Prevalence, incidence and risk factors of carpal tunnel syndrome in a large footwear factory

The study was conducted to assess the prevalence and incidence of carpal tunnel syndrome (CTS) in a large modern footwear factory and to identify factors predictive of CTS. To this end, 199 workers were examined in 1996, and 162 of them were re-examined in 1997. Ergonomic and psychosocial risk factors of CTS were assessed by workpost analysis and self-administered questionnaire. The prevalence of CTS at baseline in 1996 and in 1997 was 16.6% (95%CI: 11.4-21.7) and 11.7% (95%CI: 6.7-16.8), respectively. The incidence rate of CTS in 1997 was 11.7% (95%CI: 6.7-7.8). No specific type of job performance was associated with CTS. Obesity (OR = 4.4; 95%CI: 1.1-17.1) and psychological distress at baseline (OR = 4.3; 95%CI: 1.0-18.6) were strongly predictive of CTS. Rapid trigger movements of the fingers were also predictive of CTS (OR = 3.8; 95%CI: 1.0-17.2). A strict control of thework by superiors was negatively associatedwith CTS (OR = 0.5; 95%CI: 0.2-1.3). The prevalence and incidence of CTS in this workforce were largely higher than in the general population and numerous industries. The study highlights the role of psychological distress in workers exposed to a high level of physical exposure and psychological demand.     

The relationship of water sources and other determinants to prevalence of intestinal protozoal infections in a rural community of Saudi Arabia

A study was carried out in a rural area of Asir region in Southwest of Saudi Arabia where information on the types of domestic water supply and sociodemography in relation to intestinal protozoal infections were obtained from 1417 inhabitants (81.4% of the total) of nine villages. Stool samples were collected from the study population and examined for intestinal parasites. Overall, the prevalence rates of infection with the common water-borne parasites,Giardia lamblia andEntamoeba histolytica were 18.9% and 9.2% respectively, which were high compared to other endemic areas of the Kingdom. The sociodemographic factors including age, sex, degree of education, intrafamilial clustering and crowding index were found to be non significant determinants of both protozoal infections. The source of domestic water was the sole factor significantly associated with the high prevalence rates of infection in the community. This relationship was confirmed by multiple logistic regression analysis. A significantly high risk of contracting the infection with both parasites was observed among individuals who drank jar water (OR=2.973, 95%CI:1.515–4.402 and OR=2.831, 95%CI:1.414–3.915, forG. lamblia andE. histolytica respectively) or well water (OR=2.153, 95%CI:1.211–3.913 and OR=2.117, 95%CI:1.341–3.715, forG. lamblia andE. histolytica respectively). Those who used desalinated water for drinking seems to have the lowest degree of exposure to the risk of infection (OR=0.689, 95%CI:0.501–0.849 and OR=0.793, 95% CI:0.518–0.912, forG. lamblia andE. histolytica respectively). The results indicate that the use of improved water supply, including protection of community wells and domestic storage tanks, together with mandatory inspection measures during transportation and distribution of commercial water should reduce the rate of infection with the two protozoal parasites in this rural community.     

Epidemiological survey of the prevalence of intestinal parasites among schoolchildren in Sari, northern Iran

Parasitic infection is highly prevalent throughout the developing countries of the world. Research on the prevalence of intestinal parasitic infections in various geographic regions is a prerequisite for the development of appropriate control strategies. A cross-sectional study was conducted to determine the prevalence of intestinal parasitic infections among schoolchildren in public primary and secondary schools in the urban areas of Sari, Mazandaran province, northern Iran. The study was conducted from November 2009 to June 2010. A total of 1100 stool samples from 607 males and 493 females aged 7-14 years were examined by direct wet mounting, formalin-ether concentration, and Ziehl-Neelsen and trichrome permanent staining methods. A parental questionnaire for common risk factors was completed for each participant. Mono- or poly-parasitism was detected in 367 (33.3%) of the children (32.6% of males and 34.2% of females). Various species of protozoan or helminth infections were detected: Blastocystis hominis seemed to be the most prevalent parasite (13.5%) followed by Giardia lamblia (10.6%), Entamoeba coli (7.2%), Endolimax nana (1.5%), Enterobius vermicularis (2.2%), Trichostrongylus sp. (2.1%) and Strongyloides stercoralis (1.6%). The prevalence of intestinal parasite infections in females was slightly higher than in males, though without a statistically significant difference (p=0.56). No age association was detected, and a slightly lower positive association with increasing age was observed (p=0.33). A significant association was observed with parents' educational level, household income and practice of hand washing before meals (p<0.01). Although paediatric pathogenic intestinal parasite infections are not more prevalent in this geographical area than in other regions, improvements in personal hygienic conditions and behavioural characteristics is important to completely control parasitic infections in schoolchildren in northern Iran.     

