The epidemiology and surveillance of blood lead in Taiwan (R.O.C.): A report on the PRESS-BLL project

 To monitor the lead hazards in industries and to investigate the prevalence of elevated blood lead levels (BLLs) in lead-exposed workers, a lead surveillance system (PRESS-BLLs) has been established and operated in Taiwan, Republic of China, since July 1993. A cohort of lead-exposed workers who received a periodic annual health examination at 55 accredited hospital laboratories was constructed. A total of 9807 separate BLL measurements were reported to the system in 1994. The mean BLL was 15.8 μg/dl in male workers and 11.6 μg/dl in female workers. The mean BLL of lead-exposed workers was significantly (P<0.05, z-test) higher than that of the general Taiwanese population (8.6 μg/dl for males and 6.7 μg/dl for females). In addition, the BLLs of 983 (10.0%) workers exceeded the regulatory action level (40 μg/dl for males; 30 μg/dl for females). The workplaces and homes of 57% of the workers with elevated BLLs were thoroughly investigated to determine the sources of lead contamination. These actions identified the causes of elevated BLLs and set up strategies to reduce workers’ lead exposure. The establishment of this occupational lead surveillance system represents a method for monitoring of lead hazards from occupational and environmental settings to prevent lead poisoning. The information acquired from the system can help in the setting up of a priority of prevention and the development of control measures. It is also useful for further monitoring of changes in the BLLs of the lead-exposed-worker cohort. The Health Department of Taiwan can use this information to evaluate the effectiveness of current industrial hygiene practice. Subjects with elevated BLLs have been medically treated and placed on long-term follow-up for sequelae. Received: 2 September 1996/Accepted: 29 November 1996     

THE POINT PREVALENCE OF WOUNDS IN A TEACHING HOSPITAL

Background : Wounds are a common problem, particularly in the elderly population. The scale of wound problems in hospital is largely unknown because wounds are widely dispersed. The present study examined the point prevalence of hospital wounds and undertook a pressure ulcer risk assessment of all patients on one day. Methods : All 360 inpatients were surveyed and thoroughly examined. A risk scale for pressure sore development, the Norton score, was applied. When wounds were found, information was collected to determine their aetiology. Results : Forty leg ulcers, 40 pressure sores, 85 surgical wounds and seven other types of wounds were found. Most leg ulcer and pressure sore cases were admitted for other reasons. The Norton score did not predict all cases of pressure ulceration. A total of 52% of wounds did not qualify for additional funding under current funding criteria. Conclusion : The prevalence of non-surgical wounds in Heidelberg Repatriation Hospital was easily underestimated. Wound care management can be optimized by staff education and protocol design, early identification of troublesome wounds and of at-risk patients, and a cross-sectional approach that incorporates wound-management teams.     

我国较贫困地区农村学龄前儿童膳食状况

对１９８５～１９８９年７省较贫困的１８个乡农村儿童膳食调查资料采用平均摄入量、临界值及概率法进行了总结分析。结果表明，６～２４月龄母乳喂养儿的辅食品种单一，数量不足。断奶儿童各年龄组热能、蛋白质摄入量的平均值分别达ＲＤＡ的９２％～１０４％和７６％～８４％，但以ＲＤＡ为界值，仍有５３％～６２％及７４％～８５％的儿童热能、蛋白质摄入量低，用概率法分析蛋白质、钙、维生素Ａ、Ｂ２、Ｃ及铁摄入不足的人数比例分别是５０％～６０％、９３％～９７％、５１％～８７％、７４％～８６％、５８％～６６％和１２％～４７％。热能、蛋白质摄入量低于ＲＤＡ值儿童的身高、体重明显低于摄入量高于ＲＤＡ值的儿童。     

应用Meta分析有效估计人群归因危险度百分比的探讨

人群归因危险度百分比 (populationattributableriskproportion ,PARP)是总体人群中某种疾病归因于某种因素的暴露所引起的发病 (死亡 )占全部发病 (死亡 )的百分比 ,反映该因素所引起的发病 (死亡 )占全部发病 (死亡 )的比重。通过PARP可了解各危险因素对人群中某疾病的发病所产生的影响 ,亦即消除某危险因素后 ,所产生的对预防该疾病的效果将占有多大比重。它能够为卫生政策的制订提供依据 ,有着重要的公共卫生的实际意义。目前常用的估计PARP的方法有两种 :一种是利用全国人群抽样调查获得的人群总暴露率来估计 ;另一种是利用某地区…     

