南京市HIV感染者及艾滋病患者抗病毒治疗依从性及影响因素研究

目的 了解南京市接受抗病毒治疗(ART)的HIV感染者及艾滋病患者(HIV/AIDS)的ART依从性及其影响因素,为提高HIV/AIDS人群的ART依从性提供参考。方法 2014年5－6月在南京市第二医院接受免费高效抗反转录病毒治疗(HAART)的HIV/AIDS作为研究对象,收集一般人口学、ART情况及社会支持与歧视等信息,利用logistic回归分析HAART依从性的影响因素。结果 共调查HIV/AIDS 276例,以依从性支持评价中心的依从性指数为评价标准,调查发现总体依从性良好252例,占91.3%。经单因素及多因素分析显示,提醒服药(OR=0.13,95%CI:0.04~0.37)、年龄较大者(OR=0.52,95%CI:0.31~0.89)服药依从性较好;而存在ART副作用(OR=4.11,95%CI:1.35~12.56)、WHO分期较诊断时降低(OR=3.56,95%CI:1.37~9.21)和吸烟(OR=5.38,95%CI:2.00~14.45)是影响依从性的危险因素。结论 南京市HIV/AIDS人群ART依从性整体情况较好,为进一步巩固提高,对存在ART副作用、无提醒服药、吸烟、年龄较小、病情减轻的患者加强服药依从性教育。     

2015年我国35岁及以上高血压患者社区健康管理与高血压治疗控制情况分析

目的 了解2015年我国≥ 35岁高血压患者的社区健康管理及高血压治疗控制情况并探索其影响因素。方法 利用2015年中国成人慢性病与营养监测项目收集的问卷调查及体格测量等信息,以乡镇卫生院（社区卫生服务中心）或以上级别医疗卫生机构医生诊断为高血压的≥ 35岁的患者为研究对象,对样本进行复杂加权后,分析其一般特征、高血压社区健康管理情况及高血压治疗控制情况。结果 共纳入高血压患者23 974名,经复杂加权后,我国≥ 35岁高血压患者的社区健康管理率为54.10%（95%CI：51.02%~57.17%）,社区规范管理率为45.72%（95%CI：42.93%~48.51%）;高血压治疗率为88.16%（95%CI：87.00%~89.31%）,控制率为22.67%（95%CI：21.25%~24.09%）,治疗控制率为27.76%（95%CI：26.09%~29.42%）。多因素分析结果显示,城市和农村年龄≥ 65岁（OR=1.40,95%CI：1.05~1.87;OR=3.11,95%CI：2.22~4.36）、按医嘱服药（OR=2.15,95%CI：1.46~3.15;OR=1.35,95%CI：1.13~1.62）、进行血压监测（OR=2.34,95%CI：1.88~2.90;OR=3.10,95%CI：2.72~3.53）的高血压患者更愿意接受高血压社区健康管理;文化程度大专及以上（OR=0.51,95%CI：0.39~0.66）、适量饮酒（OR=0.69,95%CI：0.57~0.84）或过量饮酒（OR=0.73,95%CI：0.58~0.92）的城市高血压患者接受社区高血压管理的情况不佳。城市和农村超重（OR=0.74,95%CI：0.61~0.91;OR=0.83,95%CI：0.71~0.98）、肥胖（OR=0.54,95%CI：0.45~0.65;OR=0.67,95%CI：0.54~0.83）的高血压患者血压控制情况较差,按医嘱服药（OR=4.58,95%CI：3.16~6.63;OR=2.84,95%CI：2.18~3.69）的高血压患者的血压控制状况较好。地处中部（OR=0.74,95%CI：0.61~0.89）、过量饮酒（OR=0.72,95%CI：0.54~0.97）的城市高血压患者血压控制情况较差,合并其他慢性疾病（OR=1.22,95%CI：1.04~1.44）、参加高血压社区规范管理（OR=1.29,95%CI：1.06~1.58）的城市高血压患者血压控制情况较好;地处中、西部地区（OR=0.71,95%CI：0.58~0.87;OR=0.62,95%CI：0.47~0.80）、适量饮酒（OR=0.81,95%CI：0.67~0.98）、人均每日食盐摄入量>6 g （OR=0.80,95%CI：0.69~0.93）的农村高血压患者血压控制情况较差,进行血压监测（OR=1.38,95%CI：1.18~1.61）的农村高血压患者血压控制情况较好。结论 我国≥ 35岁高血压患者社区健康管理情况较之前有所改善,但是高血压控制情况距离相关政策指标还有一定差距。     

