累积噪声暴露量与血清甘油三酯和总胆固醇关系的分析

目的研究工业噪声作业工人血清中甘油三酯和总胆固醇水平是否与噪声暴露剂量有关。方法选取706名汽车制造工人进行调查,用累积噪声暴露量(CNE)来评价工人的噪声暴露。测定血清中甘油三酯和总胆固醇。结果作业环境等效连续A声级为83.2±7.99dB(A),CNE为91.5±8.50dB(A)年,高甘油三酯血症检出率为15.44%,高胆固醇血症检出率为32.01%;按CNE作分层分析,高胆固醇血症检出率与CNE间存在剂量-反应关系。控制混杂因素,进一步logistic回归分析:CNE与高胆固醇血症相关显著。结论CNE是引起高胆固醇血症的危险因素之一。     

累积噪声暴露量与血浆热应激蛋白70抗体关系的分析

目的研究工业噪声作业工人血浆热应激蛋白70(HSP70)抗体水平是否与噪声暴露剂量有关.方法用横断面流行病学方法,选取438名噪声作业工人进行调查;用Western blot免疫印迹法测定其血浆HSP70抗体滴度;用累积噪声暴露量(CNE)评价工人实际噪声暴露.结果作业环境等效连续A声级为(83.20±7.99)dB(A),CNE为(91.50±8.50)dB(A)@年,HSP70抗体阳性检出率为19.4%,按CNE进行分层分析,HSP70阳性检出率与CNE间存在剂量一反应关系.为排除年龄、性别、吸烟等混杂因素,进一步进行Logistic回归分析,模型显示:累积噪声暴露量与HSP70抗体阳性显著相关OR=1.027(P=0.031).结论累积噪声暴露量是引起HSP70抗体阳性的主要危险因素.HSP70抗体阳性率可反映噪声实际暴露水平.     

某城市中小企业职业性噪声聋与累积噪声暴露剂量的相关性研究

目的分析累积噪声暴露剂量(CNE)与职业性噪声聋的发生及发展规律的关系。方法对作业环境噪声进行监测,对调查对象进行纯音听阈测定;进行相关指标分析并计算CNE。结果听阈提高与基础听阈相关(P<0.01);当CNE由(96.9±5.9)dB(A)年提高到(102.1±3.4)dB(A)年时,语频损失与高频损失的发生率分别由8.4%和7.3%上升到21.1%;职业性噪声聋的发生率及严重程度与CNE相关,并以100dB(A)年为阈值;各频率听阈特别是高频听阈提高且具统计学意义(P<0.01)。结论早期发现听阈异常特别是早期高频听阈改变者,控制职业噪声暴露者CNE;并按规定调离噪声作业。     

水力发电工人职业性噪声聋与累积噪声暴露剂量的关系

目的 分析职业性噪声聋的发生、发展规律及与累积噪声暴露剂量(CNE)的关系.方法 对调查对象进行纯音听阈测定,对作业环境噪声进行监测;计算CNE并进行相关指标分析.结果 当CNE由(97.5±5.4)dB(A)年提高到(102.4±2.9)dB(A)年时,语频损伤及高频损失的发生率分别由4.6%和11.5%上升到10....     

用个体暴露评价脉冲噪声与稳态噪声所致高频听力损失的关系

目的用个体噪声暴露测量数据比较工业脉冲噪声与稳态噪声所致高频听力损失剂量反应关系的异同。方法1998至1999年,以32名接触脉冲噪声的机械制造工人和163名接触稳态噪声的纺织工人为观察对象,用噪声剂量计采集8h工作期间的噪声暴露数据,计算8h等效声级(LAeq.8h),并按等能量原理将LAeq.8h和噪声作业工龄合并为累积噪声暴露量(CNE)。用常规方法测量工人左右耳气导听阈,按GBZ492002对听阈做年龄性别校正,并诊断是否为高频听力损失。结果脉冲噪声组的CNE[(103.2±4.2)dB(A)·年]明显低于稳态噪声组[(110.6±6.0)dB(A)·年],脉冲噪声组高频听力损失患病率(68.8%)与稳态噪声组(65.0%)相似,分层分析和趋势卡方检验证实,两组CNE与高频听力损失患病率间均存在典型的剂量反应关系,差异有统计学意义;脉冲噪声100～104和105～109dB(A)·年两组的高频听力损失患病率(76.9%和90.9%)高出稳态噪声组(30.4%和50.0%)约1倍。logistic回归模型显示,脉冲噪声组CNE与高频听力损失患病率的剂量反应关系曲线与稳态噪声组相比出现曲线左移,斜率增大。结论采用个体噪声暴露数据计算时,在能量相同的情况下,脉冲噪声所致高频听力损失的危害大于稳态噪声。     

