我国中老年人群童年期居住社区质量与认知功能的关联研究

目的探讨我国中老年人童年期居住社区质量与中老年认知功能的关联。方法基于2011年中国健康与养老追踪调查调查数据, 纳入符合标准的≥45岁人群10 940名, 采用标准化调查问卷收集调查对象的一般人口学特征、生活方式、个人疾病史、社区质量和认知功能等信息。社区质量包括社区安全、社区热情及邻里关系, 认知功能评价包括认知完整性和情景记忆能力。采用多因素logistic回归模型分析童年期居住社区质量与中老年期认知功能的关联。结果 10 940名研究对象年龄为(58.3±9.1)岁, 女性占51.5%(5 635名), 认知功能良好者占47.3%(5 174名)。多因素logistic回归模型分析结果显示, 与童年期居住社区很不安全、童年期居住社区很不热情、童年期居住社区邻里关系很不融洽者相比, 童年期居住社区比较安全(OR=0.75, 95%CI:0.57～1.00)和非常安全(OR=0.72, 95%CI:0.55～0.95)、居住社区比较热情(OR=0.69, 95%CI:0.56～0.85)和非常热情(OR=0.70, 95%CI:0.57～0.87)、邻里关系不太融洽(OR=0.57...     

太行山食管癌高发区农村居民高血压风险预测模型构建

目的 剖析太行山食管癌高发区山西平顺农村居民高血压患病的影响因素,为制订防治对策提供根据。方法 通过随机整群抽样方法,抽取调查对象开展问卷调查和体格检查;利用非条件logistic回归模型分析高血压影响因素并建立风险预测模型。结果 调查问卷发放1 121份,有效966(86.1%)份。调查对象女性503名(52.1%),检出336人(粗率34.8%,标化率33.7%)患高血压。分析显示,BMI(OR=1.068,95%CI:1.025～1.112)、习惯性饮茶(OR=1.815,95%CI:1.290～2.555)、喜食腌制食品(OR=1.638,95%CI:1.199～2.239)、被动吸烟(OR=1.535,95%CI:1.135～2.076)、进食较快(OR=1.518,95%CI:1.120～2.058)、高血压家族史(OR=4.197,95%CI:3.080～5.718)、高脂饮食(OR=2.117,95%CI:1.556～2.880)均是高血压患病的危险因素,喜食辣椒(OR=0.621,95%CI:0.425～0.908)则是保护因素;模型检验中C=0.741(95%CI:...     

中山市高尿酸血症的流行概况及其危险因素分析

目的 分析中山市高尿酸血症的流行情况以及其危险因素,并进一步探讨预测高尿酸血症发生的可能的指标因素。方法 于2016年在广东省中山市应用多阶段随机抽样的方法进行现况调查,实际抽取7 174名居民进行问卷调查、体格检查及实验室检测,并采用多因素logistic回归分析各影响因素。结果 中山市总体高尿酸血症患病率为31.91%。多因素logistic回归分析表明,男性(OR = 1.783, 95%CI :1.544～2.059)、偶尔饮酒(OR = 1.198, 95%CI :1.030～1.394)、经常饮酒(OR = 1.388, 95%CI:1.186～1.623)、患高胆固醇血症(OR = 1.267, 95%CI :1.054～1.521)、超重/肥胖(OR = 1.901, 95%CI :1.657～2.181)、患中心性肥胖(OR = 1.311, 95%CI :1.139～1.509)、血压高(OR = 1.321, 95%CI :1.170～1.491)、空腹TG含量≥1.7 mmol/L(OR = 2.016, 95%CI:1.772～2.295)、空腹HDL - C含量＜1.0mmol/L(OR = 1.439, 95%CI: 1.088 ～1.903)等是中山市常住居民患高尿酸血症的独立危险因素。结论 中山市成年居民高尿酸血症患病率已经达到较高水平,应对其危险因素进行干预,减少中山市高尿酸血症发生的风险。     

