上海市婴幼儿血铅水平与体格发育的关系

目的探讨低水平铅暴露对儿童体格发育的影响。方法在上海市5个区县30所托幼机构,对1969名儿童进行了血铅水平的流行病学调查和体格发育等指标测量,并根据儿童身高、体重、头围和胸围计算其Z标准分,然后与血铅水平进行相关分析和逐步回归分析。结果上海市儿童血铅水平几何均数为0．400μmol／L,≥0．483μmol／L的比例为37．8％,血铅水平的几何均数与儿童身高、体重及头围的Z标准分呈显著的负相关。结论低水平铅暴露对上海市婴幼儿的体格发育可能具有不利影响。     

深圳地区妊娠各期铅暴露水平与新生儿神经发育和视听觉功能的研究

【目的】了解深圳地区妇女妊娠各期铅暴露水平及对子代神经发育的影响状况。【方法】随机抽取不同孕周的孕妇,使用石墨炉原子吸收法对孕妇静脉血进行铅含量测定,并追踪其中部分孕妇至产后2~7 d,检测新生儿神经发育情况和脑干视、听觉诱发电位。【结果】妊娠期平均血铅水平(44.46±21.99)μg/L,早期为47.96μg/L,中、晚期分别为44.14μg/L和37.82μg/L,妊娠早期与晚期血铅水平有显著性差异;低水平铅暴露新生儿听觉诱发电位检查发现右耳I波潜伏期较左侧延长。【结论】妊娠早期血铅水平较高;孕期低水平铅暴露对新生儿听觉发育的影响可能存在左右耳差异。     

郑州市2 553例儿童血铅水平分析

随着现代工业及交通业的迅猛发展，铅对环境的污染日趋严重。铅对人体有诸多负面影响，低水平铅暴露也可影响儿童的生长发育、心理行为发育、智力发育和潜能发育。前瞻性研究表明，生命早期对低水平铅暴露特别敏感和脆弱，而同样的铅暴露水平对年长儿则无明显影响。郑州市幼小儿童大样本血铅水平现状资料尚缺乏。为此对2003年7月～2004年7月检测的2553例0～14岁儿童血铅水平进行分析，现将结果报告如下。     

铅暴露对一氧化氮及氧自由基代谢的影响

【目的】了解番禺地区儿童铅暴露情况,探讨高水平铅暴露对儿童血浆中一氧化氮(nitricoxide,NO)、一氧化氮合成酶(nitricoxidesynthase,NOS)、超氧化物歧化酶(superoxidedismutase,SOD)、丙二醛(malondial-dehyde,MDA)的影响,以及NO系统与氧自由基之间的相互关系。【方法】对440例1~3岁入托体检的健康儿童,测定其血铅、血浆NO、NOS、SOD及MDA水平。【结果】儿童血铅水平为(0.561±0.211)μmol/L,≥0.483μmol/L(100μg/L)者占51.14%;高水平铅暴露的儿童血浆NOS活性明显降低(P<0.01),NO亦降低,但差异无显著性(P>0.05);NOS与铅、SOD呈负相关,与NO呈正相关,而SOD与MDA呈负相关;以NOS作为因变量进行多元回归分析,回归方程为Y’=4.228-5.309×血铅-0.083×SOD。【结论】环境铅污染对儿童已构成严重的威胁,应引起社会各界高度重视;高水平铅暴露儿童血浆中NOS活性受到明显抑制,使NO的生成减少,而且NOS活性与SOD活性存在有一定相关性。     

胎儿期低水平铅暴露对早期婴儿神经行为发育影响的研究

目的:探讨胎儿期低水平铅暴露对早期婴儿神经行为发育的影响。方法:研究对象80例,抽取脐血用原子吸收石墨炉法检测血铅水平,用Bayley婴儿发育量表在3个月时测试MDA、PDA。结果:脐血血铅水平与婴儿精神发育指数(MDI)、婴儿心理发育指数(PDI)有显著负相关,以P50为界,较高脐血血铅组高于较低脐血血铅组,差异有显著性。结论:胎儿期低水平铅暴露对神经行为发育有影响,提示预防儿童铅中毒要从胎儿期抓起。     