噪声暴露对某国有大型煤矿工人血糖和血脂水平的影响

目的 探讨某国有大型煤矿工作场所噪声对工人血糖和血脂水平的影响。方法 对新泰市某国有大型煤矿作业工人进行职业健康检查,随机选择长期接触高噪声(82.8~100.1 LAeq dB(A))428人为观察组,接触低噪声(53.9~71.0 LAeq dB(A))506人为对照组,比较两组工人血糖和血脂水平差异。结果 观察组工人血清葡萄糖为(5.32±0.79)mmol/L、总胆固醇为(4.72±0.82)mmol/L、甘油三酯为(1.67±1.31)mmol/L、高密度脂蛋白为(1.41±0.30)mmol/L、低密度脂蛋白为(2.79±0.68)mmol/L。观察组工人血清葡萄糖、总胆固醇、甘油三酯和低密度脂蛋白胆固醇水平均明显高于对照组,差异有统计学意义(P<0.05)。观察组的血清葡萄糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇异常率均高于对照组,差异有统计学意义(P<0.05);观察组的脂肪肝检出率高于对照组,差异有统计学意义(P<0.05)。随着工龄的增加,血糖、总胆固醇、甘油三酯和低密度脂蛋白胆固醇含量也增高,各工龄组之间血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇差异有统计学意义(P＜0.05)。结论 长期接触高噪声可能是煤矿作业工人血糖和血脂水平升高的危险因素。     

机场地勤人员噪声暴露与高血压患病率的剂量-反应关系

目的探讨机场地勤人员噪声暴露与高血压患病率之间的关系。方法以某机场长期接触噪声的463名地勤人员为研究对象,将其工作内容和工作性质相似的分为一组,每组抽取3~5人用噪声个体计量仪测量等效A声级(LAeq),按等能量原理将LAeq和噪声作业工龄合并计算累积噪声暴露量(CNE)。高血压判定按WHO/ISH(1999)标准:收缩压≥140 mm Hg(18.6 kPa)和/或舒张压≥90 mm Hg(12.0 kPa)者为高血压,已确诊高血压并服降压药者均按高血压统计。结果机场地勤人员8 h等效声级LAeq.8h为(89.3±4.0)dB(A),97%地勤人员的LAeq.8h高于85 dB(A)。体检发现高血压患者91人,高血压患病率19.7%。单因素分析表明工龄、年龄、体重指数(BMI)以及父母高血压史均与高血压患病率呈正相关关系(P<0.05),CNE与高血压患病率之间存在典型的剂量-反应关系(P<0.01)。多元Logistic回归显示,年龄(OR=1.062)、BMI(OR=1.280)、父母高血压史(OR=1.945)是高血压患病的独立危险因素,CNE的OR值为1.040(P=0.197)。结论CNE与高血压患病率之间存在典型的剂量-反应关系,调整混杂因素影响后CNE每增加1 dB(A)地勤人员高血压发病的危险增加约4%,但差异尚无统计学意义。     

某空调生产企业噪声暴露与高血压的关系研究

目的 探讨空调生产企业噪声暴露与高血压患病率之间的关系.方法 以某大型空调企业长期接触噪声的631名工人为研究对象,测量等效A声级(LAeq).按等能量原则将LAeq和噪声作业工龄合并计算累积噪声暴露量(CNE);用Logistic回归模型分析噪声暴露量与高血压的关系.结果 空调生产企业噪声从业人员高血压患病率为9.51％.随着累积噪声暴露量(CNE)的增加高血压患病率逐渐升高(P＜ 0.0001),CNE与高血压患病率之间存在剂量-反应关系.非条件Logistic回归分析结果显示:随着工龄的增加,CNE的增加对患高血压的相对危险性越大(OR＝1.824);体重指数(BMI) (OR=3.68)可能是高血压发病的危险因素.结论 CNE与高血压患病率之间存在剂量-反应关系,BMI可能是高血压发病的一个危险因素.     

