鄂尔多斯市煤工尘肺发病情况

目的 探讨鄂尔多斯市煤工尘肺发病情况,为进一步加强煤工尘肺防治和管理提供科学依据.方法 选择从事煤炭行业一线作业工人,采用x2检验、秩和检验分析不同接尘工龄、工种尘肺病发生情况.结果 该市煤类行业2011年进行企业健康检查,资料完整的共9 230人,检出尘肺病61例,煤工尘肺发生率为0.66％;掘进工种煤工尘肺发生率(1.11％)明显高于采煤工(0.64％)和辅助工(0.10％),差异有统计学意义(P＜0.05);接尘工龄≥30 a的煤工尘肺发生率最高,差异有统计学意义(P＜0.05).结论 该市煤炭行业尘肺发生率较低,从事掘进工作和接尘工龄长的煤矿工人煤工尘肺发生率高.     

煤工尘肺患者血清中基质金属蛋白酶-9及其抑制因子水平的变化

目的 探讨煤工尘肺患者血清中基质金属蛋白酶(MMP-9)及基质金属蛋白酶抑制剂(TIMP-9)水平的变化及意义.方法 采用双抗体夹心ELISA法检测188例煤工尘肺(煤肺组53例,煤矽肺组67例,矽肺组68例)、57例0期(0~+期组)、64例接尘对照组和50例健康对照组血清中MMP-9及TIMP-9含量;分析血清中MMP-9和TIMP-9水平在各煤工尘肺组及各对照组间的变化,以及二者的相关性;并根据煤工尘肺期别、是否有并发症以及接尘年限等因素进行分析.结果 煤肺组血清中MMP-9水平为17.16 ng/ml、煤矽肺组为15.14ng/ml,矽肺组为17.50 ng/ml,与健康对照组比较,差异均有统计学意义(P<0.05)与接尘对照组、0~+组比较,均呈降低趋势,其中矽肺组及煤矽肺组差异有统计学意义(P<0.05).3组煤工尘肺患者血清中MMP-9水平比较,差异无统计学意义(P>0.05);煤肺组、煤矽肺组和矽肺组血清中TIMP-9水平分别为(330.00±108.42),(312.044±120.09),(366.81±135.50)ng/ml,均低于健康对照组,其中矽肺组和煤肺组血清中TIMP-9水平较接尘对照组、1~+组明显增高,差异有统计学意义(P<0.05),3组煤工尘肺组间比较,矽肺组血清中TIMP-9水平较煤矽肺组升高,差异有统计学意义(P<0.05).3组煤工尘肺患者血清中MMP-9和TIMP-9水平按不同的疾病分期、是否有并发症以及接尘年限进行分析,差异均无统计学意义(P>0.05);矽肺组血清中TIMP-9水平与年龄呈正相关(r=0.249,P<0.05),血清中MMP-9和TIMP-9水平在接尘对照组中呈正相关(r=0.294,P<0.05),其他组中未发现相关性.结论 血清中MMP-9与TIMP-9水平变化与粉尘对机体的损害程度有关,MMP-9与TIMP-9共同参与了煤工尘肺的病理生理过程;动态观察0~+期及健康煤矿工人血清中MMP-9和TIMP-9水平,可为煤工尘肺的预防及早期诊断提供参考.     

矽肺与煤工尘肺血清中肿瘤坏死因子-α含量差异的研究

目的研究矽肺与煤工尘肺患者血清中肿瘤坏死因子-α(TNF-α)含量的差异,探讨TNF-α作为尘肺病生物学指标的可能性。方法矽肺55例,根据期别分为壹期12例、贰期20例、叁期23例;煤工尘肺59例,分为壹期23例、贰期20例、叁期16例;健康对照组20例。用化学发光法检测各组血清中TNF-α含量。结果矽肺组与煤工尘肺组各期别血清中TNF-α含量均高于对照组,随着期别的增高,TNF-α含量也依次增高,差异均有统计学意义(P0.05)。壹期中,煤工尘肺组年龄大、接尘年限长(P0.01),与矽肺组血清TNF-α的差异无统计学意义(P0.05)。贰期和叁期中,煤工尘肺组年龄大、接尘年限长(P0.01),矽肺组血清TNF-α含量高(P0.01)。结论血清中TNF-α的含量可能与尘肺病情的发展和接尘种类有一定关系,可作为病情评估的一项生物学参考指标。     

