Progress and prospects in the development of catastrophe medicine in the prevention and cleaning up of accidents caused by hazardous cargo

Progress in emergency medicine in the prevention and liquidation of hazardous cargo-induced accidents is analyzed. The results of development of theoretical aspects, search for adequate individual protective means and methods for chemical decontamination of hazardous cargo residues are summarized.     

新冠肺炎疫情期间医务人员安全防护文件标准研究及现状调查

目的分析新冠肺炎疫情防控医务人员防护标准及感染现状,了解北京地区医务人员职业安全防护情况,为科学、规范、安全地开展疫情防控提供建设性意见。方法梳理国家发布的医务人员安全防护法律法规、指南标准,完善地区医务人员个人防护指导原则,通过现场观察和工作人员访谈形式了解本地区医务人员个人防护用品使用现状及问题。结果文件研究发现我国缺少医务人员安全防护方面的政策实施细则。疫情期间紧急下发系列文件,有待结合实际梳理统一。20所医疗机构调查显示大部分医疗机构能按照感染暴露的风险为临床配备防护用品。结论应加快我国医务人员职业安全体系建设和安全防护用品标准体系发展,根据不同暴露风险进行防护,加强分区管理,避免个人防护用品过度使用。     

Changes of functional state of the human body and the dynamics of its recovery in hard physical work in protective devices in various air temperatures]

Effect of the hard manual work on humans using the individual protective means in temperature conditions from 17 to 30 degrees C was studied. The investigation revealed the altered thermoregulatory, circulatory, central nervous systems and the acid-base status. The changes were found depending on the environmental temperature. The recovery period (one-hour rest and shower) did not normalize the disordered functions, so further correction of the functional status is necessary.     

Hygienic assessment of new technology of tank cars

A washing and steaming station built by Finnish specialists in 1997 operates at the Ryazan petroleum processing plant. The process is completely automatic and hermetic, excludes the workers' contact with harmful industrial factors. There is a whole set of special clothes and individual protective means. The plant's gas-fighting and rescue service monitors the air environment every 3 months. There is a closed rinsing water regeneration system at the plant.     

Utilization of individual protective devices with autonomic air supply for work with hazardous materials ]

An application of individual protective means (IPM) with the autonomic air supply has considerable promise for protecting respiratory organs and eyes in hazardous conditions. The main advantage of such devices is that the respiratory zone has the forced supply with the cleansed air. Biophysical studies showed that such IPM don't harm the functional status and capacity for work in human doing the medium-difficult physical work during 8 hours and can be recommended for the application in mines.     

某企业工作场所有害因素防护效果评价

对某企业工作场所有害因素进行检测,根据检测结果对工人个体防护用品的防护效果和车间工程防护效果进行评价。检测与评价结果表明:工人个体防护服、防护面罩以及车间工程防护的防护效果比较明显,能够起到保护工人身体健康的作用,企业车间整体职业卫生状况良好。     

不同辐射事故场景个体防护集成装备的研制

  目的  根据不同的辐射事故场景，设计不同的个体防护集成装备包。
  方法  针对不同场景的应急处置人员，选择合适的个体防护装备组合，使应急处置人员在辐射事故应急处置过程中能够快速地选择并穿戴合适的个体防护装备。
  结果  按照应急处置人员可到达的污染区域，选择不同的个体防护装备组合，在减少应急处置人员所受辐射危害程度基础上，避免防护装备的浪费。
  结论  分类整合的个体防护集成装备包，可便于辐射事故应急个体防护物资的储备。
     

国外核化生战剂防护装备技术的发展

介绍了国外个体及集体核化生战剂防护装备的发展历程及现状,详细阐述了国外目前较为先进的个体及集体防护装备的性能参数及技术优势,探讨了核化生战剂防护装备的发展趋势及其新技术的应用。     

化学武器个体防护装备数字化研究现状及发展展望

主要介绍了化学武器个体防护装备数字化研究的主要内容、现状及未来发展趋势,提出加强化学武器个体防护装备数字化研究对确保核生化条件下作战人员生命安全具有重要意义。     

Safety of nursing staff and determinants of adherence to personal protective equipment

A qualitative study conducted in a teaching hospital with 15 nursing professionals. Attempted to analyze the reasons, attitudes and beliefs of nursing staff regarding adherence to personal protective equipment. Data were collected through focus groups, analyzed by the method of interpretation of meanings, considering Rosenstock's model of health beliefs as a reference framework. Data revealed two themes: Occupational safety and Interpersonal Relationship. We identified several barriers that interfere in matters of safety and personal protective equipment, such as communication, work overload, physical structure, accessibility of protective equipment and organizational and management aspects. Adherence to personal protective equipment is determined by the context experienced in the workplace, as well as by individual values and beliefs, but the decision to use the personal protective equipment is individual.     

