Post-operative endophthalmitis: the application of hazard analysis critical control points (HACCP) to an infection control problem

Hazard analysis critical control points (HACCP) is a quality assurance system widely used in the food industry to ensure safety. We adopted the HACCP approach when conventional infection control measures had failed to solve an ongoing problem with an increased incidence of postoperative endophthalmitis, and our ophthalmology unit was threatened with permanent cessation of intraocular surgery. Although time-consuming, the result was an entirely new set of protocols for the care of patients undergoing intraocular surgery, the development of an integrated care pathway, and a comprehensive and robust audit programme, which enabled intraocular surgery to continue in a new spirit of confidence. HACCP methodology has so far been little used in healthcare, but it might be usefully applied to a variety of apparently intractable infection control problems.     

The application of hazard analysis and critical control points and risk management in the preparation of anti-cancer drugs

Objective. To apply the Hazard Analysis and Critical Control Points methodto the preparation of anti-cancer drugs. To identify criticalcontrol points in our cancer chemotherapy process and to proposecontrol measures and corrective actions to manage these processes. Setting. The Hazard Analysis and Critical Control Points applicationbegan in January 2004 in our centralized chemotherapy compoundingunit. From October 2004 to August 2005, monitoring of the processnonconformities was performed to assess the method. Methods. According to the Hazard Analysis and Critical Control Pointsmethod, a multidisciplinary team was formed to describe andassess the cancer chemotherapy process. This team listed allof the critical points and calculated their risk indexes accordingto their frequency of occurrence, their severity and their detectability.The team defined monitoring, control measures and correctiveactions for each identified risk. Finally, over a 10-month period,pharmacists reported each non-conformity of the process in afollow-up document. Results. Our team described 11 steps in the cancer chemotherapy process.The team identified 39 critical control points, including 11of higher importance with a high-risk index. Over 10 months,16 647 preparations were performed; 1225 nonconformities werereported during this same period. Conclusions. The Hazard Analysis and Critical Control Points method is relevantwhen it is used to target a specific process such as the preparationof anti-cancer drugs. This method helped us to focus on theproduction steps, which can have a critical influence on productquality, and led us to improve our process.     

盒饭生产关键控制点的确立和应用

[目的]　在盒饭生产过程中建立危害分析和关键控制点(HACCP)。　[方法]　按照《HACCP原理》及《上海市盒饭卫生管理办法》的有关规定,对盒饭加工过程进行危害分析,建立盒饭生产HACCP体系。　[结果]　确立食品采购、验收、存储、热加工、餐具消毒、成品分装、分装到就餐时间、温度等为关键控制点。　[结论〗　盒饭生产单位实施HACCP管理系统,生产过程的危害得到控制,明显提高盒饭的卫生质量。     

某企业偶氮二异丁腈车间主要职业病危害因素识别与关键控制点分析

目的识别某企业偶氮二异丁腈车间的职业病危害因素,检测其危害程度,找出职业病危害的关键控制点。方法采用职业卫生现场调查、职业卫生检测和综合分析法进行评价。结果该项目存在的职业病危害因素有粉尘、化学毒物和噪声,粉尘、化学毒物和噪声分别检测6、8和4个岗位。粉尘浓度为0.3~2.7 mg/m3,合格率100%;存在的化学毒物为甲醇、硫酸、丙酮氰醇和过氧化氢,浓度分别为40.9~796.0 mg/m3、0.3 mg/m3、0.1~1.0mg/m3和0.9~1.1 mg/m3。除甲醇合格率为50%外,其余均低于职业接触限值;噪声强度为80.5~89.6 dB(A),超标率为50%。结论甲醇、丙酮氰醇和噪声是偶氮二异丁腈生产过程中职业病危害因素重点分析因素。     

HACCP在职业病危害评价中的应用

目的 通过对广州市某造纸企业职业病危害控制效果评价,提出相应的控制技术和措施,并探讨适用于职业病危害评价的"危害分析与关键控制点(HACCP)"体系.方法 运用HACCP原理,对造纸企业的生产工艺、作业环境进行职业卫生调查和检测,识别各种职业病危害因素,分析其危害程度及对劳动者健康的影响,并据此找出关键控制点,提出预防控制措施,评价职业病危害防护措施及其效果. 结果 造纸企业存在的职业病危害因素主要有化学毒物、粉尘、噪声、高温、生物致病菌等,职业病危害控制措施中选址和总体布局、生产工艺及设备布局、职业病防护设施、辅助用室、个人防护用品、应急救援设施、职业卫生管理措施等应为工作重点,且应基本符合职业卫生要求.而针对工程防护、个人防护、管理防护三方面的关键控制点实施监控,可有效控制和消除造纸企业职业病危害. 结论 HACCP可以运用到建设项目职业病危害评价中,为预防、控制和监督工业企业职业病危害提供科学依据.     

