Dietary sources apportionment and health risk assessment for trace elements among residents of the Tethys-Himalayan tectonic domain in Tibet, China.

Dietary intake of toxic elements (TEs) and essential trace elements (ETEs) can significantly impact human health. This study collected 302 samples, including 78 food, 104 drinking water, 73 cultivated topsoil, and 47 sedimentary rock from a typical area of Tethys-Himalaya tectonic domain. These samples were used to calculate the average daily dose of oral intake (ADDoral) and assess the health risks of five TEs and five ETEs. The results indicate that grain and meat are the primary dietary sources of TEs and ETEs for local residents. The intake of manganese (Mn) and copper (Cu) is mainly from local highland barley (66.90% and 60.32%, respectively), iron (Fe) is primarily from local grains (75.51%), and zinc (Zn) is mainly from local yak meat (60.03%). The ADDoral of arsenic (As), Mn, Fe and Zn were found to be higher than the maximum oral reference dose in all townships of study area, indicating non-carcinogenic health risks for local residents. Additionally, lead (Pb) and nickel (Ni) in 36.36% townships, and Cu in 81.82% townships were above the maximum oral reference dose, while As posed a carcinogenic risk throughout the study area. The concentrations of As, mercury (Hg), Pb, Mn, Cu Fe and selenium (Se) in grains were significantly correlated with those in soils. Moreover, the average concentrations of As in Proterozoic, Triassic, Jurassic and Cretaceous was 43.09, 12.41, 15.86 and 6.22 times higher than those in the South Tibet shell, respectively. The high concentrations of TEs and ETEs in the stratum can lead to their enrichment in soils, which, in turn, can result in excessive intake by local residents through the food chain and biogeochemical cycles . To avoid the occurrence of some diseases caused by dietary intake, it is necessary to consume a variety of exotic foods, such as high-selenium foods, foreign rice and flour in order to improve the dietary structure.

Dietary and drinking water intake of essential trace elements in a typical Kashin-Beck disease endemic area of Tibet, China.

BACKGROUND: Essential trace elements (ETEs), such as copper (Cu), iron (Fe), manganese (Mn), molybdenum (Mo), selenium (Se), zinc (Zn), are very important elements for human health. METHODS: In this study, 89 drinking water samples and 85 highland barleys were collected from 48 villages in 11 townships, and the average daily dose (ADD) of ETEs were calculated, in addition, health effects of ETEs to rural residents in Luolong County, a typical Kashin-Beck disease (KBD) endemic area in Tibet, were assessed. RESULTS: The mean concentrations of Cu, Fe, Mn, Mo, Se, Zn in drinking water were 0.278 ± 0.264 µg·kg-1, 0.766 ± 0.312 µg·kg-1, 0.411 ± 0.526 µg·kg-1, 0.119 ± 0.223 µg·kg-1, 0.155 ± 0.180 µg·kg-1, and 0.804 ± 1.112 µg·kg-1, respectively; and mean concentrations of Cu, Fe, Mn, Mo, Se and Zn in highland barley were 3.550 ± 0.680 mg·kg-1, 81.17 ± 38.14 mg·kg-1, 14.03 ± 1.42 mg·kg-1, 0.350 ± 0.200 mg·kg-1, 0.0028 ± 0.0056 mg·kg-1, and 23.58 ± 3.10 mg·kg-1, respectively. The ADD of Cu in the study area was appropriate; the ADD of Fe and Mn in each township were higher than the maximum oral reference dose recommended by the National Health Commission of China, indicating that Fe and Mn had non-carcinogenic health risks; the ADD of Mo and Zn in 36.36% and 54.55% of the townships exceeded the maximum oral reference dose; and 72.73% of the townships had insufficient ADD of Se. The ADD of Mo, Cu and Se in different townships was significantly correlated with the prevalence of KBD. CONCLUSIONS: Therefore, in order to prevent and control the prevalence of KBD and ensure the health of local residents, it is necessary to reduce the intake of high concentrations of Fe, Mn and Zn in diet, as well as increase the intake of Mo, Cu, especially Se.

Implementation of WHO multimodal strategy for improvement of hand hygiene: a quasi-experimental study in a Traditional Chinese Medicine hospital in Xi'an, China.

BACKGROUND: Hand hygiene (HH) is an essential component for preventing and controlling of healthcare-associated infection (HAI), whereas compliance with HH among health care workers (HCWs) is frequently poor. This study aimed to assess compliance and correctness with HH before and after the implementation of a multimodal HH improvement strategy launched by the World Health Organization (WHO). METHODS: A quasi-experimental study design including questionnaire survey generalizing possible factors affecting HH behaviors of HCWs and direct observation method was used to evaluate the effectiveness of WHO multimodal HH strategy in a hospital of Traditional Chinese Medicine. Multimodal HH improvement strategy was drawn up according to the results of questionnaire survey. Compliance and correctness with HH among HCWs were compared before and after intervention. Also HH practices for different indications based on WHO "My Five Moments for Hand Hygiene" were recorded. RESULTS: In total, 553 HCWs participated in the questionnaire survey and multimodal HH improvement strategy was developed based on individual, environment and management levels. A total of 5044 observations in 23 wards were recorded in this investigation. The rate of compliance and correctness with HH improved from 66.27% and 47.75% at baseline to 80.53% and 88.35% after intervention. Doctors seemed to have better compliance with HH after intervention (84.04%) than nurses and other HCWs (81.07% and 69.42%, respectively). When stratified by indication, compliance with HH improved for all indications after intervention (P < 0.05) except for "after body fluid exposure risk" and "after touching patient surroundings". CONCLUSION: Implementing the WHO multimodal HH strategy can significantly improve HH compliance and correctness among HCWs.