职业性紧张因素与高血压发病关系

目的 研究职业紧张与高血压之间的关系以及引起高血压发病的主要职业紧张因素。方法 应用职业紧张因素测试表（ＯＳＩ）,对福州市区住院的８６例高血压病患和８１例对照进行病例对照研究,并进行非条件Ｌｏｇｉｓｔｉｃ回归分析。结果 在控制非职业紧张因素条件下,职业紧张暴露的危险度增高（ＯＲ＝２．７２,９５％ＣＩ：１．４１￣５．２７）,并随着职业紧张程度的增加患高血压的危险性增高;引起高血压发生的主要职业紧张     

列车乘务人员职业紧张与高血压关系的研究

目的 研究职业紧张与高血压之间的关系以及引起高血压发病的主要职业紧张因素。方法 应用职业紧张因素测试表（ＯＳＩ）,对５８３名男性列车乘务人员进行职业紧张与高血压关系的人群调查,并进行多因素非条件Ｌｏｇｉｓｔｉｃ回归分析。结果 在控制了非职业紧张因素条件下,职业紧张与高血压（ＲＲ＝１．９７７,９５％ＣＩ：１．３５３～２．８８７）有独立的相关关系,而且随着职业紧张程度的增加,患高血压的危险性也增高,引     

职业因素与冠心病发病关系的病例对照研究

为了研究职业因素与冠心病发病的关系,本文应用１１配对病例对照研究方法对职业因素与冠心病之间关系进行了研究。共对１５０对资料进行了单因素分析、叉生分析、条件Ｌｏｇｉｓｔｉｃ回归分析。结果显示：（１）劳动类型中的脑力劳动（ＯＲ＝２．９３）、职业类型中的企事业管理人员（ＯＲ＝３．１０）、接触职业性有害因素种类中的工作紧张（ＯＲ＝２．４３）、有机溶剂（ＯＲ＝９．５０）与冠心病的发病密切相关,其中脑力劳动可能是冠心病的重要危险因素;（２）脑力劳动、企事业管理人员、工作紧张与高血压、高血脂之间存在明显的协同作用     

四川省抽样人群中高血压危险因素研究

根据四川省１９９１年度高血压抽样调查资料，采用病例－对照的研究方法，结合条件Ｌｏｇｉｓｔｉｃ回归模型，分析了高血压的危险因素。结果表明，影响高血压的主要危险因素是：体重指数（ＯＲ＝１．６６１，９５％ＣＩ：１．５２９～１．８０４）、高血压家族史（ＯＲ＝１．２５８，９５％ＣＩ：１．１６４～１．３６０）、脉率（ＯＲ＝１．５３９，９５％ＣＩ：１．２４９～１．８９８）、卫生知识水平（ＯＲ＝１．０５８，９５％ＣＩ：１．０２９～１．０８８）和每日酒精摄入量（ＯＲ＝１．１９０，９５％ＣＩ：１．０４２～１．３５９）。从本次调查资料，我们未发现吸烟与高血压有关联。     

天津市女性糖尿病危险因素初步研究

对天津市区居民１２１例女性非胰岛素依赖型糖尿病（ＮＩＤＤＭ）病例进行了１：１配对病例对照研究。经条件Ｌｏｇｉｓｔｉｃ回归模型分析，发现与ＮＩＤＤＭ有关的危险因素是：经济收入高（ＯＲ一３．４８，９５％ＣＩ＝２．０２～５．９８）、糖尿病家族史（ＯＲ＝６．３７，９５％ＣＩ＝２．９２～１３．８９）、既往相关病史（ＯＲ＝６．９２，９５％ＣＩ＝３．２５～１４．７３）、绝经年龄晚（ＯＲ＝３，３９，９５％ＣＩ＝２．１５～５．３５）、嗜甜食（ＯＲ＝３．５６，９５％ＣＩ＝２．２９～５．５４）、肥胖（ＯＲ＝１６．３２，９５％ＣＩ＝６．０２～４４．２３）及ＢＭＩ大（ＯＲ＝２．０８，９５％ＣＩ＝１．５２～２．８５）。同时还发现，体育锻炼（ＯＲ＝０．３６，＝３１．４７，Ｐ＜０．０１）和蔬菜、水果等是保护性因素。     

301 例急性心肌梗死病人急性期预后因素的非条件 Logistic 模型分析

本文对天津某医院３０１例急性心肌梗死病人的预后进行了分析。在３０１例病人中存活２４３人，死亡５８人。急性期病死率为１９．２７％。经非条件Ｌｏｇｉｓｔｉｃ回归模型对多因素调整，发现ＡＭＩ的预后与以下４个因素有密切关系：年龄（ＯＲ＝１．００３９５％ＣＩ１．００３～１．０７６）；糖尿病史（ＯＲ＝２．５３９９５％ＣＩ１．０５０～６．１３８）；心律失常（ＯＲ＝３．２４４９５％ＣＩ１．６０２～６．５６６）；心衰（ＯＲ＝３．５９７９５％ＣＩ１．８２５～７．０８８）。说明以上４个因素是影响急性心肌梗死急性期预后的主要因素。     

