脐血铅、初乳铅含量对新生儿神经行为发育的影响

目的 探讨在宫内低水平铅暴露状态下,新生儿脐血铅含量及初乳铅铅含量与神经行为发育的关系.方法 随机选取南京市妇幼保健院医院产科2010年1-4月出生的足月新生儿170例.以脐血铅和初乳铅铅含量作为新生儿铅暴露的指标,新生儿神经行为NBNA发育评分作为效应指标.结果 高暴露组和低暴露组在新生儿主动肌张力、原始反射和神经行...     

脐血铅与初乳铅含量与新生儿神经行为发育关系

目的探讨在宫内低水平铅暴露状态下,新生儿脐血铅含量及初乳铅铅含量与神经行为发育的关系。方法随机选取南京市妇幼保健院医院产科2010-01/04出生的足月新生儿170例。以脐血铅和初乳铅铅含量作为新生儿铅暴露的指标,新生儿神经行为（NBNA）发育评分作为效应指标。结果高暴露组在新生儿主动肌张力、原始反射和神经行为发育总评分上低于低暴露组,差异有统计学意义（t=4.625,P〈0.05）,在新生儿行为能力、被动肌张力、一般估价上差异无统计学意义。结论初乳铅脐血铅水平和与婴儿的早期发育有关,铅可通过乳汁和脐血造成新生儿的铅接触,对新生儿婴儿早期神经行为发育产生不良影响。     

新生儿脐血铅含量与神经行为发育的关系

目的 :探讨孕期低水平铅暴露下 ,脐血血铅含量对新生儿神经行为发育的影响。方法 :随机选择 2 0 0 3年 1～4月出生足月新生儿 135例。以脐血铅作为孕期铅暴露的指标 ,新生儿神经行为发育 (NBNA)评分作为效应指标 ,采用描述性分析方法评价二者之间的相关性。结果 :高暴露组和低暴露组在新生儿主动肌张力、神经行为发育总评分上差异有显著性 (P<0 .0 5 ) ,原始反射评分差异有非常显著性 (P<0 .10 ) ,在新生儿行为能力、被动肌张力、一般估价上差异无显著性。结论 :孕期低水平铅暴露对新生儿神经行为发育影响明显。     

脐血,胎粪铅含量对新生儿神经行为发育的影响

为探讨在宫内低水平铅暴露状态下,新生儿脐血铅含量及胎粪铅含量与神经行为发育的关系。随机选取某医院妇产科１９９９年１～１０月出生的足月新生儿１０３例,以脐血铅（ＣＢＰｂ）含量与胎粪铅（ＭＰｂ）含量作为新生儿宫内铅暴露的指标,新生儿神经行为评分（ＮＢＮＡ）作为效应指标。结果显示,与脐血铅含量比较,胎粪铅含量与新生儿神经行为发育的关系更为密切,可作为妊娠期胎儿体内铅蓄积的指标。     

妊娠低铅暴露与新生儿神经行为及体格发育的关系

【目的】探讨妊娠低铅暴露与新生儿神经行为及体格发育的关系,为有效预防提供参考依据。【方法】选择280例劳务女工产妇及所产280例新生儿为研究对象,检测妊娠早中晚期、分娩时和新生儿脐血铅水平,取其对数值分别与新生儿行为发育评分(NBNA),4项体格指标Z标准分进行相关分析;以孕中期血铅浓度第25,50,75百分位,分别构成相对高低铅组,进行神经行为及体格发育比较。【结果】孕中期血铅对数值与行为能力、主动肌张力、总得分及其头围和体重Z标准分显著负相关(P0.05);在58μg/L分界点时,高铅组NABA总得分显著小于低铅组(t=2.326,P0.05)。【结论】孕中期血铅水平作为孕期铅暴露示标有更高的敏感性;孕中期血铅水平即使在58μg/L水平,已对新生儿神经行为发育造成负性影响。     

