Current ecologic-hygienic questions of municipal waste disinfection]

One of the most hygienic methods for the solid municipal waste to manage is the biothermal treatment with pyrolysis of uncompostable fractions and subsequent utilization of intermediate products. This scheme of municipal solid waste management has been realized in the Leningrad experimental factory for the mechanized treatment of municipal waste.     

城市垃圾堆肥有机碳测定方法的比较

探讨垃圾堆肥中混杂的未烧尽的煤炭对有机碳测定造成的干扰。方法：采用经典的Ｋ２Ｃｒ２Ｏ７容量法和稀释热法垃圾堆肥有机碳进行了比较测定。结果和结论：稀释热法可减少垃圾中的煤炭对分析结果的影响。     

Medical waste: the problem of handling

The paper provides the environmental and hygienic characteristics of medical waste, the necessity of introducing a new system of collection, storage, transportation, and removal of waste from health care facilities. In accordance with SanPiN 2.1.7.728-99 (subparagraph 8.7.9.3a), an enterprise for thermal decontamination of hazardous waste should be necessarily set up with the purpose of possible removal of classes B and C garbage to the polygons, which will secure medical waste to man and the environment.     

Assessing ethical problem solving by reasoning rather than decision making

Context The assessment of ethical problem solving in medicine has been controversial and challenging. The purposes of this study were: (i) to create a new instrument to measure doctors’ decisions on and reasoning approach towards resolving ethical problems; (ii) to evaluate the scores generated by the new instrument for their reliability and validity, and (iii) to compare doctors’ ethical reasoning abilities between countries and among medical students, residents and experts. Methods This study used 15 clinical vignettes and the think‐aloud method to identify the processes and components involved in ethical problem solving. Subjects included volunteer ethics experts, postgraduate Year 2 residents and pre‐clerkship medical students. The interview data were coded using the instruments of the decision score and Ethical Reasoning Inventory (ERI). The ERI assessed the quality of ethical reasoning for a particular case (Part I) and for an individual globally across all the vignettes (Part II). Results There were 17 Canadian and 32 Taiwanese subjects. Based on the Canadian standard, the decision scores between Taiwanese and Canadian subjects differed significantly, but made no discrimination among the three levels of expertise. Scores on the ERI Parts I and II, which reflect doctors’ reasoning quality, differed between countries and among different levels of expertise in Taiwan, providing evidence of construct validity. In addition, experts had a greater organised knowledge structure and considered more relevant variables in the process of arriving at ethical decisions than did residents or students. The reliability of ERI scores was 0.70–0.99 on Part I and 0.75–0.80 on Part II. Conclusions Expertise in solving ethical problems could not be differentiated by the decisions made, but could be differentiated according to the reasoning used to make those decisions. The difference between Taiwanese and Canadian experts suggests that cultural considerations come into play in the decisions that are made in the course of providing humane care to patients.     

Cobalt and nickel uptake by rice and accumulation in soil amended with municipal solid waste compost

Effect of addition of municipal solid waste compost (MSWC) on cobalt (Co) and nickel (Ni) contents of submerged rice paddies were studied. A sequential extraction method was used to determine the metal (Co and Ni) fractions in MSWC and cow dung manure (CDM). Both metals were significantly bound to the organic matter and Fe and Mn oxides in MSWC and CDM. Metal content in rice straw was higher than in rice grain. Metal bound with Fe and Mn oxides in MSWC and CDM best correlated with straw and grain metal followed by water soluble and exchangeable fractions. Carbonate, organic matter bound and residual fractions in MSWC and CDM did not significantly correlate with rice straw and grain metal. MSWC would be a valuable resource for agriculture, but long-term field experiments with MSWC are needed to assess by regular monitoring of the metal loads and accumulation in soil and plants.     