The association between adolescent condom use and individual and environmental resilience protective factors

Objective: Individual and environmental resilience protective factors are suggested to be associated with adolescent condom use; however, previous studies have not comprehensively examined such associations. This study aimed to determine the associations between condom use, and numerous individual and environmental resilience protective factors in sexually active Australian adolescents. Methods: Participants were Grade 10 students attending 28 Australian government high schools (n=1,688). An online survey (2011) collected data regarding: sexual intercourse (past year), condom use and 14 individual and environmental resilience protective factors. Multivariable backward stepwise logistic regression models examined associations between student condom use and protective factors (total, subscale). Results: Only total environmental protective factors remained in the final total score model; students with higher total environmental protective factors scores were 2.59 times more likely to always use a condom(95%CI:1.80–3.74). Only three of 14 protective factor subscales were associated with a higher likelihood of always using a condom in the final subscale model (individual: goals/aspirations; environmental: community participation, pro‐social peers). Conclusions: Total environmental and three protective factor subscales demonstrated prominent associations with consistent use of condoms in sexually active adolescents. Implications for public health: Consideration of particular resilience protective factors in adolescent sexual risk behaviour prevention, such as condom use, is warranted.     

Back supports and back injuries: a second visit with the Home Depot cohort study data on low-back injuries

The back support has been controversial as a means of reducing injuries to the lower back. Diverse issues bear on the interpretation of data obtained in a major epidemiologic investigation of the utility of back supports in the retail-trade home improvement industry. These concerns are focused on alternate explanations for the changes in injury rates observed over the six-year study period, on individual and group factors other than the use of the back support that might have contributed to reducing the risk of injury, and on related methodologic issues. Each issue is addressed with specific reference to how it might affect the analyses and the conclusion that the supports showed a protective effect.     

Relationships of protective factors to stress and symptoms of illness

OBJECTIVE: To examine relationships of work and individual protective factors to health outcomes. METHODS: Participants from 2 corporate samples completed measures of supervisor support, hardiness, coping, global stress, and symptoms of illness. RESULTS: Regression analyses indicated that higher scores on hardiness and approach coping and being male predicted lower scores on stress and symptoms of illness. Additionally, supervisor support predicted fewer symptoms of illness but did not have a spillover effect onto stress. CONCLUSIONS: Interventions that enhance individual protective factors primarily and work protective factors secondarily may be most effective in reducing stress and illness among employees.     

HLA based selection of epitopes offers a potential window of opportunity for vaccine design against HIV

The pace of progression to AIDS after HIV infection varies from individual to individual. While some individuals develop AIDS quickly, others are protected from the onset of disease for more than a decade (elite controllers and long term non-progressors). The mechanisms of protection are not yet clearly understood, though various factors including host genetics, immune components and virus attenuation have been elucidated partly. The influence of HLA alleles on HIV-1 infection and disease outcome has been studied extensively. Several HLA alleles are known to be associated with resistance to infection or delayed progression to AIDS after infection. Similarly, certain HLA alleles are reported to be associated with rapid progression to disease. Since HLA alleles influence the outcome of HIV infection differentially, selection of epitopes specifically recognized by protective alleles could serve as a rational means for HIV vaccine design. In this review article, we discuss existing knowledge on HLA alleles and their association with resistance/susceptibility to HIV and its relevance to vaccine design.     

Informed well-considered consent ('informed consent'): an end or a means?]

Since World War II, all sorts of protective measures have been taken for people who receive medical care or who are involved in scientific research. More and more, informed consent has become the standard. In the field of experimental therapeutical research, informed consent is still a controversial subject; the individual person's interests versus general interests. But informed consent appears to have become such an absolute prerequisite for all types of observational research that the future of epidemiological research based on existing data is threatened. According to both the Declaration of Helsinki and the Dutch Law for Protection of Persons, it is possible to omit asking individual informed consent under certain circumstances. Permission for research could then be given by a supervisory board or a medical-ethical commission. After all, informed consent was never meant to be a goal of its own, but a means for self-protection and securing the right to autonomy. In situations where this right is curbed for other reasons, it appears that insisting on informed consent misses its target completely.     

A structural model of health behavior: a pragmatic approach to explain and influence health behaviors at the population level

BACKGROUND: Behavior is influenced by individual-level attributes as well as by the conditions under which people live. Altering policies, practices, and the conditions of life can directly and indirectly influence individual behavior. This paper builds on existing ecological theories of health behavior by specifying structural mechanisms by which population-level factors effect change in individual health behaviors. METHODS: This paper moves ecological theory from model building to a pragmatic characterization of structural interventions. We examined social and environmental factors beyond individual control and mechanisms as to how they influence behavior. RESULTS: Four categories of structural factors are identified: (1) availability of protective or harmful consumer products, (2) physical structures (or physical characteristics of products), (3) social structures and policies, and (4) media and cultural messages. The first three can directly influence individuals through facilitating or constraining behavior. The fourth, media, operates by changing individual-level attitudes, beliefs, and cognitions, as well as group norms. CONCLUSION: Interventions that target the four identified structural factors are a means to provide conditions that not only reduce high-risk behavior but also prevent the adoption of high-risk behaviors. Structural interventions are important and underutilized approaches for improving our nation's health.     

