室内挥发性有机化合物污染与儿童哮喘关系的研究

目的探讨室内挥发性有机化合物(VOCs)污染与儿童哮喘之间的关系,为进一步深入研究提供基础资料,同时也为儿童哮喘的防治提供相关的建议与措施。方法采用病例-对照流行病学研究设计,问卷调查儿童哮喘病例和对照各50例的相关信息,并测定其室内空气中VOCs浓度。结果病例组室内VOCs浓度高于对照组,且差异有统计学意义(P<0.05)。将室内VOCs浓度从低到高分为4个等级,各等级的室内VOCs平均浓度均未超过国家标准(0.60 mg/m3)。总趋势OR值表明,在调整混杂因素(性别、年龄、民族、父母吸烟史、哮喘家族史)前后,室内VOCs浓度平均升高一个等级可以使儿童患哮喘的危险性分别增加0.77倍和0.78倍。结论室内VOCs浓度的升高可以使儿童哮喘发作的危险性增加。居室内VOCs浓度即使在空气质量标准范围内,仍有可能对敏感人群产生健康危害。     

室内颗粒物污染对儿童哮喘影响的病例对照研究

目的探讨室内大气颗粒物对儿童哮喘的影响。方法于2012—2013年采用病例-对照研究方法,对武汉市82名儿童居室内环境污染情况等进行问卷调查,对室内颗粒物浓度进行检测。结果病例组儿童室内PM_(10)平均浓度高于对照组(P0.05)。将两种颗粒物质量浓度划分为0μg/m~3~、100μg/m~3~、150μg/m~3~、200μg/m~3~不同等级,以0μg/m~3~为参照组,随着污染物浓度的升高,儿童哮喘发生的OR值逐渐升高;在调整混杂因素后,其OR值仍呈增加趋势,尤其是PM_(10)浓度在200μg/m~3以上时,调整后OR值为27.05(95%CI:1.52~482.94)。结论室内PM_(2.5)和PM_(10)对儿童哮喘有影响,且存在剂量-反应关系。     

成人过敏性哮喘危险因素的病例对照研究

目的 探讨导致成人过敏性哮喘及其发作的危险因素。方法 采用病例对照流行病学研究方法,收集102例成人过敏性哮喘患者和394例健康对照人群的一般社会人口学特征、疾病健康状况、吸烟史、职业接触史、室内环境状况以及家族史等信息。结果 单因素及多因素统计分析结果均显示:成人过敏性哮喘患者职业粉尘接触率高于对照组且差异有统计学显著性(P<0.05,OR=1.78);住房类型为平房/筒子楼较多层/高层楼导致过敏性哮喘或其发作的可能性大(P<0.05,OR=3.24),哮喘患者家中床褥晾晒频率较对照组低且差异具有统计学显著性(P<0.10,OR=1.53);哮喘患者家中起居室地面使用木板比例高于对照组且差异有统计学显著性(P<0.01,OR=2.33);室内油烟污染程度哮喘患者组高于对照组且差异有统计学显著性(P<0.01,OR=2.52);同时还发现,双亲中有慢性支气管炎(慢支)或哮喘疾病史可增加其子女患过敏性哮喘的危险性(P<0.01,OR=2.32)。结论 室内环境因素中住房状况差、床褥晾晒频率少、起居室地面使用木板、室内油烟污染可能是成人过敏性哮喘的危险因素,同时职业接触粉尘、双亲有慢支或哮喘疾病史也与该疾病具有一定的关系。研究结果提示成人过敏性哮喘是遗传和环境双重因素共同作用导致的一种复杂疾病。     

