广东省老年尘肺患者死亡情况调查分析

目的 探讨老年尘肺死亡病例的流行病学特点。方法 回顾性调查了广东省１０６１例老年尘肺患者的死亡情况。结果 老年尘肺组开始接尘平均年龄,平均发病工龄及年龄,尘肺晋期时间和确诊后的存活时间都明显比尘肺对照组延长（Ｐ〈０．０１）。结论 提示接尘工人开始接尘年龄大,较易适应生产环境的不良因素,对生产性粉尘的危害抵抗力较强。     

铸钢和铸铁接尘工人肺功能损害的配对分析

本文按配对设计的原则，严格控制年龄、身高、吸烟量、接尘量等因素，分别对５２名铸钢和铸铁接尘工人进行了肺功能的比较分析，结果表明铸钢接尘工人的ＦＶＣ、ＦＥＶ_（１．０）、ＦＥＦ_（２５～７５）、Ｖ_（７５）、Ｖ_（５０）、Ｖ_（２５）等肺功能指标均低于铸铁接尘工人，ＦＶＣ、ＦＥＶ_（１．０）有显著意义的差别（Ｐ＜０．０５）；相同接尘工龄、相同累计接尘量的配对结果，尘龄小于２０年或累计接尘量小于５００毫克·年时，两组肺功能损害未见差别（Ｐ＞０．０５），当尘龄大于２０年或累计接尘量大于５００毫克·年时，铸钢接尘工人肺功能各项指标明显低于铸铁接尘工人（Ｐ＜０．０５或Ｐ＜０．０１）。     

某烟叶复烤厂接尘工人肺功能配对研究

本文分析对烟叶复烤厂１１４名接尘工人（接尘组）、６１名调离粉尘作业工人（调离组）与对照工人（对照组）进行了肺功能的配对比较分析，结果表明：不论是接尘组，还是调离组，ＦＶＣ、ＦＥＶ１、ＭＭＦ与Ｖ５０等肺功能指标的实测值、实测值占预计值的百分比均较对照组明显降低（Ｐ＜０．０５或＜０．０１）；异常率则明显升高（Ｐ＜０．０５或＜０．０１）。多因素分析结果表明，累积接尘量与接尘工龄是影响接尘工人肺功能下降的     

560例尘肺患者致残程度鉴定结果分析

目的：探讨影响尘肺致残程度的主要因素。方法：收集５６０例尘肺患者的致残程度鉴定的结果，分析致残程度与各影响因素的关系。结果：矽肺组中伤残二、三级明显高于石棉肺组、碳黑尘肺组、电焊工尘肺组、滑石尘肺组（Ｐ＜０．０５），其中矽肺Ｉ组致残程度严重于矽肺Ⅱ组（Ｐ＜０．０５）。矽肺Ｉ组的致残程度１９５８年前开始接尘组较１９５８、１９６４年及以后接尘组严重（Ｐ＜０．０５）。而且随着Ｘ线分期、病程或年龄增加而加重（Ｐ＜０．０５）。其他各尘肺组中不同期别、病程或年龄组对致残程度均无影响（Ｐ＞０．０５）。结论：粉尘性质不同，其引起的尘肺的致残程度不同，以矽尘最为严重。吸入游离二氧化硅含量高的矽尘致残能力强于含量低者，接尘年代的粉尘浓度高而致残程度重。其它影响因素还有尘肺期别、病程和年龄。     

矽尘,煤矽尘和石棉作业工人MTTp对比研究

本文采用“简易计算法”对７３６接尘工人、尘肺病人和对照人群的肺气部分平均通过时间（ＭＴＴｐ）进行对比研究，以探讨ＭＴＴｐ在评价接尘工人和尘肺病人通气功能变化中的应用价值．结果表明三组ＦＶＣ、ＦＥＶ１、Ｖ（７５）、Ｖ（５０）和Ｖ（２５）测值从大到小序位为对照组、接尘组、尘肺组，而ＭＴＴｐ测值从小到大序位为对照组、接尘组、尘肺组。接尘组内比较，煤矽尘组的时气流速和ＭＴＴｐ与矽尘肺组、石棉尘组比，均有显著差异（Ｐ＞０．０５）．提示ＭＴＴｐ在评价接尘工人肺通气功能变化中有一定实用价值，尤其是对煤矽尘工人，ＭＴＴｐ指标的应用更有实际意义．     

