吸烟、饮酒与蒙古族高血压的关联性

目的 探讨吸烟、饮酒与蒙古族高血压的关联及关联强度。方法 对2589名≥20岁的蒙古族居民进行血压的测量及吸烟、饮酒等因素的调查，采取单因素X^2及多因素非条件Logistic回归模型分析，以OR值作为评价关联及关联强度的指标，用Mantel—HaenszelX^2趋势检验法分析饮酒与高血压间的剂量-反应关系。结果 单因素分析结果显示，年龄、性别（男性）、吸烟、饮酒、超重[体质指数（BMI）≥25]、腹型肥胖[腰臀比（WHR）≥0．9]、高血糖（血糖≥6．1）以及高血压家族史与高血压相关联（P〈0．05）。经Logistic回归模型分析，调整了年龄、性别、BMI、WHR、血糖和家族史等因素后，吸烟与高血压的关联差异无统计学意义（OR；0．823，P〉0．05），而饮酒与高血压之间的关联差异有统计学意义（OR=1．705，P〈0．0001）。剂量-反应关系分析结果显示，蒙古族人群患高血压的危险性有随着饮酒量的增加而增高的趋势。结论 饮酒可能是蒙古族高血压的独立危险因素，随着饮酒量的增加患高血压的危险性增高，而吸烟可能不是蒙古族高血压的危险因素。     

酒精性脂肪肝临床流行病学调查及病因量化标准探讨

目的探讨饮酒与脂肪肝的关系 ,以及酒精性脂肪肝病因的量化标准。方法将连续性体检人群分成非饮酒组、白酒组 (按日均饮酒量下分 <5 0g、5 0～ 1 0 0g及 >1 0 0g白酒组 )和啤酒组 (按日均饮酒量下分 <2 5 0mL、2 5 0～ 5 0 0mL及 >5 0 0mL啤酒组 ) ,对各组脂肪肝检出率及脂肪肝患者饮酒至发病时间进行流行病学调查。结果 5 0～ 1 0 0g及 >1 0 0g白酒组 ,2 5 0～ 5 0 0mL及>5 0 0mL啤酒组脂肪肝检出率分别为 4 3.6 % ,5 0 .0 % ,6 4.5 % ,6 6 .7% ,较非饮酒组的 2 5 .0 %明显增高 (P <0 .0 1 )。各组中脂肪肝患者饮酒时间显著高于同酒量非脂肪肝者 (P <0 .0 1 )。以日均饮白酒 80g、时间 9.0年 ,或日均饮啤酒 4 0 0mL、时间 5 .0年作为各自酒精性脂肪肝病因量化标准 ,分别具有 82 .6 %、88.6 %敏感性 ,72 .2 %、78.3%特异性。结论饮酒与脂肪肝的发生具有量效和时效关系 ,日均饮白酒 80g、时间 9.0年 ,以及日均饮啤酒 4 0 0mL、时间 5 .0年为其各自酒精性脂肪肝较好的病因量化诊断标准。     

饮酒对血脂、血糖、血清白蛋白的影响及其与脂肪肝发病联系的初步研究

目的探讨饮酒对血脂、血糖、血清白蛋白含量的影响及其与脂肪肝发病的联系。方法将连续性体检男性人群分成非酒精组、白酒组及啤酒组 ,按日均饮酒量及饮酒时间又将白酒组及啤酒组再次分组 ,对比分析各组高脂血症、高糖血症及低白蛋白血症检出率。结果非酒精组及白酒组脂肪肝者较非脂肪肝者、啤酒组较非酒精组及白酒组非脂肪肝与脂肪肝者、5 0～ 10 0 g白酒组较非酒精组及 >10 0 g白酒组脂肪肝者、5 0～ 10 0 g白酒组较非酒精组非脂肪肝者高脂血症检出率明显增高 ,白酒组较非酒精组非脂肪肝及脂肪肝者低白蛋白血症检出率均明显增高 (P<0 .0 5～ 0 .0 0 1)。随着日均饮酒量增加 ,白酒组非脂肪肝与脂肪肝者低白蛋白血症检出率均有显著增高 (χ2 =6 .5 8,P<0 .0 5 ;χ2 =10 .0 5 ,P<0 .0 1)。而啤酒组非脂肪肝者及脂肪肝者高糖血症检出率与饮酒时间之间呈现出显著的正相关关系 (χ2 =11.4 6 ,P<0 .0 1;χ2 =7.0 2 ,P<0 .0 5 )。结论饮酒导致高脂血症或高糖血症参与酒精性脂肪肝的发病机制 ,以啤酒组中该作用机制最为明显 ,而在 >10 0 g白酒组脂肪肝的发病机制中有营养不良所致低蛋白血症这一因素参与。     

