工作应激与科技人员健康的关系

目的通过调查科技人员当前工作应激的水平和健康状况,研究工作应激和健康状况之间的关系.方法在福建省福州市随机抽取988名科技人员进行问卷调查,男性668名,女性320名,平均年龄35.62岁(21～81).年龄＜40岁的有698名,≥40岁的有290名.高校老师423名,医务工作者233名,研究所的科研人员251名以及高科技企业的工程技术人员81名.文化程度包括大专、本科、硕士和博士.结果调查对象中66.10%处于高工作应激状态,29.35%处于正常工作应激状态,而有4.55%处于低应激状态.工作应激的水平在不同年龄、性别和职业中没有差异性.＜40岁组和≥40岁组的躯体症状发生率都随着应激程度的增高而增高.＜40岁组的躯体症状除了躯体痛和胃肠不适外,失眠、头昏头痛、心慌、疲劳、食欲不振、腰酸背痛均与应激程度存在关联性(P＜0.05).但是,≥40岁组只有胃肠不适和疲劳与应激程度存在关联性(P＜0.05).两个年龄组的心理症状(抑郁、焦虑、情绪波动)均与应激程度存在高度关联性(P＜0.05).logistic回归分析显示生活事件,性别,有无业余爱好,有无研究课题,年龄和应激状况总分都是被调查者健康状况的影响因素.在控制了其他影响因素之后,与低应激者相比,正常应激者发生疾病的OR值为1.05,而高应激者发生疾病的OR值为4.13.结论工作应激是影响科技人员健康的一项危险因素.科技人员的健康状况受到工作应激的影响.     

冠状动脉梗死范围和疼痛程度与AMI患者急性应激状态的相关性

目的 了解急性心肌梗死患者急性应激反应情况及其与冠状动脉梗死范围、疼痛程度的相关性。方法 对2015年7月-2016年3月唐山工人医院急性心肌梗死患者364例,采用一般资料、斯坦福急性应激反应问卷(SASRQ)、疼痛视觉模拟评分尺(VAS)进行年龄、性别等一般资料和急性应激反应及疼痛程度的评测。结果 364例患者SASRQ总分介于40~56分者占23.4%,57~150分者占28.6%;根据SASRQ单个条目评分≥3分为阳性症状,有分离症状者42.6%,有创伤再体验症状者55.5%,有回避症状者41.8%,有醒觉性增高症状者70.9%。冠状动脉病变程度、疼痛与AMI患者急性应激状态呈负相关,多支病变、疼痛严重者的SASRQ总分及各个维度评分较高,多因素分析显示,糟糕天数、烦扰程度、受教育程度和疼痛最终进入SASRQ总分回归方程,差异有统计学意义(P<0.05)。结论 AMI患者存在明显的急性应激症状,多支病变、疼痛严重患者发生急性应激障碍的可能性越大。     

煤矿井下作业工人心理卫生现状调查分析

[目的]探讨煤矿井下作业工人心理健康状况。[方法]400名煤矿井下作业工人和400名地面作业工人统一填写症状自评量表(SCL-90)和一般情况调查表。将其SCL-90各因子分、总分、总均分等与400名地面作业工人进行对比和统计处理,并根据SCL-90总分≥200或任一因子分≥3视为存在心理问题,将煤矿井下作业工人分为心理问题组和心理健康组。[结果]煤矿井下作业工人各因子分、总分、总均分、阳性项目数、阳性症状均分均高于地面作业工人(P﹤0.01)。[结论]煤矿井下作业工人健康状况存在心理问题,值得关注,应加强心理健康教育、咨询等综合性干预。     

某市流水线作业工人人格特征与职业应激的关系

目的 了解某市流水线作业工人人格特征与职业应激的关系.方法 应用职业应激测量工具(OSI)和艾森克个性问卷(EPQ)对某市452名流水线作业工人进行测试.结果 EPQ量表的N分与职业应激因素、躯体不适、行为类型评分呈正相关(r值分别为0.196、0.202、0.164,P<0.01),与心理卫生水平评分呈负相关(r=-0.196,P<0.01);P分与职业应激程度、躯体不适评分呈正相关(r值分别为0.128、0.218,P<0.01),与工作满意感、应付策略评分呈负相关(r值分别为-0.146、-0.140,P<0.01);E分、L分与行为类型评分呈负相关(r值分别为-0.159、-0.138,P<0.01);E分与应付策略评分呈正相关(r=0.176,P<0.01),L分与职业应激程度、躯体不适、对周围事件的解释评分呈负相关(r值分别为-0.139、-0.140、-0.111,P<0.01,P<0.05).结论 具有神经质倾向、精神质倾向和性格内向的个性特征者对职业应激因素的负性主观评价更多,其身心健康状况较差.     

