中国2003年出生缺陷高发区和低发区重大体表畸形患病率监测

目的了解中国出生缺陷高发区目前常见体表出生缺陷的患病水平以及主要畸形种类。方法选择出生缺陷高发的山西省5个县市和出生缺陷低发的江苏省无锡地区作为研究现场,对研究地区2003年所有孕满20周以上的出生进行以人群为基础的出生缺陷监测,分析和比较高低发地区24种体表重大出生缺陷的患病情况。结果山西省4个县体表重大缺陷患病率为232.4/万,神经管畸形患病率138.7/万,显著高于太原市区相应的患病率(75.3/万和28.2/万)。无锡市区和锡山区(原无锡县)之间各种出生缺陷患病率差异无统计学意义。太原市区神经管畸形(NTDs)出生患病率是无锡市区(4.6/万)的6.1倍;山西省4个县无脑儿、脊柱裂、脑膨出、脑积水、腭裂和多指畸形的出生患病率显著高于无锡市区,NTDs的出生患病率是无锡市区的30.2倍。高发地区NTDs患病率与既往监测资料相比未见明显下降趋势。如果从孕满28周开始监测,则高发地区出生患病率较孕满20周监测率下降31.8%。结论NTDs仍然是山西省最常见的出生缺陷。山西省部分地区NTDs的患病率仍然是国内乃至世界最高的患病水平。NTDs出生患病率在部分出生缺陷高发地区未见明显的下降趋势。监测方法和产前诊断对于体表重大出生缺陷患病率具有较大影响。     

泽州县2003～2004年神经管畸形的流行状况

目的了解泽州县目前神经管畸形患病水平及流行特征,为今后制定本县出生缺陷的预防措施提供依据。方法以人群为基础,对泽州县26个乡镇所有在本地长期居住的妇女所分娩的孕20周及以上到生后7d的胎儿和新生儿进行监测。结果2003年1月至2004年12月,共监测到孕满20周及以上的出生7992名,发现NTDs病例128例,NTDs出生患病率为160.2/万,其中无脑儿为72.6/万(58/7992)、脊柱裂为81.3/万(65/7992)、脑膨出为6.3/万(57992)。NTDs占全部体表重大出生缺陷病例的71.5%(128/179)。NTDs的患病率与母亲年龄、文化程度及妊娠胎数显著相关。母亲年龄<20岁或≥30岁、文化程度为小学及以下、双胎或多胎的妊娠妇女中NTDs的出生患病率显著升高。结论我县NTDs出生患病率处于我国乃至世界最高的水平。文化程度低、怀孕年龄太小或较大以及多胎妊娠的妇女生育神经管畸形患儿的危险性较大。积极推动孕前保健各项措施,有望有效降低我县NTDs发生率。     

新疆某地煤矿放射性水平调查及从业人员剂量分析

目的 对新疆某地区煤矿开采过程中环境放射性水平进行调查和分析,了解该地区煤矿中伴生放射性分布情况,并估算从业人员所受有效剂量.方法 以新疆某地区煤矿开采活动为研究对象,通过现场测量、采样分析,获得开采过程中的环境放射性水平,并以此为依据评价从业人员在煤矿开采过程中的受照剂量.结果 该地区部分煤矿井下环境中γ辐射剂量率及...     

The relationship between coal rank and the prevalence of pneumoconiosis.

As part of the Periodic X-ray Scheme of the National Coal Board (NCB), a comparison is made between the previous and new films of all miners who were face-workers on the former occasion, five years earlier. This assessment is made by distributing the films randomly to all the NCB readers. This paper compares the rank of coal mined in each colliery with each colliery's percentage prevalence of pneumoconiosis of at least ILO category 1 in the films of previous face-workers obtained during the third survey round (1969-73). Of the NCB's 291 collieries in Britain, information enabling a rank classification to be made was available for 250, employing 62 362 face-workers. In these 250 mines a progressive and five-fold increase in prevalence was observed from collieries mining low-rank (bituminous) coal to those mining coal of high ranks (anthracite and high-grade steam and coking coal). A possible reason for this is that, in the past, high-rank collieries may have had the highest mass-concentrations of respirable dust.     

