目的 对2017-2021年上海市松江区不同食品来源的金黄色葡萄球菌进行肠毒素基因检测、药敏试验和脉冲场凝胶电泳分子分型,以了解金黄色葡萄球菌病原特征.方法 利用PCR方法检测金黄色葡萄球菌肠毒素基因,微量肉汤稀释法进行药物敏感试验,脉冲场凝胶电泳进行基因分型.结果 108株食源性金黄色葡萄球菌中有39株检出肠毒素基因,检出率为 36.1％,其中 sea(28.02％,11/39)、seb(41.0％,16/39)、sec(33.3％,13/39)、sed(12.8％,5/39);药敏试验结果显示氨苄西林(83.3％)、青霉素(80.6％)和红霉素(42.6％)耐药率最高;最低为万古霉素(100.0％)、达托霉素(98.1％)和庆大霉素(94.4％),且有15株耐甲氧西林金黄色葡萄球菌,20株表现出多重耐药,其中1株最高耐受6类抗生素.脉冲场凝胶电泳分子分型结果显示108株金黄色葡萄球菌中有11株不能分型,其他97株共分为19簇,包括77种型别,呈现多样性.结论 2017-2021年上海市松江区食源性金黄色葡萄球菌肠毒素基因携带率较高、多重耐药性情况需引起重视,并加强食品中金黄色葡萄球菌的监测,为食品安全风险评估和食源性疾病的预防提供科学依据.

Objective:To investigate the characteristics of enterovirus (EV) VP1 gene from cases with hand, foot and mouth disease (HFMD) in Songjiang district of Shanghai in 2019.Methods:Samples from suspected HFMD cases were detected using real-time fluorescence reverse transcription polymerase chain reaction (RT-PCR). Human rhabdomyosarcoma (RD) cells were used for EV culture. VP1 genes of the isolated EV A species were sequenced. The sequences of nucleotide and amino acid of EV A species were used in phylogenetic and homology analysis by MEGA X software.Results:Totally 207 HFMD specimens were detected in 2019, of which 188 specimens were screened positive for EV. The positive rates of Coxsackievirus (CV)-A6, CV-A16, CV-A10 and CV-A4 were 47.34% (89/188), 41.49% (78/188), 3.72% (7/188) and 2.66% (5/188), respectively. Other EV species were 4.79% (9/188) positive and EV-A71 was not detected. During the summer epidemic peak of HFMD (May to July), B1 gene subtype of CV-A16 was detected more frequently, of which B1a and B1b evolutionary branches were prevalent together. The CV-A6 virus of D3a branch dominated in secondary peak of autumn and winter (September to December). CV-A10 and CV-A4 were sporadic and both respective strains belonged to subtypes of C2 gene. Compared with the prototype strains, the nucleotide (amino acid) sequence homologies of CV-A6, CV-A16, CV-A10 and CV-A4 VP1 genes were 79.22%-81.78% (95.97%~-97.19%), 62.70%-65.54% (90.10%-91.30%), 81.76%-82.65% (91.63% -92.03%) and 81.09%-81.79% (97.27%-97.67%), respectively.Conclusions:The diversity and complexity of HFMD pathogen epidemic increase the difficulty of HFMD prevention and control. The expansion of EV surveillance programs and the studies on the molecular epidemiology of EV are helpful for the prevention and control of HFMD.

目的 了解上海市松江区腹泻患者副溶血弧菌的毒力基因、耐药性和分子分型等,为预防食源性疾病提供科学依据.方法 参照WS 271-2007进行副溶血弧菌的检测和分离,并应用微量肉汤法进行药物敏感性试验,采用PCR方法检测毒力基因,并对菌株进行脉冲场凝胶电泳(PFGE)分子分型.结果 2016-2020年采集腹泻患者肛拭子标本2 053份,共检出副溶血弧菌155株,阳性率为7.55％,其中夏秋季阳性率较高(11.80％),与冬春季(0.13％)的差异有统计学意义(x2=92.725,P＜0.01).2019年阳性率最高(10.55％),与2016和2020年相比差异有统计学意义(x2=8.890,P＜0.05),但5年阳性率差异无统计学意义(x2=4.602,P＞0.05).155株副溶血弧菌均携带毒力基因tlh,其中87.74％携带tdh,2.58％携带trh,8.39％不携带tdh和trh,三者差异有统计学意义(x2=317.890,P＜0.01).副溶血弧菌对多种抗生素敏感,对头孢唑林的耐药率最高(56.25％),其次为氨苄西林和环丙沙星,且存在多重耐药.PFGE分子分型显示,155株副溶血弧菌分为7个簇,共80种型别,部分菌株100％同源,为优势菌株.结论 上海市松江区腹泻患者副溶血弧菌检出率较高,大部分携带毒力基因tdh,且对头孢唑林耐药严重,5年内优势菌株存在聚集性,须引起重视.

