2013—2022年长春市非职业性一氧化碳中毒流行特征

目的 分析2013—2022年长春市非职业性一氧化碳中毒事件的流行病学特征和影响因素,为制定相关的防控措施提供依据。方法 收集2013—2022年长春市非职业性一氧化碳中毒事件的全部病例资料,采用描述性流行病学的方法描述中毒事件的特征。结果 2013—2022年长春市共报告非职业性一氧化碳中毒事件1 817起,中毒人数3 253人,其中死亡67人。中毒病例以女性为主（占53.55%）,青壮年人群居多（占37.32%）,秋、冬季高发（每年10月至次年3月）。中毒发生场所以家庭为主（占83.60%）,首要原因为燃煤取暖（占33.20%）,其次为燃气泄漏（占24.16%）。结论 秋冬季是长春市非职业性一氧化碳中毒的多发季节。要尽快协助群众改变供暖方式,推广安装燃气报警器,开展宣教活动,避免中毒事件的发生。     

2011—2021年上海市某区412例非职业性一氧化碳中毒病例分析

目的 分析松江区非职业性一氧化碳中毒病例的基本情况，以便有针对性地开展预防控制工作。方法 选择上海市松江区2011—2021年报告的非职业性一氧化碳中毒病例进行描述性分析。结果 上海市松江区2011—2021年期间共报告非职业性一氧化碳中毒病例412例，死亡2例，年均报告发病率为2.00/10万；中毒病例主要发生于冬春季节，共发生309例，占75.0%；月份病例数与月平均最高气温为负相关关系（r=-0.755,P <0.05）。病例数最多的是城郊接合部，160例，占38.83%;72.82%病例发生在家中；中毒患者以中青年为主；发生主要原因是炭火取暖、燃气热水器使用不当。结论 在冬春季开展有针对性的预防一氧化碳中毒知识健康宣教工作，强调室内通风的重要性，正确使用炭火、燃气热水器等设施，警惕新出现的潜在中毒危险，可有效预防非职业性一氧化碳中毒。     

2010--2013年上海市闸北区非职业性一氧化碳中毒病例分析

目的了解2010--2013年上海市闸北区非职业性一氧化碳中毒病例报告特征,分析其发生原因,研究可行的预防和干预措施。方法回顾性调查2010--2013年闸北区各级医疗机构报告的非职业性一氧化碳中毒病例。结果2010--2013年共发生病例84例,病例主要集中青年（69．05％）;中毒原因主要为人工煤气泄漏（60．71％）;每年3和11月为发病高峰期,其余时间段发病人数较少;主要为轻度中毒（73．8l％）,绝大多数病例均存活（96．43％）,居住在老式公房病例（57．14％）在所有病例中构成比最高。结论非职业性一氧化碳中毒病例人群、中毒时间、中毒地点存在一定的规律性、需要予以重视与采取有针对性的措施来降低发病率。     

南京某医院急症医学中心收治的重症中毒病例分析

目的：了解大型综合性医院急救中心重症中毒病例的发病原因、特征、抢救治疗效果．以总结经验和教训,探讨中毒防治的策略。方法：对南京某三级综合性医院急症医学中心1988年1月～2004年6月收治的全部重症中毒病例进行回顾性分析。结果：该中心16年问共收治重症中毒患者502例,涉及毒物6类,43种,主要是农药中毒和一氧化碳中毒,分别占40．44％,18．92％。1988年发病最多,占16．73％;2003年中毒患者最少,占1．39％。农药中毒以有机磷为主,春夏秋季高发;一氧化碳中毒为冬季高发。患者男女比例1：1．15;21～40岁是中毒的高发人群,占55．98％。职业分布以工人为主．占42．22％;其次是农民,占32．06％。72．71％的患者治愈．7．37％死亡。结论：南京地区中毒的发生具有明显的季节、中毒源、年龄及性别特征,病死率高,须引起重视,并要加强宣传教育,采取有效防范措施．以减少中毒的发生。     

2007年上海市杨浦区非职业性一氧化碳中毒原因分析

[目的]了解杨浦区2007年非职业性一氧化碳中毒监测病例发生特征,探讨干预方法。[方法]分析2007年杨浦区医疗机构报告的非职业性一氧化碳中毒病例的基本特征。[结果]杨浦区非职业性一氧化碳中毒病例共120例（死亡7例）,其中女性73例（占60.8%）;冬、春季高发;中毒年龄以20-30岁居多（占36.7%）;中毒原因主要为煤气灶（占51.7%）和煤气热水器（38.3%）使用不当。[结论]加强冬、春季室内通风,进行自救互救知识培训,特别是在缺乏自我保护意识的群体中,广泛开展健康教育。     