The relationship between coal rank and the prevalence of pneumoconiosis.

As part of the Periodic X-ray Scheme of the National Coal Board (NCB), a comparison is made between the previous and new films of all miners who were face-workers on the former occasion, five years earlier. This assessment is made by distributing the films randomly to all the NCB readers. This paper compares the rank of coal mined in each colliery with each colliery's percentage prevalence of pneumoconiosis of at least ILO category 1 in the films of previous face-workers obtained during the third survey round (1969-73). Of the NCB's 291 collieries in Britain, information enabling a rank classification to be made was available for 250, employing 62 362 face-workers. In these 250 mines a progressive and five-fold increase in prevalence was observed from collieries mining low-rank (bituminous) coal to those mining coal of high ranks (anthracite and high-grade steam and coking coal). A possible reason for this is that, in the past, high-rank collieries may have had the highest mass-concentrations of respirable dust.     

重庆煤矿尘肺发病规律研究

为探索重庆煤矿尘肺发病规律，对重庆1986年在册的47038名接尘工人进行了回顾性调查。结果显示，重庆煤矿尘肺患病率为13．0％．平均发病工龄为20年，平均发病年龄为46岁，尘肺死亡率为24．5％，平均死亡年龄为58．2岁，大块纤维化患病率为1．6％；尘肺的发生与工人接触高合矽量、高浓度粉尘有关；重庆煤矿粉尘中游离SiO2，平均含量为8．5％，尘肺病例以煤矽肺和煤肺为多，矽肺病例相对较少；防尘工作重点应放在采煤工作面。     

Indoor air pollution from coal combustion and the risk of neural tube defects in a rural population in Shanxi Province, China

The authors evaluated indoor air pollution from coal combustion (IAPCC) as a potential risk factor for neural tube defects (NTDs) in a rural population in Shanxi Province, China. The studied rural population has both high IAPCC exposure and a high prevalence of NTDs. A population-based case-control study was used to identify 610 NTD cases and 837 normal controls between November 2002 and December 2007. Information was collected within 1 week following delivery or pregnancy termination due to prenatal NTD diagnosis. The authors derived an exposure index by integrating a series of IAPCC-related characteristics concerning dwelling and lifestyle. Compared with women with no IAPCC exposure, women with any exposure at all had a 60% increased risk of having a child with an NTD (adjusted odds ratio (OR) = 1.6, 95% confidence interval (CI): 1.1, 2.1). An increased NTD risk was linked to both residential heating (adjusted OR = 1.7, 95% CI: 1.1, 2.4) and cooking (adjusted OR = 1.5, 95% CI: 1.1, 2.1). The risk increased with increases in the exposure index, showing a dose-response trend (P < 0.001). This is the first known study to link IAPCC to NTDs. Additional studies are needed to confirm the link between IAPCC and NTDs.     

太原地区军团菌感染流行特征的研究

目的探讨太原地区军团菌感染频度及流行特征。方法用酶联免疫吸附测定法对门诊、住院病人及不同健康人群进行９种１５型军团菌ＩｇＭ及ＩｇＧ抗体的检测。结果成人患者军团菌ＩｇＭ抗体阳性率１７．４％，儿科病人１３．２％，成人及儿童患者均以上呼吸道急性感染比率最高，夏季多发。成人患者３０～５０岁年龄高发，儿科患者随年龄增加军团菌急性感染率增大，６例住院患者住院两周后发生急性感染，军团菌ＩｇＭ抗体阳性。健康人群以煤矿职工军团菌ＩｇＧ抗体阳性率最高（３６７％），城区儿童最低（９．５％）。门诊及住院患者以米克戴德军团菌感染为主，嗜肺军团菌次之；健康人群以嗜肺军团菌感染为主。结论军团菌是感染性疾病的常见病原，且有院内感染的可能性，健康人群感染也相当普遍，在经常与水、土接触职业人群更为明显     