广西射击运动员血清脂质水平分析

目的：了解射击运动员高脂血症的发生情况和可能的引发因素，为预防高脂血症提供依据。方法：对从事专业训练半年以上，无急慢性疾病的53名省级优秀射击运动员进行膳食调查和血清脂质水平检测。结果：运动员的高脂血症检出率为28．3％，全部为高甘油三脂血症；膳食中 运动员除了摄入维生素B1、B2不足和维生素A缺乏外，其他各类营养素基本能满足机体需要，属基本合理膳食。结论：以抗阻训练和静力运动为运动特征的射击运动，可能会对机体血脂代谢产生不利的影响。     

Effect of different questionnaire formats on reporting of occupational exposures

During an exposure monitoring study, 78 saw maintenance tradesmen were randomly assigned to be interviewed about their exposures using one of two questionnaire formats: open-ended and partly prompted questions about five categories of materials; and detailed prompting about 75 agents. The more open-ended questionnaire elicited fewer exposure responses overall, but more responses about agents not included on the detailed questionnaire. Composite materials and trade name products were more frequently cited as exposures than individual metals or compounds. Validity of responses was ascertained using air measurements (individual metals) or observations of the employees (composite materials). Sums of sensitivities and specificities were very low (near 1.0) for most of the metals for both types of questionnaire. For composite materials, validity improved substantially. Sensitivities with the partly prompted format (0.44–0.85) were always lower than with detailed prompting (0.80–1.00). Specificities were usually, but not always, higher with partial prompting (0.66–0.92) than with detailed prompting (0.18–0.86). Selection of questionnaire format for an epidemiologic study would depend on the likely prevalence of exposure in controls and the effects of trade-offs in sensitivity and specificity.     

1977～1990年同济医科大学新生视力状况分析

用统计学方法对14年来（1977～1990年）我校6746名新生（13492只眼）的视力状况进行分析。结果表明；新生正常视力逐年减少，视力不良率相应上升（P＜0.001）。城市学生的视力比农村学生差，男生的视力优于女生（P＜0.001）。17～19岁组的视力明显低于其他年龄组（P＜0.001）。高考分数线升高与正常视力者减少呈明显负相关；而与视力不良者增加呈正相关（P＜0.001,＜0.05）。本文认为近距离用眼持续时间过长及环境视域小等是引起视力不良的主要原因。     

A comparison of nutritional intake, functional status and muscle strength between elderly day hospital and day centre attenders in South London

Two sample groups of elderly were compared from a population living in South London. One group attended a local day centre (a socially orientated establishment), and the other attended a local day hospital (a therapeutically orientated establishment).
The aim of the study was to compare nutritional intake, functional status and muscle strength between these two groups.
The mean nutritional intakes of the day hospital and day centre attenders were similar. Intake of macronutrients, with the exception of fibre, met Recommended Daily Allowances (RDAs) in both groups. In take of folic acid, vitamin D and zinc fell below recommendations in both groups.
Low intake of folic acid was improved by supplementation, and some individual blood levels of folate reflected this. Blood folate levels were generally within normal limits. Low intake of vitamin D was improved by supplementation, but blood levels were generally normal anyway. There was, however, a tendency for the more dependent day hospital patients to have lower vitamin D levels. This group also had less sunshine exposure.
Communal dining, whether in the setting of day hospital or day centre, may have been an essential means of bolstering nutritional intake for many 'at risk' elderly.
There were significant differences in functional status and muscle strength in favour of the day centre group and these indicate that anthropometric indices rather than nutritional or biochemical indices were the most reliable markers of disease and disability in this study.
The effect of fortifying local meals-on-wheels was also highlighted, and suggests that this may be one means of preventing nutritional deficiencies in the vulnerable, house-bound elderly.
Alcohol intake was reported as being modest. However, discrepancies were noted on review of biochemical indices known to be influenced by alcohol intake.     

北京、广州、上海城市居民营养知识、态度、行为的调查

对北京、广州和上海三大城市随机抽取的９６５名年龄在２０～５０岁的城市居民进行有关营养知识、态度和行为（Ｋ－Ａ－Ｐ）的调查。结果显示，三地区调查对象的营养知识水平不高。营养知识的得分与其自身受教育程度有相关性（ｒ＝０．３０１１，Ｐ＜０．０１）。年龄在３５岁以上的对象，营养知识的得分高于年轻人；三地区调查对象对营养知识的获取，合理的膳食模式，卫生的饮食习惯均持有积极、肯定的态度。食物消费频度调查结果表明，米／面、肉／禽、蔬菜、水果、奶及奶制品的消费量较高。此外，８９．５％，７８．８％和４７．８％的调查对象分别选择报纸、电视、广播作为其主要营养信息来源。本次调查为将来的营养宣教的内容和方法提供依据。