尘肺患者血清中趋化因子配体18水平调查

目的 测定尘肺病患者外周血清中趋化因子配体18(CC-chemokine ligand-18,CCL-18)的水平,探讨该指标作为尘肺病相关生物标志的可行性.方法 尘肺病患者77人为病例组(Ⅰ期尘肺40例,Ⅱ期22例,Ⅲ期15例),其中矽肺42例,煤工尘肺35例.以本院男性健康体检者162人为对照组.两组对象均为男性.采集空腹外周静脉血3 ml分离血清,用酶联免疫吸附法(ELISA)测定血清中CCL-18浓度.结果 尘肺病患者血清中CCL-18浓度为(116.70±82.85) ng/ml,明显高于健康对照组[(83.34±64.83) ng/ml],差异有统计学意义(P＜0.05).矽肺病患者血清中CCL-18浓度[(147.02±93.32)ng/ml]明显高于煤工尘肺患者[(96.43±47.19) ng/ml],差异有统计学意义(P＜0.05).不同期别尘肺患者血清中CCL-18浓度的差异无统计学意义(P＜0.05).尘肺患者肺功能损伤分级与血清中CCL-18浓度有正相关关系(r=0.611,P＜0.001).结论 尘肺病患者血清中CCL-18水平有可能作为尘肺病相关生物标志物.     

尘肺病患者血清PDGF和PⅢNP含量的测定

目的 探讨血小板源性生长因子(PDGF)和Ⅲ型前胶原氨基末端肽(PⅢNP)在尘肺病发生、发展中的意义.方法 采用双抗体夹心法,测定77例尘肺病患者(包括32例矽肺、45例煤工尘肺)和77例健康对照者血清PDGF和PⅢNP的表达水平.结果 尘肺病患者血清PDGF和PⅢNP含量分别为(36.31±3.31)ng/ml、(12.59±2.24)ng/ml,对照组则分别为(23.99±2.14)ng/ml、(9.33±2.63)ng/ml,差异均有统计学意义(P＜0.05);矽肺患者血清PDGF和PⅢNP含量均高于煤工尘肺患者,差异有统计学意义(P＜0.05);尘肺血清PDGF和PⅢNP呈线性关系且含量随着期别的增加而降低,差异有统计学意义(P＜0.05).结论 尘肺病患者血清PDGF和PⅢNP含量可能与尘肺病的发生、发展有关,能否作为尘肺病血清生物标志物有待进一步探讨.     

安徽省4913例新发尘肺病接尘工龄分析

2007—2017年安徽省共报告新发尘肺病例4 913例,其中壹期4 324例、贰期429例、叁期160例,男性4 845例、女性68例。接尘工龄008～4917年,中位数2100(908, 2850)年;矽肺发病以接尘工龄5年最多,煤工尘肺发病以接尘工龄25～30年最多,矽肺患者接尘工龄明显小于煤工尘肺,差异有统计学意义(H=10768,P005);壹期尘肺患者接尘工龄明显长于贰期和叁期患者,差异有统计学意义(H=20589,H=9300,P005)。尘肺患者主要集中在采矿业,其接尘工龄明显长于制造业和建筑业,差异有统计学意义(Z=-690,Z=-197,P005)。矽肺和其他各类型尘肺病患者接尘工龄与十年前相比明显缩短,差异有统计学意义(H=2482,F=331,P005)。提示应重点加强接触矽尘劳动者作业环境的监督和管理。     

“十二五”期间河南省新发尘肺病流行病学调查

目的为了解"十二五"期间河南省新发尘肺病的流行特征,寻找尘肺病的防控重点,为控制粉尘危害、防止尘肺病的发生提供依据。方法从"职业病与职业卫生信息监测系统"收集2011-2015年河南省新发尘肺病数据,运用SPSS 22.0软件处理数据,对2011-2015年河南省新发尘肺病进行流行病学特征分析。结果2011-2015年河南省新发尘肺病共计3 987例,平均接尘工龄为(17.9±10.3)年,不同期别尘肺的接尘工龄的差异具有统计学意义(F值=177.49,P0.01);矽肺患者的接尘工龄最短,煤工尘肺的接尘工龄最长,两者之间的差异有统计学意义(t=23.17,P0.05);平均患病年龄为(49.8±9.5)岁,不同期别的患病年龄差异具有统计学意义(F值=11.20,P0.01),患病年龄主要分布在30岁~、40岁~、50岁~年龄组,占86.9%;电焊工尘肺患者的患病年龄最小,煤工尘肺的患病年龄较长,两者之间的差异有统计学意义(t=5.31,P0.05);以煤工尘肺、矽肺为主,占98.1%;尘肺病多发于煤炭行业,占69.1%。结论采矿业、制造业和建筑业粉尘的治理是重点,采矿业中煤炭系统粉尘的治理是重中之重。     

