杭州市2010年碘营养状况调查

目的 了解杭州市生活环境碘水平、人群碘营养状况和甲状腺结节患病情况以及分析食盐加碘与其患病率的关系.方法 通过问卷调查、3日称量记账法和3天24小时膳食回顾法对杭州市人群进行碘营养和膳食碘摄入量水平调查,采集饮用水、食用盐、晨尿检测碘含量及所有调查对象进行甲状腺B超检查,采用SPSS 13.0、SAS 9.1统计分析.结果 (1)共回收有效问卷12620份,采集水样221份、尿样12 730份、盐样3593份,甲状腺B超检查12 515人,膳食调查1848人;(2)水碘值0.20 ～ 5.99(M=2.58)μg/L; (3)成年男性膳食碘平均摄入量为289.2 μg/d,加碘食盐对人均膳食每日碘摄入量贡献率为74.4％;(4)居民尿碘M=178.80μg/L,尿碘水平在100～、200～、＜100和≥300μg/L人群比例分别为37.14％、23.11％、21.05％和18.69％;孕妇尿碘M=141.0 μg/L;(5)女性甲状腺结节发生率(28.6％)高于男性(20.1％);甲状腺结节检出率随年龄增加而上升(6～、12～、18～、40～和65～岁组分别为6.4％、10.9％、12.0％、24.4％和38.8％);城市人群甲状腺结节发生率(29.8％)高于郊区人群(23.3％),而郊区人群高于农村人群(20.3％);比较甲状腺结节人群(160.36 μg/L)与未检出人群(182.00 μg/L)尿碘水平,发现前者尿碘水平低于后者.结论 杭州市属于环境碘缺乏地区,目前加碘食盐是该市居民碘摄入的主要来源,居民碘营养状况总体处于适宜和安全水平,但孕妇碘营养不足;尚无证据表明杭州市食盐加碘与甲状腺结节患病率有关联.     

北京45～50岁居民碘营养状况与甲状腺结节关系

目的调查分析45~50岁北京市居民甲状腺结节患病与碘营养状况的相关性。方法于2014年在北京市4个区的体检中心随机抽样方法选取1 041名45~50岁正常体检人群,问卷调查人口学信息及甲状腺结节发病可能的危险因素,收集晨尿测定尿碘含量,B超诊断甲状腺结节情况。结果共收集调查对象1 041人,总人群尿碘为1.3~2 660.4μg/L,中位数为143.3μg/L,男性尿碘中位数(154.2μg/L)高于女性(127.3μg/L),郊区(158.8μg/L)高于城区(113.8μg/L),差异均有统计学意义(均P0.05);B超共检出有甲状腺结节者366人(甲状腺结节组),占35.2%,女性检出率(43.9%)高于男性(28.2%);甲状腺结节组尿碘中位数为134.9μg/L,对照组尿碘中位数为145.8μg/L,2者差异无统计学意义;logistic回归分析结果显示,女性(OR=1.903)和遗传因素(OR=2.300)为患有甲状腺结节的危险因素。结论北京市45~50岁居民碘营养水平处于适宜范围,而甲状腺结节患病率较高,甲状腺结节的高发与碘摄入量的不足或过量无统计学意义,其危险因素仍需进一步研究。     

学龄儿童碘营养状况与甲状腺结节患病关系

目的 了解浙江省学龄儿童碘营养状况及甲状腺结节患病水平及两者的关系,为碘缺乏病防治工作提供科学依据.方法 整群随机抽取浙江省2个县区8 ～ 10岁学龄儿童共689名进行甲状腺B超检查,同时采集尿液进行尿碘检测.结果 浙江省8 ～10岁学龄儿童甲状腺结节患病率为6.96％;学龄儿童尿碘中位数为180.50 μg/L;0～99 μg/L组学龄儿童甲状腺结节患病率较高,为8.70％,100～ 199 μg/L组学龄儿童甲状腺结节患病率次之,为5.49％,200～299μg/L组学龄儿童甲状腺结节患病率最高,为9.43％,尿碘水平处于300 μg/L以上学龄儿童甲状腺结节患病率最低,为5.16％,差异无统计学意义(x2=3.71,P＞0.05);检出有结节组学龄儿童尿碘中位数为192.68 μg/L,而无结节组学龄儿童尿碘中位数为179.50 μg/L,差异也无统计学意义(Z =0.77,P＞O.05).结论 学龄儿童碘营养状况良好,碘营养水平与甲状腺结节患病水平无相关关系.碘营养水平处于WHO提出的适宜范围内时,甲状腺结节患病率处于较低水平.     