广西中部地区中老年嫖客使用助性药西地那非的相关危险因素研究

目的 了解广西中部地区中老年嫖客使用西地那非助性药情况及其相关危险因素,评估使用此类助性药对中老年嫖客感染HIV的影响。方法 在调查地区低档暗娼场所对≥50岁嫖客进行问卷调查,获取社会人口学、行为学及西地那非助性药使用史等信息,采集血样本检测HIV和梅毒抗体,使用PASW Statistics 18.0软件进行统计分析。结果 共获得有效问卷2 056份,23.1%使用过西地那非助性药。<60岁者使用助性药风险低于≥60岁者(OR=0.586,95%CI:0.459~0.749);最近30 d内商业性行为的次数≤1次(OR=0.184,95%CI:0.090~0.378)、2次(OR=0.187,95%CI:0.089~0.378)和3次(OR=0.181,95%CI:0.085~0.384)的嫖客,使用助性药的风险低于≥5次者;未婚(OR=0.608,95%CI:0.396~0.933)、已婚/同居(OR=0.533,95%CI:0.391~0.727)、有临时性伴(OR=0.558,95%CI:0.393~0.792)是中老年嫖客使用助性药的保护因素,商业性行为时从不使用安全套(OR=1.642,95%CI:1.125~2.397)、偶尔使用安全套(OR=1.840,95%CI:1.278~2.648)则是嫖客使用助性药的危险因素。检出HIV抗体阳性的嫖客47人,阳性率为2.29%,<60岁嫖客使用助性药感染HIV的风险高于≥60岁者(OR=12.933,95%CI:4.479~37.347)。结论 ≥60岁、离婚/丧偶/分居和最近30 d内发生商业性行为的次数为≥5次、商业性行为时从不使用安全套和偶尔使用安全套是中老年嫖客使用西地那非助性药的危险因素,西地那非助性药可能是中老年嫖客经商业性途径感染HIV的重要影响因素。     

重庆市病原学阳性肺结核患者密切接触者结核分枝杆菌潜伏感染现状及影响因素

目的 了解病原学阳性肺结核患者密切接触者结核分枝杆菌潜伏感染（LTBI）现状及影响因素,为制定LTBI干预措施提供基础依据。 方法 采用多阶段分层整群随机抽样方法选取重庆市39个区县病原学阳性肺结核患者密切接触者为研究对象,通过问卷调查收集人口学信息等资料,采用γ-干扰素释放试验（IGRA）检测结核分枝杆菌感染状态。采用χ²检验和二元logistic回归模型对LTBI影响因素进行分析。 结果 共纳入密切接触者2 591例,男女性别比为0.69：1,平均年龄（35.72±16.64）岁。检出LTBI 1 058例,结核分枝杆菌潜伏感染率为40.83%。单因素分析结果显示,不同年龄、身体质量指数（BMI）、职业、文化程度、婚姻状态,是否患有慢性病或大手术史,是否与指示病例共同居住,以及与指示病例累计接触时长是否≥ 250 h者,感染率不同,差异均有统计学意义（均P < 0.05）;感染率随年龄和BMI升高均呈上升趋势（均P < 0.001）,随文化程度升高呈下降趋势（P < 0.05）。Logistic回归分析显示,年龄45~54岁（OR=1.951,95%CI：1.031~3.693）、55~64岁（OR=2.473,95%CI：1.279~4.781）、其他职业（OR=0.530,95%CI：0.292~0.964）、教师（OR=0.439,95%CI：0.242~0.794）、学生（OR=0.445,95%CI：0.233~0.851）、初中及以下文化程度（OR=1.412,95%CI：1.025~1.944）、BMI < 18.5 kg/m²（OR=0.762,95%CI：0.586~0.991）、与指示病例共同居住（OR=1.621,95%CI：1.316~1.997）、与指示病例累计接触时长≥ 250 h（OR=1.292,95%CI：1.083~1.540）是LTBI的影响因素（均P < 0.05）。 结论 病原学阳性肺结核患者密切接触者结核分枝杆菌潜伏感染率高,需重点关注高龄、农民、与患者接触程度高的密切接触者,及时采取针对性干预措施以降低发病风险。     

