江西省2004～2005年流行性腮腺炎流行病学特征分析

目的分析江西省2004~2005年流行性腮腺炎(腮腺炎)流行病学特征,为制定预防控制腮腺炎规划提供依据。方法用描述流行病学方法对江西省疾病监测信息报告管理系统报告的2004~2005年腮腺炎病例进行分析。结果江西省2004~2005年腮腺炎发病率分别为17.62/10万、14.79/10万;4~7月为发病高峰;<15岁儿童病例分别占总病例数的93.88%、92.39%,4~9岁儿童发病分别占67.06%、61.94%;学生、托幼儿童、散居儿童病例分别占95.65%、95.89%。结论要降低腮腺炎发病率,应制定控制腮腺炎规划和免疫策略,重点对儿童采取接种腮腺炎减毒活疫苗等干预措施。建议将腮腺炎减毒活疫苗接种纳入儿童免疫规划。     

2008~2013年淄博市张店区流行性腮腺炎流行病学特征分析

目的了解淄博市张店区流行性腮腺炎的流行病学特征,为制定防控策略提供科学依据。方法收集整理张店区2008~2013年通过疾病监测信息报告管理系统报告的流行性腮腺炎疫情及山东省网络流腮专报系统报告的病例个案资料,进行流行病学分析。结果张店区2008~2013年流行性腮腺炎报告发病率分别为24.91/10万、29.97/10万、9.32/10万、15.27/10万、68.62/10万和41.78/10万,自2012年以来发病率明显上升。每年4~7月为发病高峰期(占病例数50.25%),其次为11月至次年1月(病例数占24.33%)。人口密度大、托幼机构及学校密集的科苑街道办事处及马尚镇病例数较多(分别占36.37%、13.46%)。发病人群集中在4~15岁,占总病例数的80.18%;托幼儿童、小学学校、中学学生分别占病例总数24.33%、49.08%和13.13%。6年间中小学校、托幼机构流行性腮腺炎聚集性暴发疫情共计13起,共发病117例,占总病例数的9.78%。结论建议应积极探索调整腮腺炎疫苗的免疫策略,开展3~6岁腮腺炎疫苗第2针常规接种,提高含腮腺炎成分疫苗两针次接种率,降低张店区腮腺炎发病季节性高峰和降低托幼机构、中小学校的发病率。     

济南市2001～2003年流行性腮腺炎流行病学分析

流行性腮腺炎(腮腺炎)是丙类传染病,2004年8~9月对济南市2001~2003年乡级及以上医院就诊的腮腺炎病例进行了回顾性调查,现将结果报告如下。1发病情况共调查腮腺炎4 151例,年平均发病率24·18/10万(表1)。表1济南市2001~2003年腮腺炎发病情况年份调查病例数发病率(/10万)2001 2     

吉林省扩大免疫前后风疹流行病学特征分析

目的分析吉林省实施扩大免疫前后风疹流行病学特征,为制定风疹预防控制策略提供依据。方法对法定传染病报告系统及突发公共卫生事件报告信息管理系统报告的风疹发病资料进行描述流行病学分析。结果实施扩大免疫前(2004-2008年)风疹发病率波动在1.26/10万~36.66/10万之间,平均发病率为9.79/10万;扩大免疫后(2009-2013年)发病率波动在1.84/10万~5.61/10万之间,平均发病率为3.76/10万,扩大免疫后较扩大免疫前平均发病率下降了61.58%;每年的4-6月为风疹发病高峰期,4~5年为1个发病高峰,有明显的季节性。各地区均有风疹病例报告,扩大免疫前平均发病率最高的为长春市(15.83/10)万,扩大免疫后平均发病率最高的为延边朝鲜族自治州(8.83/10)万。风疹发病15岁人群发病约占病例总数的47.49%,15~24岁人群发病约占病例总数的44.24%,25~34岁人群发病约占病例总数的6.12%,扩大免疫后较扩大免疫前平均发病率5岁上升19.74%,5~9岁为下降40.25%、10~14岁下降60.85%、15~19岁下降72.58%、20~24岁下降79.89%。扩大免疫前后学生、散居儿童和幼托儿童风疹病例分别占病例总数的83.15%和78.33%。结论吉林省实施扩大免疫后,风疹发病大幅下降;风疹暴发疫情主要发生在学生、散居儿童和幼托儿童;应通过摸底调查及查验接种证等方式,开展重点人群的含风疹成分疫苗(RCV)接种,不断提高适龄儿童RCV接种率和及时接种率;对高中及大学新入学学生及育龄期妇女开展RCV查漏补种工作,以降低风疹及先天性风疹综合征发病水平。     

