我国6省市5类城市职业人群自测健康状况及影响因素研究

目的了解我国城市职业人群健康状况及影响因素,为制定相关措施提供科学依据。方法采用多阶段分层抽样方法,在全国东部、中部和西部地区抽取6个省（自治区、直辖市）,每省市随机抽取2个地级市,每个地级市中按照公务员、科技人员、企事业管理人员、教师、体力劳动者5类职业人群抽取若干单位,对18-60岁5类职业人群进行问卷调查,采用许军等编制的自测健康评定量表对调查对象健康状况进行评估。结果共收回有效问卷13177份。调查对象自测健康评定量表总分为73.34±1.86分,生理健康、心理健康、社会健康子量表得分分别为77.61±11.56分、68.64±16.36分和73.17±14.91分。5类职业中,公务员量表总分最高,为74.83±11.89分,其他依次为科技人员73.84±11.39分,企事业管理人员73.58±12.09分,体力劳动者72.78±12.24分,教师得分最低,为71.65±11.44分。6个地区中,北京地区调查对象量表总分最高,为75.47±11.46分,宁夏地区调查对象最低,为69.29±11.99分。男性社会健康得分为72.77±15.25分,女性为73.56±14.54分,女性得分高于男性（P〈0.05）。多元线性回归显示,教师、离异者量表总分较低,受教育程度越高、家庭人均月收入越高,量表总分越高。结论我国城市职业人群中,教师的自测健康状况较差。自测健康状况与性别、受教育程度、婚姻状况、家庭经济水平等有关。     

湖北省城市职业人群自测健康状况及影响因素研究

目的了解居民的自测健康状况,并分析居民自测健康状况的影响因素,为今后健康教育工作提供参考依据。方法随机抽取湖北省襄樊和荆门两个城区的公务员、科技人员、企事业管理人员、教师和体力劳动者5类职业人群,采用调查问卷的方式随机调查2250人,采用自测健康评定量表对调查对象的自测健康状况进行测量。结果共收回有效问卷2137份。调查对象自测健康评定量表总分为73.89±11.89分,生理健康、心理健康及社会健康的得分分别为78.47±10.83分,69.05±16.75分和73.44±14.99分。从职业来看,体力劳动者各方面的自测健康状况得分均最高,量表总分为75.87±11.88分,科技人员的心理健康、社会健康和健康量表总分最低,量表总分为72.74±11.3分。年龄上,50岁以上调查对象的健康量表总分最高,为75.27±11.79分。高中/中专文化程度者在各方面的自测状况得分都最高,量表总分为76.95±11.67分。多因素结果显示,教师、公务员和科技人员的总分均较低;未婚、已婚和离异者较丧偶者量表总分较低。结论人口学特征对职业人群各方面的健康状况有着不同的影响,因此,应针对不同人群的特点,有针对性的开展工作,更好的提高健康教育的效果。     

城市职业人群自测健康状况及影响因素分析

目的 了解城市职业人群健康状况及影响因素,为制定相关评价指标提供科学依据。方法 采用多阶段分层抽样方法,在辽宁省丹东、营口市抽取18~60岁城市公务员、科技人员、企事业管理人员、教师、体力劳动者5类职业人群进行问卷调查,采用自测健康评定量表(SRHMS V1.0)对其健康状况进行评价。结果 本次调查共收回有效问卷2 391份,调查对象自测健康评定量表总分平均为(75.28±12.73)分,5类职业人群中,公务员量表总分为(79.34±10.80)分,科技人员(79.73±11.13)分,体力劳动者(73.38±12.59)分,企事业管理人员(72.97±14.43)分,教师(70.93±11.92)分(P=0.000);多元线性回归分析结果表明,与体力者比较,教师总分较低(P=0.000),公务员、科技人员总分较高(P=0.000);与未婚者比较,离异者总分最低(P=0.000);受教育程度越高,年龄越小,总分越高(P<0.005)。结论 城市5类职业人数中,教师、体力劳动者的自测健康状况较差;自测健康状况与地区、年龄、受教育程度、婚姻状况、职业等有关。     

