耐火陶瓷纤维对作业工人肺通气功能的影响

[目的]探讨耐火陶瓷纤维对作业工人肺通气功能的影响. [方法]选择从事耐火陶瓷纤维生产和加工的265名作业工人作为接触组,273名仅接触噪声的作业工人作为对照组,进行肺通气功能检查,指标为用力肺活量(FVC)、第一秒用力呼气量(FEV 1.0)、一秒率(第一秒用力呼气量占用力肺活量百分率,FEV 1.0/FVC),均以实测值占预计值的百分比(FVC％、FEV1.0％、FEV1.0/FVC％)表示.接触组分别按纤维计数浓度＜0.1、0.1～0.5、＞0.5 f/mL,按总粉尘质量浓度＜1、1～5、＞5 mg/m3分为低、中、高水平.低纤维低总尘亚组81人、中纤维中总尘亚组123人、中纤维高总尘亚组30人、高纤维高总尘亚组31人. [结果]接触组作业工人FVC％、FEV1.0％和FEV 1.0/FVC％的均数均低于对照组(P＜0.05);高纤维高总尘亚组作业工人FVC％和FEV1.0％的下降较其他3个亚组更为明显(P＜0.05),不同接触工龄亚组间各指标差异均无统计学意义(P＞0.05).接触组限制性、阻塞性和混合性肺通气功能障碍检出率为58.9％、4.5％和3.8％,与对照组的检出率10.9％、5.1％和4.0％比较,仅限制性肺通气功能障碍检出率的差别有统计学意义(P＜0.05).限制性肺通气功能障碍与纤维计数浓度、接触工龄具有关联性(P＜0.05),与总粉尘质量浓度、是否吸烟无关联性(P＞0.05). [结论]接触耐火陶瓷纤维可导致以限制性通气功能障碍为主的肺通气功能损害,限制性通气功能障碍检出率与纤维累计接触水平存在正相关关系,与纤维计数浓度的关联性优于总粉尘质量浓度.     

深圳市某木门制造企业接尘工人职业健康检查结果

目的 分析木尘对作业工人的健康损害,探讨健康监护指标.方法 对深圳市某木门制造企业接触木尘作业工人257名及对照组243人进行职业健康检查.结果 接触木粉尘作业工人临床症状以咳嗽、咳痰、气促、胸部不适为主,检出率分别为18.7％、17.9％、19.1％和19.5％;接尘工人肺功能指标FEV1.0、FVC、FEV1.0/FVC分别为(3 124.3 ±432.7)ml、(4 012.6±465.6)ml、(77.9±8.32)ml,明显低于对照组,差异有统计学意义(t值分别为5.405、3.054、4.122,均P值＜0.01),接尘工人肺功能损害随年龄、工龄呈增长而升高,差异有统计学意义(x2值分别为30.142和14.316,均P＜0.01);高千伏X线胸片结果显示观察组肺纹理增多增粗比例明显高于对照组,差异有统计学意义(x2=6.733,P值＜0.01).观察组还确诊2例尘肺,5例肺结核;对照组确诊1例肺结核.结论 木尘对作业工人呼吸系统和心血管系统有一定的损害,木粉尘暴露是否可致肺组织纤维化病变仍不确定.     

矽肺患者血清转化生长因子-β1和肿瘤坏死因子-α的变化

目的 观察矽尘接触者和矽肺患者及观察对象血清转化生长因子-β1(TGF-β1)和肿瘤坏死因子-α(TNF-α)水平,探讨TGF-β1、TNF-α在矽肺发生发展中的作用.方法 选择100名不接触粉尘的对照人群(对照组),200名接触矽尘1年以上的接尘工人(接尘组),32名矽尘作业观察对象(0+)(观察对照组)及130例矽肺患者(矽肺组),采用ELISA法检测其血清TGF-β1和TNF-α水平.结果 与对照组[(6.90±2.24)pg/ml]比较,接尘组、观察对象组和矽肺组TNF-α水平[(47.86±16.52)、(109.11±31.08)、(216.35±51.03)pg/ml]明显升高,差异有统计学意义(P＜0.01);与接尘组比较,观察对象组和矽肺组TNF-α水平明显升高,差异有统计学意义(P＜0.05,P＜0.01).与对照组[(23.28±12.24)pg/ml]和接尘组[(29.31±14.52)pg/ml]比较,观察对象组和矽肺组TGF-β1水平[(46.16±17.35)、(58.36±31.94)pg/ml]明显升高,差异有统计学意义(P＜0.05,P＜0.01).结论 TGF-β1和TNF-α在矽肺发生发展中有重要作用,检测外周血TGF-β1和TNF-α水平可应用于职业健康监护及矽肺的早期诊断.     

