正己烷职业接触工人外周血细胞参数分析

目的探讨正己烷职业接触人群全血液细胞指标特征，为该人群的健康监护提供动态观察依据。方法接触组53人，平均工龄3．1年，对照组64人，平均工龄2．2年。用车间空气中正己烷的溶剂解吸气相色谱分析法对环境空气中正己烷浓度进行测定，用气相色谱分析法对各组工人尿液2，5-己二酮浓度进行检测，用全自动血细胞分析仪进行全血细胞指标检测。结果工作场所空气中正己烷时间加权平均浓度（TWA），接触组为（73．2±9．7）mg／m^3，其个体采样尿液2，5-己二酮浓度为（2．11±0．46）mg／L；对照组TWA为（5．90±0．96）mg／m^3，其个体采样尿液2，5-己二酮浓度为（0．32±0．16）mg／L。接触组与对照组工作场所正己烷浓度及其个体尿液2，5-己二酮浓度差异有统计学意义（P〈0．01）；接触组红细胞计数（RBC）、血小板比容（PCT）、红细胞体积分布宽度（RDW）、平均红细胞容积（MCV）、平均红细胞血红蛋白量（MCH）指标分别为（4．74±0．22）×10^12/L，（0．16±0．04）L／L，（12．2±0．5）％，（91．6±3．6）fl，（6．1±1．1）pg，与对照组比较，差异有统计学意义（P〈0．05）；接触组尿液2，5-己二酮水平与RBC、RDW呈负相关，与MCV、MCH呈正相关关系。结论正己烷职业接触人群可能存在全血细胞某些指标的改变，其中RBC、RDW、MCV、MCH是值得深入探讨的正己烷职业健康监护动态监测指标。     

顶空-气相色谱质谱法测定血中正己烷代谢物2,5-己二酮

目的建立顶空-气相色谱质谱法测定血中正己烷代谢产物2,5-己二酮的方法。方法 3 ml血样加入内标物喹啉后,置70℃水浴40 min,经HP-5柱分离,内标工作曲线法定量。结果血中2,5-己二酮浓度在0.4μg/ml~1mg/ml时线性关系良好,相关系数为0.9994。方法的精密度相对标准偏差在5.7%~8.1%之间,血液样品加标回收率在89.2%~103.6%之间,方法检出限为0.2μg/ml。应用该法测定职业正己烷接触者53名和非正己烷接触者30名血中2,5-己二酮,结果显示职业正己烷接触者血中2,5-己二酮含量明显高于非正己烷接触者,并与接触正己烷浓度呈正线性相关(P0.01)。结论建立的顶空气相色谱法测定2,5-己二酮方法简便、快速、干扰少,可用于职业接触正己烷的生物监测。     

尿2,5-己二酮在职业危害评价中作为生物标志物应用指标的探讨

目的对车间空气中正己烷和作业环境人群尿中2,5-己二酮测定,验证2,5-己二酮作为生物代谢物在接触正己烷的职业危害评价中的意义。方法对6家皮件加工厂黏胶车间空气中正己烷和作业人群尿中2,5-己二酮进行同步测定,另选择1家服装加工厂和1个职业服装学校作为非接触正己烷对照组进行对比分析。结果环境空气中正己烷浓度与作业职工尿中2,5-己二酮含量呈正相关,r=0.899,P<0.05;通过对检测尿样中2,5-己二酮异常值逆向调查,验证其作为接触正己烷的生物标志物具有的实际意义,采用SPSS混合样本剖析法分析,对不同接触人群的尿2,5-己二酮测定值统计,推测其生物限值在8.92￣11.36mg/L范围。结论尿2,5-己二酮可以作为接触正己烷职业危害评价中灵敏、特征性强的生物标志物应用指标。     

