某企业高频变压器生产线职业病危害控制效果评价分析

目的了解某企业高频变压器制作生产线存在的主要职业危害因素,为制定职业病的预防措施提供依据。方法采用职业卫生学调查、工作场所职业病危害因素现场监测进行综合评价。结果该生产线主要存在苯、甲苯、二甲苯、噪声等,职业病危害因素的浓度（强度）符合国家职业卫生标准。结论该项目职业病危害的防护措施可行、有效。但由于存在苯,建议使用无苯材料进行替代,以保护易感职业人群身体健康。     

Prevention Research Strategies

Prevention of disease is the only method to substantially reduce morbidity and mortality in a population. The two key determinants of disease are the levels of risk factors/determinants and the adherence to efficacious therapies, and there are two approaches to these: public health and preventive medicine. Clinical trials remain the cornerstone for evaluating new approaches. Effectiveness studies are required to evaluate the best approaches to deliver efficacious therapies; public health and preventive medicine programs must include the entire population, and can be costly. Environmental changes have greater benefits and a greater likelihood of reaching large segments of the population, but the preventive medicine approach is better for high-risk diseases. New risk factors and diseases evolve from the upper to lower social classes, while preventive therapies evolve from the upper to lower education groups.     

132例继发性不孕患者病因分析

目的分析继发性不孕患者病因并探讨有效的临床预防措施。方法选择2010年2月-2011年10月在本院诊治的继发性不孕患者132例作为观察组,并选择同期来医院就诊的非不孕患者130例作为对照组,分析经期卫生、人工流产史、内分泌失调、卵巢功能障碍以及性传播疾病是否为继发性不孕发生的危险因素。结果观察组患者有人工流产史、内分泌失调、卵巢功能障碍以及性传播疾病的患者比例分别为44.7%、27.3%、31.1%、21.2%,均明显高于对照组的10.8%、14.6%、15.4%、11.5%,组间差异均有统计学意义（P〈0.05）,以上各项为继发性不孕发生的危险因素。结论临床医务工作者应了解继发性不孕发生的危险因素,针对病因采取相应的预防措施,降低该疾病的发病率。     

重视医务人员职业感染的预防

分析了医务人员职业感染的主要危险因素、常见疾病和高危人群.提出了控制措施:建立职业保健制度,加强预防技术培训,坚持实施标准预防,完善基础设施设备,积极处理职业暴露等.国家提供有力的法律保障,医院领导积极控制各种危险因素,医务工作者保持高度的自我防护意识,才能使医务人员职业感染得到有效的预防控制.     

妊娠期高血压疾病母婴结局不良的危险因素及预防对策

目的分析妊娠期高血压疾病母婴结局不良的危险因素并探讨有效的预防对策。方法选取河北省保定市妇幼保健院2012年5月-2013年4月收治的186例妊娠期高血压疾病患者作为研究对象,分析孕妇一般资料、妊娠状况以及疾病情况对母婴结局的影响。结果母婴结局良好116例,母婴结局不良70例,年龄≥35岁、文化程度低、体重指数异常、未补充叶酸、未定期孕检、疾病种类以及合并其他疾病均为母婴结局不良的危险因素。结论妊娠期高血压疾病母婴结局不良与诸多因素有关,临床工作者应该了解其危险因素,采取有效的预防措施,从而改善妊娠期高血压疾病母婴结局。     

从"非典"流行看突发性传染病的应急干预和长效管理机制

目的 :探讨高校传染病预防措施。方法 :针对师生的心理状态和传染病流行环节制订预防措施。结果 :提出在突发性传染病流行时 ,应对师生进行相应的心理干预 ,严格从 3个环节入手控制传染病 ,同时制订出长效管理机制。结论 :对传染病必须遵循预防为主 ,常备不懈的原则     

2011年盐都区农村居民主要慢性病及危险因素调查

目的 了解盐城市盐都区农村居民当前主要慢性非传染性疾病(慢性病)患病情况及其主要危险因素.方法 对盐城市盐都区5 068名农村居民进行问卷调查,了解其一般状况、慢性病史及可能与慢性病发病有关的影响因素,并测量血压、血糖等指标.描述5种主要慢性病的患病情况,并采用单因素和多因素Logistic回归分析的方法探讨5种主要慢性病的危险因素和保护因素.结果 盐都区18岁以上农村居民高血压患病率为16.97％;现场调查一行政村,糖尿病患病率为3.36％.患病人群血压知晓率、治疗率和控制率分别为73.98％、68.26％和34.77％;血糖知晓率和控制率分别为51.43％和31.43％.患病率居前5位的恶性肿瘤分别是胃癌、食管癌、肠癌、肝癌和肺癌.盐都区主要慢性病的危险因素为疾病家族史(遗传)、老龄、男性等不可预防的危险因素和饮酒、腰围长、睡眠质量差、体力活动缺乏等可干预危险因素.结论 盐城市盐都区农村居民慢性病患病率与全国其他地区水平接近,应实施有针对性的预防措施,提高预防效果.     