Intestinal parasites in African asylum seekers: prevalence and risk factors

OBJECTIVE: To determine the prevalence of potentially pathogenic intestinal parasites in asylum seekers coming from a highly endemic area, and to identify groups of asylum seekers from Africa with a high risk of an intestinal parasitic infestation which is potentially harmful of their own health or that of those in their vicinity. DESIGN: Prospective. METHOD: In the period January 1996-May 1999, 956 asylum seekers from Africa were checked for intestinal parasites by means of a stool examination within one month of arriving in the Netherlands. Independent variables for data analysis were sex, age and area of origin. RESULTS: Pathogenic intestinal parasites were found in 40.6% of the 956 African asylum seekers coming from areas south and east of the Sahara. Double-infection was found in 9.5% and triple-infection in 0.9% of the study population. The most common pathogenic parasite was Trichuris trichiura (13.6%) followed by Entamoeba histolytica/dispar (8.8%), hookworms (7.8%), Schistosoma (7.0%) and Giardia lamblia (5.0%). G. lamblia was the most commonly found potentially pathogenic parasite in children less than 13 years old (19.0%). In the population from Western Africa, 15.6% had a hookworm and 12.8% a Schistosoma. Both these helminthic infestations were three times as prevalent in men as in women. CONCLUSION: Sex, age and area of origin were important indicators for the species of parasite. On the basis of this, risk groups can be selected for screening for potentially pathogenic intestinal parasites.     

Parasitic infections and gastrointestinal symptoms among preschool children in day care centers in Alexandria, Egypt

There is a considerable amount of speculations concerning the presence of symptoms in various parasitic infections. The aim of the present study was to determine the prevalence of different parasitic infections among children in day care centers (DCCs), and to establish the relation of such infections to gastrointestinal symptoms. A total of 623 stool samples were collected from 700 preschool children aged 2-5 years who attended 3 DCCs of different social classes in Alexandria. These samples were tested for parasitic infection by the conventional microscopy. Parents were interviewed as regards the gastrointestinal symptoms frequently suffered from by their children included in the sample during the 3 months period preceding the interview. The prevalence rate of parasitic infection was 56.0%. Giardiasis was the commonest infection (34.7%), followed by Ascariasis (24.4%) and Trichuriasis (4.6%). Boys showed a significantly higher prevalence than girls (58.3% vs. 52.9%, p<0.01). Social children were more infected with G. lamblia than unsocial ones (39.6% vs. 22.1%, p<0.01). Vomiting was strongly associated with G. lamblia infection (OR=7.1, p<0.01), diarrhea with multiple infections (OR=48.2, p<0.01), while abdominal pain was not significantly associated with any of these infections. The high prevalence of Giardiasis in DCCs emphasizes the need for increased surveillance for G. lamblia as a cause of vomiting in children, especially among active and social boys. Routine and periodic administration of a protozoan treatment to such children is recommended.     

Epidemiological evidence for vaccinating wastewater treatment plant workers against hepatitis A and hepatitis B virus

Exposed to sewage workers of a wastewater treatment plant and a control group in Thessaloniki, Greece, were examined for antibodies against hepatitis A (anti-HAV) and hepatitis B virus (HBV) infection markers. The main objective of this study was to investigate for epidemiological evidence so as to recommend vaccination of the occupationally exposed workers against these viral infections. Antibodies against hepatitis A virus were detected in 65.7% of the wastewater treatment plant workers and in 32.6% of the control group. The prevalence of anti-HAV was significantly higher in less educated persons and was increasing with age (p < 0.001), whereas in logistic regression analysis the adjusted seroprevalence of wastewater treatment plant workers was 3.5 times higher (p < 0.01) than the control population. Serologic evidence of past HBV infection was observed in 32.4% of the exposed to sewage population and in 5.8% of the controls. Multivariate analysis showed that variables significantly and independently related to previous HBV infection was occupational exposure to sewage (OR: 5.81; 95% CI: 2.07-16.29) and age over 40 years old (OR: 4.49; 95% CI: 1.51-13.33). These results support the vaccination policy of young and sensitive to hepatitis A and B virus wastewater treatment plant workers in our region.     