孕前体质指数和孕期增重与子痫前期及其临床亚型的关系

目的 探讨孕前BMI和孕期增重与子痫前期（PE）及其临床亚型的发生风险的关系。方法 选取2012年3月至2016年9月在山西医科大学第一医院妇产科分娩的孕妇,根据纳入排除标准,共纳入9 274例孕妇,901例PE孕妇作为病例组,8 373例非PE孕妇作为对照组。收集一般人口学特征、孕前身高和体重、孕期生活方式、生育史和疾病史等资料,计算孕前BMI及孕期增重。采用非条件logistic回归分析孕前BMI和孕期增重与PE及其临床亚型的关系。结果 PE中早发型PE （EOPE）401例、晚发型PE （LOPE）500例,轻度PE （MPE）178例、重度PE （SPE）723例。PE孕妇和非PE孕妇在年龄、居住地、产次、妊娠期糖尿病及高血压家族史等方面差异有统计学意义（P<0.05）。调整以上因素后,logistic回归分析结果显示,孕前BMI<18.5 kg/m²和孕期增重不足是PE的保护因素（OR=0.74,95%CI：0.56~0.98;OR=0.78,95%CI：0.62~0.99）,孕前BMI ≥ 24.0 kg/m²和孕期增重过多是PE的危险因素（OR=1.82,95%CI：1.54~2.14;OR=1.82,95%CI：1.54~2.15）。对PE临床亚型分析后结果显示,孕前BMI<18.5 kg/m²是EOPE和MPE的保护因素（OR=0.52,95%CI：0.32~0.83;OR=0.47,95%CI：0.23~0.97）,孕前BMI ≥ 24.0 kg/m²和孕期增重过多是PE临床亚型的危险因素。按孕前BMI分层后,孕前18.5 kg/m² ≤ BMI<24.0 kg/m²和孕前BMI ≥ 24.0 kg/m²的孕妇中孕期增重过多（OR=1.86,95%CI：1.51~2.30;OR=1.90,95%CI：1.39~2.60）均是PE的危险因素;孕前BMI ≥ 24.0 kg/m²的孕妇中孕期增重不足（OR=0.55,95%CI：0.34~0.89）是PE的保护因素。孕前BMI<18.5 kg/m²的孕妇中孕期增重过多（OR=4.05,95%CI：1.20~13.69）是EOPE的危险因素;孕前18.5 kg/m² ≤ BMI<24.0 kg/m²的孕妇中孕期增重过多是PE各临床亚型的危险因素;孕前BMI ≥ 24.0 kg/m²的孕妇中孕期增重不足是EOPE和MPE的保护因素（OR=0.39,95%CI：0.19~0.80;OR=0.29,95%CI：0.11~0.77）,孕期增重过多是EOPE、LOPE和SPE的危险因素（OR=1.60,95%CI：1.06~2.42;OR=2.20,95%CI：1.44~3.37;OR=2.28,95%CI：1.58~3.29）。结论 孕前BMI和孕期增重影响PE及其临床亚型的发生风险,且不同孕前BMI人群孕期增重对PE的影响有差异,提倡同时关注孕前BMI和孕期体重变化,从而减少PE发生。     