冲床噪声与稳态噪声致工人高频听力损害的对比研究

目的 了解冲床噪声对工人高频率段听力的影响,并与稳态噪声进行对比.方法 接触冲床噪声的38名锻压车间工人为冲床噪声接触组,62名接触稳态噪声的拉丝、磨粉等工人为稳态噪声组.用个人声暴露计采集工作期间噪声暴露数据,计算40h等效声级(LEX,W)和累积噪声暴露量(CNE).按GBZ 49-2007《职业性噪声聋诊断标准》对工人测试听力并计算和判定结果.结果 冲床噪声接触组CNE[(97.0±6.4) dB (A)·年]与稳态噪声接触组CNE [(97.6±5.7)dB(A)·年]比较,差异无统计学意义(P＞0.05).冲床噪声接触组高频听力损失率(55.3％)明显高于稳态噪声(32.3％),差异有统计学意义(CMHX2=6.928,P=0.0085);冲床噪声接触组于CNE 95～104 dB(A)·年内损失率(13/19,68.4％)明显高于稳态噪声组( 13/37,35.1％),差异有统计学意义(P=0.018).logistic回归模型显示,冲床噪声组、稳态噪声组CNE与高频听力损失率均呈剂量-反应关系(P＜0.01).结论 应用个体噪声暴露数据计算时,在能量相同的情况下,冲床噪声所致高频听力损失的危害大于稳态噪声.     

噪声作业工人1011例听力损伤及相关因素分析

为了解某企业1 011名噪声作业工人听力损伤情况,分析听力损伤的相关因素。对作业场所进行现场噪声测定,对工人进行问卷调查及听力检测,计算累积噪声暴露量(CNE)。结果显示,噪声从业人员听力损伤检出率为17.11%。经线性趋势检验显示,听力检测结果与CNE呈线性关系,且听力损失检出率随CNE的增加而增加(Z=-4.05,P<0.0001);Logistic回归分析显示:在控制性别因素情况下,CNE>95dB(A)的两组噪声作业工人听力损伤检出率分别是CNE<85dB(A)的2.58与3.22倍。提示,对接触噪声人员实施个体防护是噪声防护最经济有效的措施;CNE可作为佩戴耳塞的噪声作业工人的听力损伤的评价指标。     

企业职工高尿酸血症与血压、血脂、血糖的相关性研究

目的探讨企业职工高尿酸血症（HUA）与血压、血脂、血糖的相关性,为企业进行健康管理提供依据。方法以中国石油长庆油田公司各下属企业为抽样单位,整群随机抽取2个单位,每个单位中所有的HUA者作为HUA组,共720人;同时在尿酸水平正常者中随机选取620人为正常组。通过Logistic回归分析HUA与年龄、性别、血压、血脂、血糖的关系。结果HUA合并高血压、高血脂、空腹m糖受损任意一项、两项、三项的比例均远高于正常组（OR值分别为：4．036,2．562,4．174）。多因素Logistic回归发现：男性、收缩压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇是HUA的危险因素（OR值分别为7．736,2．309,1．721,2．761,1．411）;高密度脂蛋白胆固醇为HUA的保护因素（OR值为0．211）。结论HUA存在性别差异,且与血压、血脂密切相关。企业对职工的健康管理应充分考虑多危险因素的综合作用,全面的进行健康教育及干预。     

癌缺氧病因及预防和治疗

目的 探讨癌及安阳林州市食管癌高发原因及癌病因预防和治疗措施.方法 对林州市食管癌等疾病现场进行调查,在进行10余年统计分析基础上,综合分析了全国156篇文献成果.结果 提出癌缺氧病因学说,使用制氧机、按摩器、饮用纯净水治疗恶性肿瘤,取得良好效果,改水能够大幅降低林州市居民食管癌发病率、死亡率.结论 癌可能是由于机体长...     

Recruitment and retention challenges and successes

Objective: Addressing health disparities requires well designed, culturally adapted research. However, recruiting/retaining minority participants has often been challenging. We present strategies used to successfully recruit and retain rural Hispanic women during a breastfeeding education intervention.

Design: This study involved a two-group repeated measures quasi-experimental design with assessments at seven intervals between enrollment and 6 months postpartum. Participants (Hispanic women?≥?15 years old) were recruited through a regional hospital.

Results: We successfully met our recruitment goals, most women contacted were enrolled (46 of 58), and 100% completed the study.

Discussion: Research staff with ties within the community helped establish trust. Using bilingual study materials, simple language, and an interpreter addressed language/literacy concerns. Phone assessments facilitated participation as transportation was an issue. Accommodating requests to deliver or mail study materials and providing incentives were important. Extra effort was needed to maintain contact when phone service was disrupted or participants moved. Keys to success were persistence, flexibility, and alleviating barriers to participation.     