学龄儿童血铅水平及高血铅对儿童健康的影响调查

【目的】了解2～12岁学龄儿童血铅水平,探讨高血铅对儿童健康的影响。【方法】采用原子吸收法测血铅含量,并对其中高血铅和临界高血铅者进行临床表现调查与部分血液指标检测,且与正常者比较。【结果】高血铅检出率为2.27%;临界高血铅检出率为3.34%。高血铅组、临界高血铅组头痛、食欲减退、咬指甲、咬学习用品发生率均高于对照组,平均红细胞容积、平均红细胞血红蛋白量均低于对照组,差异有显著性(P<0.01)。【结论】2～12岁学龄儿童的血铅水平不高,但高血铅、临界高血铅对儿童的健康已受到一定影响。     

妊娠低铅暴露与新生儿神经行为及体格发育的关系

【目的】探讨妊娠低铅暴露与新生儿神经行为及体格发育的关系,为有效预防提供参考依据。【方法】选择280例劳务女工产妇及所产280例新生儿为研究对象,检测妊娠早中晚期、分娩时和新生儿脐血铅水平,取其对数值分别与新生儿行为发育评分(NBNA),4项体格指标Z标准分进行相关分析;以孕中期血铅浓度第25,50,75百分位,分别构成相对高低铅组,进行神经行为及体格发育比较。【结果】孕中期血铅对数值与行为能力、主动肌张力、总得分及其头围和体重Z标准分显著负相关(P0.05);在58μg/L分界点时,高铅组NABA总得分显著小于低铅组(t=2.326,P0.05)。【结论】孕中期血铅水平作为孕期铅暴露示标有更高的敏感性;孕中期血铅水平即使在58μg/L水平,已对新生儿神经行为发育造成负性影响。     

儿童齿铅水平与感觉统合、行为发育的相关性研究

【目的】了解学龄前儿童齿铅水平对感觉统合能力和行为发育的影响，为改善儿童早期发展水平提供参考依据。【方法】对在园就读的171名儿童收集统一部位的离体乳牙测铅含量。【结果】本次调查儿童感觉统合失调和行为异常的发生率分别为37．4％、38．89％；以ROC曲线法确定本组资料的高齿铅值为19．50μg／g，发现高齿铅水平对儿童感觉统合能力总评定存在极显著的负相关关系（P〈0．01）．对感觉统合分测验中的学习能力影响最大．差异有显著性（P〈0．05）；同时显示与行为发育的总分评定呈显著正相关性（P〈0．05）。【结论】慢性铅的累积导致儿童感觉统合失凋和行为异常比率增高，对感觉统合能力发展和行为发育都有很大的影响。     

胎儿期铅暴露水平与脐带血钙、铁、锌含量的相关研究

【目的】研究胎儿期铅暴露水平与胎儿体内钙、铁、锌等矿物元素含量的相关关系。【方法】以脐血血铅含量作为胎儿期铅暴露的指标,脐血钙、铁、锌含量作为胎儿体内相应元素含量的指标,采用BUCK-210型原子吸收光谱仪石磨炉原子吸收光谱法和分光光度法检测100份脐带血标本四种元素的含量。【结果】胎儿体内血铅水平处于在CDC标准的Ⅰ级(<0.483μmol/L)、Ⅱ-A(0.483-0.676μmol/L)水平时,即与二价元素钙、铁含量呈显著负相关(P<0.05);血铅≥0.247μmol/L者,其脐血钙、铁含量明显低于血铅水平<0.247μmol/L者,差异有显著性(P<0.05)。【结论】在认为相对安全的铅暴露水平,随着胎儿体内血铅水平的上升,二价元素钙、铁含量有下降趋势,亦即铅作为一种外来毒素,有可能干扰胎儿体内的正常矿物元素代谢。     

低水平铅暴露对儿童智力发育影响的研究进展

当前由于减少了铅的商业用途 ,控制其环境排放以及医疗卫生事业的进步与发展 ,过去所见到的严重铅中毒事件已少见 ,一些发达国家和发展中国家人体血铅水平在过去的十年里呈下降趋势〔1〕。目前对铅毒性研究的重点已转向环境铅对人体健康的潜在威胁 ,特别是对儿童健康的影响 ,其中尤以低水平铅暴露对儿童智力发育的影响倍受关注。近年来铅对神经系统影响的神经生理研究、铅对儿童智力发育影响的流行病学调查研究以及铅对学习能力影响的动物实验等等方面都有较多的报道。本文从低水平铅暴露对儿童智力发育影响综述如下。1　铅对儿童智力发育影…     

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.     

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.     

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.     

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.