焦炉逸散物所致肺癌一例

焦炉逸散物中含有大量的致癌性多环芳烃,可使焦炉作业人群的肺癌发生率显著高于一般人群,且随接触量、接触工龄增加而增高[1]。2014年我院(石家庄市职业病防治院)确诊某焦化厂焦炉逸散物所致肺癌1例,现报告如下。     

焦炉作业工人尿中1-羟基芘水平检测及其临床意义

目的 探讨焦炉作业工人尿中1-羟基芘水平及其临床意义.方法 将煤化工厂147名焦炉作业工人分为焦油组(接触焦油作业工人)60人和焦炉烟尘组(接触焦炉烟尘作业工人)87人,另选择79名非焦炉作业工人为对照组,采用高效液相色谱紫外检测方法对作业工人尿中1-羟基芘含量进行分析.结果 焦油组和焦炉烟尘组尿中1-羟基芘水平分别为(2.20±0.49)和(1.92±0.59)μg/L,明显高于对照组[(0.59±0.40)μg/L],差异有统计学意义(P＜0.01);焦油组尿中1-羟基芘水平明显高于焦炉烟尘组,差异有统计学意义(P＜0.01).焦油组与焦油烟尘组作业工人尿中1-羟基芘水平不受工龄、性别和吸烟等因素的影响.结论 焦炉作业工人尿中1-羟基芘水平明显增高,以接触者尿中1-羟基芘水平作为评价人体接触多环芳烃指标,可以较好地反映近期接触水平.     

尿1—羟基芘作为焦炉工人接触多环芳烃的生物监测指标

对焦炉作业环境中多环芳烃（ＰＡＨｓ）浓度、作业人工接触ＰＡＨｓ的量、尿１－羟基芘（１－ＯＨ芘）排出水平的调查结果表明，焦炉工人尿１－ＯＨ芘排出水平与接触ＰＡＨｓ量呈正相关，吸烟对尿１－ＯＨ比测定影响不明显。因此，尿１－ＯＨ芘可望作评价焦炉工人接触ＰＡＨｓ的生物监测指标。     

焦炉工外周血免疫球蛋白和TNF-α水平及其与尿1-羟基芘相关性分析

目的检测焦炉工外周血免疫球蛋白和TNF-α水平,分析其与尿1-羟基芘的相关性,探讨可能的焦炉逸散物暴露的效应标志物。方法以某炼焦制气厂86名焦炉逸散物暴露工人和35名对照工人作为调查对象,用ELISA方法检测外周血IgA、IgG、IgE和TNF-α水平;用改良的高效液相色谱法测定尿中1-羟基芘。结果焦炉逸散物暴露工人外周血中IgE和TNF-α水平均明显高于对照组工人水平,而IgA和IgG水平与对照组比较,差异无统计学意义(P0.05)。尿1-羟基芘与血清中TNF-α水平呈显著性正相关(r=0.316,P0.01)关系。结论焦炉逸散物可引起接触工人血清中IgE和TNF-α水平的改变,尿1-羟基芘与血清中TNF-α水平具有相关性,为探讨TNF-α水平作为焦炉逸散物早期效应标志物提供了有意义的线索。     

尿中2-萘酚作为多环芳烃接触水平的生物监测指标研究

目的 探讨尿中2-萘酚作为焦炉工多环芳烃接触水平生物监测指标的可行性.方法 以某市钢铁炼焦制气厂109名工人和50名本厂机关工作人员为对象,收集周末班后尿20ml,用改良的碱解-高效液相色谱法测定尿中2-萘酚.焦炉作业环境多环芳烃的车间空气监测结果以苯并(a)芘的浓度水平表示.用单因素方差分析、x2检验和spearman 等级相关分析.结果 尿中2-萘酚浓度炉顶工、炉侧工、炉底工和对照组分别为(11.32±4.82)、(9.82±5.11)、(5.24±4.97)和(2.97±2.36)μnol/mol Cr,呈炉顶>炉侧>炉底>对照组的趋势;尿中2-萘酚浓度与多环芳烃接触水平呈正相关关系(r=0.435,P<0.001).结论 焦炉工尿中2-萘酚水平可有效地反映个体短期多环芳烃接触的内剂量水平,可作为焦炉工多环芳烃接触水平的生物监测指标.     

