环境危害因素对高原旅行者健康的影响

影响高原旅行者健康的环境危险因素包括：①高寒;②低气压、低氧分压;③太阳辐射;④大风、干燥和寒冷;⑤“低原反应”和“脱适应”     

检验科职业环境危害因素及防护措施分析

医院工作场所中存在着各种有害的化学、物理、生物等环境及在作业过程中产生的其他职业有害因素叫做职业危害因素。检验科是全院各种病人标本集中处理的重要科室,检验科工作人员因其职业的特殊性,每天不得不暴露于各种各样的危险因素之中,如各类传染性疾病、各种消毒剂、放射线、机     

有关化学品对健康影响和环境危害的重要综述性文件纵览

有关化学品对健康影响和环境危害的重要综述性文件纵览联合国环境规划署通过其“潜在化学品国际登记中心”（ＩＲＰＴＣ）和欧洲生态毒理学与化学品毒理学中心（ＥＣＥＴＯＣ）联合组织编写“化学品和重要综述性文件纵览”（ＩｎｖｅｎｔｏｒｙｏｆＣｒｉｔｉｃａｌＲｅｖ...     

高原旅行常见并发症的防治

研究表明,海拔1500m以上含氧量明显减少,轻者发生高原反应,重者患高原病。本文论述了高原环境对旅游者健康的影响及发生高原病的原因。对如何预防或减轻高原反应,避免高原病发生,从物理和药物防治两方面深入浅出的加以阐述,特别指出对前往高原旅游者进行旅行前教育极为重要。     

提高高原劳动能力方案效果的评估研究

将９９名生活在海拔３６８０ｍ高原１年以上的健康男性受试者随机分为三组，分别接受锻炼（Ａ）、口服中成药（Ｂ）、以及既服中成药又锻炼（Ｃ）三种不同方案处理，以自身对照的方法测量其接受处理前后的体能指标和心血管指标。结果显示，接受处理后，其体能明显增强，并且循环系统指标的变化显示了其心脏功能和微循环的改善。研究结果还表明，Ａ、Ｂ、Ｃ三种方案均能改善体循环以抵抗缺氧，增强劳动能力。     

世居高原纳西族健康人群心动过缓分析

长期以来，人们通常将海拔3000米以上地区界定为高原．但是2004年8月在青海省召开的第六届国际高原医学和低氧生理学术大会上制定的《慢性高原病青海诊断标准》中，将高原界定为海拔2500米以上地区。云南省丽江市位于祖国西南边陲的青藏高原南缘，典型低纬度高海拔地区，年平均气温12．6℃，山地面积95％，海拔高差十分悬殊（1015～5596米），平均海拔2500米。临床常见平原地区居民进入丽江地区而发生高原反应者，按照国际上的区分法，丽江市属于中度海拔与高度海拔的交界区，为观察长期暴露于此环境中的纳西族世居居民的心脏生理变化，笔者于2005年4月～2006年4月对纳西族健康人群进行了心电图普查2506例。     

降低新兵快速进入高原急性高原病发病率的对策探讨

目的对降低新兵快速进入高原急性高原病(Acute high altitude diseaes,AHAD)发病率的对策进行探讨。方法通过文献复习及我们在新兵进入高原期间医疗卫勤保障工作的回顾,对新兵快速进入高原AHAD发病情况、发病诱因及存在的问题进行分析。结果回顾发现新兵快速进入高原急性高原病的发病率随海拔的升高而升高,约32.5%～95.55%之间。发病原因为缺氧的超时反应,诱因为高海拔、进入高原速度过快、过度劳累、精神情绪过度紧张、寒冷、上呼吸道感染、劳动与休息制度不当、饮酒、过饱、水盐摄入不当等。结论新兵快速进入高原AHAD的发病率仍然较高,只要通过健康教育,纠正认知偏差,并早期采取针对性的预防措施,无疑对降低快速进入高原新兵AHAD的发病率具有积极的意义。     

高原心脏病患者生命质量影响因素分析

[目的] 了解高原心脏病患者的生命质量状况及其影响因素,为制定相应的改善措施提供依据.[方法] 采用横断面调查法,对在青海省三所三级甲等综合医院心血管内科住院治疗的204名高原心脏病住院患者,进行生存质量的测量,探讨相关因素对生命质量的影响.[结果] 通过单因素分析发现年龄、职业、家庭支持力度、性格是否开朗、NYHA分级、用药、饮酒、吸烟、家庭月收入、运动等10个方面的生命质量总评分有统计学差异.将影响因素进行多重线性回归分析后发现:年龄,职业类别、心功能、性格、运动、家庭支持等因素是影响高原心脏病患者的重要因素.[结论]高原心脏病患者的总体生命质量不容乐观,切实采取积极的干预措施来提高患者的生活质量是临床的当务之急.     

京藏铁路列车乘务人员高原习服调查研究

[目的]通过跟踪监测高原列车乘务人员相关生理指标变化,分析乘务人员高原适应性及影响因素,为高原乘务人员的健康监护及指定作业方式提供依据. [方法]随机对一列京藏线列车98名乘务人员全程监测血氧饱和度(SaO2)、眼压、眼底情况及Lake Louise急性高原病(AMS)自评评分. [结果]车厢内氧分压及乘务员血氧饱和度与海拔高程呈负相关性,94人发生不同程度AMS,在岗时间短及劳动强度大的人群AMS较明显(P＜0.05),83人出现视网膜静脉扩张,21人出现视乳头充血水肿. [结论]现行列车富氧措施不能完全防止AMS的发生；在岗时间及劳动强度均对乘务员高原适应性有影响；视网膜血管改变可作为AMS重要指征.     

