海口市2008～2010年麻疹监测系统运行效果评价

目的 了解海口市2008～2010年麻疹流行病学特征,评价麻疹监测系统运转情况,为进一步加强麻疹监测提供科学依据.方法 收集海口市4个区上报的2008～2010年麻疹监测系统数据,采用描述性流行病学方法分析,评价监测系统主要运转指标及相关资料.结果 麻疹监测系统敏感性逐年提高,2008～2010年的年排除病例报告发病率41.8/10万,个案调查及时率从2008年的94.3％提高到2010年的100％,疑似病例血标本采集率从2008年的64.5％提高到2010年的94.3％,合格标本采集率从2008年的3.6％提高到2010年的41.5％,个案调查资料48 h内专病录入从2008年的99.1％提高到2010年的100％;确诊病例36例,年平均发病率为0.63/10万;发病构成以8月～14岁为主,占总数的50％,年龄＞14岁发病数为12例,占总发病数的33.3％;病例呈散发,以3～7月发病为主,共发26例,占总发病58.8％;流动人口发病占47.2％,无麻疹疫苗(Measles Attenuated Live Vaccine,MV)免疫史或免疫史不详占72.7％.结论 2008～2010年海口市麻疹监测系统运转情况良好,应进一步提高监测系统的工作质量和人群免疫水平,切实加强流动人口麻疹防控,以实现消除麻疹目标.     

2004-2009年攀枝花市麻疹流行病学特征分析

目的 分析2004 -2009年攀枝花市麻疹监测系统的麻疹流行病学特征.方法 收集攀枝花市2004 -2009年麻疹专病监测资料,采用描述性流行病学方法进行分析.结果 2004-2009年麻疹发病呈现为2个高峰,2004年报告麻疹413例,报告发病率38.75/10万,其中225例为暴发病例;2007年麻疹报告643例,报告发病率59.54/10万;2009年发病降到历史最低水平,为0.92/10万.以每年12月至次年2月为发病高峰;病例主要集中在城乡结合部和边远少数民族地区;总体以巧岁以下儿童发病为主,但小于8月龄和大于15岁病例所占比例有逐年增加趋势;麻疹病例中无免疫史的和免疫史不详的占全部麻疹病例的66.32%,流动人口麻疹病例中有免疫史的占其病例的10.68%.结论 2004-2009年攀枝花市麻疹发病率波动较大,总体呈下降趋势,发病出现明显的季节分布,病例中无免疫史和免疫史不详比例较高.     

菏泽市2005年麻疹监测与控制对策

目的了解菏泽市2005年麻疹监测系统现状，了解麻疹流行病学特征和流行原因。方法根据菏泽市常规传染病报告系统、麻疹疫情专报系统和年度麻疹发病统计表，对2005年麻疹监测与控制结果进行描述流行病学分析。结果2005年共报告麻疹疑似病例442例，较法定传染病报告系统（381例）多16．01％。麻疹疑似病例发病后7d内报告率为91．18％，报告后48h内调查率为87．56％，病例调查完整率为100％，8月龄-7岁儿童有麻疹免疫史者为40．79％。疑似病例血清标本采集率为56．33％。麻疹确诊病例为380例。麻疹发病呈散发和爆发并存的流行模式，部分高发县影响全市麻疹发病水平。麻疹病例主要集中在1～5月份。麻疹发病以学龄前和学龄儿童为主。8月龄～7岁年龄组的病例中，无免疫史和免疫史不详者分别占38．16％、21．05％。结论菏泽市部分地区麻疹疫苗实际接种率不高，是导致麻疹疫情上升的主要原因。应继续加强适龄人群麻疹疫苗的基础免疫，继续落实应急补充免疫的各项技术措施，继续加强麻疹监测与督导工作。     

2005年菏泽市麻疹监测结果分析

[目的]评价菏泽市2005年麻疹监测系统现状，了解麻疹流行病学特征。[方法]对2005年麻疹监测与控制资料进行描述分析。[结果]2005年报告麻疹疑似病例442例，法定报告系统报告381例。麻疹疑似病例发病后7d内报告率为91．18％，报告后48h内调查率为87．56％，病例调查完整率为100．00％，疑似病例血清标本采集率为56．33％。麻疹确诊病例380例。麻疹发病呈散发和局部暴发，部分高发县影响全市麻疹发病水平。380例麻疹确诊病例中，1～5月发病的占89．74％；8月龄至7岁的占60．00％，无麻疹疫苗免疫史和免疫史不详者占59．21％。[结论]菏泽市部分地区麻疹疫苗接种率不高，是导致麻疹疫情上升的主要原因。     

海南省麻疹监测系统运行效果评价

目的 分析海南省麻疹监测系统建立运行情况和病例监测结果.方法 制定海南省麻疹监测方案,在全省建立麻疹监测系统,按照监测方案病例定义开展监测.采用描述流行病学方法对海南省2004-2008年法定传染病疫情报告系统及麻疹监测系统报告的麻疹病例进行分析.结果 海南省2004-2008年麻疹监测系统报告麻疹疑似病例3040例,比法定传染病疫情报告系统高96.00%,监测系统建立当年(2004年)报告病例数少于法定传染病报告病例数;2005年以来监测系统报告的敏感性逐年提高,2008年监测系统报告疑似病例数是法定传染病的19.12倍.监测系统报告麻疹疑似病例中确诊病例比例逐年下降,由90.34%下降到4.48%.标本采集率逐年提高,由22.73%上升到99.12%,麻疹确诊病例中实验室确诊病例比例逐年提高,由7.55%提高到86.97%.检测疑似病例中麻疹IgM抗体阳性率为31.57%,风疹IgM抗体阳性率为34.52%.海南省除2006年为麻疹流行年出现多个暴发点外,其他年份均为散发,发病有明显的季节高峰,高峰期在3-6月.发病年龄仍以15岁以下儿童为主,占86.68%,无免疫史和免疫史不详儿童占85.67%.结论 海南省自建立麻疹监测系统后监测敏感性不断提高,发病率已降到历史最低水平.     

