河北口岸出入境人员健康体检结果分析

[目的] 了解河北省出入境人员中疾病的流行情况，制定有效的控制措施。[方法] 对2002年河北国际旅行卫生保健中心的出入境人员体检结果进行分析。[结果] 4500名出入境人员中共检出高血压342例；异常心电图304例；HBsAg阳性134例；病毒性肝炎18例；梅毒1例；HIV抗体阳性1例。[结论] 出入境检验检疫机关应加强对出入境人员传染病监测工作，特别要加强回国劳务人员和入境外籍人员的传染病监测，严防境外传染病传人我国。     

境外来华人员乙型肝炎病毒感染的流行病学研究

[目的]研究境外来华人员乙型肝炎病毒感染的流行特点。[方法]采用整群抽样法调查1999年和2000年前来上海国际旅行卫生保健中心接受入境健康体检的14796名境外来华人员的HBsAg感染情况。[结果](1)1999和2000年2年境外来华人员的乙肝病毒感染率为5.38％,其中男性6.09％,女性为5.38％,男性明显高于女性;(2)华裔的感染率(8.43％)明显高于非华裔(1.65％);(3)中国内地、港澳台地区和东南亚地区特别是台湾地区人员的感染率(11.4％)明显高于其他地区。[结论]华裔人群特别是台湾地区居民的乙肝病毒感染人数占了境外来华人员乙肝病毒感染总数的绝大多数,因此在控制乙型肝炎的国际间传播中应将之作为重点监控人群。     

1例输入性HIV感染病例的疫情处理报告

[目的] 加强对来华外籍HIV感染者的卫生检疫监管,防止输入性病例在国内进一步传播.[方法] 对1例由齐齐哈尔市疾病预防与控制中心移交的来华外籍HIV 感染者进行卫生检疫监管.[结果] 依据我国现行的有关艾滋病的法律法规,在检验检疫、公安部门的监护下,该患者于2005年10月3日离境回国.[结论] 加强对外籍来华人员的艾滋病监测十分重要.     

加强出入境人员结核病监测工作重要性的探讨

[目的]做好出入境人员结核病监测工作。[方法]分析了结核病在全球和我国流行情况及其流行原因。[结果]全球流行情况：结核茵感染严重、结核病人不断增加、结核病死亡达历史最高水平；我国流行情况：高感染率、高患病率、高死亡率、高耐药率和低递降率；预防：控制结核病人、切断传染途径、接种卡介苗；结核病控制：直接监督下的短疗程治疗(DOTS)。[结论]加强出入境人员结核病监测管理，尽快成立各级结核病实验室，与地方各级医疗机构联合，建立结核病防治服务网络系统，不断提高检验检疫机构结核病防治能力。     

境外人员体检记录验证工作中的问题探讨

目的 维护验证工作的严肃性和统一性,建议制定境外人员验证的工作规程。方法 回顾涉及境外人员验证工作的有关法律法规、文件规定和工作中的一些实际做法,查找可能存在的问题。结果 学习、回顾了适用于验证工作的法律法规及有效文件有10多个(附后),对验证对象、程序、境外体检单位的资质、文件一致性,操作上的科学性、复杂性、例外情形等七个方面进行了分析、讨论,同时提出了建议。结论 检验检疫机关应及时发放的文件进行有效性清理,掌握实施工作中的情况和问题,制定切实可行的工作规程。     

境外来华人员预防接种与旅行卫生保健需求研究及其影响因素分析

目的了解境外来华人员的预防接种及旅行卫生保健需求、对口岸国际旅行卫生保健中心医疗服务的需求与利用的现状,分析其利用的主要影响因素,为国际旅行卫生保健中心医疗服务的合理设置,构建与国际旅行者需求相适应的口岸医疗服务体系提供依据。方法抽取2014年1-4月期间上海口岸入境并于上海国际旅行卫生保健中心完成法定入境体检项目的外籍人员2 000名,采用自行设计调查问卷对该群体开展调查。结果共计1 970名外籍人员入组(应答率98.50%)。境外来华人员有或可能有旅行计划的占84.56%,50.34%的旅行者知道中国有合格的旅行门诊,选择中国政府机构下的旅行门诊者仅占23.90%。影响境外来华人员选择医疗机构进行旅行保健服务的因素中,最大的是专业水平,其他依次为就诊环境、服务质量、医疗设备等。境外来华人员最想获取的旅行医学咨询为食物、水的预防措施,旅行者腹泻,疫苗接种推荐等;认为在中国最易暴露的疾病依次为禽流感、流感和乙型肝炎等。旅行者中,63.29%的成人及72.07%的儿童希望在中国进行疫苗接种,仅有8.54%的旅行者希望选择中国政府机构下属的旅行门诊。旅行者最想在中国进行接种的三类疫苗分别是流感、乙型肝炎和甲型肝炎疫苗。结论境外来华人员的预防接种及旅行卫生保健需求处于较高水平,但对国际旅行卫生保健中心医疗服务利用度较低。境外来华人员具有一定人群特征,且对旅行卫生保健服务和预防接种的需求具有一定特点。国际旅行卫生保健中心应根据需求调整业务方案,不断提高医疗服务质量,给境外来华人员带来便捷高效的旅行卫生保健服务。     

