道路伤害的病例对照研究

目的：探讨道路伤害危险因素。方法：采用病例对照研究方法，于2001年11月至2002年8月收集沈阳市皇姑区发生机动车交通事故的事故组驾驶员406例，并同期在皇姑区内于随机时间、随机地点调查道路上正常行驶的对照组驾驶员438名。采用统一问卷、面询方法，调查内容包括驾驶员的一般情况，连续驾驶时间，事故／调查前睡眠状况，急、慢性困倦程度(采用Stanford和Epworth困倦量表测量)，饮酒，吸烟，驾驶安全态度和行为，车速，车辆状况等。结果：处于慢性困倦状态的驾驶员发生事故的危险性是非困倦状态驾驶员的1．98倍(OR=1．98，95％CI：1．26—3．12)，事故组驾驶员的困倦程度高于对照组，但差异无显著性(OR＝2．38，95％CI：0．89—6．31)。夜班或倒班发生事故的危险是常白班的2．09倍(OR＝2．09，95％CI：1．48—2．94)，酒后驾车发生事故的危险性是非酒后驾车的3．59倍(OR＝3．59，95％CI：1．13--11．39)，无人约束时会违章的驾驶员发生事故的危险性是不违章驾驶员的1．73倍(OR＝1．73，95％CI：1．22—2．46)。结论：慢性困倦、夜班或倒班、酒后驾车、违章等是道路伤害的危险因素，急性困倦可能是道路伤害的一个潜在危险因素。     

机动车驾驶员道路交通伤害危险因素分析

目的 探讨道路交通伤害中机动车驾驶员生理、心理、行为等因素与交通事故发生的关系,为进一步预防道路交通伤害提供依据。方法 采用病例对照研究方法,通过问卷调查收集事故驾驶员和非事故驾驶员的生理、心理、行为等相关情况,采用SPSS 11.5软件对事故组和非事故组的调查指标进行单因素分析和多因素分析,筛选机动车驾驶员交通伤害的危险因素。结果 共调查了170名事故驾驶员和167名非事故驾驶员。非条件Logistic多因素回归分析结果表明,驾驶员的文化程度、饮酒史、酒后驾车史、超载驾驶和既往交通事故史是道路交通伤害的危险因素,其OR值及95.0%CI分别为:4.508(1.585~12.819),7.311(3.477~15.370),43.054(14.675~126.314),3.057(1.210~7.726),20.057(5.974~67.342)。结论 初中以下文化程度,经常超载驾驶,有饮酒史、酒后驾车史和既往交通事故史与道路交通伤害密切相关。     

浙江省道路交通伤害病例对照研究

目的探讨道路交通伤害危险因素,为进一步开展道路交通伤害预防控制提供科学依据。方法采用1∶2配对病例对照研究方法,通过面访形式收集病例组和对照组驾驶员的一般情况、交通工具状况、驾驶相关行为、睡眠状况、吸烟、饮酒、药物使用、道路状况等因素。结果 2008-2009年间共调查246例病例组和492例对照组驾驶员,在控制年龄、性别、驾驶机动车类型等因素下,驾车频率高(OR=3.08)、有吸烟史(OR=1.94)、行驶车道错误(OR=2.36)、驾车时身体状况差(OR=1.87)、睡眠不足(OR=4.63)、定期车辆检修(OR=0.33)、佩戴安全带/安全头盔(OR=0.30)等因素在病例组和对照组间差异有统计学意义。结论道路交通伤害与驾驶员行为、车辆和环境等因素有关,应针对人、车、路三方面采取相应干预措施,降低道路交通伤害的发生。     

