安徽省某三甲中医院2014-2018年消毒灭菌效果监测分析

目的 了解安徽省某三甲中医院消毒灭菌效果状况,查找薄弱环节,科学指导消毒工作.方法 采集2014年1月至2018年12月期间医院灭菌物品、消毒物品、消毒剂、内镜、透析液、物体表面、医务人员手卫生和空气样本,检测细菌菌落总数.结果 2014-2018年共采样10 094份,合格9 517份,总体消毒灭菌合格率为94.3％.各年合格率分别为93.8％、96.7％、92.7％、93.9％、94.6％,Ⅰ类环境总合格率95.2％,高于其他环境.5年中灭菌物品的合格率为97.6％,消毒物品合格率为91.7％,消毒剂合格率为98.5％,内镜合格率99.5％,透析液合格率93.8％,物体表面合格率89.7％,手卫生合格率90.2％,空气合格率为97.7％.结论 医院消毒与灭菌效果总体较好,但物体表面、手卫生的合格率相对较低,需加强管理,降低医院感染风险.     

2010-2011年高密市医疗机构口腔科消毒监测分析

目的 了解高密市医疗机构口腔科消毒质量状况,为给医疗机构消毒管理工作提供科学依据.方法 对2010-2011年高密市51家医疗机构口腔科的室内空气、物体表面、使用中的消毒液、口腔器械、紫外灯强度以及医护人员手进行消毒质量监测.结果 2010-2011年合计检测各级医疗机构各种样品1 419份,合格1 121份,总合格率为79.0％.检测合格率,市直医疗机构为95.8％,乡镇卫生院为80.8％,个体牙科诊所为61.8％ (P ＜0.01);物体表面为85.8％,医护人员手为78.6％,使用中消毒液为93.4％,紫外线灯为80.5％,口腔器械为69.0％.结论 高密市医疗机构口腔科消毒质量不高,乡镇卫生院和个体牙科诊所消毒样品合格率更低,尤其是要加强口腔器械和医护人员手的消毒质量监督管理.     

沈阳市2003～2005年医疗机构消毒效果监测分析

目的：掌握沈阳市医疗机构消毒卫生状况，为提高消毒质量提供依据。方法：对该市41家市级以上医疗机构3年室内空气、物体表面、医护人员手、灭菌物品、内镜和使用中消毒液进行了微生物采样监测。结果：3年共检测样品2075份，合格1826份，合格率为88．00％，其中空气和内镜样品的合格率最低。结论：沈阳市医疗机构消毒质量仍存在一定问题，需进一步加强消毒管理工作。     

中山、茂名、肇庆、江门四市医疗单位消毒效果监测简报

中山市、茂名市、肇庆市、江门市卫生防疫站分别对本市所属医疗单位消毒效果进行了调查,结果如下: 一、消毒浸泡液消毒效果监测:合格率为67.1％～95.4％,肇庆市合格率最高,茂名市最低,其49份不合格样品中,细菌总数有24份,大肠杆菌6份,HBsAg28份。二、各种物体表面消毒效果监测:肇庆市合格率为91.04％,其14份不合格样品中,细菌总数占0.43,HBsAg占0.57。茂名市合格率为76.2％,其34份不合格样品中细菌总数有28份,大肠杆菌13份,绿脓杆菌2份,HBsAg5份。     

北京市海淀区营利性口腔医疗机构消毒灭菌效果分析与政策建议

目的:了解北京市海淀区营利性口腔医疗机构的消毒灭菌现状,为进一步提高卫生监督执法的科学性提供依据.方法:采取随机分层抽样的方法对辖区内47家营利性口腔医疗机构的消毒灭菌物品进行检测.结果:共检测无菌器械、物体表面、室内空气、医务人员手、使用中的消毒液等样品799件,合格751件,合格率为94.0％.有48.9％的单位存在检测不合格的情况,无菌器械、室内空气、医务人员手的不合格率较高,开业年限≥10年的医疗机构检测合格率较高.结论:营利性口腔医疗机构的消毒灭菌工作仍存在薄弱环节,需进一步加强监督和培训.     