非职业性一氧化碳中毒201起事件分析

目的分析非职业性一氧化碳中毒事件的基本特征,探讨有效预防和控制措施。方法对北京市某区2009年11月1日-2010年10月31日报告的201起非职业性一氧化碳中毒事件进行描述性分析。结果非职业性一氧化碳中毒事件在冬季采暖期(81.6%)和城乡接合部(55.2%)高发,2010年1月为高峰期(38.3%),98.5%发生在家庭,94.0%由于燃煤取暖使用不当引起;中毒患者260人,以20~39岁的青壮年(41.2%)、女性(54.2%)居多,52.7%送往有高压氧治疗条件的急救中心救治。结论只有加强预防一氧化碳中毒知识的健康宣教工作,提高安全防范意识,强调室内通风的重要性,正确使用煤炉、燃气热水器等采暖设施,才能有效预防非职业性一氧化碳中毒。一旦发现一氧化碳中毒患者,尽快转送至有高压氧治疗条件的医疗机构救治。     

章丘市2006—2010年非职业性一氧化碳中毒病例调查分析

一氧化碳中毒,俗称煤气中毒,是一种常见病、多发病,严重危害我国居民身体健康,特别是北方地区冬春季尤为多见。一氧化碳中毒轻者引起头痛、头晕、恶心和呕吐,重者引起昏迷甚至死亡,对生命安全和生命质量形成极大危害,造成严重的经济损失。非职业性一氧化碳中毒是泛指公众在日常生活中发生的一氧化碳中毒,中毒原因多以燃煤取暖、生活做饭为主,还包括炭火取暖、煤气热水器使用不当、人工煤气泄漏和汽车尾气等。近几年来,章丘市非职业性一氧化碳中毒病例时有发生,并且出现了中毒死亡病     

谨防煤气中毒

每到冬天总有煤气中毒事件发生的报道。我们常说的煤气中毒就是指一氧化碳中毒。而一氧化碳到底是什么呢？一氧化碳是一种无色、无臭、无味的气体，它的比重是0．967，当空气中的一氧化碳浓度达到12．5％时，就有爆炸的危险。急性一氧化碳中毒是一种比较常见的生活性中毒和职业性中毒，尤其是在冬季取暖期更易发生。在生产和生活中含碳物质燃烧不完全，就会产生一氧化碳，吸入过量的一氧化碳就会发生中毒。     

2007—2011年广东省农药中毒流行病学特点分析

目的分析2007--2011年广东省农药中毒流行病学特点,为预防和控制农药中毒提供科学依据。方法收集2007--2011年广东省21个地市上报的急性农药中毒报告个案卡,并对农药中毒发生情况进行描述性流行病学分析。结果2007--2011年间广东省共报告农药中毒病例1423例,其中男性584例（41．0％）,女性839例（59．0％）。2007—2011年中毒例数分别为199、374、382、221和247例,以5—10月发生的中毒病例居多（58．26％,829／1423）。发病主要集中在清远市,共报告970例,占68．2％（970／1423）。农药种类以有机磷类最多,有726例（51．0％）,其次是除草剂类有162例（11．4％）。中毒类型主要是非生产性自服和误服,共1270例,占总中毒人数的89．2％（1270／1423）。死亡比例占9．3％（133／1423）,其中非生产性中毒的死亡比例是10．2％（129／1270）。结论广东省农药中毒发生呈增长趋势,预防的重点是逐步加强农药购销管理,提高广大农村人群健康教育,应建立合理有效的管理机制,综合防治。     

2007～2012年济南市非职业性一氧化碳中毒事件资料分析

[目的]分析2007～2012年济南市非职业性一氧化碳（CO）中毒流行病学特点,为有针对性地开展预防控制工作提供依据。[方法]对济南市2007～2012年非职业性CO中毒事件进行描述性分析。[结果]2007～2012年济南市共报告非职业性CO中毒信息（事件）2 414起,发病（中毒）3 467例,死亡118例。2 414起事件中,IV级事件4起;报告事件起数居前3位的区县为市中区（495起）、槐荫区（336起）和历城区（327起）;发病例数居前3位的为市中区（686例）、历城区（472例）和槐荫区（456例）;1、12、2月共报告1 946起和2 772例。中毒原因以燃煤取暖不当为主,占发生起数（2414起）的97.14%;中毒场所主要为家庭,占发生起数的98.22%。[结论]家庭冬季燃煤取暖不当是济南市非职业性CO中毒的主要特点。     

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.