天津成年人烟草暴露与BMI的关系分析

目的 分析天津市成年居民烟草暴露状况与BMI的关系。方法 利用天津市2015年中国成人慢性病与营养监测调查资料,选取有完整人口统计学特征、吸烟状况、体格测量数据和膳食摄入数据的成年居民作为研究对象,共计1828人。利用Logistic回归分析烟草暴露与BMI的关系。结果 共纳入有效调查样本1828人(男858,女970),平均年龄(53.94±14.67)岁。吸烟状况与BMI的Logistic回归分析显示：年龄(OR=1.011,P=0.004)、已婚(OR=1.590,P=0.005)、低文化程度(小学及以下：OR=1.828,P=0.005,初中：OR=1.596,P=0.005)是超重肥胖的危险因素,而吸烟状况与超重肥胖无显著关联。二手烟暴露状况与BMI的Logistic回归分析显示：二手烟暴露(OR=1.347,P=0.009)、年龄(OR=1.012,P=0.002)、城镇(OR=1.281,P=0.036)、已婚(OR=1.609,P=0.005)、低文化水平(小学及以下OR=1.824,P=0.006,初中OR=1.542,P=0.010)是超重肥胖的独立危险因素。结论 ...     

烟草作业工人职业危害动态观察

本文对某烤烟厂和卷烟厂各主要工种的９０４名烟草作业工人及其作业环境进行了长达１６年的动态观察，结果表明，从卷烟包装工到烤烟厂挂烟工，随着接粉尘浓度逐渐增高和接尘工龄延长，烟草尘肺和０＋患病率均相应升高，接尘水平和烟草尘肺发病之间有一定的接触水平——反应关系。纯烟叶和车间粉尘中游离ＳｉＯ２含量的差异，说明烟草尘肺是以土壤粉尘为主引起的混合性尘肺。卷接和包装工未发现烟草尘肺，包装工０＋患病率仅为２．１２％，故国家现行的烟草粉尘卫生标准（３ｍｇ／ｍ３）是可行的，烟草尘肺是可以预防的。     

烟草尘对作业工人肺部影响的调查

为了解烟草尘对作业工人肺部的影响以及烟草尘肺的发病情况,选择某卷烟厂作业工人155例(男70例,女85例)作为观察组,对其进行X线胸片拍摄、肺功能测定、心电图及化验等项目检查,分析其结果与环境烟草尘浓度的关系。X线胸片显示,两肺纹理增多、紊乱者49例,诊断无尘肺(0 )3例。肺功能测定结果显示,轻度损伤8例,小气道功能障碍59例。说明烟草尘可引起作业工人不同程度的肺部损害,本次调查烟草尘浓度0.45~15.56 mg/m3,未见有烟草尘肺的发生。     

社区人群超重和肥胖对血压影响的现况调查与干预对策研究

目的：分析体重指数（BMI）对高血压发病率的影响,对超重和肥胖人群实施行为干预指导。方法：对我院社区卫生中心30～59岁居民1256人进行BMI、血压测量及问卷调查。结果：BMI正常组的高血压发病率最低,男约17．55％,女约13．06％。BMI超重组高血压发病率男性约35．44％,女性约29．05％,BMI肥胖组高血压发病率男约67．71％,女约52．34％。BMI超重组、肥胖组与正常组之间的差异有高度显著性意义。结论：随着体重指数的增加,高血压的发病率升高,二者呈显著正相关,加强对超重、肥胖人群实施健康教育与行为干预,保持BMI在正常范围是预防高血压病发生的有效措施。     

西藏初中学生烟草广告和促销暴露现状

了解西藏初中学生烟草广告和促销暴露现状,为制定相应控烟措施提供参考.方法 采用全球青少年烟草调查(GYTS)问卷,多阶段分层整群随机抽取西藏3 652名初中学生进行问卷调查.结果 西藏初中学生烟草广告和促销暴露率为83.54%.单因素分析结果,不同性别、城乡、零花钱、父母吸烟情况和朋友吸烟情况的学生烟草广告和促销暴露率差异均有统计学意义(x2值分别为41.118,28.782,19.558,51.211,75.095,P值均<0.01).非条件Logistic回归分析结果显示,男性、城市学生、零花钱>50元、父母亲都吸烟或仅父亲吸烟、多数朋友吸烟等因素是西藏初中学生烟草广告和促销暴露的危险因素(OR值分别为0.559,0.417,2.249,6.076,1.494,2.717,P值均<0.01);烟草广告和促销暴露组学生的吸烟率和尝试吸烟率分别是非暴露组的3.45,2.94倍(x2值分别为56.145,72.822,P值均<0.01).结论 西藏初中学生烟草广告和促销暴露情况较为严重.烟草广告和促销暴露能明显提高西藏初中学生吸烟率和尝试吸烟率,应多方面共同努力,营造无烟社会氛围.     

