职业伤害与社会经济影响因素的关系

目的　分析化工行业职业伤害的社会经济影响因素。方法　采用 1∶2配对病例对照研究 ,应用单因素条件Logistic回归、主成分分析以及主成分条件Logistic回归对病例与对照的有关社会经济影响因素进行统计分析。结果　单因素分析结果有显著性意义的变量为年龄、性别、文化程度、就业类型、技术等级、就业地点、工作变换、月均工资、家庭年收入、企业规模、企业性质、安全防护设备、安全操作规程和安全教育制度。主成分分析提取的 4个主成分较好地反映了原 11个指标的信息 ,累计贡献率为 77.36 %。第一主成分解释了原变量信息的 4 6 .6 9% ,是职业伤害的指示因子 ,第二主成分是职业活动因子 ,第三主成分是工作稳定性因子 ,第四主成分是性别因子。多因素条件Logis tic分析结果显示 ,第一、第二主成分有显著性意义 (P <0 .0 1) ,在众多原变量影响因素中 ,作用较明显的因素有性别、就业类型、经济收入、企业规模和企业性质等。结论　职业伤害的社会经济影响因素较多且相互作用。职业伤害的防治应从加强安全生产教育、增强职工自我保护意识和提高企业经营者的生产安全意识等方面综合考虑。     

钢铁企业职业伤害危险因素研究

目的研究钢铁企业职工职业伤害的危险因素。方法采用1∶1病例对照研究方法,选取某钢铁企业内发生过非致死性职业伤害的男性工人作为病例,在同一企业从未发生过职业伤害的工人中随机抽取与病例同工种、同性别、年龄相差3岁以内的职工作对照,共171对。采用条件Logistic回归对文化程度、饮酒、吸烟、睡眠、工作压力、精神状况、健康状况、轮班方式、高温、噪音、经济收入等危险因素及安全意识的获取途径进行分析。结果文化程度低、饮酒、睡眠差、健康状况和精神状况不良均可使职业伤害发生的危险性增加;通过上岗前教育获得安全生产意识的职工发生伤害的概率较对照组低。结论钢铁企业发生职业伤害与工人较低的文化程度、饮酒、不良的健康状况等因素有关,应加强对职工的上岗前安全教育。 更多还原     

1993～2002年某化工开发区职业伤害直接成本影响因素分析

目的探讨职业伤害直接成本(direct cost,DC)的影响因素,控制职业伤害DC的增长。方法应用多因素分析对某化工区1993～2002年职业伤害DC的影响因素进行分析。结果影响职业伤害罹难者门诊费用的因素有年龄、性别、伤害程度、企业规模以及企业经济类型等;企业经济类型、文化程度、伤害发生年份、伴随疾病以及伤害程度既能对住院费用有直接影响,又通过工资和(或)住院天数间接影响住院费用;而性别、企业规模、医院级别、是否手术以及就业类型等仅通过住院天数和(或)工资对住院费用发生间接作用;年龄直接影响着住院费用,没有间接作用。结论有关部门应采取综合性防制措施控制职业伤害DC。     

儿童白血病相关危险因素研究

目的探讨儿童白血病发病的危险因素。方法2002年1月-2007年6月采用病例对照研究的方法,对248例白血病病儿和760名对照病例的相关资料进行单因素分析、多因素非条件Logistic回归分析和主成分分析。结果非条件Logistic多因素回归分析显示,该病有显著性意义的危险因素是儿童、孕母居住新装修房屋,儿童家用灭蚊剂≥2年,孕母自然流产史,孕期X射线照射,儿童极低频电磁场暴露,孕母农药、杀虫剂、汽油暴露,孕母孕期应用电磁用具及遗传病、肿瘤家族史。主成分分析提取6个主成分,其方差累计贡献率为79.773%。结论儿童白血病的发病受到遗传背景和社会环境的综合影响。     

主成分Logistic回归在筛选冠心病危险因素中的应用

目的探讨主成分Logistic回归方法在筛选冠心病危险因素中的应用。方法选择2009年4月-2010年8月在哈尔滨医科大学第一附属医院行冠脉造影术者,按照金标准分为冠心病组（465例）和对照组（277例）;首先对Lo-gistic回归模型进行共线性诊断,然后应用主成分改进的Logistic回归分析,得到并解释最终的回归模型。结果共线性诊断提示各变量之间存在明显的共线性,采用主成分改进的Logistic回归分析显示,冠心病与年龄、性别、载脂蛋白A、TG、HDL-C、糖尿病史、高血压史、吸烟史在内的多种因素有关。结论主成分改进的Logistic回归在筛选冠心病危险因素中具有较好的作用,在对疾病危险因素进行Logistic回归分析时,若多变量间存在多重共线性,采用主成分改进的Lo-gistic回归分析能得出更好的回归模型。     

