氟油生产对作业工人呼吸系统的影响

为探求长期接触低浓度氟对作业工人呼吸系统的影响，对５６名氟油作业工人的临床症状及肺功能进行统计。结果发现，接触组的临床症状如咽疼、咳嗽、咳痰、胸部不适等症状明显高于对照组（Ｐ＜００１）。肺功能测定结果表明，接触组ＦＥＶ１／ＦＶＣ（％）、Ｖ５０／ＨＴ、Ｖ２５／ＨＴ明显降低，与对照组相比，差异有显著性（Ｐ＜００１）。工龄大于１５年与小于１５年的相比，ＦＥＶ１／ＦＶＣ（％）、Ｖ５０／ＨＴ、Ｖ２５／ＨＴ也有明显降低（Ｐ＜００５）。提示长期接触低浓度氟可损害呼吸系统，且集中在小气道，并有一定剂量－效应趋势     

低浓度一氧化碳对工人健康的影响

对接触ＣＯ作业（ＣＯ平均浓度０～１４９．１ｍｇ／ｍ３）的工人４７名（ＣＯＨｂＸ为０．２５±０．０１７），与非接触ＣＯ作业（ＣＯ平均浓度２．２４１～５．８１９ｍｇ／ｍ３）的工人（ＣＯＨｂＸ为０．０１８±０．０２０）进行了配对调查研究，结果接触组以头痛、头晕、记忆力减退及失眠为特征的神经衰弱综合征改变明显；心电图异常的例数增多；周边视野缩小；选择反应时延长；肺功能Ｖ２５实测值降低；经统计学处理，与对照组比较有明显差异。但两组工人的暗适应时间，Ｈｂ、ＲＢＣ及ＴＣ、ＴＧ、β－ＬＰ、ＨＤＬ，以及ＦＥＶ１及ＰａＯ２、ＳａＯ２测试结果经统计学处理，无明显区别。通过本次配对调查研究结果，可初步说明，长期接触低浓度ＣＯ作业工人，脱离ＣＯ作业２４小时后，ＣＯＨｂ、ＰａＯ２及ＳａＯ２均在正常范围，但对接触工人的神经系统及心脏功能有一定影响。神经衰弱综合征（植物神经机能检查），ＣＯＨｂ、心电图、脑电图、周边视野，选择反应时，应列为对接触低浓度ＣＯ作业工人健康的必检指标。小气道功能的检测、ＴＣ、ＴＧ、ＬＤＬ－ＣＨＤＬ的检测可作为选择指标。Ｐ３００作为一个不需靠外部行为认知过程的客观指标，有必要继续进行临床探索，积累资料，以明确其临床     

低浓度CO对作业工人乳酸脱氢酶及同工酶谱的影响

通过对ＣＯ男性作业工人及配对对照的血清ＬＤＨ同工酶的观察，探讨低浓度ＣＯ对血清ＬＤＨ活性和同工酶谱的影响。结果表明：低浓度ＣＯ作业工人血清ＬＤＨＨ亚单位含量降低，Ｍ亚单位含量增高，与对照差异显著（Ｐ＜０．０５）；ＬＤＨ＿２显著低于对照（Ｐ＜０．０５），且ＬＤＨ＿１／ＬＤＨ＿２有增高趋势。两组工人血清ＬＤＨ活性未见显著差异。提示：接触低浓度ＣＯ导致作业工人血清ＬＤＨ同工酶谱发生改变。     

三硝基甲苯作业工人和HBsAg阳性者血清铁含量的变化

对河南省某化工厂三硝基甲苯（ＴＮＴ）作业现场劳动卫生学调查结果发现，车间空气中ＴＮＴ浓度多数超过国家最高容许浓度（ＭＡＣ＝１ｍｇ／ｍ３），ＴＮＴ作业工人皮肤污染严重。血清铁测定结果表明，ＴＮＴ接触组与ＨＢｓＡｇ阳性组极显著高于对照组（Ｐ＜００００５），ＨＢｓＡｇ阳性组显著高于ＴＮＴ接触组（Ｐ＜０００２５）。推测ＴＮＴ与ＨＢＶ诱发的肝损害部分机理可能与机体处于氧化应激状态有关。     

