有效预防医务人员艾滋病病毒职业暴露后感染

目的有效预防医务人员在工作中发生暴露感染艾滋病病毒。方法针对我院接触艾滋病病毒感染者和艾滋病患者发生的11名职业暴露进行分析,制定和建立了一整套防御艾滋病病毒感染的制度和监控办法。结果由于及时采取措施,医学观察追踪3年多,接触艾滋病感染者和艾滋病患者发生职业暴露的医务人员尚未发现感染艾滋病病毒。结论医院重视医务人员职业暴露安全教育,加强预防艾滋病病毒感染各个环节的监控和管理制度的落实,可以有效降低和减少医务人员职业暴露和暴露后感染艾滋病可能的发生,确保医务人员职业安全。     

艾滋病病毒职业暴露35例调查

目的完善预防艾滋病病毒感染的防控措施,有效预防和控制医护人员在工作中发生职业暴露感染艾滋病病毒。方法对35名接触艾滋病患者出现职业暴露者的工作人员暴露途径、暴露后的处理方式和工作人员身体状况等因素进行调查分析。结果职业暴露发生率为77.78%,暴露的主要途径是经皮肤性损伤暴露,医护人员对发生暴露的危险性认识不够,职业防护能力较低。结论强化职业安全教育,完善职业防护措施,减少医护人员职业暴露。     

医务人员艾滋病病毒职业暴露防护工作指导原则(试行)

(2 0 0 4年 5月 31日 )第一章　总　　则第一条　为维护医务人员的职业安全 ,有效预防医务人员在工作中发生职业暴露感染艾滋病病毒 ,制定本指导原则。第二条　本指导原则所称艾滋病病毒职业暴露是指医务人员从事诊疗、护理等工作过程中意外被艾滋病病毒感染者或者艾滋病病人的血液、体液污染了皮肤或者粘膜 ,或者被含有艾滋病病毒的血液、体液污染了的针头及其他锐器刺破皮肤 ,有可能被艾滋病病毒感染的情况。第三条　各级各类医疗卫生机构应当按照本指导原则的规定 ,加强医务人员预防与控制艾滋病病毒感染的防护工作。第二章　预　　防第…     

54名临床医务人员职业暴露的资料分析及防护对策

目的分析医务人员职业暴露分布情况,制定有效的职业暴露防护措施。方法对54名已报告职业暴露的医务人员调查资料进行总结分析,采取回顾性监测,提出防治措施。结果对54名职业暴露的医务人员中及时采取控制措施,发生乙型肝炎病毒感染2名,丙型肝炎病毒感染1名,苍白密螺旋体感染1名,职业暴露感染率为7.41%。结论应注重医务人员职业暴露教育;加强管理,规范操作程序,提高医务人员职业暴露防护意识,建立健全医务人员职业暴露防护的措施与方案,培养良好的工作习惯,可预防职业感染的发生。     

卫生部关于印发《医务人员艾滋病病毒职业暴露防护工作指导原则(试行)》的通知

各省、自治区、直辖市卫生厅局,新疆生产建设兵 团卫生局: 为维护医务人员的职业安全,有效预防和控 制医务人员在工作中发生职业暴露感染艾滋病病 毒,我部组织有关专家,在调查研究的基础上制定 了《医务人员艾滋病病毒职业暴露防护工作指导 原则(试行)》(以下简称《指导原则》)。现印发给     

医护人员HIV职业暴露的危险因素和防护措施

HIV职业暴露指医务人员从事诊疗、护理等工作中意外被艾滋病病毒感染者或艾滋病患者的血液、体液污染了皮肤或黏膜或被含有艾滋病病毒的血液、体液污染的针头及其他锐器刺伤皮肤,有可能被艾滋病病毒感染的情况。笔者所在医院近1年发生数十起医护人员HIV职业暴露事件,本文从临床工作的角度出发,探讨HIV职业暴露的危险因素及防护措施,这对于杜绝医护人员医源性HIV感染的发生具有承大的现实意义。     

天津市部分医务人员对HIV感染者/AIDS患者态度和艾滋病职业防护知识调查

目的了解天津市医护人员对艾滋病病毒(HIV)感染者/爱滋病(AIDS)患者的态度,以及医护人员职业暴露自我防护的意识。方法采用随机抽样方法,自行设计问卷,对天津市2家三级甲等综合性医疗机构的183名医务人员进行匿名问卷调查,使用SPSS 19.0进行数据分析。结果本次接受调查的医务人员中,女性比例高于男性,以<30岁组人数居多。医务人员的艾滋病防治知识知晓率为75.41%,对HIV感染者/AIDS患者存在抵触排斥态度,发生或职业暴露的比例为74.87%,普遍缺乏艾滋病职业暴露标准防护措施的相关知识。结论医疗机构应加强对院内各类医务人员艾滋病防治知识、职业暴露防护措施的培训,加强对院内感染管理、强化发生职业暴露后的处置规范,减少医务人员对艾滋病患者的歧视,提高医务人员对职业暴露的防护意识。     

医护人员艾滋病病毒职业暴露的原因分析及防护措施

目的 探讨医护人员面临艾滋病职业暴露的高危因素,强调职业暴露重在预防;探讨医护人员对艾滋痛自身防护措施,提高对艾滋病病毒(HIV)职业暴露的防护意识,防止医护人员感染HIV的危险,确保医护人员职业安全.方法 对2008年、2009年和2011年所发生的15人次HIV职业暴露的原因和过程进行调查分析;采取问卷方式对150名医护人员进行有关职业暴露防护知识的调查.结果 医护人员防护意识不强、工作经验不足、缺乏严格的防护教育培训和必要的防护设施等.结论 加强医务人员艾滋病安全操作和职业防护知识培训,避免医护人员因锐器伤和自身皮肤破损等原因被HIV感染;准确及时的评估和有效合理用药是避免职业暴露发生HIV感染的重要措施.遵照标准预防原则,采取严格的防护措施,以减少甚至杜绝医护人员感染HIV.     

某医院医务人员职业暴露监测分析

正为了解某医院医务人员职业暴露情况,我们分析了2008年8月-2013年2月该院26名医务人员发生锐器伤职业暴露的监测资料,报告如下。1对象与方法本次调查对象为2008年8月-2013年2月报告给医院感染控制科的26名职业暴露医务人员。调查工具为根据《医务人员艾滋病病毒职业暴露防护工作指导原则》、《医院感染管理办法》等法规自行设计的"医务人员血液体液职业暴     

艾滋病告知的管理

目的 探讨对人类免疫缺陷病毒(HIV)感染者和艾滋病(AIDS)患者告知的技巧,预防医疗事故发生.方法 加强对艾滋病监测、流行病学调查及对艾滋病患者进行告知的管理;提高对艾滋病患者进行告知的技巧同时,预防医疗事故发生;举办预防艾滋病职业暴露培训班,提高医务人员预防艾滋病职业暴露的知识水平;做好医院预防艾滋病等血源性疾病的消毒隔离工作.结果 2010年1-12月该院培训考核医务人员预防艾滋病感染职业暴露315人次均合格,对临床艾滋病患者流行病学调查及告知63人次均满意,使艾滋病管理及告知工作顺利.结论 根据国家传染病管理法,做好艾滋病病毒感染者和艾滋病患者的流行病学调查及告知工作,对保障医疗安全,提高全民的预防艾滋病感染预防治疗意识是很有必要的.     

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 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.     

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.