初产妇与经产妇焦虑抑郁状态分析及干预

目的：分析初产妇、经产妇心理状态特点,以便采取更有效的干预措施。方法筛选2014年6月至2015年1月在咸阳市旬邑县妇幼保健院产科门诊产前检查的健康初产和经产妇各60名,孕周为28~40周。入组时用焦虑自评量表( SAS)、抑郁自评量表(SDS)对两组孕妇进行心理评定,并给1次支持性心理干预(40~60分钟),1周后再次用SAS、SDS对两组孕妇进行评定分析。结果经产妇干预前SAS(50.73±3.45)、SDS(49.13±3.86)评分明显高于初产妇SAS(42.45±2.08)、SDS(41.77±2.21),差异均有统计学意义(t值分别为-15.921、-12.817,均P<0.01);干预后两组SAS、SDS评分均比干预前明显降低,差异均有统计学意义(t值分别为14.999、15.413;15.724、15.832,均P<0.01);干预后经产妇 SAS(38.61±5.02)、SDS(39.10±3.03)评分明显高于初产妇SAS(34.88±3.31)、SDS(32.01±4.27),差异均有统计学意义(t值分别为-4.805、-10.489,均P<0.01)。结论初产妇和经产妇均伴有焦虑、抑郁情绪,干预前后经产妇抑郁、焦虑情绪均较初产妇明显,支持性心理干预能有效改善孕妇的不良情绪。     

Continuity and change in neighborhood disadvantage and adolescent depression and anxiety

We used data from the Fragile Families and Child Wellbeing Study which includes a sample of adolescents of age 15 at the most recent wave (between 2014 and 2017) from mainly low-income urban families in the United States, to examine the association between neighborhood poverty entries and exits and adolescent depression and anxiety. In addition, we examined whether these associations differed by gender. Adolescents who consistently lived in disadvantaged neighborhoods had the highest level of depression and anxiety. Those who entered poor neighborhoods were more depressed than those who never lived in poor neighborhoods. Those who exited poor neighborhoods showed no significant difference in depression and anxiety compared to those never lived in poor neighborhoods. Furthermore, these associations applied to adolescent girls only and were not statistically significant for boys. The results suggest that neighborhood poverty has cumulative negative impacts on adolescent mental health and disproportionally affects adolescent girls. Reducing neighborhood poverty would substantially improve the health of adolescents, especially girls, which would reduce health disparities.     

Enabling positive change: Progress and setbacks in HIV and sexual and reproductive health and rights

At a point in history when the future of sexual and reproductive health including HIV looks particularly uncertain, it is helpful to recognise that many of the challenges currently faced are neither new nor insurmountable. Reflecting on past achievements and lessons learned helps us to have confidence that positive change is feasible. This paper reflects on some of the changes observed in countries like India and Mozambique and identifies a range of factors which need to coalesce to enable these developments, along with specific contextual factors. It is the combination of these influences rather than any one of them alone that brought about the change in the three instances described – fostering a positive political response to HIV in its early years in India; bringing about policy reform on abortion in Mozambique; and increasing contraceptive prevalence and age at marriage in some districts in Bihar, India. Change is always fragile and susceptible to setbacks, but change-seekers can learn in the process and gain renewed hope that progress can and often does take place if they persevere.     

儿童青少年超重肥胖评价方法及SPSS和SAS实现

超重肥胖已成为世界各国儿童青少年面临的重大公共卫生问题之一。现行的儿童青少年超重肥胖筛查标准不统一,逐条评价或自行编写程序容易出错且效率较低。本研究以中国学龄儿童青少年超重与肥胖筛查标准为例,详细介绍了国际和中国共四种评价儿童青少年超重肥胖的方法和步骤,结合具体案例详细介绍其应用方法,同时编制SPSS和SAS程序包和解...     

Car ownership and the association between fruit and vegetable availability and diet

Objective

Nearly all research on the food environment and diet has not accounted for car ownership — a potential key modifying factor. This study examined the modifying effect of car ownership on the relationship between neighborhood fruit and vegetable availability and intake.

Methods

Data on respondents' (n = 760) fruit and vegetable intake, car ownership, and demographics came from the 2008 New Orleans Behavioral Risk Factor Surveillance System. Shelf space data on fresh, frozen, and canned fruits and vegetables were collected in 2008 from a random sample of New Orleans stores (n = 114). Availability measures were constructed by summing the amount of fruit and vegetable shelf space in all stores within defined distances from respondent households. Regression analyses controlled for demographics and were run separately for respondents with and without a car.

Results

Fruit and vegetable availability was positively associated with intake among non-car owners. An additional 100 m of shelf space within 2 km of a residence was predictive of a half-serving/day increase in fruit and vegetable intake. Availability was not associated with intake among car owners.

Conclusions

Future research and interventions to increase neighborhood healthy food options should consider car ownership rates in their target areas as an important modifying factor.