2016年济南市613名8～10岁儿童碘营养状况调查

目的 了解2016年济南市8～10岁儿童碘营养状况、食用盐碘含量和甲状腺容积。方法 在济南市章丘、历城和市中3个区中,每区随机抽取5所学校,每所学校随机抽取40名8～10岁儿童,采集尿样、家庭食用盐检测碘含量并检测儿童甲状腺容积。结果 共分别检测613份尿样和食盐,尿碘中位数165.4 μg/L,盐碘中位数22.2 mg/kg。章丘、市中区尿碘中位数125.2 μg/L、144.1 μg/L,为碘营养适宜水平;历城区尿碘中位数238.1 μg/L,为超足量水平。8～10岁儿童甲状腺容积为（3.17±1.01） ml,肿大率为2.94%。盐碘含量与尿碘含量、甲状腺容积的相关性系数分别为0.0012（P = 0.766）、0.029（P = 0.468）。结论 被调查的613名8～10岁儿童碘营养状况处于碘适宜或超足量水平,仍存在一定比例的碘缺乏和碘过量情况,补碘政策应综合考虑盐碘、膳食碘和水碘等因素。     

北京市顺义区2009-2011年妊娠妇女尿碘监测结果分析

目的 了解顺义区妊娠妇女碘营养状况,为碘缺乏病防治提供科学依据.方法 采集妊娠期妇女尿样检测尿碘值,采用单因素和多因素方差分析方法对不同年份、年龄和孕期尿碘值进行分析.结果 2009-2011年妊娠妇女尿碘中位数分别为186.08 μg/L、169.27 μg/L和184.64 μg/L;3年来尿碘值＜150 μg/L的占总调查人数的37.30％,150 ～249 μg/L占38.70％,250 ～499μg/L占20.70％,≥500 μ/L占3.30％.结论 顺义区妊娠妇女总体上碘营养状况良好,但部分妊娠妇女存在碘缺乏或摄入过量的风险,提示我们应加强妊娠妇女尿碘水平监测,并指导妊娠妇女科学补碘.     

青海省黄南藏族自治州孕妇碘营养现况调查

目的 了解青海省黄南藏族自治州孕妇碘营养状况,为当地孕妇科学补碘提供依据。方法 对青海省多民族聚居的黄南藏族自治州孕妇进行随机抽样,采集尿样进行尿碘浓度检测,静脉血测定甲状腺功能,甲状腺超声测定甲状腺体积和结节。结果 最终纳入孕妇306人,随机尿碘浓度中位数为223.95(113.43,596.30)μg/L,其中30.79%和39.30%的受试者尿碘浓度<150μg/L和≥250μg/L。孕妇尿碘浓度<120μg/L比尿碘浓度120～249μg/L组甲状腺结节患病风险趋势增加。甲状腺功能异常率为32.27%,孕妇尿碘浓度≥250μg/L时,发生甲状腺功能异常的风险显著增加（OR=2.63,95%CI:1.07～6.44）。结论 尽管青海省黄南藏族自治州孕妇人群尿碘浓度中位数处于适宜水平,但仍有部分孕妇存在缺乏或过量风险。需加强孕妇碘营养监测,提供更精准的碘营养指导建议。     