孕期被动吸烟对新生儿脐血铅及听力的影响

目的 探讨孕期被动吸烟与宫内铅暴露水平及新生儿听神经发育的关系.方法 经过问卷调查,选择符合条件的孕妇及其新生儿105例,分为对照组(36例)、暴露组[包括高暴露组(36例)和低暴露组(33例)],以新生儿脐血铅含量作为胎儿宫内铅暴露的指标,新生儿耳声发射听力筛查(OAE)3日初检阳性率作为听神经发育受损概率的指标,比较组间差异.结果 对照组、暴露组的脐血铅水平的几何均值分别为:21.38、33.88μg/L(高暴露组和低暴露组分别为39.81μg/L和30.20 μg/L),各组比较,差异均有统计学意义.对照组、暴露组的新生儿OAE 3日初检阳性率分别为11.11%,31.88%(高暴露组和低暴露组分别为38.89%和15.15%),各组比较,对照组与暴露组及对照组与高暴露组的差异有统计学意义,对照组与低暴露组的差异无统计学意义.将母血铅与脐血铅进行总的及各组内的相关性分析,均呈正相关.结论 孕期被动吸烟可以明显提高脐血铅水平并可能至少在短期内进一步影响新生儿的听神经发育;母血铅水平可作为胎儿宫内铅暴露的指标,用于评价铅暴露对新生儿神经行为发育的影响.     

脐血铅水平与新生儿神经行为发育及血锌含量的相关研究

为了探讨宫内铅暴露的神经发育毒性及其预防措施,本研究选择101例足月顺产新生儿,以脐血铅水平为宫内暴露指标,新生儿神经行为发育评分为效应指标,结果表明:脐血铅超过0.48μmol/L(10.00μg/dl)时对胚胎神经发育有不良影响;新生儿的行为能力评分和总评分与脐血铅水平存在负相关关系;脐血锌含量随血铅水平增高而升高,二者间存在正相关关系,提示铅可能对体内锌的吸收、分布或利用产生影响。     

脐血铅含量与新生儿神经行为发育的关系

为了探讨宫内铅暴露与新生儿神经行为发育的关系，选择了北京地区１０１例新生儿，以脐血铅含量作为新生儿宫内铅暴露的指标，新生儿神经行为评分作为效应指标。结果：新生儿脐血铅含量与神经行为总分及行为能力评分间存在负相关关系。以脐血铅含量０．４８μｍｏｌ／Ｌ为分界，高铅组与相对低铅组新生儿行为能力评分差异有显著性，其行为能力分项评分结果表明，非生物听定向反应、生物性视和听定向反应两组比较差异有显著性。提示：宫内铅暴露对新生儿神经行为发育，特别对视和听功能可产生不良影响。     

脐血铅胎粪铅含量与新生儿神经行为发育的关系

目的 探讨在宫内低水平铅暴露状态下,新生儿脐血铅含量及胎粪铅含量与神经行为发育的关系。方法 随机选取武汉市青山区第一冶金建筑总公司职工医院妇产科1999年1－10月出生的足月新生儿103例。以脐血铅和胎粪铅含量作为新生儿宫内铅暴露的指标,新生儿神要行为发育评分作为效应指标。采用描述性分析方法评价其相关关系。脐血铅以0．483μmol/L为界、胎粪铅以127．78mg/kg为界,分别将研究对象分为高铅组与低铅组。结果 脐血高铅组与低铅组仅在新生儿神经行为发育总评分（1352．5与4003．5）、生物视听定向反应（1310．5与4045．5）得分上差异有显性,但脐血铅含量与新生儿神经行为发育总评分、非生物听定向反应、非生物视定向反应、生物视听定向反应之间不存在等级相关关系;而胎粪高铅组与低铅组在新生儿神经行为发育总评分（1636．0与3720．0）、非生物听定向反应（2110．5与3245．5）、非生物视定向反应（1836．0与3520．0）、生物视听定向反应（1828．5与3527．5）4项评分上,两组差异有显性或非常显性。胎粪铅含量与新生儿神经行为发育总评分、非生物视定向反应、生物视听定向反应3项神经评分有明确的等级负相关关系。结论 胎粪铅含量可作为妊娠期胎儿体内铅蓄积的指标。     

上海市脐带血汞水平及对新生儿体格生长的影响

目的 调查上海市胎儿期汞暴露水平;分析汞暴露对新生儿体格发育的影响;从而为减少汞暴露,提高人口素质提供参考依据.方法 采用分层整群抽样方法 随机抽取上海市10家有助产资格的医院,调查在2008年10月至2009年10月期间分娩的孕产妇及新生儿,分娩时采集脐带全血进行血汞检测;分析脐带血汞水平与新生儿出生身长、体重及头围的关系.结果 共调查1 652对产妇及新生儿,脐带血汞中位数为1.89μg/L,几何均数为(1.95±1.44)μg/L;脐带血汞水平与婴儿(r=-0.078,P=0.012)及男婴(r=-0.087,P=0.041)的出生身长负相关,与女婴的出生身长、体重及头围无相关性.结论 上海市胎儿期汞暴露水平较低.胎儿期低水平汞暴露可影响新生儿出生身长,并存在性别差异.     

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.     

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.     

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.