The impact of intestinal parasitic infections on the nutritional status of primary school children in Alexandria, Egypt

In order to investigate the relationship between intestinal parasitism and nutritional status, stool specimens obtained from 1674 school children aged 6-13 years, enrolled in primary governmental schools in the Eastern zone of Alexandria, Egypt were examined for helminth and protozoan parasites. The findings were collated with anthropometric data (weight and height) on the same children. The prevalence of parasitic infections was found to be 31.5%. The most common infections were found to be with Giardia lamblia (15.4%) and Ascaris lumbricoides (10.2%). Children infected with both helminths and protozoa showed an increased but insignificant risk of underweight relative to those without infections. The risk of stunting was found among all types of parasites as compared to children with no parasites. Also there was a higher non significant risk of wasting among those with protozoal infection especially Giardia lamblia. Children infected with three species or more of intestinal parasitic infections were significantly underweight than non infected children (OR = 4.68, 95% confidence limit = 1.04-18.03). Using stepwise logistic regression analysis, number of parasites appeared to be the most effective variable of the nutritional status of children indicated by weight for age Z score, followed by education of the mother.     

Intestinal parasites in Cambodians: comparison of diagnostic methods used in screening refugees with implications for treatment of populations with high rates of infestation

We performed a retrospective review of screening parasitology examinations on a Cambodian refugee population served by an urban neighborhood health center. Five-hundred twenty of 1084 patients were examined for ova and parasites either by purged stool, which was examined immediately, or preserved stool, examined at a teaching hospital and proprietary laboratories. Overall, 335 (64 percent) of the tested patients had at least one parasite. The prevalence of infection varied by test technique (purged stool examined immediately, 86 percent; preserved stool examined at a hospital, 65 percent; preserved stool sent to a proprietary laboratory, 31 percent, P less than 0.01). In this population where Entamoeba histolytica infection was 44 percent as measured by the purged warm stool technique, the cold preserved stool test had a measured relative sensitivity of 33 percent. Assuming a selectivity of 99 percent, it would take eight negative tests to reach a greater than 95 percent negative predictive value. The high rate of intestinal carriage of pathogenic parasites in this population and the insensitivity of commonly available diagnostic tests make routine presumptive treatment of intestinal parasites an option when the purged stool examination is unavailable.     

Digestive parasitism in Sousse area. Results of a 16 years retrospective study

To report the prevalence and type of intestinal parasites together with their kinetics in Sousse region. Our retrospective study concern data from the examination of 56,268 stool samples and 7552 tape tests, performed in the laboratory of parasitology of F. Hached Sousse hospital from 1st January 1987 up to 31 December 2002. We observed an overall parasite prevalence of 31.5%. Most common parasites were protozoa, Giardia lamblia, Dientamoeba fragilis and Blastocystis hominis being the most frequently encountered. Helminths consisted mainly of Enterobias vermicularis (35.86% positive tape tests) and Hymenolepis nanus. The kinetics data analysis showed an important decrease in the prevalence of Giardia lamblia, the other feco-oral transmitted flagellates and Hymenolepis nanus. In contrast, Dientamoeba fragilis and Blastocystis hominis prevalences increased. The prevalence of the amoeba showed a slight decrease. Intestinal parasites remain quite common in Sousse region, even though their epidemiological patterns are changing. Factors inducing these changes need to be investigated in order to plan efficient control measures.     

