评价自然灾害健康效应及其需要的指标体系

介绍了评价自然灾害健康效应及其需要的指标体系。提出通过调查死亡、伤亡、患病等，分析其与灾区人口、特定年龄人群、职业、习惯、地理位置、时间分布等关系，来科学评价灾害的严重性，提出救灾技术措施和确定主要卫生服务内容，保护易感人群，为灾后进行建筑物结构或位置的易感性分析以及制定防灾减灾计划提供科学依据。     

Epidemiology of occupational acute traumatic hand injuries: a literature review

The purpose of this review was to summarize the literature on occupational, acute, traumatic hand injury and suggest directions for future research. In 1996, the leading occupational injury treated in United States' hospital emergency departments was an acute hand injury (e.g. laceration, crush or fracture). These injuries affected 30% of an estimated 3.3 million injured workers (990,000). Cuts and lacerations of the fingers ranked third after back and leg strains in the number of lost workday cases in the USA in 1994. The incidence rate of hand injuries studied in seven manufacturing environments around the world ranged from 4 to 11 per 100 workers per year. Workers aged 24 years or less had the highest risk of hand injury. Men had higher rates of severe hand injury than women.Despite the high frequency and significant amount of lost work time associated with these injuries, they are poorly understood from an etiological perspective. There is only one case-control study of occupational hand injury in the literature. That study suggested an important role for both fixed (age) and transient risk factors (doing an unusual task) at the time of the injury. More analytic epidemiological research is needed to identify potentially modifiable risk or protective factors (e.g. glove use) for acute hand injuries. In this regard, the case-crossover design, a relatively new epidemiological approach using cases as their own controls, could prove an efficient method for determining transient, modifiable risk factors for acute, occupational hand injury.     

Incidence rates and risk factors for injury events in high school students in Lijin County, China

PROBLEM: Most investigations of injuries among Chinese populations are focused on urban or better developed areas, fewer on rural or poor areas. METHODS: From September 21 to 27, 2002, an epidemiological investigation of eight kinds of injury-related events was carried out among 1,944 students in 39 classes randomly sampled from middle schools in Lijin County, a rural area. The eight kinds of events were: (a) traffic accidents, (b) poisoning, (c) fall, (d) burn or scald, (e) blunt or sharp tools contact, (f) electrical contact, (g) animal or insect bites, and (h) non-fatal drowning. RESULTS: The total incidence rate of eight kinds of injuries in the previous year was 21.1%. The incidence rate among boys was 24.2%, while that among girls was 17.4%, which was significant (chi-square=13.4, P<0.05). The incidence rate among junior high school students was 23.1%, while that among senior high school students was 15.5%, which was also significant (chi-square=13.2, P<0.05). A case-control study of 410 students with at least one of eight kinds of injury events indicated that students' gender and their mothers' health status were related to their injuries. CONCLUSION: The injury incidence rate in a rural area was less than other results in urban or developed areas. Students' gender and mothers' health status were important factors associated with the occurrence of injury. IMPACT ON INDUSTRY: In order to improve the surroundings of the growing population of adolescents, some preventive measures should be put forward, especially to the high-risk students of injury.     

灰霾的健康效应

灰霾是颗粒物和气体污染物导致的可察觉到的能见度降低的污染天气现象.近年来,随着城市化进程的快速发展,城市大气污染加剧,灰霾天气也随之增多.总结了灰霾这一污染型天气的特征,介绍了灰霾的化学成分、污染机制等,并从影响机制和流行病学角度出发,对国内外灰霾对人体的健康效应研究成果进行了综合评述,提出目前急需解决的科学问题和今后的研究方向.     

Towards the development of a multidisciplinary understanding of the effects of toxic chemical mixtures on health

Mixtures can be divided into simple (chemicals with comparable properties—health risk assessments on the chemicals) and complex, which can be further subdivided into defined (a reasonably distinct composition, created at a specific time and place despite dissimilar components—risk assessments on the common source) and coincidental (chemicals without similar properties or constant composition in time or space—risk assessments on the receptor). Interactions recognized are: independent action, dose addition (additivity), and potentiation (synergy and antagonism). Unpredicted outcomes need recognition. New approaches in higher education and multidisciplinary investigations are essential. The community of the Society for Environmental Geochemistry and Health should help clarify points such as when transformations in mixtures may become important enough to alter the classification and the risk assessment. The multidisciplinary community is also well placed to support the integration of nonchemical influences into mixture analysis and to contribute to the investigation of cumulative and multiple exposures.     

Disease prevention and resistance in social insects: modeling the survival consequences of immunity,hygienic behavior,and colony organization

Understanding the origin of disease resistance in social insects is difficult due to the lack of well-established phylogenies of presocial and eusocial species and the absence of extant basal and intermediate forms. Moreover, comprehensive accounts of infection-control traits in social insect lineages are not available. Therefore, to explore the evolution of pathogen control in social insects we used cellular automata models to analyze the efficacy of immunity and nest hygiene, which we assumed were basal traits, and allogrooming, which likely followed the transition to eusociality, and their interactions with colony demography and patterns of worker spatial distribution. Models showed that nest hygiene provided an immediate survival benefit and that immunity lowered overall disease susceptibility under both constant and periodic exposure scenarios. Allogrooming increased survivorship in chronically challenged colonies but also increased pathogen transmission rates under conditions of periodic exposure. Colonies having demographies biased towards young or old individuals had slightly higher mortality than those with heterogeneous demographies. The distribution of older individuals relative to the nest center had no significant effect on susceptibility and provided only a minor survival advantage. Models indicated that nest hygiene and immunity function on different temporal scales and can interact with demography to lower disease risks. Our results suggest how infection control systems in social insects could have been built upon the inducible immune defenses and nest hygienic behaviors of solitary and presocial ancestors and served as important preadaptations to manage disease exposure and transmission in colonies of eusocial species.     

