Comparison of Emergency Management Strategies for Nosocomial Infections Between Two Earthquakes

Aim:Based on the experience of the 5.12 Wenchuan Earthquake and the 8.8 Jiuzhaigou Earthquake,the emergency management strategies for nosocomial infections were compared between the two earthquakes.The experience shared in the present study provides a guideline for the emergency medical rescue of future earthquake.Methods:The patients involved in this study were those injured in the earthquake and admitted to the hospital for treatment.As an earthquake relief center,the hospital participated in the emergency rescue work of the two recent major earthquakes in western China.Review analysis was carried out in the hospital's infection control experience adopted in the two major earthquakes.It was emphasized that,targeting the characteristics and difficulties in the prevention and control of nosocomial infection,different innovative infection control emergency strategies were adopted by the frontline disaster relief hospitals,under the special circumstances and medical conditions in an earthquake disaster.Results:According to the different focus of infection control in the two earthquakes,different hospital infection control strategies were adopted,and the incidence of nosocomial infections was effectively controlled.

Breast Milk Lead and Cadmium Levels in Suburban Areas of Nanjing,China

Objective To evaluate levels of lead(Pb) and cadmium(Cd) in the breast milk in the second postpartum month,to investigate the relationship between Pb/Cd levels in breast milk and some sociodemographic parameters,and to explore whether these levels affect the infants' physical status or the mothers' psychological status(postpartum depression).Methods A cross-sectional study was conducted between November 2009 and December 2010.Altogether 170 healthy mothers were enrolled from Nanjing Maternity and Child Health Care Hospital.The inclusion criteria were:voluntary to participate in this study,healthy,with no chronic disease,breastfeeding in the second postpartum month,living in a suburban but not non-industrial area of Nanjing,and not occupationally exposed to toxic metals.All the mothers completed a questionnaire and were evaluated based on the Edinburgh Postpartum Depression Scale(EPDS) to identify the risk of postpartum depression.Pb and Cd levels in breast milk were determined by inductively coupled plasma mass spectroscopy.The infants of these mothers were examined for their z scores of weight for age,length for age,head circumference for age,and body mass index for age.Results The median breast milk levels of Pb and Cd were 40.6 μg/L and 0.67 μg/L,respectively.In 164(96.5%) of the 170 samples,Pb levels were higher than the limit reported by the World Health Organization(> 5 μg/L).Breast milk Cd level was > 1 μg/L in 54(31.8%) mothers.The mothers with a history of anemia had a higher breast milk Pb level than those without a history of anemia(41.1 μg/L vs.37.9 μg/L,P = 0.050).The median breast milk Cd level in those who were active and passive smokers during pregnancy was significantly higher than that in non-smokers(0.88 μg/L vs.0.00 μg/L,P = 0.025).The breast milk Cd level in the mothers not taking iron and vitamin supplements for 2 months postpartum was higher than in those taking the supplements(iron supplement:0.74 μg/L vs.0.00 μg/L,P = 0.025;vitamin supplement:0.78 μg/L vs.0.00 μg/L,P = 0.005).Breast milk Cd level at the second postpartum month was negatively correlated with the z scores of head circumference(r = 0.248,P = 0.042) and weight for age at birth(r = 0.241,P = 0.024) in girls.No correlation was found between the breast milk Pb/Cd levels and the EPDS scores.Conclusion Considering the high levels of Pb and Cd in breast milk in this study,breast milk monitoring programs are necessary.

Blood Lead Levels During Pregnancy and Its Influencing Factors in Nanjing,China

Objective To investigate the blood lead levels (BLLs) in the duration of pregnancy and 6-12 weeks after delivery,and analyze the influencing factors of BLLs in healthy pregnant women.Methods Pregnant women were recruited from September 2009 to February 2010 at the prenatal clinic in Nanjing Maternity and Child Health Care Hospital.Altogether 174 healthy pregnant women without pregnant or obstetric complications or abnormal pregnancy outcomes were enrolled as the gravida group,and 120 healthy non-pregnant women as the control group.BLLs during pregnancy were determined by flame atomic absorption spectroscopy.Results BLLs in all the three pregnancy trimesters and postpartum were 59.8±24.3,55.4±20.1,55.9±19.7,and 67.6±17.4 μg/L,respectively,and the mean BLL in control group was 67.5±21.3 μg/L.BLLs during all the three trimesters were lower in the gravida group than in the control group (P=0.043,0.021,and 0.028).Furthermore,occupations,nutrients supplementation,and time of house/apartment painted were associated with BLLs in pregnant women.Lead-related occupations,cosmetics use,and living in a house painted less than 1 year before are risk factors of high BLLs among pregnant women,while calcium,iron,zinc,and milk supplements are protective factors.Conclusion Supplementing calcium,iron,zinc,and milk,or avoiding contact with risk factors may help people,especially pregnant women,to reduce lead exposure.