沿海产盐区与非产盐区妊娠期妇女碘营养状况及甲状腺功能水平分析

目的了解福建沿海产盐区与非产盐区妊娠期妇女碘营养状况及其甲状腺功能水平,为防治碘缺乏病提供科学依据。方法选择产盐区翔安区和非产盐区集美区为调查点,每个点随机抽取60名以上妊娠期妇女作为调查对象,采集孕妇的家中盐样、尿样及血样,分别测定盐碘、尿碘及血清甲状腺激素。结果产盐区与非产盐区孕妇合格碘盐食用率分别为81.69%和100.00%;产盐区与非产盐区孕妇尿碘的中位数分别为120.55μg/L和153.35μg/L,尿碘〈150μg/L的比例分别为62.2%和46.8%,孕早期尿碘水平〉孕中期〉孕晚期;产盐区与非产盐区孕妇的甲状腺过氧化物酶抗体（thyroid peroxidase antibody,TPOAb）,抗甲状腺球蛋白抗体（antithyroid glubulin antibody,TgAb）,总三碘甲状腺原氨酸（total-triiodothyronine,TT3）,总甲状腺素（total thyroxine,TT4）,游离三碘甲状腺原氨酸（free triiodothyronine,FT3）,游离甲状腺素（free thyroxine,FT4）,促甲状腺激素（thyroid stimulating hormone,TSH）,甲状腺球蛋白（tryroglobulin,Tg）中位数均在正常范围,产盐区与非产盐区孕妇的FT3、FT4、TSH之间差异均有统计学意义,产盐区孕妇的FT3、FT4均低于非产盐区,而产盐区孕妇的TSH则高于非产盐区。结论孕妇是易缺碘人群,产盐区孕妇相对非产盐区碘缺乏更为严重。应对孕妇开展常规碘营养和甲状腺功能监测,进一步做好碘营养知识的宣传教育工作,控制碘缺乏病的发生。     

浙江省产盐区人群碘营养水平调查

调查我省沿海产盐区居民碘盐使用情况和人群碘营养水平 ,将为我省 2 0 0 0年达到消除碘缺乏病阶段目标后 ,制订巩固碘缺乏病防治方案提供科学依据。为此 ,于 2 0 0 0年进行了本项工作。目的和方法1　目的　 (1)调查产盐区中在校小学生甲状腺肿大率、人群尿碘、新生儿促甲状腺素 (ＴＳＨ) ,并将调查结果与我国消除碘缺乏病标准、国际控制碘缺乏病理事会 (ＩＣＣＩＤＤ)推荐标准及全省 1999年配合全国统一进行的碘缺乏病流调结果进行比较得出产盐区人群的碘营养状况。 (2 )调查产盐区居民碘盐使用情况 ,分析碘盐供应情况与人群碘营养水平的关…     

轻度碘缺乏病流行区不同人群碘营养状况调查

江苏省产盐大县响水县位于盐城市北部沿海,属轻度碘缺乏病危害地区。由于该县产盐量大,盐区范围广,境内私盐泛滥。自1995年实施全民食盐加碘以来,尽管各级政府和有关职能部门不断努力,居民碘盐覆盖率仍为30％～40％,一些靠近盐场的乡镇,群众多数食用非碘盐。尽管碘盐覆盖率较低,但该县人群尿碘水平和甲肿率与全市其他各县并无显著性差异,其尿碘水平甚至高于一些碘盐覆盖率较高的县。为探讨影响该地区居民碘营养水平的因素,于2004年8～9月份对当地不同人群的碘营养状况及其影响因素进行了调查,报告如下。     

宣城市消除碘缺乏病后居民碘营养状况评估

目的动态评价人群碘营养状况及病情的消长趋势,为适时采取有针对性的防治措施和科学调整干预策略提供依据方法采取随机抽样方法,对居民户食用盐、8～10岁儿童尿碘、甲状腺肿大率、居民饮用水碘等指标进行监测分析;对小学生及家庭主妇碘缺乏病防治知识知晓率进行问卷调查结果碘盐覆盖率为99.95%,合格碘盐率为99.90%。8～10岁儿童甲状腺肿大率为1.00%,尿碘中位数为253.29ug/L,居民饮用水碘中位数为2.92ug/L,人均食盐使用量中位数为8.84g/d,小学生及家庭主妇碘缺乏病防治知识知晓率分别为96.29%、91.11%。结论宣城市消除碘缺乏病后居民碘营养水平基本适宜,但儿童摄入碘量略偏高;外环境缺碘状态未改变,需建立科学长效防治机制,保持长期消除缺乏病状态。     

潍坊市产盐区与非产盐区碘缺乏病防治资料分析

目的了解和评价潍坊市产盐区与非产盐区碘缺乏病的防治状况,探讨控制碘缺乏病的效果。方法对2005、2007、2009、2013年潍坊市碘缺乏病防治调查资料中碘盐、尿碘、甲状腺肿大和水碘等监测指标进行回顾性分析。结果4年检测13 983份盐,合格的12 970份,合格率为92.76%,合格碘盐食用率75.23%升至96.59%。尿碘中位数为185.80～282.71μg/L,呈逐年上升趋势,产盐区与非产盐区差异无统计学意义（z=-0.18、-1.27、-1.17、-1.25,P〉0.05）。全市儿童甲状腺肿大率为2.87%,各年度产盐区、非产盐区均〈5%。全市水碘中位数为5.02μg/L,产盐区、非产盐区为10.28、4.22μg/L。结论产盐区和非产盐区人群体内碘营养充足,甲状腺肿大率较低。     

