垃圾焚烧区周边居民血浆中细胞因子的表达水平及其影响因素

[目的]探讨垃圾焚烧区周边居民外周血中细胞色素P450 1A1（CYP1A1）基因mRNA表达水平和血浆中细胞因子白介素（IL）-6、IL-17A、IL-17F、IL-21、IL-23的表达水平。[方法]选择居住社区位于垃圾焚烧厂烟囱下风向〈10 km范围内某社区的男性居民42名为暴露组;居住区距垃圾焚烧区＞10 km且无明显环境接触垃圾焚烧污染物的44名男性居民为对照组。采用半定量逆转录-聚合酶链反应检测研究对象外周血中CYP1A1基因mRNA相对表达水平;Bio-PlexTM悬液芯片测定研究对象血浆中IL-6、IL-17A、IL-17F、IL-21、IL-23细胞因子的浓度。[结果]暴露组人群外周血CYP1A1基因mRNA相对表达水平高于对照组人群的平均水平（P〈0.05）。暴露组人群血浆中细胞因子IL-17F、IL-21、IL-23的浓度均高于对照组（P〈0.05）。细胞因子IL-17F、IL-21、IL-23的浓度经自然对数转换后分别与暴露、年龄、体质指数等因素做多元线性回归分析,发现暴露与IL-17F、IL-23表达水平的升高有关（P〈0.05）。[结论]暴露组人群外周血CYP1A1基因mRNA表达水平高于对照组人群的平均水平,且两组人群血浆中IL-17F、IL-23的表达水平亦有差异。     

深圳市酒店公共场所从业人员健康状况调查分析

目的由于公共场所的卫生学特点,存在着危害健康的不利因素,影响从业人员的身体健康。本研究对酒店公共场所从业人员的健康状况进行调查分析,旨在提高从业人员的自我保护意识。方法选取2016-2017年深圳市区144家酒店住宿场所,并对其从业人员发放调查问卷,问卷内容主要包括从业人员个人基本情况、卫生知识知晓情况、采取的防护措施及健康状况等。结果共发放问卷760份,收回754份,回收率99.2%。不同性别从业人员工作期间,眼部症状(χ~2=0.365,P=0.546)、呼吸系统症状(χ~2=0.865,P=0.352)、皮肤症状(χ~2=0.390,P=0.532)及其他症状(χ~2=1.069,P=0.301)发生率,差异均无统计学意义。不同工龄从业人员,呼吸系统症状发生率差异有统计学意义,χ~2=13.157,P=0.004;眼部症状、皮肤症状和其他症状发生率,差异均无统计学意义,均P0.05。不同性别从业人员,使用防护用品方面差异无统计学意义,χ~2=3.144,P=0.076;使用洗手液或肥皂洗手(χ~2=7.082,P=0.008)、关注工作场所健康影响(χ~2=9.531,P=0.002)及获得工作场所健康知识(χ~2=5.182,P=0.023)方面,差异有统计学意义。不同工龄从业人员对个人防护及认知情况,差异均无统计学意义,均P0.05。结论酒店公共场所从业人员不良症状有一定的发生率,应当加强对公共场所卫生的监督管理;同时要加强从业人员的健康教育,提高其自我保护意识。     

湘江流域土壤高镉地区人群肾损伤调查

目的调查湘江流域土壤高镉地区人群肾健康状况,探索尿镉水平与肾损伤生物标志物的关系。方法采用横断面研究,选择湘江流域某土壤高镉地区常住居民作为暴露组,土壤镉较低地区常住居民为对照组,通过问卷调查收集研究对象基本情况和重金属接触典型症状情况,采集尿液并检测尿中镉和NAG、β_2-MG水平。结果暴露组尿镉水平中位数为5.36μg/g Cr,高于对照组(2.66μg/g Cr)(P0.001),且暴露组尿镉水平随着年龄的增加呈升高趋势(P0.05)。人群肾损伤生物标志物检测结果显示暴露组尿NAG活力中位数为10.62 U/g Cr,高于对照组(8.11 U/g Cr)(P0.05),两组人群尿β_2-MG水平的差异无统计学意义(P0.05)。暴露组与对照组人群重金属接触典型症状发生率之间的差异无统计学意义(P0.05)。尿NAG和尿β_2-MG异常率随尿镉水平的升高而升高(P趋势0.05)。相关分析结果显示尿镉水平与尿NAG活力、尿β_2-MG水平及年龄之间均存在正相关关系(P0.05)。多重线性回归分析结果显示,尿镉水平的变化仅可显著影响尿NAG活力(B=0.466,P0.001);而尿β_2-MG水平的变化受到年龄的影响较大(B=0.008,P0.05)。结论长期环境土壤镉暴露将造成人群肾损伤,湘江流域土壤高镉地区人群肾肾功能损伤存在一定风险。     

