铁路糖尿病患病职工血糖控制现状分析

了解某地区铁路糖尿病患病职工血糖控制情况,为改进健康干预措施提供依据。选取新诊断糖尿病职工272人及已确诊糖尿病职工175人,分析其健康体检结果及影响因素。结果表明,目前该地区糖尿病患病职工HbA1c <7%占46.98%,原已确诊糖尿病职工糖化血红蛋白控制率29.14%,入院治疗原因中健康体检检出血糖增高和出现糖尿病症状占75.43%,药物治疗率65.71%,运动和饮食控制率均为21.71%;新诊断与原已确诊糖尿病职工在血脂异常、肥胖、腹型肥胖差异有统计学意义。该地区糖尿病患病职工规范治疗后血脂异常、肥胖等有所降低,但糖尿病患病职工新诊断病例高、血糖控制率低,原已确诊糖尿病患病职工自我健康管理能力不足;提出应充分发挥健康体检筛查作用、早诊断早防治早干预、劝导规范就医、加强精准健康干预等建议。     

铁路职工血尿酸水平与高尿酸血症流行特征分析

了解铁路职工血尿酸(SUA)水平及高尿酸血症(HUA)流行特征,为高尿酸血症的防治提供依据。收集2021年某地区参加健康体检的31 415名铁路职工的体检资料,对SUA、HUA流行特征进行统计分析,计数资料的比较采用χ^(2)检验,计量资料两组间的比较采用t检验。结果表明,该地区铁路职工血尿酸水平为(377.00±91.94)μmol/L,男性(391.31±86.17)μmol/L,女性(290.1±76.81)μmol/L;调查人群中HUA总患病率为31.43%,男性HUA患病率33.78%,高于女性患病率(17.17%),差异有统计学意义(χ^(2)=487.531,P<0.01);不同年龄组间HUA患病率差异有统计学意义(χ^(2)=405.398,P<0.05),患病率随年龄增长呈下降趋势(趋势χ^(2)=397.239,P<0.01),其中男性HUA患病率年龄组差异有统计学意义且随年龄增长呈下降趋势;不同系统间HUA患病率差异有统计学意义(χ^(2)=243.716,P<0.01),机务、工务和供电系统HUA患病率高于其他系统。该地区铁路职工血尿酸水平及高尿酸血症患病率较高,男性高于女性,年轻化趋势明显,应引起重视并加强职工的HUA与相关疾病的防治工作。     

某铁路局职工健康体检结果分析

目的研究铁路职工健康现况,对建立职工健康管理制度提供依据。方法收集2014年度某铁路局2 672名基层站段职工的体检报告并对其进行分析。结果职工高血压患病率为37.3%,不同工种、年龄之间高血压患病率存在显著性差异;心电图异常率为20.2%;甘油三酯指标异常率为42.1%,不同年龄段之间存在显著性差异;B超异常率为33.6%,其中以肝脏疾病居多(24.1%),包括脂肪肝、肝囊肿、肝血管瘤。结论铁路职工脂肪肝、高血压以及高甘油三酯患病率较高,应加强这一特殊群体的健康宣教等干预措施。     

不同代谢综合征标准在某地区铁路职工体检中的适用性分析

采用整群抽样方法,按照国际糖尿病联盟流行病预防工作组联合过渡声明(JIS)、中华医学会糖尿病分会标准(CDS2013、CDS2004)、美国国家胆固醇教育计划成人治疗方案第三次报告(ATPⅢ)、国际糖尿病联盟标准(IDF)等5种代谢综合征(MS)诊断标准,分析某地区铁路职工体检资料。结果表明,按照JIS、CDS2013、ATPⅢ、CDS2004和IDF标准,MS检出率分别为40.52%、34.17%、34.99%、29.82%和27.92%;男性分别为44.97%、38.72%、38.43%、33.55%和30.54%;女性分别为16.23%、9.36%、16.23%、9.50%和13.60%,差异有统计学意义。JIS标准检出率最高,同一标准下不同性别患病率差异有统计意义,5种标准MS患病率均随年龄增长而升高;MS各组分检出率低HDL-C均为最低,其他组分排行有所不同,具有性别差异。除JIS与CDS2004诊断标准一致性为较好外,其他诊断指标一致性均为极好。该地区铁路职工MS检出率较高,建议采用JIS诊断标准筛查MS,并结合实际加强MS防控。     