中国北方少数民族聚居地农村居民饮酒与农业伤害的流行病学研究

目的 了解北方少数民族聚居地农村居民农业伤害的发生情况和饮酒与农业伤害的关系.方法 采用多级抽样的方法选取样本,通过面对面访谈方式收集资料;共抽取2366名达斡尔族聚居地农村居民,收到合格问卷2198份.结果 在2198名达斡尔族聚居地农村居民中,农业伤害发生率为11.8%,男性伤害发生率(13.8%)明显高于女性(9.7%)(P=0.003).年龄、职业、从事农业生产的年限、睡眠困难、从事农业生产时吸烟、驾驶农用机动车、使用农用机械和饮酒是伤害的危险因素(P＜0.01).通过控制混杂因素,饮酒与农业伤害有关,先前饮酒者、目前饮酒者发生伤害的危险性分别是不饮酒者的1.57倍(95%CI:1.05～2.37)和1.80倍(95%CI:1.24～2.62).目前的饮酒率为29.1%(640/2198).随着每周饮酒次数、每次饮纯酒精量、饮酒年限、饮用酒精饮料种类的变化,农业伤害的危险性增加;在早午餐饮酒发生农业伤害的危险性是不饮酒者的2.15倍(95%CI:1.43～3.22),经常醉酒者发生农业伤害的危险性是不饮酒者的2.09倍(95%CI:1.38～3.15).结论 饮酒是农业伤害的主要危险因素.控制饮酒、加强道路安全知识和农用机械使用知识培训,是预防农业伤害的主要措施.     

上海出国留学生酒后驾驶知识、态度和行为调查

目的了解上海出国留学生酒后驾驶知识、态度和行为及其影响因素,为相关的干预措施提供一定的科学依据。方法采用分层随机抽样方法对上海出国留学生进行问卷调查,对影响酒后驾驶的因素进行分析。结果实际发放问卷780份,回收有效问卷738份(94.6%)。调查对象的"饮酒后驾驶的最低血液酒精浓度""醉酒驾驶的最低血液酒精浓度""醉酒驾驶是否会追究刑事责任"和"因醉驾吊销驾驶证的规定年限"等知识知晓率分别为25.88%、15.31%、94.58%和12.33%。有驾照者酒后驾驶知识知晓率高于无驾照者(P0.05)。"醉酒驾驶者会受到的处罚"的知晓率仅为5.83%。94.72%调查对象认同"酒后驾驶对公共交通安全危害很大",98.78%调查对象反对酒后驾驶。有驾车经历者的酒后驾驶发生率为18.13%,且男性高于女性(χ~2=6.0111,P0.05)。影响酒后驾驶的因素包括性别、饮酒频率、酒后驾驶相关知识知晓度和乘坐饮酒者驾驶的机动车。男性(OR=3.20,95%CI=1.02~10.60)相对于女性发生酒后驾驶风险更大;饮酒频率(OR=4.73,95%CI=2.23~10.01)越高,发生酒后驾驶的风险更大;酒后驾驶知识知晓度越高(OR=5.28,95%CI=1.71~16.29),发生酒后驾驶的风险更小;乘坐饮酒者驾驶的机动车的人群(OR=7.64,95%CI=1.74~33.57)发生酒后驾驶的风险更大。结论上海出国留学生酒后驾驶相关知识欠缺,相关态度尚可,酒后驾驶行为报告率较高,可重点针对高危人群进行相应的干预措施,提高对酒后驾驶的相关知识的认知,减少酒后驾驶行为的发生。     

机动车驾驶员道路交通伤害的危险因素分析

目的 探讨机动车驾驶员道路交通伤害(RTI)的危险因素,为进一步预防和控制RTI提供科学依据.方法 通过广西壮族自治区公安厅交警总队收集柳州市2000-2009年的RTI数据,用SPSS 13.0统计软件对机动车驾驶员的性别、年龄、驾龄、各种交通行为等进行单因素和多因素非条件logistic回归分析.结果 多因素非条件logistic回归分析结果表明,疲劳驾车、酒后驾车、超速行驶及违章变更车道是机动车驾驶员RTI的主要危险因素,其OR值(95％ CI)分别为4.73(1.94～11.87)、9.89(5.52～36.45)、11.55(3.93～58.63)、3.78(1.94～7.85).结论 疲劳驾车、酒后驾车、超速行驶及违章变更车道与RTI密切相关.     