尘肺病患者抑郁状态自评及影响因素调查研究

目的探讨尘肺病患者抑郁状态自评及其影响因素,为制定该人群心理干预方案提供参考。方法采用SPS抽样方法选取2011-2014年确诊的63名尘肺病患者者设为尘肺病组,选取65例接触粉尘工龄5年,无职业性尘肺病的接尘者为对照组。两组对象统一发放调查表,调查了解并比较两组对象的人口学特征、职业史、个人生活方式及尘肺病诊断期别、呼吸系统症状、抑郁评分,分析该类人群抑郁状态及影响因素。两组间比较计量资料采用t检验,计数资料采用χ2检验,并采取协方差分析消除混杂因素影响,组内比较采用方差分析,两两比较采用q检验,尘肺病抑郁影响因素在单因素分析的基础上再用非条件logistic回归作多因素分析,P0.05为差异有统计学意义。结果两组吸烟指数、工龄、呼吸系统症状、诊断期别、抑郁评分比较差异有统计学意义(t=3.254,t=1.363,χ2=0.291,0.214,χ2=1.343,1.237,1.351,t=3.212,P0.05);尘肺组组内抑郁评分比较,壹期、贰期、叁期患者抑郁评分随着诊断期别的增高而增高,3组比较差异有统计学意义(F=3.170,P0.05);叁期患者的评分与壹期患者比较(q=4.163,P0.05),叁期患者的评分与贰期患者比较差异有统计学意义(q=4.182,P0.05),壹期、贰期患者比较差异有统计学意义(q=4.632,P0.05);3种及3种以上呼吸系统症状者评分与3种以内呼吸系统症状者比较差异有统计学意义(F=1.313,P0.05)。非条件logistic多因素回归分析显示,尘肺诊断期别、呼吸系统症状是影响尘肺病患者抑郁自评的因素(OR=2.549,95%CI=1.415~4.519;OR=1.037,95%CI=1.010~1.012)。结论尘肺诊断期别、呼吸系统症状是影响尘肺病患者抑郁自评的因素,因此,在心理干预中应结合患者期别和症状进行个体化干预和心理疏导。     

北京市丰台区公共场所集中空调对从业人员健康的影响

目的了解北京市丰台区公共场所集中空调对场所内从业人员的健康影响。方法选择北京市丰台区使用集中空调的18家宾馆饭店和商场超市内的703名从业人员作为暴露人群,9家不使用集中空调的宾馆饭店和商场超市内的447名从业人员作为对照人群,于2012年11—12月对以上人员进行健康状况问卷调查及血样采集,检测血清免疫球蛋白IgA、IgG、IgM、IgE水平。结果暴露组人群最近1年平均感冒次数[(1.7±1.6)次]高于对照组[(1.4±1.2)次],最近1个月上班时间的眼部、呼吸系统、皮肤、神经系统等不适症状发生率高于对照组,差异均有统计学意义(P0.05)。暴露组人群血清IgA、IgG、IgM、IgE水平高于对照组,差异均有统计学意义(P0.05)。多元线性回归分析结果显示,公共场所使用集中空调可能是人群血清免疫球蛋白水平的影响因素,与对照组相比,暴露组人群的血清IgA、IgG、IgM、IgE平均升高0.19、1.3、0.07 g/L和44 IU/ml,差异有统计学意义(P0.05)。结论公共场所使用集中空调可能对场所内从业人员免疫水平及相关症状产生一定影响,应加强卫生管理及监测。     