某焦化厂职业接触多环芳烃焦炉工肝脏某些酶活性的变化

目的探讨多环芳烃(PAHs)对炼焦作业工人某些肝血清酶活性改变的可能影响。方法对乙肝表面抗原(HBsAg)阴性的炼焦作业工人和非PAHs职业接触工人进行总PAHs累积接触指数(CEL-PAHs)评估,尿中1-羟基芘(1-OHP)浓度等级划分,和血清中丙氨酸转移酶(ALT)、天门冬氨酸转移酶(AST)、γ-谷氨酰转移梅(GGT)、碱性磷酸酶(ALP)的检测。结果焦炉工职业性PAHs暴露水平明显高于对照组(P<0·05)。与对照组相比,血清ALT的明显升高可见于CEL-PAHs<50μg/(m3·a)组和尿中1-OHP浓度<2·3μmol/mol肌酐CEL-PAHs≥200μg/m3组,血清AST的明显升高可见于CEL-PAHs<50μg/(m3·a)组;当CEL-PAHs(200μg/(m3·a)或尿中1-OHP浓度≥10·0μmol/mol肌酐时,可发现四种肝生化指标实测值的明显升高(P<0·05),以及ALT、AST和GGT异常率的明显升高(P<0·05),以血清GGT水平的升高(10倍CEL-PAHs的上升导致1·24倍血清GGT水平的升高,10倍尿中1-OHP浓度的上升导致1·19倍的升高)和异常率的上升(logistic回归,调整OR值为6·2~7·2,P<0·05)最为明显。结论PAHs职业暴露可导致炼焦作业工人肝脏某些血清酶活性的升高。     

儿童哮喘及过敏性疾病室内环境因素病例对照研究

[目的]探讨与儿童哮喘及过敏性疾病有关的室内环境因素。[方法]采用1︰1配对的病例对照研究方法,问卷调查152例儿童哮喘、过敏性紫癜、变应性鼻炎、湿疹的患者以及与152例非病例儿童室内环境因素,采用单因素和多因素条件Logistic回归模型进行数据分析。[结果]单因素条件及多因素条件Logistic回归分析结果均显示,病例组有住房装修史、室内油烟污染、厨房无排烟设备的频率高于对照组,并且在两组之间差异有统计学意义(P﹤0.01),OR值分别为3.05,7.04,2.03。对照组床褥经常晾晒的比例高于病例组,且差异有统计学意义(P﹤0.05,OR值为0.46)。[结论]住房装修、室内油烟污染及厨房无排烟设备可能会增加患儿童哮喘及过敏性疾病的危险性,床褥经常晾晒可降低儿童哮喘及过敏性疾病的发生。     

环境卫生与监测

足月产小于胎龄儿孕妇危险因素病例-对照研究；沈阳地区成人血清和脐带血中全氟有机物污染现状；镉污染对居民亚健康状态和慢性病发生的影响；室内甲醛与成人过敏性哮喘关系的研究；某地下医院真菌污染状况调查。     

辽宁地区过敏性鼻炎发生与室内环境质量变化

目的探讨2019年辽宁地区过敏性鼻炎发生与室内环境质量变化的关系。方法将2019年1月1日至2019年12月31日医院耳鼻喉科门诊收治的968例过敏性鼻炎患者作为病例组,匹配同期辽阳市第三人民医院就诊的968例非过敏性鼻炎患者作为对照组。分析过敏性鼻炎发生影响因素。结果与对照组比较,病例组城市、母亲过敏性鼻炎史、职业接触粉尘和吸烟比例高,住宅面积60m~2、住宅建成时间1～3年、地毯地板、近1年装修、油漆墙表、冬/夏季使用空调、封闭式厨房、无厨房/卫生间换气扇、室内可见发霉、经常使用空气清新剂、夏季开窗通风时间12h/d、冬季开窗通风时间8h/d、使用煤气/炭、熏香、总是/经常有蟑螂、老鼠和蚊蝇、饲养宠物、暴露于吸烟环境、有时/偶尔清洗被褥、室内养花比例高,室内甲醛浓度高(P0.05);地毯地板、冬季空调采暖、无厨房换气扇、室内可见发霉、冬季开窗通风时间8h/d、饲养宠物、使用煤气/炭、室内养花和室内甲醛浓度100μg/m~3为过敏性鼻炎独立危险因素(P0.05)。结论 2019年辽宁地区过敏性鼻炎发生与室内环境因素密切相关,其中空气质量对疾病影响较大。     

