铬酸盐生产工人肺癌发病情况的流行病学调查研究

对六个地区２５４５名铬酸盐生产工人和５１９７名对照工人的恶性肿瘤发病情况调查结果，铬酸盐生产工人肺癌高发。其男工肺癌的发病和死亡分别占全恶性肿瘤发病和死亡的３５．６３％和３７．５０％；其肺癌的发病率和死亡率分别高达８２．０８／１０万和７９．４３／１０万，均显著高于对照男工（Ｐ＜０．００１）；其肺癌的ＳＭＲ为１．９６７和２．５７１，表明其肺癌死亡率显著高于全国大城市和中等城市男性同年龄组人群的肺癌死亡率；接触铬化物较多的转炉和制造两工种肺癌的发病率分别高达１３１．２１／１０万和７７．２３／１０万，均显著高于对照男工；吸烟与接触铬化物有明显的协同致肺癌作用。     

吸烟与油毡生产男性工人肺癌死亡关系的研究

对４３２０名油毡生产工人和４１０１名对照组工人进行了吸烟与肺癌死亡关系的回顾前瞻性流行病学调查研究。结果表明，油毡生产男工吸烟组肺癌标准化死亡率为４０．８６／１０万，不吸烟组肺癌标化死亡率为２４．７３／１０万，均显著高于对照组男工肺癌的死亡率，吸烟与油毡生产男工接触沥青烟有相加作用。     

铬酸盐对生产工人生殖结局影响的研究

应用回顾性队列研究方法对全国６个地区６４５名已婚铬酸盐生产工人和１５９４名已婚对照工人的生殖结局进行了调查。结果显示，铬酸盐生产男工妻子的自然流产发生率为４．９２％，显著高于对照组的２．６７％（Ｐ＜０．０５），但不孕、死胎死产、早产、过期产、低体重儿、子代出生缺陷、新生儿死亡和围产儿死亡的发生率与对照组相比，差异均无显著性；铬酸盐生产女工的各项异常生殖结局的发生率与对照组相比，差异均无显著性。     

氯乙烯作业工人恶性肿瘤发病情况的流行病学调查

对全国12个城市的13个聚氯乙烯制造工人中5459名氯乙烯作业工人和6461名对照厂工人进行了从投产到1989年12月31日为止的恶性肿瘤发病情况的回顾性和前瞻性队列调查。结果表明,男工接触组肝癌的发病率、死亡率均显著高于对照组,男性肝癌的死亡率也显著高于我国中等城市男性肝癌的死亡率。在恶性肿瘤的分类构成中,接触组男工的肝癌居首位。接触组男工肝癌的发病年龄比对照组显著提前。     

氨气作业工人肺功能测定

氨气作业工人肺功能测定北京化工职业病防治院王红为探讨长期低浓度下氨气对作业工人呼吸系统的不良影响，我们选择某化工厂无器质性心肺疾患的氨气作业男工６６名作为接触组。年龄３０～４０岁，吸烟人数５５人，吸烟量１５支／日·人。选择某化工厂男工６２名作为对照组...     

吸烟对接铅男工血铅影响的探讨

分析了７８名接铅男工和２７名非接铅男工血铅含量与吸烟的关系。结果表明,接触组与对照组工人的血铅含量差别非常显著（Ｐ〈０．０１）;接触组中吸烟人群的血铅显著高于不吸烟人群（Ｐ〈０．０１）;在作业场所吸烟的频数对血铅的影响有显著意义（Ｐ〈０．０１）。提示：吸烟会加重铅作业工人的职业危害,铅作业工人应提倡戒烟。     

美国等国家559例石棉工人肺癌的X线特点及组织学分型

肺癌在石棉工人中的发病率很高,石棉与肺癌的关系早在1935年Lunch等就有报告,1955年Doll发表了石棉工人肺癌流行病学调查,继而Selikoff Jacob Newhouse等人进一步证实了石棉与肺癌的联系。如Selikoff发现石棉工人死因中的百分之廿为石棉引起的肺癌;他比较了吸烟的石棉作业工人与不吸烟不接触石棉的普通人群的肺癌死亡率前者比后者高90倍以上。吸烟的石棉作业工人比吸烟但不接触石棉工人的死亡率也要高达5倍以以上。目前认为石棉和吸烟是一种互助促进的致癌原。     

橡胶行业与吸烟

众所周知,吸烟是有百害而无一利的,对不同职业的人吸烟,其危害健康的程度是各不相同的。对于从事橡胶职业的职工来说,如果他们吸烟,危害就更大了。上海卫生部门对一家橡胶厂1600名工人进行的为期12年的考查得出:吸烟的橡胶工人肺癌发病率明显升高。调查结果还表明:如果吸烟者与不吸烟人相比较,吸烟者患肺癌者比不吸烟人高出8倍,而追踪调查的12年中共有163人死于各种疾病和其它因素,其中死于肺癌的有20名,死亡率为49/10万。     

云南锡业公司职工肺癌流行病学研究

1954—1983年云锡矿共发生职工肺癌1,448例,死亡1,253例。1972—1981年井下矿工肺癌发病率为435.44/10~5·年,死亡率为370·16/10~5·年。进一步将工人按主要职业史划分为7组,分别计算其发病率和死亡率。结果发现:有井下作业史的冶炼工人>单纯井下作业工人>单纯冶炼工人>无井下并无冶炼史工人。提示井下及冶炼厂,由于存在某些有害因素导致肺癌增多。通过吸烟与肺癌关系分析表明,吸烟也是一个不可忽视的重要因素。     

铅对接触男工妻子妊娠结局的影响

为评价铅对接触男工妻子妊娠结局的影响,对387名接触工人和575名非接触工人进行了调查。接触组和对照组男工妻子的人工流产率,分别为20.2％和22.9％,无显著性差异(P>0.05);接触组男工妻子的自然流产率和围产儿死亡率均高于对照组,接触组分别为10.3％和37.7‰。对照组分别为4.6％和12.0‰。(RR分别为2.23和3.14),有显著性差异(P<0.05);接触组男工妻子中有自然流产史的人数所占比例亦明显高于对照组,前者为12.1％,后者为6.4％(P<0.05)。多因素分析表明:自然流产和子女出生体重与接触铅、接触工龄和婚育年龄有关。     

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.