儿童中毒相关因素分析与干预

目的:探讨儿童意外中毒的原因,寻求相应的干预措施。方法:回顾性分析1999年1月~2004年12月诊治的150例儿童意外伤害的临床资料。结果:61例儿童为意外中毒,其中药物中毒(过量)33例,占54.10%;28d~1岁20例,占32.79%,>1~3岁15例,占24.59%。城市儿童药物中毒(过量)26例,42.62%;乡村药物中毒(过量)7例,11.48%;其次灭害药(灭鼠、灭蟑、灭蝇)及农药中毒8例,占13.11%。结论:儿童意外中毒以药物中毒为首要因素,以家中发生为主;28 d~3岁是意外中毒发生的主要年龄,与这一年龄段的发育特点有关,儿童意外中毒应以预防为主。     

2009-2014年盱眙县农药中毒流行病学分析

摘要:目的　了解盱眙县农药中毒的流行病学特点,为农药中毒的防治、安全防护措施的制订及施行提供参考依据。方法　收集2009-2014年盱眙县《农药中毒报告卡》中农药中毒病例数据,进行流行病学分析。结果　2009-2014年盱眙县共报告各类农药中毒552例,涉及7大类农药。生产性中毒108例,占中毒总病例数的19.57%,男性多于女性;非生产性农药中毒444例,占中毒总病例数的80.43%,女性多于男性。中毒病例平均年龄（43.95±10.89）岁,主要集中在35～55岁年龄段。生产性农药中毒在第三季度高发,占全年生产性农药中毒的60.19％。生产性农药中毒主要集中在观音寺镇、马坝镇、淮河镇和维桥乡,4个乡镇病例占全部病例的51.85%,而非生产性农药中毒病例较为分散。农药中毒的主要类别是杀虫剂（79.89%）,其次是除草剂（8.88%）和杀鼠剂（6.34％）,杀虫剂中以有机磷为主,共327例,占总病例的59.24%,其中前三顺位的农药是氧乐果（16.67%）、甲胺磷（12.14%）和敌敌畏（11.05%）。农药中毒病死率最高的前3类农药分别是混合制剂（16.67%）、生物化学农药（16.67%）和除草剂（8.16%）。结论　农药中毒严重威胁着盱眙县公众的健康,非生产性农药中毒应该引起重视,有机磷类杀虫剂是主要中毒农药。     

2009年青岛市急性农药中毒情况分析

[目的]掌握青岛市急性农药中毒的现状,为制定控制与减少农药中毒的有效防治对策提供科学依据。[方法]根据健康危害因素监测信息系统农药中毒数据库,将2009年农药中毒报告数据库导入Excel进行汇总,统计学处理用SPSS 12.0统计软件。[结果]2009年青岛市共报告农药中毒497例,死亡50例,病死率10.06%。其中,生产性中毒、非生产性中毒分别占中毒总数的4.83%和95.17%。中毒者平均年龄47.12±17.33岁,35-54岁占45.07%。杀虫剂是引起农药中毒的主要类别,占80.89%。其中,87.81%是有机磷杀虫剂中毒,以敌敌畏、对硫磷、氧乐果（含乐果）、甲胺磷为主。[结论]非生产性农药中毒病例是我市急性农药中毒主要来源,加强农村精神文明建设,加强农药监管力度,降低农药中毒发生率,维护劳动者健康。     

