Fifteen years of experience in cholinesterase monitoring of insecticide applicators

INTRODUCTION: Measuring cholinesterase(ChE) enzyme levels in red blood cells (RBC) and plasma has become a useful tool in the early detection of organophosphate and carbamate poisoning in insecticide handlers. Since 1974 the State of California has required testing of pesticide applicators to prevent disease. This study is a review of the testing experience of two physicians and using one laboratory so that a comparison can be made to previous studies by the author and others. METHODS: The files of 366 workers who were referred by their employers for ChE activity monitoring were abstracted for patient data, employer identification, and testing data. Results were entered into the EPIINFO program for analysis. RESULTS: A total of 366 workers from 45 companies were tested over a 15-year period between 1989 and 2004. Most were applicators. There were 690 attempts to establish baselines, of which 545 (79%) were successful. There were 519 monitoring tests on 228 workers, resulting in the removal from exposure of 18 employees, most in 1996. Self-reported exposure history and symptoms resulted in only 3 responses (.6%). The costs were significant ($47,160 total and $36 per test), especially when considering the failure of 145 (21%) employees to establish baselines. There was monthly and yearly variation in plasma and RBC baselines, monthly variance in plasma monitoring tests, and no monthly variance in RBC monitoring. The use of a third baseline test when the first two varied by 15% avoided two false positives. The mean time for recovery from ChE depression was 5.38 weeks. DISCUSSION: The California ChE monitoring program remains a valuable tool. There was significant monthly and yearly variation in values for both baseline and monitoring plasma and RBC values, with the exception of RBC monthly variance. Self-reported symptoms were not found to be a valuable tool in measuring exposure. Rates of recovery from ChE depression were highly variable. The warning feature of the program was very effective. The costs of monitoring were substantial, but possibly not as great as a single workers' compensation case. CONCLUSIONS: The California ChE monitoring program serves as a useful and cost-effective means of preventing organophosphate and carbamate overexposure. Elimination of the third baseline test requirement should be considered.     

医院新型放射防护管理实践与体会

目的 介绍福建医科大学附属协和医院新型放射防护管理的具体做法和成效,以期为同类医疗机构放射防护管理提供借鉴。方法 对比新型管理模式前后的做法及管理成效。结果 新型放射防护管理模式完善了事前、事中、事后监管,放射防护管理工作更加科学、有效。结论 医院领导的高度重视、职能部门的积极监管、放射工作人员对防护工作重要性的清醒认识与积极配合、行政监管部门主动监督检查是放射工作安全、可持续发展的重要保障。监管过程中部分流程的进一步优化,将使放射防护管理工作更加科学、更加有效。     

Forty years on: how radiological protection has evolved internationally.

In the 40 years since the Society for Radiological Protection (SRP) was founded, the international scene has changed considerably. The United Nations bodies primarily involved, the United Nations Scientific Committee on the Effects of Atomic Radiation and the International Atomic Energy Agency, have evolved from fledgling organisations to indispensable major resources. A similar development characterises regional entities such as Euratom and the OECD Nuclear Energy Agency. The International Commission on Radiological Protection (ICRP), once interested in occupational health in the practice of medicine only, has shifted its emphasis towards protection of members of the public and of patients exposed to ionising radiations and is currently looking at protection of non-human species. The International Radiation Protection Association, the federation that is now the 'mother society' of the SRP, had not even been launched formally when the SRP started. At that time, non-ionising radiation was on nobody's mind, and the forerunner of today's International Commission on Non-Ionizing Radiation Protection (ICNIRP) was not formed until 1977. Basically, the developments during this period must be described as a great success story. Average occupational exposures to ionising radiation have decreased markedly, the number of accidents is small, almost all countries now regulate exposures roughly in line with ICRP and ICNIRP recommendations, and quite a large number of countries also have reasonable regulatory infrastructures. An area where problems appear to be on the increase, perhaps in part because of increasing awareness, concerns 'orphan sources' and lack of source security. This may indicate a need for closer attention to security outside the nuclear fuel cycle, e.g. in hospitals and non-nuclear industry.     

A contribution to optimizing radiological protection in a U mine

This article presents an optimization study for radiological protection in a U mine. The mathematical model of the alpha contamination associated with short-lived Rn daughters allows the comparison of various protection strategies through a cost-effectiveness analysis. Determining the optimal protection strategy is carried out by choosing a value for the mansievert. This procedure may be of use as a decision-aiding tool within the framework of radiological protection.     

Fifteen years of investigations on hepatitis C virus in Poland

The paper reviews published results of investigations on hepatitis C virus on several fields: epidemiology, virology, pathogenesis, immunology, coinfections, and antiviral-treatment. Articles of Polish investigators, as well as Polish--international research groups were taken into consideration.     

某医院正电子发射计算机断层扫描显像仪工作场所防护监测与评价

目的监测和评价某医院1台正电子发射计算机断层扫描显像仪(PET-CT)及其工作场所放射防护效果,讨论放射防护最优化。方法根据相关标准和资料,通过现场卫生学调查和工作场所放射性水平和工作人员个人剂量检测,对其放射防护效果进行评价。结果加速器靶前工作位、药物注射时手部辐射水平较高,分别达到188、6.6×103μSv/h,个别工作人员体表污染水平超过国家标准。结论工作人员没有得到充分的放射防护,加速器靶前操作、放射性药物分装注射等环节放射防护可以进一步改善,实现放射防护的最优化。     

Dosimetric quantities in radiological protection and risk assessment

Central to the application of the system of protection recommended by the International Commission on Radiological Protection (ICRP) are the physical quantity, absorbed dose, and the protection quantities, equivalent and effective dose. These protection quantities are used to set dose limits, constraints and reference levels and to test compliance in the various activities of occupational and public exposure. They are also used in the assessment of doses from medical procedures. Effective dose in particular has proved to be a very valuable quantity that allows the summation of doses from external radiation and internal doses from different radionuclides in a single risk-related value. However, while it is possible to measure external radiation exposures and estimate internal exposures down to very low levels of dose, the associated risks, principally of cancer, are much less certain. Equivalent and effective doses are calculated using simplifying assumptions to apply to reference workers and members of the public for the purpose of control of exposures. Risks to individuals or specific population groups should be calculated not using these quantities but using best scientific information. The purpose of this note is to provide a short and readily accessible account of the purpose of the ICRP dosimetric quantities, how they are calculated, how they should be used, and how they relate to risk estimation.     