静海县2006年麻疹监测及流行病学特征分析

目的 分析静海县2006年麻疹监测情况及流行病学特征,探讨控制对策和措施,加强麻疹防控.方法 对2006年静海县常规传染病疫情网络直报系统和麻疹监测系统资料进行流行病学分析.结果 2006年共报告麻疹疑似病例232例,发病率44.97/10万,其中流动人口病例占46.12%;实验室确诊病例占76.29%.病例主要发生在流动人口较多的乡镇;3～6月份病例占报告例数的96.98%,有明显的季节高峰;发病年龄以学龄前及学龄期为主;有免疫史的15.95%,无免疫史的37.93%,未达到免疫月龄的28例;7天报告率99.57%;疑似麻疹病例血清标本采集率81.90%.结论 为了更好地控制麻疹,应抓好计划免疫管理工作,特别是重视流动人口管理,加强麻疹疫苗的常规免疫和强化免疫;改善监测工作,提高麻疹疑似病例的血清标本采集技术和采集率,及时掌握疫情动态.     

定西市安定区2008—2017年麻疹监测及流行病学特征分析

目的 分析定西市安定区2008—2017年麻疹监测情况及流行病学特征，为制定针对性的麻疹防控措施提供参考依据。 方法 采用描述性流行病学方法对中国疾病监测信息报告管理系统和麻疹监测信息报告管理系统报告的安定区2008—2017年麻疹病例进行统计分析。 结果 安定区2008—2017年共报告麻疹疑似病例190例，其中麻疹病例87例，年均发病率为1.90/10万，2008年发病率最高（7.46/10万），2009年、2012年和2013年无麻疹病例报告, 排除麻疹/风疹病例97例；48小时内完整调查率为100.00%，血标本采集率为93.68%，咽拭子采集率为99.25%；发病高峰主要集中在4～7月份；病例发生在流动人口较多的城区，以外地病例为最多；发病人群以学龄前儿童及成人为主；15岁以下麻疹病例有免疫史者占30.51%；成人病例无免疫史和免疫史不详者占92.59%。 结论 　安定区麻疹监测系统运行良好，各监测指标达到国家要求；应继续加强麻疹高发季节的提前防控，重视成人及学龄前儿童麻疹类疫苗接种工作，提高全人群免疫水平。     

连云港市2007年麻疹临测与分析

目的评价连云港市麻疹流行病学特征和麻疹监测系统运转现状。方法对该市2007年麻疹流行病学和实验室监测工作进行分析。结果2007年全市共报告麻疹疑似病例89例，其中确诊38例（实验室确诊37例、临床确诊1例），法定传染病报告系统符合率100％。麻疹报告发病率为0．792／10万，与2006年比，发病率下降了94.51％（692例）；发病年龄主要集中在5岁以下（15例）。占总发病人数的39．47％。其中小于1岁发病人数12例，占31．57％。有免疫史的仅有7例，占18．42％；无免疫史的20例，占52．63％；免疫不详的11例，占28．94％，其中0～12月龄无免疫史的占31．57％。结论该年度麻疹监测系统灵敏性较高，个案调查质量有明显改善，主要监测指标已达较高水平，麻疹病例标本采集率和血清学诊断率提高明显，说明监测系统的运转质量在逐步提高，麻疹发病率已控制在较低水平。局部仍有散在发病，需进一步采取有效措施；加强麻疹监测，提高监测质量，是加速控制和消除麻疹的关键。     

2005-2009年广元市麻疹流行病学特征分析

目的分析广元市2005-2009年麻疹流行病学特征,为消除麻疹提供依据。方法采取描述流行病学方法分析广元市2005-2009年麻疹监测资料。结果共报告1 979例病例,年均发病率12.33/10万。3~6月发病数占全年的55.06%。男女性别比1.14∶1。〈15岁病例占79.81%。无明确免疫史的占23.10%,有1剂次免疫史的占10.52%,2次及以上免疫史的占11.55%,免疫史不详的占54.35%。采集合格血清标本834例,实验室确诊病例占37.85%。暴发疫情病例占10.86%。结论 2005-2009年广元市麻疹年均发病率仍较高,且有暴发疫情发生,免疫接种率较低。     

连云港市2007年麻疹监测与分析

目的 评价连云港市麻疹流行病学特征和麻疹监测系统运转现状.方法 对该市2007年麻疹流行病学和实验室监测工作进行分析.结果 2007年全市共报告麻疹疑似病例89例,其中确诊38例(实验室确诊37例、临床确诊1例),法定传染病报告系统符合率100%.麻疹报告发病率为0.792/10万,与2006年比,发病率下降了94.51%(692例);发病年龄主要集中在5岁以下(15例),占总发病人数的39.47%.其中小于1岁发病人数12例,占31.57%.有免疫史的仅有7例,占18.42%;无免疫史的20例,占52.63%;免疫不详的11例,占28.94%,其中0～12月龄无免疫史的占31.57%.结论 该年度麻疹监测系统灵敏性较高,个案调查质量有明显改善,主要监测指标已达较高水平,麻疹病例标本采集率和血清学诊断率提高明显,说明监测系统的运转质量在逐步提高,麻疹发病率已控制在较低水平.局部仍有散在发病,需进一步采取有效措施;加强麻疹监测,提高监测质量,是加速控制和消除麻疹的关键.     

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.