田间作业致有机磷农药中毒与口服中毒的临床比较

目的 探讨田间作业中毒和口服有机磷农药中毒在临床表现及治疗上的差异.方法 回顾性分析我院2007年7月至2010年7月收治的85例中、重度急性有机磷农药中毒患者的临床资料,按中毒途径分为口服组(51例)和非口服组(34例),比较不同途径中毒后的临床表现、治疗特点及预后.结果 口服组中度中毒患者的肌颤肌痉挛和共济失调的发生率(86.4%、90.9%)均明显高于非口服组(50.0%、55.0%),差异有统计学意义(P＜0.05,P<0.01);口服组重度中毒患者的肺水肿、肌颤肌痉挛及昏迷的发生率(100.0%、89.7%、93.1%)均明显高于非口服组(71.4%、64.3%、50.0%),差异有统计学意义(P<0.05 ).非口服组解毒时间[中度:(35.0±6.2)h、重度:(45.0±11.1)h]较口服组[中度:(49.0±7.7)h、重度:(77.0±10.3)h]明显缩短,差异有统计学意义(P＜0.05).治疗后24、48、72 h,中、重度非口服组胆碱酯酶活力明显高于口服组,差异有统计学意义(P<0.05或P<0.01);中、重度非口服组的氯磷定用量、阿托品化用量及阿托品总量明显低于口服组,差异有统计学意义(P＜0.05或P<0.01).结论 田间作业有机磷农药中毒在临床表现上与口服中毒不尽相同,且治疗的阿托品及氯磷定用量相对较少,胆碱酯酶活力恢复较快.

Abstract：

Objective To investigate the differences of clinical manifestation and therapy of organophosphorus pesticide poisoning (OPP) between oral exposure and occupational exposure in field work. Methods From July 2007 to July 2010, 85 patients with acute severe OPP were treated in a hospital, which were divided into oral poisoning group (51 cases) and non-oral poisoning group (34 cases). The differences of clinical manifestations, curative effects and prognosis between two groups were compared. Results The rates of myoclonus and ataxia in cases with moderate poisoning of oral poisoning group were 86.4% and 90.9%, which were significantly higher than those (50.0% and 55.0% ) of non-oral poisoning group (P<0.05 or P< 0.01). The rates of myoclonus, lung fluid and coma in cases with severe poisoning of oral poisoning group were 100.0%, 89.7% and 93.1%, respectively, which were significantly higher than those (71.4%, 64.3% and 50.0%) of non-oral poisoning group (P<0.05). The mean detoxification hours in cases with moderate poisoning and cases with severe poisoning of non-oral poisoning group were (35.0±6.2) and (45.0±11.1) hours which were significantly lower than those [(49.0±7.7) and (77.0±10.3) hours] in cases with moderate poisoning and cases with severe poisoning of oral poisoning group (P<0.05). In 24, 48 and 72 h after treatment, the cholinesterase (ChE) activities of non-oral poisoning group were higher than those of oral poisoning group (P< 0.05 or P<0.01). The used doses of pyraloxime methylchloride (PAM-Cl) or atropine and the used total dose of atropine in non-oral poisoning group were lower than those in oral poisoning group (P<0.05 or P<0.01). Conclusions The clinical manifestation of non-oral poisoning group is different from the clinical manifestation of oral poisoning group due to the high morbidity of OPP occurred at field site in summer. The used doses of atropine and PAM-Cl are less and the ChE activity recovers quickly for non-oral poisoning group.     

Deaths from pesticide poisoning in South Korea: trends over 10 years

Objectives  Pesticide poisoning is a major cause of death in the world. The objective of this study was to examine the trends of pesticide poisoning deaths and their epidemiologic characteristics in South Korea. Methods  We evaluated the age-standardized mortality rates from pesticide-related deaths (intentional self-poisoning, accidental poisoning, assault, undetermined intent poisoning) in South Korea from 1996 through 2005, using registered death data obtained from the Korea National Statistical Office. The regional rurality index was calculated and correlation analyses were used to estimate the association with pesticide poisoning mortality. Results  The number of pesticide poisoning deaths from 1996 through 2005 was 25,360, which accounted for 58.3% of the total poisoning fatalities. The age-standardized mortality rates by pesticide poisoning significantly increased from 4.42 to 6.42 per 100,000 population, whereas the total death rate was decreased in the same period. Intentional self-poisoning was the majority cause of death from pesticides (84.8% of total pesticide poisoning deaths). The majority of the pesticide poisoning deaths were men, over 50 years old, with education less than middle school, and residing in rural areas. The rate of pesticide poisoning deaths was the highest in the farming period and was significantly correlated with the rurality index of each region. Conclusions  Pesticide poisoning deaths substantially increased during the 10-year study period, and showed demographic, seasonal and regional variations. More intensive intervention efforts to reduce pesticide mortality should become a public health priority in South Korea.     

