1999年萧县医疗机构消毒灭菌质量监测分析

为分析评价萧县三级医疗机构消毒灭菌质量 ,为预防和控制医源性感染提供科学依据。对 1 999年萧县县、乡、村医疗机构 4类标本微生物污染监测结果分析。共监测医疗单位 42 4个 ,采集标本 2 950份 ,合格率 77.4 %。县、乡、村监测合格率分别为 86 .1 %、77.3 %和75 .7% (P <0 .0 1 ) :4类标本监测合格率依次是 :一次性使用医疗用品 1 0 0 % ;使用中消毒用品92 .6 % :消毒后医疗用品 67.8% ;灭菌后医疗用品 60 .7% (P <0 .0 1 )。结果表明医疗机构消毒灭菌质量均不高 ,但级别高的医疗相对医疗相对较好 ,一次性使用医疗用品消毒灭菌合格率高 ,而医院灭菌后医疗用品合格率偏低 ,应强化消毒管理措施 ,全面提高医疗单位消毒灭菌质量     

河南省周口市各类医疗机构消毒状况调查

目的:为了解周口市各类医疗机构消毒工作质量,以便采取相应的的改进措施。对各类医疗机构各科室消毒灭菌进行了监测。方法:按卫生部2 0 0 2年版《消毒技术规范》、《医院消毒卫生标准》进行采样、检验和结果评价。结果:市级、县(区)级、乡(镇)级、个体诊所的合格率分别为82.5 8%、78.86 %、6 5.6 0 %、6 7.2 9%。市、县(区)级医疗机构与乡(镇)、个体诊所的合格率相比差异有显著性( χ2 =3 9 .98　P <0 . 0 1) ;所监测的窥镜、牙钻的合格率10. 0 % ,消毒剂的合格率91 6 3 % ,无菌物品的合格率79 73 % ,物体表面的合格率6 9 .75 % ,空气的合格率6 2 . 16 % ,医护人员手的合格率6 1 .6 6 % ;合格率较高的窥镜、牙钻、消毒剂、无菌物品与合格率较低的空气、医护人员手、物体表现相比其差异有显著性( χ2 =79. 96　P <0 . 0 1)结论:乡(镇)医院、个体诊所存在着较大的医源性感染隐患。医护人员的消毒意识有偏差,消毒灭菌的主要精力放在重点科室及部位     

2010年惠阳区医疗机构消毒灭菌质量监测结果分析

目的 了解2010年惠阳区医疗机构的消毒灭菌状况,为预防和控制医院内感染提供科学依据.方法 对惠阳区医疗机构按卫生部颁布的<消毒技术规范>和<医院消毒卫生标准>进行消毒灭菌质量抽样监测.结果 一级、二级医疗机构、社康中心总体上消毒灭菌状况良好,各项监测指标合格率在76.70%～98.00%,但民营、个体医疗诊所消毒灭菌...     

广东省2000～2002年医疗机构消毒监测情况分析

目的　分析广东省医疗机构消毒监测资料 ,掌握广东省医疗机构消毒工作的状况。方法　收集 2 0 0 0～ 2 0 0 2年广东省疾病预防控制机构对医疗机构进行消毒监测的数据 ,并进行统计分析。结果　 2 0 0 0～ 2 0 0 2年全省医疗机构消毒监测样品总数依次为 1 0 4 35 2、1 5 1 1 76、1 4 0 1 71份 ,总合格率依次为 87 4 4 %、86 4 2 %、88 91 %。市以上、县和镇以下医疗机构消毒监测样品合格率分别为94 1 8%、92 82 %及 82 5 3% ,三者差异有显著性 (P <0 0 1 )。各类监测样品中以使用中消毒液合格率最高 (96 31 % ) ,最低为空气中细菌含量 (6 2 4 1 % )。结论　镇级医疗机构是今后消毒监测工作的重点 ,同时应加强空气消毒工作的落实     

2010—2012年龙门县医疗机构消毒质量监测结果分析

目的了解龙门县医疗机构的消毒质量情况,为采取预防院内感染措施提供科学依据。方法按卫生部《消毒技术规范》及国家标准GB15982—1995《医院消毒卫生标准》进行抽样监测及评价。结果 2010—2012年共抽样4 632份,合格3 872份,平均合格率为83.59%;各类样品中使用中消毒剂、灭菌医疗用品、压力蒸汽灭菌效果、医护人员手、物体表面、无菌器械浸泡液、室内空气的合格率分别为98.96%、76.12%、93.69%、81.01%、83.70%、86.84%、66.39%;各医疗机构中县级医院、镇级医院、乡(村)卫生站、民营医院及个体诊所合格率分别为86.32%、87.50%、86.04%、66.25%。结论医疗机构应加强室内空气和医疗用品的消毒、灭菌工作,卫生监督部门应加大对民营医院、个体诊所的监督和监测力度。     