焦炉逸散物对职业接触者神经功能和神经递质水平的影响

目的通过职业流行病学调查评价焦炉逸散物(多环芳烃类化合物)对职业接触人群神经功能和神经递质水平的影响。方法选择100名某钢铁公司焦化厂健康成年男性焦炉作业工人作为接触组,100名氧气厂健康成年男性工人作为对照组,平衡相关影响因素后通过问卷调查收集人群职业接触的基本信息及自觉症状等。采用高效液相色谱-电化学检测法测定研究对象血浆中多巴胺(DA)、肾上腺素(AD)、去甲肾上腺素(NE)和五羟色胺(5-HT)的水平。结果接触组研究对象出现打喷嚏、嗓子痛、咳嗽、食欲不好、皮疹的比例高于对照组,差异有统计学意义(P0.05);接触组研究对象在过去1年中出现轻、中、重度集中精力或记忆困难的总比例高于对照组,差异有统计学意义(P0.05)。接触组研究对象血浆中的NE,DA,5-HT水平明显高于对照组,差异有统计学意义(P0.05);2组研究对象血浆中的AD水平比较,差异无统计学意义(P0.05)。结论含多环芳烃类化合物的焦炉逸散物可对接触人群的神经功能和血浆中的神经递质水平产生影响。     

色谱—质谱法分析焦化厂空气中气相多环芳烃

焦化厂工人癌症发病率明显高于当地居民或本厂对照组,其原因与职业性接触焦炉逸散物有关[1～3]。焦炉烟气逸散到空气中,一部份形成气溶胶颗粒,一部份呈气态存在。低环的多环芳烃(PAH)因本身有一定的蒸气压[4,5],在空气呈气一固两相平衡的状态。单用玻璃纤维滤纸     

多环芳烃对接触人群外周神经传导速度的影响

为探讨多环芳烃对焦炉工外周神经功能的影响,选取焦炉工炉顶、炉侧、炉底工种各15名作为研究对象。收集工人的班后尿,用高效液相色谱法检测尿中1-羟基芘的水平,同时测定研究对象的双侧正中神经和尺神经的感觉和运动神经(排除受伤神经)传导速度(SCV和MCV)、远端潜伏期(SL和ML)。结果显示焦炉工人尿中1-羟基芘水平显著高于对照组,各接触组感觉和运动神经传导速度、远端潜伏期与对照组比较差异无统计学意义,提示多环芳烃未引起焦炉作业工人外周神经传导速度的改变。 更多还原     

某焦化企业焦炉逸散物职业病危害调查

采用职业卫生学调查、现场检测和健康监护体检的方法对某焦化公司焦炉逸散物相关工作场所进行职业卫生调查。结果显示,炼焦工段焦炉作业工人接触焦炉逸散物时间加权平均浓度超标率为75.0%,按超限倍数要求,作业工人接触焦炉逸散物超标率为33.3%,其中炉顶导烟车工为高度危害作业。 更多还原     

某焦化厂作业场所污染水平及作业工人身体状况调查

80年代我国对焦化厂的焦炉逸散物进行了调查,认为职业性接触焦炉逸散物、煤焦油蒸气与工人肺癌、皮肤癌有直接关系。河南省某焦化厂80年代调查时,有3座焦炉炼焦炭,在炼焦过程中产生大量的脂肪烃、多环芳烃类化合物、一氧化碳等。经过近几年的改造和治理,为了加强劳动保护,综合治理污染,保障工人及周围居民的身体健康,我们以苯并(a)芘为代表物分别于1997年和1999年2次对该厂3座焦炉的污染状况进行了卫生学调查。     

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.     

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.     

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.     

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.