中山市医用X射线诊断频率与剂量水平调查

目的：为提高中山市放射卫生监督监测及管理水平，调查中山市1996和1998年总医用X射线诊断频率与剂量。方法：按照全国“九五”期间全国医疗照射调查方案要求采用规范统一的方法调查。结果：1998年医用X射线诊断为513．54人次／千人，较1996年的429．11人次／千人高，其检查类型以胸部透视和其他摄影为主；剂量水平调查发现腰椎侧位片皮肤入射剂量为21．71mGy／次，最低是正位胸片0．28mGy／次。结论：中山市医用X射线诊断频率1998年较1996年高，检查部位以胸透和摄片为主；以剂量水平调查结果分析，应提倡胸片代替胸透。     

上海市2007年X射线诊断的医疗照射应用频率及其分布

[目的]掌握上海市X射线诊断的基本状况及其医疗照射应用频率与分布的发展趋势,为放射诊疗的监督管理和加强医疗照射防护打好基础。[方法]优化设计相关调查表,依照行政分区普查上海市开展X射线诊断的1075家医疗机构的基本现状,并按各种X射线诊断检查类型、众多受检者的性别以及年龄组等分别统计各类X射线诊断检查的人次数,以《上海统计年鉴》公布的当年常住人口数计算X射线诊断的医疗照射应用频率。[结果]2007年上海市从事X射线诊断的放射工作人员4250名;装备了各类医用诊断X射线机2743台。上海市X射线诊断的医疗照射应用频率达745．44人次／千人口。其中,胸部摄影、胸部透视、x射线CT检查、四肢及关节摄影、脊柱摄影等频率较高,分别占31．33％、17．22％、14．88％、12．39％、7．66％。中心区X射线诊断的应用频率为1018．97人次／千人口,比周边区高93．5％。女性乳腺x射线摄影检查占总检查量的2．17％。0～15岁年龄组的X射线诊断年频率为563．33人次／千人口,其中胸部摄影占56．59％;16～40岁年龄组的x射线诊断年频率为828．42人次／千人口,其中胸部检查超过半数;〉40岁年龄组的X射线诊断年频率为664．48人次／千人口,胸部摄影和X—CT检查分别占32．37％和16．93％。[结论]随着国民经济和医疗卫生事业的持续发展,上海市放射学事业发展迅速,新增许多高新放射医学设备,但布局有待进一步调整和完善。全市x射线诊断医疗照射应用频率与“九五”期间相比明显增加。因此,为了实现趋利避害,大力加强医疗照射防护已迫在眉睫。     

舟山市医用X射线诊断频率分析

通过对舟山市开展医用X线诊断的医疗卫生单位1996、1998年各种类型X线检查、人次数及构成和舟山医院2年X射线诊断受检者性别、年龄分布的调查.从而得出舟山市普通X线检查1996、1998年使用频率分别为297人次/千人、378人次/千人,X-CT则为19人次/千人、24人次/千人,二者检查频率均高于全省平均水平.全市2年照射类型以胸片构成比最高,1998年透视构成比高于1996年,受检者性别分布男性高于女性,与国内调查一致.年龄分布40岁以上＞16～40＞0～15岁组.     

淮阴市医疗照射调查报告

目的 调查淮阴市1996年和1998年医疗照射频率。方法 根据卫生部"关于开展我国`九五'期间对受检者医用照射调查工作的通知"。结果 淮阴市1996年和1998年医疗照射频率均为每千人口157人次,X射线透视人次占年总受照人次数52.87%和48.08%。结论 各类放射学工作量仍以X射线透视检查为主。     

周口市X射线诊断医疗照射频率水平调查

目的 了解周口市X射线诊断及其各种类型医疗照射频率,为X射线防护工作提供科学依据。方法 采取普查与分层抽样调查相结合。结果 1996年、1998年X射线诊断医疗照射年频率分别为93.10人次/千人、102.05人次/千人,两年透视检查分别占所有检查的41.46%、40.02%。结论 X射线诊断医疗照射频率水平较低,但结构趋于合理,X-CT检查所占比例较小,但发展快。放射诊断人员素质有待提高。     

河南省X射线诊断医疗照射频率及剂量调查

目的 了解河南省X射线诊断医疗照射的频率及剂量水平。方法 采取普查、分层抽样与重点调查相结合。结果 1996、1998年X射线诊断医疗照射的年频率水平分别为每千人134.59人次和139.27人次。结论 胸透检查剂量有明显降低。     

中小学生常规体检应取消X线胸透

X射线胸透（以下简称胸透）已成为中小学生常规体检中不可缺少的项目。笔者通过实践认为对常规体检中胸透的效果、伙值和危害性值得探讨。我市1986～1991年对5所省监测点学校的中小学生每年9月进行一次集体胸透，6年间对6～21岁学生胸透共24052人次，阳性者17人，阳性率仅占0．71‰（0．25～1．05‰），其疾病顺序依次力气管炎（0．46％）肺炎（0．17‰）、肺结核（0．08‰），可见大多数学生接受了不必要的X射线照射。据此推算，学生每年受X线照射，有效量约为8.3mSv，超过了人群中个人承受剂量当量限值（＜1mSv）的7.3倍；连续6年的X线…     

连云港市放射诊断学服务现状调查分析

目的 观察连云港市放射诊断学服务现状。方法 对放射诊断学服务状况进行填表调查:其结果输入计算机Excel数据库进行处理分析。结果 ①全市有X射线机(含CT)270台,其中大于200 mA X射线机市、县级单位占76.8%,小于200 mA X射线机乡级单位占74.6%;②1996年、1998年接受X射线检查的患者分别为677 208,714801;占总诊疗人次分别为11.94%,12.4%;年检查频率分别为156.4人次/千人,161.2人次/千人;③透视检查占总检查数的36.8%~38.9%,胸透占透视量的87%;④摄片检查占总检查数的50%,胸片占摄片量的38.1%~43.1%。结论 不同容量的X射线机应合理配置和布局:临床医生在选择X射线检查时应实践正当化;在X射线检查时应首选摄片。     

“九五”期间孝感市医疗照射水平调查研究

目的调查孝感市医疗照射水平.方法按"九五"期间全国医疗照射调查方案进行普查,分层抽样和重点调查.结果 1996年和1998年孝感市X射线检查的频率为每千人口112.78人次和每千人口116.05人次.1998年核医学诊断和放射治疗的应用频率为每千人口0.202人次和每千人口0.05例.X射线照射类别构成摄影居首位,其次为透视.X射线受检者的年龄分布以＞40岁居多,性别分布差异不显著.结论孝感市医疗照射水平低于湖北省医疗照射水平.基层医院放射防护工作是重点.     

汕头市医疗照射应用频率与剂量水平调查研究

目的 调查汕头市医疗照射应用频率与剂量水平。方法 采用普查，分层抽查与重点调查，现场监测结合。结果 X射线诊断，临床核医学，放射治疗应用频率1996年和1998年分别为每千人166，0.058,0.52和201，0．71，0．47人次；X射线诊断受检查入射体表剂量0.21-33.30mGy。结论 医疗照射频率总体呈上升趋势，剂量水平降低。     

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.