1995-2004年太原铁路管区法定传染病疫情分析

目的掌握太原铁路管区传染病的流行特征,以便更好地制定传染病预防控制规划。方法采用描述性流行病学方法,对太原铁路管区1995-2004年传染病疫情资料进行综合描述、分析。结果太原铁路管区1995-2004年传染病年平均发病率为707.70/10万。发病率居前5位的传染病是其他感染性腹泻、痢疾、病毒性肝炎、流行性腮腺炎和肺结核。病种以肠道传染病和呼吸道传染病为主,分别占传染病发病总数的72.10%和14.93%。结论太原铁路管区1995-2004年传染病年发病率呈明显的下降趋势,主要传染病病种近10年没有发生根本性改变,肠道传染病的发病仍居主要地位,肠道传染病和呼吸道传染病仍是今后传染病防治工作的重点。     

2001—2010年南京市雨花台区乙类传染病的发病趋势

目的分析南京市雨花台区乙类传染病疫情动态和流行特征,为制定和完善传染病防治策略和措施提供科学依据。方法采用描述流行病学方法进行分析。结果 2001—2010年共报告乙类传染病15种,累计发病5 882例,死亡5例,年平均发病率为221.25/10万,年平均死亡率为0.16/10万。痢疾、肺结核、梅毒10年中一直位居发病率的前5位。发病分类构成以血源及性传播传染病所占比例最高,为35.02%,结论 2001—2010年该区乙类传染病报告发病率总体呈现下降趋势,呼吸道传染病呈上升趋势,肠道传染病呈下降趋势。痢疾、肺结核、梅毒是雨花台区传染病防治的工作重点,同时进一步关注和控制血源及性传播传染病。     

西城区法定传染病疫情分析

目的了解北京市西城区法定传染病的流行特征。方法从中国疾病预防控制信息系统导出2012—2016年西城区法定传染病报告疫情资料,采用描述性流行病学方法分析西城区法定传染病的发病特点和流行规律。结果 2012—2016年西城区共报告法定传染病37 429例,年均报告发病率为563.49/10万,死亡72例,报告死亡率为1.08/10万。报告甲乙类传染病16种11 630例,年均报告发病率为175.09/10万,报告发病率前三位是痢疾、肺结核和梅毒;报告丙类传染病9种25 799例,年均报告发病率为388.40/10万,报告发病率前三位是其他感染性腹泻、手足口病和流行性感冒。2016年流行性感冒报告发病率为92.06/10万,较2015年上升413.44%。按传播途径分,肠道传染病报告居多,报告发病率为391.66/10万,呈逐年下降趋势(P0.05);其次为呼吸道传染病,报告发病率为123.72/10万,呈逐年上升趋势(P0.05)。西城区2012—2016年再次报告乙脑、黑热病和斑疹伤寒各1例。结论肠道传染病发病率虽有下降,但仍将是西城区法定传染病的防控重点;呼吸道传染病发病率上升,尤其是流行性感冒,应引起重视;同时应加强对新发、少见传染病的监控。     

1990～2010年湘西自治州法定甲乙类传染病流行趋势分析

[目的]了解湘西自治州传染病发病情况和流行趋势,为卫生行政部门制定防制策略提供科学依据。[方法]对湘西州1990～2010年甲乙类传染病疫情资料进行分析。[结果]1990～2010年累计报告甲乙类传染病22种171 269例,年均发病率为325.87/10万,呈明显下降趋势;合计死亡680例,年均死亡率、病死率分别为1.29/10万、0.40%。年均报告发病率,肠道传染病为170.03/10万,呼吸道传染病为102.85/10万,血源及性传播传染病为46.67/10万,自然疫源及虫媒传染病为5.90/10万。肠道传染病发病率呈下降趋势,呼吸道和血源及性传播传染病发病率呈上升趋势,主要与痢疾、伤寒、甲肝等肠道传染病发病数减少和肺结核、乙肝、梅毒等发病数增加有关。[结论]1990～2010年湘西自治州传染病发病率明显下降,血源及性传播传染病是当前重点防治的传染病。     

舟曲县2005-2010年法定传染病的流行病学分析

目的了解舟曲县2005-2010年法定传染病发病趋势和流行特征,为今后传染病防控工作提供科学依据。方法采用Excel 2003对舟曲县2005-2010年法定传染病疫情报告资料建立数据库,并进行描述性流行病学分析。结果 2005年1月~2010年12月,舟曲县法定传染病累计报告病例2 688例,未发生甲类传染病;乙类传染病7种2 384例,年平均发病率为305.64/10万;丙类传染病8种304例,年平均发病率为38.97/10万;报告死亡病例4例,均为肺结核,年平均死亡率为0.49/10万。乙类传染病发病率在前3位的病种依次为肺结核、病毒性肝炎、痢疾。丙类传染病发病率在前5位的病种依次为流行性腮腺炎、黑热病、水痘、其他感染性腹泻和流行性感冒。结论舟曲县今后应以肺结核、乙肝和痢疾等呼吸道、血源及肠道传播传染病防治作为重点。     