某地区铁路职工ASCVD总体发病危险评估调查分析

评估某地区铁路职工ASCVD总体发病危险,为健康干预提供依据。按照《中国成人血脂异常防治指南(2016年修订版)》分析该地区2 910名铁路职工ASCVD总体发病危险、ASCVD危险因素及降LDL-C/非-HDL-C达标率。结果表明,铁路职工中ASCVD极高危、高危、10年高危、10年中危、10年低危和余生危险人数比例分别为1.48%、9.48%、5.36%、11.75%、68.76%和2.16%;危险因素中前三位为超重和肥胖、吸烟、血脂异常;降LDL-C/非-HDL-C达标情况极高危人群、高危人群、10年高危人群均低于30%。说明该地区铁路职工ASCVD发病危险高,中青年人群余生危险应引起重视;ASCVD危险因素多,高危人群降LDL-C/非-HDL-C达标率低;应采取积极措施,根据ASCVD发病危险分层进行不同强度健康干预。     

进水方式对序批式深床人工湿地硝化效能的影响

针对现有人工湿地硝化效能低、占地面积大的问题,研究污水处理厂尾水人工湿地高效硝化深度处理技术,采用序批式深床人工湿地反应器(DSCW),考察进水方式及其运行工况对硝化效能的影响。结果表明,进水方式、进水时间和闲置时间对湿地硝化效能影响显著。进水方式采用"连续进水-间歇出水"较连续进出水运行工况NH_4~+-N去除率高39.69%。连续进水时间为5.5 h、7.5 h、11.5 h时,NH_4~+-N去除率分别为81.82%、88.12%、89.91%;闲置时间为0、2 h、4 h时,NH_4~+-N去除率分别为88.12%、94.46%、92.60%。反应器在水温(20±3)℃、负荷35.56 g NH_4~+-N/(m2·d)、连续进水7.5 h-间歇出水0.5 h-排空闲置2 h运行工况下,出水NH_4~+-N为0.91 mg/L,去除率为94.46%,系统NH_4~+-N去除效能大幅提高。     

铁路职工高血压状况及影响因素分析

为了解铁路职工高血压状况及影响因素,以便有针对性地开展高血压的控制工作,对吉林铁路车辆段1 285名职工于2014年进行血压测量,并对测量的结果进行分析。结果表明,共检出高血压580人,检出率为45.14%。其中Ⅰ级高血压占检出高血压总人数的68.10%,Ⅱ级高血压占检出高血压总人数的25.86%,Ⅲ级高血压占检出高血压总人数的6.04%。随着年龄的增大,高血压患病率上升,饮酒职工的高血压患病率高于不饮酒的职工。应对职工进行健康教育,提高防病知识,降低高血压发病率。     

SBR法处理高盐肝素废水运行参数优化研究

采用SBR法处理高盐肝素钠生产废水,探讨了曝气时间、进水p H、温度等参数对COD和氨氮降解效果及污泥生长的影响。结果表明,控制曝气时间为10 h、进水p H为7.5、反应温度在26~29℃时,COD和氨氮去除率均能稳定在85%以上;对氨氮去除效果较差的反应器,适当添加K+、Ca2+、Mg2+可以取得一定的改善作用,其中K+对Na+和NH4+双重毒性抑制的拮抗效应最明显;经参数优化后的SBR反应器对不同污泥负荷和盐度负荷具有较好的适应能力,受到冲击后COD和氨氮去除率均能在2~3个运行周期内恢复至90%以上。     