为提高实验室病毒核酸检测能力,减少检测人员暴露风险,该研究利用机械臂取代人工操作,整合病毒样本前处理、核酸提取纯化、PCR体系构建、PCR扩增检测4个子系统,并通过优化开盖功能、吸液防堵塞功能及液面追踪功能,实现全流程自动化病毒核酸检测系统稳定运行.优化后,开盖成功率提高至99.13％(P<0.001),吸液成功率提高至99.31％(P<0.001),构建PCR扩增体系成功率提高至98.89％(P=0.005).通过优化时序管理,实现24小时千人份病毒样本全流程自动化核酸检测,满足高通量精准病毒核酸检测需求.

Objective:To analyze the prevalence of influenza B virus and its HA and NA genes characteristics during 2017—2020 in Songjiang district, Shanghai.Methods:Samples from suspected cases of influenza were detected using real-time fluorescence reverse transcription-polymerase chain reaction. Influenza B virus positive specimens were cultured by MDCK cells and embryonated chicken eggs. The hamagglutinin (HA) and neuraminidase (NA) genes of influenza virus B strains were sequenced and analyzed for gene evolution and amino acid variation. The sensitivity of the strains to oseltamivir and zanamivir was studied by neuraminidase inhibition assay.Results:The positive rate of influenza B virus in Songjiang district from 2017 to 2020 was 14.24% (506/3554). Influenza B virus circulated mainly in winter-spring season and alternated between B/Victoria and B/Yamagata subtypes. Subclade 1A (△3) B was the predominant Victoria lineage circulating in Songjiang district. Otherwise, the remaining strains belonged to subclade 1A(△2)and clade 1A. Compared with vaccine strain B/Brisbane/60/2008, the nucleotide homology of circulating strains HA (NA) was 97.62%~98.19% (98.11%~98.78%). The mutations of HA in 1A (△3) B subclade mainly were in 120 loop and 160 loop. All the Yamagata strains circulating in Songjiang district belonged to clade 3. Compared with vaccine strain B/Phuket/3073/2013, the nucleotide homology of HA and NA were 98.71%~99.04% and 98.69%~99.27%, respectively. No amino acid change was found in the antigenic clusters. Neuraminidase inhibition assay showed that the influenza B virus strains were sensitive to both oseltamivir and zanamivir.Conclusions:Inconsistence of the antigenicity between the vaccine strains and the circulating strains during 2017—2020, influenza B virus should be persistently monitored, including the epidemic situation and the etiological characteristics, which might be helpful in vaccine screening and drug development.

目的 通过调查分析一起由多种致病菌混合感染引起的食源性疾病暴发,为预防此类事件的再次发生提供参考.方法 开展现场流行病学调查、卫生学调查,采集病人和从业人员生物样本、环境和食品样本进行致病菌、血清分型及分子分型检测.结果 本次暴发罹患率为10.00％(7/70),临床表现以腹泻(100.00％)、腹痛(100.00％)、呕吐(42.86％)为主.6份病人肛拭样中,4份同时检出副溶血性弧菌和沙门氏菌(2份伦敦沙门氏菌、2份鼠伤寒沙门氏菌),2份仅检出副溶血性弧菌;1份从业人员肛拭样中检出鼠伤寒沙门氏菌;1份食品原料检出副溶血性弧菌.脉冲场凝胶电泳结果显示:病人的6株副溶血性弧菌呈现两种带型,相似度分别为93.10％和87.50％～100.00％,但是和食品样本检出的副溶血性弧菌带型均不相同;病人的2株鼠伤寒沙门氏菌为同一带型,但与从业人员生物样本检出的鼠伤寒沙门氏菌带型相似度较低,仅为28.00％;病人的2株伦敦沙门氏菌为同一带型.结论 本次食源性疾病暴发是由副溶血性弧菌和两种血清型沙门氏菌共同引起,食品加工过程的交叉污染是此次事件的危险因素.

