Impact of home carpets on childhood lead intervention study

Blood lead data for a childhood lead exposure study have been reanalyzed to examine the impact of carpets on the effectiveness of a cleaning intervention in 39 New Jersey urban houses. All eligible houses in the study were classified as carpeted and uncarpeted depending on the number of rooms that were carpeted. The cleaning protocol was associated with a significant reduction in the blood lead concentrations for the uncarpeted homes (P = 0.004), whereas no significant change was found for the carpeted homes (P = 0.566). We also completed correlation analyses between the number of cleaning visits and the percentage reduction in blood lead for the carpeted/uncarpeted houses. There was a significant correlation (r = 0.67) between the number of cleanings and blood lead reduction for the uncarpeted homes, but no correlation (r = 0.04) for the carpeted homes. In a multiple regression model that took confounding variables into account, the carpet status (carpeted or uncarpeted) remained a factor of the effect of cleaning on blood lead (P = 0.05). We conclude that the presence of contaminated carpets inhibits the effectiveness of home cleaning despite a high-efficiency particulate air filtered vacuum protocol that removes a substantial amount of lead dust.     

Fecal lead excretion in young children as related to sources of lead in their environments

Summary Fecal lead excretion (PbF) was studied in young children with elevated lead exposure. PbB was generally 40–70 g/dl. The children's home environments were classified as to lead-base paint hazard and traffic density. There was a significant correlation between paint hazard classification and PbF but not between traffic density and PbF. There also was a correlation of PbB with paint hazard classification. Long-term fecal collections were instituted using 10 children who lived in high hazard homes and three children with low PbB's, whose PbF's were considered normal. Among the children living in high hazard homes, median fecal lead excretion generally was only moderately elevated. Grossly elevated amounts of lead were found only occasionally and only in a few of the children. Movement of two children from a high hazard home to a low hazard home resulted in prompt and substantial reduction in PbF. By contrast, PbB fell only very slowly.This study was supported by a grant from the US National Science Foundation—RANN Program, Grant 77-22186     

不同方法保湿清洗医疗器械效果的对比分析

目的 检测分析3种不同保湿方法清洗医疗器械的效果.方法 选择＜7d全院临床科室使用后的医疗器械,采用3种不同的保湿和清洗方法处理;A组:0.5％含氯消毒剂保湿+手工清洗,B组:酶清洗剂保湿+机洗,C组:碱性清洗液+酶清洗剂保湿+超声+升级后的清洗机清洗;清洗后的器械用目测方法:裸视和带光源5倍放大镜下观察及隐血试验法检测其清洗效果.结果 3种方法处理器械裸视目测合格率A组:为92.01％,B组:为96.07％,C组:为99.14％,C组明显高于A组,差异有统计学意义(P＜0.01).结论 医院应根据新标准的要求,选择合适的保湿清洗器械方法,建立正确的清洗流程.     

氧气湿化瓶清洗方法的改进与效果观察

目的 探讨氧气湿化瓶清洗方法改进的效果.方法 60个回收氧气湿化瓶随机等分两组,试验组:湿化瓶用改进清洗方法即洗衣粉和多酶混合液浸泡10 min,清洗后消毒;对照组:用传统方法即清水清洗后消毒,分别于7d进行肉眼观察和细菌学检测.结果 试验组与对照组清洗后的氧气湿化瓶残留物检出率分别为6.7％、60.0％,试验组的透明度、外观清洁度为96.7％、100.0％,对照组为56.7％、50.0％,两组比较,差异均有统计学意义(P＜0.05);试验组湿化瓶储存7d细菌总数＜15 CFU/cm2,细菌监测合格率为100.0％,对照组为93.3％,两组比较,差异无统计学意义.结论 洗衣粉及多酶混合液浸泡有助于清洗效果的提高.     

MLC-120多叶准直器清洁保养前后马达电流对比

目的:通过对瓦里安MLC-120多叶准直器系统清洁保养前后的马达驱动电流对比,确认该保养能有效减小马达驱动电流、提高马达使用寿命、降低设备故障率.方法:在对MLC-120系统进行清洁保养前、后通过系统软件分别记录叶片马达的驱动电流值并加以比较.结果:通过对两组数值的比较,可以发现清洁保养后的马达驱动电流值比保养前明显减小.结论:定期对MLC-120多叶准直器进行清洁维护保养十分必要.根据MLC-120多叶准直器的使用环境和频率以及其自身的结构需要,6~18个月清洁保养一次为宜.     

