职业接触灭蚁药物人群的肝功能损伤

[目的]探讨职业性接触氯丹、含砷化合物灭蚁药物对作业人员肝功能水平的影响。[方法]对作业人员进行血清丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、γ-谷氨酰转移酶(γ-GT)、碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)、甘胆酸(CG)、氯丹和尿液砷水平进行了检测分析。并对工龄、吸烟、饮酒和体内毒物的浓度对肝功能各项指标的影响进行统计学分析。[结果]职业接触灭蚁药物使血清γ-GT、LDH和CG水平增高(P<0.05),并与接触工龄相关;饮酒能加重含砷和氯丹类灭蚁药物对职业人群肝脏的损伤作用(P<0.05),使血清γ-GT、LDH和CG水平显著增高,吸烟对接触含砷或氯丹类灭蚁药物的职业人群肝脏的损伤没有影响;血清γ-GT、LDH和CG水平均与血清氯丹和尿砷含量呈正相关。[结论]接触灭蚁药物能使职业人群肝功能水平明显损伤。     

灭蚁药物对职业人群肾功能损伤的研究

[目的]探讨职业性接触含氯丹、砷化合物的灭蚁药物对作业人员肾功能的影响。[方法]对作业人员进行血清中尿素氮(BUN)、肌酐(SCr)、白蛋白(Alb)、氯丹和尿中α_1-微球蛋白(α-_1-MG)、β_2-微球蛋白(β_2-MG)、视黄醇结合蛋白(RBP)、砷含量检测。并对工龄、吸烟、饮酒及体内氯丹、砷含量与肾功能各项指标的关系进行统计学分析。[结果]职业接触灭蚁药物使尿中α_1-MG、β_2-MG和RBP水平显著增高,并与接触工龄相关;饮酒能加重含砷和氯丹类灭蚁药物对职业人群肾脏的损伤作用,使尿中α_1-MG、β_2-MG和RBP水平显著增高,吸烟则无影响;尿中α_1-MG、β_2-MG和RBP水平均与血清氯丹和尿砷含量呈正相关。[结论]长期接触灭蚁药物对职业人群肾脏功能有一定损害。     

接触灭蚁药物对男工体内性激素水平的影响

为探讨职业性接触氯丹、含砷化合物灭蚁药物对作业人员男性性激素水平的影响,对作业人员血清中血清促滤泡成熟素(FSH)、促黄体生成素(LH)和睾酮(T)水平进行了检测分析,并对工龄、吸烟、饮酒和体内毒物的浓度对男性性激素水平各项指标的影响进行统计学分析。结果显示,职业接触灭蚁药物使血清中FSH、LH和T水平显著下降,并与工龄相关;吸烟、饮酒能加重含砷和氯丹类灭蚁药物对人体男性性激素水平的抑制作用,使FSH、LH和T水平显著下降;体内男性性激素水平FSH、LH和T与血清氯丹和尿砷含量呈负相关。提示职业性接触灭蚁药物能使体内男性性激素水平明显抑制。     

灭白蚁药物对人体脂质过氧化水平的影响

为探讨职业性接触氯丹、含砷化合物灭蚁药物对作业人员脂质过氧化水平的影响,对作业人员进行了血清中过氧化脂质代谢物(MDA)和红细胞超氧化物歧化酶(SOD)、谷胱甘肽氧化酶GSH-Px、血清氯丹和尿砷水平的检测分析,并对工龄、吸烟、饮酒和体内毒物的浓度对脂质过氧化各项指标水平的影响进行统计学分析。结果显示,职业接触灭蚁药物使作业人员血清中MDA增高、SOD、GSH-Px水平显著下降,并与工龄相关;吸烟、饮酒能加重灭蚁药物对人体脂质过氧化水平的影响,MDA与血清氯丹和尿砷含量呈正相关,SOD、GSH-Px的水平与血清氯丹和尿砷含量呈负相关。提示职业性接触灭蚁药物能使体内脂质过氧化反应明显增强。     

接触灭蚁药物对人体免疫功能的影响

采用美国Beckman公司生产的免疫化学系统ICS仪和PFG紫外定量法,对接触灭蚁药物人员进行了血清IgG、IgA、IgM、C3、C4、CRP、CIC检测,并对工龄、吸烟、饮酒和体内毒物的浓度对免疫水平的影响进行了分析。结果显示职业接触灭蚁药物使血清中IgG、IgA、IgM水平显著下降,但与工龄无关;吸烟、饮酒能加重含砷和氯丹类灭蚁药物对人体免疫水平的影响,使IgG、IgA、IgM水平显著降低;体内免疫球蛋白的水平与血清氯丹和尿砷含量呈负相关。提示职业性接触灭蚁药物能显著降低作业人员机体的免疫水平。     