目的 了解上海市松江区腹泻患者、禽肉类来源弯曲菌的流行状况及耐药情况,探讨不同来源弯曲菌的相关性,为制定针对性预防措施提供科学依据.方法 对来自2017-2019年上海市松江区部分医院就诊的腹泻患者粪便或肛拭子以及来自农贸市场和超市的禽肉类样品进行弯曲菌分离培养和生化鉴定,应用微量肉汤稀释法进行药物敏感性试验,PFGE方法进行分子分型.结果 653份腹泻患者样品中分离出弯曲菌60株,阳性率9.19％,438份禽肉类样品中分离出弯曲菌51株,阳性率11.64％,二者阳性检出率差异无统计学意义(x2=1.730,P＞0.05).食品和腹泻患者来源的弯曲菌对环丙沙星(90.20％和90.00％)、萘啶酸(94.12％和88.33％)、四环素(88.24％和71.67％)耐药严重,耐药率＞71％.PFGE结果显示同源性大于等于90％的亚型群有24组,共79株弯曲菌,占71.17％.同源性100％的有21组,共63株菌,占56.76％,其中4组出现食品和腹泻患者来源弯曲菌100％同源的情况.结论 上海市松江区禽肉类和腹泻患者弯曲菌检出率较高,多重耐药情况严重,禽肉食品和腹泻患者来源的部分菌株具有100％同源性,提示腹泻患者感染弯曲菌可能与食用被弯曲菌污染的禽肉食品有关,为今后更好地预防弯曲菌相关疾病提供数据支持.

BackgroundThere are few studies on the diet quality of patients with thyroid cancer, and the relationship between diet quality and thyroid cancer remains uncertain.ObjectiveThis study aims to assess the diet quality with the Chinese Health Diet Index (CHDI) and to explore the relationship between diet quality and papillary thyroid carcinoma (PTC).MethodsA 1∶1 gender- and age-matched hospital-based case-control study included newly diagnosed PTC patients and matched controls from Shanghai Cancer Hospital and Renji Hospital (East) in Shanghai, China. A structured questionnaire was applied to collect data on general characteristics, history of diseases, dietary intakes, and lifestyles. Food intakes in the past one year were assessed using a validated food frequency questionnaire, from which the CHDI score was calculated. The CHDI, according to the Dietary Guidelines for Chinese Residents, was employed to evaluate the diet quality of the two groups. A multiple conditional logistic regression model was conducted to explore the relationship between diet quality and PTC.ResultsA total of 350 pairs of cases and controls were recruited. The overall median CHDI score of the cases was lower than that of the controls (67.8 vs. 73.4, P<0.001). The cases had lower median scores of fruits (6.8 vs. 9.5), dairy products (3.6 vs. 5.6), and soybeans (4.6 vs. 5.5) than the controls (P<0.05); the cases had a higher median score of refined grains than the controls (5.0 vs. 4.9), and the percentage of the cases that met diet recommendations for refined grains was higher than the percentage of the controls (65.4% vs. 48.6%) (P<0.05); the cases showed lower median scores of whole grains/beans/tubers, total vegetables, dark vegetables, and fish/shrimps (0.9 vs. 1.4, 3.1 vs. 4.4, 3.6 vs. 5.0, and 3.3 vs. 4.0, respectively), and the percentages of the cases meeting their diet recommendations were lower than the percentages of the controls (6.3% vs. 8.6%, 32.6% vs. 42.0%, 38.6% vs. 50.6%, and 34.0% vs. 40.3%, respectively, P<0.05). The results of multiple conditional logistic regression analysis suggested that qualified and good diet quality were associated with a reduced the risk of PTC (qualified diet quality, OR=0.37, 95%CI: 0.23−0.62; good diet quality, OR=0.19, 95%CI: 0.10−0.36); the statistical significance remained after excluding patients who had a history of benign thyroid conditions (qualified diet quality, OR=0.28, 95%CI: 0.15−0.52; good diet quality, OR=0.20, 95%CI: 0.09−0.43).ConclusionThose with qualified or good diet quality have a lower risk of PTC. PTC patients have insufficient intakes of fruits, dairy, soybeans, whole grains/beans/tubers, vegetables, and fish/shrimps.