河北省2018年城乡老年人常见慢性病流行特征及影响因素分析

目的 了解河北省城乡老年人慢性病患病现况及流行特征,为制定公共卫生政策提供客观依据。方法 采用多阶段分层整群随机抽样的方法,抽取河北省石家庄市、唐山市、临城县、沧县4个调查点,每个调查点各抽取1个城市点和1个农村点,对其常住人口进行调查。结果 本次共计调查60岁以上老年人2 772人。其中肥胖的患病率为19.0%;高血压的患病率为56.5%;糖尿病的患病率为16.2%;血脂异常的患病率为34.0%;高尿酸血症的患病率为16.9%。至少患有一种慢性病的人数为2 183人（占78.8%）,其中有1 163人（占42.0%）同时患有两种慢性病,454人（占16.4%）同时患有三种或三种以上慢性病。多因素logistic回归分析结果显示,居住在城市(OR = 0.545,95%CI:0.445～0.668)、低教育程度（OR = 0.556,95%CI:0.392～0.789）、相对低龄（OR = 0.598,95%CI:0.428～0.837;OR = 0.439,95%CI:0.252～0.763）的老年女性（OR = 1.860,95%CI:1.473～2.349）肥胖的风险更高;高年龄（OR = 1.449,95%CI:1.130～1.858;OR = 1.658,95%CI:1.156～2.377）,低教育程度（OR = 0.740,95%CI:0.601～0.911;OR = 0.710,95%CI:0.552～0.914）和每天饮酒（OR = 0.571,95%CI:0.344～0.947;OR = 0.621,95%CI:0.452～0.854）的人患高血压的风险更高。居住在城市(OR = 0.727,95%CI:0.588～0.899)的老年人患糖尿病风险更高;受教育程度高（OR = 1.301,95%CI:1.046～1.618;OR = 1.367,95%CI:1.052～1.777）的女性（OR = 1.407,95%CI:1.172～1.689）血脂症异常的风险更高;城市居民(OR = 0.609,95%CI:0.494～0.752)和几乎每天饮酒（OR = 0.320,95%CI:0.149～0.689;OR = 0.476,95%CI:0.327～0.692）的人患高尿酸血症的风险更高（P＜0.05）。结论 河北省老年人常见慢性疾病患病率仍处于一个较高水平,不同的慢性疾病危险因素不同,应针对不同危险因素积极采取防控措施。     

中国中老年妇女吸烟、饮酒行为与抑郁症状相关性分析

目的探索吸烟、饮酒行为对中国中老年妇女抑郁症状的影响,为改善中老年妇女抑郁状况提供政策依据和干预措施。方法选用2013和2015年中国健康与养老追踪调查(CHARLS)数据,采用10项流调中心抑郁量表(CES-D10)评估中老年妇女的抑郁症状,运用logistic模型分析吸烟、饮酒行为对中老年妇女抑郁症状的影响。结果本研究中基线5 532名无抑郁症状的中老年妇女2年后出现抑郁症状1 405例,抑郁症状发生率为25.40%,农村(29.25%)高于城镇(19.93%)。Logistic分析结果显示,与不吸烟的中老年妇女相比,吸烟者(OR=1.23,95%CI=0.95～1.60)和戒烟者(OR=0.70,95%CI=0.47～1.08)发生抑郁症状的风险无显著增加;与不饮酒的中老年妇女相比,每周饮酒者(OR=1.16,95%CI=0.90～1.52)与偶尔饮酒者(OR=1.03,95%CI=0.83～1.29)发生抑郁症状的风险无显著增加。按居住地对中老年妇女进行分层后发现,居住在城镇的中老年妇女,吸烟者(OR=1.53,95%CI=1.01～2.32)发生抑郁症状的风险高于不吸烟者;居住在农村的中老年妇女,相比不吸烟者,吸烟者(OR=1.10,95%CI=0.78～1.57)和戒烟者(OR=0.77,95%CI=0.46～1.29)发生抑郁症状的风险无显著性差异。无论是居住在农村还是城镇,相比不饮酒者而言,每周饮酒和偶尔饮酒的中老年妇女发生抑郁症状的风险无显著变化。结论中国中老年妇女抑郁症状发生率较高,农村高于城市。应加强中老年妇女的健康教育,告诫其减少吸烟,同时加强中老年妇女的心理干预,为提高中老年妇女的身心健康提供保障。     

2018年湖南省成人中心性肥胖现状及影响因素分析

目的 了解湖南省2018年成人中心性肥胖现状及影响因素,为政府制定肥胖防控措施提供理论依据。方法 数据来自2018年湖南省常住居民慢性病与危险因素调查项目,采用多阶段分层整群随机抽样方法选取湖南省≥18岁常住居民7 464名为研究对象。进行问卷调查、体格检查和实验室检测。利用SAS 9.4软件进行加权,并进行χ²检验、秩和检验和多因素logistic回归分析。结果 加权后,2018年湖南省成人中心性肥胖率为26.3%,男性和女性分别为28.4%和24.2%,差异无统计学意义(P>0.05)。多因素logistic回归分析结果显示,60～岁年龄组(与18～40岁相比OR=1.90,95%CI:1.01～3.57)、居住城市(OR=1.62,95%CI:1.12～2.34)、超重(OR=21.52,95%CI:15.55～29.79)、肥胖(OR=845.69,95%CI:564.01～999.99)、患高血压(OR=1.65,95%CI:1.29～2.10)、患糖尿病(OR=1.69,95%CI:1.33～2.15)与中心性肥胖高风险相关,均有统计学意义(P&...     

