2001-2003年四川省麻疹流行病学分析及控制策略探讨

目的　探讨控制麻疹的策略和措施。方法　对四川省 2 0 0 1- 2 0 0 3年麻疹的发病情况、麻疹暴发疫情、麻疹疫苗接种率、麻疹疫苗强化免疫等进行综合分析。结果　四川省麻疹报告发病率呈上升趋势 ,发病以小年龄组和学龄儿童为主 ,1～ 14岁占 80 %以上 ;发病地域广泛 ,以春季高发 ;暴发病例占总病例的 10 4 4% ;10 73%的报告病例无免疫史 ,5 4 2 5 %免疫史不详。 2 0 0 2年对 8～ 30月龄儿童进行麻疹疫苗强化免疫后 ,根据出生队列分析 ,除 2岁组 (该年龄组全体儿童进行强化免疫 )发病率下降了 31 4 9%外 ,其余各年龄组发病率均较 2 0 0 2年有所上升。未开展麻疹强化免疫的各年龄组发病率上升幅度大于开展部分儿童强化免疫的 1岁和 3岁组发病率。结论　在麻疹常规接种率较低情况下 ,要在短时间内提高易感人群免疫力 ,应尽快对 14岁以下儿童进行麻疹强化免疫 ,以减少暴发 ,降低发病率。     

2003-2005年惠州市麻疹监测

目的 了解惠州市2003-2005年麻疹流行病学特征,探讨该市加速控制麻疹策略.方法 利用麻疹疫情监测和人群免疫状况资料,对惠州市2003-2005年麻疹发病情况及相关因素进行流行病学分析.结果 2003-2005年惠州市麻疹监测系统共报告麻疹疑似病例1 143例,年平均报告发病率10.9/10万.发病季节高峰在3～6月,发病年龄主要是≤14岁儿童(75.6%);麻疹病例22.4%未接种麻疹疫苗,58.4%免疫史不详;病例中流动人口占29.0%.人群麻疹抗体阳性率94.6%,保护率为58.5%.结论 惠州市近3年麻疹发病呈上升趋势,人群麻疹免疫保护水平较低,应在1～14岁儿童中开展麻疹疫苗初始强化免疫和入托、入学儿童预防接种证查验工作,同时要求外来青工新招入厂时接种麻疹疫苗.     

麻疹发病年龄特征及强化免疫对其影响

[目的]分析麻疹发病年龄特征,了解麻疹疫苗强化免疫对发病的影响.[方法]对2004～2008年南充市顺庆区麻疹病例年龄特征进行描述流行病学分析;比较2007年麻疹疫苗强化免疫前后麻疹发病年龄特征.[结果]2004～2007年南充市顺庆区共报告麻疹病例教460例.83.70%(385/460)的麻疹患者为15岁以下儿童,其中婴儿麻疹病例构成比分别为0%、10.81%、13.51%、25.82%.2007年9月进行麻疹疫苗强化免疫,2008年仅发生麻疹病例数10例.其中80.00%(8/10)的病例为15岁以下儿童,婴儿麻疹病例构成比为40.00%.2007年、2008年麻疹病例年龄构成之间的差异没有统计学意义(P=0.842,P>0.05).[结论]2004年以来南充市顺庆区麻疹发病年龄特征发生较大变化,要儿麻疹病例构成比持续增加.麻疹疫苗强化免疫对麻疹发病年龄分布影响不大.应进一步针对麻疹发病年龄特征发生的变化,开展防控和消除麻疹的应用性研究.     

保定市1999～2007年麻疹发病年龄变化对消除麻疹的影响分析

[目的] 分析保定市1999～2007年麻疹发病年龄变化,为调整免疫和监测策略,实现消除麻疹目标提供依据. [方法] 对保定市不同时期麻疹发病年龄特征进行描述性流行病学分析. [结果] 1999～2002、2003～2007年1～14岁人群麻疹病例构成比分别为:75.90%、45.95%,呈减少趋势.<1岁人群构成比1999～2002、2003～2007年分别为:O.92%、22.33%,呈增加趋势.≥15岁人群麻疹病例分别占总病例数的14.86%和30.72%,呈增加趋势. [结论] 保定市发病年龄由儿童为主逐渐出现向未到免疫年龄和大年龄组移位现象.因此,要实现消除麻疹目标,做好儿童麻疹疫苗的初免和复种是关键,同时关注流动人口,完善麻疹监测系统及时处理麻疹疫情,重点地区应开展强化免疫,消除免疫空白.     