BackgroundThyroid carcinoma is a serious threat to human health in Shanghai and a focus of cancer prevention and treatment.ObjectiveThis study aims to assess the relationship between foods rich in iodine and papillary thyroid carcinoma (PTC)．MethodsIn a hospital-based case-control study matched by gender and age (±3 years old), 402 pairs of cases (new incidences) and controls were included and studied. A validated questionnaire and food frequency questionnaire survey was conducted face to face to obtain demographic characteristics and dietary intake. A multiple conditional logistic regression model was applied to explore the relationship between foods rich in iodine (including seaweeds, kelp, and dried shrimps) and PTC.ResultsThe mean age of the participants was (41.17±11.51) years in this study. Compared with the controls, more cases had a lower education and a manual occupation (P<0.05); more cases were overweight or obese, had a history of benign thyroid conditions, and had a family history of thyroid diseases (P<0.05); the two groups were different in the frequency of CT examination in the past ten years (P<0.05). The results of multiple conditional logistic regression analysis showed that consumption of iodine-rich foods was associated with a lower risk of PTC (for <1 time per week, OR=0.20, 95%CI: 0.12−0.35; for 1−2 times per week, OR=0.18, 95%CI: 0.10−0.33; for ≥3 times per week, OR=0.13, 95%CI: 0.04−0.44) (P<0.05). Specifically, those who consumed seaweeds (for <1 time per week, OR=0.18, 95%CI: 0.11−0.30; for 1−2 times per week, OR=0.11, 95%CI: 0.05−0.23; for ≥3 times per week, OR=0.15, 95%CI: 0.03−0.75), kelp (for <1 time per week, OR=0.28, 95%CI: 0.18−0.43; for ≤2 times per week, OR=0.24, 95%CI: 0.11−0.50), and dried shrimps (for <1 time per week, OR=0.44, 95%CI: 0.29−0.69; for ≤2 times per week: OR=0.34, 95%CI: 0.18−0.65) had a lower risk of PTC (P<0.05). After excluding patients who had a history of benign thyroid conditions, the favorable association remained significant among patients who had consumption of iodine-rich foods, seaweeds, shrimps, and kelp (P<0.05).ConclusionLess PTC patients consume iodine-rich foods than the controls.

目的 掌握2016-2019年上海市松江区学龄儿童与孕妇的碘营养状况和变化趋势,为科学制定防治措施提供依据.方法 2016-2019年,采用分层随机抽样法,按上海市松江区地理区域划分,每年抽5个街镇,每街镇随机抽20例孕妇;每街镇随机抽1所学校,从学校随机抽40名8～10岁学生.对孕妇和儿童行盐碘、尿碘和甲状腺容积的检测.结果 共检1273份家庭食盐,合格碘盐食用率为71.64％,碘盐合格率为84.76％.4年间儿童和孕妇尿碘中位数各为208.00和150.10 μg/L,男童高于女童(223.50 vs 161.00μg/L),差异有统计学意义(Z=-3.179,P＜0.01).孕晚期尿碘水平低于孕早、中期,但不同孕期尿碘水平比较,差异无统计学意义(x2=2.741,P＞0.05).330名儿童进行甲状腺容积检测,肿大检出率为0.结论 儿童和孕妇的盐碘覆盖率和合格碘盐食用率均偏低,8～10岁儿童尿碘水平超适宜量,孕妇尿碘水平刚达适宜水平,但孕妇碘营养缺乏占比较大,应继续坚持全民食盐加碘政策,加强重点人群的宣教,合理科学食用碘盐,使儿童和孕妇盐碘量提高至较优水平.