银川市5类城市职业人群心理、生理及社会支持状况调查

目的了解银川市不同人群心理、生理及社会支持状况。方法采用多阶段分层抽样方法,抽取体力劳动者、公务员、企事业管理人员、教师和科研人员5类职业人群进行问卷调查。调查工具为《状态焦虑量表》、《自评抑郁量表》和《社会支持评定量表》。结果收回有效问卷2245份,体力劳动者、公务员、企事业管理人员、教师和科研人员5类职业人群的状态焦虑得分分别为42.19±7.26分、39.31±6.61分、38.38±6.81分、40.06±5.57分和40.41±6.09分,体力劳动者得分最高,企事业管理人员最低,平均为40.03±6.58分;5类职业人群的自评抑郁得分分别为35.94±6.74分、38.76±6.72分、37.58±6.83分、37.97±5.89分和38.90±5.83分,公务员得分最高,体力劳动者得分最低,平均得分为37.83±6.50分,处于无抑郁、轻度抑郁、中至重度抑郁和重度抑郁状态的人分别占59.6%、34.3%、5.9%和0.2%;5类职业人群的社会支持得分分别为33.65±10.15分、39.80±5.85分、38.57±7.63分、38.86±8.40分和39.29±6.48分,平均得分为38.03±8.16分。调查对象的状态焦虑得分与自评抑郁得分呈正相关(r=0.4037,P0.05)。结论良好的社会支持有助于不同人群的心理健康。     

城市职业人群社会支持状况影响因素分析

目的 了解城市职业人群健康状况及影响因素,为制定相关评价指标提供科学依据。方法 采用多阶段分层抽样方法,在辽宁省丹东、营口市抽取18~60岁城市公务员、科技人员、企事业管理人员、教师、体力劳动者5类职业人群进行问卷调查,采用社会支持评定量表对其获得社会支持状况进行评价。结果 本次调查共收回有效问卷2 391份,调查对象社会支持评定量表总分平均分为(40.80±8.64)分,5类职业人群中,公务员量表总分最高,为(43.92±7.88)分,其他依次为科技人员(41.05±8.03)分,教师(40.60±8.08)分,企事业管理人员(39.84±10.42)分,体力劳动者(38.51±7.66)分(P=0.000);多元线性回归分析结果,与体力劳动者比较,公务员量表总分较高(P=0.000);与未婚者比较,已婚者量表总分较高(P=0.000);受教育程度越高,年龄越大,收入低者,量表总分越高(P<0.005)。结论 城市5类职业人群中,体力劳动者获取社会支持状况较差;社会支持状况与年龄、受教育程度、婚姻状况、经济状况、职业等有关。     

深圳市某区公共卫生机构工作人员自测健康状况及影响因素分析

[目的]了解深圳市公共卫生机构工作人员自测健康现状及影响因素,为有针对性地改善公共卫生人员健康状况提供参考依据。[方法]应用自测健康评定量表及自制的影响因素调查表在深圳市某区慢性病防治院、疾病预防与控制中心、妇幼保健院3家公共卫生机构随机抽取200名工作人员进行调查。[结果]深圳市公共卫生机构工作人员自测健康总分终得分为(67.85±11.83)分,三个子量表中,生理健康子量表得分最高为(74.09±12.64)分,心理健康子量表得分最低为(62.69±12.10)分。不同学历、职称和经济收入的公共卫生机构工作人员量表得分差异有统计学意义(P0.05)。多重线性回归分析显示,学历、职称、经济收入是影响公共卫生机构工作人员自测健康状况的影响因素。[结论]深圳市公共卫生机构工作人员自测健康水平不高,应重点关注人员的职业发展对人员健康水平的影响。     

医学生人格特征与自测健康状况的相关陛研究

目的 了解医学生人格特征和自测健康状况,分析二者的联系与相关性.方法 采取多级随机整群抽样方法,选择878名医学生采用艾森克人格问卷简式量表(中国版,EPQ-RSC)及自测健康评定量表(SRHMS1.0)进行人格和自测健康状况调查.结果 男女医学生EPQ-RSC中的测谎量表得分均高于全国常模水平,其余差别无统计学意义;男生精神质得分高于女生(P＝0.000);医学生SRHMS量表总分为(339.28±41.19)分,高于一般人群水平,男生生理健康子量表总分高于女生(P=0.005);除精神质不同等级的医学生生理健康子量表得分未见差别有统计学意义外,不同人格特征医学生的自测健康各子量表及量表总分均差别有统计学意义(P＜0.01);内外向和测谎量表分与自测健康各子量表和总分均呈正相关(r≥0.134),神经质和精神质量表分则与之均呈负相关(r≤-0.070),相关有统计学意义(P=0.000).结论 医学生人格的不同特征对自测健康有显著影响,健全和完善医学生人格是改善他们健康状况的有效途径.     

