2011—2020年郑州市二七区居民恶性肿瘤死亡趋势及减寿分析

目的了解郑州市二七区居民2011—2020年恶性肿瘤死亡流行趋势及对居民寿命的影响情况,为制定恶性肿瘤防治对策提供科学依据。方法对2011—2020年郑州市二七区居民恶性肿瘤死亡资料进行分析,计算恶性肿瘤死亡率、潜在减寿年数(potential years of life lost,PYLL)、标化潜在减寿年数(standardized potential years of life lost,SPYLL)、标化潜在减寿率(standardized potential years of life lost rate,SPYLLR)和人均减寿年数(average years of life lost,AYLL)等指标,采用年度变化百分比(annual percent change,APC)分析率的时间变化趋势。结果2011—2020年郑州市二七区居民恶性肿瘤年均死亡率为114.68/10万,标化死亡率为103.52/10万,男性年均死亡率(146.09/10万)高于女性(84.56/10万)。恶性肿瘤前5位死因依次为肺癌、肝癌、胃癌、结直肠癌和食管癌,共占恶性肿瘤死亡构成的65.36%。2011—2020年该区居民恶性肿瘤死亡率呈上升趋势(APC=3.70%,P<0.001)。0~44岁年龄组恶性肿瘤死亡率处于较低水平,45岁后随年龄增长逐渐升高,75岁以后迅速升高。恶性肿瘤总PYLL为39067人年,SPYLLR为6.73‰,AYLL为12.59年。结论肺癌、肝癌、胃癌、结直肠癌和食管癌是二七区恶性肿瘤预防控制的重点工作,同时宫颈癌和乳腺癌对女性健康的影响不可忽视,应针对主要恶性肿瘤和重点人群开展综合防控措施,以降低恶性肿瘤的死亡率。     

西安市15岁以下儿童2016-2019年主要死因及减寿评估

分析2016-2019年西安市15岁以下儿童死亡原因和减寿情况,为制定相应的干预策略和措施提供科学依据.方法 收集整理2016-2019年西安市儿童死亡资料,按照国际疾病分类法(ICD-10)进行统一编码分类,计算平均死亡率、死因构成比、潜在减寿年数(potential year of life lost,PYLL)、标化潜在减寿年数(standardized potential year of life lost,SPYLL)、潜在减寿率(potential year of life lost rate,PYLLR)、标化潜在减寿率(standardized potential year of life lost rate,SPYLLR)、平均减寿年数(average years of life lost,AYLL)等健康测量指标,并运用x2检验对组间差异进行统计分析.结果 西安市15岁以下儿童平均死亡率为40.34/10万,其中男童为45.43/10万,女童为34.72/10万.死亡谱排在前5位的分别为围生期疾病、伤害、先天异常、恶性肿瘤、神经系统疾病.交通事故、意外窒息、意外跌落、溺水、意外中毒占所有伤害死亡数的90.18%.儿童死因PYLL为123 338人年,SPYLLR为6.16%,AYLL为65.57年/人,其中SPYLLR顺位前3位分别是围生期疾病、先天异常和伤害.结论 2016-2019年西安市15岁以下儿童死亡率呈逐年下降趋势,并且随着年龄的增加也呈现下降趋势.围生期疾病、先天异常和伤害是造成西安市儿童死亡和减寿的主要原因,相关部门应采取针对性干预措施促进儿童身心健康.     

哈尔滨市南岗区2006-2014年居民伤害死亡及减寿分析

目的 通过对哈尔滨市南岗区2006-2014年居民伤害的死亡资料进行分析,研究伤害对居民寿命的影响。方法 依据2006-2014年间哈尔滨市南岗区常住人口中对死亡率、标化死亡率、全死因期望寿命、去伤害死因期望寿命、潜在减寿年数（years of potential life lost, YPLL）、标化潜在减寿率（standard years of potential life lost‰, SYPLL‰）、平均减寿年数（average years of life lost,AYLL）等指标进行计算。结果 伤害是南岗居民第4位死亡原因,南岗区 2006-2014年,伤害各年龄组的死亡率随着年龄的增加不断上升（χ2=566.607,P<0.001）。该地区的居民伤害死亡,性别上差异具有统计学意义,男性大于女性（χ2=320.389,P<0.001）。伤害对哈市南岗区居民造成的潜在减寿年数为53 286人年,标化潜在减寿率为112.25‰,平均减寿年数为22.34人年,伤害对居民造成的寿命损失占全死因寿命损失的14.25%。由此可见,伤害是导致居民早死主要原因之一。结论 2006-2014年哈尔滨市南岗区伤害的死亡率较高,其造成的寿命损失较大,其中交通事故、意外跌落以及自杀的发生率较高。因此,进行必要的交通事故安全教育对于预防伤害有着重要的价值与意义。     