医院清洁工职业暴露的调查及防护措施

目的 了解医院清洁工锐器损伤情况及对职业防护相关知识掌握程度,采取有效措施,避免防护不当危害健康.方法 通过问卷调查,到科室询问、实地检查了解清洁工职业防护掌握情况;加强清洁工自身防护教育,加强医务人员对医疗废弃物知识培训,正确采取防锐器伤措施;规范洗手,配备劳动防护用品,保护清洁工合法权益,建立健康档案.结果 通过上述各项预防措施,最大限度控制了清洁工的职业伤害,保障了清洁工的安全和身体健康.结论 加强清洁工职业防护意识,强化医疗废弃物源头管理,正确执行手卫生,加强检查监督,可以有效避免清洁工的职业伤害.     

Occurrence and determinants of increases in blood lead levels in children shortly after lead hazard control activities

This study is an examination of the effect of lead hazard control strategies on children's blood lead levels immediately after an intervention was conducted as part of the US Department of Housing and Urban Development's Lead-Based Paint Hazard Control Grant Program. Fourteen state and local government grantees participated in the evaluation. The findings indicated an overall average reduction in the blood lead levels of 869 children soon after the implementation of lead hazard controls. However, 9.3% of these children (n = 81) had blood lead increases of 5 microg/dL or more. Data routinely collected as part of the evaluation, as well as additional information supplied by the individual programs, were used to determine potential reasons for these observed increases in blood lead. A logistic regression analysis indicated that three principal factors were associated with the blood lead increases: the number of exterior deteriorations present in the child's home (prior to intervention), the educational level of the female parent or guardian of the child, and the child's age. The statistical analysis did not find evidence that children living in households that either did not relocate or relocated for less than the full work period were significantly more likely to have a blood lead increase equal to or greater than 5 microg/dL than children living in households that fully relocated. Statistical analyses also did not reveal any single interior strategy to be more or less likely than others to be associated with a blood lead increase of 5 microg/dL or more.     

保洁员在医院感染控制中的现状与对策

目的分析保洁员在医院感染控制中的现状和存在的问题,提出相应的解决对策。方法对保洁员在医院感染中出现的问题进行重点分析。结果加强对保洁员的管理,保持医院环境的清洁舒适;深化保洁员在医院感染控制中制度的完善与落实,强化培训,不断改进预防医院感染的工作方法及措施,切断医院感染传播途径,有效控制医院感染,确保医疗护理的质量和安全。结论对保洁员进行规范化管理,减少或防止医院感染的发生。     

National evaluation of the US Department of Housing and Urban Development Lead-Based Paint Hazard Control Grant Program: study methods

The US Department of Housing and Urban Development (HUD) undertook an evaluation of its Lead Hazard Control Grant Program between 1994 and 1999. The Evaluation is the largest study ever done on the effectiveness of lead hazard controls implemented in residential dwellings. The Evaluation had several major objectives: determining the effectiveness of various lead hazard controls in reducing residential dust lead levels and children's blood lead levels, establishing the costs of doing lead hazard control work and factors that influence those costs, determining the rate of clearance testing failures and their causes, and identifying possible negative effects of lead hazard control work on children's blood lead levels. This paper reports the overall research design and data collection methods of the Evaluation. The large number of dwelling units enrolled in the Evaluation was possible only by the innovative partnership among HUD, the Evaluators, and the grantees. HUD and the Evaluators relied on the grantees for essentially all of the data collection. The 14 participating HUD Lead Hazard Control Grantees were responsible for implementing the lead hazard control programs in their communities and collecting the study data. This paper describes the methods for recruiting and enrolling dwellings and families, collecting environmental and housing data, interviewing participating families, and collecting data on lead hazard control work performed and its costs. The paper also describes the basic quality control and quality assurance procedures used. The principal outcome measures were lead in dust collected using wipes from floors, window sills, and window troughs and lead in blood collected from children who were 6 years old or younger at enrollment. Data collection was conducted before intervention, immediately postintervention, and 6 and 12 months postintervention. For a subset of dwellings undergoing an extended follow-up data were also collected at 24 and 36 months postintervention. This paper provides the context for subsequent reports that will describe such findings as the influence of lead hazard control work on serial dust lead levels, the influence of lead hazard control work on serial blood lead levels in children, the nature and costs of the lead hazard control work done at the dwellings, and the experience of the grantees in meeting clearance testing requirements.     

手术室内镜清洗消毒规范的实施与管理

目的 预防由内镜检查治疗所造成的医源性感染,探讨加强内镜的清洗消毒方法以及灭菌质量管理.方法 制定完善的手术室内镜管理制度,规范内镜清洗消毒流程,建立内镜器械分科分套的标识体系,强化内镜清洗消毒训练.结果 完善规范的制度和严密周到的管理措施,确保了内镜的清洗消毒质量,防止医疗质量事故的发生,该院2008-2010年清洗消毒内镜1万余例,无1例发生内镜手术后的感染.结论 根据卫生部的相关规范要求和医院设施条件,严格并细化手术室内镜清洗消毒流程,建立健全手术室内镜清洗消毒的各项规章制度,是预防手术室内镜感染的关键.     

