消毒剂在计划生育技术服务机构使用中的质量控制

目的分析影响消毒剂使用质量的危险因素,提出质量控制的措施,保障计划生育技术服务对象的医疗安全。方法针对消毒剂使用中7个关键环节,即健全管理制度、消毒剂知识的培训教育及消毒剂使用品种、配制、盛装容器、使用过程、监督检查,实施重点质量控制。结果使用中消毒剂卫生指标达到国家标准,有效地杜绝了消毒剂使用质量问题造成的外源性站内感染。结论消毒剂在计划生育技术服务使用中的质量控制至关重要,职能机关和计划生育技术服务机构要齐抓共管。     

内镜消毒剂万福金安与2%戊二醛使用对比

内镜的消毒灭菌是否规范直接影响医疗质量和患者的健康,更是预防和控制医院感染的一项重要措施.笔者将多年来内镜消毒剂的使用对比如下.     

新型消毒剂使用中的质量控制

目的对新型消毒剂广泛应用于临床医疗的消毒效果的管理进行探讨。方法加强组织管理,建立健全消毒剂使用工作制度、完善监控机制;对消毒剂的购进应严格把关;加强临床使用管理,作好业务培训、规范操作、统计反馈、监测。结果对新型消毒剂使用中的质量得到了有效的控制。结论确保消毒效果,必须注重质量控制。建议有关部门和领导还须进一步在新型消毒剂的研究、生产、采供、监测中加强科学管理。     

南京市鼓楼区2001～2003年不同类别医疗单位使用中消毒剂微生物指标监测分析

为了解医疗单位常用消毒剂的污染状况,更好地控制医院内感染,对2001～2003年南京市鼓楼区不同类别医疗单位使用中消毒剂进行微生物指标监测分析.     

社区医疗使用中消毒剂的监测

目的:了解社区医疗消毒剂使用情况以及使用中消毒剂污染病菌和真菌的现状.方法:利用社区医疗使用消毒剂监测结果进行分析.结果:社区医疗使用中戊二醛合格率较低(90.9%),各使用中消毒剂微生物污染较普遍,合格率为96.4%,不同的机构消毒剂合格率差异无显著性(P＞0.05).消毒剂中污染菌革兰氏染色差异无显著性(P＞0.05).结论:该区社区医疗使用中的消毒剂仍需加强管理,对消毒剂中真菌污染需加强研究.     

2%戊二醛消毒剂的使用方法

为了进一步加强医院感染管理,提高消毒灭菌质量,有效预防和控制医院感染,保障医疗安全,依据<医院感染管理办法>、<医疗卫生机构消毒技术规范>等的相关规定及要求,对目前我院各科室使用的低效消毒剂(苯扎溴铵)浸泡消毒器械改用高效消毒剂2%戊二醛浸泡消毒灭菌.     

医院消毒剂的正确使用

医院使用消毒剂被细菌或致病菌污染,可能造成医院感染的流行或暴发流行。因此,正确使用和管理消毒剂是预防医院感染、保证医疗质量和医疗安全的重要问题。1消毒剂使用中存在的问题(1)在临床使用中医院消毒剂管理制度不健全,责任不明确;医院消毒剂配制不规范,对消毒剂的性能不了解。(2)盛装消毒剂的容器不清洁,容器过大、不消毒、破损不更换等。(3)医护人员在操作时,无菌观念不强,造成消毒剂在使用过程中被细菌污染。(4)消毒剂监督管理力度不强,以致影响消毒质量,酿成严重后果。2合理使用消毒剂的正确方法2.1健全机制,规范管理把消毒剂使用作…     

