皖南地区中学生伤害危险因素的病例对照研究

目的：探讨中学生伤害的危险因素。方法：按性别、年龄、班级1：1配对原则，选择254例伤害病例和对照，采用单因素和多因素条件logistic回归分析。结果：单因素分析发现父亲年龄、父亲文盲、母亲文盲、家庭经济收入、家庭和睦程度、知道交通常识、常爬高、接受安全教育、独生子女、外向型性格、防范措施不健全、住房周围危险环境及高危行为与伤害发生有关；多因素分析发现高危行为(OR=18．0600)、防范措施不健全(OR=12．6455)、常爬高(OR=9．6552)、父亲文盲(OR=7．7191)、住房周围危险环境(OR=5.7402)、外向型性格(OR=5.4707)、母亲文盲(OR=3．0581)是中学生伤害的危险因素；而接受安全教育(OR=0.2356)、家庭和睦(OR=0．4941)、独生子女(OR=0．5233)、知道交通常识(OR=0．5340)、家庭经济较好(OR=0．5609)是中学生伤害的保护因素。结论：中学生伤害是多因素相互作用的结果，应采取干预措施，改变其伤害的影响因素。通过健康教育、消除环境危险等策略来控制伤害的发生。     

蚌埠市0-5岁儿童出生缺陷危险因素的病例对照研究

目的探讨儿童出生缺陷发生的各种危险因素,为制定出生缺陷干预措施、做到优生优育提供依据。方法采用1∶1配对病例对照研究,对565对病例与对照进行调查,采用SPSS软件对所有调查因素进行单因素χ2检验和多因素的条件logistic回归分析。结果有统计学意义的危险因素是：家庭附近有污染（OR=5.18）、父母近亲结婚（OR=12.37）、有生育畸形儿史（OR=2.52）、孕育期接触有害物质（OR=10.81）、孕育期用药（OR=3.27）、孕育期接触宠物（OR=4.26）、父亲吸烟（OR=1.95）。结论家庭附近有污染、父母近亲结婚、有生育畸形儿史、孕育期接触有害物质、孕育期用药、孕育期接触宠物、父亲吸烟是出生缺陷的危险因素。     

浙江省部分地区中小学生伤害危险因素logistic回归分析

目的探索浙江省部分地区中小学生伤害的危险因素.方法采用分层整群随机抽样的方法,对40 625名中小学生伤害调查资料采用单因素和多因素非条件logistic回归分析.结果单因素分析发现伤害与性别、年龄、近视、爱好户外运动、经常骑自行车、喜欢爬高玩耍、父亲文化程度、母亲文化程度、燃放烟花爆竹等有关;多因素分析显示：性别（OR=0.88）、近视（OR=1.11）、养猫（OR=1.18）、业余爱好户外运动（OR=1.25）、喜欢爬高玩耍（OR=1.14）、家里药物农药放置不安全（OR=1.11）、经常骑车（OR=1.13）是主要影响因素;跌伤、刀割伤、碰撞伤、动物咬伤的危险因素基本一致.结论学生伤害由多因素作用导致,学生个人行为特征和家庭因素起重要作用.     

广州市中小学生运动伤害危险因素的配对病例对照分析

目的 探讨中小学生运动伤害的危险因素.方法 按性别、年龄、班级1:1配对原则,通过样本量计算选择349对运动伤害病例和对照,采用单因素和多因素条件logistic回归分析.结果中小学生发生运动伤害的危险因素是:鞋底磨损大(OR=7.20,95%CI:2.37～21.84)、疲倦(OR=14.34,95%CI:2.29～89.66)、带病时参加运动的频率高(OR=1.96,95%CI:1.29～3.06)和既往伤害史(OR=2.11,95%CI:1.41～3.96).运动伤害的保护因素:体育训练时有老师指导动作(OR=0.46,95%CI:0.26～0.79)、运动时做防护措施(OR=0.36,95%CI:0.20～0.64)和运动前热身运动的频率高(OR=0.31,95%CI:0.14～0.67).结论 中小学生运动伤害与个人因素、家庭因素和社会因素有关;应提高学生和老师的安全运动意识,减少运动伤害危险行为的发生.     

曲靖市中小学生伤害发生现状和危险因素分析

目的 了解曲靖市中小学生伤害发生现状和危险因素,为制定相应的干预措施预防和控制学生伤害事件的发生提供科学依据.方法 于2010年4月采用分层整群随机抽样的方法,抽取曲靖市2所小学、2所中学共10 561名中小学生为调查对象,进行问卷调查,回顾性调查过去1年的伤害情况.采用非条件logistic回归分析影响伤害发生的危险因素.结果 曲靖市中小学生伤害发生率为23.97％.男生伤害发生率（27.31％）高于女生（20.39％）,差异有统计学意义（x2=69.26,P＜0.01）.小学、初中和高中学生伤害发生率差异有统计学意义（X^2=126.434,P＜0.01）,初中生为伤害高发人群（31.06％）.居于前5位的伤害类型依次为跌落伤（22.59％）、碰撞伤（11.44％）、刀割伤（9.84％）、动物咬伤（4.52％）和烧烫伤（4.38％）.多因素非条件logistic回归分析结果显示,初中生（OR=1.44,95％CI：1.26～1.64）、与母亲生活的学生（OR=1.47,95％CI：1.15～1.87）、母亲的民族为苗族的学生（OR=2.78,95％CI：1.20～6.43）更容易发生伤害事件;而女生（OR=0.67,95％CI：0.60～0.74）、父亲职业为工人（OR =0.83,95％CI：0.70～0.99）或农民（OR =0.82,95％CI：0.71～0.94）的学生、在家排行较小的学生（OR=0.84,95％CI：0.73～0.96）、年龄小的学生（OR=1.05,95％CI：1.03～1.07）相对不容易发生伤害事件.结论 中小学生伤害发生率较高,伤害由多因素作用导致,与个人、家庭及学校环境危险因素有关.     