金属粉尘对男性作业工人呼吸系统影响的调查

为了探讨金属粉尘作业工人的呼吸系统症状阳性率和肺通气功能状况,我们选择129名接触金属粉尘的作业工人作为接触组,126名非接触粉尘的作业工人作为对照组,采用美国胸科协会制订的标准化呼吸系统症状询问表和用力肺活量测试方法进行了调查。结果显示,咳嗽、咯痰、气短、喘息等呼吸系统症状阳性率和慢性支气管炎患病率,接触组中吸烟者(27.13%,20.15%,17.83%,19.38%,16.93%)和非吸烟者(14.73%,10.85%,15.50,10.85%,8.13%)高于对照组中吸烟者(13.49%,9.52%,8.73%,11.11%,8.97%)和非吸烟者(7.93%,7.14%,8.73%,4.76%,4.05%),差异均有统计学意义(P<0.05),且以接触组中吸烟者发生率最高。肺通气功能指标FVC,FEV1.0,FEV1.0%的实测值占预计值百分比,接触组中吸烟者(83.23±18.03,84.42±21.36,89.50±13.31)和非吸烟者(86.83±15.61,85.59±17.16,90.67±18.13)低于对照组中吸烟者(93.44±12.49,88.75±12.56,93.97±17.13)和非吸烟者(94.86±11.19,90.63±12.27,94.73±16.02),差异均有统计学意义(P<0.05)。接触组中吸烟者和非吸烟者FVC,FEV1.0,FEV1.0%的实测值占预计值百分比随着接尘工龄的延长而呈递减趋势,尤其吸烟者和非吸烟者接尘工龄≤5 a组分别与接尘工龄≥11 a组比较,差异均有统计学意义(P<0.05)。说明金属粉尘与作业工人呼吸系统功能的变化有直接关系;吸烟是金属粉尘作业工人发生呼吸系统功能损伤的危险因素;且随着接尘工龄的延长有加重的趋势。     

吸烟与粉尘接触对蔺草工人第1秒用力呼气量的影响

目的 探讨蔺草粉尘接触与吸烟对工人第1秒用力呼气量(FEV1.0)的影响.方法 选择蔺草接尘工人122名为接触组,118名非接尘人员为对照组,进行问卷调查和FEVL11.0的测定,分析粉尘接触与吸烟对工人FEV1.0的影响.结果 接尘组FEV1.0%(81.8%±13.9%)明显低于对照组(95.9%±15.3%),差异有统计学意义(t=7.49,P＜0.01).接尘组FEV1.0%异常率为46.7%(57/122)明显高于对照组(8.5%,10/118),差异有统计学意义(x2=43.6,P＜0.01).吸烟组FEV1.0%(82.02%±12.9%)明显低于不吸烟组(93.33%±12.4%),差异有统计意义(t=5.18,P＜0.05).吸烟组FEV1.0%异常率(55.9%)明显高于不吸烟组(16.7%).差异有统计意义(x2=22.2,P＜0.05).接尘工龄与FEV1.0%呈负相关,差异有统计学意义(Rs1=-0.299,P=0.0008).接尘与吸烟对FEV1.0%有影响(F吸烟=42.42,F接尘=259.06.均P＜0.01),且接尘与吸烟的交互作用影响大于单独效应(F=34.70,P＜0.01).结论 粉尘接触、吸烟及其联合作用可影响蔺草工人的肺功能.

Abstract：

Objective To study the effect of smoking and rush-mat dust exposure on pulmonary function. Method 122 rush-mat dust exposed workers and 118 controls without dust exposure were selected.Questionnaire and FEV1.0 measurement were performed on them. Results For dust exposure, FEV1.0% of cases (81.8%±13.9% ) was statistically lower than controls (95.9%±15.3% )(t=-7A9,P＜0.01 ),the abnormal rate of FEV1.0% was 46.7%(57/122) for cases, statistically higher than controls (8.5%,10/118),x2=43.6,P＞＜0. 01. For smoking, FEV1.0% of cases(82.02%±12.9%)was statistically lower than controls(93.33%±12.4%), t=-5.18, P＜0.05,the abnormal rate of FEV1.0% is 55.9% for cases, statistically higher than controls(16.7% ),x2=22.2, P＜0.05.The exposing ages of workers has negative correlation with FEV1.0% (Rs1 =-0.299, P =0.0008).Exposure and smoking could affect FEV1.0% (Fe =259.06, P＜0.01, Fs =42.42, P＜0.01 ),and their interactive effect on FEV1.0%was greater than single ones (F=34.70,P＜0.01). Conclusion Rush-mat dust exposure, smoking and their interaction have influnce on FEV1.0%.     