Effects of exercise at high altitudes on young adults

Outward Bound programs are carried out throughout the world, and many of these courses occur at altitudes above 3000 m (10,000 ft). As more knowledge is accumulated about health problems at high altitudes, exercise has been implicated as a factor contributing to acute mountain sickness in susceptible individuals. Thus, exercise conditioning programs occurring at high altitudes have come under scrutiny. Twenty-eight young men and women were enrolled in an Outward Bound course at an altitude over 3000 m for a 21-day period. Twelve of the 28 individuals developed shortness of breath, cough, or both by the third day of the course. Of these 12, seven had pulmonary function abnormalities: three having evidence of large airway involvement and four having findings of small airway involvement. The symptoms were not significant enough to interfere with acclimatization and the muscular conditioning aspects of the program. Although at altitudes between 3000 m and 4300 m, pulmonary function abnormalities of acute mountain sickness develop in a significant number of participants, the abnormalities were not significant enough to prevent persons from completing the course or achieving marked improvements in fitness measurements.     

Feeding practice among younger Tibetan children living at high altitudes

OBJECTIVE: Few published data are available on the feeding practice of younger children in Tibet. Our study investigated feeding pattern of younger Tibetan children. DESIGN AND SUBJECTS: The study was a cross-sectional survey conducted in Tibet. A sample of 1655 children younger than 36 months old and their mothers was obtained by stratified multistage cluster random sampling method. Mothers were interviewed to collect information on feeding practice by a designed family questionnaire including initial time and duration of breastfeeding and time, frequency and types of complementary foods introduced. RESULTS: Most of the children was ever or being breastfed at the time of interview. The median duration of breastfeeding was 26 months. The prevalence of almost exclusive breastfeeding for 4 months was 20.1%. Mothers' age and education, child's residence, and introduction of egg, fresh milk and milk powder were strongly associated with the duration of breastfeeding. The partial feeding was a main pattern in the first 6 months of life. Zanban and porridge were offered at about 1 month after birth. By 6th month, less than 25% of children were fed protein foods such as egg and meats and only near 20% of children were fed fresh vegetables. Bean products, fish and chicken were seldom offered to children. CONCLUSIONS: We conclude that although they were breastfed for long time, complementary feeding practice of Tibetan children was disadvantaged, especially of rural children. Improvement of monotonous complementary foods and timely introduction should be stressed in local programmatic nutritional interventions.     

International business travel: impact on families and travellers

Objectives: Spouses and staff of the World Bank Group (WBG) were questioned about the impact of international business travel on families and travellers. Dependent variables were self reported stress, concern about the health of the traveller, and negative impact on the family. We hypothesised that several travel factors (independent variables) would be associated with these impacts. These travel factors had to do with the frequency, duration, and predictability of travel and its interference with family activities.     

Poor nutritional status of younger Tibetan children living at high altitudes

BACKGROUND: The growth, development and nutrition of children in Tibet with high-altitude and unique traditional culture have recently gained attention. However, few researches are available on the nutritional status of younger children of Tibet. OBJECTIVE: The objective of the study was to evaluate the nutritional status of children below 36 months old in Tibet by means of anthropometry. DESIGN: The cross-sectional survey was conducted between August and September in 1999 and a sample of 1655 children below 36 months old was obtained using a stratified multistage cluster random sampling method from a total of seven districts of Tibet. Height, weight and hemoglobin concentration were measured and at the same time related sociodemographic and environmental information were collected. NCHS/CDC/WHO reference data were used to evaluate the nutritional status of the entire study children population and estimate the prevalence of stunting, underweight and wasting. RESULTS: Compared with the reference of NCHS/CDC/WHO, the distributions of HAZ and WAZ shifted to the left significantly and the means of HAZ and WAZ were -1.53 and -1.05, respectively, which were significantly lower than the reference value. The distribution of WHZ, however, was close to that of the reference. The reduction of Z-scores for height and weight occurred very early in life and was greatest in the second year after birth. The prevalence of malnutrition of children was 39.0% for stunting, 23.7% for underweight and 5.6% for wasting, respectively. Rural children had prevalence of stunting of 41.4% and underweight of 24.7%, as compared with prevalence of stunting of 25.3% and underweight of 18.1% for urban children. Stunting and underweight were associated with altitudes. The mean of hemoglobin (Hb) of children was 120.4 g/l and rural children had a significantly lower Hb concentration (119.9 g/l) than urban children (123.3 g/l). The prevalence of anemia seemed higher when using different altitude corrections for Hb to estimate the prevalence, but the consequences were uneven. CONCLUSIONS: For Tibetan young children, the nutritional status of the entire population is poor and the prevalence of malnutrition is higher, especially for stunting. Malnutrition is related to high altitudes. Although the Hb concentration is higher induced by high altitude, there must be quite a lot of anemic children at high altitudes. The relationship between altitude and Hb for children on the Tibetan plateau requires further study in order to determine correctly the magnitude of anemia of children.     

Industrial activities in sites at high environmental risk and their impact on the health of the population

A second mortality analysis of 15 areas of Italy identified in 1986 by the Italian Ministry of Environment as areas at high risk of environmental crisis has confirmed and extended the findings of the first. In regional comparisons, these areas, in which potentially hazardous industries are located, show excesses of deaths from almost all cancers and other diseases, particularly among men. Although more information is needed to identify corrective public health measures, the official recognition of areas in need of cleaning up, which appears to be unique to Italy and which fostered the study, is a promising beginning.     

Sexual health and HIV in travellers and expatriates

Travellers engaging in sexual contact with a new partner abroad may be at high risk of acquiring a sexually transmitted infection. This review examines the impact of travel on sexual health and provides prevention, management and treatment recommendations to practising occupational health physicians.