被动吸烟与家养宠物对儿童哮喘及哮喘样症状影响

目的 探讨被动吸烟与家养宠物对儿童哮喘及哮喘样症状的交互效应.方法 采用整群随机抽样方法在广西百色市随机抽取6所小学,采用国际统一的标准问卷美国胸腔协会(ATS)调查表对所选学校的所有儿童进行有关被动吸烟、饲养宠物以及哮喘及哮喘样症状等情况调查.结果 广西百色市3 473名儿童中,持续咳嗽、持续咳痰、哮喘、哮喘现患、喘鸣现患的发生率分别为11.52％ (400/3 473)、6.68％ (232/3 473)、7.63％(265/3 473)、2.04％ (71/3 473)、4.15％(144/3 473),17.71％(615/3 473)的儿童目前家中饲养宠物,目前暴露环境烟雾的比率高达39.48％(1 371/3 473);在调整了儿童的年龄、性别、父母文化程度等混杂因素后,多因素非条件logistic回归分析表明,与既不被动吸烟又不家养宠物的儿童比较,单纯暴露被动吸烟或家养宠物可使儿童患有持续咳嗽的风险分别增高28％(OR=1.28,95％ CI=0.98～1.66)和8％(OR=1.08,95％ CI=0.73～1.61),而同时暴露于这2个因素使儿童患有持续咳嗽的危险性增加155％(OR=2.55,95％CI=1.85 ～3.51);暴露于被动吸烟和家养宠物对儿童持续咳嗽影响的交互效应有统计学意义(x2=5.50,P=0.019),但对哮喘及其他哮喘样症状影响的交互效应均无统计学意义(P＞0.05).结论 被动吸烟与家养宠物均可增加儿童患有哮喘及哮喘样症状的风险,且两者对儿童持续咳嗽的影响存在明显交互效应.     

家养皮毛宠物对儿童哮喘及哮喘样症状影响的流行病学调查

目的 探讨家养皮毛宠物对儿童哮喘及哮喘样症状的影响.方法 采用随机整群抽样方法,随机抽取百色市6所小学的3244名小学生作为调查对象.采用标准的呼吸卫生调查表(来自美国胸科协会即ATS)对儿童哮喘及哮喘样症状和家养宠物等环境因素进行调查.结果 百色市儿童哮喘、哮喘现患、喘鸣、喘鸣样症状、持续咳嗽和持续咳痰的发生率分别为3.76%、1.20%、4.69%、2.93%、4.93和2.56%.儿童哮喘及哮喘样症状性别间差异未有统计学意义(P>0.05).多元非条件logistic回归分析显示,暴露家养皮毛宠物可显著的增加儿童持续咳嗽(OR=1.89; 95%CI: 1.30～2.76)和持续咳痰(OR=2.01;95%CI:1.22～3.33)的发生率;分宠物类别分析,与非家养宠物儿童相比,家养宠物狗对儿童哮喘患病的危险性具有统计学意义(OR=2.39;95%CI:1.31～4.37).结论 家养宠物是儿童发生哮喘及哮喘样症状的危险因素.     