母亲饮食因素与神经管畸形危险性的病例对照研究

目的探讨母亲饮食因素在神经管畸形（NTD）发病中的作用。方法选择山西省出生缺陷高发的平定、昔阳、太谷和泽州4个县，进行以人群为基础的出生缺陷病例对照研究。病例为2003年1月至2005年6月在4个县监测到的363例NTD病例，对照为同期在同地区出生的523名无体表畸形的健康婴儿。结果单因素分析结果表明，与NTD发生有关的饮食因素有食用肉类、蛋奶、豆类、腌菜、发芽土豆、食物烹调习惯、饮用水水源类型、饮啤酒、红酒或米酒和饮茶。在调整妇女文化程度和畸形生育史的基础上，多因素logistic回归分析表明，肉类和豆类为NTD的保护因素，NTD的危险性随着肉类、豆类食用频率的增加逐渐下降，其在人群中的归因危险度（PAR）分别为69．4％和22．0％。食用腌菜为危险因素，NTD危险性随着腌菜食用频率增加而显著增加，具有明显的剂量反应关系，其PAR值为18．5％。此外，饮用河水或池塘水的妇女较饮用井水或自来水者的危险性增高（OR=3．42，95％CI：1．44～8．09），每天饮茶者较不饮或偶尔饮茶妇女的危险性增高（OR=4．65，95％CI：1．41～15．36），但二者PAR值较低，分别为4．7％和2．6％。结论富含叶酸的肉类和豆类对NTD发生具有显著的保护作用。怀孕前后食用腌菜、饮用河水或池塘水以及每天饮茶是NTD的危险因素。     

Lung cancer among Dutch coal miners: a case-control study

A case-control study was conducted in the southern part of The Netherlands to investigate the risk of lung cancer in coal miners; 381 age-matched pairs of primary lung cancer cases and controls, diagnosed between 1972 and 1988, were selected from the pathology department of the University Hospital in the region. Information about past employment in coal mines was obtained through the registers of the collaborative pension fund for Dutch miners. 20% of the cases were (at some time) employed in coal mining, compared with 21% of the controls (odds ratio 0.95; 95% confidence interval: 0.65-1.38). 9% of both cases and controls had an underground work history (odds ratio 0.96; 95% confidence interval: 0.56-1.65). The duration of underground coal mining did not differ substantially between cases and referents (average duration: respectively 117 and 108 months). No relation between specific histologic tumor cell types and coal mining could be demonstrated. The study gives no indication that workers in Dutch coal mines have an increased risk of developing lung malignancies.     

妊娠神经管畸形孕妇血清叶酸与同型半胱氨酸水平分析

目的:比较妊娠早期神经管畸形(neural tube defects,NTDs)孕妇及正常孕妇血清叶酸和同型半胱氨酸(ho-mocysteine,Hcy)水平,分析两种物质的代谢水平与妊娠NTDs的关系。方法:采用病例对照研究方法,以NTDs高发的山西省5个县作为研究现场,选择9所医院收集研究对象,对所有研究对象采集肘静脉血5ml,检测其血清叶酸和Hcy水平,比较病例组和对照组血清叶酸和Hcy的差异。分别以对照组血清叶酸和Hcy浓度的第10和第90百分位数作为界值,划分为2个水平组,比较不同水平组NTDs的发病风险。结果:妊娠NTDs孕妇血清平均叶酸水平显著低于对照组(10.4nmol/Lvs14.7nmol/L,P0.05),同时血清Hcy高于对照组,差异无统计学意义。低叶酸水平孕妇妊娠NTDs的危险性显著增加(AOR=3.0,95%CI为1.2～7.7)。结论:孕期血清叶酸低水平是研究人群NTDs发生的危险因素。     