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。     

陕西省2003年麻疹流行病学特征及健康人群麻疹抗体水平监测分析

为了解陕西省麻疹流行病学特征 ,评价健康人群麻疹抗体水平 ,对麻疹发病和实验室资料进行分析。结果显示 :陕西省 2 0 0 3年麻疹流行模式为爆发和散发并存 ,局部地区麻疹爆发影响着全省麻疹发病水平 ,发病年龄和免疫史状况说明 8月龄～ 7岁为高发年龄段 ,该年龄段病例麻疹疫苗 (MV)接种率为 4 3%。 4、5月为麻疹高发月 ,病例数占全年病例总数的 6 0 %。麻疹抗体水平监测结果显示 :2 0 0 3年健康人群麻疹抗体阳性率和几何平均滴度倒数 (GMRT)较 2 0 0 1年上升明显 ,处于较高水平。 2～ 4岁麻疹抗体GMRT较低。提示MV初种和复种均必须加强 ,有效接种率有待提高。应对 1 5～ 2岁儿童增加 1次MV免疫 ,8月龄～ 14岁儿童开展MV的强化免疫。     

隆回县2009年麻疹疫苗强化免疫活动效果分析

目的：评价麻疹疫苗强化免疫活动效果,为控制和消除麻疹提供依据。方法：收集隆回县2009年麻疹疫苗强化免疫活动报表和免疫前后1年麻疹疫情资料,采用描述流行病学方法进行分析。结果：隆回县2009年麻疹疫苗强化免疫应接种儿童数209 262人,实际接种206 827人,接种率98.8%;流动儿童应种4 803人,实种4 464人,接种率为92.9%。强化免疫前1年麻疹发病专率为14.7/10万,强化免疫后1年麻疹发病专率为3.2/10万,下降率78.2%。结论：该次强化免疫活动效果明显,达到预期目的。要控制和消除麻疹,提高疫苗接种率,对目标儿童适时进行麻疹强化免疫活动是有效的措施;加强健康教育,提高群众预防接种知识,全民参与,是提高流动儿童免疫接种率的重要手段;同时要重视对乡、村接种单位和接种人员的管理和培训,切实落实麻疹疫苗初始免疫和复种的接种成功率。     

泉州市2006～2008年麻疹流行特征分析

目的分析泉州市2006～2008年麻疹流行特征,提出控制麻疹策略。方法采用描述性流行病学方法,运用EXCEL2003软件进行分析评价。结果2006～2008年泉州市发病较高的为晋江、石狮、鲤城、丰泽、南安等5个县(市、区),占全市总病例数的86.82%;病例中15岁以下儿童占77.75%,8月龄以下儿童占发病总数比例从2004年5.81%上升到2008年15.67%,流动人口的病例占总发病数的57.01%;病例中有麻疹疫苗(MV)免疫史的仅占10.76%;本地儿童的麻疹疫苗接种率维持在90%以上;全市7岁以下流动儿童麻疹疫苗第一针接种率为78.89%,第二针接种率仅为46.50%。麻疹疫苗免疫干预后发病明显下降。结论人口流动频繁、疫苗接种率低、免疫空白人群积累是麻疹发病升高的主要因素。采取有效措施,确保所有儿童完成麻疹疫苗免疫是泉州市麻疹防控的主要措施,重点要加强流动儿童的免疫接种工作。     

2005～2011年南宁市麻疹疫情分析

目的:了解近几年南宁市麻疹流行规律,为制定防制政策提供依据。方法:通过国家疾病报告管理系统监测数据对2005～2011年南宁市麻疹发病资料进行统计分析,发病人数按报告地区查询。结果:2008年南宁市麻疹发病率回升,强化免疫后发病率逐步下降。7岁以下年龄的病例居多;城区发病明显高于县份;发病时间具有明显的周期性,2月起发病增多,3～8月达到高峰;2010年和2011年强化免疫率达95%以上。结论:以麻疹疫苗接种为主导措施,间歇性开展麻疹疫苗强化免疫,加强麻疹疫情监测管理和分析,尤其是完善流动儿童的计划免疫管理,减少免疫空白,保护易感人群符合我市当前的麻疹预防控制策略。     

2008年湛江市麻疹流行病学分析

目的 了解湛江市2008年麻疹发病情况,分析其发病原因,为制定控制麻疹策略提供科学依据.方法 对湛江市2008年报告麻疹病例进行流行病学分析.结果 2008年湛江市法定传染病报告系统共报告麻疹病例1 038例,发病率为15.34/10万,其中暴发病例5例.病例集中在1～6月份,3月份和5月份有两个发病高峰;9个县(市、区)均有病例;发病最小年龄为3月龄,最大为46岁;0～14岁儿童病例占总病例数84.10%,其中0～3岁组最多,占总病例数48.94%;男女性别比为2.13:1;901例监测病例中,有免疫史占16.32%,无免疫史占23.2%,免疫史不详占60.48%.实验室检测血清学标本289份,麻疹IgM抗体阳性172份,阳性率59.5%.结论 免疫接种工作落实不到位,常规免疫接种率低,免疫空白儿童积累增加是我市麻疹发病率上升的主要原因.提高麻疹监测系统监测质量,加强麻疹常规免疫接种,及时做好适龄儿童麻疹疫苗查漏补种和开展麻疹疫苗强化免疫接种,是降低我市麻疹发病率,消除麻疹的关键.     

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.