过氯酸铵粉尘对作业工人健康的影响

目的研究过氯酸铵(AP)粉尘对作业工人健康的影响。方法选择甲、乙两厂接触AP粉尘的作业工人66人为接触组,选择不接触AP粉尘的作业工人48人为对照组。调查两厂一般情况,监测作业场所的AP粉尘浓度,对两组人群进行职业体检,询问职业史和临床表现,检测血常规、肝肾功能、甲状腺激素指标、肺通气功能和X射线胸片检查。结果乙厂的AP粉尘平均浓度(31.36 mg/m3)显著高于甲厂(2.53 mg/m3),差异有统计学意义(P<0.01)。调查显示,接触组的年龄和工龄(40.97岁,19.8 a)、分别与对照组(40.04岁,20.8 a)比较,差异无统计学意义(P>0.05)。接触组呼吸系统及消化系统症状检出率(31.8%,18.2%)均显著高于对照组(10.4%,4.2%),差异有统计学意义(P<0.05或P<0.01)。肺通气功能检查,接触组人群的FEV1.0/FVC%显著高于对照组。X线胸片检查发现,1名接触AP粉尘26年的退休工人,其胸片可见不规则形肺间质纤维化阴影,诊断为尘肺Ⅰ期。结论长期吸入较高浓度的AP粉尘,会导致肺部纤维化改变,AP接尘工人呼吸系统症状显著高于对照人群,表明AP粉尘对呼吸系统存在危害影响...     

钍稀土混合粉尘作业工人血清抗氧化酶活力和丙二醛含量变化

目的 探讨钍稀土混合粉尘对作业工人血清某些抗氧化酶指标和丙二醛(MDA)的影响.方法 采用分光光度法分析血清MDA含量、超氧化物歧化酶(SOD)、过氧化氢酶(CAT)和过氧化物酶(POD)活力.结果 接尘组血清MDA含量[(9.74±3.60 )μmol/L]显著高于对照组[(6.90±2.87)μmol/L,P<0.001],抗氧化酶POD[(10.65±5.94)×103 U/L]显著低于对照组[(22.73±11.64) ×103 U/L,P<0.001],SOD和CAT与对照组比较差异无统计学意义.接尘组MDA含量与工龄呈正相关(r=0.248,P=0.038).结论 职业接触钍稀土混合粉尘者血清MDA水平升高,而POD活力下降.     

长期职业性锰暴露对工人肺功能的影响

[目的]分析长期职业性锰尘和粉尘暴露对工人肺功能的影响,评价锰尘累积暴露与肺功能的剂量-效应关系. [方法]于2011年对广西某锰冶炼厂280名男性工人进行调查,并回顾性收集历年各车间锰、粉尘浓度监测资料和2006年与2010年工人肺功能检测结果;根据各车间锰、粉尘浓度和接触工龄分别计算出截至2006年与2010年的锰、粉尘累积暴露量.[结果]该厂锰作业工人2010年各项肺功能指标均值均低于2006年检测值,其中用力肺活量(FVC)、第一秒时间肺活量(FEV1)、最高吸气流量(PIF)、75％呼气流速(MEF75)降低明显,差异有统计学意义(P＜0.05);锰作业工人2006年时锰作业工龄平均为(14.27±6.48)年,FVC、FEV1、MEF75与粉尘累积暴露量负相关(P＜0.05),肺功能各指标与锰累积暴露量均无相关关系(P＞0.05); 2010年时锰作业工人工龄平均为(18.05±6.41)年,FVC、FEV1与粉尘累积暴露量负相关,最高呼气流量(PEF)、MEF75、50％呼气流速(MEF5o)与锰累积暴露量负相关(P＜0.05). [结论]职业性锰尘长期累积暴露与肺功能降低有剂量-效应关系.     

烟酸对接尘工人血清中一氧化氮和诱导型一氧化氮合酶的影响

目的 探讨烟酸对矽尘接触工人和矽肺患者血清中一氧化氮(NO)、诱导型一氧化氮合酶(iNOS)的影响.方法 将Ⅰ期矽肺患者53例、矽肺观察对象88例及长期接尘的无尘肺工人55例分为烟酸干预组和对照组,观察两组对象干预前后血清中iNOS和NO的变化.结果 干预组观察对象干预6个月后,血清中NO平均含量为(79.76:±4.72).μmol/L,低于对照组[(83.67:±:4.05)μmol/L],差异有统计学意义(P＜0.05).干预组接尘工人烟酸干预6和12个月后,血清中iNOS平均活力分别为(34.99±2.01)和(39.86±2.84)U/ml,均低于对照组[(38.74±2.18)和(43.94±2.61)U/ml],差异有统计学意义(P＜0.05).干预组观察对象烟酸干预6和12个月后,血清中iNOS平均活力分别为[(34.65±2.67)和(37.36±2.03)U/ml],均低于对照组[(39.86±2.52)和(42.38±2.17)U/ml],差异有统计学意义(P＜0.05,P＜0.01).结论 烟酸可通过抑制接尘工人血清中iNOS活力,减少过量NO的生成量.     

石灰石粉尘对接尘工人健康影响的调查

目的 探讨石灰石粉尘对接尘工人健康的影响.方法 对360名接触石灰石粉尘的工人进行问卷和健康检查,同时选择不接尘的360名工人为对照组,将接尘组与对照组症状、体征、胸片、及肺功能各项指标进行比较.结果 接尘组呼吸系统症状阳性率明显高于对照组差异有统计学意义(P＜0.01),与对照组比较,接尘组的肺功能指标均降低,差异均有统计学意义(P＜0.01).结论 石灰石粉尘属低矽量粉尘,但其分散度高,如长时间高浓度接触可对肺功能造成损害,甚至产生尘肺.     

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.