3种消毒剂洗手在连续护理操作中的效果观察

目的：选择一种高效、快速、刺激性小、经济实用的消毒洗手液，用于临床护士连续性静脉输液时手部皮肤消毒。方法：选用洗必泰酒精、健之素、诺延手消毒者哩，抽取临床护士20名，在连续性静脉输液中，分次应用不同消毒液进行手消毒后取样，实验室细菌培养；判断对手的刺激性。结果：洗必泰酒精、健之素消毒效果较好，合格率100％；诺延手消毒者哩刺激性最小；但差异均无统计学意义，P〉0．05。结论：诺延手消毒者哩消毒效果不理想（20％不合格率），且市场价格比较昂贵，不宜临床普及使用。     

免洗手泡沫消毒液在外科手消毒中应用的效果观察

目的 探讨免洗手泡沫消毒液在外科手消毒中的应用效果.方法 对手术人员外科洗手随机应用葡泰免洗手泡沫消毒液洗手法与刷手、聚维酮碘消毒洗手法,通过手部微生物采样监测,发放调查表对皮肤舒适度和接受程度进行调查,并对两种洗手法的成本进行分析.结果 葡泰免洗手泡沫消毒液消毒作用持久,抑菌时间＞6 h,洗手成本(0.50元/人次)低于聚维酮碘手消毒法(0.62元/人次),皮肤不良反应少,医务人员接受度高,为8 8.5%.结论 葡泰免洗手泡沫消毒液洗手法是一种好的洗手方法,值得推广.     

免刷手式外科手消毒法的临床应用与研究

目的：观察免刷式外科手消毒法在临床中实际消毒效果。方法：研究医院2013年参加择期手术的医护人员200人次,随机分为对照组和实验组,每组100人次;应用同一种洗手液和消毒液（手洁肤柔抗菌洗手液和消毒凝胶）,将采用免刷手消毒法作为实验组,采用刷洗外科手消毒法作为对照组,对两种外科手消毒法进行分析,并比较两组消毒后的无菌率和操作时间。结果：免刷手式外科手消毒方法消毒效果达到卫生部《消毒技术规范》,且操作时间短,对皮肤损害小,得到医院医护人员的肯定。     

包头市口腔诊疗机构消毒状况调查

目的了解包头市口腔诊疗机构消毒工作现状，采用分层抽样方法，对公立医院和私营诊所进行了抽查。结果现场卫生监督合格率为66．28％，室内空气合格率为67．44％；使用中的消毒液合格率为80．23％；灭菌器械合格率为90．84％；物体表面合格率为83．93％；医务人员手消毒合格率为66．21％。结论包头市公立医院口腔诊疗机构的消毒工作状况好于私营诊所，口腔诊疗机构室内空气和医护人员手消毒合格率比较低。     

应用不同刷手材料皮肤消毒效果临床分析

目的 探讨医护人员术前用纱布擦洗及手刷刷洗手臂的消毒效果,评估其皮肤的舒适度.方法 将参加手术的97名医护人员随机分成两组,试验组48人用纱布挤取洗手液擦洗手臂,对照组49人采用耐高温、高压的手刷刷洗手臂；分别于刷手即刻及术中1、2、3、4h进行手细菌培养以监测消毒效果,并对参加手术的97人进行皮肤舒适度的问卷调查,评分越高,不良反应越重.结果 两组人员皮肤消毒在各时段进行细菌学监测菌落数均＜5 CFU/cm2,消毒效果均达到卫生部颁布的《消毒技术规范》标准,培养结果差异无统计学意义；采用纱布擦洗手臂组的医护人员皮肤的不良反应评分明显低于应用手刷组人员,两组数据比较差异有统计学意义(P＜0.01).结论 用纱布挤取洗手液擦洗手臂不仅符合消毒技术标准而且皮肤的不良反应小,是一种合格的手刷替代品.     