上海市成年双生子健康生活方式与肥胖的关联研究

目的分析上海市成年双生子健康生活方式的数量与超重/肥胖及腹型肥胖的关联。方法使用2017-2018年上海市双生子项目第二轮调查数据, 通过病例对照的研究设计分析健康生活方式与肥胖的关联, 并进一步利用双生子配对控制遗传等混杂因素。结果共纳入7 864名(3 932对)成年双生子。同卵双生子配对病例对照分析显示, 与0～2种健康生活方式者相比, 有3种和4～5种健康生活方式者患超重/肥胖的风险分别降低49%(OR=0.51, 95%CI:0.28～0.93)和70%(OR=0.30, 95%CI:0.13～0.69), 患腹型肥胖的风险分别降低17%(OR=0.83, 95%CI:0.44～1.57)和66%(OR=0.34, 95%CI:0.14～0.80);并且每增加1种健康生活方式, 患超重/肥胖的风险降低41%(OR=0.59, 95%CI:0.42～0.85), 患腹型肥胖的风险降低37%(OR=0.63, 95%CI:0.44～0.90)。结论健康生活方式的数量与超重/肥胖及腹型肥胖均相关, 数量越多, 患病风险越低。     

居民血脂异常影响因素的列线图分析

目的调查杭州市上城区居民血脂异常及影响因素,并建立列线图分析居民血脂异常风险。方法采用多阶段随机抽样方法,从上城区随机抽取5个街道,每个街道各抽取2个社区,每个社区抽取153户家庭,纳入家庭户中≥18岁居民进行问卷调查,体格检查和血糖、血脂检测;采用Logistic回归模型分析血脂异常的影响因素,并采用列线图分析血脂异常风险。结果有效调查3 061人,检出血脂异常536例,患病率为17.51%,标化患病率为13.74%。多因素Logistic回归分析结果显示,年龄≥45岁(OR45岁～=2.623, 95%CI:1.738～3.961; OR65岁～=3.941, 95%CI:2.632～5.900; OR75岁～=3.264, 95%CI:2.095～5.084)、超重/肥胖(OR=1.725, 95%CI:1.390～2.140)、糖尿病(OR=3.103,95%CI:2.369～4.063)、高血压(OR=2.789,95%CI:2.196～3.542)、有冠心病家族史(OR=2.215,95%CI:1.443～3.399)是血脂异常的危险因素;日常锻炼(OR=0.790,95%CI:0.630～0.991)是血脂异常的保护因素。建立的血脂异常风险列线图显示,年龄45～64岁为70分,65～74岁为100分,≥75岁为86分,患高血压为75分,患糖尿病为83分,有冠心病家族史为58分,日常不锻炼为17分,超重/肥胖为40分,总分0～373分,一致性指数C-index为0.790 (95%CI:0.779～0.801)。结论年龄≥45岁、超重或肥胖、患糖尿病、患高血压、有冠心病家族史和缺乏日常锻炼与血脂异常相关,根据上述影响因素建立的列线图对个体血脂异常风险有一定预测作用。     

2022年四川汉族地区农村12岁儿童恒牙患龋状况调查及影响因素分析

目的 调查四川农村12岁儿童恒牙患龋状况及其影响因素,为相关部门开展儿童龋病防治提供参考依据。方法 2022年采用整群随机抽样法在四川省随机抽取9个地级市,再从每个市抽取1个县,每个县中抽取3～4所乡镇小学,对12岁农村儿童进行口腔检查及问卷调查,并采用χ²检验、多因素Logistic回归分析农村12岁儿童恒牙患龋影响因素。结果 共调查2 307名四川农村儿童,患龋率为32.90%,龋均为0.73,龋补充填比为2.89%。多因素Logistic回归分析显示性别(OR=1.517,95%CI:1.266～1.817)、是否每天刷牙(OR=0.663,95%CI:0.496～0.886)、蛋白质摄入(OR=0.729,95%CI:0.606～0.878)、零食(OR=1.383,95%CI:1.116～1.714)、口腔健康状况自我评价(OR一般=1.261,95%CI:1.037～1.534,OR较差=2.486,95%CI:1.762～3.508)、乳牙患龋(OR=1.350,95%CI:1.047～1.740)和牙齿发育状况(OR=2.486,95%CI:1.7...     