母乳喂养与家养皮毛宠物对儿童哮喘及哮喘样症状的交互效应

目的探讨母乳喂养与家养皮毛宠物对儿童哮喘及哮喘样症状的影响,以及对儿童呼吸系统健康的交互效应。方法在沈阳市各个行政区整群随机抽取2所幼儿园和1所小学,抽取10所幼儿园和5所小学共8 212名儿童。采用国际统一的标准问卷对儿童的喂养方式、居住环境及呼吸系统疾病与症状等状况进行调查。结果沈阳市儿童母乳喂养率为78.87%;目前暴露家养皮毛宠物的儿童占14.56%;3.40%的儿童在母亲怀孕期间曾经暴露家养皮毛宠物。多因素Logistic回归分析显示,母乳喂养可降低儿童患有哮喘及哮喘样症状的风险;而暴露家养皮毛宠物与儿童哮喘及其相关症状存在正相关,且随着与家养皮毛宠物接触的程度越密切,儿童患有哮喘及其相关症状的风险性也越高。与未暴露宠物且母乳喂养的儿童相比,单纯非母乳喂养可使儿童患有哮喘的风险增高27%(OR=1.27,95%CI=1.00~1.61);单纯暴露皮毛宠物使儿童患有哮喘的风险性增高51%(OR=1.51,95%CI=1.15~1.97);而同时暴露于2个因素对哮喘的风险性增高了147%(OR=2.47,95%CI=1.66~3.66);宠物暴露和母乳喂养对儿童的哮喘存在一定的相加效应,但两者的相乘效应未达到统计学水平(P0.05)。结论母乳喂养可降低皮毛宠物对儿童哮喘及哮喘样症状的影响效应,但两者并不存在显著的相乘效应。     

家养皮毛宠物与儿童哮喘关系

目的 了解家养皮毛宠物与儿童哮喘的关系.方法 采用整群抽样方法,在沈阳市5个行政区内随机选取10所幼儿园和5所小学,采用国际统一标准问卷ATS调查表对所有学生进行呼吸系统疾病及症状调查.结果 沈阳市儿童持续咳嗽、持续咳痰、哮喘、哮喘现患、喘鸣现患和过敏性鼻炎的患病率分别为9.53％、4.49％、6.23％、2.42％、5.61％和5.27％,其中男生哮喘、喘鸣现患及过敏性鼻炎的患病率明显高于女生(P＜0.05);家养宠物对儿童哮喘无明显影响,但与宠物同室睡会增加儿童患哮喘的危险(P＜0.05);logistic回归分析显示,与无家族易感史且未饲养宠物的儿童相比,具有家族易感史的儿童患哮喘的危险增加了229％(95％ CI=2.55～4.25),而同时暴露家族易感史和宠物的儿童患哮喘的危险增加了101％(95％CI=1.17 ～3.43),家族易感史与家养宠物的交互效应差异无统计学意义(P＞0.05).结论 家族易感史是儿童患哮喘及哮喘样症状的危险因素,家养皮毛宠物对儿童哮喘的影响与儿童跟宠物接触的密切程度有关.     

母乳喂养与被动吸烟对儿童哮喘及哮喘样症状的交互作用

目的 探讨母乳喂养与被动吸烟的交互作用对儿童哮喘及哮喘样症状的影响.方法 采用整群随机抽样法在辽宁省7个城市各抽取1所小学和2所幼儿园,共25所小学和50所幼儿园,对所选学校所有在此居住满2年的31 049名儿童的喂养方式、居住环境、被动吸烟等情况及呼吸系统疾病与症状的信息进行收集.采用Glimmix回归模型分析母乳喂养与被动吸烟的交互作用对儿童哮喘及哮喘样症状(持续咳嗽、持续咳痰、喘鸣现患、过敏性鼻炎)的影响.结果 在调查的31 049名儿童中,年龄为(8.32±2.75)岁,母乳喂养的儿童有23 987名,母乳喂养率为77.26％;被动吸烟的儿童有11 820名,被动吸烟率为38.07％.母乳喂养的儿童哮喘、过敏性鼻炎阳性率分别为6.22％(1491/23 987)、4.67％(1120/23 987),非母乳喂养的儿童分别为7.70％(544/7062)、5.48％(387/7062).母乳喂养儿童发生哮喘(OR=0.79,95％ CI:0.72～0.88)、过敏性鼻炎(OR =0.85,95％CI:0.75～0.95)的风险较低.父亲吸烟的儿童喘鸣现患阳性率为7.89％(929/11 770),父亲未吸烟的儿童为5.37％(1036/19 279),父亲吸烟的儿童发生喘鸣现患(OR=1.51,95％CI:1.38 ～1.65)的风险较高.母亲吸烟的儿童持续咳嗽阳性率为18.96％(51/269),母亲未吸烟的儿童为9.51％(2926/30 780),母亲吸烟的儿童发生持续咳嗽(OR =2.23,95％ CI:1.64～3.03)的风险较高.家中其他任何人吸烟的儿童持续咳痰阳性率为5.69％(871/15 316),家中无人吸烟的儿童为3.50％(550/15 733),家中其他任何人吸烟的儿童发生持续咳痰(OR=1.67,95％CI:1.49～ 1.86)的风险较高.Glimmix回归模型分析显示,母乳喂养与被动吸烟对儿童哮喘及哮喘样症状存在交互影响:在父亲吸烟暴露下,母乳喂养的儿童发生哮喘的风险低于非母乳喂养儿童;在母亲吸烟暴露下,母乳喂养的儿童发生过敏性鼻炎的风险低于非母乳喂养儿童;在家中其他任何人吸烟暴露下,母乳喂养的儿童发生哮喘、过敏性鼻炎的风险低于非母乳喂养儿童(P值均＜0.05).结论 母乳喂养使被动吸烟的儿童发生哮喘及哮喘样症状的风险降低.     