成年人脂肪肝与代谢综合征关系

目的 分析脂肪肝的危险因素,探讨脂肪肝(FED)与代谢综合征(MS)的关系.方法 对2006-2007年参加健康体检的成人1 113人进行现况调查、体检、生化检验、肝胆脾实时B超检查;代谢综合征的诊断及代谢指标异常的阳性标准采用美国国家胆固醇教育计划成人治疗组第三次报告2005年修订版(ATPIII2005).结果 脂肪肝、代谢综合征的检出率分别为17.1%,9.0%,经年龄标准化后男性为20.5%,9.97%;女性为9.7%,8.54%;腰围(WC)、体质指数(BMI)、空腹血糖(FPG)、甘油三酯(TG)、收缩压(SBP)及舒张压(DBP)异常的阳性率FLD组明显高于非FLD且(P<0.01),OR值为2.80～19.5,前3位分别为BMI、WC、TG;以MS的5指标异常的阳性项数为聚集标志,≥1、≥2、≥3项情况下发生脂肪肝的危险度(OR值)分别为9.56,17.67,41.13;WC、FPG、TG、HDL-C、SBP、DBP异常的阳性率及FLD的检出率MS组明显高于非MS组(P<0.01),OR值为3.00～30.7,TG、WC、FPG位列前3位,FLD的OR值为10.7.结论 肥胖、高甘油三酯、高血糖和高血压是脂肪肝的危险因素,肥胖是关键,危险因素聚集越多脂肪肝发病率越高;脂肪肝与代谢综合征有共同的危险因素;脂肪肝往往伴有代谢综合征.     

杭州市城区初中生蔬菜水果摄入情况及影响因素分析

目的 了解杭州市城区初中生蔬菜水果摄入情况及影响因素.方法 在杭州市3个城区初中生中开展横断面自填问卷调查,了解学生每周蔬菜水果的摄入频率、摄入量及相关社会人口学特征,采用logistic多因素回归法分析影响每周吃蔬菜≥21份和水果≥14份的因素.结果 纳入分析的3724名初中生每周每日食蔬菜水果为54.7％,每周进食蔬菜≥21份和水果≥14份(相当于每日食蔬菜≥3份和水果≥2份)为23.6％.女生、母亲文化程度较高、家庭社会经济水平较高的初中生每周蔬菜水果摄入频率和摄入量均较高(P＜0.05).控制了5种社会人口学因素后,每日体力活动≥60 min(OR=1.667,95％CI:1.216 ～ 2.203)、家人每日鼓励多进食蔬菜水果(OR=1.881,95％CI:1.498 ～ 2.363)、每日表扬食蔬菜水果(OR=1.275,95％CI:1.025 ～ 1.586)、每周3 ～6 d(OR=1.691,95％CI:1.310～2.183)和每日(OR=2.944,95％CI:2.348～ 3.690)准备好蔬菜水果、每周3 ～6 d(OR=1.392,95％CI:1.056 ～ 1.835)和每日(OR=2.817,95％CI:2.217～3.580)一起进食蔬菜水果、早餐通常自家做(OR=1.364,95％CI:1.158～1.607)、蔬菜水果健康益处的课程教育(OR=1.238,95％ CI:1.035 ～ 1.480)和认知(OR=3.150,95％CI:1.121 ～ 8.856)与初中生每周食蔬菜≥21份和水果≥14份均有正性关联.结论 杭州市城区初中生蔬菜水果的摄入水平与社会人口学特征、体力活动、家庭饮食环境、蔬菜水果健康益处的教育和认知程度有关.     

脂肪肝与其相关因素的logistic回归分析

[目的]探讨健康体检人群中脂肪肝的危险因素,为疾病的预防和治疗提供依据.[方法]对2006年1220名健康体检者的肝脏超声检查资料和其他相关资料进行单因素和多因素logistic回归分析.[结果]单因素分析显示,脂肪肝与性别、年龄、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-c)、血糖、体重指数(BMI)、高血压、冠心病、糖尿病、胆结石、吸烟、饮酒相关(P<0.05).经多因素回归分析,脂肪肝危险因素依次为:TG (OR: 10.538)、BMI (OR: 5.333)、糖尿病(OR: 3.590)、高血压(OR: 2.620)、TC(OR: 1.922)、吸烟(OR: 1.892).[结论]脂肪肝的患病率与TG、BMI、糖尿病、高血压、TC、吸烟密切相关,可作为预防和治疗脂肪肝的依据.     

LEPR基因多态性与未绝经女性BMI变化的关系研究

目的探讨瘦素受体(LEPR)基因多态性与未绝经女性近5年体质指数(BMI,)变化之间的关系。方法采用横断面研究,于2015年3月~6月收集四川省人民医院体检中心和成都双流区妇保院体检中心未绝经健康女性463人,收集其一般人口学特征、人口测量指标、日均能量摄入等信息,以5年前BMI与现在的BMI变化情况将研究对象分为低风险组(BMI5year24 kg/m~2→BMI_(present)24 kg/m~2BMI_5year≥24 kg/m~2→BMI_(present)24 kg/m~2)、增重至超重组(BMI_5year24kg/m~2→BMI_(present)≥24kg/m)、持续超重/肥胖组(BMI_5year≥24 kg/m2→BMI_(present)≥24kg/m~2)。采用飞行时间质谱检测LEPRrs1137100,LEPRrs1137101基因型。采用多分类Logistic回归,估计LEPR基因多态性与未绝经健康女性人群近5年BMI变化的关联值(OR)。结果 LEPR rs1137100和LEPR rs1137101突变等位基因的携带率分别为83.3%和89.0%;调整重要的混杂因素后,携带LEPRrs1137100AA+AG或LEPRrs1137101AA+AG可增加发生持续超重/肥胖的风险(OR=1.67,95%CI:1.02-2.73;OR=1.76,95%CI:1.01-3.07)。结论LEPRrs1137100和LEPRrs1137101基因多态性可能与未绝经女性持续超重/肥胖有关。     