高压输电线周边居民神经系统症状及血液系统的横断面研究

目的 研究高压输电线电磁场暴露对神经系统症状的影响.方法 以高压输电线周边居住的居民为调查对象,并根据距离高压输电线20、100、500 m分为3组;采用面对面问卷调查方式对居民生活情况、健康状况进行调查研究,同时测定研究对象的白细胞数(WBC)、红细胞数(RBC)、血红蛋白量(HGB)、血小板数(PLT)、IgG和IgM等水平.结果 在居民日常生活习惯,如吸烟、饮酒上,不同距离组间的差异无统计学意义(P＞0.05).比较不同距离组间健康调查的结果显示,离高压输变电线不同距离,居民头痛或头晕、失眠和乏力易疲劳等神经系统症状发生率差异有统计学意义(P＜0.05).血液学检查显示,居民PLT水平随着离高压输电线水平距离的减少而下降,且差异有统计学意义(P＜0.001),而各组间居民的WBC、RBC、HGB、IgG和IgM的差异均无统计学意义(P＞0.05).结论 近距离暴露电磁场可能与头痛等神经系统症状发生率和PLT水平降低有关.     

上海市闵行区公共场所集中空调对从业人员健康状况影响分析

目的了解上海市闵行区公共场所集中空调对场所内从业人员的健康影响。方法以上海市闵行区使用集中空调的7家宾馆饭店和候车室内的276名从业人员作为暴露人群,13家不使用集中空调的宾馆饭店、候车室内的356名从业人员作为对照人群,于2017年7—9月对以上人员进行健康状况问卷调查。结果暴露组人群最近1个月上班时间的眼部、呼吸系统及皮肤等不适症状发生率均高于对照组,差异均有统计学意义(P0.01)。多元Logistic回归分析显示,集中空调暴露、女性、高文化程度和高家庭总收入是从业人员出现不适症状的危险因素,佩戴或使用防护用品是从业人员出现不适症状的保护因素(P0.05)。结论公共场所使用集中空调可能对场所内从业人员健康相关症状产生一定影响,应加强卫生管理及监测。     

空气细颗粒物对交通警察肺通气功能及呼吸道症状的影响

目的 研究空气细颗粒物(PM2.5)暴露对交通警察呼吸道症状及肺通气功能的影响.方法 使用个体采样器测定上海市区107名男性外勤交通警察(高暴露组)及101名居民(一般暴露组)PM2.5的暴露情况,问卷调查获得交通警察和居民的基本情况、呼吸道症状,测定用力呼气肺活量(FVC)、第1秒用力呼气容积(FEV1.0)、FEV1.0/FVC%和最大呼出流速(PEF).比较交通警察和居民PM2.5暴露及呼吸道症状、肺通气功能的差异,对交通警察按工龄分组,研究工龄对肺通气功能的影响,并对肺通气功能降低与颗粒物暴露水平的进行相关分析.结果 交通警察和居民细颗粒物24 h个体平均暴露浓度为分别(115.4±46.17)和(74.94±40.09)μg/m3,高暴露组PM2.5暴露水平明显高于一般暴露组,差异有统计学意义(P＜0.01).高暴露组咳嗽、咳痰、咽部不适及气喘、气短和鼻部不适的发生率明显高于一般暴露组,差异有统计学意义(P＜0.05,P＜0.01),高暴露组肺通气功能指标FVC实测/FVC预计%和FEV 1.0实测/FEV1.0预计%的异常率分别为25.23%和12.15%,一般暴露组FVC实测/FVC预计%和FEV1.0实测/FEV1.0预计%的异常率分别为11.88%和2.97%,两组比较,差异有统计学意义(P＜0.05,P＜0.01),且高暴露组FVC实测/FVC预计%、FEV1.0实测/FEV1.0预计%异常率随工龄延长呈现升高的趋势.结论 长期暴露于较高水平的PM2.5会危害人体呼吸系统健康,导致呼吸道症状增多,降低肺通气功能.     

