吉林省居民中心性肥胖及其前期流行特征的影响因素分析

目的 了解吉林省居民中心性肥胖及其前期的流行特征的影响因素,为制定相关预防与控制策略及措施提供参考依据。方法 本研究以2017-2018年吉林省心血管病高危人群早期筛查与综合干预项目为基础,纳入吉林省6个项目点35~75岁常住居民11 903人为研究对象,进行体格检查、实验室检测和问卷调查。采用χ²检验、趋势χ²检验、F检验计算不同特征人群和健康指标的中心性肥胖及其前期情况,其影响因素采用多因素logistic回归模型分析。结果 吉林省居民中心性肥胖率为33.35%（3 970/11 903）,标化率为31.73%,中心性肥胖前期率为28.79%（3 427/11 903）,标化率为28.86%。多因素分析结果显示,农村居民（OR=1.99,95%CI：1.78~2.23）、女性（OR=1.76,95%CI：1.57~1.97）、65~75岁组（OR=1.21,95%CI：1.03~1.45）、高中/中专文化程度（OR=1.38,95%CI：1.17~1.63）、家庭年收入>10万元（OR=1.65,95%CI：1.20~2.26）、超重（OR=9.27,95%CI：8.26~10.41）、肥胖（OR=82.82,95%CI：62.63~109.52）、正常高值血压（OR=1.49,95%CI：1.27~1.74）、高血压（OR=1.70,95%CI：1.42~2.04）、糖尿病（OR=2.30,95%CI：1.94~2.73）、血脂异常（OR=1.33,95%CI：1.18~1.50）与中心性肥胖及其前期发生风险呈正相关。结论 吉林省居民中心性肥胖及其前期率均处于较高水平,农村居民、女性、年龄大、高中/中专文化程度、高收入、超重、肥胖、正常高值血压、高血压、糖尿病、血脂异常是吉林省居民中心性肥胖及其前期的危险因素。     

安徽省成年居民慢性肾病患病流行现状及相关因素研究

目的 利用2018年安徽省中国成人慢性病与营养监测数据,比较不同特征成年居民慢性肾病（CKD）患病率,并分析其相关因素。方法 采用多阶段分层整群随机抽样方法,选取≥18岁居民进行询问调查、身体测量和实验室检测。使用复杂加权方法估算不同特征居民的CKD患病率,CKD患病及其相关因素的多因素分析采用复杂抽样数据logistic回归模型。结果 共纳入7 181人,成年居民CKD患病率为11.06%,女性CKD患病率（12.49%）高于男性（9.59%）,差异有统计学意义（P<0.05）。居民CKD进展的中、高和极高风险程度比例分别为8.66%、2.02%和0.38%。多因素分析结果显示,年龄（OR=1.03,95%CI：1.00~1.05）和BMI（OR=1.05,95%CI：1.01~1.09）增加、女性（OR=1.38,95%CI：1.22~1.55）、高血压（OR=2.50,95%CI：1.76~3.56）、糖尿病（OR=2.28,95%CI：1.51~3.43）、血脂异常（OR=1.26,95%CI：1.11~1.43）和高尿酸血症（OR=2.16,95%CI：1.68~2.78）均为CKD的危险因素。结论 安徽省成年居民CKD患病率较高,CKD与年龄、性别、BMI、高血压、糖尿病、血脂异常和高尿酸血症相关,应当注重相关危险因素的管控,包括超重/肥胖、高血压、糖尿病、血脂异常和高尿酸血症,预防CKD及其并发症。     