2014年北京市碘营养监测结果分析

目的了解北京市碘缺乏病防治现况。方法按照《东部地区碘营养监测试点方案》,在北京市抽取8个区县开展碘盐监测、8~10岁学生人群及孕妇人群的碘营养水平监测;在其中2个区县同时检测8~10岁学生甲状腺容积。结果北京市碘盐覆盖率为97.42%,合格碘盐食用率为95.67%,城乡间碘盐监测结果差异无统计学意义;北京市8~10岁学生人群尿碘中位数176.0!g/L,城乡间人群尿碘水平差异有统计学意义;孕妇人群尿碘中位数:159.6!g/L,城乡间人群尿碘水平差异无统计学意义;8~10岁学生人群甲状腺肿大率为0.30%;孕妇人群碘缺乏病防控知识知晓率为88.85%。结论北京市实现消除碘缺乏病控制目标,但需要加强孕妇碘缺乏病防控与健康教育工作。     

2016～2020年沂水县重点人群碘营养监测

目的通过分析沂水县重点人群碘营养状况的动态变化,为科学补碘调整干预策略提供依据。方法 2016～2020年每年将所辖乡镇按东、西、南、北、中划分5个片区,每个片区随机抽取1个乡镇(街道),每个乡镇(街道)抽取20名孕妇及1所小学的8～10岁非寄宿学生40名,采集所有对象的尿样和家中食用盐样,检测尿碘和盐碘(2017年无尿碘检测任务)。结果 2016～2020年8～10岁儿童碘盐覆盖率分别为98.00%、99.00%、85.50%、97.00%、98.00%,合格碘盐食用率分别为90.50%、95.00%、80.00%、95.00%、97.50%;孕妇碘盐覆盖率分别为92.00%、95.00%、89.00%、95.00%、99.00%,合格碘盐食用率分别为91.00%、91.00%、74.00%、91.00%、99.00%。各年份间儿童、孕妇碘盐覆盖率、合格碘盐食用率差异均有统计学意义(P0.01)。2016～2020年8～10岁儿童尿碘中位数分别为211.00、139.00、213.50、210.50μg/L,孕妇尿碘中位数分别为180.00、91.00、127.00、180.00μg/L。各年份间儿童、孕妇尿碘中位数差异均有统计学意义(P0.01)。结论 2018年沂水县未达到碘缺乏病消除判定标准。2016、2019、2020年儿童碘营养为超适宜水平,2018～2019年孕妇碘营养为碘缺乏状态。     

2016—2022年彭泽县重点人群碘营养监测结果分析

目的：分析2016—2022年彭泽县重点人群的碘营养监测结果,为制定调整碘营养干预措施提供科学依据。方法：按照《江西省碘缺乏病监测方案(2016年版)》要求,每年随机抽取彭泽县东南西北中五个方位的5个乡镇200名8～10岁儿童、100名孕妇,采集其尿碘与家庭食盐样品,采用直接滴定法和分光光度法检测其水平。结果：彭泽县总体家庭盐碘中位数为24.1 mg/kg,碘盐覆盖率为99.9%,合格碘盐覆盖率为93.7%,不同年份间重点人群家庭盐碘水平无明显差异(P<0.05)。儿童尿碘中位数分别为242.2μg/L,<100μg/L比例为7.2%,>30μg/L比例为29.4%,不同年份间有所差别(P<0.05)。不同年龄组、性别儿童尿碘分级构成无明显差异(P>0.05)。孕妇尿碘中位数分166.6μg/L,不同年份间有所差别(P<0.05)。不同孕期孕妇尿碘分级构成无差别(P>0.05)。儿童尿碘碘缺乏2.0%～10.5%、碘过量25.5%～37.0%之间波动,孕妇尿碘碘缺乏26.0%～58.0%、碘过量0.0%～9.0%之间波动。结论：2016—202...     

名山县消除碘缺乏病综合干预效果分析

[目的]探讨居民合格碘盐食用率低的原因,通过综合干预措施的实施,提高目标人群的碘缺乏病防治知识。[方法]采用碘盐市场监管,举办教师培训班,广泛开展多种形式的宣传等综合干预措施;在干预措施实施前后对盐库、销售点、居民的盐样进行碘含量检测,对家庭主妇的尿碘进行检测,同时对学生、教师、家庭主妇进行问卷调查。[结果]综合干预措施实施前后,盐库、销售点的盐样碘含量全部合格,碘盐覆盖率100%,居民合格碘盐食用率由干预前的93.35%上升至干预后的99.00%,干预后居民合格碘盐食用率高于干预前。家庭主妇尿碘中位数干预前后分别为208.82μg/L、228.84μg/L;健康教育问卷调查显示：学生、教师、家庭主妇碘缺乏病防治知识知晓率、知识传播率有了显著提高。[结论]名山县实施消除碘缺乏病综合干预项目取得显著成效。     

轻度碘缺乏病流行区食用碘盐和食用非碘盐不同人群碘营养状况调查

响水县位于盐城市北部沿海,北与连云港市毗邻,属轻度碘缺乏危害地区。该县系江苏省产盐大县,年产海盐80万吨左右,约占全省海盐产量的1/3。由于该县产盐量大,盐区范围广,受利益驱动的影响,境内私盐冲销严重,自1995年实施全民食盐加碘以来,尽管各级政府和有关职能部门多方努力,但全县居民碘盐覆盖率一直在30%～40%左右,一些靠近盐场的乡镇,群众基本上都食用非碘盐,严重影响了该县碘缺乏病的防治进程,并被NTTST列为全国碘盐重点干预项目县之一。但在多年的调查中我们发现,尽管该县碘盐覆盖率一直较低,但该县人群尿碘水平和甲肿率与全市其他各…     

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.