兰州市城关区大气污染对儿童呼吸系统疾病和症状的影响

目的了解兰州市城关区大气污染对儿童呼吸系统疾病和症状的影响。方法于2013年9—11月,采用随机整群抽样的方法抽取兰州市城关区和榆中县的2 016名学龄期儿童(城关区1 087名,榆中县929名)为研究对象,采用美国流行病学标准问卷(ATS-DLD-78-C)进行呼吸系统疾病和症状发生情况调查。结果 2013年城关区大气SO2、NO2、PM2.5、PM10日均浓度均高于榆中县,差异有统计学意义(P0.05)。城关区儿童感冒时咳嗽、不感冒时咳嗽、感冒时咯痰、不感冒时咯痰、鼻炎、支气管炎、肺炎、哮喘等8种呼吸系统疾病和症状的发病危险性分别是榆中县的1.563、1.606、2.055、1.849、2.786、2.514、1.976、2.599倍,均有统计学意义(P0.05)。采用多因素logistic回归分析调整年龄、厨房燃料、冬季采暖方式等混杂因素后,与榆中县比较,城关区儿童感冒时咳嗽、不感冒时咳嗽、感冒时咯痰、鼻炎、支气管炎、肺炎等疾病和症状发生的危险性均较高,OR值(95%CI)分别为1.571(1.273~1.938),1.568(1.028~2.391),2.026(1.580~2.597),2.136(1.430~3.192),2.142(1.463~3.136),1.741(1.190~2.548),均有统计学意义(P0.05)。结论城关区儿童部分呼吸系统疾病和症状发生率高于榆中县,可能与城关区大气污染有关。     

2016-2019年青川县60岁及以上常住居民结核病主动发现效果分析

目的 通过对2016-2019年青川县常住6个月以上60岁及以上居民开展入户面对面结核病可疑症状筛查及后续检测诊断,了解主动发现在老年人群的结核病防控中的实践意义。方法 在2016-2019年组织经过培训的工作人员对青川县常住6个月以上60岁及以上居民开展入户面对面结核病可疑症状筛查,对发现肺结核可疑症状者推荐到乡镇中心卫生院进行胸部X线摄片检查,收集痰标本进行痰涂片与痰培养检查并确诊,比较主动发现与被动发现患者的年龄、性别、职业和菌阳率等情况,分析患者的特征。率的比较采用χ~2检验及χ~2_(趋势)检验,以P0.05为差异有统计学意义。结果 2016-2019年期间共计完成60岁及以上人群结核病症状筛查95 202人次,发现结核病可疑症状者5 970人(6.27%,5 970/95 202);其中男性可疑症状发生率(7.99%)高于女性可疑症状发生率(3.79%)(P0.05);农民可疑症状发生率(6.77%)高于非农民可疑症状发生率(3.14%)(P0.05);可疑症状发生率随年龄的增长而增长(χ~2_(趋势)=999.25,P0.001)。后续确诊活动性结核病患者176例,可疑症状者活动性肺结核检出率为2.95%(176/5 970),其中不同性别、职业人群的检出率差异无统计学意义(P0.05);不同年龄组结核病可疑症状者中的检出率差异有统计学意义(P0.05),且检出率随年龄的增长而降低(χ~2_(趋势)=13.33,P0.001)。主动与被动两种发现方式下患者的年龄分布与痰菌检出结果差异有统计学意义(P0.05),职业与性别构成差异无统计学意义(P0.05)。结论 在贫困地区为60岁及以上老年人群开展结核病主动筛查,能够早期发现活动性结核病患者,提高老年结核病患者发现率。     

The World Trade Center residents' respiratory health study: new-onset respiratory symptoms and pulmonary function

The destruction of the World Trade Center (WTC) on 11 September 2001 in New York City resulted in the massive release of pulverized dust and combustion products. The dust and smoke settled in the surrounding area, which encompassed a large residential community. We hypothesized that previously normal residents in the community surrounding the former WTC would have an increased incidence of persistent respiratory symptoms and abnormalities in screening spirometry. A hybrid cross-sectional and retrospective cohort study using a symptom-based questionnaire and onsite screening spirometry in residents in an exposed area and in a control area was performed 12 +/- 4 months after the collapse. Surveys were analyzed from 2,812 residents. New-onset respiratory symptoms were described by 55.8% of residents in the exposed area, compared with 20.1% in the control area after the event. Persistent new-onset symptoms were identified in 26.4 versus 7.5% of residents in the exposed area versus control area, respectively. No differences in screening spirometry between the groups were detected. A small pilot study suggested the possibility of an increase in bronchial hyperresponsiveness in exposed participants with persistent symptoms. The data demonstrate an increased rate of new-onset and persistent respiratory health effects in residents near the former WTC compared with a control population.     