2015年我国35岁及以上高血压患者社区健康管理与高血压治疗控制情况分析

目的 了解2015年我国≥ 35岁高血压患者的社区健康管理及高血压治疗控制情况并探索其影响因素。方法 利用2015年中国成人慢性病与营养监测项目收集的问卷调查及体格测量等信息,以乡镇卫生院（社区卫生服务中心）或以上级别医疗卫生机构医生诊断为高血压的≥ 35岁的患者为研究对象,对样本进行复杂加权后,分析其一般特征、高血压社区健康管理情况及高血压治疗控制情况。结果 共纳入高血压患者23 974名,经复杂加权后,我国≥ 35岁高血压患者的社区健康管理率为54.10%（95%CI：51.02%~57.17%）,社区规范管理率为45.72%（95%CI：42.93%~48.51%）;高血压治疗率为88.16%（95%CI：87.00%~89.31%）,控制率为22.67%（95%CI：21.25%~24.09%）,治疗控制率为27.76%（95%CI：26.09%~29.42%）。多因素分析结果显示,城市和农村年龄≥ 65岁（OR=1.40,95%CI：1.05~1.87;OR=3.11,95%CI：2.22~4.36）、按医嘱服药（OR=2.15,95%CI：1.46~3.15;OR=1.35,95%CI：1.13~1.62）、进行血压监测（OR=2.34,95%CI：1.88~2.90;OR=3.10,95%CI：2.72~3.53）的高血压患者更愿意接受高血压社区健康管理;文化程度大专及以上（OR=0.51,95%CI：0.39~0.66）、适量饮酒（OR=0.69,95%CI：0.57~0.84）或过量饮酒（OR=0.73,95%CI：0.58~0.92）的城市高血压患者接受社区高血压管理的情况不佳。城市和农村超重（OR=0.74,95%CI：0.61~0.91;OR=0.83,95%CI：0.71~0.98）、肥胖（OR=0.54,95%CI：0.45~0.65;OR=0.67,95%CI：0.54~0.83）的高血压患者血压控制情况较差,按医嘱服药（OR=4.58,95%CI：3.16~6.63;OR=2.84,95%CI：2.18~3.69）的高血压患者的血压控制状况较好。地处中部（OR=0.74,95%CI：0.61~0.89）、过量饮酒（OR=0.72,95%CI：0.54~0.97）的城市高血压患者血压控制情况较差,合并其他慢性疾病（OR=1.22,95%CI：1.04~1.44）、参加高血压社区规范管理（OR=1.29,95%CI：1.06~1.58）的城市高血压患者血压控制情况较好;地处中、西部地区（OR=0.71,95%CI：0.58~0.87;OR=0.62,95%CI：0.47~0.80）、适量饮酒（OR=0.81,95%CI：0.67~0.98）、人均每日食盐摄入量>6 g （OR=0.80,95%CI：0.69~0.93）的农村高血压患者血压控制情况较差,进行血压监测（OR=1.38,95%CI：1.18~1.61）的农村高血压患者血压控制情况较好。结论 我国≥ 35岁高血压患者社区健康管理情况较之前有所改善,但是高血压控制情况距离相关政策指标还有一定差距。     

成年人睡眠状况与糖尿病患病关系的研究

目的 探讨成年人睡眠状况与糖尿病患病关系。方法 利用“中国慢性病前瞻性研究”苏州市项目点53 260名30~79岁常住居民基线调查数据,通过多因素logistic回归模型分析睡眠状况与糖尿病患病关系。结果 调查人群糖尿病患病率为5.3%,入睡困难、容易早醒和经常打鼾的比例分别为7.2%、10.0%和29.5%,22.6%的调查对象报告睡眠时间≤6 h。经多因素模型调整后,入睡困难（男性：OR=1.63,95%CI：1.30~2.05;女性：OR=1.48,95%CI：1.27~1.73）、容易早醒（男性：OR=1.37,95%CI：1.12~1.68;女性：OR=1.31,95%CI：1.14~1.51）和经常打鼾（男性：OR=1.16,95%CI：1.00~1.34;女性：OR=1.39,95%CI：1.23~1.57）均与糖尿病罹患风险存在关联。女性服用助眠药物与糖尿病的患病相关（OR=1.42,95%CI：1.06~1.92）。与睡眠时间8 h相比,睡眠时间不足（≤6 h）与男女性糖尿病患病均存在统计学关联,OR值分别为1.37（95%CI：1.17~1.60）和1.24（95%CI：1.08~1.41）,睡眠时间过长（≥9 h）与糖尿病未见统计学关联。结论 睡眠问题（入睡困难、容易早醒、药物助眠、经常打鼾和睡眠时间不足）与糖尿病患病风险密切相关,睡眠时间过长与糖尿病患病未见统计学关联。     