Removal and destruction of intestinal parasitic protozoans by sewage treatment processes

This paper reviews the literature which addresses the occurrence of intestinal protozoan parasites in sewage as well as the removal and destruction of these pathogens in sewage treatment processes. The concentration of intestinal protozoa within sewage depends upon the catchment; the prevalence and intensity of human infection within the catchment; the contribution of animal waste to the sewage and the prevalence and intensity of animal infection within the catchment. Some research indicates that some sewage treatment processes may result in relatively high removal efficiencies of some intestinal protozoa, whereas other data indicate that the concentration of cysts and oocysts discharged in sewage effluent may be in the order of several thousand per litre. For some protozoan parasites, such as Cyclospora, Microsporidia and Isospora, knowledge is scarce on the potential importance of sewage in their transmission and their likely removal and destruction by sewage treatment processes.     

Intestinal parasitosis in Mbyá-Guaraní populations from Misiones Province, Argentina: epidemiological and nutritional aspects

Intestinal parasite infestation in indigenous Mbyá-Guaraní communities in Misiones, Argentina, was described and associated with nutritional status and environmental and cultural factors. The results were compared with those from Takuapí, a neighboring indigenous population, and the nearest urban population, Aristóbulo del Valle. The Ritchie, Willis, and Kato Katz techniques were used to analyze the stool samples. Anthropometric parameters were analyzed and earth samples processed. From a total sample of 296 individuals analyzed in the four populations, 100 (87.7%), 63 (88.7%), 49 (96.1%), and 50 (82%) were infested in Kaaguy Poty, Yvy Pytá, Takuapí, and Aristóbulo del Valle, respectively. 84% of infested individuals had multiple parasites. The 43% of the individuals presented malnutrition, and 87% of these were infested. There was an association between use of latrines and Giardia lamblia (p < 0.01); open-air defecation, lack of footwear, and hookworms (p < 0.01); and housing type and total helminthes (p < 0.01). Earth samples were contaminated with parasites. The results suggest the relationship between environmental contamination and high prevalence of intestinal parasites in these human populations.     

The risk of infection from Giardia lamblia due to drinking water supply, use of water, and latrines among preschool children in rural Lesotho

Stool samples were collected from 267 rural, preschool children in four districts in Lesotho during October-November, 1984. Sixty-three children (23.6%) were tested positive for Giardia lamblia, the most commonly recovered parasite from stool samples. The use of low amounts of water for personal hygiene was associated significantly with having G. lamblia (OR = 2.42), but the use of traditional, non-improved drinking water sources (OR = 1.38) or lack of latrines (OR = 0.94) was not. Although G. lamblia may be primarily waterborne in developed countries, the amount of water that is used for personal and domestic hygiene may be more important than the quality of drinking water in developing countries. Other risk factors that were identified to be associated significantly with having or not having Giardia were child older than 24 months (OR = 6.79), mother less than 20 years of age (OR = 5.18), residing in Mohales Hoek district (OR = 2.33), and possessing several agricultural tools (OR = 0.70).     

451例恶性肿瘤患者中肠道原虫感染情况研究

摘要:目的　了解恶性肿瘤患者的肠道原虫感染情况,为采取有效防治措施提供依据。方法　对2013年6月－2014年6月广西医科大学第一附属医院收治的451例恶性肿瘤住院患者进行肠道原虫的病原学检查,并分析感染情况。结果　共查出肠道原虫感染者85例,总感染率为18.85%。检出3种肠道原虫,感染率分别为人芽囊原虫16.19%、溶组织内阿米巴1.77%、蓝氏贾第鞭毛虫0.89%。男性感染率为19.28%,女性为18.32%,性别差异无统计学意义（P＞0.05）;各年龄组的感染率差异无统计学意义（P＞0.05）;化疗组的感染率最高,为31.01%,显著高于其余治疗组（P＜0.001）;消化系统组的感染率最高,为32.67%,显著高于其余肿瘤类别组（P＜0.001）;感染者大多有不良卫生饮食习惯。结论　恶性肿瘤患者易受肠道原虫感染,应及时诊治,以免影响患者的预后及生存质量。     

某电网企业职工职业紧张与抑郁症状的关联研究

目的 了解某电网企业职工职业紧张与抑郁症状的现况及相关性,探究抑郁症状的影响因素.方法 选择某电网企业1 091名职工为研究对象,采用工作内容问卷(JCQ)和付出-回报失衡问卷(ERIQ)测量职业紧张情况,采用中文版流行病学研究中心用抑郁量表(CES-D)调查职工抑郁症状.采用多因素logistic回归分析抑郁症状的影...     