国际旅行卫生保健中心对其他医疗机构医学检验结果认可的思考

国际旅行卫生保健中心及分中心(以下简称保健中心)是隶属于检验检疫系统以传染病监测体检职能为主的医疗机构。在实践中,我们经常碰到入出境人员体检或复检时提供近期地方大中型医疗     

卫生处理机构的作用与管理模式

[目的]探讨检验检疫系统所属卫生处理机构的管理模式。[方法]根据卫生处理机构应发挥的作用，对在“政事分开，政企分开”的改革环境下，卫生处理机构如何在市场竞争中求发展的课题进行研究。[结果]卫生处理机构是针对危害人类健康的传染病和骚扰人类生活的有害昆虫与动物进行综合治理和有害生物防治的专业服务机构。其要想在市场竞争中求发展必须做到：(1)转变观念，寻求发展；(2)落实法规条例，强化内部管理；(3)建立集团化管理模式。[结论]作为检验检疫系统所属的卫生处理机构，应实行企业化管理。在为检验检疫执法提供服务的同时，通过合理合法途径向市场寻求发展。     

加强保健中心体检风险管理初探

近年来,随着国际交往的日益频繁,国际旅行卫生保健中心或分中心(简称保健中心)承载的法定出入境体检业务也得到蓬勃发展,检体诊断服务功能不断增强,以旅行保健服务为载体,在WHO<国际卫生条例>(2005)框价下,体现了检验检疫积极有效的社会职能,捍卫了国家形象和声誉:一是为卫生检疫技术执法提供了强有力的依据,防止疫情疫病扩散传播,维护国家安全;二是通过<健康证>签发、涉外体检(免疫)证明填写、健康(适任)评估等,为出入境人员顺利通过国外口岸查验、移民或卫生部门审核签证以及健康完成赴外劳务等目的起到积极的作用;三是出入境人员疾病"三早"(早期发现、早期诊断、早期治疗)水平不断提升,国际旅行特色保健服务更是极大地维护旅行者身心健康.     

社会中医养生保健机构管理模式的构建

[目的]探索社会中医养生保健机构的管理模式,为完善养生保健服务标准与服务内容的规范化监管、维护市场秩序提供保障。[方法]梳理2008年-2018年6月,在国内学术期刊上发表的有关社会中医养生保健机构监管方面的研究文献,以及现行的关于医疗机构与社会中医养生保健机构的法律、法规,采用归纳分析法总结出社会中医养生保健机构管理模式的关键环节与核心要素,并用比较分析法分析管理模式核心要素构成的完备性。[结果]社会中医养生保健机构的管理模式分为准入、监督、退出3个环节,准入的核心要素包括人员配置、厂房规模、设备配置、从业人员资质、执业登记、服务项目;监督的核心要素包括人员培训、诊疗行为;退出的核心要素包括服务安全、服务费用、服务范围、违规与违法行为。[结论]应加大对人员培训监督及退出(服务安全、服务费用、服务范围、违规与违法行为)的审查力度,维护良好市场秩序。     

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.     

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.     

Assessing occupational and environmental exposure

Exposure assessment is a poorly understood component of the science of epidemiology. The relationship between exposure to chemicals and ill-health outcomes is often calculated using crude exposure measures such as ever/never exposed or duration. When investigating subtle effects, exposures need to be characterized much more fully in terms of intensity, frequency, duration and route. While occupational exposures tend to be much greater than those experienced from the wider environment there is a need to remember that, for many chemicals, exposure can occur occupationally, environmentally and through consumer use of products containing the material of interest. Inhalation exposure has generally been the traditional focus for most epidemiological investigations but there is now growing awareness of the importance of the dermal and ingested routes of contact and internalization. Quantification of the exposure also needs to be related to a biological mechanism of action and exposure metrics need to be selected accordingly. Occupational exposures can generally be measured using simple well-validated techniques. Environmental exposures require much more sensitive instruments and are more difficult to assess. Exposure modelling, particularly for the environmental fate of chemicals has undergone many recent developments and Monte Carlo techniques can be used to characterize model uncertainty and variability. This approach to exposure assessment can now be used in the setting of the wider environment and will enable a far better understanding of the relationship between exposure and disease.     

Mercury toxicity due to the smelting of placer gold recovered by mercury amalgam

A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [Mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (Mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited.     

How Adults with Acquired Brain Damage Perceive Computer Training as a Rehabilitation Tool: A Focus-group Study

The aim of this study was to explore and describe how adult outpatients with acquired brain damage and referred to occupational therapy perceive computer training with the RehaCom programs, in order to evaluate the method of treatment as a tool in the rehabilitation of persons with cognitive disorders. By using focus-group discussions as a qualitative method of research when analysing the result, five themes with corresponding categories emerged, describing a development of understanding and learning about capacities. Themes describing how the participants could apply strategies to overcome shortcomings in daily occupations and the therapeutic role of the occupational therapist were identified as well. The result shows that a computer training program such as RehaCom can be used as an educational tool, for example, to guide a person who is trying to adopt compensatory strategies to avoid overload by taking pauses. It was found that anything the participants learned was also applicable to occupational performance in daily life.