-term changes in the DS prevalence in several other European regions is presented and explained by exposure, especially to (137)Cs. In many areas, (137)Cs uptake reached its maximum one year after the Chernobyl accident. Thus, the highest increase in trisomy 21 should be observed in 1987/1988, which is indeed the case. Based on the fact that maternal meiosis is an error prone process, the assumption of a causal relationship between low-dose irradiation and nondisjunction is the most likely explanation for the observed increase in DS after the Chernobyl reactor accident.     

Insurance effects on US medical spending (1960–1993)

Regression results show that nearly half of 1960–1993 growth in real per capita medical spending and almost two-thirds of its 1983–1993 growth were due to ever-increasing levels of insurance coverage (the spending portion paid by third parties). Growth in coverage may have played a minor part as well; we would not rule out the standard finding that it has had a positive but relatively small effect. Viewed from a different perspective, the results imply that about two-thirds of 1960–1993 spending growth came via cost-increasing advances in medical technology resulting from: (1) commercial research and development induced by coverage levels and (2) noncommercial medical research. The remaining one-third, was due to standard factors: age–sex mix changes, income growth and coverage growth (the latter playing a small but indeterminate part).Copyright © 1998 John Wiley & Sons, Ltd.     

Work-related asthma among health care workers: surveillance data from California, Massachusetts, Michigan, and New Jersey, 1993-1997

BACKGROUND: Asthma morbidity has increased, posing a public health burden. Work-related asthma (WRA) accounts for a significant proportion of adult asthma that causes serious personal and economic consequences. METHODS: Cases were identified using physician reports and hospital discharge data, as part of four state-based surveillance systems. We used structured interviews to confirm cases and identify occupations and exposures associated with WRA. RESULTS: Health care workers (HCWs) accounted for 16% (n = 305) of the 1,879 confirmed WRA cases, but only 8% of the states' workforce. Cases primarily were employed in hospitals and were nurses. The most commonly reported exposures were cleaning products, latex, and poor air quality. CONCLUSIONS: Health care workers are at risk for work-related asthma. Health care providers need to recognize this risk of WRA, as early diagnosis will decrease the morbidity associated with WRA. Careful product purchasing and facility maintenance by health care institutions will decrease the risk.     

青岛市2009-2013年女性性工作者艾滋病哨点监测数据分析

目的 分析山东省青岛市2009-2013年女性性工作者人群（FSWs）艾滋病病毒感染流行趋势。方法 2009-2013年对青岛市酒吧、洗浴中心、夜总会等地的FSW人群进行问卷调查和艾滋病病毒（HIV）、梅毒、丙型肝炎病毒（HCV）的血清学检测。结果 共监测FSW人数4 033人,总样本平均年龄（24.8±5.8）岁,未婚者占73.9%,本省户籍占62.8%,汉族占99.1%,文化程度以初中为主,占71.4%;总的艾滋病知识知晓率为76.4%;总的HIV阳性率0.1%,梅毒抗体阳性率12.8%,HCV抗体阳性率0.5%;最近1次商业性性行为安全套使用者占60.3%,最近1月与客人发生性行为使用安全套比例为24.8%。结论 应进一步扩大艾滋病预防服务利用的覆盖面,针对该人群特点进行有效干预,提高其安全套使用率。