珠海市15～69岁居民健康素养水平及影响因素分析

目的了解珠海市居民健康素养状况及其影响因素。方法应用整群抽样方法在珠海市3个行政区内共抽取6个居委会和6个行政村15～69岁居民3 000人,进行健康素养问卷调查,采用因子分析模型分析健康素养量表维度情况,应用Logistic回归分析健康素养的影响因素。结果珠海市居民健康素养因子分析模型包括健康知识、健康行为、健康技能、健康理念4个公因子成分,共解释原始变量54.56%的信息;居民健康素养综合测量及格率为89.1%;Logistic回归分析显示健康素养水平的高低与调查对象的性别、年龄、文化程度、职业、家庭收入及疾病史有关。结论珠海市居民健康素养包括健康知识、健康行为、健康技能、健康理念4个方面,居民健康素养水平受性别、年龄、文化程度、职业、家庭收入和疾病史的影响。     

苏州市涂阳肺结核患者治疗转归情况影响因素分析

目的:探寻涂阳肺结核病例治疗转归的影响因素.方法:对登记管理的涂阳肺结核病例进行调查,以治愈与否作为应变量,以病例有关特征作为自变量,进行Logistic回归分析.结果:单因素Logistic回归分析结果显示,有统计学意义的变量为:性别、年龄、职业、就诊来源、治疗分类、患者来源;多因素Logistic回归分析显示:性别...     

苏州市涂阳肺结核患者治疗转归情况影响因素分析

目的:探寻涂阳肺结核病例治疗转归的影响因素.方法:对登记管理的涂阳肺结核病例进行调查,以治愈与否作为应变量,以病例有关特征作为自变量,进行Logistic回归分析.结果:单因素Logistic回归分析结果显示,有统计学意义的变量为:性别、年龄、职业、就诊来源、治疗分类、患者来源;多因素Logistic回归分析显示:性别、年龄、治疗分类3个因素是影响转归的独立相关因素.结论:涂阳肺结核患者的性别、年龄、治疗分类是影响其转归情况的关键因素.     

某钢铁企业非致死性职业伤害的影响因素分析

目的了解钢铁厂职业伤害特点,分析个体因素、职业因素以及职业安全知识、态度、行为与职业伤害的关系,找出其危险因素,为预防和控制职业伤害发生提供科学依据。方法采用成组病例对照研究,对广西某钢铁企业发生非致死性职业伤害职工及未发生伤害职工进行统一的问卷调查,调查内容包括职业伤害情况、职业因素及职业安全认知、态度、行为的情况。用单因素及多因素非条件logistic回归模型分析影响非致死性职业伤害发生的危险因素。结果共调查发生非致死性职业伤害职工112人,未发生伤害职工144人。112例职业伤害职工中轻伤94例(83.9%),重伤18例(16.1%),男性(91.1%)多于女性(8.9%),20~39岁(占81.5%)为职业伤害高发年龄段,一线工人占67.9%,发生的月份以6月(13.4%)最高,多数伤及手腕部(21.0%),物体打击(28.6%)为主要伤害类型。伤害的影响因素包括:性别(OR=2.633)、健康状况(OR=0.127)、每天接触机器时间(OR=1.214)、组织协调程度(OR:0.084~0.160)、认为从事的工作是否安全(OR=3.574)、认为是否有必要进行安全生产教育(OR=0.075)、认为...     

黑龙江省居民高血压患病及影响因素分析

目的 探讨黑龙江省高血压的主要影响因素,为制定高血压的防治措施提供依据.方法 对黑龙江省哈尔滨市太平区、肇东市和双城市常住居民进行高血压影响因素的问卷调查和医学体检.对调查结果进行单因素和多因素非条件Logistic回归分析.结果 单因素分析显示,有意义的变量有性别、年龄、文化程度、高血压家族史、饮酒、职业性体力劳动、腰围和体质指数.经Logistic回归模型分析,调整年龄和性别后,进入主效应模型的变量为文化程度、高血压家族史和腰围,其OR值分别为1.331,1.478,2.730.结论 文化程度、高血压家族史和腰围是黑龙江省居民高血压的主要危险因素.     

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.