女性月经初潮年龄与肥胖关系的研究

目的 探讨中国中老年女性中,月经初潮年龄与一般性肥胖（基于BMI）和中心性肥胖[基于腰围（WC）与腰围身高比（WHtR）]之间的关系。方法 以中国健康与养老追踪调查的6 363名中老年女性为研究对象,采用限制性立方样条分析初潮年龄与肥胖的关系类型,采用二分类logistic回归模型分析初潮年龄（分为≤ 13、14~、16~和≥ 18岁组,以14~岁组为对照组）与肥胖的关系。结果 调整潜在的混杂后,初潮年龄与一般性肥胖和中心性肥胖均呈现线性负相关关系,初潮年龄每增长1岁,BMI、WC和WHtR定义的肥胖风险降低6%（OR=0.94,95%CI：0.90~0.99）、4%（OR=0.96,95%CI：0.92~1.00）和6%（OR=0.94,95%CI：0.90~0.99）。与初潮年龄14~岁组的女性相比,初潮年龄≥ 18岁组BMI（OR=0.71,95%CI：0.55~0.91）、WC（OR=0.75,95%CI：0.62~0.92）、WHtR（OR=0.76,95%CI：0.61~0.96）定义的肥胖风险分别降低29%、25%和24%。结论 中老年女性中,初潮年龄与一般性肥胖和中心性肥胖风险随初潮年龄的增长呈线性降低趋势,初潮年龄较晚与肥胖存在负相关关系。     

江苏省心血管病高危人群颈动脉斑块流行及影响因素分析

目的 了解颈动脉斑块（CP）在江苏省心血管病高危人群中的流行概况及相关影响因素。方法 2015-2016年依托中国心血管病高危人群早期筛查与综合干预项目,以江苏省6个项目点筛查出的11 392名心血管病高危人群作为研究对象,进行问卷调查、身体测量、实验室检测以及颈动脉彩色超声检测,探讨CP的流行概况,对CP发生的影响因素进行多因素logistic回归分析。结果 研究对象年龄为（59.4±8.9）岁,男性4 821例（42.3%）。颈动脉异常5 971例（52.4%）,其中颈动脉内中膜增厚1 782例（15.6%）,CP 3 811例（33.5%）,颈动脉狭窄378例（3.3%）。高龄（OR=2.253,95%CI：2.127~2.386）、城市居民（OR=2.622,95%CI：2.375~2.895）、高血压（OR=1.439,95%CI：1.195~1.732）、吸烟（OR=1.441,95%CI：1.259~1.650）、脉压差增大（OR=1.270,95%CI：1.198~1.347）、FPG升高（OR=1.109,95%CI：1.059~1.161）、LDL-C/HDL-C升高（OR=1.225,95%CI：1.164~1.288）增加心血管病高危人群发生CP的风险,女性（OR=0.558,95%CI：0.494~0.630）、高BMI（OR=0.948,95%CI：0.904~0.994）、较高的文化程度（OR=0.708,95%CI：0.531~0.945）和较高的家庭年收入（OR=0.773,95%CI：0.669~0.894）则降低其风险。结论 江苏省超一半心血管病高危人群颈动脉异常,高血压、高血糖、高血脂和吸烟是相关影响因素。     