中山市居室装修对儿童哮喘样症状的影响

目的 探究中山市居室装修对儿童哮喘及哮喘样症状的影响。方法 于2016年3-7月在中山市城区采用随机整群抽样方法,抽取小学和初中各5所共11 611名儿童,采用国际统一的标准问卷ATS调查表调查所选学生的哮喘及哮喘样症状及家庭装修等情况,分析居室装修对儿童哮喘和哮喘样症状的影响。结果 学生年龄介于5~17岁,平均年龄是（11.49±2.66)岁,持续咳嗽、持续咳痰、喘鸣、哮喘和哮喘现患的患病率分别是2.85%、1.20%、6.93%、5.70%和1.46%。单因素分析显示,家庭2年内住房装修,装修材料中的油漆和墙壁涂料壁纸和新家具均是儿童哮喘和哮喘样症状危险因素(P＜0.05);多因素二分类非条件Logistic回归分析结果显示,油漆是儿童持续咳嗽和哮喘现患的危险因素(OR:1.38-1.51,P＜0.05),墙涂料壁纸是儿童喘鸣和哮喘的危险因素(OR:1.24-1.29,P＜0.01)。结论 中山市居室装修是儿童患有哮喘及哮喘样症状的危险因素,不同的装修材料危害不一,应注意装修材料的使用。     

安徽地区儿童暴露于农村生活环境对过敏性哮喘的影响

目的 研究暴露于农村生活环境对预防儿童哮喘及致敏的保护作用.方法 向2986名在校儿童父母发放哮喘标准调查表,采用放射性变应原荧光酶免疫吸附实验(RAST-FEIA)检测儿童血清中特异性IgE(sIgE)含量.结果 与在城镇生活的儿童相比,暴露于农村生活环境儿童的过敏性哮喘与非过敏性哮喘、过敏性哮鸣及特应性哮呜危险度显著性降低(OR=0.45,95%CI:0.13～0.96:OR=0.41,95%CI:0.15～0.95;OR=0.32,95% CI:0.11～0.62;OR=0.44,95% CI:0.13～0.91).1周岁内暴露与农村生活环境的儿童过敏性哮喘及特应性致敏危险度较低(OR=0.23,95% CI:0.04～0.91;OR=0.32,95%CI:0.17～0.78);若暴露持续至6周岁,过敏性哮喘及特应性致敏危险度更低(OR=0.21,95%CI:0.03～0.87;OR=0.31,95%CI:0.15～0.78).结论 暴露于农村环境对预防儿童过敏性哮喘及致敏的发生可能有保护作用,持续的暴露能加强此作用.     