Effects of water-damaged homes after flooding: health status of the residents and the environmental risk factors

We evaluated the health status of residents and the environmental risk factors of housing after flooding. Questionnaires were distributed to 595 selected households (one adult resident per household) in six areas in Japan which were severely flooded between 2004 and 2010. A total of 379 responses were obtained. Indoor dampness and visible mold growth significantly increased in homes with greater flood damage. The incidence of respiratory, dermal, ocular, and nasal symptoms one week after flooding was significantly higher in flooded homes compared with non-flooded homes, the incidence of psychological disorders was significantly high for six months after flooding, and the incidence of post-traumatic stress disorder was significantly high six months after flooding. Significant risk factors for respiratory and nasal symptoms included proximity to industrial and waste incineration plants. Our results suggest that rapid action should be taken after flooding to ensure adequate public health and environmental hygiene in the water-damaged homes.     

Comparison of respiratory symptoms among community residents near waste disposal incinerators

A previous survey found that residents near a hazardous waste incinerator reported more respiratory symptoms than residents of a nearby community. To explore the possibility that these findings might have been due to the use of a rural control site, far removed from urban pollution, we expanded the analysis to include reports of respiratory symptoms from residents of six additional communities. Residents of each of four study communities were exposed to the plumes of biomedical, municipal or hazardous waste combustors. For each study community, a comparison community was surveyed that was distant from major point sources of air pollution. Over 4200 respondents were queried by telephone about respiratory symptoms, smoking and other risk factors such as chemical exposures in the workplace and home, and provided a subjective assessment of air quality in their neighborhoods. Differences in symptom prevalence between each study community and its respective control community, as well as a combined control group, were explored, controlling for factors other than community exposure that may affect respiratory health. Results indicate a higher prevalence of all self-reported respiratory symptoms in one community near a hazardous waste incinerator compared with its control community. While this relationship persisted after controlling for perceived air quality and when compared with a combined control group, only respiratory symptoms of long duration remained significant. These results suggest that further examination of the respiratory health of residents living near this waste combustor source is warranted.     

新型冠状病毒肺炎相关急性呼吸道感染及就诊情况调查

目的了解我国新型冠状病毒肺炎(新冠肺炎)流行期间,人群急性呼吸道感染(ARI)的患病和就诊情况。方法根据截至2020年3月31日各省(市)新冠肺炎病例累计报告发病率,将各省(市)划分为高、中、低流行地区,采用分层两阶段整群随机抽样方法抽取社区人群进行面对面问卷调查。收集新冠肺炎流行期间社区人群新冠肺炎相关ARI的患病和就诊资料,计算新冠肺炎相关ARI罹患率和就诊比例,采用非条件logistic回归分析社区人群新冠肺炎相关ARI患病和就诊的影响因素。结果共调查34857名社区居民,647名(1.9%)调查对象自报在新冠肺炎流行期间出现过新冠肺炎相关ARI,其中241名(37.2%)患者曾前往医疗机构就诊。从新冠肺炎相关ARI患病情况来看,在高流行地区,罹患新冠肺炎相关ARI的风险是低流行地区的1.36倍(95%CI:1.12~1.65);在不同年龄组中,20~39岁、≥60岁组罹患新冠肺炎相关ARI的风险分别是1~9岁组的1.80倍(95%CI:1.29~2.59)、1.63倍(95%CI:1.14~2.40);有基础疾病史罹患新冠肺炎相关ARI的风险是无基础疾病史的1.53倍(95%CI:1.23~1.89);有新冠肺炎确诊病例、发热或呼吸道症状者接触史的人群罹患新冠肺炎相关ARI的风险分别是无接触史的1.53倍(95%CI:1.01~2.27)、6.60倍(95%CI:5.05~8.53)。有发热或呼吸道症状者接触史的新冠肺炎相关ARI患者就诊的比例是无接触史的1.68倍(95%CI:1.05~2.70)。结论新冠肺炎相关ARI的罹患率受该地区的新冠肺炎流行水平高低的影响,新冠肺炎高流行地区新冠肺炎相关ARI罹患率也高。然而我国新冠肺炎相关ARI患者发病后就诊的比例较低。因此,在新冠疫情流行期间,应加强卫生服务利用宣传,积极提高人群ARI等疾病的就诊意识。     

The UCLA population studies of chronic obstructive respiratory disease. I. Methodology and comparison of lung function in areas of high and low pollution.

