2011-2013年长兴县医疗机构消毒效果监测分析

目的:了解长兴县医疗机构消毒效果状况,加强医疗机构消毒规范管理.方法:对2011-2013年长兴县各医疗机构的空气、物体表面、医护人员手、使用中消毒液进行检测.结果:2011-2013年总共监测消毒样品2 882份,总合格率96.2％;各年度合格率为94.9％、96.4％、97.1％;各医疗机构县级医院、乡镇卫生院、个体诊所、社区卫生服务站总合格率分别为97.8％、96.6％、95.5％、96.1％;医疗机构空气、物体表面、医护人员手、使用中消毒液的总合格率分别为96.2％、95.9％、93.3％、99.5％.结论:长兴县各医疗机构消毒效果一直保持较高水平,但仍然需要加强管理.     

静脉药物配置中心持续质量改进对医院感染的控制效果

目的探究静脉药物配置中心持续质量改进对医院感染的控制提供参考依据。方法通过比较2011年12月-2014年12月3年中配置中心每年的空气、物品、医护人员手卫生检测及患者医院感染发生率,探讨静脉药物配置中心持续质量改进对医院感染的控制效果。结果 3年中静脉药物配置中心的水平层流台、无菌物品、生物安全柜、消毒剂和紫外线灯等抽查物品的合格率不断上升,在第3年所检查的5种物品合格率均为100.0%,上述5种物品在静脉药物配置中心实施持续质量改进以后的合格率均有明显升高;第3年中空气培养和医护人员手部卫生的合格率均达到100.0%,3年中每年的医院感染发生率逐年下降分别为10.2%、5.4%、0。结论静脉药物配置中心持续的质量改进,可以有效提高工作人员操作的规范性和科学性,降低医院感染率。     

临泉县医院2008～2011年消毒监测结果分析

目的通过对临泉县医院相关科室消毒后的空气、手、物体表面和使用中消毒液的采样检测,了解消毒效果和消毒过程中存在的问题。方法依据《消毒技术规范》2002年版和GB 15982-1995《医院消毒卫生标准》进行检测并评价。结果临泉县医院2008～2011年消毒合格率分别为79.73%,84.47%,83.13%,87.37%。结论医院消毒质量不高,物体表面消毒合格率94.68%,使用中消毒液合格率最低,仅为73.68%。     

沈阳市市级以上医院细菌污染监测结果分析

目的掌握沈阳市市级以上医院细菌污染结果,及时发现消毒工作薄弱环节,为评价消毒规划措施效果提供准确依据.方法对沈阳市市级以上医院进行各科室和部门的物体表面、医护人员手、空气及使用中消毒液污染状况监测. 结果物体表面平均合格率为77.50%,医护人员手平均合格率为85.31%,空气平均合格率为44.38%,使用中消毒液平均合格率为88.61%.结论加强对消毒工作的监督监测管理,探讨新的空气消毒方法.     

安徽省某三甲中医院2014-2018年消毒灭菌效果监测分析

目的 了解安徽省某三甲中医院消毒灭菌效果状况,查找薄弱环节,科学指导消毒工作.方法 采集2014年1月至2018年12月期间医院灭菌物品、消毒物品、消毒剂、内镜、透析液、物体表面、医务人员手卫生和空气样本,检测细菌菌落总数.结果 2014-2018年共采样10 094份,合格9 517份,总体消毒灭菌合格率为94.3％.各年合格率分别为93.8％、96.7％、92.7％、93.9％、94.6％,Ⅰ类环境总合格率95.2％,高于其他环境.5年中灭菌物品的合格率为97.6％,消毒物品合格率为91.7％,消毒剂合格率为98.5％,内镜合格率99.5％,透析液合格率93.8％,物体表面合格率89.7％,手卫生合格率90.2％,空气合格率为97.7％.结论 医院消毒与灭菌效果总体较好,但物体表面、手卫生的合格率相对较低,需加强管理,降低医院感染风险.     