目的 分析上海市松江区2017-2019监测年度A(H1N1)pdm09流感病毒HA和NA基因特征.方法 对松江区分离的毒株随机挑选46株A(H1N1)pdm09流感病毒毒株进行HA和NA基因序列进化分析和氨基酸位点变异分析,采用神经氨酸酶抑制实验开展奥司他韦和扎那米韦敏感性监测.结果 A(H1N1)pdm09流感病毒属于6B.1A分支且进化出了 6B.1A2、6B.1A5A和6B.1A6进化簇.核苷酸序列分析显示,HA和NA基因与WHO推荐的2019-2020年度的疫苗株A/Brisbane/02/2018的亲缘关系较为接近,同源性分别为98.6％～99.4％和99.1％～99.7％.氨基酸序列分析显示,HA1蛋白共有23个位点发生氨基酸序列变异,43.48％病毒发生位于抗原决定簇Cb、Sa和Sb区的S74R、S164T、T185I共同突变,提示病毒发生抗原漂移.鸡胚适应性分析发现HA蛋白D187V、Q223R和E224K位点的适应性突变.NA蛋白共有25个位点发生变异,存在酶活性中心E1 19K(2/46)突变.神经氨酸酶抑制实验显示,所测流感病毒对奥司他韦和扎那米韦均敏感.结论A(H1N1)pdm09流感病毒HA和NA基因及其编码的氨基酸持续变异,因此应持续监测流感病毒,为科学防控提供依据.

目的 建立吹扫捕集-气质联用测定饮用水中一氟三氯甲烷的方法.方法 以相同浓度下一氟三氯甲烷和氟代苯内标标准物质来测定,在不同实验条件下,优化吹扫时间、解吸温度、吹扫流速等吹扫捕集参数和色谱、质谱条件.吹扫流速为40 ml/min、吹扫时间为11 min、解吸温度为250℃、为最佳实验条件.在选定的实验条件下,饮用水中的一氟三氯甲烷经吹扫捕集吹脱出后,捕集阱吸附,再经热解吸将目标物进入气相色谱仪分离,质谱检测,以特征离子与内标离子峰面积比值定量.结果 在选定的仪器条件卞,饮用水中一氟三氯甲烷在0.2 μg/L～ 10.0 μg/L浓度内具有良好的线性关系,线性相关系数为0.998,检出限为0.03μg/L,回收率为90％～95％,相对标准偏差＜5％.结论 本研究建立的方法操作简单,准确度精密度高,检出限低,适用于生活饮用水中一氟三氯甲烷的测定.

目的 优化溶藻弧菌脉冲场凝胶电泳(PFGE)分子分型方法,并应用到食品与腹泻患者的分离菌株,分析其多样性.方法 通过BioEdit软件对5种溶藻弧菌标准菌株全基因组序列进行677种酶的限制性片段分析,选择片段数量适中、有效片段比例高的酶作为备选酶,并模拟电泳效果图.再利用溶藻弧菌标准菌株及分离菌株对备选酶进行验证试验,确定PFGE分型方法.结果 根据片段数量、有效片段比例及PFGE模拟图,显示SfiⅠ、NotⅠ、SbfⅠ和MreⅠ片段分布相对均匀,标准菌株和分离株验证结果显示,sfi Ⅰ和NotⅠ分别为溶藻弧菌PFGE分型的首选酶和备选酶,且脉冲场电流转换时间分别为2.16s～63.8s和10 s～35 s.22株食品和腹泻患者分离株PFGE分子分型辛普森多样性指数为100.00％,获得良好的分辨率.结论 sfiⅠ是作为溶藻弧菌PFGE分子分型的最优限制性内切酶.此研究提供的程序可用于其他细菌PFGE方法的建立.

[目的]利用职业卫生大数据,提前发现高危企业和劳动者早期职业健康损害,阻断或延缓职业病发展进程,延缓或使早期职业健康损害的劳动者不至于发展为职业病,实现职业病防治的精准防控.[方法]连续系统的收集上海市松江区职业病危害申报信息、企业职业卫生档案信息、作业场所委托检测信息、重点职业病危害因素主动监测信息、职业病工伤鉴定及理赔信息、劳动者职业健康监护信息和职业病报告信息等职业卫生数据,以噪声危害控制为例探讨职业卫生大数据在职业病精准防控中的应用和前景.[结果]2017—2018年上海市松江区辖区体检机构共开展噪声在岗职业健康体检30265人次,复查率为9.57％、职业禁忌证率为1.91％;2017年噪声转上级复查53例(0.40％),2018年疑似噪声聋5例(0.03％);2017年发现双耳高频平均听阈≥40 dB(A)1421人次(1180人,占整体的10.69％),分布在390家企业;2018年发现双耳高频平均听阈≥40 dB(A)1736人次(1308人,占整体的10.27％),分布在413家企;噪声委托检测合格率与主动监测合格率之间存在巨大差距,差异有统计学意义(P<0.001),并且噪声委托检测数据合格率与噪声职业健康监护结果也存在矛盾.[结论]利用职业卫生大数据分析可以提升职业卫生监管部门监管效率、可使疾控部门职业卫生宣传和干预更加有的放矢、更直观的评估委托检测数据的质量、可以规范职业健康体检和职业病诊断、企业职业病防控和管理决策更加科学精准.