Human exposure to dioxins through diet in Italy

We have measured the content of polychlorinated dibenzo-p-dioxins, and polychlorinated dibenzofurans (together defined as “dioxins”) in 269 samples of food of animal origin collected through the regional veterinary services, covering the national territory. Quantification of the dioxins was accomplished by isotope dilution method, and toxic equivalents (TEQ) were calculated. The average daily food intake was obtained from two main sources: national data collected by the National Institute of Nutrition, and data from an ongoing cohort study on diet and cancer including 40, 000 Italian subjects.

The mean value of dioxins measured in food of animal origin was 0.144 ± 0.266 pg-TEQ/g (range: 0.003–1.655 pg-TEQ/g). Fish was the item with the highest content. The estimated intake of dioxins with main food items of animal origin is presented. The major contribution to dioxins intake with food comes from cow milk and fish consumption. These results are in agreement with what observed in studies conducted in other countries, such as Germany, Finland, Japan, Spain, and are below the limits set by the European legislation.     

Prevalence of low back pain in three occupational groups in Shanghai, People's Republic of China

PROBLEM: Low back pain (LBP) is one of the most prevalent work-related conditions affecting employed populations in developed countries, yet little is known about this condition among the world's largest, single-nation labor force: The People's Republic of China. METHOD: This is a cross-sectional study of the prevalence of low back pain (LBP) among garment workers, battery/kiln workers, and teachers in Shanghai, People's Republic of China. Data were collected by personal interview and physical examination at six work sites. The overall response rate was 78%. RESULTS: The overall (N=383) self-reported annual prevalence of LBP symptoms lasting 24 hours or more was 50%. Garment workers had a higher annual prevalence of LBP (74%) than teachers (40%), prevalence ratio (PR=1.9, 95% CI=1.4-2.4). DISCUSSION: The overall annual prevalence of self-reported LBP (50%) was higher than that reported among 50 other Chinese employed study populations (30%). Healthy worker effects may have limited the conclusions from this cross-sectional study. SUMMARY: These results suggest that LBP is a prevalent condition in Chinese workers and that more work should be done to estimate its impact on the Chinese workforce. The findings for garment workers were consistent with increased risk of LBP among persons doing work in fixed, sedentary postures.     

Uncertainty in epidemiology and health risk and impact assessment

Environmental epidemiology and health risk and impact assessment have long grappled with problems of uncertainty in data and their relationships. These uncertainties have become more challenging because of the complex, systemic nature of many of the risks. A clear framework defining and quantifying uncertainty is needed. Three dimensions characterise uncertainty: its nature, its location and its level. In terms of its nature, uncertainty can be both intrinsic and extrinsic. The former reflects the effects of complexity, sparseness and nonlinearity; the latter arises through inadequacies in available observational data, measurement methods, sampling regimes and models. Uncertainty occurs in three locations: conceptualising the problem, analysis and communicating the results. Most attention has been devoted to characterising and quantifying the analysis—a wide range of statistical methods has been developed to estimate analytical uncertainties and model their propagation through the analysis. In complex systemic risks, larger uncertainties may be associated with conceptualisation of the problem and communication of the analytical results, both of which depend on the perspective and viewpoint of the observer. These imply using more participatory approaches to investigation, and more qualitative measures of uncertainty, not only to define uncertainty more inclusively and completely, but also to help those involved better understand the nature of the uncertainties and their practical implications.     

Animal-related injuries: a population-based study of a five-state region in the upper Midwest: Regional Rural Injury Study II

PROBLEM: While agricultural injury has been identified among the major causes of occupational injury mortality and morbidity, data have been limited pertinent to the magnitude, consequences, and potential risk factors for animal-related injuries -- a major source of morbidity among agricultural operations. METHODS: Demographics, exposure, and injury data were collected for 1999 and 2001 among agricultural households in a five-state region. Causal models facilitated survey design, data analyses, and interpretation of results; directed acyclic graphs guided multivariate modeling. RESULTS: From 7,420 households (84% response of eligible), a total of 5,045 injury events were reported; 1,016 (20.1%) were animal-related. Multivariate analyses revealed increased risks for those <20 years; residents of all states compared to Minnesota; all age groups compared to 0-4 years; >0 hours worked; and prior agricultural injury history. For those 20+ years, increased risks were identified for: South Dakota residents; males; >0 hours worked; and prior agricultural injury history. For those cases <20 and 20+ years of age, 58% and 46%, respectively, resulted in lost work time on their agricultural operations (31% and 50%, one week or more). CONCLUSIONS: Animal-related injury has a major impact on the agricultural industry. Results serve as a basis for interventions and further research. IMPACT ON INDUSTRY: The impact of animal-related injuries on the agricultural industry appears significant; among age groups <20 and 20+, 85% and 82%, respectively, had some resulting restriction. For all events combined, 29% and 30%, respectively, involved restriction from one week to 3+ months; 12% and 15% involved restriction for one month or more. Among those <20 and 20+ years of age, 58% and 46%, respectively, lost work time on their own agricultural operation as a result of injuries associated with their own operation; 22% and 15% lost one week or more. Moreover, of the non-agriculture-related injuries, 31% and 50% resulted in lost work time on their own operation; 15% and 28%, respectively, lost one week or more. Restrictions such as these can affect the productivity of the operation, resulting in financial impacts, especially on small operations that have few people to manage the required tasks.