老年人群体质指数和腰围与心血管病危险因素聚集的研究

目的探讨老年人群体质指数、腰围与心血管病危险因素聚集的关系。方法对654名老年人进行健康查体,对不同体质指数（BMI）、腰围（WC）老年人的收缩压（SBP）、舒张压（DBP）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）和空腹血糖（FPG）平均水平及高血压、高TC、高TG、低HDL-C、糖尿病检出率进行分析,对心血管病危险因素聚集性进行分析。结果BMI、WC升高是老年人最常见的心血管病危险因素。随着BMI、WC的增加,老年人SBP、DBP、TC、TG、FPG平均水平明显升高,HDL-C平均水平降低,高血压、高TC、高TG、糖尿病的检出率明显增高。BMI为24．0～27．9ks／m^2时,老年人高血压、高TC、高TG、糖尿病的检出率分别为59．74％、3．89％、28．57％、10．06％,患高血压、高TG、糖尿病的危险性分别是正常BMI的1．65、1．88、1．85倍;BMI≥28．0ks／m^2时,老年人高血压、高TC、高TG、糖尿病的检出率分别为83．05％、5．08％、35．59％、15．25％,患高血压、高TG、糖尿病的危险性分别是正常BMI的5．44、2．60、2．98倍。男性WC≥85cm、女性WC≥80cm时,老年人高血压、高TC、高TG、糖尿病的检出率分别为66．15％、4．47％、29．57％、10．12％,患高血压、高TC、高TG的危险性分别是正常WC的3．52、6．51、1．68倍。BMI≥24．0kg／m^2或男性WC≥85cm、女性WC≥80cm的老年人伴随多个心血管病危险因素的比例显著增高。结论BMI、WC升高是导致老年人群心血管病危险因素聚集的重要因素。     

成人肥胖与高血糖高血压血脂紊乱聚集的关系

目的探讨成人肥胖与与高血糖、高血压、血脂紊乱聚集的关系。方法采用分层整群随机抽样方法,随机调查杭州市城乡社区居民20～79岁1600人。应用logistic回归模型分析肥胖的两个主要指标体质指数(BMI)和腰围对发生高血糖、高血压、血脂紊乱聚集的OR值。结果调整年龄、吸烟史、饮酒史、体育锻炼等影响因素后,男性超重(24kg/m2≤BMI28kg/m2)和肥胖(BMI≥28kg/m2)均比正常体重更易引起聚集发生,OR值分别为3.187(95%CI:1.731～5.869)和3.050(95%CI:1.248～7.453);女性中心性肥胖(腰围≥80cm)对聚集发生的OR值为2.330(95%CI:1.440～3.771)。结论成人发生高血糖、高血压、血脂紊乱聚集与肥胖存在一定关联,男性体质指数和女性腰围对心血管病的一级预防具有重要意义。     

妊娠期合并乙型肝炎危险因素的探讨

目的　探讨妊娠期合并乙型肝炎的相关危险因素 ,为妊娠期预防和控制危险因素提供依据。方法　采用病例对照研究方法对天津市塘沽地区 2 0 0 1年 7月～ 2 0 0 2年 12月期间接受产前健康检查的孕妇 ,其中病例组 2 3例 ,对照组 10 0例。用非条件logistic回归方法来分析探讨妊娠期合并乙型肝炎在本地区潜在的危险因素。所有数据采用SPSS 10 0处理。结果　①调查对象年龄分布病例组为 2 1～ 3 2岁 ,平均为 (2 6 17± 2 95 )岁 ;对照组为 2 0～ 3 9岁 ,平均为 (2 6 0 3± 3 3 8)岁。②非条件logistic回归单因素分析显示 ,与妊娠期合并乙型肝炎有显著性统计学意义的 9个变量 ,即危险因素如下 :文化程度(OR =2 5 91) ,文化程度高者危险性高 ;职业 (OR =2 .5 81) ,脑力劳动者危险性高 ;收入 (OR =3 .467) ,收入高者危险性高 ;经常接受注射史 (OR =8.981) ;父母患有乙肝史 (OR =3 .60 8) ;公共场所进餐方式 (OR =8.62 6) ,集体共餐危险性高 ;洗漱用具 (OR =7.3 49) ,共用危险性高 ;爱人患有乙肝史 (OR =2 0 83 7) ;血型 (OR =1.5 61) ,危险性由高到低依次为AB型、O型、B型、A型。结论　非条件logistic多因素回归分析得出 :职业、洗漱用具 2个变量是妊娠期合并乙型肝炎的独立危险因素。     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

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.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

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.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.