2006至2009年某市农药中毒情况

目的 了解湖州市农药中毒的危害现状,为农药中毒预防控制提供依据.方法 将2006至2009年每年应用"中国疾病预防控制信息系统"的子系统"健康危害因素检测信息系统"所建立的农药中毒报告数据库导入Excel,进行汇总统计,使用SPSS 12.0软件进行统计分析.结果 2006至2009年该市共发生农药中毒2298例,其中生产性农药中毒588例,占全部病例的25.59%;死亡4例,病死率为0.68%;男性(458例,77.89%)多于女性(130例,22.11%);具有明显的季节性,主要集中在7至9月;35至55岁和65岁以上为高发年龄.非生产性农药中毒1710例,占全部病列的74.41%;女性(952例,55.67%)多于男性(758例,44.33%);35至65岁为高发年龄段;死亡112例,病死率为6.55%.有机磷农药是引起农药中毒的主要品种,尤以甲胺磷、敌敌畏和氧乐果(含乐果)为主,共占有机磷类中毒总数的79.98%.结论 该市生产性农药中毒得到了有效的控制,非生产性农药中毒比例较高,应加强监管,有效预防和控制农药中毒的发生.

Abstract：

Objective To understand the situations of pesticide poisoning in Huzhou and take preventive strategy and measures against the pesticide poisoning. Methods Case reports between 2006 and 2009 in the data base of reporting system for occupational diseases were computed by Excel for windows and statistical significance by SPSS12.0. Results A total of 2298 patients were reported from 2006 to 2009.Among them, the incidence of occupational poisoing accounted for 25.59% (588 cases), including 4 fatalities (fatality rate, 0.68% ). Male patients (458 cases, 77.89% ) were more than femal ones ( 130 cases, 22.11% ) in occupational pesticides poisoning. Summer and autumn were the most seasons in occupational pesticides poisoning occurring. The incidence of non-occupational pesticides poisoning accounted for 74.41% ( 1710 cases ),including 112 fatalities (fatality rate, 6.55%). Femal patients (952 cases, 55.67% ) were more than male ones (758 cases, 44.33% ) in non-occupational pesticides poisoning. 15-55 years were the highest incidences among non-occupational pesticides poisoning patients. Insecticides especially organophosphorus insecticides such as methamidophos, parathion, and omethoate comprised a higher proportion, accounting for 79.98% of the pesticides poisoning. Conclusion The incidence and the fatality rate of occupational pesticide poisoning were reduced in the city. However, more attention should be paied to non-occupational pesticides poisoning. To decrease the numbers of pesticide poisoning and the risks of death, the relevant departments should take preventive strategy and measures against the pesticide poisoning.     

慢性砷中毒患者皮肤及神经损伤发展情况的调查

目的研究慢性砷中毒患者的病情发展情况.方法对312例轻度慢性砷中毒患者在8年后进行随访调查,将所得数据输入计算机,用SPSS 10.0软件进行统计处理.结果 8年后312例患者:①有300例(96.15%)中毒级别无变化,11例(3.52%)转为观察对象,1例(0.32%)转为重度中毒.②有135例皮肤损伤加重,占43.27%,其中1例发展为皮肤癌;有50例好转,占16.03%,以砷轻度污染水平的好转率高(40.00%),但各项皮肤损伤的阳性率均呈增高趋势(P＜0.05).③神经系统症状方面,除男性头晕、头痛、睡眠障碍外,各症状阳性率均显著增高(P＜0.05).结论轻度慢性砷中毒患者的病情随着时间的推移有加重的趋势,慢性砷中毒除以皮肤损伤为主外,还必须考虑神经损伤.     