2014-2019年珠海市居民恶性肿瘤死亡特征及潜在减寿分析

目的 了解珠海市居民恶性肿瘤死亡变化趋势及减寿情况,为恶性肿瘤防治提供参考依据。方法 收集整理2014-2019年珠海市居民恶性肿瘤死亡资料,采用死亡率、死因顺位、年度变化百分比(annual percent of change, APC)、潜在减寿年数(potential years of life lost, PYLL)等指标对恶性肿瘤死亡及减寿情况进行分析。结果 2014-2019年珠海市恶性肿瘤平均死亡率为115.24/10万,标化死亡率为114.99/10万,男性恶性肿瘤死亡率高于女性(χ²=581.09,P<0.01),差异有统计学意义。恶性肿瘤标化死亡率居前5位的分别是肺癌、肝癌、结直肠癌、胃癌、鼻咽癌。恶性肿瘤死亡率随着年龄的增长而上升。0～14岁以白血病、脑及神经恶性肿瘤为主,15～44岁组肝癌是第1位死因,45岁及以上年龄组首位死因是肺癌。恶性肿瘤总PYLL为150640人年,肺癌、肝癌和结直肠癌居前3位;平均减寿年数(average years of life lost, AYLL)为18.46年/人,乳腺癌、鼻咽癌和肝癌居前3位;男性...     

2011年广西城乡监测点居民伤害死亡状况和疾病负担分析

目的分析2011年广西城乡居民伤害死亡流行病学特征及疾病负担,为广西地区制定伤害预防控制策略及措施提供科学依据。方法采用死亡率、标化死亡率、潜在寿命损失年数(years of potential life lost,YPLL)、潜在工作损失年数(work years of potential life lost,WYPLL)、潜在价值损失年数(value years of potential life lost,VYPLL)等指标对居民伤害死亡数据及伤害疾病负担进行分析。结果 2011年广西疾病监测点居民伤害死亡率为56.39/10万,标化死亡率58.34/10万,农村居民伤害死亡率为城市的1.77倍。居民伤害死因前5位依次为:运输事故、跌倒、溺水、自杀和中毒。除中毒外,农村各伤害死因死亡率均高于城市(均有P<0.05),且以溺水差别最大为2.74(8.20/2.99)倍。农村YPLL、WYPLL、VYPLL居前3位的均为运输事故、溺水和自杀。城市YPLL、WYPLL居前3位的为运输事故、溺水和中毒,而VYPLL居前3位的为运输事故、中毒和自杀。结论伤害是广西城乡居民的主要死因之...     

2015-2019年云南省居民肝癌死亡趋势及寿命损失分析

  目的  了解2015-2019年云南省居民肝癌的死亡水平、变化趋势及寿命损失情况,为当地制定科学的防制措施提供依据。  方法  通过《人口死亡信息登记管理系统》获取云南省2015-2019年的肝癌死因监测数据,利用Stata 16软件和Excel 2019软件计算肝癌死亡和寿命损失相关指标,并用Joinpoint 4.9.0软件分析肝癌死亡和寿命损失的变化趋势,采用统计描述方法对云南省肝癌的死亡水平和寿命损失情况进行流行病学描述。  结果  2015-2019年云南省肝癌死亡累计报告30 912例,平均死亡年龄为(61.76±13.81)岁,标化死亡率(standardized mortality rate, SMR)从2015年的12.40/10万上升到2019年的14.10/10万,男性死亡率均高于女性,农村高于城市。云南省肝癌死亡率随年龄增长而增加,男性35岁死亡趋势开始快速增加。2015-2019年因肝癌死亡导致的潜在减寿年数(potential years of life lost, PYLL)为256 380人年,潜在减寿年率(potential years of life lost rate, PYLLR)为1.08‰;标化潜在减寿年数(standardized potential years of life loss, SPYLL)为266 962人年;标化潜在减寿年率(standardized potential years of life loss rate, SPYLLR)为1.12‰;男性的寿命损失高于女性;农村的寿命损失高于城市。  结论  2015-2019年云南省肝癌粗死亡率(crude death rate, CDR)和寿命损失呈上升趋势,男性和农村居民是高危人群,今后须加强对男性的早期体检,农村地区须投入更多的医疗资源,向全社会倡导合理膳食、体育锻炼等健康的生活方式,做好肝癌的早期预防工作。     