医院消毒供应中心全自动清洗消毒设备的管理

目的：分析医院消毒供应中心（CSSD）全自动清洗消毒设备的管理实践,探索、宠善相关管理办法。方法：对全自动清洗消毒设备管理中的若干问题分析归类．逐一进行评价。结果：全自动清洗消毒设备从采购到使用、维护,得到了较为完善的管删。结论：正确的僻理方法保证拿自动清洗消毒设备的正常工作。     

消化内镜清洗消毒过程中存在的问题与对策

目的 研究分析医院消化内镜清洗消毒过程中存在的问题,提出相应的解决策略,以提高消化内镜的清洗消毒合格率,同时保证患者的安全.方法 依据卫生部制定颁发的《内镜清洗消毒技术操作规范》(2004年版)的要求,对山东省52所医院的内镜清洗消毒过程进行了问卷调查与现场勘查,对消化内镜清洗过程中存在的问题进行总结和分析,并提出相应的对策.结果 内镜消毒过程中存在的问题以清洗消毒设施不完全、缺乏岗位培训及对工作人员的防护,分别占34.6％、42.3％、38.5％,其次为清洗流程以及消毒方法不规范,占19.2％;针对这一情况,需要建立完善消毒管理体制、增加操作人员的技术培训,并加大基础设施投入等,以达到基本的清洗消毒要求.结论 重视与解决消化内镜清洗消毒过程中存在的问题,对于患者的健康及预防医院感染,具有非常重要的意义.     

某公司阀控式密封铅酸蓄电池生产项目职业危害现状评价

目的调查某公司阀控式密封铅酸蓄电池生产过程中存在的职业性有害因素及其危害程度,确定职业性有害因素关键控制点,制定职业病危害预防控制的有效对策。方法采取现场卫生学调查、检测分析、定量分级相结合的方法进行评价。结果在生产过程各个环节中产生的主要职业危害因素有铅尘、铅烟、硫酸、石墨尘、煤尘、锰尘、噪声等。经检测粉尘浓度范围在0.6～10.7 mg/m^3,分片区石墨尘时间加权平均（TWA）浓度超标。化学毒物铅烟浓度范围在0.004～11.629mg/m^3,铅尘浓度范围在0.004～13.637 mg/m^3,所有测点的TWA均超标。硫酸浓度范围在〈0.14～2.20 mg/m^3,化成区水洗作业点短时间接触浓度（STEL）超标。噪声检测铅粉车间熔炉区噪声超标,最大值达到97.9 dB（A）。80%工作场所照度不符合职业卫生要求。根据检测结果确认,粉尘的关键控制点是分片作业。化学毒物的关键控制点是合膏、化成、固化、包装、焊接、铸条作业。物理因素的关键控制点是铅粉机打磨时的噪声。结论该企业铅尘、铅烟TWA浓度均不同程度地超过职业卫生限值,属职业危害严重的生产企业,必须进行整改。应增加生产厂房,改善设备布局空间,有效运行防尘防毒设施,防止职业危害因素的产生。     

机器人手术物品清洗与灭菌的管理

目的探讨机器人手术器械、物品术后清洗与灭菌的方法。方法对300例机器人手术器械、物品进行浸泡、清洗、保养、灭菌处理。结果通过对机器人手术物品规范化、系统化地管理,建立了标准的清洗灭菌流程,使机器人手术物品的清洗质量提高,精密器械的损伤减小,术中使用效果良好。结论规范的清洗与灭菌方法是机器人物品在术中安全使用的保障。     

上海市71所医院环境清洁消毒及监测现状调查

目的了解上海市二甲以上医院环境清洁消毒频率、消毒剂、操作者及常规环境监测频率。方法上海市医院感染质控中心统一下发调查表格并制定标准,要求二级甲等以上的71所医院调查全院所有病区的环境及物体表面消毒现状,将表格及时上传。结果 ICU环境清洁消毒59.17%由护士完成,65.56%采用腐蚀性强、有刺激性气味的含氯消毒剂进行物体表面消毒,仅39.45%的环境表面消毒每天至少两次,63.89%的环境不进行常规微生物采样;普通病房与ICU相差不大,常规采样的比例更低,仅为11.91%。结论上海市二级甲等以上医院环境清洗消毒方法不统一,消毒剂的选择不完全合理,环境监测有待进一步规范。     