2017年成都市有毒植物中毒监测分析

目的 探索分析成都市有毒植物中毒流行特征,以明确预防控制工作方向。方法 收集整理2017年国家“食源性疾病监测报告系统”和“食源性疾病暴发监测系统”中成都市报告的有毒植物中毒的病例与事件资料,进行描述性分析。结果 2017年成都市共报告有毒植物中毒散发病例467例,暴发事件29起;其中毒蘑菇中毒散发病例和暴发事件分别占39.8%、75.9%。有毒植物中毒的高发时间是7-9月,毒蘑菇中毒散发病例中农民占60.2%,发生在家庭的占98.9%。散发病例和暴发事件的可疑中毒食物均以毒蘑菇和四季豆为主,占比分别为67.0%和89.7%。农民、家庭及待业人群的可疑中毒食物种类多于其他人群。结论 需大力开展预防有毒植物中毒的分类宣传,提升医疗救治和检测鉴定能力,进一步提高监测系统的敏感性。     

2010-2017年广西有毒动植物中毒事件分析

目的 分析广西2010-2017年有毒动植物食物中毒事件流行病学特征,为下一步预防和控制有毒动植物食物中毒的发生提供科学依据。方法 收集广西2010-2017年食源性疾病暴发监测系统资料数据,并按时间、地区、场所、中毒因素等进行统计分析。结果 2010-2017年广西共报告有毒动植物事件148起,其中有毒植物144起(97.3%),有毒动物4起(2.7%)。发生暴发最多的是第二季度63起(42.6%),发生起数最多的地区是南宁市29起(19.6%),发生起数最多的场所是家庭(62.2%),7~19岁青少年是主要中毒人群(37.5%),误食误用是中毒主要致病原因(81.8%),毒菌毒素(43.9%)和桐子酸及异桐子酸(27.0%)是主要致病因子。结论 广西有毒植物中毒问题仍较突出,应加强广泛宣传有毒植物中毒的预防知识,以有效地减少广西有毒植物中毒事件的发生。     

我国农药中毒的流行特点和农药中毒报告的现状

目的 介绍我国农药中毒报告的历程,阐述我国农药中毒的流行特点.方法 把1997至2003年每年应用《全国劳动卫生职业病信息管理系统》建立的全国农药中毒报告数据库逐年导入Excel,用其筛选法进行汇总统计,再使用SAS 6.12软件进行结果的统计学检验.结果 1997至2003年全国共报告农药中毒108 372例,其中生产性中毒、生活性中毒分别占总中毒例数的25.39%和74.61%,病死率为6.86%.中毒者平均年龄为36.83岁,15～59岁青壮年占84.11%;0～14岁组的生活性中毒病例中,有33.51%是0～4岁儿童;生产性中毒以男性为主,生活性中毒以女性为主;杀虫剂是引起农药中毒的主要类别,占86.02%,且以甲胺磷、对硫磷和氧乐果3种高毒类有机磷中毒为主.结论 目前我国农药中毒的严重性应引起全社会和从事公共卫生工作人员的高度关注.     

NQO1、GSTT1和GSTM1基因多态性与慢性苯中毒的遗传易感性

目的探讨NQO1、GSTT1和GSTM1基因多态性与慢性苯中毒遗传易感性之间的关系。方法选择100名慢性苯中毒病例为病例组及90名同期接苯但无苯中毒表现的同工种工人为对照组,应用PCR-RFLP及多重PCR方法判定NQO1、GSTT1和GSTM1基因型。结果携带NQO1C609TT/T基因型(纯合突变型)个体发生苯中毒的危险性是具有C/T基因型(杂合型)和C/C基因型(野生型)个体的2.82倍(95%CI1.42～5.58,P<0.05),是具有C/C基因型(野生型)个体的2.94倍(95%CI1.25～6.90,P<0.05);携带GSTT1缺失(null)基因型个体发生苯中毒的危险性是具GSTT1非缺失(non-null)基因型个体的1.91倍(95%CI1.05～3.45,P<0.05),未发现GSTM1基因型与苯中毒的关系。同时携带NQO1C609TT/T基因型、GSTT1缺失、GSTM1缺失任何两种基因型的个体发生苯中毒的危险性均高于同时携带野生型及非缺失基因型的个体;并且同时携带NQO1C609TT/T基因型、GSTT1缺失与GSTM1缺失个体接苯时发生苯中毒的危险性最高,是NQO1C609TC/T基因型和C/C基因型、GSTT1非缺失型(non-null)与GSTM1非缺失型(non-null)个体的20.41倍(95%CI3.79～111.11,P<0.01)。结论基因之间的交互作用在苯中毒的发生中起重要作用。同时携带NQO1C609TT/T基因型、GSTT1缺失基因型和GSTM1缺失基因型个体发生苯中毒的风险最     