成人过敏性鼻炎危险因素的病例-对照研究

目的 探讨成人过敏性鼻炎的环境危险因素.方法 采用1:1配对的病例-对照流行病学研究设计,选择由北京大学人民医院耳鼻喉科确诊的100例过敏性鼻炎患者为病例;同时选择该院耳鼻喉科确诊的非过敏性鼻炎患者,以年龄(相差3岁以内)、性别(同性别)为配比变量,与病例1:1相匹配者为对照.通过问卷调查的方法收集两组人群的一般社会人口学特征、疾病健康状况、吸烟史、职业接触史、室内环境状况及家族史等信息.问卷的分析和统计采用单因素及多因素的条件Logistic回归分析.结果 病例组有花粉过敏史者患过敏性鼻炎的危险性高于对照组,且有统计学意义(OR=2.04,95%CI:1.31～3.20),母亲有过敏性鼻炎增加其子女过敏性鼻炎发生的可能性(OR=2.05,95%CI:1.03～4.07),病例组职业接触粉尘率高于对照组,且有统计学意义(OR=1.46,95%CI:0.83～2.57),成人过敏性鼻炎患者居室内开窗频率低于对照组,且有统计学意义(OR=0.70,95%CI:0.34～1.18).结论 职业接触粉尘、母亲有过敏性鼻炎、花粉过敏史、开窗频率低可能是成人过敏性鼻炎的主要危险因素,与成人过敏性鼻炎的发生有一定的联系.     

新装修居室空气中甲醛和苯水平厦其对小鼠骨髓细胞微核率的影响

[目的]了解泸州市新装修居室空气中甲醛和苯的污染状况,以及两者单独、联合作用对小鼠骨髓细胞微核率的影响。[方法]采用酚试剂及活性炭采样管分别采集泸州市内57户新装修住宅（装修结束6个月之内）室内空气,用可见光分光光度法及气相色谱法测定甲醛及苯的浓度,并根据测定结果确定动物染毒基础剂量,应用小鼠骨髓细胞微核试验观察甲醛及苯单独、联合染毒对小鼠骨髓细胞的致突变作用。[结果]简单装修组甲醛及苯的平均浓度分别为0．203mg／m3及0．135mg／m3,最高浓度分别为0．780mg／m3、0．450mg／m3,分别超过国家标准9．75倍和5倍;复杂装修组甲醛及苯的平均浓度分别为0．331mg／m3、0．222mg／m3,最高浓度分别为1．039mg／m3、0．660mg／m3,分别超标12．99倍、7.33倍;室内甲醛、苯浓度有随装修时间的延长明显下降的趋势（P〈0．005）。基础剂量组甲醛、苯单独及联合作用所引起的小鼠骨髓细胞微核率（MNCF）与对照组比较差异无统计学意义（P〉0．05）。而高于基础剂量组10倍、20倍组,无论是单独还是联合作用所引起的小鼠MNCF与对照组比较差异均有统计学意义（P〈0．005）;联合作用所引起的MNCF明显高于单独作用（P〈0．005）。[结论]泸州市内新装修居室空气中甲醛及苯的浓度明显超标,复杂装修污染程度更加严重。较高浓度的甲醛、苯单独及联合作用均可造成小鼠MNCF升高。     

新装修住宅空气中甲醛的污染状况

甲醛是一种具有刺激性气味的无色气体 ,也是一种潜在的致癌物质 ,对人体的健康有较大的危害 ,许多疾病的诱发均与之相关。如哮喘、白血病等与之有显著的相关关系。我国甲醛的室内标准为 0 0 8mg/m3 [1] ,美国和加拿大的甲醛室内标准为0 1× 10 -6(Φ) [2 ] 。近年来 ,随着大量室内装修材料和日用化工品的使用 ,以及房屋建造的密闭性增加 ,使新装修居室空气中甲醛的含量增高 ,对人们的健康造成了威胁。为了解新建商品房装修后室内空气中甲醛的污染状况 ,本文选择了一些有代表性的新建和新装修的住宅 (装修后 1个月之内 ) ,进行了甲醛的浓度…     

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.     

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.     

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.     

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.     

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.     

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.