气相色谱法测定尿中2,5-己二酮监测正己烷

正己烷在人体内经生物转化为2,5-己二酮(2,5-HD),由尿中排出,其排出量与职业接触有关。美国官方工业卫生家协会规定正己烷的生物接触限值(BEI)为尿中2,5-HD含量为5mg/L。本文报道了尿液中2,5-HD的测定方法,利用2,5-HD与正丁胺衍生化反应生成正丁基-2,5-二甲基吡咯(BDP),可用气相色谱法氢焰检测器和热离子检测器以及质谱仪测定。试剂2,5-HD、正丁胺等所有试剂皆为     

三氯乙烯药疹样皮炎患者肝功能动态变化

目的 观察职业性三氯乙烯( trichloroethylene,TCE)药疹样皮炎患者血清肝功能指标动态变化,为TCE药疹样皮炎肝损害的治疗提供依据.方法 收集10例职业性TCE药疹样皮炎并发肝损害患者不同时间点血清,采用全自动生化分析仪测定血清总蛋白(TP)、白蛋白( ALB)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、谷氨酰转移酶(GGT)、碱性磷酸酶(ALP)、AST/ALT比值、白蛋白/球蛋白比值(A/G)等11项指标,分析各指标动态变化.结果 10例TCE药疹样皮炎患者11项肝功能指标变化范围是TP:43.2～74.2 g/L,ALB:24.6～44.6 g/L,A/G:0.77～2.10,TBIL:3.7～268.2 μmol/L,DBIL:1.0～166.0 μmol/L,IBIL:2.4～167.5 μmol/L,ALT:11～5985 U/L,AST:14～5586 U/L,GGT:15～1500 U/L,ALP:35～309 U/L,S/L:0.07～1.94.TBIL、DBIL、ALT、AST、GGT、ALP浓度明显升高,尤以ALT、AST、GGT变化最明显;ALT最高达5985U/L,AST最高达5586 U/L,GGT最高达1500 U/L.TP、ALB、S/L明显降低,TP最低降到43.2g/L,S/L最低至0.07.A/G基本保持不变,IBIL变化不规律.结论 TCE药疹样皮炎患者早期肝损害严重,病情易反复发作.     

纳米纯铁粉对小鼠的毒性和血清生化指标的影响

目的探讨纳米纯铁粉的急性毒性及其对小鼠血清生化指标的影响。方法按照固定剂量(5 g/kg)法以纳米纯铁粉一次经口灌胃,14天后处死;分别测定肝、肾脏器系数和血清生化指标的变化情况。结果与对照组相比,纳米纯铁粉组小鼠肝脏器系数(0.054 9±0.004 1)明显高于对照组(0.049 3±0.006 2,P<0.05);血清铁(Fe)和总铁结合力(TIBC)则无显著性变化(P>0.05)。纳米纯铁粉组小鼠血清总铁未饱和度(UIBC)、乳酸脱氢酶(LDH)、总胆红素(TBIL)和总胆汁酸(TBA)水平分别为(8.93±7.39)%,(301.78±120.50)U/L,(1.48±0.26)μmol/L和(1.01±0.42)μmol/L,明显低于对照组的(12.65±9.82)%,(407.75±101.29)U/L,(1.96±0.59)μmol/L和(1.73±1.02)μmol/L,差异有显著性(P<0.05)。纳米纯铁粉组小鼠血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、尿酸(UA)、尿素氮(BUN)、肌酐(Cr)和葡萄糖(GLU)水平与对照组相比有所降低,但差异无显著性(P>0.05)。结论纳米纯铁粉基本无毒,其对血清生化指标的影响可能与一般铁材料有所不同。     

