2004—2013年某金属加工企业职业伤害流行病学调查

对某金属加工企业2004—2013年间发生的职业伤害事故进行回顾性调查。职业伤害平均发生率为1.07%,不同年份之间差异无统计学意义(χ2=16.03,P=0.066)。受伤部位多为腕部和手部(占51.26%),不同部位伤害发生率差异不同(χ2=81.72,P=0.000)。伤害主要原因为违规操作(占39.52%)和设备异常(占24.55%)。金属加工企业需有针对性开展职业伤害干预。     

重庆市居民伤害状况调查

目的了解重庆市居民伤害发生状况,为开展伤害预防提供依据。方法采用多阶段随机抽样方法,选取重庆市3个区1 087名居民为调查对象,由经过培训的调查员进行入户调查,了解调查对象的人口学信息、伤害状况。用SAS 8.0软件进行统计学分析,计数资料的比较用χ2检验。结果过去1年内伤害发生率为20.33%,男性人群伤害发生率为21.54%,女性人群伤害发生率为18.99%。不同年龄人群伤害发生率随着年龄的增长而降低,差异有统计学意义(χ2=44.49,P0.05)。不同职业人群中伤害发生率差异有统计学意义(χ2=30.19,P0.05),技术工作人员伤害发生率(31.11%)较高。不同性别伤害类型分布差异有统计学意义(χ2=20.63,P0.05),男性人群因骑摩托车或电动车、体育运动引起的伤害发生率(分别为4.20%、8.93%)明显高于女性人群(分别为1.94%、4.46%),女性人群在家庭生活中烫伤、动物咬伤、触电、碰撞等伤害发生率(14.15%)明显高于男性人群(9.98%)。结论重庆市居民意外伤害发生率较高,应针对伤害危险因素全面系统地实施人群干预措施,提高居民对伤害的预防和自我保护意识,预防控制伤害的发生。     

马鞍山市医务人员艾滋病职业暴露危险因素现况调查

目的了解和掌握医务人员艾滋病职业暴露危险因素及防护现况,为医务人员艾滋病职业暴露防护提供科学依据。方法采用整群抽样方法选择马鞍山市级综合医院4家、县级医院1家、乡镇卫生院15家、社区服务中心12家、村卫生室25所,于2010年11月~2011年1月对567名医务人员进行问卷调查。结果 27.0%(153/567)的医务人员有过艾滋病职业暴露经历;60.8%(345/567)在诊疗或护理操作时刺伤过自己;46.0%(261/567)的医务人员在诊疗服务中曾被血液或体液溅到破损的皮肤或粘膜上。艾滋病职业暴露率在不同级别医院、科室医务人员之间差异有统计学意义(χ21=33.14,P<0.001;χ22=15.21,P=0.019);针刺伤发生率在不同职业、科室医务人员之间差异有统计学意义(χ21=6.31,P=0.043;χ22=71.07,P<0.001);有血(体)液溅到破损的皮肤或粘膜上的发生率在不同职称、职业及科室医务人员之间差异有统计学意义(χ21=15.70,P=0.001;χ22=6.46,P=0.040;χ23=49.83,P<0.001)。结论马鞍山市医务人员对艾滋病职业暴露相关知识掌握较低,发生...     

北京海淀区和平谷区儿童意外伤害的比较研究

目的 比较并分析北京市海淀区和平谷区0-6岁儿童意外伤害发生的特点及差异性.方法 采用多级整群抽样方法,对海淀区2 970名和平谷区2 558名0-6岁儿童进行伤害现况调查,并对伤害发生率进行差异性比较.结果 共调查5 528例,伤害发生率为8.65%(478/5 528).海淀区0-6岁儿童非致命性伤害发生率为10.54%(313/2 970),平谷区为6.45%(165/2 558).海淀区伤害发生率高于平谷区,其差异具有统计学意义(χ2=29.081,P<0.001).依据年龄、性别和严重程度分层分析:两区高年龄段(3-6岁)不同年龄组间儿童意外伤害的发生率经比较其差异均具有统计学意义(均P<0.05);不同性别儿童意外伤害的发生率海淀区均高于平谷区(男童χ2=9.145,P=0.002;女童χ2=21.973,P<0.001);海淀区重度伤害发生率为0.13%,平谷区为0.51%,其差异性亦具有统计学意义(χ2=6.255,P=0.012).结论 两区0-6岁儿童的伤害情况均较为严重,应根据城乡伤害发生的特点,有针对性地制定干预措施,预防伤害的发生.     

岱山县小学生意外伤害现况调查

目的了解岱山县城区小学生意外伤害发生的情况,揭示意外伤害发生的原因,探讨预防意外伤害的干预措施。方法采用随机整群抽样的方法,对岱山县城区2所小学1 570名1～5年级学生家长进行问卷调查,用SPSS13.0软件进行统计分析。结果共调查1 520名学生,一年内发生意外伤害239例,伤害发生率为15.72%。男生意外伤害发生率高于女生(χ~2=4.20,P<0.05)。伤害发生地点以校内(30.77%)和家中(28.85%)最为常见。意外伤害类型前6位依次为跌伤、碰撞伤、扭伤、交通事故、烧烫伤、割刺伤。学生母亲文化程度不同,学生意外伤害发生率差异有统计学意义﹙χ~2=14.53,P<0.01﹚;父亲文化程度不同,学生意外伤害发生率差异无统计学意义(P>0.05);家庭收入水平不同的小学生意外伤害发生率差异有统计学意义(χ~2=38.40,P<0.01)。学生因为伤害治疗所发生的费用以100～499元占比最多。结论针对海岛城区小学生意外伤害特点,应采取以综合性伤害干预为主的健康教育手段,对男女学生伤害原因根据性别差异制定防备对策,强化提升母亲的意外伤害知识及正确应对行为,跟踪干预效果和效应评价。     