目的 分析社区老年人多病共存的流行现状及其对死亡的影响程度,为社区老年人健康管理提供科学依据.方法 本研究采用前瞻性队列研究设计,首先于2015年采用多阶段随机抽样的方法选择上海市松江区的4 008名60岁及以上社区居民作为调查对象,于2016年、2017年和2018年分别追踪随访研究对象的死亡情况.对所有调查对象进行问卷调查,问卷内容包括基本人口学信息、多病共存情况、生活状态与健康行为和日常生活活动能力(ADL)测评.使用SPSS22.0进行数据整理及分析,使用R3.6.2软件进行绘图.生存资料使用COX比例风险模型分析.绘制生存曲线,并用log-rank法进行统计检验.结果 基线时多病共存发生率为34.6％,3年随访中共死亡214例,其中无病组死亡49例(4.10％),单一疾病组死亡71例(4.98％),多病共存组死亡94例(6.78％),差异有统计学意义(P＜0.01).COX比例风险模型显示,控制其他影响因素后,多病共存患者死亡风险是无病组的3.18倍(HR=3.18,95％CI:2.16～4.67).log-rank检验结果显示,多病共存的死亡风险更高,有统计学意义(x2=9.333,P＜0.01).结论 多病共存会导致死亡风险增加,应积极开展以社区为基础的老年人综合管理.

[目的]以职业安全卫生防护"工具包"为研究对象,探讨"工具包"在松江区应用经验,为其他地区开展"工具包"研究提供经验和借鉴意义.[方法]该项目以《工效学检查要点》为基础,并结合我国职业卫生实际情况,组织专家反复论证,形成具有地区特点的工效学检查"工具包".选取松江区重点行业如电子、机械、铸造、化工等典型企业作为试用对象,通过调查、指导、干预、整改、验收,总结,推动企业进行持续性改进"工具包"的利用,以控制和预防职业危害.[结果]2017—2019年对松江区78家企业开展"工具包"项目推广和应用,共提出824个整改项目,整改率均大于80％.同时企业自主开展"工具包"项目100余个;企业共投入资金3800余万元用于工具包项目的开展,企业职业卫生安全卫生状况逐年提高,切实保障劳动者的职业健康权益,改善企业生产效率.[结论]为了加强中小企业职业安全卫生服务,开展职业安全卫生防护"工具包"的适用性研究和推广项目是十分必要.该"工具包"切实可行,具有多方面的价值意义,值得进一步推广和应用.

目的 了解上海市松江区生活中毒发生情况及特征,构建松江区生活中毒谱,为制定生活中毒预防控制对策提供科学依据.方法 对2017年7月1日-2019年6月30日收治的1 351例中毒病例进行分析.结果 1 351例中毒病例中男性占56.2％,女性占43.8％;中毒病例的年龄集中在21～40岁(共568例,占42.0％);中毒好发职业是离退休230例(占17.0％),技术工人212例(占15.7％)、商业或服务业职员205例(占15.2％);三大中毒原因是环境暴露、滥用酒精、自杀;50.4％(681例)的中毒发生在7～ 10月;中毒患者中共有14人经抢救无效死亡,致死率1.0％.结论 松江区应根据中毒谱,在高危时节,针对高危人群加强相关危害毒物的宣传教育,切实保护和促进当地居民的健康.应充分发挥中毒病例监测在掌握当地中毒谱方面的重要作用,提高中毒预防控制措施的针对性和有效性.