1997～2005年广州市流行性腮腺炎流行病学分析

目的了解广州市流行性腮腺炎的流行特征。方法采用描述流行病学分析方法对1997~2005年广州市流行性腮腺炎发病情况进行分析。结果1997~2005年广州市共发生流行性腮腺炎22 955例,年平均发病率为36.23/10万,2004~2005年发病率明显上升,其中2005年发病最高,发病率为105.53/10万。全年均有发病,发病高峰在6、7月份,分别占发病总数的13.37%和13.16%。病例主要分布在学生(50.46%)、幼托(23.68%)和散居儿童(12.95%),病例集中在0~14岁年龄组,占总病例数的87.12%;男性年平均发病率为44.25/10万,女性年平均发病率为27.80/10万,男性发病率高于女性,差异有统计学意义(P<0.01)。结论近年广州市腮腺炎发病率呈逐年上升趋势。降低学生和幼托儿童发病率是今后腮腺炎防控工作重点。     

湖北省2009-2010年流行性腮腺炎疾情分析

目的分析湖北省2009-2010年流行性腮腺炎(腮腺炎)的流行病学特征,为预防控制腮腺炎提供依据。方法对法定传染病报告系统及突发公共卫生事件报告信息管理系统报告的腮腺炎发病资料,进行描述流行病学分析。结果湖北2009、2010年腮腺炎报告发病率分别为30.479/10万和39.5682/10万,报告发病数分别为17 406例和22 633例,各市(直管市林区)均有病例报告,发病年龄组构成以<10岁发病最多,分别占全部病例数的85.34%、87.23%。结论 2010年腮腺炎报告发病比2009年增加了29.83%,已成为危害儿童、青少年健康的主要传染病之一。建议在腮腺炎流行季节来临前在易感人群中开展预防接种,提高其免疫水平。在托幼机构、中小学校及时启动晨检制度,开展健康教育。建立健全疫情报告制度,加强监测工作,有效的控制流行性腮腺炎疫情。     

佳木斯市2004-2017年流行性腮腺炎流行特征分析及趋势预测

  目的  分析佳木斯市流行性腮腺炎的流行特点,并对其发病趋势进行预测,为黑龙江省高寒地区采取有针对性的防控方法提供一定依据。  方法  通过传染病报告信息管理系统,收集佳木斯市2004-2017年报告的腮腺炎病例。选用描述流行病学方法,对其流行病学特点进行系统分析,并用自回归移动平均模型（autoregressive integrated moving average,ARIMA）对2018年腮腺炎的发病趋势进行预测。  结果  2004-2017年佳木斯市腮腺炎共报告1 586例,年均发病率达到4.52/10万,近三年腮腺炎发病率出现上升趋势;男女发病率比为1.67∶1;病例主要集中在3~19岁,占全部病例的86.32%,5~9岁,10~14岁儿童发病率较高;发病有明显的季节性,每年的4-7月和11-次年1月为发病高峰;城区年发病率高于外郊县市区;ARIMA（4,1,2）（2,0,0）₁₂模型为相对最佳模型,预测的2018年1~6月腮腺炎发病率和实际值相符,预测2018年7~12月发病率为0.30/10万、0.35/10万、0.38/10万、0.39/10万、0.35/10万、0.33/10万。  结论  ARIMA模型可以较为准确地预测佳木斯市腮腺炎发病趋势,为有效降低儿童发病率,建议在儿童学龄前阶段（3~6岁）或小学阶段开展第二剂次的腮腺炎疫苗接种,同时应继续做好托幼机构等集体单位的疫情监测防控工作。     

