职业接触灭蚁药物人群的肝功能损伤

[目的]探讨职业性接触氯丹、含砷化合物灭蚁药物对作业人员肝功能水平的影响。[方法]对作业人员进行血清丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、γ-谷氨酰转移酶(γ-GT)、碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)、甘胆酸(CG)、氯丹和尿液砷水平进行了检测分析。并对工龄、吸烟、饮酒和体内毒物的浓度对肝功能各项指标的影响进行统计学分析。[结果]职业接触灭蚁药物使血清γ-GT、LDH和CG水平增高(P<0.05),并与接触工龄相关;饮酒能加重含砷和氯丹类灭蚁药物对职业人群肝脏的损伤作用(P<0.05),使血清γ-GT、LDH和CG水平显著增高,吸烟对接触含砷或氯丹类灭蚁药物的职业人群肝脏的损伤没有影响;血清γ-GT、LDH和CG水平均与血清氯丹和尿砷含量呈正相关。[结论]接触灭蚁药物能使职业人群肝功能水平明显损伤。     

灭白蚁药物对人体脂质过氧化水平的影响

为探讨职业性接触氯丹、含砷化合物灭蚁药物对作业人员脂质过氧化水平的影响,对作业人员进行了血清中过氧化脂质代谢物(MDA)和红细胞超氧化物歧化酶(SOD)、谷胱甘肽氧化酶GSH-Px、血清氯丹和尿砷水平的检测分析,并对工龄、吸烟、饮酒和体内毒物的浓度对脂质过氧化各项指标水平的影响进行统计学分析。结果显示,职业接触灭蚁药物使作业人员血清中MDA增高、SOD、GSH-Px水平显著下降,并与工龄相关;吸烟、饮酒能加重灭蚁药物对人体脂质过氧化水平的影响,MDA与血清氯丹和尿砷含量呈正相关,SOD、GSH-Px的水平与血清氯丹和尿砷含量呈负相关。提示职业性接触灭蚁药物能使体内脂质过氧化反应明显增强。     

含砷和氯丹类灭蚁药对职业人群心脏功能损伤的研究

目的:探讨职业性接触含砷和氯丹类灭蚁药对作业人员心脏功能水平的影响.方法:对作业人员的血清心肌酶谱:肌酸激酶(CK)及其同工酶(CK-MB)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、α-羟丁酸脱氢酶(α-HBDH)和乳酸脱氢酶(LDH)水平进行检测,同时做心电图检查,并对工龄、吸烟、饮酒等因素的影响进行分析.结果:职业接触灭蚁药物会使血清CK、α-HBDH和LDH水平显著升高,心电图异常率增高,且与接触工龄相关;饮酒能加重含砷和氯丹类灭蚁药物对职业人群心脏的损伤作用;血清CK、α-HBDH和LDH水平及心电图异常率,均与血清氯丹和尿砷含量呈正相关.结论:含砷和氯丹类灭蚁药能使职业接触人群心脏功能明显受损.     

接触灭蚁药物对男工体内性激素水平的影响

为探讨职业性接触氯丹、含砷化合物灭蚁药物对作业人员男性性激素水平的影响,对作业人员血清中血清促滤泡成熟素(FSH)、促黄体生成素(LH)和睾酮(T)水平进行了检测分析,并对工龄、吸烟、饮酒和体内毒物的浓度对男性性激素水平各项指标的影响进行统计学分析。结果显示,职业接触灭蚁药物使血清中FSH、LH和T水平显著下降,并与工龄相关;吸烟、饮酒能加重含砷和氯丹类灭蚁药物对人体男性性激素水平的抑制作用,使FSH、LH和T水平显著下降;体内男性性激素水平FSH、LH和T与血清氯丹和尿砷含量呈负相关。提示职业性接触灭蚁药物能使体内男性性激素水平明显抑制。     

职业接触灭蚁药物对人体淋巴细胞DNA的损伤作用

[目的]探讨职业性接触灭蚁药物氯丹、含砷化合物对作业人员外周血淋巴细胞DNA损伤水平的影响。 [方法]采用碱性单细胞凝胶电泳技术检测灭蚁药物作业工人外周血淋巴细胞的DNA损伤,研究灭蚁药物对职业接触人群的遗传毒性,观察指标包括DNA断裂分级(将DNA断裂损伤细胞按其损伤程度分级)及DNA彗星尾长(彗头末端到彗尾的长度)。并对工龄、吸烟、饮酒和体内毒物的浓度对外周血淋巴细胞DNA损伤水平各项指标的影响进行统计学分析。[结果]职业接触灭蚁药物工人外周血淋巴细胞DNA断裂程度及DNA彗星尾长两个指标,均明显高于对照组,差异有显著性(P<0．01),并与体内毒物水平、接触工龄有明显正相关关系,吸烟、饮酒能加重含氯丹、砷化合物对DNA的损伤水平。[结论] 职业性接触灭蚁药物可对职业工人外周血淋巴细胞DNA造成损伤,并存在遗传毒性。     