2128名北京市职业人员自测健康现状及影响因素分析

目的了解北京市职业人群自测健康现状及其影响因素。方法采取分层随机抽样的方法抽取2128名18~60岁的5类职业人群为研究对象,采用访谈和问卷相结合的方式进行问卷调查。结果不同文化程度、职业、经济收入、婚姻状况、工作紧张程度、锻炼程度的职业人群自测健康得分差异具有统计学意义（P〈0.05）;教师、企事业单位员工、科技人员的自测健康得分分别为320.50±50.45分,322.02±50.64分和325.50±45.60分,低于体力劳动者的349.69±47.33分和公务员的340.07±51.89分（P〈0.01）;参加锻炼者的得分为344.70±49.48分,高于不锻炼者322.90±49.35分（P〈0.01）;自测健康得分呈现随工作紧张度增加而降低的趋势（P〈0.01）。多因素方差分析结果显示高中或中专文化程度、在婚、体力劳动者、工作紧张度低的人群自测健康得分较高。结论以教师、企事业单位员工、科技人员为重点人群,以增加体育锻炼和促进心理健康为主要内容,开展广泛的工作场所健康教育与健康促进工作。     

我国6省市5类城市职业人群心理健康状况及社会支持状况调查

目的了解我国5类职业人群的心理健康状况及社会支持状况,为制定相关健康教育措施提供科学依据。方法采用多阶段分层抽样方法,从北京、辽宁、浙江、湖北、青海和宁夏6省（自治区、直辖市）中抽取公务员、科技人员、企事业管理人员、教师和体力劳动者5类职业人群进行问卷调查。调查工具为状态焦虑量表、自评抑郁量表和社会支持评定量表。结果收回有效问卷13177份,公务员、科技人员、企事业管理人员、教师和体力劳动者5类职业人群的状态焦虑得分分别为39.91±10.58分、40.67±10.00分、40.98±10.21分、43.08±10.29分和41.82±9.89分,教师的得分最高,公务员的最低,平均得分为41.30±10.25分;5类职业人群的自评抑郁得分分别为39.63±9.04分、39.16±8.76分、39.83±8.58分、40.86±8.54分和41.08±8.47分,体力劳动者的抑郁得分最高,科技人员的最低,平均得分为40.14±8.71分,处于无抑郁、轻度抑郁、中至重度抑郁和重度抑郁状态的人分别占49.30％、25.60％、23.52％和1.58％;5类职业人群的社会支持得分分别为42.32±7.72分、40.87±8.62分、40.58±8.09分、41.45±7.45分和40.18±7.85分,平均得分为40.95±7.77分。调查对象的状态焦虑得分与自评抑郁得分的相关系数为0.72（P〈0.01）,两者与社会支持得分的相关系数分别为-0.33和-0.32（P〈0.01）。结论我国职业人群的焦虑和抑郁状况较为严重,而良好的社会支持有助于职业人群的心理健康。职业人群的社会支持来源需要增加,对他们的心理疏导亟待加强。     

北京市5类职业人群心理健康及社会支持状况调查

目的了解北京市5类职业人群的心理健康状况及社会支持状况,为制定相关健康教育措施提供科学依据。方法采用分层抽样方法,抽取公务员、科技人员、企事业管理人员、教师、体力劳动者5类职业人群进行问卷调查。调查工具为《状态焦虑量表》、《自评抑郁量表》和《社会支持评定量表》。结果收回有效问卷2136份,5类职业人群的状态焦虑平均得分为40.19±10.44分,公务员、科技人员、企业管理人员、教师和体力劳动者得分分别为38.41±11.53分、40.55±9.94分、41.31±9.58分、42.64±10.67分和38.04±9.70分,教师得分最高,体力劳动者最低;5类职业人群的自评抑郁的平均得分为45.98±4.94分,各职业得分分别为45.51±5.28分、45.99±4.81分、46.29±4.85分、46.63±5.12分和45.54±4.57分,教师的抑郁得分最高,公务员的最低,处于无抑郁、轻度抑郁、中至重度抑郁和重度抑郁状态的人分别占10.7%、48.1%、39.0%和2.2%;5类职业人群的社会支持平均得分为40.39±8.24分,各职业得分分别为42.96±8.40分、38.81±8.12分、38.81±7.79分、39.75±8.14分和41.58±7.97分。被调查对象的状态焦虑得分与自评抑郁得分的相关系数为0.630(P<0.01),两者与社会支持总得分的相关系数分别为-0.319和-0.285(P<0.01)。结论北京市职业人群中焦虑和抑郁状况较为严重,尤其在教师这一职业。今后应加强对职业人群的心理健康教育,为其提供更多的社会支持渠道,以减轻其心理压力。     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.     

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.     

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.