CYP2E1和GSTM1基因型与胃癌易患性关系初探

应用病例对照分子流行病学的方法对细胞色素Ｐ４５０２Ｅ１（ＣＹＰ２Ｅ１） 、谷胱甘肽转硫酶Ｍ１（ＧＳＴＭ１） 基因型与胃癌易患性的关系作了初步探讨。采用ＰＣＲ 方法检测９１ 例原发性胃癌病例和９４ 例正常对照的ＣＹＰ２Ｅ１ 和ＧＳＴＭ１ 基因型。结果表明,ＧＳＴＭ１ 基因缺失与胃癌易患性有关,携带ＣＹＰ２Ｅ１ 的Ｃ１／Ｃ２ 或Ｃ２／Ｃ２ 基因型且ＧＳＴＭ１ 缺失者胃癌易患性增高,ＯＲ＝ ４５８ ,９５ ％ ＣＩ＝ １５４ ～１４１１ 。若同时有吸烟暴露,则胃癌的危险性显著增高（ＯＲ＝ ２０００ ,９５ ％ ＣＩ＝ ３６９ ～１３１６１） ,提示ＣＹＰ２Ｅ１ 和ＧＳＴＭ１ 基因多态与胃癌易患性有关     

武汉市前列腺癌的流行病学研究

前列腺癌是欧美国家男性的主要死亡原因，我国还没有全面的发病率和死亡统计资料。为了解我国前列腺癌的流行情况，在武汉市１９９０～１９９２年前列腺癌的发病及死亡报告的基础上，收集了１９９０～１９９５年住院治疗的１０２例前列腺癌现患病例进行了１１配比的病例对照研究。结果显示：武汉市前列腺癌的发病率和死亡率分别为１．３７／１０万和０．７５／１０万，世界人口年平均标化发病率和死亡率分别为１．１０／１０万和０．６６／１０万。泌尿系统病史〔ＯＲ＝５．４２，９５％可信区间（ＣＩ）＝１．５６～１８．８３〕、子女数超过３个（ＯＲ＝２．４３，９５％ＣＩ＝１．１７～５．０２）、青壮年期每周性交超过３次（ＯＲ＝３．３８，９５％ＣＩ＝１．５１～７．５８）、滥用药物（ＯＲ＝４．１１，９５％ＣＩ＝１．６５～１０．２５）、体质指数高（ＯＲ＝２．５８，９５％ＣＩ＝１．３０～５．１１）等是前列腺癌的危险因素，而体力劳动（ＯＲ＝０．３５，９５％ＣＩ＝０．１７～０．７１）、初次遗精年龄晚于１８岁（ＯＲ＝０．２０，９５％ＣＩ＝０．０８～０．５２）等是其保护性因素。     

鞍钢工人的肿瘤危险度——肺癌病例-对照研究

对鞍钢男工中６１０例肺癌新发病例及９５９例对照进行了访问调查。经吸烟、其他肺疾患、家族肿瘤史、食用水果等非职业因素调整后，岗位工龄等于或超过１５年的下列工人的肺癌危险度显著增高：冶炼工和轧钢工（ＱＲ＝１．５，９５％ＣＩ＝１．１～２．２），耐火砖厂工（ＯＲ＝２．９，９５％ＣＩ＝１．４～５．９），装卸工（ＯＲ＝２．５，９５％ＣＩ＝１．０～６．１），焦炉工（ＯＲ＝３．４，９５％ＣＩ＝１．４～８．５）。各种粉尘和Ｂ［ａ］Ｐ暴露与肺癌危险性呈显著的剂量－反应关系，但与粉尘的特殊成分未见此种关联。长期暴露于污染物的钢铁工人的肺癌的危险度增加４０％。     

孕妇早期流产与使用电热毯关系的病例对照研究

通过病例对照研究探讨自发流产与怀孕期使用电热毯的关系。结果，孕早期使用电热毯的自发流产和总异常妊娠的ＯＲ值分别为１．９５（９５％ＣＩ１．３１～２．９０）和１．６１（９５％ＣＩ＝２．３４），但异常妊娠ＯＲ值的增高是由于自发流产增高所致。当排除孕早期使用有关药物、孕期职业暴露于化学物质和噪声这些干扰因素后，仍显示相似结果。提示孕早期使用电热毯可能增加自发流产。     

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.     

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.     

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.     

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.