煤工尘肺患者血清MMP9与TIMP1的表达

[目的]了解基质金属蛋白酶9（MMP9）及其组织抑制因子1（TIMP1）与煤工尘肺发生的关系。[方法]用酶联免疫吸附试验（ELISA）检测对照组、接尘组及病例组血清中MMP9、TIMP1的含量，计算相应的MMP9/TIMP1值。采用多因素回归对年龄和接尘工龄校正后进行分析。[结果]与对照组比较，接尘组血清中MMP9、TIMP1均有增加，尤其是MMP9增加较为明显（P〈0．05），而TIMP1的差异没有统计学意义（P〉0．05），各期煤工尘肺患者的MMP9、TIMP1浓度呈增加趋势，而MMP9/TIMP1值呈下降趋势，且与对照组相比，差异有统计学意义（P〈0．05）；经接尘工龄校正，与接尘组比较，Ⅰ期煤工尘肺的TIMP1升高（Х^2=8．80）以及Ⅲ期的MMP9、TIMP1升高（Х^2=12．18，8．20）。MMP9／TIMP1随煤工尘肺患者的晋期增加呈下降趋势（Х^2=13．42），差异均有统计学意义（P〈0．05）。[结论]MMP9和TIMP1的平衡可能与煤工尘肺的发生与发展有关。     

煤矿在职接尘工人煤工尘肺的发病情况

目的 探讨煤矿在职接尘工人煤工尘肺病发病特点,为指导煤工尘肺防治工作提供依据.方法 选择某矿业集团坚持定期健康检查、资料保存完整的3个煤矿,以调查前一年进行过尘肺病检查,但未诊断为尘肺的全部在岗接尘工人为调查对象,共8535人,收集调查对象的一般情况和职业史,对其进行尘肺健康检查,由具有尘肺病诊断资质的尘肺诊断组按GBZ 70-2002<尘肺病诊断标准>做出尘肺诊断.比较煤工尘肺的发病率,分析煤工尘肺患者发病年龄、发病工龄及不同工龄、不同工种人群煤工尘肺发病率的分布.结果 共8527人受检,受检率为99.9%(8527/8535).新发现Ⅰ期煤工尘肺49人,发病率为0.57%;平均发病年龄为(44.4±2.7)岁,平均发病工龄为(26.1±4.7)年.掘进工煤工尘肺病的发病率为0.92%(21/2282),高于采煤工(0.35%,5/1430)和辅助工(0.35%,5/1430),差异有统计学意义(P＜0.05).掘进工和混合工的平均发病工龄分别为(21.7±4.8)和(22.3±5.1)年,明显低于采煤工(27.8±4.6年)和辅助工(29.4±4.7年),各工种煤工尘肺平均发病工龄比较,差异具有统计学意义(F=6.42,P=0.001).煤工尘肺发病工龄多在20～30年,发病年龄多集中在45～55岁.结论 煤矿在职接尘工人煤工尘肺发病率为0.57%,掘进工的发病率高于采煤工和辅助工.掘进工和混合工的平均发病工龄较采煤工和辅助工短.     

尘肺病例的发病特点分析

目的 探讨尘肺诊断病例的发病特点,为尘肺病防治提供参考依据.方法 对2004至2009年受理的353例尘肺诊断病例的发病情况进行分析,并着重对矽肺、煤工尘肺及陶工尘肺3种尘肺的发病年龄、发病工龄及发病潜伏期进行比较.结果 诊断的353例尘肺包括10种尘肺,其中矽肺(102例)、煤工尘肺(153例)及陶工尘肺(53例)分别占全部尘肺的28.90%、43.34%及15.01%.50年代至80年代开始接尘诊断为尘肺的病例占全部诊断病例的84.99%(300/353).不同年代Ⅰ期矽肺、煤工尘肺及陶工尘肺的发病年龄、发病工龄及发病潜伏期均呈逐渐缩短的趋势.与80年代前比较,80年代以后开始接尘的矽肺和煤工尘肺发病年龄、接尘工龄及发病潜伏期缩短,差异有统计学意义(P＜0.01);80年代后,因北京市的陶瓷业转产,再未见陶工尘肺发病.玉器加工工人矽肺的发病年龄小和发病潜伏期短.结论 矽肺、煤工尘肺发病情况仍不乐观,特别对生产条件较为落后的玉器加工乡镇企业应加强监管.     

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.