上海市社区35岁及以上人群高血压筛查结果分析

目的了解上海市社区高血压筛查对象的血压水平分布及影响因素,为新时期高血压早发现政策和措施的制定提供依据。方法于2017年11—12月,采用多阶段抽样方法抽取上海市7个区共21 496名35岁及以上常住居民为调查对象,进行问卷调查、身体测量和实验室检测。采用SAS 9.4软件进行复杂抽样下一般线性模型分析、Rao-Scottχ2检验、趋势χ2检验和多因素有序多分类反应变量的logistic回归分析。结果本次调查共有高血压筛查对象(自报未患高血压者)13 980名,其平均收缩压为130.6 mm Hg(95%CI:127.8～133.5 mm Hg),平均舒张压为81.3 mm Hg(95%CI:79.6～83.1 mm Hg)。男性平均收缩压[132.5 mm Hg(95%CI:128.4～136.5 mm Hg)]和平均舒张压[83.4 mm Hg(95%CI:81.0～85.7mm Hg)]均高于女性[平均收缩压为128.8 mm Hg(95%CI:126.5～131.2 mm Hg),平均舒张压为79.4 mm Hg(95%CI:77.9～80.8 mm Hg)],均有统计学意义(P0.05,P0.01)。≥75岁组平均收缩压最高,为145.4 mm Hg(95%CI:141.8～149.0 mm Hg),而平均舒张压最高的是45～59岁组,为82.2 mm Hg(95%CI:80.1～84.3 mm Hg)。高血压筛查对象的高血压、正常高值检出比例分别为32.94%(95%CI:27.91%～37.96%)和45.62%(95%CI:42.90%～48.34%),男性高血压比例高于女性(P0.05),75岁以上年龄组高血压检出率最高,为61.57%(95%CI:52.95%～70.20%)。多因素回归分析表明,男性(OR=1.67,95%CI:1.43～1.95)、高年龄(45～59岁OR=1.53,95%CI:1.22～1.92;60～74岁OR=2.18,95%CI:1.83～2.59;≥75岁OR=5.08,95%CI:4.28～6.03)、现在饮酒(OR=1.30,95%CI:1.04～1.62)、糖尿病(OR=1.66,95%CI:1.30～2.11)、血脂异常(OR=1.45,95%CI:1.28～1.65)和超重或肥胖(OR=1.79,95%CI:1.61～1.98)人群血压水平升高的风险较高,均有统计学意义(P0.05,P0.01),而文化程度较高人群(高中或中专OR=0.67,95%CI:0.53～0.85;大专及以上OR=0.62,95%CI:0.52～0.73)血压水平升高的风险较低,有统计学意义(P0.01)。结论社区高血压筛查对象的正常高值、高血压检出率较高。需探索多途径、高效的筛查和干预模式,重视高血糖、高血脂、超重肥胖和饮酒等高血压危险因素的控制。     

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.     

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.     

Assessing occupational and environmental exposure

Exposure assessment is a poorly understood component of the science of epidemiology. The relationship between exposure to chemicals and ill-health outcomes is often calculated using crude exposure measures such as ever/never exposed or duration. When investigating subtle effects, exposures need to be characterized much more fully in terms of intensity, frequency, duration and route. While occupational exposures tend to be much greater than those experienced from the wider environment there is a need to remember that, for many chemicals, exposure can occur occupationally, environmentally and through consumer use of products containing the material of interest. Inhalation exposure has generally been the traditional focus for most epidemiological investigations but there is now growing awareness of the importance of the dermal and ingested routes of contact and internalization. Quantification of the exposure also needs to be related to a biological mechanism of action and exposure metrics need to be selected accordingly. Occupational exposures can generally be measured using simple well-validated techniques. Environmental exposures require much more sensitive instruments and are more difficult to assess. Exposure modelling, particularly for the environmental fate of chemicals has undergone many recent developments and Monte Carlo techniques can be used to characterize model uncertainty and variability. This approach to exposure assessment can now be used in the setting of the wider environment and will enable a far better understanding of the relationship between exposure and disease.     

Mercury toxicity due to the smelting of placer gold recovered by mercury amalgam

A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [Mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (Mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited.     

How Adults with Acquired Brain Damage Perceive Computer Training as a Rehabilitation Tool: A Focus-group Study

The aim of this study was to explore and describe how adult outpatients with acquired brain damage and referred to occupational therapy perceive computer training with the RehaCom programs, in order to evaluate the method of treatment as a tool in the rehabilitation of persons with cognitive disorders. By using focus-group discussions as a qualitative method of research when analysing the result, five themes with corresponding categories emerged, describing a development of understanding and learning about capacities. Themes describing how the participants could apply strategies to overcome shortcomings in daily occupations and the therapeutic role of the occupational therapist were identified as well. The result shows that a computer training program such as RehaCom can be used as an educational tool, for example, to guide a person who is trying to adopt compensatory strategies to avoid overload by taking pauses. It was found that anything the participants learned was also applicable to occupational performance in daily life.