陕西省妇女既往生育史与末次妊娠早产的相关分析

目的 探讨陕西省单胎活产新生儿早产发生率及母亲既往生育史与其的相关性。方法 采用分层多阶段随机抽样方法,以问卷调查方式收集2010-2013年陕西省怀孕且其结局明确的育龄妇女生育史等相关信息。结果 共调查29 608名育龄妇女及其子女,活产单胎新生儿早产发生率为2.7%。logistic回归分析显示,早产史（OR=7.99,95%CI：5.59~11.43）、末次妊娠年龄≥35岁（OR=2.03,95%CI：1.59~2.59）、出生缺陷史（OR=1.54,95%CI：1.01~2.34）是发生早产的危险因素。妊娠间隔3~4年（与妊娠间隔≤2年者比,OR=0.74,95%CI：0.58~0.93）、妊娠间隔5~6年（与妊娠间隔≤2年者比,OR=0.66,95%CI：0.52~0.82）、妊娠间隔>6年（与妊娠间隔≤2年者比,OR=0.48,95%CI：0.37~0.61）、生产次数1次（与初产者比,OR=0.80,95%CI：0.67~0.95）、生产次数≥2次（与初产者比,OR=0.62,95%CI：0.39~0.97）是早产的保护因素。有序多分类logistic回归分析显示,影响孕周长短的主要因素是早产史、高龄妊娠（≥35岁）及妊娠间隔时间。结论 2010-2013年陕西省单胎活产新生儿早产发生率低于全国平均水平。有早产史、高龄妊娠（≥35岁）、出生缺陷史可能增加早产发生风险;妊娠间隔长、分娩次数多可能降低早产发生风险。     

HIV阳性男男性行为人群多性伴高危性行为状况及其影响因素分析

目的 调查HIV阳性MSM多性伴高危性行为状况,分析其影响因素。方法 通过"滚雪球"方法,在成都、重庆和广州市招募年龄≥18岁、经男男性行为感染HIV者为研究对象,取得知情同意后进行电子问卷调查,调查内容包括社会人口学特征、最近6个月的性伴和性行为状况、焦虑和抑郁症状评定等。采用χ²检验、t检验和非条件logistic回归的方法分别进行单因素和多因素分析。结果 501名HIV阳性MSM平均年龄(30.24±7.70)岁,最近6个月多性伴高危性行为报告率为17.4%(87/501)。多因素分析结果显示,最近6个月多性伴高危性行为的危险因素:婚姻状况为在婚(OR=1.93,95%CI:0.77~4.84)、离异或丧偶(OR=3.94,95%CI:1.66~9.36),有焦虑症状(OR=2.22,95%CI:1.16~4.27),有男性固定性伴(OR=5.04,95%CI:1.08~23.54)、男性偶然/商业性伴(OR=2.54,95%CI:1.34~4.80),高危性行为时饮酒(OR=3.00,95%CI:1.37~6.62)、性行为时使用Rush主要成分为(烷基亚硝酸盐)(OR=3.53,95%CI:1.72~7.23),将自己的HIV感染状况对男性固定性伴部分告知(OR=1.84,95%CI:0.78~4.33)、均未告知(OR=2.68,95%CI:1.25~5.73)和性感觉评分高者(OR=1.09,95%CI:1.03~1.15)。结论 HIV阳性MSM的多性伴高危性行为加速HIV的流行,因此,在发展针对该人群心理行为特征的高危性行为干预方法的同时,亟需建立有效遏制HIV经性传播的医学或生物学措施。     

河南省2011-2015年艾滋病哨点吸毒人群HCV感染状况及影响因素分析

目的 分析河南省艾滋病哨点吸毒人群HCV感染情况及影响因素,为制定防治策略提供依据。方法 2011-2015年,在哨点监测期(4-6月)内以重复横断面调查的方法对河南省吸毒人群进行问卷调查和血清学检测,分析该人群HCV感染情况及影响因素。结果 2011-2015年,河南省吸毒人群HCV感染率从2011年的3.70%上升到2015年的6.54%(趋势χ²=25.93,P<0.01)。多因素分析结果显示:年龄较高(OR=1.23,95%CI:1.13~1.35,P=0.00)、外省户籍(OR=3.45,95%CI:2.59~4.60,P=0.00)、传统毒品和混合毒品使用者(OR=1.46,95%CI:1.10~1.93,P=0.01;OR=1.82,95%CI:1.18~2.81,P=0.01)、有注射毒品史(OR=2.88, 95%CI:2.45~3.39,P=0.00)、最近一年有商业性行为史(OR=1.44,95%CI:1.20~1.72,P=0.00)、来自强制戒毒所和美沙酮门诊的吸毒人员(OR=1.79,95%CI:1.28~2.50,P=0.00;OR=1.74, 95%CI:1.17~2.58,P=0.01)是感染HCV的危险因素。结论 河南省吸毒人群HCV抗体阳性率较高,且呈上升趋势,应加强对吸毒人群的监管,制定有效干预措施,控制HCV的传播。     

