耐火陶瓷纤维对作业工人皮肤的刺激作用

[目的]探讨耐火陶瓷纤维对作业工人皮肤的刺激作用. [方法]选择从事耐火陶瓷纤维生产和加工的281名作业工人作为接触组,274名仅接触噪声的作业工人作为对照组,进行皮肤检查和问诊,观察的效应指标主要为刺激性接触性皮炎和皮肤瘙痒症状.接触组按总粉尘质量浓度＜1、1～5、＞5 mg/m3分为低、中、高三个水平(分别为83人、128人、70人),按纤维计数浓度＜o.1、0.1～0.5、＞0.5 f/mL分为低、中、高三个水平(分别为83人、163人、35人).[结果]接触组刺激性接触性皮炎检出率、皮肤瘙痒发生率(13.2％、36.0％),均高于对照组(0％、10.6％)(P＜0.05).二者均与总粉尘质量浓度水平呈线性趋势关系(p＜0.05),并随总粉尘质量浓度水平的增加而升高;均与纤维计数浓度水平和接触工龄无关联性(P＞0.05). [结论]接触耐火陶瓷纤维可引起刺激性接触性皮炎和皮肤瘙痒症状等刺激作用,刺激作用与总粉尘质量浓度的关联性优于纤维计数浓度,可考虑作为制定总粉尘容许浓度的关键效应指标.     

317名电焊工眼晶状体混浊的调查

目的 了解电焊作业工人眼晶状体混浊发生情况,为制定综合防治对策提供参考依据.方法 选择某大型国有车辆制造厂电焊作业工人(全部为手工电弧焊)317人(634只眼)为接触组,选不接触电焊作业的机加工、辅助工等作业工人321人(642只眼)为对照组,对两组工人不同年龄和不同工龄组眼晶状体混浊检出情况进行统计分析.结果 接触组眼晶状体混浊总检出率和不同工龄组的检出率均明显高于对照组,差异有统计学意义(P＜0.05,P＜0.01),且接触组与对照组眼晶状体混浊的检出率均随工龄的增加而升高,差异有统计学意义(P＜0.01).接触组不同年龄组眼晶状体混浊的检出率除50岁～年龄组外,均明显高于对照组,差异有统计学意义(P＜0.01),且接触组与对照组眼晶状体混浊的检出率均随年龄增加而升高,差异有统计学意义(P＜0.01).结论 电焊弧光对作业工人眼晶状体的影响非常明显,应当引起高度重视,并采取积极有效的预防措施.     

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.     

钒对职业接触人群心血管系统基本症状及血压的影响

[目的]探讨钒对职业接触人群心血管系统的影响. [方法]通过横断面研究方法,对钒职业接触工人心血管系统的症状、血压、心电图进行分析,探讨钒对职业人群心血管的影响. [结果]接钒组心血管系统症状检出率是对照组的2.6倍(OR=2.60,P＜0.05),且接钒工龄与心血管系统症状检出率呈正相关(OR=1.40,P＜0.05).接钒组收缩压高于对照组(P＜0.05),两组舒张压差异无统计学意义(P＞0.05);接钒组高血压的检出率与对照组比较,差异无统计学意义(P＞0.05).两组心电图异常情况比较,差异亦无统计学意义(P＞0.05). [结论]钒化合物对职业接触人群的心血管系统可产生潜在危害.     

沥青烟作业工人肺通气功能和胸片的改变

目的 探讨沥青烟作业工人肺通气功能和X线胸片的改变.方法 选择碳素分厂生阳极车间接触沥青烟工人53名作为接触组,选择该厂非沥青烟作业职工50名作为对照组,比较两组肺通气功能和胸部X线片的变化.结果 接触组肺活量(VC)、用力肺活量(FVC)、1秒钟用力呼气量(FEV10)、最大自主通气量(MVV)的异常率分别为34.0%、30.2%、35.8%、37.7%,对照组的异常率分别为10.0%、16.0%、12.0%、10.0%,两组比较,差异有统计学意义(P＜0.01).与对照组比较,接触组VC、MVV、FEV10明显降低,差异有统计学意义(P＜0.05或P＜0.01).接触组FEV10与接触工龄呈负相关(r=-0.321,P＜0.05),MVV与接触工龄呈负相关(r=-0.287,P＜0.05).接触组肺纹理改变阳性检出率为34.0%,对照组肺纹理改变阳性检出率为16.0%,两组比较,差异有统计学意义(P＜0.05).接触工龄5～20年组和＞20年组肺纹理改变阳性胸片检出率均高于＜5年组,差异均有统计学意义(P＜0.05).结论 沥青烟能引起作业工人肺通气功能的改变,与接触工龄有关.     