超重肥胖与儿童哮喘及哮喘样症状相关性分析

目的探讨超重与肥胖对儿童哮喘及哮喘样症状的影响效应。方法采用整群随机抽样方法随机抽取沈阳市5所小学和10所幼儿园,采用国际统一标准问卷ATS调查表对所选学校的所有学生的呼吸系统疾病及症状进行调查,并进行体格测量。结果本次共调查儿童5 096人,超重、肥胖患病率分别10.73%和9.93%。肥胖儿童哮喘患病率(11.41%)高于正常体重儿童患病水平(6.11%),且超重肥胖对女性儿童哮喘及哮喘样症状的影响更加明显。多因素分析结果显示,与正常体重儿童相比,无家族易感史和有家族易感史的儿童患有哮喘的危险性分别增加了80%(OR=1.80,95%CI=1.15～2.96)和113%(OR=2.13,95%CI=1.12～3.15);进一步分析结果显示超重肥胖与家族易感史对儿童哮喘的交互效应并无统计学意义(P>0.05)。结论超重肥胖可显著增加儿童患有哮喘及哮喘样症状的风险,且女性儿童受到的影响较大。     

家养宠物和肥胖对儿童哮喘及哮喘样症状的交互效应北大核心CSCD

目的研究家养宠物和肥胖对儿童哮喘及哮喘样症状的交互效应。方法本研究于2007年4月至2008年5月采用整群随机抽样的方法,在沈阳市各行政区随机抽取10所幼儿园、5所小学,应用国际标准问卷ATS调查表对在所选学校和幼儿园居住满两年的全部儿童有关家养宠物、肥胖、哮喘和哮喘样症状等情况进行调查。结果本次研究共发放9335份问卷,回收问卷共8371份,应答率为89.7%,经逻辑审查符合上机统计分析的共8212份问卷,合格率为98.1%。其中患有持续咳嗽、咳痰、哮喘、哮喘现患、喘鸣现患以及过敏性鼻炎的儿童例数及自我报告率分别为768例(9.35%)、356例(4.34%)、520例(6.33%)、202例(2.46%)、494例(6.02%)、370例(4.51%)。将性别、年龄、家族易感史、父母应答、教育程度、被动吸烟及母乳喂养等因素作为自变量放到logistic回归模型里进行调整,经过分析得出,单纯暴露于家养宠物或单纯肥胖均可增加儿童哮喘及哮喘样症状的患病风险。且两者对持续咳嗽、咳痰、哮喘、喘鸣现患、过敏性鼻炎有交互效应。结论家养宠物和肥胖是儿童哮喘及哮喘样症状的危险性因素,且两者对儿童持续咳嗽、咳痰、哮喘、喘鸣现患、过敏性鼻炎存在交互效应。     

青岛地区儿童哮喘影响因素病例对照研究

目的探讨儿童哮喘的影响因素。方法应用1：1配对的病例一对照研究方法，采用问卷调查方式，调查300对病例和对照儿童，并分析有关的暴露因素。结果单因素Logistic回归分析结果显示，有17个因素与儿童哮喘有关联，包括父亲呼吸系统疾病史、母亲呼吸系统疾病史、家庭收入情况、特应性体质、急性呼吸道感染史、食肉习惯、海产品摄入量、是否有泡沫制品、是否装修过、厨房排烟方式、排烟效果、是否饲养宠物、家族哮喘病史、家族过敏性鼻炎史、父母食物过敏史、父母粉尘过敏史、首次发病后是否经过系统治疗。多因素Logistic回归分析显示，7个因素进入主效应模型，其中父亲有呼吸系统疾病史（OR=3．771，95％CI：1．533～9．278）、家庭低收入（OR=I．503，95％CI：1．258～1．795）、特应性体质（OR=3．788，95％CI：2．368～6．058）、喜食肥肉（OR=2．042，95％CI：1．481～2．815）、家族哮喘病史（OR=I．710，95％CI：0．988～2．958）、家族过敏性鼻炎史（OR=I．991，95％CI：1．234～3.211）是儿童哮喘的危险因素，饲养宠物（OR=0．443，95％CI：0．265～0．739）是保护因素；回归系数分别为1．327，0．407，1．332，0．714，0．536，0．689，-0．814。结论儿童哮喘是遗传和环境双重因素共同作用导致的一种复杂疾病。     

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.     

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.     

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.     

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.