Fifteen years of using a second stage protein substitute for weaning in phenylketonuria: a retrospective study

Background

In phenylketonuria (PKU), during weaning, it is necessary to introduce a second stage phenylalanine (Phe)‐free protein substitute (PS) to help meet non‐Phe protein requirements. Semi‐solid weaning Phe‐free PS have been available for >15 years, although no long‐term studies have reported their efficacy.

Methods

Retrospective data from 31 children with PKU who commenced a weaning PS were collected from clinical records from age of weaning to 2 years, on: gender; birth order; weaning age; anthropometry; blood Phe levels; age commenced and dosage of weaning PS and Phe‐free infant L‐amino acid formula; natural protein intake; and issues with administration of PS or food.

Results

Median commencement age for weaning was 17 weeks (range 12–25 weeks) and, for weaning PS, 20 weeks (range 13–37 weeks). Median natural protein was 4 g day^?1 (range 3–11 g day^?1) and total protein intake was >2 g kg^?1 day^?1 from weaning to 2 years of age. Children started on 2–4 g day^?1 protein equivalent (5–10 g day^?1 of powder) from weaning PS, increasing by 0.2 g kg^?1 day^?1 (2 g day^?1) monthly to 12 months of age. Teething and illness adversely affected the administration of weaning PS and the acceptance of solid foods. Altogether, 32% of children had delayed introduction of more textured foods, associated with birth order (firstborn 80% versus 38%; P = 0.05) and food refusal when teething (80% versus 29%; P = 0.02).

Conclusions

Timing of introduction of solid foods and weaning PS, progression onto more textured foods and consistent feeding routines were important in aiding their acceptance. Any negative behaviour with weaning PS was mainly associated with food refusal, teething and illness. Parental approach influenced the acceptance of weaning PS.

     

医疗照射防护中有关放射诊断的放射卫生标准现状分析

目的 为我国医疗照射防护中放射诊断相关的标准及标准化工作提供有益的意见和建议。方法 根据医疗照射防护的原则,分析我国放射诊断相关的放射卫生标准现状,提出合理的建议。结果 至2018年12月,医疗照射防护中有关放射诊断的现行有效放射卫生标准共21项,标准内容较为全面,基本覆盖了在放射诊断过程中实践医疗照射防护原则所需要的各个方面,但诊断参考水平等标准需要加强。结论 我国医疗照射防护中有关放射诊断的放射卫生标准较为完备,标准内容涵盖全面。在诊断参考水平、设备质量控制检测等方面需进一步完善。     

山东省某县级市放射诊疗受检者防护现状调查

目的 分析基层放射诊疗受检者防护现状,为监管提供依据,引导受检者正确认知放射诊疗自身防护,促进放射诊疗工作安全、有序的开展.方法 采用填报调查表、现场核实的方法,对40家放射诊疗单位受检者个人防护用品的配备与使用情况以及防护设施、管理措施进行调查,采取现场发放调查问卷的方式对126个受检者进行调查,并对调查数据进行统计...     

某放射防护监督监测中心2016年生物剂量估算能力分析

[目的]检验某放射防护监督监测中心生物剂量估算能力,强化核与辐射事故应急救援能力。[方法]通过参加2016年全国生物剂量估算能力考核结果,分析影响该中心剂量估算能力的因素。[结果]2份盲样估算值与分配剂量真值的偏差均小于20%,评定成绩合格。[结论]该中心生物剂量估算水平符合国家要求,下一步应适时建立剂量估算曲线,加强染色体标本制备的质量控制和畸变的分析判断能力,提高生物剂量估算水平,在事故应急救援时发挥指导作用。     

某医院核医学科改建放射防护探讨

通过分析某三级甲等综合医院核医学科的改建的情况,根据其特点运用查阅资料、现场调查、检测、综合分析等客观科学的方法对放射性工作场所平面布局,人员流程,防护设施等进行评价。对核医学科建设项目的平面布局改造,通风改造,人员流程,放射性药物和放射性废物流程,防护检测结果进行客观的描述。本核医学改建基本能够满足放射防护要求,在正常运行时能控制放射性职业病危害,但也存在一些问题需要改进。本文总结出了一些实践经验供相似核医学改建时参考,并提出了一些核医学改建的要求、原则和注意事项,为其他医疗机构在改建核医学科时提供一个参考。     

职业辐射防护和患者放射防护的国际行动计划

近年来,国际劳工组织(ILO)、世界卫生组织(WHO)、国际原子能机构(IAEA)和联合国原子辐射效应科学委员会(UNSCEAR)很关注职业辐射防护和患者放射防护问题.它们分别联合发布了国际职业辐射防护行动计划和患者放射防护行动计划,目的在于帮助其成员国建立、维持和改进各国的防护计划.本文概要介绍这两个行动计划的主要内容.