某聚氨酯生产线职业病危害识别与关键控制点分析

目的分析某化工厂聚氨酯生产线生产过程中存在的职业病危害因素及其危害程度,确定职业病危害的关键控制点。方法采用职业卫生调查、职业卫生检测、职业健康检查等方法进行识别。结果该厂房存在化学毒物、粉尘、噪声等职业病危害因素。现场检测各岗位噪声强度为72.6～81.2 dB(A),各职业病危害因素的浓度或强度均符合国家规定的职业接触限值。结论该厂职业病危害因素不多,但仍应加强关键控制点的职业病防治工作。     

HACCP在婴儿米粉生产中的应用

目的:通过对我市婴儿米粉的生产厂家实施危害分析和关键控制点(HACCP)体系来提高婴儿米粉生产企业的管理水平及产品质量,确保产品的安全性。方法:HACCP作为生产(加工)安全食品的一种控制手段;对原料、关键生产工序及影响产品安全的人为因素进行分析,确定加工过程中的关键环节,建立、完善监控程序和监控标准,采取规范的纠正措施。试图找到生产中造成安全的关键点,从而为生产企业进一步提高产品质量。结果:根据危害分析,确定婴儿配方米粉生产过程中的关键控制点为原料(奶粉、蛋粉)、工作台、车间空气、操作人员的手。结论:通过HACCP体系的运行,明确了奶粉、蛋粉的质检工作,工作台面和车间空气的消毒,操作人员的卫生和提高从业人员的专业素质是保证产品质量合格的根本措施。     

HACCP原理在企业职业病危害控制过程中的应用

目的将危害分析和关键控制点(HACCP)原理应用于职业病危害企业中,进行危害分析,提出职业病危害的关键控制点和关键控制措施并加以验证。探讨HACCP应用到企业职业病危害控制中的适用性。方法以某玻璃制品制造企业为研究对象,分析其生产工艺流程,进行职业卫生调查,识别各种职业病危害因素,进行职业病危害因素检测和职业健康检查,提出关键控制点和控制措施并加以验证。结果该玻璃制品制造企业存在的职业病危害因素主要有化学毒物、噪声、高温、粉尘等,其中化学毒物主要包括甲苯、二甲苯、丁酮、乙酸丁酯、乙苯、甲醇、氟化氢、硫酸和盐酸。2013年现场检测切割、倒角岗位8 h等效声级85.7~87.9 d B(A),超过国家规定的职业接触限值,其他职业病危害因素检测结果均低于职业接触限值。126名接害作业工人在岗职业健康检查发现3名噪声职业禁忌证者,未发现疑似职业病者。2014年职业在健康检查中也未发现职业禁忌证者和疑似职业病者。结论 HACCP可广泛应用于存在职业病危害的企业中,有利于提高企业职业病防治的针对性,建立有效的职业卫生管理体系,保护劳动者健康,具有一定的可操作性和现实意义。     

外送盒饭生产中危害因素分析和关键控制点确定的应用研究

[目的 ]　在盒饭生产过程中建立危害分析和关键控制点 (HACCP)体系。　 [方法 ]　根据国际食品法典委员会 (CAC)文件《HACCP原理及其应用准则》推荐的原理和程序 ,参照我国餐饮业卫生管理方法的要求 ,对人员、设备、环境、原料、产品等对象的微生物指标进行一系列检测 ,并对原料及加工工艺进行危害因素分析 ,建立盒饭生产HACCP体系。　[结果 ]　确立原料贮存、烹调加热、盒饭贮存、餐具消毒为关键控制点 ,制定了一套详细的HACCP计划。　 [结论 ]　危害分析和关键控制点体系的建立为盒饭生产安全控制提供了保障     

超高温灭菌乳生产流程危害分析和关键控制点确定的应用研究

[目的 ]　在超高温灭菌 (UHT)乳生产过程中建立危害分析和关键控制点 (HACCP)。　 [方法 ]　参照国际食品法典委员会 (CAC)文件《HACCP原理及其应用准则》推荐的原理和程序 ,以及我国乳制品良好生产规范 (GMP)的要求 ,对原料、产品、人员、环境等对象的微生物指标进行一系列检测 ,并对生产加工过程进行危害分析 ,建立超高温灭菌乳生产HACCP体系。　 [结果 ]　确立原料冷却贮存、设备管道就地清洗 (CIP)清洗、超高温灭菌、无菌灌装、封合成型等为关键控制点 ,制定了一套详细的HACCP计划。　 [结论 ]　超高温灭菌乳生产过程中的危害得到控制 ,为超高温灭菌乳生产安全控制提供科学依据     

What is the HACCP (hazard analysis critical control point) approach and how can it be applied to enteral tube feeding?