75%乙醇甘油的临床手消毒应用效果观察

为了恰当地选择一种对皮肤刺激性小,又能快速有效地达到一定的消毒效果,同时具有一定的护肤作用的皮肤消毒剂,我院改用75%乙醇甘油应用于手消毒。针对其应用效果,我们进行手部微生物的监测试验观察。1材料和方法1.1一般资料180例均为我院临床一线的医护人员。一般性洗手用肥皂认真揉搓时间不少于15s,然后在流水下冲净。消毒采用3种不同的消毒液棉球擦手。在洗手前后、操作后、消毒液擦手后分别采样并培养观察计数。这3种消毒液是:(1)0.1%有效氯的"84"消毒液。(2)     

不同类别护手霜对洗必泰类外科手消毒剂消毒效果的影响

目的探讨不同护手霜对洗必泰类外科手消毒剂消毒效果的影响。方法将60名手术室医护人员随机分成A、B、C三组。受试者均按六步洗手法洗手1 min,用无菌擦手纸擦干双手。 A组不使用护手霜,B、C组分别使用3M爱护佳9260护手霜（水包油乳化液）及某品牌凡士林护手霜（油包水乳化液）。分别采集各组洗手后、使用护手霜后30 min及外科手消毒后的手部样本,进行细菌培养及菌落计数。结果洗手后各组间菌落计数比较,差异无统计学意义（P＞0.05）。擦护手霜后30 min,各组间［A组：（3.33±0.64）CFU/cm2;B组：（3.32±0.97）CFU/cm2;C组：（4.05±1.78）CFU/cm2］比较, 菌落计数差异有统计学意义,C组菌落计数显著高于A、B组(P<0.05);A、B两组差异无统计学意义（P＞0.05）。外科手消毒后,A、B两组受试者均达到外科手消毒要求,差异无统计学意义（P＞0.05）;C组有2人未达到外科手消毒要求,且菌落计数［（1.28±1.45）CFU/cm2］显著高于A组［（0.07±0.10）CFU/cm2］及B组［（0.06±0.12）CFU/cm2］ (P<0.05)。结论使用与乳胶及洗必泰兼容的护手霜（水包油乳化液）可有效保护手部皮肤,同时对外科手消毒无显著影响。     

手消毒液选择评估

目的 进行医院现有消毒液监测,科学评估选择.方法 随机抽取医护人员,按使用丹尼尔-外科皮肤消毒液、洁芙柔消毒凝胶、洁肤消毒液分为3组,比较洗手效果,同时调查洗手时消毒液对手部的影响.采用X2检验进行统计学处理.结果 3种消毒液均可以达到使用要求,但丹尼尔外科皮肤消毒液合格率为100%,使用中无过敏现象,洁芙柔消毒凝胶使用时间长,有不明原因的过敏现象.结论 丹尼尔-外科皮肤消毒液及丹尼尔-自动杀菌净手器可在手术室等重点部门先使用.     

护理人员操作前手消毒方法的探讨

目的　加强护理人员静脉操作前手的清洁和消毒 ,预防医院感染与穿刺处的不良反应。方法　对 15个普通病房护理人员 90人 ,分 3组进行监测 (对照组 1∶ 5 0 0“84”消毒液毛巾擦洗手、0 .2 %活力碘消毒液毛巾擦洗手 )。结果　未洗手暂居菌量 >2 0 0 CFU / cm2 34例 ,检出 7种细菌共 10 9株 ;实验 1组除菌率 96 .74 % ,实验 2组除菌率 10 0 %。结论　护理人员每次静脉操作前运用两组实验方法消毒手皮肤 ,可以达到良好的消毒效果     

四种消毒剂对外科术前手消毒的效果

几年来我们就4种皮肤消毒剂对于外科术前手消毒效果作了调查、比较；现简要介绍如下：一、材料与方法1．对象：随机抽检按规定程序进行的外科前流水肥皂刷洗1～3分钟，规定浓度消毒液浸泡或自肘关节至手指尖擦拭1～3分钟，经无菌报手巾擦拭后的医护人员手。2．中和剂：0．5％硫代酸钠、0．75％卵磷脂、3％吐温80。3．消毒剂：0．5％碘伏（广州庆丰药械厂），0．2％过氧乙酸（福州消毒站），？5％酒精，0．1％洗必泰（本院药厂）。4．采样与监测：参照《消毒技术规范》，用充分湿润含中和剂稀释液的无苗棉拭子，在被检者双手指曲面从指根至指…     

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.     

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.     

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.     

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.     

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.