煤尘,矽尘对血液中性粒细胞碱性磷酸酶和过氧化物酶的影响

采用血细胞组织化学方法，对接触煤尘，矽尘工人及尘肺病人血液中性粒细胞（ＰＭＮ）碱性磷酸酶（ＡＫＰ）和过氧化物酶（ＰＯＸ）进行测定，结果显示，煤尘和矽尘均可致血液中性粒细胞的ＡＫＰ升高（Ｐ〈０．０１）ＰＯＸ降低（Ｐ〈０．０１），接触煤尘和矽尘工龄与ＡＫＰ和ＰＯＸ的相关分析表明，接尘工龄与ＡＫＰ和ＰＯＸ呈负相关关系（煤尘ｒ＝－０．３７７４，ｒ＝－０．２６９９，矽尘ｒ＝－０．２４０１，ｒ＝－０．２２７２     

烟草工人粉尘接触水平与肺功能损害的卫生学调查

对３０２名接触烟草粉尘工人与３２３名对照工人进行了肺功能检测．结果表明．接尘组工人肺功能各项指标（ＦＶＣ、ＦＥＶ１、ＭＭＦ、Ｖ（５０）、Ｖ（２５））的实测值占预计值百分比均较对照组为低；肺功能损害随累积接尘量增加而加重（Ｐ＜０．０１），肺功能异常率则随累积接尘量增加而增高（Ｐ＜０．０１）。     

1996～2001年上海市新发尘肺患者特点分析

目的 浅析近六年上海市尘肺发病特点及原因。方法 对196年1月1日—2001年12月31日上海市新诊断尘肺患者进行构成、所属企业性质、发病年龄、接尘工种、工龄等方面进行比较分析。结果 近六年来上海市尘肺检出数、检出率有逐年升高的趋势。国有企业所占比例逐渐下降，平均发病年龄、接尘工龄均高于非国有企业患者(P＜0.05).电焊工尘肺比上海1949—1986年尘肺流行病学调查资料提供的尘肺构成所占比例增多(P＜0．005)，并且发病年龄轻，接尘工龄短。45．8％的电焊工尘肺来自新兴的、绝大多数是中外合资企业的集装箱制造业，在发病年龄和接尘工龄上比其他行业电焊工均提前(P＜0．001)。工龄不超过10年的新发尘肺工种以电焊、风钻、喷砂例数最多，电焊工、喷砂工尘肺88．9％来自支资企业或乡镇企业，风钻工81．8％来自国企。结论 国企尘肺防治工作是有成效的，平均发病年龄超过工人退休年龄。非国有企业尘肺所占比例升高，新发尘肺发病年龄轻，工龄短，病情重。     

淄博矿区煤矿尘肺死亡回顾性队列研究

应用回顾性队列研究方法对淄博矿区１２个煤矿１９７７年１月１日在册的２０３７例煤矿尘肺的死因进行了调查。队列成员追访至１９８６年，共死亡４４３人，煤矿尘肺全死因死亡率为２４０８．８／１０万，与用山东省居民死亡率计算的期望值比较显著超高，ＳＭＲ＝２３５，９５％ＣＩ＝２１４～２５８。４非恶性呼吸道疾病（主要是尘肺病）死亡为全死因之首，占２５．１％，其次是恶性肿瘤、心血管疾病和肺结核。恶性肿瘤死亡明显超高，ＳＭＲ＝１９０，且主要集中于肺癌（占５９．２％，ＳＭＲ＝５５６），与呼吸道疾病相关的肺心病ＳＭＲ＝１９０，以及肺结核ＳＭＲ＝１００６的死亡率也明显超高。在掘进工和采煤工尘肺中，全死因、呼吸系疾病、恶性肿瘤、肺结核的死亡率显著增高，Ｐ＜０．０１。此外，在掘进工尘肺中心血管疾病，尤其是肺心病的死亡人数高于预期值（ＳＭＲ＝２７１，Ｐ＜０．０１）。     

广东省尘肺流行病学调查分析（1987～1994年）

对广东省１９８７～１９９４年新发尘肺２６０７例进行了流行病学调查分析。结果显示，在２６０７例尘肺中，男性占９８．７３％，女性占１．２７％。广东省累计尘肺患病比、病死率、尘肺并发结核率均较１９８７年前有显著降低（Ｐ＜０．０５或Ｐ＜０．０１）。煤工尘肺发病剧增，矽肺发病降低。说明广东在控制粉尘尤其矽尘危害及预防尘肺结核方面是有成效的。提出了今后应加强煤工尘肺的预防工作。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.