Prevention of cardiovascular disease among the elderly

Cardiovascular diseases are a major cause of mortality, morbidity and disability of the elderly in both developed and developing countries. Their prevention has two aims: to add life to years and years to life. Observational studies suggest that the risk factors for these diseases in the middle-aged predict their incidence and the mortality due to them among the elderly. Direct evidence on the effectiveness of prevention by controlling these risk factors in the elderly, however, is still largely lacking or inconclusive. Nevertheless, the recent falling mortality trends in several countries indicate that deaths due to cardiovascular diseases can decrease rapidly also among the elderly, although the causes of the trends are not yet all clear. The very large cross-national differences in mortality from coronary heart disease and cerebrovascular diseases are a challenge for the wider application of preventive measures now. For the control of some risk factors, particularly of high blood pressure, further research focused on the elderly is urgently needed.     

Congenital toxoplasmosis: priorities for further health promotion action

Toxoplasmosis is a disease of considerable public health impact. As the transmission, occurrence and phenotype of this disease are influenced in a complex way by host genetics, immunity, behaviour and by the agent characteristics, prevention will not be simple. This article aimed to review studies defining seroprevalence of and characteristic sociodemographic, biological and lifestyle risk factors for Toxoplasma gondii infection in pregnant women, to evaluate screening and educational programmes, and to assemble recommendations for combating toxoplasmosis in populations at risk. Electronic databases were searched, using a specific search strategy, from 1975 to 2007. There is a high prevalence of T. gondii antibodies in pregnant women worldwide, with some geographic discrepancies attributed to climatic conditions, local food customs, hygiene, lifestyle and cultural differences. The main risk factors for toxoplasmosis in pregnant women are unsanitary feeding habits, poor immune system, contact with cats, contact with soil, pregnancy, number of births, older age, race, travelling outside the country, drinking beverages prepared with unboiled water, consumption of municipal or uncontrolled (well/spring) water and T. gondii strain virulence. Knowledge of these risk factors helps to identify priorities for further epidemiological work and defines effective preventive measures along five main themes of action: information and health education; screening of pregnant women and infants; limiting harm from risk behaviour; treatment of cases found to be at risk; and vaccination.     

Risk factors for tick exposure and suboptimal adherence to preventive recommendations

BACKGROUND: Tickborne diseases are the most common vectorborne illnesses in the United States. Understanding risk factors for tick bites and adherence to preventive measures are important in preventing morbidity associated with tickborne disease. METHODS: A random-digit-dialing telephone survey was administered to 1820 residents of 11 counties in Tennessee. RESULTS: Of respondents, 16.4% reported a tick bite within the previous year. Only 29% consistently used insect repellant in high-risk situations, and only 54% always checked their bodies for ticks after leaving potentially infested areas. Nearly one fourth of dog owners removed ticks from their pets with bare hands. Dog ownership, rural residence, and exposure to a farm were associated with increased risk of tick bites. CONCLUSIONS: We identified several groups that were at increased risk of tick bites and might benefit from targeted prevention messages.     

Risk factors for mortality among elderly people

OBJECTIVE: The risk factors for diseases and premature deaths are important in drawing up preventive measures. This study had the aim of analyzing the risk factors for death among elderly people. METHODS: This study was carried out among participants in the SABE (Health, Wellbeing and Aging) study, in the city of S?o Paulo in 2000. Interviews were conducted with 2,143 elderly people (60 years old or over), using a standardized questionnaire for the SABE study. The sample was obtained from census tracts, in two stages, with replacements and with probability proportional to the population, and with supplementation of the sample of people aged 75 years or over. The final data were weighted so that they could be expanded. Between the two data collection times, there were 38 deaths which comprised study sample. Logistic regression was utilized for the data analysis, with a significance level of 5%. RESULTS: The risk factors found were: locomotion difficulty, advanced age, male gender, self-assessment of health as "bad" and difficulty in going to the bathroom, OR=3.15; 2.93; 2.90; 2.69 and 2.51, respectively. CONCLUSIONS: The results may contribute towards the adoption of preventive measures for elderly people, with the aim of diminishing the expected number of fatal outcomes.     