烟草粉尘对卷烟厂作业工人的肺脏损害

对蚌埠市卷烟行业接触烟草粉尘的２１６名生产工人进行了综合性调查和探讨。发现烟草粉尘可导致肺功能改变，并对肺脏有明显损害。经胸部摄片，诊断出烟草工人尘肺５例。通过１６０名卷烟工人的死因调查，死于呼吸系统疾病的居首位，占３７．５％，说明烟草尘是损害肺脏的有害粉尘。因此改进卷烟行业的工艺流程、加强通风防尘措施、定期对作业工人进行体格检查，是卷烟厂迫切需要解决的重要课题。     

烟草尘对作业工人呼吸系统损害的调查研究

目的探讨烟草作业环境中烟草尘对作业工人呼吸系统的损害。方法对烟草作业环境进行职业卫生现场调查、采样检测及分析,并对作业工人进行肺通气功能测定、胸部X线检查和呼吸系统症状的调查等职业健康体检。结果作业环境中烟草尘浓度在0.2～28.8mg/m3,生产性粉尘作业监测点超标率为29.12%,烟草尘作业危害岗位占32.02%;1322名接触烟草尘工人肺功能通气损害的为73人,肺功能异常率为5.52%;X胸片检查肺纹理增粗、紊乱改变121例,占9.15%;24.28%的工人出现咳嗽,21.56%的工人出现咳痰;调查显示接触烟草尘浓度高、时间长的作业工人肺部病变增加。结论烟草作业现场中存在的烟草尘与接尘工人呼吸系统损害有关,是导致接尘工人呼吸系统损害的原因。     

机械性噪声暴露对工人血压正常高值的影响

目的 研究机械性噪声暴露对工人血压正常高值的影响,及早采取有效措施,降低高血压发病率,同时为制定工业噪声的卫生标准提供间接参考依据。方法 对深圳市某外企4 349位工人进行职业健康检查。健康检查前,发放调查问卷,排除不符合调查要求人数464人。检查中,采用具有美国医疗仪器促进协会(AAMI)认证的电子血压计由护士测量诊室血压并记录。按暴露与否分噪声暴露组和对照组,人数分别为1 273和2 612人。收缩压和舒张压分别按正常血压、血压正常高值和高血压分类。结果 噪声组职业人群收缩压水平高于对照组,差异有统计学意义(χ2=18.025,P<0.01);噪声组血压正常高值显著高于对照组,差异有统计学意义(χ2=12.942;P<0.01);噪声组职业人群舒张压水平高于对照组,差异有统计学意义(χ2=7.456,P<0.05),噪声组血压正常高值显著高于对照组,差异有统计学意义(χ2=5.730,P<0.05)。结论 噪声与血压正常高值有关,噪声是引起职业人群血压正常高值的比例升高的一个重要因素,应降低噪声对人体的危害,有效控制或降低血压正常高值,减少高血压发病的风险。     

钢铁冶金工厂职业性噪声与高血压的流行病学研究

目的 探讨冶金工人噪声暴露与高血压发病的关系。方法 对某钢铁冶金企业1694名男性工人（噪声暴露1225例,对照469例）,采用问卷、现场环境噪声测试等方法进行调查研究。结果 高血压的患病率在噪声暴露组为13．31％,明显高于对照组（7．8％）,两组比较,差异有显著性（P＜0．01）。随累积噪声暴露量水平的增高,高血压患病率有增高的趋势。Logistic回归分析结果表明,在控制了年龄、父母高血压史和体重指数等混杂因素后,累积噪声暴露量是高血压发病的危险因素,文化程度高是高血压的保护因素。结论 噪声暴露可能是高血压发病的危险因素,降低作业现场噪声,可能是降低冶金企业工人高血压发病的有效措施。     

噪声作业工人听力损伤与血压和高血压的相关性研究

目的 探讨噪声与血压、高血压的相关性及其年龄别特点.方法 结合职业健康检查对157家工厂14 537名噪声作业工人纯音听力和血压进行检测,以听力损伤作为累计噪声暴露量的替代指标,经年龄和性别分层后,分析听力损伤、接噪工龄与血压和高血压的相关性.结果 调查对象以男性为主(占81.2％),多数在35岁以下(占77.8％),从事噪声作业不足5年(占73.6％).听力异常率男性高于女性,且随年龄和接噪工龄的增加而增加;仅在男性＜35岁组发现,感音性聋者收缩压和舒张压明显升高,其中舒张压和高血压现患率均随接噪工龄的增加而增加;男性感音性聋者高血压患病风险显著增加,＜35岁组和≥35岁组OR分别为3.0(95％CI:1.5～6.1)和2.1( 95％CI:1.2～3.4).结论 噪声致严重听力损伤与高血压有关,建议重点关注噪声对年轻作业者高血压的影响.     