火箭推进剂应急抢险个体防护装备的设计与研究

目的:研制一种用于液体火箭推进剂应急救援的个体防护装备。方法:防护服采取全包覆隔绝式结构,主要材料采用丁基胶或丁基胶涂覆聚乙烯胶布,内部安装温度、压力监测传感器。大眼窗全闭合头罩,内部安装量程为(0~20)×10-6(V/V)、精度为±1%的推进剂毒气监测传感器,内置头戴式有线耳麦和具备有线/无线2种传输方式的通信模块,无线和有线传输距离不小于150 m和1 000 m。采用空气压缩机作为主供气源,出口含油量不大于2 mg/m3,露点1~3℃。长管正压供气,气路安装涡流降温阀。结果:个体防护装备系统防护因数不小于100,呼吸防护因数不小于10 000,推进剂"气-液"防护时间不小于150 min。结论:该防护装备适用于保护操作人员在遂行推进剂突发事件应急抢险任务时免受推进剂伤害,防护性能好,并显著改善人体生理负荷,可满足发射场推进剂安全防护保障的需要。     

Racial disparities in low birthweight and the contribution of residential segregation: a multilevel analysis

This study investigates the geography of racial disparities in low birthweight in New York City by focusing on racial residential segregation and its effect on the risk of low birthweight among African-American infants and mothers. This cross-sectional multilevel analysis uses birth records at the individual level (n=96,882) and racial isolation indices at the census tract or neighborhood level (n=2095) to measure their independent and cross-level effects on low birthweight. This study found that residential segregation and neighborhood poverty operate at different scales to increase the risk of low birthweight. At the neighborhood scale residential segregation is positively and significantly associated with low birthweight, after controlling for individual-level risk factors and neighborhood poverty. Residential segregation explains neighborhood variation in low birthweight means and race effects across census tracts, which cannot be accounted for by neighborhood poverty alone. At the individual scale-increasing levels of residential segregation does not significantly reduce or exacerbate individual-level risk factors for low birthweight; whereas increasing levels of neighborhood poverty significantly eliminates the race effect and reduces the protective effect of being foreign-born on low birthweight, after controlling for other individual-level risk factors and residential segregation. These findings are contradictory to previous health research that shows protective mechanisms associated with ethnic density in local areas. It is likely that structural factors underlying residential segregation, i.e., racial isolation, impose additional stressors on African-American women that may offset or disguise positive attributes associated with ethnic density. However, as poverty is concentrated within these neighborhoods, differences between races in low birthweight cease to exist. This study demonstrates that residential segregation and neighborhood poverty are important determinants of racial disparity in low birthweight in New York City.     

北京市怀柔区养殖人群禽流感相关防护状况调查

目的了解北京市怀柔区养殖人群禽流感相关防护情况,从而更有针对性地做好该人群人禽流感防控的健康教育和健康促进工作,并为制定人禽流感防护策略提供依据。方法 2013年11月—2014年4月期间,通过多阶段典型整群抽样方法抽取怀柔区1 050名从事禽、猪养殖人员（包括大型养殖场从业者,个体和家庭养殖者）进行暴露情况问卷调查。结果共调查1 044人,其中大型禽养殖场人员84人,占8.05%;个体和家庭养禽人员710人,占68.01%;大型养猪场人员30人,占2.87%;个体和家庭养猪人员220人,占21.07%。戴工作帽、戴护目镜、戴口罩、戴手套、穿工作服、穿鞋靴或鞋套、采用消毒洗浴防护措施的分别占9.86%、1.63%、15.90%、32.76%、19.64%、27.30%、24.42%,7项均采用者仅为0.57%。结论怀柔区养殖人员防护措施采用率较低,存在发生和流行人禽流感的隐患,需要加强相关宣教、制度、政策的落实。     

略论铁路突发公共卫生事件应急处理个人防护装备基本要求

铁路突发公共卫生事件主要包括重大传染病疫情、集体性食物中毒和集体性职业中毒三种,危害因素复杂多样,个体防护装备是应急处理首选的预防性措施,在构建＂以人为本,和谐铁路＂的时代背景下,对个人防护装备的种类和性能提出更高要求。本研究分析了铁路突发公共卫生事件中的主要危害因素,提出了个人防护分级和防护装备分类原则,并对防护装备的性能选择、使用维护以及培训演练提出基本要求,以确保防护装备切实起到防护作用,充分保障应急队员的健康和安全,保证应急处理工作的顺利进行。