深圳口岸出入境人员HIV感染者的流行病学调查

〔目的〕了解深圳口岸出入境人员HIV感染的特点,为加强口岸艾滋病监测工作,对艾滋病高危人群实施行为干预提供科学依据。〔方法〕初筛试验采用酶联免疫吸附试验(ELISA)、明胶颗粒凝集试验(PA法)、胶体硒法;初筛阳性标本采用免疫蛋白印迹法(WB)确认。对HIV抗体确认阳性者进行流行病学调查,并对流行病学调查资料进行统计分析。〔结果〕2002￣2005年共对229969名出入境人员进行艾滋病血清学检测,检出HIV抗体阳性者28例,总检出率为0.12‰。28例HIV感染者中外籍人员占60.7%,外籍人员感染率为0.46‰;30￣39岁为高发年龄组,占42.9%;男性感染者明显高于女性感染者;未婚感染者高于已婚感染者;从职业分布来看技术人员、商务人员和驾驶员所占比例较高;并且以不洁性行为为主要传播途径。〔结论〕我国艾滋病传入的风险高于传出的风险。应加强口岸高危人群的艾滋病监测力度,加强对出入境人员艾滋病防治知识的宣传教育和行为干预,防止艾滋病在国际间的传播。     

厦门口岸出国劳务人员艾滋病与梅毒监测结果分析

〔目的〕掌握厦门口岸出国劳务人员中艾滋病、梅毒感染情况。〔方法〕对1988～2000年经厦门口岸出入境的出国劳务人员25900人次进行了HIV感染和梅毒的血清学检测。〔结果〕HIV感染者检出8例,总检出率为0.31‰,其中30～40岁年龄组为7例,占感染者总数的87.5％;检出梅毒感染者26例,总检出率为1.01‰,其中男性20例,女性6例;年龄在20～40岁年龄组的25例,占感染者总数的96.15％。1994年检出首例梅毒感染者至2000年平均年递增24.5％。〔结论〕厦门口岸出入境劳务人员HIV感染均属境外经异性性接触传播,地区主要来自东南亚。梅毒主要是在国内因性乱感染。说明出入境检验检疫部门加强对性传播性疾病监测,及时发现病例,对阻止其经出入境口岸传播起到了重要作用。     

南宁口岸出入境人员HIV感染流行趋势分析

〔目的〕总结和分析南宁口岸1990￣2005年出入境人员艾滋病监测结果,为加强口岸艾滋病防治工作提供科学依据。〔方法〕采用酶联免疫吸附试验、明胶颗粒凝集试验等方法对出入境人员进行HIV感染初筛,对初筛阳性标本采用免疫印迹法确认,对监测资料进行整理、分析。〔结果〕检测出入境人员100 945人次,检出HIV感染者43例,HIV感染率为4.26/万;2001年以后保持比较高的检出率,2004年高达9.34/万。HIV感染者中,外籍人员18例,占41.86%;中国大陆人员25例,占58.14%;男性38例,占88.37%,女性5例,占11.63%;20￣49人员占94.34%,40￣49岁年龄组的比例有所上升。3种传播途径均已出现,性接触传播占67.43%。〔结论〕出入境人员中HIV感染者的检出率呈快速增长趋势,以性接触传播为主。在口岸地区应加强艾滋病的综合监测,积极开展有针对性的健康教育和行为干预,以保护人民的身体健康和公共卫生安全。     

云南口岸1623例出入境人员HIV感染者分析

〔目的〕了解云南口岸出入境人员HIV感染的流行分布情况及趋势,为艾滋病监测工作提供科学依据。〔方法〕对云南口岸2000～2006年1623例出入境人员HIV抗体阳性者的资料进行统计分析。〔结果〕云南口岸出入境人员中HIV感染者的数量呈逐年上升趋势;HIV感染者以瑞丽口岸检出的较多,占感染者总数的51.32%;从国籍分布来看,以外国人为主,外国人中缅甸籍人员最多,占64.51%;感染者中,男性多于女性,男性占79.67%;年龄以青壮年较多,20～49岁年龄段占92.91%;职业分布以驾驶员最高,占45.22%,其次是商务人员。〔结论〕驾驶员、商务人员是云南口岸出入境人员中HIV感染的高危人群,必须加强重点监测。     

瑞丽口岸2005年出入境人员HIV感染情况分析

〔目的〕通过对瑞丽口岸2005年出入境人员艾滋病监测结果进行分析,了解瑞丽口岸出入境人员艾滋病感染情况,为今后口岸艾滋病监测和预防控制工作提供科学依据。〔方法〕对瑞丽口岸2005年出入境人员先采用胶体金法快速检测试剂筛查,阳性血清标本用酶联免疫吸附试验(ELISA)复核,最后送确认实验室用蛋白印迹法(WB)检测。〔结果〕从2042名出入境人员中共检出HIV感染者177名,总感染率高达8.67%。感染人群职业分布以缅甸籍驾驶员最多;感染者以青壮年为主;感染途径以性传播为主;缅甸籍感染者最多;男性感染者明显高于女性。〔结论〕应加强艾滋病知识的宣传教育,对重点人群要实施重点监测,才能有效控制艾滋病在我国的流行。     