Association between blood polychlorinated biphenyl concentration and serum triglyceride level in chronic “Yusho” (polychlorinated biphenyl poisoning) patients

Summary The association between blood polychlorinated biphenyl (PCB) concentration and serum triglyceride level was investigated in 259 Yusho patients (PCB poisoning) who underwent health examinations for Yusho in 1988. Geometric means of PCB and triglyceride were 3.84 ppb (95% confidence interval: 3.54–4.17) and 114.3 mg/dl (106.6–122.6), respectively. Both correlation and multiple regression analyses showed a weak but statistically significant correlation between these two variables. The mean triglyceride level adjusted for age and sex was then calculated for comparison among four PCB levels, using analysis of covariance. This indicated a progressive increase with increasing PCB: 98.36, 117.78, 117.84, and 127.65 mg/dl at <2.7, 2.7+, 4.1+, and 6.1+ ppb, respectively (F= 2.01, P = 0.113). Comparing PCB levels, the difference in adjusted mean triglyceride levels was marginally significant between the first and second (P = 0.088), and the first and third quartiles (P = 0.066), and reached significance between the first and fourth quartiles (P = 0.021). Thus, a weak but significant association between blood PCB and serum triglyceride was observed in the patients 20 years after exposure, although their blood PCB and serum triglyceride were relatively close to the normal levels.     

A bedside test for methemoglobinemia,Sri Lanka

ProblemPropanil is an aniline herbicide that is widely used for rice cultivation, but is also used for self-poisoning. Toxicity from propanil is largely due to methemoglobinemia. In resource-poor settings, the capacity to determine methemoglobin concentration is insufficient and prevents effective case management, which results in increased deaths from propanil poisoning.ApproachBlood with a methemoglobin concentration greater than 15% of total haemoglobin levels appears brownish in colour. We introduced a colour reference chart that can be used to semiquantitatively determine methemoglobinemia. Each ward in three rural hospitals received a chart. Ward staff, medical officers and trainee doctors were given a presentation describing the test method and how it should be used with the relevant national treatment guidelines.

Local setting

In three rural hospitals in Sri Lanka, 401 patients were admitted with a diagnosis of propanil poisoning before the introduction of this test (2003–2007) and 262 patients after it was introduced (2008–2014), 46 of 663 patients died.

Relevant changes

The chart can be freely produced with any good-quality colour printer. In three rural hospitals, deaths from propanil poisoning fell from 10% of those admitted with this diagnosis in 2003–2007 (38/401) to 3% (8/262) in 2008–2014 and the use of methylene blue increased from 10% (13/136) to 55% (59/107) over this period.

Lessons learnt

This simple bedside test was associated with increased use of the first line treatment for propanil poisoning and improved survival. In 2011, the test was included in the national guidelines for the management of propanil poisoning.     

Influence of socio-economic crisis on epidemiological characteristic of suicide in the region of Nis (southeastern part of Serbia, Yugoslavia)