2011-2016年重庆市18～44岁青年主要死因分析和减寿评估

  目的  分析2011-2016年重庆市18~44岁青年死亡水平和减寿情况,为制定相应干预措施提供依据。  方法  收集2011-2016年重庆市青年死亡资料,疾病分类按照国际疾病分类法（international classification of diseases,ICD）-10统一编码,采用健康测量指标:粗死亡率、标化死亡率、潜在减寿年数（potential year of life lost,PYLL）、潜在减寿率（potential year of life lost rate,PYLLR）、平均减寿年数（average years of life lost,AYLL）进行分析。  结果  重庆市青年年均死亡率为92.21/10万,标化死亡率为78.95/10万,死因顺位前3位依次为损伤中毒外部原因、肿瘤和循环系统疾病,男性死亡率为124.63/10万,女性死亡率为57.69/10万;青年死因年均PYLL为477 134.10人年,PYLLR为36.39‰,AYLL为39.48年/人,其中死因年均PYLL和PYLLR顺位前3位与死因顺位相同。  结论  2011-2016年重庆市18~44岁青年人群死亡率总体呈下降趋势,损伤中毒和慢性非传染病是造成重庆市青年人群死亡和减寿的重要原因。     

2015年四川省胃癌和食管癌发病及死亡分析

目的分析2015年四川省上消化道恶性肿瘤(胃癌和食管癌)发病、死亡和潜在减寿情况。方法收集四川省24个肿瘤登记处上报的2015年恶性肿瘤发病、死亡及人口资料。提取ICD-10编码C15-C16选择食管癌、胃癌的发病和死亡数据,用SAS 9.3软件分别计算性别、年龄别发病和死亡的粗率、标化率、构成比、累积率(0~74岁)、潜在减寿年数(potential years of life lost,PYLL)、潜在减寿率(potential years of life lost rate,PYLLR)和平均减寿年(average years of life lost,AYLL)。标准人口采用2000年全国普查人口年龄构成和Segi’s世界人口年龄构成。结果2015年四川省肿瘤登记地区食管癌和胃癌发病率分别为29.29/10万和28.60/10万,分别居发病第3位和第4位;胃癌和食管癌死亡率分别为23.90/10万和22.20/10万,分别居死亡第3位和第4位;根据上消化道恶性肿瘤发病率和死亡率的年龄性别分布,男女性45岁后发病率和50岁后死亡率均显著升高;无论城乡,男性食管癌和胃癌各项发病和死亡指标均高于女性。农村地区人群食管癌和胃癌疾病负担高于城市。食管癌潜在减寿年数为23399人年,平均减寿年数为15.41年,减寿率为1.92‰;胃癌潜在减寿年数为25390人年,平均减寿年数为16.74年,减寿率为2.09‰。结论四川省食管癌和胃癌发病与死亡水平相对较高,男性为食管癌和胃癌的高发人群,45岁以上的中老人群是上消化道恶性肿瘤高风险人群,农村地区人群的上消化道肿瘤疾病负担高于城市。     

2002-2009年上海市普陀区伤害死亡流行病学分析

目的 了解上海市普陀区居民伤害死亡流行状况及相关特征,为制定预防控制措施提供科学依据.方法 分析上海衅胀忧?002-2009年死因登记系统资料,用伤害死亡率、构成比和潜在减寿年数(potential years of life lost,PYLL)描述伤害的死亡水平.结果 2002-2009年普陀区居民年平均伤害死亡率为38.2/10万,伤害死亡的标化潜在减寿年数为4 048人年,减寿顺位为第3位.首位伤害死亡原因为跌落,近年来呈上升趋势,第2位伤害死亡原因为交通伤害,近年来呈下降趋势.结论 65岁以上的老年人是上海市普陀区伤害死亡的高危人群,跌落和交通伤害是该地区伤害防治的重点.     

厦门市2002-2009年糖尿病死亡趋势及寿命损失年分析

目的了解2002-2009年厦门市居民糖尿病的死亡趋势、分布特征及寿命损失情况。方法对2002-2009年厦门市糖尿病死亡登记资料和人口数据进行统计分析,计算死亡率、标化死亡率、累积死亡率、年均增长死亡率及寿命损失年(years of life lost,YLL)等指标并绘制死亡分布地图。结果 2002-2009年厦门市糖尿病年均死亡率为10.07/10万,标化死亡率为5.51/10万,0~74岁累积死亡率为0.90%,居全死因顺位第8位,总体呈明显上升趋势。糖尿病城市死亡率高于农村,女性死亡率高于男性,差异有统计学意义(均有P<0.001),但农村年均增长死亡率高于城市,男性年均增长死亡率高于女性。糖尿病主要危害中老年人群,死亡年龄的中位数为71岁,85.37%的死亡病例发生在60岁以上人群。2002-2009年厦门市糖尿病潜在寿命损失年(potential yearsof life lost,PYLL)为7 987.5人年,占全死因PYLL的1.28%,平均减寿年数(average years of life lost,AYLL)为6.3人年,减寿率为0.63‰,男性和农村居民寿命损失较严重。结论厦门市糖...     

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.     

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.     

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.     

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.     

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.