1997-2006年息烽县传染病流行趋势分析

目的分析息烽县传染病流行状况,为今后制定防制措施提供科学依据。方法收集息烽县1997-2006年法定报告传染病疫情资料,用描述性流行病学的方法进行统计分析。结果1997-2006年全县共报告甲、乙类传染病21种6786例,死亡42人。年平均发病率为281.27/10万,死亡率为1.74/10万,病死率为0.62%。发病率居前3位的是肺结核、痢疾和病毒性肝炎,分别为135.41/10万、55.42/10万和51.31/10万,是息烽县传染病发病的主要病种。呼吸道传染病年平均发病率为141.09/10万,居各类传染病的首位;肠道传染病年平均发病率为92.80/10万,居各类传染病的第2位;自然疫源性及虫媒传播疾病其发病率在4.47/10万～25.90/10万之间波动;血源及性传播传染病其发病率在19.10/10万～71.10/10万之间波动;新生儿破伤风年平均发病率为0.27/10万。结论10年间息烽县肠道传染病有较大幅度的下降,呼吸道传染病大幅度上升,肺结核发病构成维持在相当高的水平。血源及性传播传染病一直处于较低水平,但发病率呈上升趋势。     

2005-2014年抚州市法定传染病疫情分析

目的 分析2005-2014年抚州市法定传染病的发病与流行变化趋势,为控制法定传染病疫情提供科学依据。方法 采用Excel和SPSS22.0对2005-2014年抚州市法定传染病疫情资料进行描述性流行病学分析。结果 2005-2014年抚州市报告法定传染病31种,发病105 719例,年均发病率270.80/10万,年均死亡率0.37/10万,病死率0.14％,发病率为223.19/10万~328.09/10万,2005-2010年呈下降趋势,而2010-2014年呈上升趋势;肠道传染病、血源及性传播传染病呈上升趋势,呼吸道传染病发呈下降趋势。年均发病率前5位的法定传染病依次为肺结核、病毒性肝炎、手足口病、感染性腹泻病、痢疾,占总发病数的87.30%。结论 抚州市重要传染病病种为肺结核、病毒性肝炎(乙肝)、手足口病、其他感染性腹泻、痢疾、流行性腮腺炎、梅毒、淋病、麻疹等,法定传染病防治工作重点为肺结核、乙型肝炎、手足口病、感染性腹泻病、痢疾,应加强梅毒、艾滋病等性传播传染病管理与监测。     

2011～2018年天津市东丽区法定传染病流行特征分析

目的了解天津市东丽区近8年法定传染病发病趋势和流行特征,为进一步采取干预措施提供依据。方法采用描述性流行病学方法和Cochran-Armitage趋势检验对2011～2018年天津市东丽区法定传染病疫情资料进行分析。结果 2011～2018年无甲类传染病报告,共报告乙丙类传染病29种30 938例,年均报告发病率为575.06/10万,死亡病例27例,年均死亡率为0.50/10万,病死率为0.09%。乙类和丙类传染病报告发病率均呈下降趋势(P0.05或0.01)。肠道传染病和呼吸道传染病的报告发病率均呈下降趋势(P0.01)。结论天津市东丽区传染病发病率呈下降趋势。     

1996-2006年邻水县传染病发病分析

目的探讨1996-2006年邻水县法定传染病疫情的流行特征,为制定和完善传染病防制策略与措施提供科学依据。方法应用描述流行病学分析邻水县11年间传染病发病率、发病病种变化以及发病顺位。结果11年间邻水县共报告甲、乙类传染病20种19665例,传染病年平均发病率为193.10/10万;死亡55例,年平均死亡率为0.54/10万;传染病总发病率呈波浪式下降趋势,肺结核、乙肝、肝炎（甲肝、戊肝和未分型）、痢疾、麻疹和乙脑6种传染病占传染病总发病数的95.83%。结论1996-2006年邻水县传染病总发病率呈波浪式下降趋势,肺结核、乙肝、肝炎（甲肝、戊肝和未分型）、痢疾、麻疹、乙脑是传染病发病的主要病种,应积极做好相应防治工作。     

1956—2008年蓬莱市法定传染病疾病谱分析

目的分析蓬莱市1956—2008年甲、乙类传染病的发病趋势,为制定传染病防控措施提供理论依据。方法采用描述性流行病学的方法对蓬莱市1956—2008年法定传染病疫情资料进行统计分析。结果1956—2008年,蓬莱市法定报告甲、乙类传染病发病率和死亡率均呈下降趋势,总体发病率最高为7521.35/10万(1957年),最低为103.48/10万(2007年),年平均发病率为671.29/10万。死亡率最高为55.81/10万(1958年),年平均死亡率为5.90/10万。各类传染病发病比例发生明显变化,50—60年代,以呼吸系统传染病为主,发病率居前5位的是流行性感冒、麻疹、百日咳、流行性脑脊髓膜炎和肝炎。90年代后,以肠道传染病为主。2000—2008年居前5位的传染病是病毒性肝炎、肺结核、痢疾、淋病和梅毒。结论蓬莱市在控制普通传染病的同时,应将工作重点放在肠道和呼吸道等传染病的防治上,并制定针对性的防治策略。同时也应加强血源及性传播传染病的防治和监测。     

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.