The prevalence of symptoms of chronic obstructive respiratory disease and of functional respiratory impairment was determined in 3465 residents (70 per cent of enumerated) of an area historically exposed to photochemical/oxidant pollutants and 4509 residents (79 per cent of enumerated) of an area exposed to low levels of chemical pollutants. Tests administered included the NHLI questionnaire, electronic volume spirometry, whole body plethysmography, and the single-breath nitrogen test (deltaN2750-1250 and closing volume). Cough and cough with sputum were more frequently reported in the low-pollution area. Lung function was better among residents of the low-pollution area according to FEV1, FVC, maximal expiratory flow rates, closing volume fraction, thoracic gas volume, and airway resistance. Maximal mid-expiratory flow rate, considered to be a sensitive spirometric test for detection of small airways disease, was similar in residents of both areas. Mean deltaN2750-1250 was slightly worse among residents of the low-pollution area. Findings suggest that adverse effects of long-term exposure to photochemical/oxidant pollutants may occur primarily in the larger airways both among smokers and never smokers. The greatest differences between areas were observed in residents 18-59 years of age, suggesting that long-term exposure may be required to cause measurable impairment and that these differnces may be obliterated by such factors as smoking, differential out-migration and differential survival.     

北京市某垃圾焚烧厂周边大气二噁英污染特征及暴露风险

  目的   基于北京某垃圾焚烧厂的二噁英排放数据,评估其周边居民通过不同暴露途径面临的健康风险。  方法   参考美国加州热点计划,采用AERMOD模型,模拟北京某垃圾焚烧厂排放二噁英在大气中的扩散情况;借助多介质扩散模型,模拟二噁英在不同环境介质中的扩散情况;计算垃圾焚烧厂周边居民通过不同暴露途径的二噁英摄入量,评估人群终身致癌风险。  结果   在垃圾焚烧厂周边最大落地点浓度处,居民通过呼吸、皮肤接触、泥土摄入和母乳喂养等途径面临的终身致癌风险为5.28 × 10^–7;当居民饮用水来自于5大水库,饮食取自垃圾焚烧厂周边蔬菜基地、养殖场和水库时,所面临的终身致癌风险为1.77 × 10^–8。  结论   该垃圾焚烧厂在现有排放状况下,其周边居民面临的健康风险在充分安全边际内,其中呼吸和母乳喂养是最主要的暴露途径。     

Health effects on nearby residents of a wood treatment plant

OBJECTIVES: The aim of the study was to evaluate the health status of nearby residents of a wood treatment plant who had sustained prolonged low-level environmental exposure to wood processing waste chemicals. METHODS: A population of 1269 exposed residents who were plaintiffs or potential plaintiffs in a lawsuit against the wood treatment plant were evaluated by questionnaire for a health history and symptoms. A representative sample of 214 exposed subjects was included in the analysis. One hundred thirty-nine controls were selected from 479 unexposed volunteers and matched to the exposed subjects as closely as possible by gender and age. Subjects and controls completed additional questionnaires and were evaluated by a physician for medical history and physical examination, blood and urine testing, neurophysiological and neuropsychological studies, and respiratory testing. Environmental sampling for wood processing waste chemicals was carried out on soil and drainage ditch sediment in the exposed neighborhood. RESULTS: The exposed subjects had significantly more cancer, respiratory, skin, and neurological health problems than the controls. The subjective responses on questionnaires and by physician histories revealed that the residents had a significantly greater prevalence of mucous membrane irritation, and skin and neurological symptoms, as well as cancer. (Exposed versus unexposed, cancer 10.0% versus 2.08%, bronchitis 17.8% versus 5.8%, and asthma by history 40.5% versus 11.0%) There were significantly more neurophysiologic abnormalities in adults of reaction time, trails A and B, and visual field defects. CONCLUSIONS: Adverse health effects were significantly more prevalent in long-term residents near a wood treatment plant than in controls. The results of this study suggest that plant emissions from wood treatment facilities should be reduced.     