百色市不同民族小学生伤害类型及危险因素分析

目的了解不同民族小学生伤害常见类型及其危险因素,为预防伤害的干预提供科学依据。方法采用分层整群抽样、问卷调查法,对百色市1 155名不同民族小学生2002年2月至2003年1月伤害发生情况进行调查。结果百色市小学生伤害发生率为39.13%,男生明显高于女生(χ2=15.813,P=0.000);不同年龄组学生伤害发生率差别有统计学意义(χ2=61.327,P=0.000),其中五六年级小学生发生率最高(54.41%);壮族、瑶族、其他民族学生伤害发生率均高于汉族学生,且差别有统计学意义(χ2=8.108,P=0.044)。前5位伤害类型依次为跌伤(16.19%)、碰伤(7.10%)、刀割伤(4.16%)、动物咬伤(2.94%)和硬物击伤(1.39%)。结论小学生的身心健康面临伤害的严峻挑战,应积极采取综合防范措施以减少伤害的发生。     

广州某高校大学生伤害就医情况分析

了解大学生伤害就医情况,为干预和及时治疗伤害提供科学依据.方法 整群抽取广州某高校2006级全体学生4 573名为研究对象,以入学4a因伤害在校医院就医门急诊记录和住院病历为依据,进行伤害调查和特征分析.结果 大学4a间共发生伤害2 913人次,伤害累计发生率为63.70%,不同性别伤害发生率差异有统计学意义(x2=87.084,P<0.01).伤害原因前3位的是跌伤、碰撞伤和锐器伤.伤害类型以扭伤最多,其次是擦皮伤和皮下组织伤.不同性别伤害类型比较差异有统计学意义(P<0.01).不同年级大学生伤害发生率不同,差异有统计学意义(P<0.01).伤害地点前2位是:体育运动区域(49.33%)和学生宿舍(18.39%).在2 913人次伤害中,33人(1.13%)入院治疗,其中男25人,女8人.结论 大学生伤害发生率较高,男生是伤害重点保护人群.鉴于新型伤害不断涌现,预防医学专业人员应加强防范.     

外来人口小学生伤害现状及其影响因素分析

目的分析外来人口小学生伤害发生现状及影响因素,并根据研究结果为实施相应的伤害防范措施提供依据。方法对江苏省南部地区(简称"苏南")某市两所外来人口学校共1 700名小学生开展调查并进行统计分析。结果苏南某市外来人口学校小学生伤害发生率为18.94%(322/1 700),其中男生伤害发生率为20.71%(193/932),女生伤害发生率为16.80%(129/768),男女生伤害差异有统计学意义(χ~2=4.195,P=0.041);跌倒/坠落为主要伤害类型。多因素分析结果显示,男生(OR=1.336,95%CI:1.015~1.758);校车接送(OR=1.538,95%CI:1.129~2.097);主要看护人为母亲(OR=1.478,95%CI:1.026~2.128);看护人职业为离退休人员(OR=2.020,95%CI:1.196~3.412);看护人职业为农牧与水利业生产人员(OR=4.030,95%CI:1.821~8.919);看护人职业为生产运输设备操作人员及有关人员(OR=2.303,95%CI:1.261~4.208);看护人性格为外向型(OR=1.700,95%CI:1.146~2.520)是伤害的危险因素。结论外来人口小学生的性别和看护人的部分情况是其伤害的主要影响因素,学校和家庭应采取相应的防范措施,同时外来人口家庭应积极融入当地生活从中受益,提高生活质量,从而降低外来人口小学生的伤害发生率。     

某医院血源性职业暴露的监测分析

目的探讨医务人员发生血源性职业暴露的危险因素,为制定预防措施提供依据。方法对2014-2016年某医院发生血源性职业暴露人员的调查资料进行统计分析。结果三年共发生血源性职业暴露97例,不同年份间发生率差异无统计学意义(χ2=0.550,P0.05),2014年和2016年不同性别、不同岗位和不同工龄之间发生率差异有统计学意义(P0.05),2015年不同工龄之间发生率差异有统计学意义(χ2=11.161,P0.05)。暴露时操作以注射和采血最多(25.77%),暴露部位以手为主(83.51%),暴露源病种以乙型肝炎(41.79%)最多。72.16%的暴露者能够进行规范化的局部处理,至随访结束无感染发生。结论加强医务人员,尤其是低工龄护士的职业防护培训,增强个人防护意识,是减少血源性职业暴露的关键。     

淄博市小学生意外伤害流行病学调查

目的了解淄博市小学生意外伤害的发生情况,为制定相应的干预措施提供依据。方法采用分层整群抽样的方法抽取淄博市的3个区6 所小学共3 000名学生进行调查。结果淄博市小学生的意外伤害率为9.58%,前3位伤害类型依次是跌伤(3.97%)、中毒(3.71%)、车辆刮碰伤(1.91%)。伤害的发生率与性别和年龄有关, 男生发生率明显高于女生 (χ2=10.635,P=0.001)。各年龄组伤害的发生率差异有统计学意义(χ2=22.587,P<0.001)。非条件 Logistic 回归分析显示:意外伤害的危险因素有性别、收入是否减少、主要养育人、学生年龄。结论小学生的意外伤害发生率较高,应切实加强安全管理和教育,预防意外伤害的发生,以减少伤残率。     

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.