氯气对作业工人上呼吸道及肺功能的影响

氯气是一种强烈的刺激性气体。氯气被吸入呼吸道与粘膜接触除元素氯外，还形成次氯酸、氯化氢等。通过对氯气作业环境及１７５名作业工人的上呼吸道及肺功能检查，发现工人在低浓度（０．０９～０．９９ｍｇ／ｍ３）氯气环境下作业，鼻粘膜充血、咽炎等明显高于对照组（Ｐ＜０．０５）。且接触组内，又以咽部充血最为突出，慢性咽炎的发病率也较高、吸烟者的患病率比不吸烟者高（前者为５０％，后者为１２．３０％），而对照组内则无此差异。接触组的肺功能以阻塞性通气功能相关的指标均有不同程度的改变。氯气对作业工人上呼吸道及肺功能的…     

噪声作业对生产工人血脂成分影响的调查研究

对１３６名生产性噪声作业工人血脂成分含量进行了测定。结果表明,噪声可导致接噪工人血脂中ＣＨＯ、ＴＧ含量明显升高;噪声暴露组血脂成分异常检出率为２５０％,非噪声暴露组血脂异常检出率为１０９％（Ｐ＜００５）;两组之间总胆固醇含量差异具有非常显著性意义（Ｐ＜００１）,甘油三酯含量差异有显著性意义（Ｐ＜００５）。噪声强度、接噪工龄均与血脂异常检出率呈正相关（ｒ＝０９７８４,Ｐ＜００１;ｒ＝０９５０９,Ｐ＜００５）。提示噪声作业可致人体脂代谢发生异常。此外,就累积噪声暴露量与血脂的关系进行了探讨,结果显示二者间存在剂量反应关系,并呈正相关（ｒ＝０９８８３,Ｐ＜００１）。     

对苯二甲酸作业人群尿液离子水平的变化

探讨对苯二甲酸（ＴＰＡ）作业人群尿液离子水平的变化。方法留取２２４名ＴＰＡ作业工人和１１４名对照组工人当日工前工后尿样。对尿ｐＨ、Ｎａ＋、Ｃｌ－、Ｃａ２＋、ＮＨ４＋、ＰＯ４３－和ＳＯ４２－进行测定分析。结果接触组尿Ｎａ＋、Ｃｌ－、Ｃａ２＋和ＳＯ４２－离子浓度显著高于对照组（Ｐ＜００１）,同时ＮＨ４＋与尿ＴＰＡ负荷存在明显的剂量依赖关系;指标聚类分析表明,尿ＴＰＡ水平与尿ＮＨ４＋水平相关系数最大（ｒ＝０２４０５,Ｐ＜００１）,提示ＴＰＡ可能是导致尿ＮＨ４＋离子排泄增加的原因。结论由于ＮＨ４＋长期排泄过多,会导致机体负氮平衡,因此似可以尿ＮＨ４＋作为接触ＴＰＡ的早期生物学监测指标。     

长期接触低浓度氯气对工人鼻粘膜功能的影响

目的：观察长期接触低浓度氯气对工人鼻粘膜功能的影响。方法：３１名工人接触氯气平均浓度为０．２３±０．０２ｍｇ／ｍ３、平均接氯量为１．９８ｍｇ／ｍ３，历时３年，检查鼻粘膜纤毛运动功能和腺体分泌功能的改变。结果：两种功能较接触氯气前显著降低（Ｐ＜０．０５），且鼻粘膜功能与接触氯气量呈负相关。结论：长期接触低浓度氯气可导致鼻粘膜功能损害，并存在剂量－效应关系。     

接触高温,CO工人血清GH和CS的变化

采用放射免疫方法，对长期接触高温、ＣＯ、高温＋ＣＯ作业工人及对照人员血清生长激素（ＧＨ）和皮质醇（ＣＳ）水平进行了测定。年龄和工龄在４个组间无显著性差异（Ｐ＞０．０５）。其结果：（１）高温工人血清ＧＨ、ＣＳ水平与对照组相近（Ｐ＞０．０５）；（２）接触ＣＯ、高温＋ＣＯ工人血清ＧＨ虽呈下降趋势，但无明显差异（Ｐ＞０．０５）；而血ＣＳ则明显升高（Ｐ＜０．０５）。从结果看出，长期接触高温、ＣＯ对ＧＨ和ＣＳ     

甲醛对作业工人呼吸系统及肺功能的影响

为探讨低浓度甲醛接触对工人健康的影响,对７９名甲开人进行了健康检查及肺功能测定。结果表明甲醛对作业工人的主要危害表现为上呼吸道症状体征发生率增加,接触组肺功能异常率增高,且以小气道功能异常为主。提示长期接触低浓度甲醛损害工人呼吸系统健康,对肺功能损害属于阻塞性肺通气功能障碍,肺功能测定不失为甲醛作业工人健康监护的理想指标。     

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.