目的 了解上海市松江区食源性疾病流行特征,为食源性疾病防控提供依据.方法 对2016-2018年上海市松江区辖区内食源性疾病病例病原信息进行分析.结果 2016-2018年上海市松江区共收集食源性疾病病例1 495例,5-10月发病较多(65.69％),20～39岁年龄段人群发病率较高(51.31％).可疑进食场所以家庭为主(53.18％),可疑食物以肉与肉制品占比最大(32.35％),其次为水产品及其制品(22.61％).2016-2018年共采集生物样本1 011份,检出阳性193份(19.09％),其中副溶血性弧菌阳性率最高为7.81％,其次为诺如病毒和沙门菌,阳性率分别为6.94％和5.44％.除志贺菌和弯曲菌之外,其余病原体检出具有明显的季节差异,细菌在第二、三季度检出率较高,病毒在等一季度检出率较高.结论 上海市松江区食源性疾病的高发季节为夏秋季,主要病原体为副溶血性弧菌、诺如病毒和沙门菌,需针对重点人群和场所开展食品安全健康宣教,同时进一步完善监测体系,减少食源性疾病的发生.

目的 了解上海市松江区市售苦丁茶及茶汤中砷(As)、镉(Cd)、铅(Pb)、铬(Cr)、铜(Cu)、镍(Ni)、铝(Al)、锰(Mn)8种元素含量情况及饮用风险,为苦丁茶风险监测提供依据.方法 于2017年在上海市松江区各大农贸市场和超市采集大叶和小叶苦丁茶样品各5份.采用微波消解-电感耦合等离子质谱法检测茶叶及茶汤中8种元素的含量,利用风险商(THQ)和风险指数(HI)评估茶叶和茶汤对消费者的潜在健康风险.结果 大叶苦丁茶中Cd超标率为40.00％,小叶苦丁茶中Cd超标率为60.00％,As超标率为20.00％,其他元素均处于标准范围内.苦丁茶茶汤中存在Cd、Ni、A1和Mn元素超出生活饮用水卫生限值的情况,随着浸泡次数的增加,苦丁茶茶汤中金属元素浓度逐渐降低.茶汤中THQ和HI的范围分别为1.11×10-7～7.48×10-2和0.004～0.200,均小于1,HI中占比较大的元素为As、Cd、Mn.结论 饮用上海市松江区市售苦丁茶茶汤无明显健康风险,对苦丁茶中As、Cd、Mn等元素应继续加强监测.

[背景]上海市松江区是上海市工业产业集中的郊区之一,辖区内接触职业病危害因素劳动者众多,其中因长期接触生产性粉尘导致的尘肺病是松江区最主要的职业病,尤其以电焊工尘肺为主。因此,如何有效控制辖区电焊作业场所电焊烟尘浓度成为劳动者、企业和职业卫生监管部门关注的重点。[目的]了解上海市松江区哨点企业中劳动者电焊烟尘暴露水平,并分析其影响因素。[方法]2014—2018年,采用三阶段分层抽样方法抽取松江区62家企业共228名焊接作业劳动者为研究对象。采用个体采样仪采样,采用重量法测定工作场所电焊烟尘8 h时间加权平均浓度（TWA）。采用现场调查问卷,收集和分析可能影响暴露的因素。[结果]本研究共获得228份电焊烟尘样品,8 h TWA中位数为1.76 mg/m~3,总超标率为17.54%。5年间电焊烟尘超标率差异有统计学意义（χ2=17.46,P ＜0.01）,呈现逐渐下降趋势（P趋势＜0.01）。专用设备制造业企业电焊烟尘超标率（30.19%）和8 h TWA（2.40 mg/m~3）最高,不同行业间电焊烟尘超标率和8 h TWA差异有统计学意义（χ2=10.66,P ＜0.05;H=15.78,P ＜0.01）。连续作业超标率（23.08%）和8 h TWA（2.10 mg/m~3）高于间歇作业（χ2=4.05,P ＜0.05;Z=-3.17,P ＜0.01）。CO2气体保护焊的超标率（22.09%）高于氩弧焊和焊条电弧焊（χ2=6.19,P ＜0.05;P ＜0.05）;CO2气体保护焊的8 h TWA（1.92 mg/m~3）也高于氩弧焊（Z=-3.84,P ＜0.01）。通风效果较差的作业场所中电焊烟尘超标率（34.29%）和8 h TWA（3.63 mg/m~3）高于通风效果好的作业场所（χ2=8.70,P ＜0.05;H=44.73,P ＜0.01）。[结论]2014—2018年上海市松江区哨点企业电焊烟尘暴露水平和超标率呈现下降趋势。作业场所通风效果、焊接工艺类型和作业特征是影响电焊烟尘暴露水平的主要因素。今后仍要对通风效果差、连续作业和CO2气体保护焊等重点岗位的电焊烟尘暴露进行防控。