上海市部分地区散发性戊型肝炎病毒基因型别和发病危险因素研究

目的探讨上海市部分地区急性散发性戊型肝炎（戊肝）病毒（HEV）型别和发病危险因素.方法用巢式RT-PCR方法检测HEV序列,并进行序列的同源性比较分析;同时采取1：2病例对照研究的方法,选取上海市3个区2003-2004年急性散发性确诊戊肝86例住院病例,分别配以本区和其他区健康人群对照组,用单因素和多因素logistlc回归模型进行分析.结果病毒序列分析表明戊肝病例中的HEV病毒序列属于Ⅳ型;单因素分析结果显示居住条件、外出就餐、有海鲜河鲜食用史等均为戊肝发病的危险因素;多因素分析结果显示海鲜（生、炝）食用史（OR=7.048）是戊肝感染 的危险因素.结论上海市部分地区散发性HEV流行株以Ⅳ型病毒株为主,海鲜（生、炝）食用史等是戊肝发病的危险因素.     

戊型病毒性肝炎感染危险因素病例对照调查

目的了解上海市徐汇地区戊型病毒性肝炎发病危险因素。方法病例对照调查,选择临床和血清学诊断为戊型病毒性肝炎的患者102例作为调查对象,按1：2配比204名对照者,采用单因素和多因素条件Logistic回归分析。结果单因素分析显示发病前2个月内经常外出就餐或购买外卖、食用火锅、食用生炝贝壳类、生炝河鲜类食物、生炝海鲜类食物、外出史（包括旅游、出差等）为戊型病毒性肝炎发病的主要危险因素,经多因素条件Logistic回归模型分析,OR值分别为5.779、3.042、2.592、3.460、3.196和2.492。结论上海市徐汇区戊型病毒性肝炎以经常外出就餐、食用火锅、食用生炝贝壳类、河海鲜类食物、外出史等危险因素为主。     

女性非酒精性脂肪性肝病危险因素的病例对照研究

目的 探讨女性非酒精性脂肪肝的危险因素,为预防和控制女性人群非酒精性脂肪肝的发生提供流行病学依据.方法 采用成组匹配的病例对照研究方法,通过调查问卷、体格检查和生化检测等方法收集暴露因素,通过非条件Logistic回归方法探讨女性非酒精性脂肪肝的发病影响因素.结果 单因素非条件Logistic回归分析结果显示,女性非酒精性脂肪肝的危险因素有肥胖(BMI≥24 kg/m2)、食用油炸食品、食用烟熏和腊味食品、食用腌晒和盐渍食品、应酬频率、近五年体重变化、既往病毒性肝炎史、高血压史及高血脂病史;多因素非条件Logistic回归分析中,最终进入模型的变量有肥胖(BMI≥24 kg/m2)、不清楚既往病毒性肝炎史、不吃油炸食品、高血压史和高血脂病史,其中肥胖BMI≥24 kg/m2 (OR=4.084,95％CI=1.927～8.658)、不清楚既往病毒性肝炎史(OR=8.618,95％CI=1.915～38.773)、高血压史(OR=3.782,95％CI=1.097～12.673)和高血脂病史(OR=5.369,95％CI=2.521～11.435)是危险因素,不吃油炸食品(OR=0.052,95％CI=0.016～0.173)是保护因素.结论 通过合理膳食、改变不良生活饮食习惯、增加运动、减轻体重、治疗高血压病及脂质代谢紊乱等措施,有助于预防非酒精性脂肪肝.     

上海市中老年戊型病毒性肝炎危险因素调查

[目的 ]　了解上海市中老年戊型病毒性肝炎发病危险因素。　 [方法 ]　病例对照调查 ,选择临床和血清学诊断为戊型病毒性肝炎的病人 14 4例作为调查对象 ,按 1∶2配比 2 88名对照者 ,采用单因素和多因素条件Logistic回归分析。　 [结果 ]　单因素分析显示食用火锅、饭前便后不洗手、到个体摊点和饮食店就餐、食用河鲜类食物为戊型病毒性肝炎发病的主要危险因素 ,经多因素条件Logistic回归模型分析 ,OR值分别为 4.718、3 .0 5 8、2 .117和 2 .14 7。　 [结论 ]　上海市中老年戊型病毒性肝炎发病仍以食用火锅、饭前便后不洗手、到个体摊点和饮食店就餐、食用河鲜类食物等危险因素为主     