职业接触灭蚁药物对人体淋巴细胞DNA的损伤作用

[目的]探讨职业性接触灭蚁药物氯丹、含砷化合物对作业人员外周血淋巴细胞DNA损伤水平的影响。 [方法]采用碱性单细胞凝胶电泳技术检测灭蚁药物作业工人外周血淋巴细胞的DNA损伤,研究灭蚁药物对职业接触人群的遗传毒性,观察指标包括DNA断裂分级(将DNA断裂损伤细胞按其损伤程度分级)及DNA彗星尾长(彗头末端到彗尾的长度)。并对工龄、吸烟、饮酒和体内毒物的浓度对外周血淋巴细胞DNA损伤水平各项指标的影响进行统计学分析。[结果]职业接触灭蚁药物工人外周血淋巴细胞DNA断裂程度及DNA彗星尾长两个指标,均明显高于对照组,差异有显著性(P<0．01),并与体内毒物水平、接触工龄有明显正相关关系,吸烟、饮酒能加重含氯丹、砷化合物对DNA的损伤水平。[结论] 职业性接触灭蚁药物可对职业工人外周血淋巴细胞DNA造成损伤,并存在遗传毒性。     

职业接触灭蚁药物对人体淋巴细胞染色体损伤的影响

目的 探讨职业性接触灭蚁药物作业人员外周血淋巴细胞染色体损伤效应的影响。方法对作业人员进行了外周血淋巴细胞染色体畸变率和姐妹染色单体互换（SCE）水平的检测。并对工龄、吸烟、饮酒和体内毒物的浓度对血淋巴细胞染色体畸变率和SCE水平的影响进行统计学分析。结果随工龄的增长血淋巴细胞染色体畸变率和SCE水平增高；吸烟、饮酒能加重含砷和氯丹类灭蚁药物对血淋巴细胞染色体的损伤，使畸变率和SCE水平显著增高；体内血清氯丹含量和与染色体畸变率、SCE水平呈正相关，而尿砷含量与染色体、SCE水平无相关关系。结论职业性接触灭蚁药物对作业人员外周血淋巴细胞遗传学效应存在着不同程度的损伤。     

血清心肌酶与脑脊液LDH及TNF-α对神经内科颅内感染患者的诊断分析

目的探讨血清心肌酶指标乳酸脱氢酶(LDH)、天门冬氨酸氨基转移酶(AST)、α-羟丁酸脱氢酶(α-HBDH)、肌酸肌酶同功酶(CK-MB)和肌酸肌酶(CK)及脑脊液LDH、肿瘤坏死因子α(TNF-α)水平对神经内科颅内感染患者的诊断价值。方法选取医院2014年2月-2017年2月神经内科收治的58例颅内感染患者为研究组,按照性别相同、年龄相差不超过2岁的原则选择同时期在同一科室住院的116例未发生颅内感染患者为对照组;分析两组患者血清心肌酶指标LDH、AST、CK-MB、α-HBDH、CK水平及脑脊液中TNF-α和LDH指标水平。结果研究组血清心肌酶指标LDH、AST、CK-MB、CK和α-HBDH水平及脑脊液LDH和TNF-α水平均高于对照组(P0.05);不同类型颅内感染患者血清LDH和CK水平及脑脊液LDH和TNF-α水平比较差异有统计学意义(P0.05),血清AST、CK-MB和α-HBDH水平比较差异无统计学意义。结论血清心肌酶及脑脊液中LDH、TNF-α可作为颅内感染诊断的重要指标,同时血清LDH和CK水平及脑脊液中LDH、TNF-α水平检测有助于鉴别颅内感染类别。     

电焊作业对工人心血管功能的影响

目的探讨电焊对男性作业工人心血管功能的影响。方法选择135名男性电焊工人及138名无职业接触的管理岗位人员(对照组)为对象,检测心电图和血压,测定尿锰含量和血清心肌酶谱:肌酸激酶(CK)及其同工酶(CK-MB)、天冬氨酸转氨酶(AST)、α-羟丁酸脱氢酶(α-HBD)和乳酸脱氢酶(LDH)。结果接触组尿锰含量显著高于对照组,接触组血清CK、α-HBD和LDH水平显著升高(P0.05);舒张压降低,心电图异常率增高(P0.05)。结论电焊对作业工人的心血管功能有一定影响。     

病毒性脑炎血清酶学水平变化的临床意义分析

目的探讨病毒性脑炎血清酶学变化的临床意义。方法选择某医院入住的病毒性脑炎患者60例做研究组,抽取静脉血2 mL,抽取时间应为次日晨起,空腹。对天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、丙氨酸氨基转移酶(ALT)、γ谷氨酰基转移酶(γ-GT)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、α-羟丁酸脱氢酶(α-HBDH),进行检测,并与80例对照组头痛患者同类酶检测结果进行比较。结果病毒性脑炎组血清酶学变化异常检出率为65%,对照组血清酶学检出率是27%,2组比较差异有统计学意义(P<0.05)。结论对血清酶学进行测定在病毒性脑炎的鉴别和早期诊断上有重要帮助意义。     

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 human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

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.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

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.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

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.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.