柳州市33 685例动物致伤流行病学资料分析

[目的]了解柳州市狂犬病及动物致伤人群的流行特征.为狂犬病防制提供科学依据.[方法]采用描述性流行病学方法,对柳州市2002～2007年发生的33 685例动物致伤者资料进行统计分析.[结果]2002～2007年共登记被动物致伤者33 685例,平均每月467.85人.各年被动物致伤者人数分别为4 033、3 386、3 545、6 088、6 680和9 953例.以柳北区和柳南区最为严重(占64.00%);8月最多(占15.72%);男、女性别之比为1:1.36;常住人口为主(占94.00%);<18岁占37.21%;以学生为主(占30.93%);致伤部位中以上肢伤者最多(占54.45%);家养犬伤者占61.49%;24 h狂犬病疫苗及时注射率为39.19%;狂犬病疫苗全程注射率100.00%;伤口及时处理率为64.00%;伤口处理率仅为80.93%.[结论]加强犬、猫等动物的管理,普及狂犬病防治知识,暴露后正确处理伤口,及时进行疫苗注射是预防狂犬病发生的有效措施.     

2002年青岛市市区居民被动物致伤及狂犬病疫苗接种状况调查

[目的]了解青岛市市区居民动物致伤及狂犬病疫苗接种状况。[方法]对2002年在青岛市预防接种服务中心就诊的动物致伤并全程接种狂犬病疫苗者进行调查。接种国产狂犬病疫苗者全程接种后半个月检测血清狂犬病抗体。[结果]全年动物致伤7076例，占市区总人口的456．02／10万，无狂犬病病人发生。7～8月为致伤高峰；致伤者男女持平，青壮年居多。伤人动物86．59％是犬，其次是猫；80％的动物未进行免疫接种。上肢伤占64．78％。患者92．25％在24h内就医，狂犬病疫苗接种率为99．11％，85％的患者能得到及时清洗伤口。全程接种国产精制狂犬病疫苗后半个月，抗体阳性率为99．12％。[结论]青岛市市区居民动物致伤者较多，受伤者狂犬病疫苗接种率很高。     

2008年玉林市3573例动物致伤者资料分析

[目的]掌握狂犬病暴露人群的特征和暴露后处理情况,为狂犬病防制工作提供科学依据。[方法]对2008年玉林市疾病预防控制中心狂犬病门诊动物致伤就诊者3573例资料进行分析。[结果]3573例动物致伤者中,男性占57.82%,20岁的占39.49%;5～9月受伤者占47.58%,被犬伤者占62.22%,致伤下肢者占50.24%,Ⅱ度伤占68.26%,在门诊处理伤口的占88.75%,狂犬病疫苗全程接种率为100.00%,狂犬病人用免疫球蛋白注射率为13.74%。检测3075例致伤者,全程免疫后10～15d血清抗狂犬病抗体阳性率为90.11%。有2例发生狂犬病死亡。[结论]玉林市动物致伤者以犬伤为主,均接受狂犬病疫苗的全程免疫,接种后血清抗体水平较高。     

太康县1 200例被动物致伤及处理情况调查

[目的]了解太康县居民被犬、猫类动物致伤及处理情况。[方法]对2005年9月1日至2006年8月31日在太康县卫生防疫站狂犬病疫苗接种门诊就诊的被犬、猫类动物致伤人员进行详细的调查与登记。[结果]共调查1200例受伤者，第三季度受伤最多，417例，占34．8％；城区高于乡镇；16～50岁750例，占62、5％；农民较多，共640例，占53．3％；被犬致伤者1121例，占93．4％；受伤部位上下肢1148例，占95．6％；狂犬病疫苗全程免疫者1169例，占97．4％。全程免疫者未发生狂犬病。[结论]受伤后伤口处理和接受免疫预防率均较高，显示了目前居民对狂犬病的预防意识较强。     

2010年夏津县867例动物致伤者资料分析

[目的]了解动物致伤情况及致伤后采取的措施。[方法]对夏津县疾病预防控制中心预防接种门诊2010年接诊的所有动物致伤者资料进行分析。[结果]全年合计接诊867例动物致伤者。其中，男性占61．82％，20～59岁的占64．53％，来自农村的占77．85％，5～9月就诊的占53．86％；致伤后24h内就诊的占70．13％；犬类致伤的占91．93％；单用狂犬病疫苗接种的占91．70％。免疫接种后检测502例，血清狂犬病病毒抗体阳性率为94．42％。经过9～21个月的观察，无1例狂犬病病例发生。[结论]动物致伤者以男性、20-59岁、来自农村的、5～9月就诊的居多，大多数致伤后及时就诊。     