2013—2014年北京市石景山区医疗机构的消毒效果

目的了解北京市石景山区各级各类医疗机构的消毒状况,为进一步提高消毒工作质量和管理监督提供科学依据。方法 2013—2014年对北京市石景山辖区内各级各类医疗机构进行监测,依据GB 15982-2012《医院消毒卫生标准》、GB 15981-1995《消毒与灭菌效果的评价方法与标准》、WS/T 367-2012《医疗机构消毒技术规范》进行采样检测。结果北京市石景山区2013—2014年共计监测医疗机构样品4 298份,合格4 098份,合格率为95.35%。其中2014年合格率96.38%高于2013年合格率94.23%。监测物体表面、医务人员手、空气细菌总数、紫外线灯强度(2014年二级以下私立医疗机构)、压力蒸汽灭菌效果(二级及其以下医疗机构)合格率分别为97.29%、91.15%、94.95%、87.50%、93.10%。二级及以上医疗机构监测样品合格率(97.00%)高于二级以下机构合格率(94.36%),Ⅰ、Ⅱ类环境中监测样品合格率(97.89%)高于Ⅲ、Ⅳ类环境合格率(94.88%)。结论 2013—2014年北京市石景山区医疗机构消毒工作质量总体较好,但仍需进一步提高。依法开展消毒管理执法与监督检查,健全并落实消毒管理制度,提高医院感染防控意识和消毒意识等,是提高医疗机构消毒水平的重要措施。     

2011年重庆市涪陵区不同级别医疗机构消毒检测结果

目的了解重庆市涪陵区医疗机构消毒效果,为提高医疗机构消毒灭菌质量,有效预防和控制医院感染提供科学依据。方法对重庆市涪陵区211所医疗机构的室内空气、物体表面、医护人员手、使用中消毒剂、医疗用品进行采样检测。结果共采样品2136份,合格1600份,平均总合格率74．91％。室内空气合格率54．69％,物体表面合格率76．16％,医护人员手表面合格率64．03％,消毒剂合格率83．15％,医疗用品合格率95．02％。结论涪陵区医疗机构消毒质量总体合格率不高,室内空气和医护人员手表面合格率低,空气合格率最低。区直医院的消毒效果状况较好,但镇级医院、卫生站和个体诊所的消毒状况较差,应加强监督管理。     

2010-2012年马山县医疗机构消毒效果监测分析

目的了解医疗机构消毒、灭菌效果，为预防和控制医院感染提供依据。方法对2010-2012年马山县县乡级医疗机构消毒效果监测资料进行分析。结果2010-2012年合计检测各类监测对象765份，合格的703份，平均合格率为91．90％。检测合格率，2010～2012年分别为87．74％、92．67％、96．86％（P〈0．01）；县乡两级医疗机构分别为97．83％、87．56％（P〈0．01）；室内空气为95．00％，物体表面为97．30％，医护人员手为92．21％，使用中消毒液为98．94％，灭菌物品为70．71％，器械浸泡液为72．00％。结论马山县医疗机构消毒质量总体较好，灭菌物品和无菌器械保存液合格率较低。     

普洱市医疗机构消毒效果监测结果分析

[目的]通过对普洱市医疗机构消毒效果监测结果进行分析,发现存在的问题,提出对策及时改进,控制医院感染。[方法]按照《消毒技术规范》对医院消毒与灭菌质量采取随机,抽样进行检测。[结果]2009年、2010年两年共抽检565份,致病菌未检出;菌落总数合格509份,检测合格率为90．09％：其中无菌物品及使用中的消毒液合格率最高为100％,其次是物体表面97．96％;医护人员手合格率较低85．86％,空气合格率最低为70．38％。市直医疗机构监测合格率为96．44％,市区个体医疗机构监测合格率82．42％。[结论]普洱市医疗机构空气、医护人员手、物体表面合格率欠佳,个体医疗机构监测合格率低于市直医疗机构监测合格率。在医院消毒效果方面有待进一步加强监督管理,加强技术知识培训,提高医院感染的控制能力。     

2011-2014年鄂尔多斯市医疗机构消毒灭菌效果监测与分析

目的 了解鄂尔多斯市近几年医疗机构消毒灭菌质量效果,确定今后重点加强区域.方法 按照《医院消毒卫生标准》(GB15982-1995,GB15982-2012),《医院洁净手术部建筑技术规范》(GB50333-2002,GB50333-2013)进行采样、监测与评价.结果 共采集样品6 468份,合格样品6 050份,合格率为93.54％.使用中消毒液合格率为96.91％,物体表面合格率为93.30％,医务人员手合格率为90.57％,室内空气合格率最低,为88.14％.结论 鄂尔多斯市医疗机构2011-2014年消毒灭菌质量总体水平呈现上升趋势,但室内空气、医务人员手合格率较低,需要提高这些方面的消毒灭菌质量效果,加强监管,预防医源性感染的发生.     

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.     

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.