南京市城乡结合部地区摩托车驾驶员酒后驾驶行为危险因素分析

目的了解摩托车驾驶员酒后驾驶行为危险因素。方法将南京市3次路面拦截机动车调查酒后驾驶行为获得的摩托车驾驶员数据合并,进行分析。结果筛选符合条件的摩托车驾驶员468人,酒后驾驶57人(12.18%),饮酒驾驶44人(9.40%),醉酒驾驶1人(0.21%)。外地牌照摩托车驾驶员酒后驾驶发生率为20.25%,高于本地车辆(χ2=5.792,P=0.016);周末和节假日酒后驾驶发生率分别为17.79%、25.00%,高于工作日(χ2=9.287,P=0.010);教育程度越高酒后驾驶发生率越低(χ2=18.887,P0.01)。多因素Logistic回归结果显示,以18~30岁年龄组为参照,31~40岁年龄组OR值为4.342(95%CI:1.582~11.912),41~50岁年龄组OR值为12.560(95%CI:4.578~34.455),51~66岁年龄组OR值为12.616(95%CI:3.594~44.281);次驾车时间0.5 h为参照,驾驶时间≤0.5 h的OR值为3.884(95%CI:1.262~11.954);以一般点为参照,高危点的OR值为2.549(95%CI:1.122~5.794);以下午时间(13:00—14:30)为参照,晚上(20:00—22:00)OR值为9.702(95%CI:1.275~73.811),深夜(22:00~)OR值为23.389(95%CI:2.752~198.753);以戴头盔为参照,不戴头盔OR值为2.706(95%CI:1.366~5.359)。结论摩托车驾驶员酒后驾驶发生率较高,影响因素较为复杂,相关部门应针对其危险因素采取人群干预和加强执法活动。     

饮酒与肺癌发病关联的Meta分析

目的探讨饮酒与肺癌的关系。方法全面检索相关文献,应用Meta分析方法对各研究进行数据合并与分析。结果纳入合并分析的文章共21篇,其中队列研究6篇,随访人数累计122288例,病例3053例;病例对照研究15篇,累计病例8838例,对照21591例。Meta分析饮酒与肺癌合并OR值为1.17(95%CI:0.96～1.42);男、女饮酒合并OR值分别为1.67(95%CI:0.61～4.59)和0.93(95%CI:0.51～1.68);男性饮啤酒合并OR值为1.46(95%CI:1.28～1.67);饮烈酒合并OR值为1.34(95%CI:1.02～1.74);饮酒≥7次/周与肺癌呈正相关(P<0.05)。结论饮用啤酒、烈酒和经常饮酒与肺癌有统计学关联。     

高血压、体质指数与良性前列腺增生关系

目的 探讨高血压、体质指数(BMI)与临床术后良性前列腺增生(BPH)的关系.方法 采用病例对照研究方法,病例为55～90岁临床诊断为BPH、施行手术治疗、术后病理证实为BPH的患者;对照为同期住院的非前列腺增生患者,年龄与病例相同;病例与对照各380例,以1:1匹配;采用自行设计的调查表对研究对象进行调查,内容包括一般情况、身体测量、生活方式、既往史以及BPH家族史等,采用Logistic回归模型计算OR值及其相应的95%C1.结果 调整年龄因素后,与收缩压正常者(＜140 mmHg),(1 mmHg=O.133 3 kPa)相比较,收缩压160-179mmHg者和收缩压≥180 mmHg者发生BPH的危险性明显增加(分别为OR=2.135,95%CI=1.139～4.001和OR=2.704,95%CI=1.475-4.958);高血压病程与BPH呈正相关(x2=8.876,P=0.031),病程≥20年组发生BPH的危险性明显增加(OR=4.984,95%a=2.006-12.203,P=0.001).与非高血压者比较,超重或肥胖者罹患高血压发生BPH的危险性明显地增高(OR=2.548,95%CI=1.397-4.648和OR=2.667,95%CI=1.038-13.212).结论 高血压是BPH发病的危险因素;长期罹患高血压、尤其是高收缩压状态能够促进BPH的发生和发展;超重和肥胖的男性高血压BPH的危险性明显增加.     

广州市中小学生运动伤害危险因素的配对病例对照分析

目的 探讨中小学生运动伤害的危险因素.方法 按性别、年龄、班级1:1配对原则,通过样本量计算选择349对运动伤害病例和对照,采用单因素和多因素条件logistic回归分析.结果中小学生发生运动伤害的危险因素是:鞋底磨损大(OR=7.20,95%CI:2.37～21.84)、疲倦(OR=14.34,95%CI:2.29～89.66)、带病时参加运动的频率高(OR=1.96,95%CI:1.29～3.06)和既往伤害史(OR=2.11,95%CI:1.41～3.96).运动伤害的保护因素:体育训练时有老师指导动作(OR=0.46,95%CI:0.26～0.79)、运动时做防护措施(OR=0.36,95%CI:0.20～0.64)和运动前热身运动的频率高(OR=0.31,95%CI:0.14～0.67).结论 中小学生运动伤害与个人因素、家庭因素和社会因素有关;应提高学生和老师的安全运动意识,减少运动伤害危险行为的发生.     

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.