沸石-陶粒BAF处理微污染水源水的影响因素研究

探讨沸石-陶粒BAF工艺对微污染水源水中CODMn、氨氮、UV254、浊度等污染物质的去除效果.通过模型试验,研究了填料高度、水力负荷、气水比等因素对沸石-陶粒曝气生物滤池(BAF)工艺处理效果的影响.结果表明,在水力负荷为1.2～4.8 m3/(m2·h)、气水比为1时,CODMn、氨氮、UV254和浊度的去除率随填料层高度的增加而增加,其中CODMn、UV254、浊度的去除在最初的440 mm内最为显著,而氨氮的去除在220～440 mm范围内较明显; 在气水比为1,水力负荷分别为1.2 m3/(m2·h)、2.4 m3/(m2·h)和4.8 m3/(m2·h)时,CODMn的总去除率分别为38.62%、32.23%和25.37%,较合适的水力负荷为1.2 m3/(m2·h); 在水力负荷为1.2 m3/(m2·h)、气水比由0.5增为1时,CODMn的平均去除率由26.34%增为36.31%,氨氮的平均去除率由78.15%增为94.4%,当气水比增大为2时,CODMn、氨氮的去除率增加很少,合适的气水比为1.研究表明,沸石-陶粒BAF工艺处理微污染水源水的效果良好,且所需的填料高度小,气水比低.     

2015年西安铁路局健康宣传效果评估

目的为开展健康行动计划提供参考依据。方法计算健康知识宣传普及率。采用整群抽样的方法抽取43 891名职工调查健康知识知晓率。调查37 222名食堂就餐职工的健康行为生活方式改变情况。结果职工健康知识宣传普及率为100%。健康知识知晓率为90%以上。食盐、食油摄入量达标率明显提升,水果、蔬菜摄入达标率提高不明显。结论职工健康知识宣传普及率、健康知识知晓率提升明显,健康行为生活方式有所改善,但水果、蔬菜摄入达标率仍有待提高。     

2014—2018年铁路辖区职工癌胚抗原检测结果与分析

为了解某铁路辖区职工癌胚抗原异常情况,探讨该人群癌胚抗原异常检测结果的影响因素,以提出防控策略,采用全自动电化学发光仪对2014—2018年铁路辖区职工的癌胚抗原进行测定,共检测159 214份。结果表明,癌胚抗原异常率12.1%,56～60岁人群癌胚抗原异常率最高、为14.5%,男性职工癌胚抗原异常率高于女性,血糖偏高人群癌胚抗原异常率为16.5%。最后提出应进一步重视检测结果,充分利用铁路现有卫生资源,采取健康体检、健康宣传、健康休养、健康管理的防控手段。     

Safe driving practices and factors associated with motor-vehicle collisions among people with insulin-treated diabetes mellitus: Results from the Diabetes and Driving (DAD) study

IntroductionThe aim of this study was to assess the prevalence of people with insulin-treated diabetes mellitus (ITDM) who have discussed issues related to diabetes and driving with their health care providers (HCPs). We also sought to determine the safe driving practices that are currently employed by this group. Finally, we investigated the factors that might increase the risk of motor-vehicle collisions (MVCs) among this group in Saudi Arabia.MethodThis cross-sectional study surveyed a representative sample of 429 current male drivers with ITDM using a structured questionnaire in Saudi Arabia.ResultsMost of the participants (76.5%) never discussed topics regarding diabetes and driving with their HCPs. The majority of the participants (61.8%) reported at least never doing one of the following: (a) carrying a blood glucose testing kit while driving, (b) testing their blood glucose level before driving or during a journey, or (c) having thought of a specific threshold of blood glucose level that would preclude driving. Three factors were associated with a higher risk of MVCs among participants with ITDM: (a) being on a basal/boluses regimen, (b) never having a discussion regarding diabetes and driving with their HCPs, and (c) having experienced hypoglycemia during driving.ConclusionsThe majority of people with ITDM had not had a discussion regarding diabetes and driving with their HCPs, which was reflected by a lack of safe driving practices. People with ITDM should be encouraged to take precautions while driving in order to prevent future MVCs.Practical applicationsThis research highlights the importance of investing more effort in educating drivers who have diabetes about safe driving practices by their health care providers. Also, it will attracts the attention of policymakers for an urgent need to establish clear policies and procedures for dealing with drivers who have diabetes.     