出生体重对成年期慢性病患病风险及血尿酸的影响研究

目的 探索出生体重对成年期罹患高血压、糖尿病等慢性病的患病风险,并研究出生体重与血尿酸的关系。方法 根据中国成年人慢性病与营养监测方案,在天津市河西、南开、红桥、武清、津南、宝坻、蓟州区共计调查1 131名成年人,收集其出生体重、血压等数据,并采集空腹静脉血检测血尿酸、血糖和血脂等。描述调查人群出生体重状况分布,并分析出生体重对其成年期罹患高血压、糖尿病等慢性病风险及与血尿酸的关系。结果 天津市调查人群平均出生体重为3.37 kg,男性高于女性;无论是超重/肥胖、高血压还是糖尿病,正常出生体重者成年期患病率最低,经单因素logistic回归分析,校正年龄、性别、吸烟、饮酒后发现,与正常出生体重者相比,低出生体重与成年期罹患糖尿病（OR=2.91,95%CI：1.46~5.76）、血脂异常（OR=1.79,95%CI：1.01~3.19）关联较强,巨大儿与成年期罹患超重/肥胖关联较强（OR=1.47,95%CI：1.08~2.01）;不同出生体重的血尿酸差异无统计学意义。结论 天津市调查人群低出生体重与其成年期糖尿病、血脂异常患病风险关联较大,巨大儿与其成年期超重/肥胖患病风险关联较大。     

维生素D受体基因多态性与妊娠期糖尿病关系的病例对照研究

目的 探讨维生素D受体（VDR）基因多态性与妊娠期糖尿病（GDM）之间的关系,为GDM的机制研究提供线索与依据。方法 采用病例对照研究设计,以2012年3月1日至2014年7月30日在山西医科大学第一医院产科分娩的孕妇为研究对象,其中334例被诊断为GDM,按年龄、妊娠时间及居住地1∶1匹配相应健康对照。对研究对象进行DNA基因分型,剔除基因分型缺失率>10%者,最终323例病例和320例对照纳入研究。在共显性、显性、隐性和等位基因遗传模型下,通过非条件logistic回归分析VDR基因位点多态性和GDM之间的关系,并采用Haploview软件分析单倍型与GDM之间的关系。结果 在基因水平上,VDR基因与GDM发病风险有关（P<0.05）。在调整孕前BMI、糖尿病家族史后,rs7967152位点在共显性（AC vs. AA,OR=1.58,95%CI：1.13~2.21）、显性（AC+CC vs. AA,OR=1.58,95%CI：1.15~2.18）和等位基因（C vs. A,OR=1.41,95%CI：1.10~1.82）遗传模型下与GDM风险升高有关;rs2238140位点在共显性（AA vs. GG,OR=2.24,95%CI：1.19~4.20）、显性（GA+AA vs. GG,OR=1.48,95%CI：1.07~2.03）和等位基因（A vs. G,OR=1.43,95%CI：1.11~1.83）遗传模型下与GDM风险升高有关。在共显性和显性遗传模型下,孕妇携带rs2853564位点AG基因型、AG+GG基因型（OR=1.46,95%CI：1.04~2.05;OR=1.45,95%CI：1.05~2.00）与携带AA基因型相比,是GDM的危险因素;孕妇携带rs2853566位点AG基因型、AG+GG基因型（OR=1.43,95%CI：1.03~2.00;OR=1.41,95%CI：1.02~1.94）与携带AA基因型相比,是GDM的危险因素。在VDR基因内由rs1544410、rs7967152组成的单倍型区块,其GC单倍型与是GDM的危险因素（OR=1.50,95%CI：1.15~1.97）。结论 VDR基因rs7967152、rs2238140、rs2853564、rs2853566位点多态性和区块（rs1544410、rs7967152）GC单倍型与GDM的发病风险升高有关。     