襄阳市2008-2014年流行性腮腺炎流行病学分析

目的分析湖北省襄阳市2008-2014年流行性腮腺炎(简称腮腺炎)报告发病情况,为开展预防控制工作提供依据。方法对襄阳市2008-2014年报告的腮腺炎病例及腮腺炎突发公共卫生事件应用描述流行病学方法进行分析。结果襄阳市2008-2014年共报告腮腺炎病例12 342例,无死亡,年平均发病率为32.04/10万。4~6月发病数占病例总数的47.37%;襄阳市7年平均报告发病率最高的为樊城区(104.06/10万),其次是谷城县,最低为枣阳市。男女性别比为1.62:1,15岁病例数占病例报告总数的90.87%(11 215/12 342)。突发公共卫生事件管理信息系统共报告25起腮腺炎公共卫生事件,全部发生在学校,小学占88.00%(22/25)。结论襄阳市腮腺炎发病高峰主要在4~6月,半数病例集中在襄阳市城区,发病人数以15岁以下少年儿童为主,男性多于女性,小学是腮腺炎公共卫生事件发生的主要场所。     

2004—2008年铜川市免疫规划疫苗针对传染病流行特征分析

目的分析2004-2008年铜川市免疫规划疫苗针对传染病流行特征,了解流行趋势,探讨进一步控制疫苗针对传染病的防治措施。方法采用描述流行病学方法,对疫情网2004-2008年疫苗针对传染病的报告数据用Excel系统进行分析。结果2004-2008年脊髓灰质炎、白喉、新生儿破伤风、炭疽和钩体病无病例报告,共报告免疫规划疫苗针对传染病10种10 784例,死亡30例,流脑、百日咳、乙脑、肾综合症出血热、甲肝和风疹的年均发病率在0.07/10万~4.59/10万之间,呈低水平发病;麻疹年均发病率为6.83/10万;流行性腮腺炎年均发病率为22.60/10万,发病有上升趋势;乙肝(133.51/10万)和肺结核(85.64/10万)的发病在较高水平,发病数占总病例数的84.52%,且以成人(20岁~)为主,成人的肺结核和乙肝分别占了91.30%和85.27%。结论免疫是预防控制传染病最为有效的手段,预防和控制疫苗针对传染病应采取以预防接种为主的综合性防治措施,保持高水平的接种率,对重点人群实施有效的免疫策略,增加免疫覆盖面,并做好疫苗针对传染病的疾病监测。     

中国2008～2009年流行性腮腺炎流行病学特征分析

目的分析中国(未包括香港、澳门特别行政区和台湾地区,下同)2008～2009年流行性腮腺炎(腮腺炎)的流行病学特征,为预防控制腮腺炎提供依据。方法对法定传染病报告系统及突发公共卫生事件报告信息管理系统报告的腮腺炎发病资料,进行描述流行病学分析。结果全国2008、2009年腮腺炎报告发病率分别为23.52/10万和22.54/10万,报告发病数分别为310826例和299329例,各省(自治区、直辖市)均有病例报告;发病年龄组构成以15岁发病最多,分别占全部病例数的84.81%、85.05%;2008年8～9岁儿童发病率最高(236.66/10万),2009年5～6岁儿童发病率最高(184.83/10万);存在两个发病高峰,分别为4～7月和11月～翌年1月。结论 2009年腮腺炎报告发病比2008年有所下降,但发病水平仍很高,主要以学龄儿童发病为主。应制定切实可行的全国预防控制腮腺炎策略。     

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.     

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.