血液净化患者深静脉导管感染的危险因素研究

目的分析血液净化患者深静脉导管感染的危险因素,为临床实施有效的预防措施提供参考信息。方法选择2010年1月-2011年10月湖北医药学院附属太和医院收治的血液净化患者142例,观察患者是否发生深静脉导管感染,并分析患者性别、年龄、置管部位、置管时间、导管腔数、基础疾病种类是否为感染发生的危险因素。结果本组142例血液净化患者发生深静脉导管感染17例,发生率为12.0%,其发生不受患者的性别、年龄影响(P>0.05),受患者的置管部位、置管时间、导管腔数、基础疾病种类的影响(P<0.05)。结论血液净化患者的置管部位、置管时间、导管腔数、基础疾病种类均为发生深静脉导管感染的危险因素,应针对以上各项采取有效的预防措施以提高患者的治疗效果。     

某木片码头工程职业病危害控制效果评价

目的识别、分析该建设项目可能产生的职业病危害，评价职业病危害防护措施及其效果，提出职业病危害的关键控制点，为卫生行政部门对建设项目职业病防护设施竣工验收提供科学依据。方法采用现场调查法和检测检验法。结果该项目生产过程中存在的主要职业病危害因素有：木尘和噪声。木尘合格率为42．9％，噪声合格率为100％，噪声作业分级为安全作业。工程选址、生产工艺布局、建筑卫生学、卫生工程技术防护措施、辅助卫生措施、职业卫生管理措施等基本符合国家有关法律法规，但总平面布局和防尘措施需要整改、制定应急救援预案。整改后木尘仍有两个作业点不合格。结论本建设项目的职业病危害控制措施基本能满足职业卫生要求。     

Dutch monitor on stress and physical load: risk factors, consequences, and preventive action

OBJECTIVES: Due to recent changes in legislation on occupational health and safety, a national monitor on stress and physical load was developed in The Netherlands to monitor (a) risks and consequences of stress and physical load at work, (b) preventive actions in companies to reduce these risks, and (c) organisational and environmental variables that facilitate preventive actions. METHODS: Information was gathered from employers, employees, and employees' representatives. The monitor was used with a nationally representative sample of companies in industry, wholesale trade, and banking and finance, 782 companies in total. RESULTS AND CONCLUSIONS: The information from the employees, aggregated at the company level, was not found to be correlated with that from the employer from the same companies. Although many employers do recognise risk factors for both physical load and stress as a problem they often seem to underestimate the problem when compared with employees or their representatives. This is particularly the case for psychosocial risk factors. Also, the perception of outcome measures, especially employers who consider emotional exhaustion to be work related, were fewer than the employees' representatives of the same organisation. Preventive measures on physical load are much more popular than measures against stress. It is the responsibility of the employer to take more preventive action of all kinds. They need to recognise risk factors as problems and health outcomes to be related to work. Employees of larger companies should participate with employers to consider effective measures, and more use should be made of support at branch level. For specific preventive measures, specific predictors emerged. Except for measures to prevent work stress, information from employees did not sufficiently contribute to the initiation of preventive measures in the workplace.

 

     

Coronary heart disease. At the interface of molecular genetics and preventive medicine.

BACKGROUND: Susceptibility to common chronic diseases such as coronary heart disease (CHD) appears to be influenced by "context-dependent effects," which include interactions among genes (genetic epistasis) and among genes and environmental factors (gene-environment interactions). METHODS: A synthesis of current knowledge and research findings demonstrates the importance of integrating genetic research on cardiovascular disease with preventive medicine and public health initiatives. RESULTS: A variety of candidate genes have been implicated in risk for CHD, but only limited examples of context-dependent effects have been described. Interactions between genetic and environmental factors appear to influence lipid metabolism, plasma homocysteine levels, and pharmacologic response to many commonly prescribed medications. Quantification of genetic effects associated with increased disease risk that are modifiable by interventions such as diet, exercise, and smoking cessation is an important interface between molecular genetics and preventive medicine. CONCLUSIONS: As a primary focus of preventive medicine expands to encompass early detection and treatment of asymptomatic individuals at risk for disease, the ability to quantify the influence of context-dependent effects on disease risk will be critical for determining drug safety and effectiveness in diverse patient populations and for implementing effective prevention and treatment programs.     

ERCP术后并发胆道出血的危险因素分析及措施

目的探析经内镜逆行胰胆管造影(ERCP)术后并发胆道出血相关高危因素以及预防措施,为今后更好预防胆道出血提供参考和借鉴依据。方法本研究回顾性分析2010年2月至2013年5月期间248例行ERCP术患者的临床资料,根据是否发生胆道出血分为研究组和对照组,22例胆道出血为研究组,226例胆道无出血为对照组,总结分析ERCP术后胆道出血的高危因素并探析有效地预防措施。结果 ERCP术后并发胆道出血的高危因素主要包括:凝血时间长、血小板计数减少,胆总管多发结石、乳头旁憩室或者其内乳头、胆道系统肿瘤等原发疾病(P<0.05),针状刀切开术后胆道出血率明显高于弓形刀切开术(P<0.05);EST中大切开术出血率明显高于乳头气囊扩张术(P<0.05)。预防措施主要包括:术前健康教育和心理疏导、完善术前评估和准备;术中、后优质护理;并发症紧急处理。结论凝血功能、原发疾病、手术方式、操作者的经验与操作熟练程度均为ERCP术后并发胆道出血的高危因素,通过积极有效的预防措施能避免或者减少术后胆道出血,最大程度减轻患者的痛苦,提升其生活质量。     