119家煤矿企业肺结核管理和发病情况调查

目的 调查119家煤矿企业肺结核体检管理和煤矿工人肺结核发病情况,探讨我国煤矿工人肺结核纳入职业健康体检情况和存在的主要问题。方法 对全国9省54家国有重点煤矿、24家地方国有煤矿和41家乡镇煤矿共119家煤矿企业开展问卷调查,对资料进行统计分析。结果 国有重点煤矿、地方国有煤矿肺结核体检的主要管理部门为企业附属医院(33.3%和41.7%),乡镇煤矿为企业行政管理部门(68.3%)。51.9%的国有重点煤矿和41.7%的地方国有煤矿制定了肺结核体检管理制度,乡镇煤矿均未制定相关制度。109家煤矿(91.6%)无肺结核专职管理人员,31家(26.1%)无肺结核兼职管理人员。2010—2012年,17.3%的国有重点煤矿、33.3%的地方国有煤矿和62.6%的乡镇煤矿未开展岗前职业健康体检,国有重点煤矿岗前肺结核检出率年均47.53/10万人,其他煤矿均未检出病例。国有重点煤矿、地方国有煤矿和乡镇煤矿工人年均在岗体检率分别为51.7%、37.4%和25.0%,肺结核检出率分别为134.86/10万人、472.27/10万人、1 816.75/10万人,未开展在岗体检的企业比例分别为9.3...     

皖南石煤开发利用对周围环境放射性水平影响调查

目的 对皖南地区石煤开采和利用过程环境中放射性水平进行调查和研究，评价其对周围环境和居民剂量的影响。方法 本文以皖南典型石煤矿区的石煤矿、石煤衍生产品和周边环境为研究对象，通过现场测量、采样和实验室分析，获得相关数据。结果 石煤矿中²³⁸U、²²⁶Ra和²¹⁰Pb含量最高可以达到1 298 Bq/kg、1 598 Bq/kg和1 212 Bq/kg，已属于伴生放射性矿的范畴。石煤在燃烧后，煤渣中²¹⁰Pb的浓度总体有所降低，矿区周边土壤和水体样品中部分天然放射性核素的含量远高于调查地区的平均水平。通过估算，矿区周边石煤碳化砖建筑室内天然贯穿辐射外照射所致人均年有效剂量范围在1.01~1.24 mSv，氡及子体所致内照射人均年有效剂量为1.8~4.9 mSv。结论 石煤矿区的天然放射性核素已经部分转移到周边土壤和水体中，居住或工作在碳化砖房的居民的年附加有效剂量显著增加。     

Effectiveness of Folic Acid Fortified Flour for Prevention of Neural Tube Defects in a High Risk Region

Despite efforts to tackle folate deficiency and Neural Tube Defects (NTDs) through folic acid fortification, its implementation is still lacking where it is needed most, highlighting the need for studies that evaluate the effectiveness of folic acid fortified wheat flour in a poor, rural, high-risk, NTD region of China. One of the most affected regions, Shanxi Province, was selected as a case study. A community intervention was carried out in which 16,648 women of child-bearing age received fortified flour (eight villages) and a control group received ordinary flour (three villages). NTD birth prevalence and biological indicators were measured two years after program initiation at endline only. The effect on the NTD burden was calculated using the disability-adjusted life years (DALYs) method. In the intervention group, serum folate level was higher than in the control group. NTDs in the intervention group were 68.2% lower than in the control group (OR = 0.313, 95% CI = 0.207–0473, p < 0.001). In terms of DALYs, burden in intervention group was approximately 58.5% lower than in the control group. Flour fortification was associated with lower birth prevalence and burden of NTDs in economically developing regions with a high risk of NTDs. The positive findings confirm the potential of fortification when selecting an appropriate food vehicle and target region. As such, this study provides support for decision makers aiming for the implementation of (mandatory) folic acid fortification in China.     