口腔医院环境带菌状况调查研究

目的调查某口腔专科医院环境、医务人员手及口腔诊疗用水等的带菌状况。方法对该院手术室和病房的空气、物体表面、医务人员手及工作区周围空气、口腔诊疗用水、使用中消毒液进行采样检测。结果共采集133份样本，检测合格118份（88．72％），其中物体表面合格率为96．67％，病房空气合格率90．00％，层流手术间空气合格率60．00％，医务人员手合格率76．19％，使用中消毒液合格率100．00％，口腔诊疗用水检测均不合格。结论应加强对口腔诊疗用水、医务人员手卫生、手术室空气的监控，以减少医院感染及职业暴露的发生。     

医院消毒灭菌效果的监测与分析

目的 了解各科室消毒灭菌的现状,为控制医院感染提供依据.方法 对29个临床科室的空气、使用中的消毒液、高压蒸汽灭菌效果、医护人员手和物体表面的消毒灭菌质量进行监测.结果 2006年全年空气消毒合格率为70.74%,消毒液和高压蒸汽灭菌合格率为100.00%,医护人员手和物体表面消毒合格率分别为88.03%和93.71%.结论 应加强医院消毒火菌效果的监测,充分合理地利用监测资料,及时发现医院感染的各种隐患,降低医院感染的发生率.     

科学城医院院内消毒灭菌质量监测报告

目的 :了解和掌握科学城医院消毒灭菌工作现状和存在的问题。方法 :按照 1991年版卫生部《消毒技术规范》规定的方法 ,定期对院内空气、物体表面、使用中消毒液、医护人员手进行采样监测。结果 :四年共监测空气样 881份 ,合格率 96 .0 3% ;物体表面 10 7份 ,合格率 10 0 % ;使用中消毒液 88份 ,合格率 10 0 % ;医护人员手 12 5份 ,合格率 85 .6 0 %。手的合格率与空气、物体表面、使用中消毒液的合格率相比差异均有显著性 (P<0 .0 5 )。结论 :科学城医院消毒灭菌质量较高 ,但医护人员手的污染应引起重视     

宁波市2013-2017年市属医疗机构消毒监测结果分析

目的了解2013-2017年宁波市市属医疗机构消毒效果,进一步加强医疗机构的消毒管理,有效防控医院感染的发生。方法采用现场采样和实验室微生物检测的方法,对宁波市10家市属医疗机构的空气、物体表面、医务人员手、使用中消毒液、透析液、压力蒸汽灭菌器和医院污水进行监测;监测结果用Excel 2007和SPSS 19.0进行整理和分析。结果 2013-2017年共采样2 222份,合格2 014份,合格率为90.64%;不同检测项目中,室内空气合格率为97.33%,Ⅰ类环境室内空气合格率为98.92%,高于Ⅱ～Ⅳ类环境;物体表面合格率为91.75%,Ⅲ类环境物体表面合格率最低,为87.98%;医务人员手卫生合格率为77.08%,其中外科手合格率(90.91%)高于卫生手合格率(74.32%);使用中消毒液、透析液、压力蒸汽灭菌和医院污水合格率分别为100.00%、98.53%、100.00%和85.33%。结论宁波市市属医疗机构消毒效果质量总体较好,但医务人员手卫生和医院污水的合格率相对较低,应加强管理,提高医院消毒灭菌质量。     

西安市2006～2009年医院消毒/灭菌效果和环境卫生学监测结果

目的 对西安市医院的消毒/灭菌效果和环境卫生学监测结果进行分析,为医院感染管理工作提供参考.方法 按照《消毒技术规范》要求,2006～2009年,对西安市市属医院手术室空气、无菌物品、医疗环境物体表面、医护人员手、消毒液、2％戊二醛、紫外线灯进行监测.结果 总体来说三级医院监测样品合格率优于二级医院和一级医院,分别为88.18％,84.08％和79.02％,差异有统计学意义(x2=17.08,P＜0.05).手术室空气、无菌物品、物体表面、医护人员手、消毒液、2％戊二醛、紫外线灯合格率差异有统计学意义(x2=381.49,P＜ 0.01),分别为75.19％、97.96％、88.93％、75.77％、98.80％、87.70％,71.07％.无菌物品和使用中的消毒液合格率较高,三级医院监测的无菌物品全部合格,与一、二级医院合格率相比,差异有统计学意义(x2=7.49,P＜0.05).医务人员手和紫外线灯管监测合格率较低,尤其是一级医院合格率分别为62.96％和61.90％,与二、三级医院间差异明显.其他监测样品的合格率,不同年度、不同等级医院间无统计学差异.结论 消毒/灭菌效果和环境卫生学监测对加强基层医院感染管理有一定的作用,应有针对地开展目标监测和干预.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.