山东省中小学生麻疹爆发原因的病例对照研究

为探讨山东省中小学生麻疹爆发的原因 ,采用 1∶2配比的病例对照方法对中小学生麻疹疫苗 (MV)效力进行了研究 ,同时对近年来中小学生MV接种率进行了估算。结果显示 :中小学生MV效力为 74 % ,95 %可信区间为4 7%～ 88% ;小学生MV效力明显高于中学生 ,分别为 82 %和 6 8% ;1999～ 2 0 0 1年学龄儿童的估算接种率分别为75 4 %、75 6 %和 5 5 7%。较低的MV效力和接种率是计划免疫工作薄弱地区中小学生麻疹爆发的主要原因。     

麻疹发病与麻疹疫苗接种的病例对照研究

目的探讨甘肃省部份地区发生麻疹爆发或流行的原因,分析麻疹减毒活疫苗(MV)效力与麻疹发病之间的关系。方法选择4个县进行1∶1配对病例对照研究。结果共调查病例和对照各358人,病例中<7岁儿童占27.65%,7~14岁占66.48%,平均年龄8.62岁。病例组MV接种率36.87%,对照组MV接种率89.94%;接种MV后≥5年发病者占68.94%,7~9岁发病儿童距接种MV≥5年的占74.47%。1∶1配对病例对照研究计算,接种MV与麻疹发病的比值比95%可信区间为0.028~0.079,MV效力95%可信区间为92.1%~97.2%。结论甘肃省部份地区发生麻疹爆发或流行的主要原因是MV接种率过低,存在免疫空白。提高MV接种率,缩短MV 2针接种间隔时间,适时开展MV强化免疫可有效控制麻疹。     

德州市1999～2002年麻疹控制与监测分析

为了解德州市麻疹流行病学特点和麻疹监测系统运行状况 ,对 1999～ 2 0 0 2年麻疹监测的数据进行了分析。结果显示 :4年共报告麻疹疑似病例 2 6 4例 ,比常规传染病报告系统多出 138% ,确诊麻疹 12 3例 ,及时报告、及时调查和血清标本采集率分别达到 10 0 %、10 0 %、99%。麻疹发病呈散发和爆发并存的流行病学模式 ,爆发病例占总发病数的 5 1%。麻疹散发以学龄前儿童和成年人为主 ,爆发病例以学龄儿童为主。确诊病例中有麻疹疫苗 (MV)免疫史者占 32 5 2 % ,无免疫史者占 19 5 1% ,免疫史不详者占 4 7 97%。 3年麻疹监测报告的及时性、完整性和病例调查的完整性均达到 10 0 %。发病主要原因是MV接种率低和免疫失败。应在提高常规免疫接种率和接种质量的同时 ,要抓好大年龄儿童的MV强化免疫 ,进一步提高人群的免疫水平 ,预防控制麻疹爆发。     

陕西省2000～2002年麻疹流行病学分析及控制策略探讨

为了解陕西省麻疹流行状况 ,以加速控制麻疹 ,对陕西省 2 0 0 0～ 2 0 0 2年麻疹发病资料进行流行病学分析。结果显示 :陕西省 2 0 0 0～ 2 0 0 2年麻疹年平均发病率比 1997～ 1999年上升了 6 5 7%。病例分布广泛 ,流行模式为爆发和散发并存 ,局部麻疹爆发影响着全省的麻疹发病水平。 3～ 6月为麻疹高发季节 ,0～ 2岁和 6～ 8岁为麻疹高发年龄组。对麻疹病例的免疫史分析表明 ,2 5 %的麻疹病例未接种麻疹疫苗 (MV) ,2 4 %的病例免疫史不详。报告病例的年龄和免疫史状况说明 ,MV的初种和复种需加强 ,同时要在全省范围开展一定年龄组儿童的MV强化免疫 ,调整现行MV的免疫程序 ,健全麻疹监测系统。     

学龄儿童麻疹疫苗效力和接种率研究

为探讨安徽省学龄儿童麻疹爆发原因和预防麻疹爆发,运用1∶2匹配的病例对照方法研究学龄儿童麻疹疫苗(MV)的效力.在经实验室确诊的麻疹爆发中,选6～15岁的学生患者为对象,其同年出生、同班或邻居而又未患过麻疹的学生为对照.共调查了156例麻疹患者,309名对照.以预防接种卡/证MV记录统计,学龄儿童中1剂次MV效力估计为65%,95%的可信区间(CI)为38%～81%;2剂次MV效力估计为78%,95%CI为43%～92%;≥1剂次MV效力估计为69%,95%CI为45%～83%.学龄儿童性别、居住地和年龄对MV效力有影响,男性、农村及≥10岁学生MV效力较低.学龄儿童≥1剂次MV估计接种率＜70%,2剂次MV接种率＜50%.学龄儿童中较低的MV效力和/或较低的MV接种率是麻疹爆发的主要原因.提高和维持高水平2剂次MV接种率是预防麻疹爆发的关键,在学龄儿童中应开展MV强化免疫活动.     