Relationships of job,age, and life conditions with the causes and severity of occupational injuries in construction workers

Objectives To assess the relationships of job, age, and life conditions with the causes and severity of occupational injuries in male construction labourers.Methods The sample included 880 male construction workers having had at least one occupational injury with subsequent sick leave. The survey used a standardised questionnaire, filled in by the occupational physician in the presence of the subject: socio-demographic data, job, safety training, smoking habit, alcohol consumption, sporting activities, physical disabilities, hearing, vision, and sleep disorders. Statistical analysis was via the logistic regression method.Results Logistic models showed that falls and injuries from the handling of objects or hand tools was similar for all jobs, while masons, plumbers and electricians had a higher risk of injury from moving objects, and carpenters, roofers and civil-engineering workers were more exposed to injury from construction machinery and devices. Age <30 was related to injury from hand tools [adjusted OR (95%CI) 2.20 (1.28–3.79)]; sleep disorders and hearing disorders to those from moving objects [ORs 2.29 (1.27–4.12) and 1.85 (1.01–3.41) respectively]; no sporting activity to those from the handling of objects [OR 1.54 (1.09–2.17)]; and being overweight to falls on the same level [OR 2.04 (1.30–3.21)] and falls to a lower level [OR 1.55 (1.13–2.13)]. Injuries from the handling of objects were less frequent in overweight workers [OR 0.62 (0.46–0.84)]. Injuries with hospitalisation or sick leave 60 days were associated with age 30 and hearing disorders.Conclusions The causes of injuries were related to jobs. Prevention through working conditions could be made against the revealed risks. The risks for each worker depended on age, body mass index, hearing disorders, sleep disorders, and sporting activities. The occupational physician could inform the workers of these risks and encourage them to practise sporting activities and reduce their hearing disorders and sleep disorders.     

上海市某区基层卫生工作者慢病状况调查及相关因素研究

目的 了解上海市某区社区卫生服务中心卫生工作者慢性疾病现状及相关影响因素,为开展早期防治提供建议。 方法 采用方便抽样方法,以该区全体基层卫生工作者为调查对象,对慢性非传染性疾病的影响因素进行logistic回归分析。 结果 共发放问卷1 816份,独立完成知情同意的人数为1 515人,应答率83.43%。平均年龄(38.77±8.07)岁,研究对象慢性疾病检出率为53.07%。按国际疾病分类患病率前三位依次为肌肉骨骼系统疾病47.79%、消化系统疾病46.73%、泌尿生殖系统疾病22.77%。患病率在10%以上的病种共13种,前三位分别是颈椎病34.72%、龋齿21.72%、视疲劳18.68%。基层卫生工作者的职业紧张发生率为11.55%,在卫生技术人员中为12.26%。多因素回归分析结果显示影响基层卫生工作者慢性疾病患病率的危险因素包括女性(OR=1.506, 95%CI:1.079～2.102),35～44岁(OR=2.568, 95%CI:1.752～3.766),45～65岁(OR=3.766, 95%CI:1.965～7.026),收入7～11万(OR=1.812, 95%CI:1.214～2.706),收入＞11万(OR=1.649,95%CI:1.064～2.555),工龄≥21年(OR=2.077, 95%CI:1.156～3.732),业务培训＞1次/周(OR=1.829, 95%CI:1.329～2.517),职业紧张(OR=2.533, 95%CI:1.469～4.368)。已婚(OR=0.596, 95%CI:0.426～0.835)为其保护因素。 结论 基层卫生工作者慢性疾病患病率较高,相关部门需针对危险因素进行有效干预,促进卫生工作者健康。     