接触灭蚁药物对人体免疫功能的影响

采用美国Beckman公司生产的免疫化学系统ICS仪和PFG紫外定量法,对接触灭蚁药物人员进行了血清IgG、IgA、IgM、C3、C4、CRP、CIC检测,并对工龄、吸烟、饮酒和体内毒物的浓度对免疫水平的影响进行了分析。结果显示职业接触灭蚁药物使血清中IgG、IgA、IgM水平显著下降,但与工龄无关;吸烟、饮酒能加重含砷和氯丹类灭蚁药物对人体免疫水平的影响,使IgG、IgA、IgM水平显著降低;体内免疫球蛋白的水平与血清氯丹和尿砷含量呈负相关。提示职业性接触灭蚁药物能显著降低作业人员机体的免疫水平。     

职业接触灭蚁药物对人体淋巴细胞染色体损伤的影响

目的 探讨职业性接触灭蚁药物作业人员外周血淋巴细胞染色体损伤效应的影响。方法对作业人员进行了外周血淋巴细胞染色体畸变率和姐妹染色单体互换（SCE）水平的检测。并对工龄、吸烟、饮酒和体内毒物的浓度对血淋巴细胞染色体畸变率和SCE水平的影响进行统计学分析。结果随工龄的增长血淋巴细胞染色体畸变率和SCE水平增高；吸烟、饮酒能加重含砷和氯丹类灭蚁药物对血淋巴细胞染色体的损伤，使畸变率和SCE水平显著增高；体内血清氯丹含量和与染色体畸变率、SCE水平呈正相关，而尿砷含量与染色体、SCE水平无相关关系。结论职业性接触灭蚁药物对作业人员外周血淋巴细胞遗传学效应存在着不同程度的损伤。     

汞作业人员肾脏早期损伤指标的探讨

[目的]探讨汞作业人员早期肾脏损伤的生物效应指标。[方法]将116名汞作业人员分为尿汞值超标组、尿汞值正常组,并以无汞接触史的50名健康成人作为对照组,分别测定尿中肌酐(UCr)、γ-谷氨酰基转移酶(γ-GT)、α1-微球蛋白(α1-MG)、β2-微球蛋白(β2-MG)、视黄醇结合蛋白(RBP)、N-乙酰-β-D氨基葡萄糖苷酶(NAG),排除肾病史和肾脏疾病患者后对其结果进行分析。[结果]汞作业人员α1-MG、β2-MG、RBP、NAG和对照组相比均有升高趋势,其中RBP和NAG与对照组相比,差异有统计学意义。尿汞值超标组和尿汞值正常组NAG水平均明显高于对照组。[结论]汞作业人员NAG活性增高较尿汞出现得早,建议将尿NAG活性测定作为汞作业人员健康监护指标之一,与尿汞同时检测。     

三氯乙烯作业人群尿中小分子蛋白水平研究

目的探讨三氯乙烯(TCE)职业接触对尿中3种小分子蛋白水平的影响。方法以112名TCE接触工人和70名对照作为调查对象,收集职业史、年龄、性别、吸烟和饮酒等信息。收集班后尿,测定三氯乙酸(TCA)水平及α1微球蛋白(α1-M)、β2微球蛋白(β2-M)、视黄醇结合蛋白(RBP)的水平。结果3种小分子蛋白α1-M、β2-M、RBP水平在两组调查对象中比较,差异均无统计学意义。以作业工龄、TCE浓度、尿中TCA水平分组后,作业工龄≥1.9a的工人α1-M水平明显高于对照组,差异有统计学意义(P<0.05);高TCE浓度(198.0～257.0mg/m3)组及尿中TCA水平≥50mg/L组的工人RBP水平均明显高于对照组,差异有统计学意义(P<0.05)。结论长时间和高水平TCE职业接触可致作业工人尿中α1-M、RBP水平增高。     

尿蛋白和尿酶联合检测在糖尿病肾病早期诊断中的应用价值

目的探讨尿微量白蛋白/肌酐(ACR)、尿β_2-微球蛋白(β_2-MG)、尿视黄醇结合蛋白(RBP)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、尿α1-微球蛋白(α1-MG)及其联合测定在糖尿病肾病(DKD)早期诊断中的应用价值。方法收集83例糖尿病肾病早期患者(DKD组)和70例健康体检者(对照组)的尿液标本,测定所有受试者尿ACR、尿β_2-MG、尿RBP、尿NAG、尿α1-MG水平,并对结果进行统计学分析。结果与对照组比较,DKD组尿ACR、尿β_2-MG、尿RBP、尿NAG、尿α1-MG水平均升高且差异均有统计学意义(P均0.01)。ROC曲线结果显示,尿ACR的AUC为0.916,尿β_2-MG的AUC为0.779,尿RBP的AUC为0.9,尿NAG的AUC为0.868,尿α1-MG的AUC为0.915;联合检测的AUC为0.989。5个指标联合检测的阳性率和灵敏度均高于各单独指标。结论尿ACR、尿β_2-MG、尿RBP、尿NAG、尿α1-MG的联合检测可以有效提高糖尿病肾病的早期检出率,值得临床推广。     

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.     

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.     

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.     

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.