Needle stick and sharps injuries among health care workers in Gondar city, Ethiopia

Background

All employees in health care settings handling needles or other sharps are at risk for needle stick and sharps injuries (NSSIs). Health care workers in under developed countries are at greater risk of infection from blood borne pathogens because of the lack of safety devices and the high prevalence of these pathogens.

Objectives

The aim of this study was to assess the prevalence of NSSIs and associated factors among health care workers in government health institutions in Gondar city, Ethiopia.

Methods

Institution based cross sectional study was conducted from May-December, 2010. The study included 344 health care workers who were selected from the source population using simple random sampling technique. Data were collected through interviews using structured and pre-tested questionnaire and the collected data were entered and analyzed using SPSS version 16.0.

Results

The prevalence of NSSIs among health care workers in the preceding 12 months was 106 (30.8%), of which 58 (54.7%) was reported by females. Lack of training on occupational health and safety, working more than 48 h/week, dissatisfaction with work environment and work culture, greater than 10 years of work experience and having low and moderate perception of risk were found to be significantly associated with NSSIs.

Conclusion

The study found high prevalence of NSSIs among health care workers. Effective training, ongoing awareness on the risk of hazards, preventive measures such as engineering control, and post-exposure prophylaxis following NSSIs are essential to reduce the risk of such injuries.     

基于多主体建模的安全注意力衰减模型研究

为预防由安全注意力衰减引起的虚假安全问题,构建员工安全注意力衰减模型。采用多主体建模法并基于Netlogo仿真平台,分析个体因素、管理因素和环境因素对员工安全注意力水平的影响。试验结果表明:在环境因素和管理因素确定的情况下,员工安全注意力水平主要受熟悉程度和安全意识的影响。同时员工安全注意力水平对管理者的危机意识有反馈作用。安全信号强度、频率、员工对安全信息的期待和任务难度以及管理者的监督有效性,均影响员工安全注意力水平。在企业安全管理的具体实施过程中,企业应该考虑如何有效控制上述调节因素并提高员工安全注意力水平。     

An awareness campaign decreases distracted driving among hospital employees at a rural trauma center

Abstract

Objective: To evaluate whether an educational campaign on distracted driving will have an impact in a given community.

Methods: Investigators were stationed in an employee parking lot of a 256-bed hospital to determine baseline distracted driving followed by a 4-week hospital-wide distracted-driving awareness campaign. The campaign included signs/posters in the hospital, a booth outside of the cafeteria with flyers, a large banner in the employee lot and an opportunity for people to sign a pledge form to drive distraction free. The same employee lot was observed at the same time of the day to re-assess distracted driving immediately following the campaign. The observations were repeated again one year later to evaluate the short and long-term impact of the campaign.

Results: A total of 485 vehicles were observed pre-campaign, identifying 170 (35%) distracted drivers at baseline. The awareness campaign resulted in 525 people pledging to drive distraction free. Following the campaign, 495 vehicles were observed and the number of distracted drivers was 64 (12.9%), showing a significant decrease in the number of distracted drivers by 22.1% (p?<?0.01). One year later, 530 drivers were observed with 150 (28%) displaying one form of distraction.

Conclusions: A local distracted driving educational campaign resulted in a significant decrease in the number of distracted drivers immediately following the campaign. However, one year after the campaign, there was an increase in distracted driving. The proportion of distracted drivers was still significantly lower than the initial rate of distracted-drivers.     

Decreasing residential fire death rates and the association with the prevalence of adult cigarette smoking — United States, 1999–2015