Association between blood levels of lead, blood pressure and risk of diabetes and heart disease in workers

Background: Previous studies have supported the association between high levels of blood lead levels (BLL) and elevated blood pressure. In addition, significant correlations between BLL and a variety of risk factors for blood pressure and diabetes mellitus have been well-established. Objective: To examine the relationship between BLL, blood pressure and diabetes as well as other selected social and biochemical factors, among workers in the United Arab Emirates (UAE). Methods: This comparative study included 110 industrial workers (exposed to lead in the workplace) and 110 non-industrial workers (not exposed); all were recruited in the city of Al-Ain, Abu-Dhabi Emirate, UAE and the groups were evenly matched for age, gender and nationality. Results: The industrial workers had a significantly higher mean of BLL (median 81 and geometric mean (GM) 62 μg/dl) than did non-industrial workers (median 11 and GM 13 μg/dl). In the present study, the lead-exposed group also had significantly higher blood lead levels, body-mass index (BMI), systolic and diastolic blood pressures, fasting blood glucose and plasma levels of total cholesterol, lactate dehydrogenase and uric acid than did the non-exposed group. Furthermore a significant correlation between BLL and systolic blood pressure was observed. Conclusion: The study supports the hypothesis of a positive association between lead exposure, high blood pressure and risk of diabetes and heart disease. Received: 11 July 2000 / Accepted: 5 January 2001     

Long-term effects of radium exposure in female dial workers: Hematocrit and blood pressure

Hematocrit readings and systolic and diastolic blood pressure were analyzed in women first employed as radium dial workers in 1913–1929 and in 1930–1954. Internal comparisons on these variables were made by dose groups, using average skeletal dose estimated some years after exposure to radium, and external comparisons were made using normative data from the U. S. National Health Survey. In women exposed from 1913 to 1929, a possible long-term effect of high-dose radium exposure on hematocrit was evident. Statistically significant results were obtained using univariate and multivariate (multiple regression) analyses for women aged 65–84. This effect appeared to be greatest in the highest-dose groups (especially 1000+ rad), but did not involve a higher frequency of “low” hematocrit suggestive of anemia. No association between dose and blood pressure was evident in the women exposed in 1913–1929. In women exposed in 1930–1954, dose was a significant predictor of systolic blood pressure in those 45–54 years old but not in those 55–64 years old. Analysis of longitudinal data on these populations will be required.     

高血压病患者中超重/肥胖与血压负荷及血压变异的关系

目的 探讨超重和肥胖高血压病患者与血压变异性关系。方法 191例原发性高血压患者根据体重指数（BMI）分为正常组，超重组，肥胖组，采用24h动态血压检测方法探讨血压负荷及血压变异的特征。结果 BMI增加血压负荷和血压变异性指数均增加，与正常组相比超重组和肥胖组夜间收缩压变异（nSBPSD)增加14.10%。夜间舒张压变异（nDBPSD)增加13.15%。夜间平均动脉压变异（nMAPSD)增加15.92%。肥胖组增加更明显，分别为20.06%,17.92%,21.63%；但这种血压变异性的差异仅表现在男性。结论 超重和肥胖的高血压病患者不仅加重血压负荷，而且使血压变异性增加；这种血压变异性增加只见于男性病人，且出现在夜间。     

广州厂企职工血压水平与心脑血管疾病死亡的关系

目的分析工人高血压与心脑血管疾病(CVD)死亡的相对危险度(RR),探讨减少工人CVD死亡危险性的预防办法.方法由广州399家工厂年龄35岁或以上的78 379名工人组成队列,进行前瞻性研究.资料处理采用分层和多因素调整统计分析方法(Cox模型).结果(1)队列中男48 705名、女29 674名,追踪8.0年,CVD死亡363人,男305人、女58人,粗死亡率分别为78.58/10万人年和24.55/10万人年,主要死于脑卒中、冠心病和高血压.(2)与理想或正常血压比,高血压CVD死亡的RR(95%)分别为男6.19(4.85～7.91)、女2.78(1.59～4.85);男性工人基线无患病者和非CVD患者Ⅰ级高血压CVD死亡的RR和CVD患者Ⅱ级高血压CVD死亡的RR明显增加,分别为3.98、3.25和3.15,理想或正常血压与Ⅰ级高血压和Ⅱ级高血压CVD死亡的RR增加趋势差异有显著性(P＜0.01).(3)按年龄、吸烟、饮酒、文化程度和职业接触有害因素分层后,年轻、吸烟、不饮酒、文化程度较高者以及职业接触有害因素者的高血压患者CVD死亡RR较高.结论血压水平与心脑血管疾病死亡率呈连续性相关,高血压对CVD死亡的影响在较年轻时已经出现;应采用综合预防办法减少CVD死亡危险性.     

