1995～2005年连城县碘缺乏病监测结果分析

[目的]了解连城县碘缺乏病（IDD）的病情消长趋势，评价措施的落实情况和防治效果，为制定防治措施提供科学依据。[方法]对连城县1995年、1997年、1999年、2001年、2003年、2005年IDD病情监测资料进行分析。[结果]合计调查8～10岁小学生7677人，甲状腺肿大的233人，甲状腺肿大率为3．03％；合计检测家庭食盐2265份，碘含量合格的2015份，合格率为88．96％；合计检测小学生尿样1297份，尿碘中位数296．4μg／L，碘含量≥100μg／L的占90．13％。儿童甲状腺肿大率有逐年下降的趋势。盐碘、尿碘指标均有逐年提高的趋势。[结论]连城县碘缺乏病综合防治措施的成果是巩固的。     

2004年潍坊市碘缺乏病防治现况调查

[目的]了解潍坊市基本消除碘缺乏病(IDD)后的防治现状。[方法]2004年4月随机抽取3个县(市)各1个乡镇中心小学，对儿童甲状腺肿大、尿碘水平，居民户盐碘含量、IDD防治知识进行调查。[结果]调查270名儿童．甲肿率为10．37％；检测尿样60份，尿碘中位数为108．30μg／L，≥100μg／L的占81．67％；检测家庭用盐150份，合格碘盐食用率、碘盐合格率、碘盐覆盖率分别为78．00％、85．40％、86．67％；调查五年级小学生120人、家庭主妇90人，IDD防治知识及格率分别为97．67％、84．44％。[结论]儿童甲肿率较高，碘盐使用率与家庭主妇IDD知识合格率均不太高，应进一步加强有关措施，巩固防治成果。     

1995-2002年青岛市碘缺乏病监测资料分析

[目的] 评估青岛市碘缺乏病(IDD)防治状况与消除进程。[方法] 分析我市1995、1997、1999和2002年4次IDD随机抽样监测资料。[结果] 4次监测的儿童甲状腺肿大率分别为9．6％、11．9％、15．0％和5．0％。尿碘中位数及大于100μg／L的比例分别为181．99μg／L和75．7％、460．0μg／L和100％、133．70μg／L和54．3％、164．15μg／L和72．2％。居民户益碘含量中位数分别为0、11．60、10．60和28．55(mg／kg)，碘盐覆盖率分别为24．6％、59．4％、61．7％和100％，合格碘盐食用率分别为17．2％、36．9％、40．0％和94．2％；1995—1999年的非碘益较多，源于大粒粗盐。[结论] 青岛市的甲状腺肿大率呈下降趋势，碘盐覆盖率和合格碘盐食用率均逐年升高，碘营养状况明显改善，表明近几年来的IDD综合防治成效显著。应巩固防治成果和完善可持续消除碘缺乏病工作机制。     

2005年东营市碘缺乏病病情调查

[目的]了解碘缺乏病（IDD）病情现状，评价干预措施与效果，进一步巩固防治成果，为持续消除IDD工作提供科学依据。[方法]2005年在东营市采用PPS抽样和随机整群抽样法进行IDD病情调查。[结果]东营市合计检查8～10岁儿童1800名，甲状腺肿大者85人，甲状腺肿大率为4．72％，5个县（区）分别为广饶县11．11％、利津县4．72％、垦利县2．78％、东营区2．22％、河口区2．78％；检测8～10岁儿童尿样560份，尿碘中位数为197．32μg／L，≥100μg／L的占92．14％；检测儿童家庭用盐600份，碘盐覆盖率为97．33％，合格碘盐食用率为95．65％。调查五年级小学生670人，家庭主妇209人，IDD防治知识及格率分别为71．64％、70．33％。非碘盐冲击现象各县区不同程度的存在。[结论]东营市IDD病情稳定，消除碘缺乏病工作已步入稳定发展阶段，居民碘营养状况处于基本适宜水平，建议有关部门应继续加大对碘盐市场的监督检查力度，坚决抵制非碘盐冲击，碘缺乏病健康教育工作需有待加强。     

2002年山东省碘缺乏地区饮用水与儿童尿碘含量调查

[目的]了解山东省碘缺乏地区水碘与儿童尿碘水平。[方法]2002年在山东省14个碘缺乏城市中随机抽取30个县(市、区)，对8—10岁儿童进行尿碘检测，在其所在学校驻地的行政村采取水样检测碘含量。[结果]检测地区水碘均值为6．40μg/L；＜10μg／L的水样占81．6％；儿童尿碘中位数为200．0μg/L，＜20μg/L的占0．6％；水碘值与儿童尿碘值之间无相关关系。[结论]相当一部分被调查地区仍为碘缺乏地区，但尿碘值达到了我国消除碘缺乏标准，表明食盐加碘的预防措施非常有效，应继续实施。     