深圳市高血压患者血压控制情况与周围绿地特征的关联分析

目的 探讨高血压患者血压控制情况与周围绿地特征的关系。方法 深圳市基本公共卫生服务管理满一年的≥35岁高血压患者为研究对象。采用分层多阶段随机抽样方法抽取代表性样本1 158人,回收有效问卷1 116份,应答率为96.4%。于2019年11月至2020年1月对纳入分析的1 116人进行问卷调查、体格测量、实验室检测。采用二元logistic回归模型分析绿地特征对高血压患者血压控制的影响。结果 深圳市基本公共卫生服务管理高血压患者血压控制率为67.8%（757/1 116）,二元logistic回归分析调整混杂因素后结果显示,周围绿地设置有健身区（OR=1.678,95%CI：1.231~2.288）、集体锻炼场地（OR=1.373,95%CI：1.020~1.848）、健康知识宣传区（OR=1.416,95%CI：1.049~1.911）对高血压患者血压控制具有积极影响。患者对周围绿地的安全性（OR=1.010,95%CI：1.000~1.019）、舒适性（OR=1.011,95%CI：1.001~1.021）、维护情况（OR=1.011,95%CI：1.001~1.021）的满意度得分均与血压控制呈正相关。居住小区有专属绿地的患者血压控制率高于无专属绿地的患者（OR=1.333,95%CI：1.009~1.762）。结论 绿地中健康促进元素及绿地的安全性、舒适性、维护情况以及专属绿地等绿地特征对血压控制有积极影响。     

抗病毒治疗HIV感染者神经认知损伤与认知表现特征研究

目的 联合应用两种神经认知评价量表,探讨接受抗病毒治疗（ART）的HIV感染者神经认知损伤患病率、影响因素及其神经认知表现特征。方法 纳入浙江省台州市开展的HIV与衰老相关疾病前瞻性队列研究中2 250例接受ART的HIV感染者。使用中国版简易智能精神状态检查量表（MMSE）和国际HIV相关性痴呆量表（IHDS）评价其神经认知损伤情况,并对2个量表中的7个神经认知域进行聚类分析。结果 在接受ART的HIV感染者2 250例中,年龄集中在45~89岁（48.0%,1 080/2 250）,男性占79.2%（1 782/2 250）,小学及以下文化程度者占37.8%（852/2 250）。MMSE和IHDS判断的神经认知损伤的患病率分别为14.3%（321/2 250）和31.8%（716/2 250）。多因素logistic回归分析结果显示,HIV感染者MMSE判断的神经认知损伤危险因素包括60~89岁（aOR=2.63,95%CI：1.52~4.56）、抑郁症状（aOR=5.58,95%CI：4.20~7.40）和使用依非韦伦（EFV）治疗（aOR=2.86,95%CI：1.89~4.34）;男性（aOR=0.71,95%CI：0.51~1.00）、偏胖（aOR=0.63,95%CI：0.44~0.89）和文化程度较高（aOR=0.11,95%CI：0.05~0.25）为保护因素。IHDS判断的神经认知损伤危险因素包括60~89岁（aOR=3.10,95%CI：2.09~4.59）、抑郁症状（aOR=1.78,95%CI：1.44~2.20）和使用EFV治疗（aOR=1.79,95%CI：1.41~2.29）;男性（aOR=0.75,95%CI：0.58~0.97）、偏瘦（aOR=0.67,95%CI：0.47~0.96）、基线CD4⁺T淋巴细胞（CD4）计数≥350个/μl（aOR=0.69,95%CI：0.53~0.91）和文化程度较高（aOR=0.23,95%CI：0.14~0.39）是保护因素。HIV感染者的神经认知表现分为4种主要类型,在年龄、性别、文化程度、饮酒、抑郁症状、腰臀比、高血压病史、糖尿病病史、基线CD4计数和使用EFV治疗的差异有统计学意义（均P < 0.05）。结论 接受ART的HIV感染者神经认知表现分为4种类型,神经认知损伤患病率较高,需对不同类型者采取针对性的监测、预防与控制措施。     

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.     

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.     

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.     

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 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.     

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.