Hepatitis A in workers exposed to sewage: a systematic review

OBJECTIVES—To assess whether the scientific literature supports the hypothesis that workers exposed to sewage are at higher risk of hepatitis A (HA).
METHODS—All original papers reporting epidemiological studies published in English, French, or German which reported on the risk of HA infection in workers exposed to sewage were eligible. They were identified by several methods and each original paper was assessed independently with a checklist by two people. Studies were classified according to the strength of their design. Non-eligible studies were also examined to assess the impact of publication bias. If the risk estimates diverged widely, causes for heterogeneity were assessed. A distinction was made between seroprevalence studies based on subclinical HA (defined only by the presence of anti-HA antibodies) and clinical HA.
RESULTS—17 eligible studies were identified. No indication of an increased risk of clinical HA could be found. For seroprevalence the studies with the strongest design suggested a slightly increased risk of subclinical HA with an odds ratio (OR) <2.5. Heterogeneity was considerable and precluded a meta-analysis. Considering non-eligible studies would still decrease the OR.
CONCLUSIONS—The systematic review does not confirm an increased risk of clinical HA in workers exposed to sewage. An increased risk of subclinical HA cannot be excluded but the association between seropositivity and exposure to sewage was not strong and became still weaker if publication bias was taken into account.


     

Effectiveness of a new decolonisation regimen for eradication of extended-spectrum β-lactamase-producing Enterobacteriaceae

Reduced biocide susceptibility in staphylococci is associated with quaternary ammonium compound (qac) gene-encoding efflux proteins. This study compared the prevalence of antiseptic-resistance genes (qacA/B, smr) in staphylococci colonising nurses and non-healthcare workers. Staphylococcus aureus and coagulase-negative staphylococci (CoNS) isolated from 249 nurses were compared for qacA/B and smr positivity with carriage isolates from non-healthcare workers. Associations between qac genes and antibiotic resistance were investigated and minimum inhibitory concentrations (MICs)/minimum bactericidal concentrations (MBCs) to benzalkonium chloride and chlorhexidine determined. Both genes had higher prevalence in CoNS from nurses (OR: 8.4; 95% CI: 5.4-13.2) and qacA/B was more common in nurses'S.?aureus isolates than those of the general population (OR: 5.5; 95% CI: 2.7-11.2). Meticillin-resistant S.?aureus (MRSA) carriage was low (3.2% nurses; 0.5% general population). The risk of harbouring qacA/B and smr was associated with presence of mecA (OR: 2.9; 95% CI: 1.8-4.8) and contact with MRSA-infected patients (OR: 2.0; 95% CI: 1.0-3.9) in S.?aureus and CoNS. S. aureus with qac genes displayed significantly more antibiotic resistance and all gene-positive isolates had higher MICs and MBCs to antiseptics. Increased prevalence of antiseptic-resistance genes in staphylococci from nurses indicates that the hospital environment could exert selective pressure for carriage of these strains. The increased proportion of qac genes in meticillin-resistant strains suggests co-selection of these genes, as does the increased carriage of gene-positive strains by those in contact with MRSA-positive patients. Reduced antiseptic susceptibility may allow persistence of organisms in the presence of low level residues and contribute to survival of MRSA.     

Dust exposure and respiratory symptoms among cement factory workers in the United Arab Emirates

This study was conducted in a cement factory in the United Arab Emirates to assess cement dust exposure and its relationship to respiratory symptoms among workers. A total of 149 exposed and 78 unexposed workers participated in this cross-sectional study. Information on demographic and respiratory symptoms was collected by questionnaire. Personal total dust levels were determined by the gravimetric method. Concentration of the total dust ranged between 4.20 mg/m(3) in the crushers and 15.20 mg/m(3) in the packaging areas, and exceeded the exposure limit in the packaging and raw mill areas. The prevalence of respiratory symptoms was higher among the exposed workers, but the difference from that of unexposed workers was statistically significant only for cough (19.5%; OR=4.5; 95%CI=1.5-13.2), and phlegm (14.8%; OR=13.3; 95%CI=1.8-100.9). Cough and phlegm were found to be related to exposure to dust, cumulative dust and smoking habit, while chronic bronchitis was related to smoking habit. The few factory workers (19.5%) who used masks all the time had a lower prevalence rate of respiratory symptoms than those not using them. High dust level was the only variable that influenced the workers to use the mask all the time. It is recommended that control measures be adopted to reduce the dust and workers should be encouraged to use respiratory protection devices during their working time.