2009年和2013年电视烟草广告及控烟节目播出情况分析

目的对比2009年和2013年电视烟草广告及控烟节目播出情况,评价全面禁止烟草广告政策在我国主要电视媒体的执行情况。方法监测2009年31个电视频道和2013年32个电视频道5月某一周的全部电视节目,对其播出的烟草广告及控烟节目进行记录、分析和比较。结果 2009年发布烟草广告的电视频道占监测数量的61.0%,共发布烟草广告562次;2013年发布烟草广告的频道数量占监测数量的9.4%,发布频次下降到159次。直接烟草广告的比例由60.7%下降为0。烟草广告在黄金时段播出的比例由89.7%下降到27.0%。但控烟节目的播出频次也由52次下降到12次,播出频道所占比例也由32.3%下降到18.8%。结论电视烟草广告仍有播出。须尽快修改烟草广告相关法律,明确烟草广告定义,去除法律盲区;加强电视烟草广告监管力度;提高媒体控烟能力。     

中国成年人体质指数与血压关系的探讨

利用 1992年全国营养调查中的体格测量资料 ,选取 2 0岁以上的成人作为研究对象 ,探讨我国成人体质指数的分布状况及与血压的关系 ,并拟为确定我国居民的适宜BMI参考值提供一定的参考资料。结果表明 ,我国成人体质指数的分布存在明显的年龄、性别及城乡差异 ;平均收缩压和平均舒张压均随着BMI的增加呈逐渐上升的趋势 ,多元线性回归分析显示BMI对血压值存在明显的线性关系 ;控制年龄、性别及城乡等混杂因素后 ,Logistic回归分析显示体质指数对高血压发生的相对危险度随着BMI值的增加大体呈升高趋势     

Study of noise exposure and high blood pressure in shipyard workers

A cross-sectional and case-reference study of occupational noise exposure and blood pressure was conducted in a shipyard company. There were 158 male workers from the higher noise environment (greater than 85 dBA) and 158 matched workers from a lower noise environment (less than 80 dBA). The workers in the higher noise environment had higher systolic and diastolic blood pressure (p less than .05) after adjusting for confounding factors. Comparison of regression revealed that there is no different increase in blood pressure with age in different environmental noise exposure. Based on 63 matched hypertensive-normotensive pairs from 2,730 shipyard workers, the relative risk of hypertension among workers exposed to an over-85-dBA acoustic environment, compared to those under 80 dBA, was 2.38. It is suggested that there may be a population of noise-exposed workers at increased risk of high blood pressure.     

A comparative study of variable selection methods in the context of developing psychiatric screening instruments

The development of screening instruments for psychiatric disorders involves item selection from a pool of items in existing questionnaires assessing clinical and behavioral phenotypes. A screening instrument should consist of only a few items and have good accuracy in classifying cases and non‐cases. Variable/item selection methods such as Least Absolute Shrinkage and Selection Operator (LASSO), Elastic Net, Classification and Regression Tree, Random Forest, and the two‐sample t‐test can be used in such context. Unlike situations where variable selection methods are most commonly applied (e.g., ultra high‐dimensional genetic or imaging data), psychiatric data usually have lower dimensions and are characterized by the following factors: correlations and possible interactions among predictors, unobservability of important variables (i.e., true variables not measured by available questionnaires), amount and pattern of missing values in the predictors, and prevalence of cases in the training data. We investigate how these factors affect the performance of several variable selection methods and compare them with respect to selection performance and prediction error rate via simulations. Our results demonstrated that: (1) for complete data, LASSO and Elastic Net outperformed other methods with respect to variable selection and future data prediction, and (2) for certain types of incomplete data, Random Forest induced bias in imputation, leading to incorrect ranking of variable importance. We propose the Imputed‐LASSO combining Random Forest imputation and LASSO; this approach offsets the bias in Random Forest and offers a simple yet efficient item selection approach for missing data. As an illustration, we apply the methods to items from the standard Autism Diagnostic Interview‐Revised version. Copyright © 2013 John Wiley & Sons, Ltd.