伊犁口岸1997～2001年出入境人员HIV感染监测结果分析

〔目的〕掌握伊犁口岸出入境人员中HIV感染情况。〔方法〕建立HIV初筛实验室,对1997～2001年8月经伊犁口岸出入境的人员实施HIV感染情况监测。〔结果〕共监测出入境人员18378人次,检出HIV感染者26例,感染率为1.42‰。在检出的26例感染者中,男性占96.15％,女性占3.85％;从年龄分布来看,20～30岁年龄组人员所占比例最高,为88.46％;从职业分布来看,个体商贩占92.31％,居第1位;感染者中有20例为伊宁市人,占总例数的76.92％,感染者全部为少数民族。〔结论〕从流行病学调查结果来看,静脉吸毒人员是HIV感染的高危人群;家庭中预防和控制艾滋病是一个值得研究的课题;出入境检验检疫机关应加强对出入境人员的HIV感染情况的监测,防止艾滋病的传入传出。     

福州口岸出入境人员HIV感染者流行病学调查

目的了解福州口岸出入境人员HIV感染特点、流行状况和趋势,为加强口岸艾滋病监测工作提供依据。方法用ELISA方法对2013—2016年福州口岸出入境人员进行HIV抗体检测,用免疫印迹法确认,对确认阳性者进行流行病学调查。结果 2013—2016年,对福州口岸的38 444名出入境人员进行HIV抗体检测,确认阳性26例,总检出率为0.68‰;外国籍人员感染率为0.82‰;20~39岁为高发年龄组,占65.4%;男性感染率明显高于女性,未婚者高于已婚者;劳务人员、交通员工和学生所占比例较高;不洁性行为是感染者的主要传播途径。结论 HIV感染者呈年轻化趋势,性传播成为最主要传播途径,应加强对出人境人员的艾滋病监测、健康教育和行为干预。     

盘锦口岸首例HIV感染者的流行病学调查报告

〔目的〕了解盘锦口岸艾滋病流行情况,为确定口岸重点人群提供依据。〔方法〕采用酶联免疫吸附试验(ELISA)和颗粒凝集法(PA)初筛;蛋白印迹法(WB)确认,对出入境人员进行HIV抗体血清学检测,对发现的HIV感染者进行流行病学调查及检测后咨询。〔结果〕于2006年5月17日在出境人员中发现盘锦口岸首例HIV感染者。经流行病学调查,此例感染者是1名船员,曾去过美国、俄罗斯、伊朗,并多次往返于东南亚等国。其承认2004年曾在中国某地有“冶游史”。〔结论〕盘锦口岸首例HIV感染者是在出境人员中被检出的,提示口岸艾滋病监测的重点不应局限于入境人群;出境人群,尤其是出境船员及往返出境的劳务人员也应成为重点监测对象。     

云南临沧思茅口岸入境重点人群艾滋病监测结果分析

〔目的〕通过对临沧、思茅口岸入境人员的艾滋病检测,了解艾滋病感染在这类人群中的分布情况,为加强重点口岸重点人群的艾滋病防制提供科学信息。〔方法〕采用人类免疫缺陷病毒(HIV1/2)抗体诊断试剂盒进行初筛或用雅培层析快速法试剂条进行初筛,蛋白印迹法(WB)做确认。〔结果〕2006年4～8月共对3702名入境人员进行艾滋病监测,检出42例HIV抗体阳性者,阳性率为1.13%;30～40岁年龄组人员占感染者总数的40.48%;男性感染者显著多于女性;驾驶人员阳性率最高,为3.95%;中国籍感染者16例,缅甸籍26例;从感染途径看,有不洁性行为者27例,占感染者总数的64.29%。〔结论〕对入境重点人员的艾滋病防治工作需要加强。     

江西口岸出入境人员梅毒血清学检测结果分析

〔目的〕通过对江西口岸2005年出入境人员梅毒血清学检测结果的流行病学分析,从而了解江西出入境人群中梅毒的感染情况,为做好口岸梅毒的防治工作提供科学依据。〔方法〕对2005年度江西口岸5737名出入境人员采取静脉血,用甲苯胺红不加热血清试验(TRUST)进行初筛,初筛阳性标本采用梅毒螺旋体抗体血清凝集试验(TPPA)进行确认;并结合对梅毒感染者的年龄、性别、职业进行统计学分析。〔结果〕全年从出入境人员中检出梅毒感染者35例,梅毒感染者在性别、年龄、职业分布上都存在明显差异。在性别分布中,男性相对女性感染率高,男性感染率为0.73%;在年龄分布中,20～50岁的年龄段的感染者较多,占感染者总数的97.14%;在人群分布中,劳务人员中感染者最多,占感染者总数的71.43%。〔结论〕出入境人群不同于一般的社会人群,国境口岸检验检疫机构对梅毒的监测,对防治传染病的传入和传出具有重要的意义。     

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.