杭州市戊型肝炎流行特征及危险因素研究

目的了解杭州市戊肝疫情特征及发病的危险因素。方法对杭州市2006-2010年戊肝病例进行描述性流行病学分析。采用病例对照调查方法,选取实验室确诊戊肝病例作为病例组,同期在同所医院就诊,血清戊肝抗体阴性的非感染性疾病患者作为对照组。制定统一的调查表进行调查,资料采用SPSS 13.0单因素和多因素非条件logistic回归分析。结果 2006-2010年,杭州市共报告戊肝病例2 063例,年平均发病率为5.51/10万,年发病率逐年上升,疫情以散发病例为主。多因素logistic回归分析结果显示,在外就餐(OR=1.554;95%CI:1.234～1.958)及与他人共用水杯(OR=1.889;95%CI:1.120～3.184)是危险因素,饭前有洗手习惯(OR=0.370;95%CI:0.184～0.745)是保护因素。结论杭州市戊肝发病呈逐年上升趋势,接触及食源性传播是主要的传播方式,开展餐饮从业人员戊肝检测很有必要。     

广东省传染性非典型肺炎感染危险因素病例对照研究

目的了解SARS感染的危险因素。方法选择2002年11月16日至2003年6月30日广东省报告的符合“卫生部《传染性非典型肺炎临床诊断标准(试行)》”的病例,在病例的邻居中选择与病例年龄相差不超过5岁,性别相同,无接触史且无发病者作为对照,采用回顾性调查方法,调查内容包括一般情况、流行病学史、家庭环境、工作场所环境、个人饮食和卫生情况。采用单因素和多因素Logistic回归分析方法进行比较。结果共调查病例809例、对照331例。多因素条件Logistic回归分析结果表明,发病前20 d有外县旅行史(OR=1.82,95%CI为1.05~3.17)、去过医院(OR=1.59,95%CI为1.06~2.39),有SARS/可疑SARS病例接触史(OR=1.66,95%CI为1.33~2.08)和有动物接触史(OR=1.53,95%CI为1.05~2.24)是SARS感染的危险因素,工作场所通风良好(OR=0.56,95%CI为0.41~0.76)是SARS感染的保护因素。结论接触SARS或可疑SARS病例、去过医院、有外县旅行史和有接触动物史是SARS感染的危险因素。     

儿童乙型病毒性肝炎发病影响因素的研究

目的探讨福建省<15岁儿童乙型病毒性肝炎(乙肝)发病的影响因素,为控制乙肝流行提供依据。方法根据2003年分层整群随机抽样进行儿童乙肝病毒表面抗原(HBsAg)携带率调查结果,随机抽取其中6个县(市、区),采用1∶2病例对照研究设计,对2005年以临床确诊为新发乙肝的儿童为病例,其同性别,同自然村或街道和年龄相差±2岁的、无血缘关系的、排除为乙肝的儿童为对照,使用统一调查表,进行问卷调查。资料编码量化后录入计算机,用SPSS13.0软件包进行条件Logistic单因素和多因素统计分析。结果儿童新发乙肝病例对照调查显示,单因素分析结果:乙肝疫苗接种史β=-2.259,本次发病前是否是HBsAg携带者β=-4.103,静脉输液史β=1.005,肌内注射、静脉注射史β=1.005,家庭内乙肝病人或HBsAg携带者β=1.366。多因素分析结果:乙肝疫苗接种史β=-4.131,本次发病前是否是HBsAg携带者β=-6.709。结论家庭内有乙肝病人或HBsAg携带者、有静脉输液史、有肌内或静脉注射史,对儿童乙肝的发病有危险作用;而有乙肝疫苗接种史、本次发病前不是HBsAg携带者,对儿童乙肝的发病有相对的保护作用。     