安徽省2000～2001年麻疹爆发的原因分析

为探讨安徽省麻疹爆发的原因,将麻疹控制在较低水平,采用1∶2匹配的病例对照方法研究麻疹疫苗(MV)的效力.2000～2001年安徽省麻疹爆发病例数平均占病例总数的62%,爆发病例主要集中在7～14岁儿童,其构成占70%以上.调查156例麻疹,309名对照,MV的效力为68%(95%可信区间为50%～86%).发生麻疹爆发到报告疫情时间为6～49d.中小学生中MV效力较低和疫情报告不及时是发生麻疹爆发的主要原因.有必要在中小学生中开展1次MV接种工作.提高麻疹监测系统的灵敏性.     

浙江省2001～2003年麻疹流行病学分析

目的　了解浙江省麻疹流行病学特征 ,探讨加速控制麻疹的策略。方法　对 2 0 0 1～ 2 0 0 3年麻疹发病情况进行描述性流行病学分析。结果　浙江省 2 0 0 1～ 2 0 0 3年麻疹年平均发病率高于 1 998～ 2 0 0 0年。病例分布广泛 ,散发和局部爆发并存 ,个别高发县影响全省麻疹发病水平。 3～ 6月为麻疹高发季节 ,≤ 2岁和 6～ 8岁为麻疹高发年龄组。对麻疹病例的免疫史分析表明 ,<1 5岁的病例 2 9.8%未接种麻疹疫苗 (MV) ,2 9 .9%免疫史不详。结论　根据报告病例的年龄和免疫史状况表明 ,MV的常规免疫仍需加强 ,同时要考虑对大年龄组人群接种MV ,继续加强麻疹监测     

广西壮族自治区2000～2006年麻疹流行病学分析

目的 了解广西壮族自治区麻疹流行病学特征,为消除麻疹提供依据.方法 采用描述流行病学方法分析广西壮族自治区2000～2006年麻疹监测资料.结果 广西壮族自治区2000～2006年麻疹年平均发病率为6.50/10万(1.81/10万～13.32/10万).3～6月发病数占全年的55.24%.男女性别比为1.34:1.<15岁病例占81.73%,爆发病例占29.90%.8月龄～14岁病例无麻疹减毒活疫苗(MV)免疫史的占33.32%,有1剂免疫史的占29.75%,≥2剂免疫史的占6.38%,免疫史不详的占30.56%.结论 MV接种率低是造成麻疹发病的主要原因.提高MV常规免疫接种率,加强局部地区麻疹疫情控制,是广西壮族自治区控制麻疹亟需解决的问题.     

马关县苗族村寨麻疹爆发的调查

目的了解云南省马关县苗族村寨2005年10月16日~11月12日麻疹爆发的原因。方法对麻疹疫情进行流行病学调查分析,收集患者急性期鼻咽拭子和尿标本,分离麻疹病毒;采集现症病例和未发病人群血清标本,用酶联免疫吸附试验检测抗体。结果119例麻疹分布于4个村。年龄最小的8月龄,最大32岁,0~13岁占84.87%。现症病人63.16%无麻疹减毒活疫苗(MV)免疫史,31.58%免疫史不详。疫区301名儿童MV接种率88.37%,疫苗效力88.79%,麻疹感染人群中62%有接触史。患者血清标本麻疹IgM抗体阳性率59.09%,未发病人群血清标本麻疹IgG抗体阳性率61.76%。分离到麻疹病毒4株,基因型为H1。结论马关县苗族村寨发生的经血清学和病毒学检测证实的麻疹疫情,由于卫生院报告疫情滞后,部分村寨存在免疫空白,MV接种不落实导致爆发。麻疹感染者作为传染源应引起重视。     

浙江省1999年麻疹暴发疫情特征分析

浙江省 1999年麻疹监测系统报告 10起麻疹暴发疫情 ,发病 475例 ,无死亡。农村和学校为主要发生地 ;最高罹患率171 6 0‰ ,同时存在城区流动人口聚集地的麻疹暴发 ,但是发病强度偏低 ;发病时间主要分布在 1～ 6月和 10月 ;暴发病例中有明确麻疹疫苗 (MV)接种史的占 13 1% ,无MV接种史的占 2 8 2 % ,MV接种史不详的占 5 8 7% ;<14岁儿童病例数占总病例数的91 1%。对于学校和城区型暴发 ,应急免疫措施效果相对较好。建议在切实提高常规免疫接种率的同时 ,对持续有麻疹暴发和计划免疫工作薄弱地区采取MV的强化免疫     

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.