It is well known that gross social crises greatly influence the change in epidemiological features of suicide. The aim of this study is to determine whether the social-economic crisis in Yugoslavia influenced the change in epidemiological features of suicide in the region of Nis (southeastern Serbia). The material included death certificates for 1987–1999. The rates were calculated per 100,000 inhabitants (1991 Census) and standardization was performed by direct method (Segi's world population was used as standard population). Generally, trends for suicide rates in the region of Nis from 1987 to 1999 have decreasing tendency among both sexes. The average annual suicide rate in the region during the period 1987/1989 (relatively economically and politically stable) was 14.8 among males, and 6.8 among females. In 1999 (maximum influence of socio-economical and political crisis) suicide rate among males was 13.8 and among females it was 3.7. The decrease in suicide rate in females can be observed in all age groups, and in males in the age groups 15–29 and 50–64. During 1999, compared to 1987/1989, the increase in the number of suicides is perceived in the summer months (1999 – 41.5%; 95% CI: 30.8–52.2%; 1987/1989 – 23.8%; 95% CI: 18.9–28.7%), as well as the decrease of suicide on Monday (1987/1989 – 21.2%; 95% CI: 16.2–26.1%; 1999 – 9.8%; 95% CI: 3.4–16.2%). During 1999 the rate of suicides committed by fire arms increased (from 8.1 to 14.5%), while there was a decrease in poisoning, in both males (from 26.3 to 9.7%; p < 0.05) and females (from 39.1 to 10.0%; p < 0.05). During 1999 significant changes in epidemiological features of suicide were registered, compared to 1987/1989. These changes were probably enhanced by changed socio-economic factors (primarily war action and the bombing of Serbia, as well as the decline of standard of living and other aspects of economic and political crisis), which requires additional, more complete and thorough research.     

1989至2003年全国有机溶剂重大急性职业中毒的特征

目的探讨有机溶剂重大急性职业中毒事故的发生规律和特点,为制定有机溶剂中毒的防制策略提供科学依据。方法对1989至2003年15年间收集到的有机溶剂重大急性职业中毒资料进行描述性分析。结果(1)15年间共报告有机溶剂重大急性职业中毒事故58起,中毒393例,中毒死亡48人,总中毒率为51．2%,总中毒死亡率为12．2%；平均中毒年龄(30．9±8．8)岁,平均中毒死亡年龄(30．6±12．0)岁。(2)直接导致中毒的有机溶剂有11种,以苯及其同系物为主。(3)有机溶剂重大急性职业中毒以制造业、化学工业、建筑、运输与仓储、服务业与商业等行业多发,喷漆和清洗岗位的危险性较高,事故相对集中发生在4～7月份。(4)导致中毒事故发生的主要原因是没有密闭通风排毒设备或效果不好、没有个人防护设备、缺乏安全教育和没有安全操作规程等。结论作业场所要加强通风,避免劳动者皮肤直接接触有机溶剂,使用无毒或低毒的替代物质。     

Urinary chlorophenols in sawmill workers

Summary The concentration of urinary chlorophenol was assayed for 230 sawmill workers. Information on the work tasks was obtained through questionnaires from occupational health centres. The workers were divided into three groups on the basis of the type of exposure: (1) those with skin absorption as the main route, (2) those with skin and respiratory route of equal importance and (3) those with respiratory tract as the main route. The concentrations of urinary chlorophenol were higher in workers with skin absorption as the main route (median concentration: 7.8 mol l^–1; range 0.1 to 210.9 mol l^–1) than in those with both routes of equal importance (1.4 mol l^–1; range 0.1 to 47.8 mol l^–1, P<0.001) or in those with mainly respiratory route (0.9 mol l^–1; range 0.1 to 13.3 mol l^–1, P<0.001). The urinary chlorophenol concentration was below 15 moll^–1 in all workers with the lungs as the main absorption route. In nine out of 112 workers whose main absorption route was the skin, the urinary chlorophenol values were above 50 mol l^–1. Six were loaders when the through-dipping method was used. In two of them urinary chlorophenol concentrations were as high as 170.8 and 210.9 mol l^–1, These results emphasize the need to develop and use simple methods of protection against skin contact with chlorophenols.     

Investigation of saliva, faeces, urine or semen samples for the presence of GBV-C RNA

GBV-C/HGV has been demonstrated to be distributed worldwide with a prevalence in blood donors higher than HCV. This distribution in the general population probably requires an effective non-parenteral route of transmission. A previous study was performed to evaluate the presence of GBV-C/HGV in serum. Saliva, faeces and urine samples of 30 patients (15 males and 15 females) and 15 semen samples from patients whose serum gave a GBV-C/HGV RNA positive result were then tested by a sensitive polymerase chain reaction (PCR) test. Five semen supernatant samples (33.3%) tested positive – four of them belonged to HIV positive patients – and two saliva samples contained GBV-C/HGV sequences (6.6%) – one from a HIV-positive patient. An internal control was used to detect PCR non-specific inhibitors in the samples. The data suggest possible non-parenteral routes of transmission from this virus. Its presence in body fluids other than serum has clinical implications other than possible hepatic damage that remain to be investigated.     