加强消毒剂在医疗使用中的规范化管理

我院对在医疗工作中使用消毒剂的品种、采购、发放、操作监控实行了规范化管理,以达到品种质量达标,配制操作规范,使用安全有效。具体做法:1健全管理体系,把好采购质量关1.1医院成立药事委员会与护理部、感染科、药剂科共同参与全院消毒剂的管理。制定、明确各职能管理部门职责,药剂科定期发布消毒剂的新信息、新进展,感染科、药剂科定期介绍消毒剂作用及使用范围,限定其使用品种和范围,确保消毒剂医疗使用的质量。1.2严格把好采购质量关医院定期清理、审查消毒剂品种的各种证件及质量,选择效果好、浓度稳定、毒性低的品种用于临床。规定临…     

浅谈我院消毒剂的应用与管理

目的 加强医院消毒剂的应用与管理。方法 总结、分析近几年来我院消毒剂的使用情况与消毒剂监控、监测的管理办法。结果 医院领导高度重视医院感染,医院规范了消毒剂的使用与管理,降低了手术切口感染。结论 确保消毒质量是预防医院感染的可靠保证,是医院质量与医疗安全的重要组成部分。     

医疗垃圾集中处理管理模式探讨

医疗垃圾的处理是医院感染控制的一个重要环节 ,医疗垃圾处理的好坏直接关系到人们的生存环境和身体健康 ,越来越引起世界各国的普遍重视〔1〕。1　当前医疗垃圾管理存在的主要问题1 1　使用后的一次性医疗用品的初消浓度不够　目前 ,医院使用后一次性医疗用品大都采用消毒毁形的方法 ,许多医院对消毒剂的配置、使用管理比较混乱 ,尤其是对用后的一次性医疗用品进行初消的消毒剂 ,消毒剂配制无有专门的人员、无有配制记录 ,配制人员对消毒剂的杀菌性能、杀菌浓度不了解。1 2　有些医疗垃圾不能彻底地焚烧　当前医院焚烧炉焚烧的医疗垃圾仅为…     

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.     

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.     

Assessing occupational and environmental exposure

Exposure assessment is a poorly understood component of the science of epidemiology. The relationship between exposure to chemicals and ill-health outcomes is often calculated using crude exposure measures such as ever/never exposed or duration. When investigating subtle effects, exposures need to be characterized much more fully in terms of intensity, frequency, duration and route. While occupational exposures tend to be much greater than those experienced from the wider environment there is a need to remember that, for many chemicals, exposure can occur occupationally, environmentally and through consumer use of products containing the material of interest. Inhalation exposure has generally been the traditional focus for most epidemiological investigations but there is now growing awareness of the importance of the dermal and ingested routes of contact and internalization. Quantification of the exposure also needs to be related to a biological mechanism of action and exposure metrics need to be selected accordingly. Occupational exposures can generally be measured using simple well-validated techniques. Environmental exposures require much more sensitive instruments and are more difficult to assess. Exposure modelling, particularly for the environmental fate of chemicals has undergone many recent developments and Monte Carlo techniques can be used to characterize model uncertainty and variability. This approach to exposure assessment can now be used in the setting of the wider environment and will enable a far better understanding of the relationship between exposure and disease.     

Mercury toxicity due to the smelting of placer gold recovered by mercury amalgam

A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [Mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (Mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited.     

How Adults with Acquired Brain Damage Perceive Computer Training as a Rehabilitation Tool: A Focus-group Study

The aim of this study was to explore and describe how adult outpatients with acquired brain damage and referred to occupational therapy perceive computer training with the RehaCom programs, in order to evaluate the method of treatment as a tool in the rehabilitation of persons with cognitive disorders. By using focus-group discussions as a qualitative method of research when analysing the result, five themes with corresponding categories emerged, describing a development of understanding and learning about capacities. Themes describing how the participants could apply strategies to overcome shortcomings in daily occupations and the therapeutic role of the occupational therapist were identified as well. The result shows that a computer training program such as RehaCom can be used as an educational tool, for example, to guide a person who is trying to adopt compensatory strategies to avoid overload by taking pauses. It was found that anything the participants learned was also applicable to occupational performance in daily life.