碘用食物频率问卷对在校大学生碘摄入水平调查的应用研究

目的探讨针对北方在校大学生碘营养评价而设计的碘用食物频率问卷(I-FFQ)在个体碘摄入水平评估中的应用效果和反映个体实际碘摄入水平的能力。方法针对北方在校大学生设计一份评价其碘摄入水平的I-FFQ,选取30名志愿者,平均年龄(22.0±1.5)岁,对过去半年的膳食情况进行问卷调查,并用双份饭法收集连续3d的膳食样品进行碘含量测定同时收集3d 24h尿样测定尿碘排出量。结果 I-FFQ调查显示30位志愿者的平均碘摄入量为261.18μg/d,双份饭法3d膳食碘摄入量测定值为219.51μg/d,3d 24h尿碘排出量中位数为221.35μg/d。I-FFQ与双份饭结果显著相关(r=0.497,P=0.005),24h尿碘排出量占I-FFQ碘摄入量的86%,两者之间显著相关(r=0.471,P=0.009)。结论针对碘营养水平设计的I-FFQ问卷,简便易行,可以作为快速评价北方在校大学生个体碘摄入状况及碘营养水平的有效工具,为公众提供个体碘营养评价技术支撑。     

舟山群岛碘营养状况和甲状腺结节患者调查

目的调查舟山群岛城镇居民、农民、岱山盐民、嵊泗渔民及普陀山僧侣碘营养状况、甲状腺结节患病情况及致甲状腺结节的相关影响因素。方法对舟山群岛1389名城镇居民、502名农民、737名岱山盐民、362名嵊泗渔民及294名普陀山僧侣进行流行病学问卷调查、甲状腺B超检查和尿碘测定。结果舟山群岛城镇居民、农民、岱山盐民、嵊泗渔民及普陀山僧侣的尿碘中位数(MUI)分别为320.7μg/L,188.9μg/L,122.2μg/L,193.6μg/L,271.7μg/L,甲状腺结节的患病率分别为25.9%,25.5%,32.0%,16.0%,16.7%。女性较男性更易患甲状腺结节(P0.05),年龄越大,患甲状腺结节的危险性越高。饮食史、吸烟史、饮酒史、饮茶史、尿碘值与甲状腺结节无明显相关性。结论本调查研究表明,舟山群岛居民碘营养充足;各人群甲状腺结节患病率均较高。     

深圳市15岁以上居民尿碘水平及其影响因素分析

目的了解深圳市15岁以上居民碘营养状况及影响尿碘水平的因素,评估居民碘营养状况。方法采用整群随机抽样方法,于2009年在深圳市共抽取73个社区,入户调查15岁以上居民8152人,采集其晨尿并进行尿碘水平检测,用食物频率法评估碘摄入量。结果人群尿碘范围为9.65~4039.09μg/L,尿碘中位数为194.59μg/L;尿碘水平50μg/L者占2.49%,100μg/L者占12.12%,100~200μg/L者占40.16%,200~300μg/L者占26.94%,≥300μg/L者占20.78%;男女间尿碘水平差异有统计学意义(P=0.0001),男性尿碘中位数(201.32μg/L)略高于推荐适宜范围;各年龄组尿碘中位数(186.59~197.44μg/L)均处于推荐适宜范围,各组差异无统计学意义,但各组尿碘中位数随年龄增大呈下降趋势;每日碘摄入量、性别、饮酒在有序多因素Logistic回归分析中差异有统计学意义(P0.05)。结论深圳市居民碘营养状况良好,低碘和高碘人群仍然存在,特别是碘摄入超足量和过量的人群比率占47.72%,需要加强监测,进一步探索尿碘水平较高的原因,采取相应的防控措施,使人群碘营养水平适宜。     

忻州市175例甲亢患者碘营养状况调查

[目的]探讨甲亢患者膳食中碘的摄入量及碘营养水平.[方法]尿碘测定用酸消化砷-铈接触法.[结果]甲亢患者尿碘中位数504.21 μg/L,尿碘<200.00 μg/L的占5.16%.[结论]甲亢患者的碘营养水平过量,限制碘的摄入是必要的.     

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.     

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.     

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.     

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.