钦南区2009-2011年不同级别医疗机构消毒效果监测

目的了解钦州市钦南区各级医疗机构消毒隔离工作状况,为提高医疗机构消毒质量提供科学依据。方法对2009-2011年辖区内58家医疗机构消毒灭菌效果与环境卫生学进行监测。结果共采样1 036份,合格910份,合格率87.27%。2009-2011年合格率分别为85.63%(46/274)、89.33%(38/318)和87.84%(42/318),差异均无统计学意义(P>0.05)。县级医院、乡镇卫生院和个体诊所的消毒合格率分别为94.93%(206/217)、92.25%(476/516)、75.25%(228/303),差异有统计学意义(P<0.01)。医护人员手、使用中消毒液、物体表面、器械浸泡液、室内空气、一次性医疗卫生用品、压力蒸汽灭菌监测合格率依次为100.00%、98.35%、76.76%、83.02%、80.00%、73.08%、75.63%。结论县级医院消毒灭菌效果比乡镇卫生院、个体诊所好;个体诊所使用中消毒液、物体表面、一次性医疗卫生用品、空气、压力蒸汽灭菌等消毒工作仍有待加强。     

钦州市钦南区2009-2011年不同级别医疗机构消毒效果监测分析

目的:了解钦州市钦南区各级医疗机构消毒隔离工作状况,为提高医疗机构消毒质量提供科学依据.方法:对2009-2011年辖区内58家医疗机构消毒灭菌效果与环境卫生学进行监测.结果:共采样1 036份,合格910份,合格率87.84％.2009-2011年合格率分别为85.63％(274/320)、89.40％(329/368)和87.93％(306/348),差异均无统计学意义(P＞0.05).县级医院、乡镇卫生院和个体诊所的消毒合格率分别为94.93％ (206/217)、92.25％(476/516)、75.25％ (228/303),差异有统计学意义(P＜0.01).医护人员手、使用中消毒液、物体表面、室内空气、一次性医疗卫生用品、压力蒸汽灭菌监测合格率依次为100.00％、98.35％、76.76％、83.02％、80％、73.08％、75.63％.结论:县级医院消毒灭菌效果比乡镇卫生院、个体诊所好;个体诊所使用中消毒液、物体表面、一次性医疗卫生用品、空气、压力蒸汽灭菌等消毒工作仍有待加强.     

重庆市万州区医疗机构消毒效果现状调查

目的:分析万州区医疗机构消毒状况,提高消毒工作的质量.方法:2007年6～12月对全区各级医疗机构的室内空气、物体表面、医护人员双手、使用中消毒剂、灭菌医疗用品等按<医院消毒卫生标准>及<消毒技术规范>进行了采样和监测.结果:检测各类医院和个体诊所样品5072份,合格4067份,总合格率80.19,其中区级、乡镇和个体诊所的合格率分别为94.86%、84.17%和75.02%,三者之间具有显著性差异(χ2=183.68,P<0.01).在个体诊所的操作台面和手样品中各检出1株金黄色葡萄球菌.结论:万州区医疗机构消毒质量在个体诊所中存在着较大问题,应加强质量控制和监测.     

1998~2003年巢湖市医疗机构消毒灭菌质量监测分析

目的　研究巢湖市医疗机构消毒灭菌工作状况,探索进一步控制医院感染的策略。方法　依据GB15982-1995《医院消毒卫生标准》和GB15981-1995《消毒与灭菌的评价方法与标准》进行采样监测。结果　1998~2003年各医疗机构消毒监测总合格率呈逐年上升趋势(P<0. 01);市、县两级医疗机构消毒监测总合格率分别为80. 38%、76. 02%,两者差异有显著性(P<0. 05 )。各类监测样本中以压力蒸汽灭菌合格率最高( 93.10% ),空气中细菌含量合格率最低(38. 49% )。结论　应进一步加强对医疗机构特别是县级医疗机构医院感染和医院消毒的管理,进一步提高医务人员的无菌意识。     

合肥市庐阳区2011-2012年医疗机构消毒效果监测分析

目的了解庐阳区医疗机构消毒灭菌质量状况,加强医院消毒规范管理。方法按照卫生部《医疗机构消毒技术规范》、《消毒与灭菌效果的评价方法与标准》(GB15981-1995)、《医院消毒卫生标准》(GB15982-1995)的方法和要求对庐阳区医疗机构2011-2012年消毒质量进行评价分析。结果 2011-2012年共检测样品582份,总平均合格率85.05%,两年消毒合格率无统计学差异;不同医疗机构消毒质量以村卫生室最差,合格率仅为69.50%,显著低于社区卫生服务站和个体诊所;6类监测项目中合格率最高的是一次性医疗用品(100%),最低的是物体表面(62.31%)。医务人员手消毒合格率上升显著,差别有统计学意义,其他项目合格率变化不明显。结论 2011-2012年庐阳区医疗机构除医务人员手消毒合格率呈明显上升趋势外,总体消毒灭菌质量变化不大,不同类别医疗机构消毒合格率差别有非常显著意义。今后需加强对物体表面、使用中消毒液、医疗器械、高压灭菌器的消毒监测工作。对医院,重点是村卫生室,应加强监督管理、强化医院感染知识培训,严格落实规范化消毒灭菌工作。     

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.