安溪县碘缺乏病病情监测报告

[目的]通过碘缺乏病病情监测，掌握病情动态，为防治工作提供依据。[方法]对8～10岁儿童进行甲状腺检查，同时测定居民户盐碘及儿童尿碘含量。[结果]检查1224名儿童，甲状腺肿大率4．9％，尿碘中位数172．3μg／L，碘盐覆盖率97．6％，合格碘盐食用率96．7％。[结论]儿童甲状腺肿大率，尿碘水平、盐碘含量已达到国家碘缺乏病消除标准。     

深圳市福田区碘缺乏病现状调查的分析

[目的]了解深圳市福田区碘缺乏病（IDD）现状。[方法]用随机抽样的方法检查深圳市福田区8～10岁小学生甲状腺肿大、尿碘、智商及居民食用碘盐。[结果]深圳市福田区盐碘含量中位数为30．0g／kg，碘盐覆盖率为96．9％，碘盐合格率为98．0％，合格碘盐食用率为95．0％；8～10岁小学生甲状腺肿大率为3．1％，均为I度肿大；男女生甲状腺肿大率相近（P〉0．05）；8～10岁小学生尿碘值中位数为190．0μg／L；2．8％的小学生尿碘值不足100μg／L。[结论]深圳市福田区碘缺乏病防治工作取得较好的效果。     

2003年温州市碘缺乏病现况调查分析

[目的]在消除碘缺乏病的阶段性目标后,为巩固防治效果．完善可持续消除碘缺乏病X-作机制提供科学的依据。[方法]按照《全国碘缺乏病监测方案》测定。[结果]温州市8～10岁儿童甲状腺肿大率为6.3％,尿碘中位数为201．90μg／L,≥10μg／L的占81．3N,碘盐覆盖率为88．0％,碘盐合格率为71.3％。[结论]我市碘缺乏病形势仍然严峻．应加大碘缺乏病危害宣传力度,提高碘盐覆盖率及合格率。     

调整食盐加碘量前后山东省儿童碘营养状况分析

[目的]分析食盐加碘量调整对学龄儿童碘营养水平的影响。[方法]对食盐加碘量为20~60 mg/kg的1995年、1997年、1999年和食盐加碘量为(35±15)mg/kg的2002年、2005年山东省碘缺乏病监测中儿童碘营养状况进行分析。[结果]食盐加碘量调整前后分别检测尿样1 051份、720份,尿碘中位数分别为269.4μg/L、213.9μg/L,推算的每人每天碘摄入量分别为404.1μg、320.8μg,尿碘<100μg/L者所占比例分别为14.94%、11.53%,尿碘≥300μg/L者所占比例分别为46.52%、27.22%(P<0.01)。盐加碘量调整前后分别调查8~10岁儿童3 668人2、400人,甲状腺肿大率(触诊法)分别为14.53%、5.08%(P<0.01)。[结论]调整食盐加碘量后儿童碘营养状况良好,儿童甲状腺肿大率明显下降。     

当前盐碘水平对广东哺乳妇女及其婴幼儿碘营养的影响

[目的]了解当前盐碘水平下，广东省部分地区哺乳妇女及其婴幼儿的碘营养状况。[方法]采用一次性点状调查法，选择3个基本代表广东轻、中、重缺碘地区深圳、佛冈和乐昌的城市和农村各两个点，调查哺乳妇女及其墨幼儿的尿碘、盐碘、水碘和乳汁碘等。[结果]深圳市、佛冈县和乐昌市的婴幼儿尿碘中位数分别为281．2μg／L、237．1μg／L、286．6μg／L，大于300μg／L的比例分别占43．3％、34．9％和49．0％；哺乳妇女尿碘中位数分别为207．8μg／L、172．6μg／L和260．5μg／L，大于300μg／L的比例分别占34．4％、23．8％和41．5％；盐碘中位数分别为32．8mg／kg、27．5mg／kg和36．0mg／kg。[结论]当前的盐碘浓度完全可满足哺乳妇女及婴幼儿的碘营养需求，部分地区有偏高趋势。建议将我省重度和中度缺碘病区盐碘浓度的平均水平下调至30mg／kg，轻度缺碘地区下调至25mg／kg。     

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.     

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.