浅析口岸卫生处理工作中的关键点控制

[目的]为把卫生处理质量控制由事后检查转向事前控制以达到“预防为主”的目的,对卫生处理关键点控制进行探讨。[方法]介绍关键点控制的内容、设置和验证程序。[结果]关键点的控制是保证口岸卫生处理质量控制的前提,关键点的设置是保证口岸卫生处理质量控制的有力措施,关键点的验证是保证口岸卫生处理质量控制的重要手段。[结论]口岸卫生处理工作只有通过关键点控制,才能规范卫生处理药品器械、现场操作和安全防护等各项工作的管理。     

口岸卫生处理环节控制的研究

目的卫生处理质量控制由事后检查转向事前控制。方法通过引进环节控制新概念，重点介绍环节控制的内容、控制点的设置和验证程序。结果环节控制的内容是保证口岸卫生处理质量控制的提升前提，环节控制点的设置是保证口岸卫生处理质量控制的有力措施，环节控制的验证是保证口岸卫生处理质量控制的重要手段。结论口岸卫生处理工作只有通过环节控制，才能规范卫生处理药品器械、现场操作和安全防护等各项工作的管理。     

浅论温州空港口岸卫生检疫发展思路

〔目的〕根据温州空港口岸(永强机场)发展概况,探讨温州空港口岸卫生检疫发展思路,提升温州口岸应对突发公共卫生事件能力。〔方法〕通过对温州空港口岸卫生检疫发展历史、以及存在主要问题进行分析。〔结果〕温州空港口岸卫生检疫工作面临严俊的挑战,国际传染病流行态势复杂多变,外来医学媒介生物入侵隐患不容忽视。《国际卫生条件(2005)》对卫生检疫工作提出了更高要求。要尽快与国际接轨,并对检疫查验,卫生监督、疾病监测、卫生处理和突发公共卫生事件控制等卫生检疫工作进行改革。〔结论〕要坚持以科学发展观来促进温州空港口岸卫生检疫事业发展,加强卫生检疫专业队伍的建设,完善口岸基础设施,全面提升口岸公共卫生水平,加强与相关部门的合作,才能确保温州空港口岸卫生安全。     

山东空港口岸检验检疫工作情况分析

目的 加强空港口岸检验检疫工作情况分析和研究.方法 通过对山东4个空港口岸情况分析,查找出个别法律规章滞后、卫生专业人员不足、执法依据欠缺、设施设备尚未达到要求和口岸技术支撑不到位问题.结果 详细阐述了山东空港口岸主要成功做法,不断加强口岸核心能力建设、完善“人-机-犬”三位一体查验模式、加强口岸卫生监督、推行集中查验模式、创新机场快件管理模式和加强口岸应急能力建设.并提出3条意见和建议.结论 加强空港口岸检验检疫工作情况分析和研究,对于进一步提高空港口岸检验检疫技术执法有着重要意义.     

引入HACCP体系 创卫生监管新模式构建航空食品安全双重保障

[目的]改革卫生监管模式，保障航空食品安全。[方法]对引入HACCP管理体系以来，福州空港口岸保障航空食品安全所取得的成效进行分析。[结果]航空食品生产企业应用HACCP体系进行管理，口岸检验检疫机构在口岸卫生监督中应用HACCP原理进行关键点控制，双管齐下，最大限度地避免了航空食品卫生安全事件的发生。[结论]在航空配餐企业和口岸卫生监督中应用HACCP原理，是一种必然的趋势，是航空食品安全的双重保障。     

天津空港航空器卫生检疫管理信息化的实践

随着航空业的迅速发展，天津滨海机场的进出港航班量不断增加，传统的卫生检疫模式已经不能适应新形势的需要，因此创新航空器卫生检疫监管模式，运用信息化手段对进出境航空器进行有效监管，同时加快航空器及旅客通关速度成为必然趋势。此文通过论述天津口岸航空器信息化管理系统在卫生检疫工作实践中的应用。提出了空港口岸航空器卫生检疫管理的新手段。     

上海空港口岸公共场所集中空调通风系统卫生状况调查分析

目的了解上海空港口岸公共场所集中空调通风系统卫生状况,进一步提升口岸卫生监督效能。方法采用现场调查方法对上海空港口岸内使用集中空调通风系统的公共场所空调通风系统卫生管理情况进行调查,并对部分场所污染情况进行卫生检测。结果上海空港口岸公共场所集中空调卫生通风系统冷却水及冷凝水全部合格,个别场所微生物污染较严重,部分公共场所集中空调从未开展过风管清洗工作,一些公共场所卫生管理存在误区,自律意识较差,国境口岸公共场所集中空调卫生监督管理工作亟待规范。结论应尽快建立健全国境口岸公共场所集中空调通风系统卫生监督法制环境,制定监督规范及技术标准。引导企业加强自律,严格落实卫生管理,逐步提高上海空港口岸公共场所集中空调通风系统卫生管理水平,维护口岸卫生安全。     

开展中俄双边卫生检疫业务合作与交流的现况与思考

黑龙江省东部，北部与俄罗斯山水相连，黑龙江出入境检验检疫局下辖15个口岸局，管理着省内20个国家一类口岸，其中有13个口岸与俄罗斯接壤，此外，2个空港和3个沿江开放口岸与其通航，八十年代工末，中苏边境贸易快速起步，发展迅猛，进出境人员，货物大幅度增加，这给卫生检疫工作提出了新的要求，迫切需要加强中俄卫生检疫机关的业务交流与合作。几年来，中俄双方不断开展经常性的交流与互访，加学了了解，拓展了合作范围。建立了良好的卫生检疫屏障，促进了卫生检疫工作的健康。     

海港口岸卫生检疫风险管理模式与应用的研究简

目的 提高口岸卫生检疫监管能力和工作效率,保障口岸公共卫生安全,促进外贸经济的快速发展.方法 根据法律法规的相关规定,运用风险分析的原理,结合海港口岸卫生检疫监管特点,对相关风险因子进行评估、量化和分级管理,通过建立数学分析模型,搭建信息管理平台,实现对相关风险因子的综合分析和应用,建立新的海港口岸卫生检疫监管模式.结果 新模式的建立,以出入境船舶检疫监管模式为载体,把国际航行船舶卫生检疫风险、码头经营单位卫生监督风险,船舶代理公司信用管理风险进行综合研判,实现了在卫生检疫风险可控的情况下,提高船舶通关效率、缩短了船舶滞港时间,实现了“提速、减负、增效、严密监管”的目的.结论 新的海港口岸卫生检疫监管模式及电子监管系统的建立,实现了海港口岸卫生检疫风险的有效管理及控制,提升卫生检疫监管能力和水平.     

入境集装箱船舶预防控制甲型H1N1流感的卫生检疫模式探讨

海港口岸入境集装箱船舶的甲型H1N1流感的预防控制工作是整个口岸预防控制工作的重要组成部份。入境集装箱船舶具有航线相对固定,在港停留时间较短,入境人员以交通员工（船员）为主等特点。这些特点决定了在甲型H1N1流感爆发流行期间对入境集装箱船舶不能完全引用陆路口岸、空港口岸对入境旅客所采用的卫生检疫模式。为此,根据国务院、卫生部和国家质检总局对预防控制甲型H1N1流感工作的总体要求,按照传染病防治的基本原则,结合海港口岸入境集装箱船舶的特点,提出了相应的预防控制甲型H1N1流感的卫生检疫模式并在实际工作中加以实施和检验。     

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 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.     

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.     

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.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

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.     

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.