IntroductionEach year from 1999 through 2015, residential fires caused between 2,000 and 3,000 deaths in the U.S., totaling approximately 45,000 deaths during this period. A disproportionate number of such deaths are attributable to smoking in the home. This study examines national trends in residential fire death rates, overall and smoking-related, and their relationship to adult cigarette smoking prevalence, over this same period.MethodsSummary data characterizing annual U.S. residential fire deaths and annual prevalence of adult cigarette smoking for the years 1999–2015, drawn from the National Vital Statistics System, the National Fire Protection Association, and the National Health Interview Survey were used to relate trends in overall and smoking-related rates of residential fire death to changes in adult cigarette smoking prevalence.ResultsStatistically significant downward trends were identified for both the rate of residential fire death (an average annual decrease of 2.2% – 2.6%) and the rate of residential fire death attributed to smoking (an average annual decrease of 3.5%). The decreasing rate of residential fire death was strongly correlated with a gradually declining year-to-year prevalence of adult cigarette smoking (r = 0.83), as was the decreasing rate of residential fire death attributed to smoking (r = 0.80).Conclusions and practical applicationsDecreasing U.S. residential fire death rates, both overall and smoking-related, coincided with a declining prevalence of adult cigarette smoking during 1999–2015. These findings further support tobacco control efforts and fire prevention strategies that include promotion of smoke-free homes. While the general health benefits of refraining from smoking are widely accepted, injury prevention represents a potential benefit that is less recognized.     

Low back pain among residential carpenters: ergonomic evaluation using OWAS and 2D compression estimation.

Occupational low back pain (LBP) remains a leading safety and health challenge. This cross-sectional investigation measured the prevalence of LBP in residential carpenters and investigated ergonomic risk factors. Ninety-four carpenters were investigated for LBP presence and associated risk factors. Ten representative job-tasks were evaluated using the Ovako Working Posture Analysis System (OWAS) and ErgoMaster 2D software to measure elements of posture, stress, and risk. Job-tasks were found to differ significantly for total lumbar compression and shear at peak loading (p < .001), ranging from 2 956 to 8 606 N and 802 to 1 974 N respectively. OWAS indicated that slight risk for injury was found in 10 job-tasks while distinct risk was found in 7 of the 10 job-tasks. Seven of the 10 job-tasks exceeded the National Institute for Occupational Safety and Health (NIOSH) action limit of 3 400 N for low back loading. The point prevalence for LBP was 14% while the annual prevalence was 38%.     

Falls and fall prevention programmes in developing countries: environmental scan for the adaptation of the Canadian Falls prevention curriculum for developing countries

Problem

Falls in older persons in developing countries are poorly understood, and falls prevention and health promotion programmes for this population are largely lacking.

Methods

A systematic review was carried out of relevant literature on falls and prevention programmes, and falls prevention education, and a scan undertaken of health promotion programmes for older persons in a representative country - South Africa.

Results

Studies on the risk and prevalence of falls are largely retrospective and hospital-based, with varied methodology, including study period, sampling method and sample size. Falls prevalence is based largely on self-reports in studies on general trauma in all age groups. Falls incidence varies from 10.1% to 54%. No reports could be traced on sustained falls prevention or health promotion programmes.

Conclusion

Scant research has been conducted and little preventive education offered on falls in older persons. Adaptation of the Canadian Falls Prevention Curriculum for developing countries will help to fill gaps in knowledge and practice.

Impact on industry

With rapid increase in the populations of older persons in developing countries, research on age related disorders such as falls is required to guide policy and management of falls.     

83家井工煤矿在岗农民工尘肺病现状调查及预防对策研究

为调查井工煤矿在岗农民工尘肺病防治现状并提出对策措施,采用分层整群抽样调查方法对4省（市）的83家井工煤矿进行调研,调查内容包括:职业卫生管理现状、职业健康监护与尘肺病诊断资料、X线胸片、农民工基本情况、职业卫生知识知晓情况、社会保险待遇等。调查结果显示:83家井工煤矿的职业病危害防治工作领导小组设置率和管理制度制定率均为100%,但制度内容和职业卫生培训缺乏针对性;粉尘危害防治费用平均为吨煤0.18元/月;采煤和掘进工作面的总尘浓度约为1.02～49.5 mg/m3;在岗检查时,农民工肺部异常的检出率高于正式工,在岗农民工疑似尘肺病检出率为7.94%,农民工尘肺病平均发病工龄14.47 a±6.79 a,平均发病年龄42.56岁±5.80岁,与正式工相比,农民工发病工龄短、发病年龄小。因此,建议政府从法规标准建设、探索职业健康责任险、加大监管力度等方面,企业从强化主体责任意识、源头治理及农民工职业卫生培训等方面,加强农民工尘肺病的防治工作。