Upper respiratory symptoms and other health effects among residents living near the World Trade Center site after September 11, 2001

The authors investigated changes in respiratory health after September 11, 2001 ("9/11") among residents of the area near the World Trade Center (WTC) site in New York City as compared with residents of a control area. In 2002, self-administered questionnaires requesting information on the presence and persistence of respiratory symptoms, unplanned medical visits, and medication use were sent to 9,200 households (22.3% responded) within 1.5 km of the WTC site (affected area) and approximately 1,000 residences (23.3% responded) in Upper Manhattan, more than 9 km from the site (control area). Residents of the affected area reported higher rates of new-onset upper respiratory symptoms after 9/11 (cumulative incidence ratio = 2.22, 95% confidence interval (CI): 1.88, 2.63). Most of these symptoms persisted 1 year after 9/11 in the affected area. Previously healthy residents of the affected area had more respiratory-related unplanned medical visits (prevalence ratio = 1.73, 95% CI: 1.13, 2.64) and more new medication use (prevalence ratio = 2.89, 95% CI: 1.75, 4.76) after 9/11. Greater impacts on respiratory functional limitations were also found in the affected area. Although bias may have contributed to these increases, other analyses of WTC-related pollutants support their biologic plausibility. Further analyses are needed to examine whether these increases were related to environmental exposures and to monitor long-term health effects.     

Pesticides and respiratory symptoms among farmers

OBJECTIVE: Despite the intensive use of pesticides in agriculture there are few studies assessing the risk of respiratory conditions from this exposure. The study aimed at quantifying the prevalence of respiratory symptoms among farmers and evaluating its relationship with occupational use of pesticides and the prevalence of respiratory symptoms. METHODS: A cross-sectional study was conducted among 1,379 farmers from two municipalities of Southern Brazil in 1996. Frequency and type of chemical exposure and pesticide poisoning were recorded for both sexes. All subjects aged 15 years or older with at least 15 weekly hours of agricultural activity were interviewed. An adapted questionnaire developed by the American Thoracic Society was used for the assessment of respiratory symptoms. Multivariate logistic regression analysis was carried out. RESULTS: More than half (55%) of interviewees were male. The prevalence of asthma symptoms was 12% and chronic respiratory disease symptoms was 22%. Higher odds ratios for both asthma (OR=1.51; 95% CI: 1.07-2.14) and chronic respiratory disease (OR=1.34; 95% CI 1.00-1.81) symptoms were found in women. Logistic regression analysis identified associations between many forms of exposure to pesticides and increased respiratory symptoms. Occurrence of pesticide poisoning was associated with higher prevalence of asthma symptoms (OR=1.54; 95% CI: 1.04-2.58) and chronic respiratory disease symptoms (OR=1.57; 95% CI: 1.08-2.28). CONCLUSIONS: In spite of causality limitations, the study results provide evidence that farming exposure to pesticides is associated with higher prevalence of respiratory symptoms, especially when the exposure is above two days per month.     

Health effects of occupational exposures to vehicle emissions in Shanghai

The authors investigated the health effects of occupational exposures to vehicle emissions in 745 bus drivers, conductors, and taxi drivers, compared with 532 unexposed controls, in Shanghai. Logistic regression and general linear models were used to examine the relationship between exposure and respiratory illness. Results showed that the prevalences of some respiratory symptoms and chronic respiratory diseases were significantly higher (p < 0.05) in the exposed group than in the controls. The adjusted odds ratios for throat pain, phlegm, chronic rhinitis, and chronic pharyngitis were 1.95 (95% CI 1.55-2.46), 3.90 (95% CI 2.61-5.81), 1.96 (95% CI 1.11-3.46), and 4.19 (95% CI 2.49-7.06), respectively. Also, there were exposure time response relationships for the prevalences of phlegm and chronic respiratory disease. Pulmonary function and blood lead levels were not significantly correlated with exposure status. The results suggest that occupational exposure to vehicle emissions may induce detectable adverse health effects.