某化工厂过氯酸铵粉尘作业工人健康状况调查

目的 了解过氯酸铵(AP)粉尘对作业工人健康的影响,为其预防措施提供依据.方法 选择该厂接触AP粉尘的36名作业工人为接触组,不接触AP粉尘的48名该厂工人为对照组.调查工厂的一般情况,监测作业场所的AP粉尘浓度,对两组人群进行职业健康体检,检测血常规、肝肾功能、甲状腺激素指标,进行肺通气功能和X线胸片检查.结果 AP总粉尘浓度以组批车间最高,为(51.63±43.27) mg/m3.接触组收缩压[(146.14±21.03)mmHg]明显高于对照组[(134.67±18.58)mmHg],差异有统计学意义(P＜0.05).接触组全身各系统症状(皮粗、皮痒、气短、咳嗽、咳痰、咽干、疲乏无力等)累计检出率、气短及皮痒的检出率分别为86.11％、30.56％、36.11％,均明显高于对照组(66.67％、12.50％、10.42％),差异均有统计学意义(P＜0.05).接触组的游离三碘甲状腺原氨酸(FT3)水平[(1.29±0.20) ng/ml]明显低于对照组[(1.41±0.23) ng/ml],差异有统计学意义(P＜0.01).接触组工人的1秒用力肺活量与用力肺活量百分比值(FEV1.0/FVC)低于对照组,但差异无统计学意义(P＞0.05).接触组检出1例肺部X线影像异常者,并诊断为尘肺,对照组检出1例左肺门区有1约1.0x1.0小结节影.结论 接触组工人的收缩压明显高于对照组,不排除与接触AP粉尘有关;接触组工人的FT3低于对照组,提示长期接触AP粉尘可能会对作业工人甲状腺功能造成影响.     

甲醛对作业工人健康影响的调查分析

以某生物药厂392名作业工人为接触组,以某企业行政、后勤人员224名为对照组.采用职业性健康体检方法进行调查分析.接触组头晕、头痛、失眠.心悸等神经衰弱症状及全身酸痛检出率明显高于对照组(P＜0.01),甲醛对作业工人嗅觉也有明显损害,两组检出率比较差异有显著性(P＜0.01).接触组咽部、眼结膜和鼻黏膜异常症状检出率组间差异明显,＞10年工龄各组较＜10年工龄各组比较差异均有统计学意义,且异常检出率随接触工龄延长而增高.长期接触甲醛对作业工人健康造成负面影响,应加强作业环境治理,降低作业场所甲醛浓度,并加强个人防护措施.     

二硫化碳对接触工人心血管系统的影响

目的 探讨二硫化碳(CS2)接触对作业工人心血管系统的影响.方法 选取某化纤厂CS2污染程度不同的、有代表性的车间,对其633名接触CS2作业工人作业场所的CS2浓度进行检测,同时对工人进行血压、心电图、血常规、胆固醇(TCHO)、甘油三酯(TG)等测定;用X2检验和多元logistic回归分析方法,对数据进行统计学处理.结果 作业工人接触CS2水平检测结果显示,共有389名作业工人接触CS2的浓度≤5 mg/m3,244名作业工人接触CS2的浓度＞5 mg/m3,其中接触CS2浓度最高值为15.73 mg /m3.CS2对作业工人的心电图各检查指标、红细胞、白细胞、血小板等指标以及TCHO和TG均无明显影响,对血压有正向影响,对血红蛋白有负向影响;男性CS2接触工人TCHO升高、TG升高及高血压检出率明显高于女性,差异有统计学意义(P＜0.05),年龄≤30岁的CS2接触工人的窦性心律失常、高血压及TCHO升高的检出率均明显高于年龄＞30岁的CS2接触工人,差异有统计学意义(P＜0.05).1≤工龄＜10年组接触CS2工人的窦性心律失常检出率明显高于工龄≥10年工人,1≤工龄＜10年组接触CS2工人的高血压及TCHO升高的检出率明显低于工龄≥10年工人,差异有统计学意义(P＜0.05).结论 CS2接触对心血管系统相关指标未见明显影响.     

高原地区低质量浓度三硝基甲苯对作业者肝脏及眼晶体影响

目的 了解高原地区低质量浓度2,4,6-三硝基甲苯(TNT)时作业者肝脏及眼晶体的影响,为高原环境因素与TNT交互作用的研究提供基础数据.方法 对高原地区莱厂采用职业卫生调查,对接触.TNT的184名生产工人进行健康检查.结果 2000-2005年被调查工厂的工作场所空气检测TNT质量浓度均值基本符合国家职业卫生标准;肝功能异常检出率接触组高于对照组(17.9%和5.5%,P＜0.01);B超肝肿大检出率接触组高于对照组(7.6%和6.3%,P＞0.05);眼晶体混浊和白内障检出率接触组(7.6%,4.3%)均高于对照组(1.6%,0%),盖异有统计学意义(P＜0.05).结论 高原地区长期接触低质量浓度TNT可对作业工人产生慢性职业危害.     

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.     

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.     

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.