生化指标变化对婴儿肝炎综合征的临床诊断价值

目的:观察生化指标在婴儿肝炎综合征中的变化情况,探讨生化指标变化对婴儿肝炎综合征的临床价值。方法:采用全自动生化分析仪检测82例婴儿肝炎综合征患儿的血清中总胆红素(TB)、结合胆红素(DB)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、γ-谷氨(酰转肽酶(γ-GT)、总胆汁酸(TBA),检测血清及胆汁丙二醛(MDA)和超氧化物歧化酶(SOD)分别采用硫代巴比妥酸法(TBA法)和黄嘌呤氧化酶法检测。结果:婴儿肝炎综合征患儿血清TB为(210.53±75.64)μmol/L,DB为(90.21±26.49)μmol/L,AST为(102.52±52.36)U/L,ALT(108.27±48.63)U/L,γ-GT为(158.37±72.56)IU/L,TBA为(152.04±56.30)μmol/L,MDA为(5.87±1.86)μmol/L,SOD为(52.34±24.36)μU/L。婴儿肝炎综合征患儿血清中TB、DB、AST、ALT、γ-GT、TBA以及MDA、SOD等生化指标与正常对照组比较均有明显差异(P<0.05),其中TB、DB、AST、ALT、γ-GT、TBA以及MDA等明显高于正常对照组(P<0.05),SOD明显降低(P<0.05)。结论:肝炎综合征的患儿血清生化指标变化明显,生化指标能较好反映婴儿肝功能受损情况,对婴儿肝功能综合征的诊断、治疗效果以后预后有重要参考价值。     

人体铅的胎盘转运和乳汁传递

采用原子吸收光谱法对上海市区165名无职业铅接触史产妇的血铅、脐血铅、乳汁铅(119份)、胎盘组织铅(153份)样品进行测定,其均值分别为0.68±0.33μmol/L(14.13±6.79μg/d1)、0.40±0.23μmol/L(8.27±4.87μg/d1)、5.63±4.39ppb、1.14±1.10μmol/kg(23.73±     

丙酮、丁酮和二甲基甲酰胺协同作用对职业人群肝功能指标的影响

了解电子企业二甲基甲酰胺(DMF)作业人员的接触水平和健康状况,探索丙酮、丁酮和DMF协同作用对职业人群肝功能指标的影响。采用整群抽样方法选择中山市某电子企业接触DMF和丙酮、丁酮的所有生产工人作为观察组,共计145人;以单纯接触DMF的143名生产工人作为对照组。采用问卷调查法获得研究对象的一般情况和职业史,用生化分析仪测定研究对象肝功能指标,应用t检验、卡方检验等统计学方法分析研究对象的职业健康检查结果。结果显示,观察组岗位空气中DMF、丙酮、丁酮的时间加权平均(TWA)浓度为(5.87±2.25)、(34.46±49.50)、(140.20±139.81)mg/m3,对照组岗位空气中DMF的TWA为(4.86±1.83)mg/m3。丙氨酸转氨酶(ALT)水平,观察组为(27.21±34.15)U/L,对照组为(18.20±11.14)U/L;观察组的肝功能异常率高于对照组(P0.05)。提示,丙酮、丁酮对DMF的肝毒性具有协同作用,应减少多种毒物接触机会,密切关注多种有机溶剂接触的岗位,保护接触人群的职业健康。     

肝移植患者生化系列指标40例分析

目的:观察原位肝移植患者围手术期一系列生化指标的改变,探讨术后恢复过程中的规律和特点。方法:用日立7170全自动生化分析仪检测11项反映肝功酶学、蛋白质、胆红素和肾功能的生化指标,观察这些指标术前、术后1、10、20、30天的动态变化。结果:ALT术前70.80±60.25IU/L,1天612.05±360.36IU/L。术后ALT与AST同步直线上升,第1天超过术前8倍,10天快速下降,第20、30天接近正常水平。GGT、ALP1天活性稍下降。GGT(88.83±144.90IU/L);ALP(76.18±82.25IU/L)10天后上升。30天后大部分患者GGT降至正常。ALP30天仍保持高水平。TBiL、DBiL术后大多持续下降。第l天TBiL119.76±122.52μmol/L、DBiL70.19±70.13μmol/L,30天接近正常。TB、ALB术后与术前无明显区别。Urea术后升高,20天后降至正常。Cr术后无变化,TBA术后1天降至正常。结论:肝移植围手术期生化指标改变的规律和特点可能为临床病情判断提供依据。     

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 occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

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.     

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.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.