山东省围产儿出生缺陷危险因素的病例对照研究

【目的】探讨山东省围产儿出生缺陷的危险因素．为提高出生人口素质提供参考依据。【方法】采用以医院为基础的1：1配比的病例对照研究方法．以统一的调查表及调查方式对341例出生缺陷儿和对照的父母进行了调查．应用SAS软件对所有调查因素进行单因素及多因素非条件Logistic回归分析。【结果】出生缺陷的主要危险因素是：多次自然流产（OR=12．72）、有既往分娩畸胎儿史（OR=10．12）、妊娠异常反应史（OR=20．10）、母亲孕期饲养宠物（OR=25．14）、感冒并发烧〉38℃（OR=20．90）、服用镇静药（OR=7．16）、解热镇痛药（OR=26．13）、激素类药（OR=11．31）、接触有机溶剂（OR=13．01）、母亲孕期有不良精神刺激（OR=12．08）、父亲接触噪声（OR=6．74）、父亲接触有机溶剂（OR=6．27）。【结论】母亲孕期饲养宠物、感冒并发烧〉38℃、服用镇静药、解热镇痛药、激素类药、接触有机溶剂、母亲孕期有不良精神刺激、多次自然流产．母亲职业为工人、农民．有既往分娩畸胎儿史、妊娠异常反应史。父亲接触噪声、接触有机溶剂等是围产儿出生缺陷的危险因素。     

蚌埠市0~5岁儿童出生缺陷危险因素的病例对照研究

目的探讨儿童出生缺陷发生的各种危险因素,为制定出生缺陷干预措施、做到优生优育提供依据。方法采用1∶1配对病例对照研究,对565对病例与对照进行调查,采用SPSS软件对所有调查因素进行单因素χ2检验和多因素的条件logistic回归分析。结果有统计学意义的危险因素是:家庭附近有污染(OR=5.18)、父母近亲结婚(OR=12.37)、有生育畸形儿史(OR=2.52)、孕育期接触有害物质(OR=10.81)、孕育期用药(OR=3.27)、孕育期接触宠物(OR=4.26)、父亲吸烟(OR=1.95)。结论家庭附近有污染、父母近亲结婚、有生育畸形儿史、孕育期接触有害物质、孕育期用药、孕育期接触宠物、父亲吸烟是出生缺陷的危险因素。     

恶性血液病危险因素病例对照研究

目的了解恶性血液病患者发病的危险因素。方法采用1：1配对病例对照研究方法，对150例恶性血液病人及150例健康对照进行问卷调查，使用条件Logistic回归模型进行分析。结果居室装修3年及以上（OR=60．89）、住所临近繁忙交通要道（OR=5．172）或化工厂（OR=25．257）、化学胶接触史（OR=13．522）、汽油接触史（OR=7．486）、农药接触史（OR=4．421）、父亲生育前饮酒吸烟（OR=2．259）、母亲生育年龄30～35岁（OR=5．891）等因素与血液病发生的差异均有统计学意义。结论恶性血液病的发生与室内外空气污染、有害物质接触史、父亲生育前饮酒吸烟、母亲生育年龄高等因素有关，应积极控制危险因素，以减少恶性血液病的发病率。     

MTHFR基因、CBS基因、环境因素与先天性心脏病的病例对照研究

目的 探讨父母亚甲基四氢叶酸还原酶（MTHFR）基因C677T、胱硫醚β-合酶（CBS）基因T833C、环境因素与子代先天性心脏病（CHD）发生之间的关联。方法 采用1：1配对病例对照研究方法，分析115对CHD患儿与对照儿父母的环境暴露因素，并检测其MTHFR与CBS基因型，对CHD可能的危险因素进行单因素及多因素条件logistic回归分析。结果 母亲怀孕早期接触农药（OR=8．62）、妊娠合并症（OR=2．069）、孕早期感冒（OR=4．125）、孕期情绪状况（OR=4．653）、母亲MTHFR基因677TT型（OR=3．872）共5个因素为予代发生CHD的危险因素。结论 母亲MTHFR基因677TT型与子代CHD发生有关，未发现父母CBS基因T833C与子代CHD存在关联，母亲怀孕早期接触农药、妊娠合并症、孕早期感冒、孕期情绪紧张或忧郁可能增加子代发生CHD的危险。     

广东省连平县中小学生运动伤害及其危险因素分析

目的探索中小学生运动伤害的危险因素。方法采用整群抽样方法抽取广东省连平县4所中学的初一、初二、高一和高二及16所小学3～6年级的所有在校学生为调查对象;调查其在2005年7月至2006年6月期间的运动伤害发生情况、相关高危行为及相关知识等,并用单因素和多因素非条件logistic回归分析其运动伤害的危险因素。结果共调查9470名学生,其运动伤害发生率为21.45%。其中男、女生运动伤害发生率分别为29.23%(1404/4804)、13.44%(627/4666),小学生、初中生和高中生分别为19.98%、18.98%和25.60%。多因素分析结果显示:年龄大(OR=1.059),外向型性格(OR=1.265),父亲文化程度高(OR=1.133),运动时口袋装有尖锐物品(OR=1.349),在硬地板上做翻滚运动(OR=1.314),在走廊内(OR=1.210)或在运动场地(OR=1.267)追逐、打闹,与同学在校内攀爬玩耍(OR=1.475)是中小学生运动伤害的危险因素,而女性(OR=0.326)则是保护因素。结论个人行为、性格因素是影响广东省连平县中小学生运动伤害发生的主要因素,应组织有针对性的运动安全教育和干预,降低中小学生运动伤害的发生率。     

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.