The HACCP (hazard analysis critical control point) concept is now widely applied in the food industry and provides a structured and critical approach to the identification and control of hazards that may affect food safety. It has shifted the emphasis for control from retrospective end-product testing to the effective control of raw materials and key processing operations.
This paper discusses how the HACCP approach can be applied to enteral feeding. This involves each unit assembling a multidisciplinary team of personnel involved in enteral feeding. This team will then carry out a detailed analysis of the process from selection of ingredients and feeding systems through to consumption of the feed by the patient by constructing a flow chart that relates specifically to each unit. They can then identify and assess the hazards associated with the handling of the product at each stage in the process. This will enable them to identify the points where control over an identified hazard can be achieved (critical control points, CCP) such as quality of ingredients, design of administration systems, preparation and distribution of the feeds and the procedures involved in the assembly and manipulation of the systems. Control and monitoring procedures can then be specified and implemented at relevant stages in the process. The major strengths of the HACCP procedure are that it entails a team effort from key personnel involved in the full range of activities associated with the product and each detailed analysis is specific to each unit's practices and resources and can be continually reviewed and modified in response to changing circumstances.     

Implementation of hazard analysis critical control point in jameed production

The average of standard plate count and coliforms, Staphylococcus aureus and Salmonella counts for three home-made jameed samples, a traditional fermented dairy product, before applying hazard analysis critical control point system were 2.1?×?10(3), 8.9?×?10(1), 4?×?10(1) and less than 10?cfu/g, respectively. The developed hazard analysis critical control point plan resulted in identifying ten critical control points in the flow chart of jameed production. The critical control points included fresh milk receiving, pasteurization, addition of starter, water and salt, straining, personnel hygiene, drying and packaging. After applying hazard analysis critical control point system, there was significant improvement in the microbiological quality of the home-made jameed. The standard plate count was reduced to 3.1?×?10(2)?cfu/g whereas coliform and Staphylococcus aureus counts were less than 10?cfu/g and Salmonella was not detected. Sensory evaluation results of color and flavor of sauce prepared from jameed showed a significant increase in the average scores given after hazard analysis critical control point application.     

HACCP在“5·12”震中区映秀镇媒介生物控制中的应用探讨

目的应用危害分析和关键点控制（HACCP）体系，指导地震灾害后的媒介生物控制。方法按照HACCP的7个步骤实施媒介生物控制，即危害分析、关键控制点确定、关键控制点阈值确定、关键控制点阈值评价、纠偏措施、验证程序、建立文件和记录档案。结果确定9个关键控制点（critical control points，CCP），主要控制对象是蝇类和中华白蛉，主要控制场所是废墟尸体场所和生活垃圾及厕所。对每个CCP确立控制阈值。动态纠偏8项控制阈值。建立10个数据记录档案.不同场所的除臭率达到50％-100％，不同场所蝇类密度下降率为87．5％～100％，白蛉杀灭率100％，临时厕所达到国家城市三类厕所卫生指标。流行病学调查结果显示，2008年同期各类疾病发病率均低于2005—2007年的发病率，无虫媒病的发生：结论HACCP的应用，使得震中区媒介生物控制取得有效、经济、安全、科学合理的结果，为今后突发公共卫生事件、自然灾害发生后的卫生防疫、疾病控制提供了理论依据和实施方案。     

压水堆核燃料元件生产线辐射危害特点及其关键控制点探讨

通过对压水堆核燃料元件生产线各工序辐射源项、职业人员接触情况、辐射防护措施等现场调查,结合现场检测,该生产线正常生产运行时化工转化和芯块制备工艺存在较强的内照射及潜在的UF6泄漏、还原炉氢气爆炸、物料洒落等风险,应将其作为关键控制点.提示在生产运行过程中加强化工、芯块制备部分区域的现场防护管理;加强设备、管道密封性的定...