医院保洁人员职业防护行为调查及分析

目的 了解医院保洁人员职业防护行为的状况,探讨保洁人员职业防护行为的影响因素.方法 采用自行设计的一般资料调查表、职业防护行为调查问卷,对76名医院保洁人员进行调查,然后对医院保洁人员职业防护行为情况进行统计分析.结果 保洁人员所采取的职业防护行为介于“有时”与“很少”之间,总平均得分为(2.62±1.03)分,年龄、工龄、教育程度是保洁员职业防护行为的影响因素.结论 保洁人员职业防护意识缺乏,保洁公司与医院应加强对保洁人员的职业防护培训与安全教育,以提高其职业防护意识,降低职业危害的发生率.     

2011—2013年中山市公共场所集中空调通风系统清洗效果评价

目的评价中山市公共场所集中空调通风系统清洗效果。方法2011年1月—2013年3月,对该市57家公共场所集中空调通风系统进行清洗前后卫生状况检测,检测指标包括集中空调送风系统、风管系统、冷却系统,统计分析各项指标。结果清洗前后送风中PM,。、细菌总数、真菌总数,风管内表面积尘量、细菌总数、真菌总数,冷却水、冷凝水中嗜肺军团菌合格率显著升高（P〈0．05）,分别由46．81％、73．19％、52．64％,85．34％、76．87％、68．68％,40．51％提高至100％、92．65％、89．96％,100％、100％、98．5％,91．11％;清洗前后送风系统、风管系统各项检测指标平均水平均显著降低（P〈0．05）。结论该市57家公共场所集中空调通风系统清洗效果显著,应定期对其进行清洗消毒,降低集中空调卫生安全风险。     

昆山市部分公共场所集中空调清洗消毒效果分析

目的比较昆山市公共场所集中空调通风系统清洗消毒前后卫生状况,了解其清洗消毒效果。方法随机选择昆山地区10家有集中空调的公共场所,对集中空调通风系统清洗前后卫生学指标进行检测,并进行比较,分析清洗消毒效果。结果空调清洗后,通风管道积尘量和送风中可吸入颗粒物(PM)10显著降低。中央空调送风细菌总数与管道积尘中细菌总数呈显著正相关,送风中真菌总数与PM10、送风细菌总数、管道积尘细菌总数、管道积尘真菌总数呈显著正相关。结论集中空调清洗消毒后,积尘量降低明显,但细菌和真菌等指标改善仍不理想,对集中空调的消毒管理仍有待规范。     

ATP检测系统在临床清洁消毒效果评价中的应用

目的探讨总结ATP检测系统在临床的适用范围。方法应用ATP检测系统对医院环境的不同科室及不同物体表面进行检测,并与常规环境微生物检测进行比较。结果 ATP检测结果显示,在动态下不同物体表面ATP检测值合格率由低至高前3位为:患者接触物体表面(诊疗床、候诊座椅、床头柜等)、工作人员手、医务人员办公用品(电话机、打印机、电脑键盘和鼠标等);不同科室ATP检测值合格率由低至高前3位为:重症监护病房、检验科、普通门急诊;消毒前后ATP检测值差异有统计学意义,同步消毒前后常规环境微生物采样结果差异无统计学意义,ATP检测可以立即得到结果,环境微生物培养结果至少需要2 d,微生物学检测检出多药耐药菌的同时,ATP检测值有高有低。结论日常工作中需要加强检测值高的位点的清洁消毒;对于环境清洁程度的评价使用ATP检测更敏感更快捷,适用于容易被忽视的清洁消毒的场所和科室,以及危急事件发生时的紧急处理;更适用于环境清洁程度的考评,能够提示物体表面受污染程度,但是无法代替常规微生物检测对于致病菌的检出。     

某公司安装LJD系列除尘设备后除尘效果评价

目的 对公司燃运部部分工段安装LJD系列除尘设备后的除尘效果进行职业病危害因素控制效果评价。方法 依据《中华人民共和国职业病防治法》、《工业企业设计卫生标准》对安装LJD系列除尘设备前后相同岗位的粉尘分别进行采样、检测、比较分析评价。结果 2007年某公司燃运部的6^#、10^#、11^# A、B皮带，在安装新除尘器后运行期间检测其粉尘浓度分别为2．5～3．8mg／m^3、2．55～4．12mg／m^3、3．44～4．47mg／m^3，与2004年检测数据相比有很大的改善，除尘效果明显。结论 某公司燃运部工作场所6^#、10^#、11^#A、B皮带工段在使用LJD系列除尘设备后，职业病危害因素控制效果符合《工作场所有害因素职业接触限值》等相关标准要求。