Selected nonvaccine interventions to prevent infectious acute respiratory disease

INTRODUCTION: Infectious acute respiratory disease (ARD) is a significant cause of worldwide morbidity, disproportionately affecting individuals living in crowded conditions, such as found at military training centers, school dormitories, and correctional facilities. Vaccines have been used to protect against ARD; however, these are not always available or effective. METHODS: The medical literature (1963-2004) on preventive nonvaccine ARD interventions (NOVARDIs) for infectious diseases, which addressed personal measures, administrative controls, and engineering controls, was studied during 2000 to 2004. Population-based studies in community settings (non-health care) were reviewed in detail to evaluate the effectiveness of NOVARDIs. Budgetary and logistic factors as well as acceptance were considered in formulating recommendations for implementation of NOVARDIs in military training centers. RESULTS: Thirty-eight population-based studies contained in 35 publications were examined. Three studies contained information on multiple NOVARDIs. Nine studies supported the use of personal measures relating to hand hygiene. Ten studies supported administrative controls such as cohorting military training units to reduce contact between units (4 studies), providing adequate personal space to reduce crowding (5), and cloth barriers between beds (1); and 14 studies supported the use of engineering controls such as increased indoor air dilution and ventilation (2), dust suppression (4), and air sterilization (8). CONCLUSIONS: Promoting hand hygiene and reducing crowding through the provision of adequate living space and cohorting of training units may offer benefits in respiratory disease control. These interventions, along with UV lights and air dilution/ventilation, deserve further evaluation in controlled studies to assess their efficacy. NOVARDIs could benefit military and other populations living in close contact.     

Mothers' management of childhood diseases in Yorubaland: the influence of cultural beliefs

Several studies have noted that, besides inadequate availability of health care services in many areas, especially the less developed countries, certain disease-specific and non-disease-specific cultural beliefs may influence people's health seeking behaviour. It has even been noted that health services may be underutilized and several health and child care instructions may be ineffective or ignored in traditional and transitional societies where people's ideas and behavioural patterns conflict with the knowledge being passed to them (Feyisetan and Adeokun 1992; Feyisetan 1992). Feyisetan and Adeokun (1992) argued that non-adoption of modern preventive and curative measures cannot be attributed to poverty alone since the costs of some preventive and curative measures are not exorbitant in several of these societies. Rather, they suggested that the gap between awareness of modern health measures and health seeking behaviour must be sought in the social and cultural determinants of behaviour in such matters as child care and disease management. Earlier studies have noted that children in Nigeria die mainly from malaria, diarrhoea, measles, neonatal tetanus, whooping cough, tuberculosis, and bronchopneumonia (Morley and MacWilliam 1961; Ogunlesi 1961; Morley, Woodland and Martin 1963, 1966; Baxter-Grillo and Leshi 1964; Animashaun 1977; Tomkins 1981). Because these diseases are preventable at low cost to the individual, there is a need to investigate why large percentages of children are still subjected to many episodes of these diseases. In this paper, we examine (1) the mothers' perceptions of the aetiology of the three most cited childhood diseases in our study areas, measles, diarrhoea and fever, and the effect of these perceptions on the mothers' suggested curative measures; and (2) the persistence of the belief in abiku and how this cultural belief can influence mothers' management of childhood diseases. Since, for most mothers, perceptions of the aetiology of the childhood diseases are rooted in cultural beliefs, a brief review of disease-specific cultural beliefs is undertaken. In order to determine the effect of socio-economic factors, the mothers' perceptions of the aetiology of the childhood diseases, their recommended curative measures and the belief in abiku are examined according to selected socio-economic variables.     

138例肾移植术后患者医院感染及影响因素

目的：探讨肾移植术后患者医院感染情况及其影响因素，以采取有效预防控制措施。方法：对某院1999年2月～2002年12月收治的138例肾移植患者的病历进行回顾性调查分析。结果：肾移植术后发生医院感染75例，感染率54．35％；感染部位以下呼吸道最多见(33例，44．00％)，其次为泌尿道(19例，25．33％)。贫血、合并慢性疾病、低蛋白血症、总住院时间、排异反应、高血糖是主要危险因素。结论：肾移植术后医院感染率高，应引起重视；须针对危险因素采取有效措施，降低感染率。