北京市2013-2014年禽流感疫情期间居民活禽暴露调查

目的 了解北京市居民在第二波人感染H7N9禽流感疫情期间的活禽暴露（饲养和购买活禽行为）及其影响因素,为禽流感防控提供科学依据。方法 采用多阶段分层抽样方法,对7 366名≥ 18岁居民进行问卷调查。应用非条件logistic回归分析活禽暴露的影响因素。结果 北京市居民在过去1年活禽饲养率和购买率分别为5.3%（95% CI：4.8%~5.8%）和6.0%（95% CI：5.5%~6.5%）。logistic回归分析结果显示,饲养活禽的危险因素包括小学及以下文化程度者（比大学及以上文化程度者,OR=1.82,95% CI：1.22~2.72）;农民（比在职人员,OR=2.49,95% CI：1.89~3.29）和待业（比在职人员,OR=1.65,95% CI：1.08~2.52）;非北京出生（比北京出生者,OR=1.54,95% CI：1.10~2.16）;住在郊区（比城市居民,OR=2.36,95% CI：1.77~3.16）;家庭有1名儿童（比没有儿童的家庭,OR=1.76,95% CI：1.42~2.17）或≥ 2名儿童（比没有儿童的家庭,OR=2.15,95% CI：1.43~3.22）。购买活禽的危险因素包括农民（比在职人员,OR=1.61,95% CI：1.27~2.02）;非北京出生（比北京出生者,OR=1.76,95% CI：1.31~2.35）;住在郊区（比住在城区,OR=2.05,95% CI：1.61~2.61）;家庭有1名儿童（比没有儿童的家庭,OR=1.24,95% CI：1.02~1.52）或≥ 2名儿童（比没有儿童的家庭,OR=1.78,95% CI：1.21~2.63）。结论 北京市居民仍然存在活禽暴露的情况,应针对不同对象特征采取措施减少活禽暴露。     

北京市18～65岁居民戒烟意愿、吸烟危害认知及其对吸烟情况的影响

目的 了解北京市18～65岁居民吸烟危害认知水平及戒烟意愿,对控烟工作及相关政策措施的制定完善实施提供科学依据。方法 数据来自2017年北京市成人慢性病及其危险因素监测,以多阶段分层整群的抽样方法在北京市16个区165个村/居抽取调查对象进行调查,采用logistic回归进行多因素分析。结果 11 594例有效样本中,49.93%不想戒烟,男性不想戒烟者比例为50.39%,女性为43.01%,差异有统计学意义（χ²=14.211,P=0.002）,郊区为56.78%,城区为45.30%,差异有统计学意义（χ²=51.977,P<0.001）。吸烟者与戒烟者戒烟动机中,因所患疾病原因,戒烟者中比例（29.88%）高于吸烟者（11.50%）,差异有统计学意义（χ²=85.865,P<0.001）。吸烟危害认知较好女性的比例（34.97%）高于男性（32.63%）,差异有统计学意义（Z=5.612,P<0.001）;郊区的比例（35.44%）高于城区（33.03%）,差异有统计学意义（Z=-3.734,P<0.001）;从不吸烟者的比例（35.15%）高于吸烟者（30.06%）,差异有统计学意义（χ²=62.277,P=0.005）。多因素logistic回归结果显示,认知一般者（OR=0.61,95% CI：0.39～0.94）与认知较差者（OR=0.67,95% CI：0.50～0.90）不易产生戒烟行为,认知一般者（OR=0.64,95% CI：0.53～0.76）与认知较差者（OR=0.87,95% CI：0.78～0.98）更易产生吸烟行为。结论 北京市18～65岁吸烟者戒烟意愿较低,戒烟动机主要出于健康考虑,从不吸烟者吸烟危害认知优于吸烟者,吸烟危害认知是吸烟情况的影响因素。     

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.     

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.     

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.     

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.