Prevalence and consequences of low back problems in the Netherlands, working vs non-working population, the MORGEN-study

Objective: To study the burden of illness of low back problems—prevalence and consequences—in the working and the non-working population.Methods: Data from the Monitoring Project on Risk factors for Chronic Diseases, the MORGEN-study, were used. This project provided data on a probability sample of the general population aged 20–59 y in the Netherlands. Cross-sectional questionnaire data on 6317 men (24% non-working) and 7505 women (47% non-working) gathered over the period 1993–1995 were analysed.Results: The 12 month period prevalence of low back problems for the working and non-working population was 44.4% and 45.8% for men, and 48.2% and 55.0% for women. Larger differences were found for chronic low back problems, and activity limitation and use of health services due to low back problems. More than one-third of those who were disabled were so because of low back problems. When those unable to work because of disability (work disabled) were excluded, the prevalence and consequences of low back pain were still higher in the non-working group in comparison with the working population. Most of the non-working women were housewives and this group was both large in size and had a high prevalence of low back problems.Conclusions: Among the men studied, more than a quarter of the total burden of low back problems in those aged 20–59 y were found in the non-working population, among women this was 50%. Both research on causes and determinants of low back pain and the development of preventive actions—now being extensively focused on the working population—should also be translated to the non-working population.     

1989至2003年全国金属及类金属化合物重大急性职业中毒的特征

目的通过分析我国报告发生的金属及类金属化合物重大急性职业中毒事故的发生特点,提出优先、重点的防制建议。方法对1989至2003年全国报告发生的金属及类金属化合物重大急性职业中毒资料进行整理和分析。结果15年间共报告金属及类金属化合物重大急性职业中毒39起,年均2．6起,直接导致中毒的金属及类金属化合物约13种。确诊中毒609例,死亡32例,平均每起事故中毒15．6例,中毒死亡0．8例,总中毒率为52．9%,总中毒死亡率为5．3%；平均中毒年龄(29．2±9．0)岁,平均中毒死亡年龄(32．3±9．9)岁。自1997年起报告的中毒事故增多,43．6%的中毒由砷化氢导致；发生在制造业和化学工业的中毒较多,清洗和搬运作业易发生中毒。导致中毒事故发生的主要原因是没有密闭通风排毒设备或效果不好(22．5%)、没有个人防护设备(19．8%)、缺乏安全教育(19．8%)和没有安全操作规程(15．3%)等。结论加强砷化氢、砷及其化合物的急性中毒防治,注意在冬夏两季有针对性地加强安全教育和个人防护。     

控制高毒农药在预防农村急性农药中毒中的意义

目的 探讨控制危害最大的农药在预防农村急性农药中毒中所起的作用.方法 通过对某省某县医院既往中毒病例的分析,发现在农村中最易发生中毒的特危农药,假设在控制这些农药后,估测生产性农药中毒的发生和非生产性农药中毒病死率的变化趋势.结果 对硫磷(含甲基对硫磷)是某省某县引起生产性农药中毒危害最大的农药,在控制了对硫磷农药的使用之后,生产性农药中毒危害的大小[生产性农药中毒的例数(A)与非生产性农药中毒的例数(B)的比值]由控制前的0.63下降为0.32,差异有统计学意义(P<0.01).对硫磷同样是引起非生产性农药中毒危害最大的农药,其病死率高达15.8%.在控制了对硫磷的获得之后,非生产性农药中毒的整体病死率由9.4%下降至7.4%.文献资料的分析也得到了类似的结果.结论 若控制了危害最大的农药就能明显减少生产性农药中毒的发生和降低非生产性农药中毒的病死率.