母亲解偶联蛋白(UCP2)基因多态性与后代神经管畸形的关系

目的:探索山西省母亲解偶联蛋白(UCP2)基因多态性与后代神经管畸形发生的关系。方法:采用1:1配对病例对照研究方法,对山西省116例曾孕育过NTDs患儿的母亲和116例配对的未孕育过任何畸形患儿的母亲采血并进行UCP2基因的多态性分析。结果:病例组母亲3’末端缺失纯合子基因型D/D显著高于对照组母亲(P0.01),而A55V基因多态性与NTDs无相关(P0.05)。结论:母亲UCP2基因第8外显子45bpD/I多态性可能是后代发生神经管畸形的遗传危险因素。     

Respiratory Status of Surface Coal Miners in the United States

The United States Public Health Service examined 1,438 surface coal miners to determine the prevalence of coal worker’s pneumoconiosis (CWP), chronic bronchitis, and ventilatory impairment among them. Four percent (fifty-nine individuals) showed some roentgenographic evidence of pneumoconiosis, but only seven miners had films interpreted as CWP of category2 or greater (according to the UlCC/Cincinnati classification system). Moreover, most of the affected miners had worked in underground coal mines for prolonged periods. Significant decrements in pulmonary function to increasing exposure to surface mine dust were demonstrated only in the forced vital capacity of smokers. Increased prevalence of chronic bronchitis with increasing exposure was found in all smoking categories. However, significant airway obstruction was an uncommon finding (6.6%) in nonsmoking miners. Employment in surface mining was not likely to cause either the development of CWP or clinically significant respiratory impairment.     

郑州市10年神经管缺损发生率的变化趋势

目的 描述1996-2005年郑州市围产儿神经管缺损(neural tube defects,NTDs)的流行病学特征及动态变化趋势.方法 采用医院监测的方法进行数据收集,调查孕满28周至产后7 d住院分娩的围产儿中NTDs的发生情况,分别按年份、围产儿性别、产妇户口所在地(城/乡)、产妇年龄计算其发生率.共监测围产儿162 074名,全市同期出生围产儿496 203名,监测比例为32.66%.结果 NTDs 238例,总发生率为14.68/万,年度发生率呈下降趋势.NTDs的发生率乡村为29.28/万,城镇为9.63/万;女性为17.74/万,男性为11.42/万;产妇年龄别发生率的差异有统计学意义(χ2=22.952,P=0.000),＜20岁和≥35岁组高于其他年龄组,其发生率分别为53.76/万和21.74/万.结论 郑州市NTDs发生率乡村高于城镇、女性高于男性.10年间年度发生率呈下降趋势.     

失能调整生命年在煤矿职业性疾病负担分析中的应用

为估计煤矿外伤性截瘫疾病负担,采用横断面抽样调查,共抽样调查全国５ 个统配矿务局的２６ 个煤矿。以煤矿外伤性截瘫的患病和死亡资料为基础,用失能调整生命年（ＤＡＬＹ） 估计煤矿外伤性截瘫疾病负担。结果表明：煤矿外伤性截瘫疾病负担为每千人口３２２５ＤＡＬＹ。各矿务局比较：铜川矿务局外伤性截瘫疾病负担最重,每千人口５４４７ ＤＡＬＹ,高于５ 个矿务局的平均水平每千人口３２２５ＤＡＬＹ。其次为阳泉、峰峰矿务局、三路安矿务局和晋城矿务局,分别为每千人口２７ ．８５ 、２６ ．６０ 、１５１０ 和１１ ．７１ＤＡＬＹ。结果提示：ＤＡＬＹ 可用于煤矿职业性疾病负担分析。各统配矿务局外伤性截瘫的ＤＡＬＹ 差异较大