2008年博白县狂犬病暴露人群门诊处理情况分析

[目的]了解动物伤人分布情况及相关特点,以便采取针对性狂犬病的防治措施提供依据。[方法]对博白县疾病预防控制中心狂犬病预防门诊2008年动物咬伤患者就诊处理记录,对就诊预防处理情况进行统计分析。[结果]2008年共接诊犬、猫等动物伤2648例。其中,犬伤1758例,占66．39％;疑是疯狗致伤4例,其他动物无明显狂犬症状;猫伤594例,占22．43％;鼠、猪等其他动物伤296例．占11．18％。年龄以10岁以下儿童居多（847例）,占31．99％;以农民、学生暴露居多（1352、938例）,分别占51．07％、35．43％;夏秋季节为暴露高峰期,暴露者中自行处理伤口者1658例,占62．62％;24h内接种疫苗者2271例。占85．76％;全程足量接种疫苗者2647例,占99．98％;联合注射狂犬病免疫球蛋白者1251例,占47．24％;全程免疫后检测狂犬病抗体者965例,阳性945例,阳性率为97．92％。[结论]群众动物伤后能主动到疾控部门接受伤口处理和免疫接种,显示了目前居民对狂犬病的预防意识较强。     

2008年临沂市河东区狂犬病暴露人群资料分析

[目的]掌握狂犬病暴露人群流行病学特征及暴露后处理情况,为制订狂犬病防控措施提供科学依据。[方法]对2008年临沂市河东区15处狂犬病门诊报告的狂犬病暴露人群资料进行分析,对发生的狂犬病例进行调查。[结果]被动物致伤到狂犬病暴露处置门诊就诊者合计6678例。其中,男性3846例,14岁以下1935例．学生、工人2820例;5～8月就诊的3076例;被犬致伤者占91．17％;暴露部位为上肢的占51．20％,下肢占33．09％;暴露程度为Ⅱ级的占72．66％,就诊前伤口自行处理的占33．98％,狂犬病疫苗全程接种率为97．72％。Ⅲ级暴露者狂犬病抗血清／免疫球蛋白注射率为11．47％。报告1例被家犬致伤的本地狂犬病病例。[结论]儿童、少年是动物致伤的高危人群。群众防范意识差．暴露后自行处理比例低。     

3584例狂犬病暴露者预防处置分析

[目的]了解福建省CDC门诊狂犬病暴露后的预防处置现状,为防治提供依据。[方法]抽取2009年1～12月主动到接种门诊进行狂犬病免疫预防处置者,对登记资料进行分析。[结果]3 584例动物致伤暴露者,男多于女,性别比1.2∶1,20～60岁占65.7%,犬伤占72.0%,致伤高峰在7～9月,伤口以下肢为主,且以浅层和多部位伤多见,暴露者受伤后24 h内就诊者占75.0%,伤后暴露者未能处理或不能正确处理占24.2%,注射狂犬病免疫球蛋白者占就诊的26.8%。[结论]暴露后预防处置对预防狂犬病发挥重要的作用,今后将继续落实暴露人群的规范处置,加强对群众狂犬病防治知识的宣传教育,普及防治知识,提高高危人群的自我保护意识,做到被动物致伤后及时清洗伤口,并到疾控或医疗机构接种狂犬病疫苗和狂犬病免疫球蛋白。     

2002年青岛市市区居民被动物致伤及狂犬病疫苗接种状况调查

[目的 ]了解青岛市市区居民动物致伤及狂犬病疫苗接种状况。 [方法 ]对 2 0 0 2年在青岛市预防接种服务中心就诊的动物致伤并全程接种狂犬病疫苗者进行调查。接种国产狂犬病疫苗者全程接种后半个月检测血清狂犬病抗体。[结果 ]全年动物致伤 70 76例 ,占市区总人口的 45 6 0 2 /10万 ,无狂犬病病人发生。 7～ 8月为致伤高峰 ;致伤者男女持平 ,青壮年居多。伤人动物 86 5 9%是犬 ,其次是猫 ;80 %的动物未进行免疫接种。上肢伤占 64 78%。患者 92 2 5 %在 2 4h内就医 ,狂犬病疫苗接种率为 99 11% ,85 %的患者能得到及时清洗伤口。全程接种国产精制狂犬病疫苗后半个月 ,抗体阳性率为 99 12 %。 [结论 ]青岛市市区居民动物致伤者较多 ,受伤者狂犬病疫苗接种率很高     

2012年广州市越秀区人群狂犬病暴露相关因素流行病学分析

目的分析被动物咬伤到犬伤门诊就诊的流行病学因素,为加强狂犬病防治工作提供依据。方法采用描述性研究方法,对动物咬伤病例的性别、年龄、伤口部位、伤口数目、受伤程度、暴露分级、伤人动物情况、伤口处理、狂犬病疫苗及人狂犬病免疫球蛋白接种进行统计分析。结果2012年越秀区犬伤门诊共接诊22349例,女性占55．19％,其中15～44岁年龄组被咬伤人数最多,占54．01％,伤口部位上肢占53．23％,受伤程度浅表占82．25％,暴露分级中Ⅲ级占61．29％,伤人动物中宠物犬占36．97％,早期伤口自行处理率仅29．61％,全程接种狂犬病疫苗20143例,占90．13％,使用狂犬病免疫球蛋白人数占病例总数的14．77％。结论必须加强对群众狂犬病防治知识的宣传教育,加强犬类管理,在被动物致伤后应及时清洗伤口,并及时到医疗机构接种狂犬病疫苗和人狂犬病免疫球蛋白。     

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.     

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.     

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.     

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.