Trace metal distribution in soluble organic matter from municipal solid waste compost determined by size-exclusion chromatography

Municipal solid waste (MSW) composts carry high amounts of trace metals and organic complexing agents that may influence metal bioavailability and mobility after application to soils. In order to assess the degree of organic complexation of trace metals in the solution phase of MSW compost and the relevance of organic ligand type, size exclusion chromatography (SEC) was applied to compost-extracted organic ligands. Adjustment of the elution conditions minimized the interaction with the gel matrix for compost humic substances and dissolved organic matter (DOM) fractions. The SEC was then used to separate the aqueous compost extract into samples with distinct differences in chemical constituents. The highest quantities of Cu, Zn, Ni, Mn, and Cd were found to coelute with the main peak of the SEC elution curve, which, as observed by Fourier-transformed infrared (FTIR) spectroscopy, also had the highest density of carboxyl groups. The ratio of aromatic to aliphatic structures was higher for eluates with low retention times, and cations such as Al, Cr, and Fe were preferably associated with these larger organic molecules. All trace metals in the compost solution phase were bound mostly to DOM rather than forming inorganic complexes.     

医疗废物容器清洁消毒后使用时间的调查

目的评价医疗废物容器清洁消毒后的使用时效,探寻最佳的清洁消毒后使用时间,以降低医院感染率的发生。方法 2014年3月-2015年3月以科室为单位抽取医院10个临床层流病区使用的医疗废物容器500件次,按随机数字表法分为7-8月组、10-12月组,每组各250件次,比较医疗废物容器清洁消毒后使用7、14、21、30d的ATP数值检测。结果不同使用时间ATP检测数值,在7-8月组使用后的医疗废物容器检测合格率1~14d为100.0%、21d为90.0%、30d为84.0%;在10-12月组使用后的医疗废物容器检测合格率1~21d为100.0%、30d为92.0%,两组清洁消毒后均达到外观清洁的效果。结论临床病区的医疗废物容器在使用后携带病原菌,应加强清洁消毒的检查与检测,定期进行医疗废物容器的清洁消毒,为临床合理制定医疗废物容器的清洁消毒制度提供依据。     

3种空气消毒方法效果的比较

目的 评价3种消毒方法对空气的消毒效果。方法 分别用紫外线、戊二醛和臭氧3种消毒方法消毒空气,用3种不同的评价方法按消毒前后同步采样进行消毒效率的评价。结果 消毒前细菌本底撞击法的高峰在10：00,冲击法在9：00,平皿法在10：00;3种消毒方法之间差异有显性,按撞击法评价时戊二醛消毒率最高,消毒后3h细菌恢复率43．4％－55．8％,按冲击法评价时戊二醛效果较好,消毒后3h细菌恢复率21．8％－35．7％,按平皿沉降法评价时紫外线效果较好,消毒后3h细菌恢复率42．1％－60．6％,但相互之间差别无显性;在实验过程中,温度和相对湿度对紫外线强度略有副影响,对其它几乎无影响。结论 戊二醛消毒法和臭氧消毒法能够代替紫外线消毒法。     

探讨不同消毒方法对超声探头消毒效果的影响

目的了解某院医用超声探头带菌状况,以及探讨不同消毒方法对超声探头的消毒效果,旨在为医用超声探头清洁与消毒提供参考依据。方法采集某三甲医院实际使用的普通超声探头和妇科经阴道超声探头标本274份,按不同采样时机分组:普通超声探头为接触患者后普通卫生纸擦拭前、普通卫生纸擦拭后、探头消毒后;经阴道超声探头为接触患者黏膜检查后且脱去一次性保护套后、探头消毒后。按不同消毒方法又分为2组:A组为消毒湿巾组(复合双链季铵盐消毒湿巾),B组为超声探头消毒器组,分别进行菌落总数计算及鉴定。结果共采集普通超声探头标本174份,其中接触患者后普通卫生纸擦拭前、普通卫生纸擦拭后、消毒后标本平均菌落数为1.61×10~4、1.57×10~3、2.41 CFU/件,3个不同采样时机平均菌落数比较,差异有统计学意义(P0.05);共采集妇科经阴道超声探头标本100份,其中接触患者黏膜且脱去一次性保护套、经消毒后平均菌落数分别为13.20、0.24 CFU/件,2个不同采样时机平均菌落数比较,差异有统计学意义(P0.05)。采用消毒湿巾和超声探头消毒器对普通超声探头进行消毒,平均菌落数分别为5、0CFU/件;对妇科经阴道超声探头进行消毒,平均菌落数分别为0.40、0CFU/件;两种消毒方法比较,差异均无统计学意义(均P0.05);超声探头消毒后均未检出致病菌。结论复合双链季铵盐消毒湿巾和超声探头消毒器对超声探头消毒效果均较好,可以推荐使用于超声诊疗室。