2005—2019年北京市顺义区戊型肝炎流行病学特征及危险因素分析

目的 了解北京市顺义区2005—2019年报告的戊型肝炎（戊肝）发病情况,探讨影响戊肝发病的危险因素,为戊型肝炎的防控提供依据。方法 利用中国疾病预防控制信息系统的传染病报告信息管理系统模块,按发病日期导出2005—2019年戊肝报告发病数据,采用描述流行病学方法对戊肝发病特征进行分析,采用1：2配对的病例对照方法对戊肝发病危险因素进行统计分析。结果 2005—2019年北京市顺义区戊肝病例报告发病率整体呈下降趋势（P<0.01）,报告发病率波动于1.27/10万~5.69/10万。60~69岁是发病高峰,发病例数占比最高的职业是农民,占35.98%;农村报告发病率高于城市（P<0.01）,男性报告发病率高于女性（P<0.01）。多因素分析显示食用海鲜类（OR=1.794）、食用河鲜类（OR=1.826）、喝生水（OR=1.798）、经常外出就餐（OR=1.774）和传染源接触史（OR=11.807）是戊肝发病的危险因素。结论 中老年人、男性、农民是戊肝的主要发病人群。戊肝发病的主要危险因素为食用海鲜、河鲜、喝生水、经常外出就餐以及传染源接触史。     

福建省育龄妇女麻疹发病相关因素的病例对照研究

目的探讨福建省育龄妇女麻疹发病的危险因素。方法采用病例对照研究,收集福建省2007-2011年发生的全部育龄妇女麻疹病例477例和1 431例健康人群的一般社会人口经济学、麻疹疫苗免疫史、人口性质、医院暴露史和病人接触史等信息。结果多因素分析显示,病例组中未接种麻疹疫苗的比例明显高于对照组(OR=0.34,95%CI=0.27～0.43),病例组中医院暴露的比例明显高于对照组(OR=2.28,95%CI=1.17～4.43),病例组中有接触史的病例明显高于对照组(OR=4.43,95%CI=2.94～6.67);单因素分析提示,两组人群的家庭人均月收入差异有统计学意义(OR=0.35,95%CI=0.28～0.44)。结论无麻疹疫苗免疫史人群、医院暴露人群、有接触史人群、家庭人均收入低的人群是福建省育龄妇女麻疹发病的高危人群。     

封开农村地区COPD相关危险因素的Logistic回归分析

目的了解封开农村地区慢性阻塞性肺疾病(COPD)的患病率及相关危险因素,为COPD的有效干预提供科学依据。方法以整群抽样随机分层方法对封开县农村地区1 386例调查对象(年龄≥40岁)进行问卷调查及肺功能检测,采用单因素和多因素非条件Logistic回归分析COPD发病的相关危险因素。结果本农村地区COPD总患病率为10.24%;COPD相关危险因素分析显示:年龄(OR=4.002,95%CI=2.339~7.605)、吸烟(OR=3.846,95%CI=1.925~7.564)、职业粉尘暴露(OR=5.339,95%CI=3.062~9.743)、烧柴烧煤(OR=1.206,95%CI=0.895~2.666)、厨房通风设备差(OR=2.599,95%CI=1.056~4.009)、不良烹饪习惯(OR=1.408,95%CI=0.758~2.255)和肺部疾病个人史(OR=1.296,95%CI=1.015~2.847)。结论 COPD发病是多种因素相互作用的结果,提倡使用清洁燃料,改善通风条件,以减少COPD的发病率。     

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.     

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.     

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.     

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.     

Hydrazine inhalation hepatotoxicity

Abstract Hydrazine is a hazardous chemical commonly used as a reactant in rocket and jet fuel cells. Animal studies have demonstrated hepatic changes after hydrazine inhalation. Human case reports of hydrazine inhalation hepatotoxicity are rare. We report a case of mild hepatotoxicity following brief hydrazine vapour inhalation in a healthy young man, which resolved completely on expectant management.     

Fitness standards in airline staff

Employers have a legal duty to manage safety and to meet this duty it is necessary to control risks arising from pre-existing medical conditions. Such conditions can be identified at the time of job placement, but there is little published information about the approach to fitness standards by most airlines. This review is therefore limited to the practice of one major airline. It is illustrated by reference to various occupations within the airline, with the associated rationale.