护士疲劳程度与工作压力源的相关性分析

目的了解护士疲劳的现状及其与工作压力源的关系。方法采用疲劳量表-14、护士工作压力源量表对306名在职护士进行问卷调查。结果护士的疲劳总分为7.17±3.41,躯体疲劳得分为4.84±2.19,脑力疲劳得分为2.33±1.67。疲劳总分、躯体疲劳得分、脑力疲劳得分均与工作压力源的5个维度呈正相关(P0.01);疲劳总分、躯体疲劳得分与年龄及护龄呈正相关(P0.05)。Logistic回归分析显示,压力总分的OR值是为1.068;与ICU相比,内科、外科、手术室、妇科、儿科的OR值分别是为0.095、0.187、0.187、0.029和0.005。结论工作压力是影响护士疲劳程度的主要因素,管理者应注重护士压力应对能力的培养,关注护士的工作和生活,降低护士整体疲劳程度。     

广州市区级卫生监督人员工作应激状况及相关因素研究

目的了解广州市区级卫生监督工作人员的工作应激状态及相关影响因素,据此提出相应的预防干预措施。方法应用专用调查表,对广州市12个区的卫生监督所在编工作人员进行调查。结果在人际关系维度上,66．25％的人员处于高应激状态;在工作条件维度上,34．38％的人员处于正常应激状态;在工作兴趣维度上,72．5％的人员处于高应激状态。而应激总分中,则有55％的人员处于高应激状态。工作应激的相关因素涉及人口统计学变量和职业相关因素变量等多方面。结论通过合理配置卫生监督人力资源,加强卫生执法宣传,提供社会支持来缓解卫生监督工作人员的工作应激程度。     

互联网企业员工疲劳及影响因素研究

目的 了解互联网企业员工躯体疲劳和脑力疲劳现状,探究疲劳的影响因素。 方法 于2016年6月~9月,采用横断面研究方法对3省(市)35家互联网企业3 603名员工进行了问卷调查,分别采用疲劳量表-14与简明中文版职业应激量表、职业倦怠自评量表、工作相关肌肉骨骼疾患量表,分析互联网企业员工疲劳现况及影响因素,运用多因素Logistic二元回归模型,分析职业应激等因素对疲劳的影响。 结果 互联网企业员工躯体疲劳得分(4.53±2.56),脑力疲劳得分(2.37±1.64),总疲劳得分(6.90±3.55)。躯体疲劳与职业倦怠、肌肉骨骼疾患呈明显正相关(r=0.426、r=0.485,P<0.05),脑力疲劳与职业倦怠呈正相关(r=0.429,P<0.05)。JDC模式职业应激、ERI模式职业应激、职业倦怠、高度肌肉骨骼系统疾患为躯体疲劳发生的危险因素,OR值分别为1.58、1.72、4.08、5.91(P<0.05);上述影响因素同为脑力疲劳发生的危险因素,OR值分别1.73、1.37、2.61、2.08(P<0.05)。睡眠时间7 h以上是脑力疲劳、躯体疲劳发生的保护因素,OR值分别为0.61、0.62(P<0.05)。 结论 互联网企业员工疲劳现状不容乐观,企业关注员工职业心理健康、积极采取有效措施对缓解互联网企业员工疲劳至关重要。     

山西煤矿接尘工人生存质量的影响因素研究

目的对山西省煤矿接尘工人的生存质量进行测评,探讨其影响因素。方法采用分层整群随机抽样的方法,选取山西省7家煤矿的2 300例接尘工人为调查对象,应用《SF-36量表》对其生存质量进行调查,采用SAS 9.2统计软件进行多重线性回归分析,探讨其生存质量的可能影响因素。结果煤矿接尘工人生存质量生理健康领域(PHC)影响因素为家庭人口数、呼吸道症状出现频率、工作疲劳度等13个因素(F=82.50,P<0.000 1),其中影响最大的是家庭人口数(b=-0.903,P=0.016 5);心理健康领域(MHC)影响因素为呼吸道症状出现频率、工作疲劳程度、对单位福利满意度等17个因素(F=63.71,P<0.000 1),其中影响最大的是呼吸道症状出现频率(b=-4.739,P<0.000 1)。结论影响煤矿接尘工人生存质量的因素是多方面的,需采取综合措施提高煤矿接尘工人的生存质量。     

女性医生疲劳状况的影响因素分析

目的分析济宁市女性医生疲劳状况的影响因素,为进一步预防女性医生慢性疲劳的发生提供参考. 方法 采用疲劳量表(FS-14)对济宁市的120名女性医生进行问卷调查,收回有效问卷109份,有效率为90.83%,对所得结果进行统计分析. 结果 女性医生的躯体疲劳、脑力疲劳、疲劳总分得分与常模组相比均较高且有统计学意义.线性回归分析,与躯体疲劳、脑力疲劳、疲劳总分具有统计学意义的影响因素分别是工作紧张度、文化程度(保护性因素)、工作紧张度.结论 女性医生疲劳程度比普通人群严重,解决女性医生疲劳的关键是缓解工作紧张程度.     

煤矿工人慢性胃炎流行病学调查研究

目的探讨煤矿井下工人慢性胃炎的患病现状及患病的危险性因素。方法对617名男性煤矿井下矿工采用单纯随机抽样问卷方法进行慢性胃炎相关症状调查,根据症状决定进行胃镜检查。结果肥城矿区井下作业工人慢性胃炎患病率为30.79%,矿区附近一般人群患病率为16.37%。两组患病率差异有统计学意义(P<0.05)。井下作业环境、口服非甾体抗炎药、心理障碍、不良生活习惯是患病的危险性因素。结论慢性胃炎已成为矿井下煤矿工人常见的疾病,应积极改善工作环境以及生活习惯。     

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.