突发公共卫生事件应急指挥与决策系统GIS应用设计

突发公共卫生事件应急指挥系统的建设是一个复杂的系统工程，任何一种传染性疾病都具有一定的地理空间分布特征，GIS技术在整个系统建设过程中具有重要作用。本文结合突发公共卫生事件应急处置工作中预防监测、预警准备、快速反应、收尾恢复和总结提高等业务环节的工作重点，对突发公共卫生事件应急指挥与决策系统GIS功能进行了详尽的需求分析；并在此基础上，重点对应急指挥系统的GIS功能进行了设计。利用GIS强大的数据采集、管理与分析功能，结合临床研究、流行病学研究和实验室研究所采用的分析模型与方法，GIS在应急指挥系统中可以提供如下功能：数据的可视化、空间查询、空间分析、专业模型研究、医疗设施分布、资源调度、报警处理与反馈、信息发布等。GIS为其他子系统提供基本的地图、空间查询、空间分析服务，同时通过WebService的方式与其他子系统集成，通过信息综合门户为领导、专家、工作人员提供日程运营、应急反应提供决策支持服务。实现整个系统方便、高效、快捷的信息采集和展示，建立各种空间分析模型，为决策提供科学依据。     

突发危险化学品泄漏事故人群健康风险评价方法的应用

目的建立突发危险化学品泄漏事故健康风险评估方法,评价重庆开县井喷事故中的人群健康风险。方法按照国际上通用的危害鉴定、暴露评价、剂量-反应关系评价和风险特征分析4步评价程序,结合危险化学品泄漏事故的自身特征,并借鉴国外突发事故相关研究成果,建立突发危险化学品泄漏事故健康风险评估方法。通过查询污染物特征数据库,确定重庆井喷事故中硫化氢健康损害效应的性质、特点和强度;根据事故现场实时环境监测的污染物浓度值进行事故风险场内人群暴露总量计算;采用阈值法和概率方程法相结合,对暴露人群可能出现的健康效应及其概率进行估算;预测事故可能造成的人员伤亡数量;并给出健康风险评估结果的不确定性。结果重庆井喷事故中,伤亡情况最为严重的高桥镇晓阳和高旺两村共死亡212人。本研究采用美国化学工程师协会-化工安全中心与荷兰应用科学研究组织提供的参数值模拟预测结果分别为364人和176人,预测结果与事故实际后果之间的相对误差分别为71.7%和17.0%。结论采用荷兰应用科学研究组织提供的参数值可以对井喷事故的死亡风险进行较准确的预测。本研究建立的突发危险化学品泄漏事故健康风险评估方法能够为突发危险化学品泄漏事故健康风险评估提供技术支撑,从而为事故应急预案的制定、应急响应和应急救援提供科学依据。     

危险化学品泄漏事故的院前救护

近年来,在生产、储存、经营、运输和使用化学品的过程中,中毒事故屡有发生,带来的安全隐患引起了社会的广泛关注。因此,积极开展危险化学品泄漏的院前救护,对挽救伤病员的生命起着至关重要的作用。据此,拟对发生危险化学品事故时的院前急救护理要点作一探讨。     

消防部队在突发危险化学品事故中的职责与处置措施

通过分析突发危险化学品事故特点,结合《中华人民共和国消防法》等法律法规,阐述消防部队在此类灾害事故应急救援中应当承担的职责使命,指出消防部队的主要职责是搜救疏散人员、处置危险化学品、供水和洗消等,并就现场处置的措施进行了探讨。     

建立长效机制确保突发公共卫生事件应急指挥与决策系统发挥实效

随着国家加大对突发公共卫生事件应急指挥与决策系统建设的投入及地方政府用于应急体系建设配套资金的逐步落实,各地突发公共卫生事件应急指挥与决策系统建设如火如荼般展开。各地应急指挥系统建成后能否实现互联互通、资源共享、应急指挥高效,成了人们关注的焦点。文章从当前全国突发公共卫生事件应急指挥决策系统建设存在的问题、应急信息系统运营维护长效机制的建立与怎样发挥突发公共卫生事件应急指挥系统的实效等方面进行了探讨,提出了建立长效机制,确保突发公共卫生事件应急指挥与决策系统发挥实效的一些观点。     

危险化学品伤害事故分析

通过危险化学品伤害事故分析 ,对事故发生原因进行了归纳 ,并针对不同特点的伤害事故 ,提出了相应的防治对策。     

2015—2020年上海市危险化学品事故分析

  目的  研究上海市危险化学品事故发生的特点和规律，为事故的预防和应急处置研究提供理论支撑。
  方法  采用描述性统计分析法，对2015年1月—2020年12月上海市危险化学品事故发生的时间、地区和环节等分布进行统计，分析事故特点和事故原因。
  结果  2015—2020年上海市共发生一般和较大危险化学品事故217起，未发生重大事故和特别重大事故，共造成236人受伤，92人死亡。其中发生在第三季度的事故起数及造成的受伤人数最多，但引起死亡人数最多则为第二季度；8—10时和14—16时是事故发生的高峰时段；浦东新区为事故高发地区；微型、小型企业单位发生的危险化学品事故较多，分别为93起（占42.8%）和98起（占45.2%）；主要事故类别为爆炸，爆炸、火灾、中毒和窒息3类事故造成的受伤、死亡人数分别占伤亡总人数的90.2%和94.6%；按事故环节分类，使用环节导致事故起数、受伤和死亡人数均最多，分别占总事故起数、受伤人数和死亡人数的54.8%、73.3%和54.3%。
  结论  2015—2020年上海市危险化学品事故数总体平稳，建议从监管部门、企业等角度采取针对性预防对策，为减少同类危化品事故的发生提供技术支持。
     

上海市危险化学品水运污染事故应急处置对策建议

<正>上海港危险货物的年吞吐量已达4 000多万吨,是城市运行安全和生产安全工作必须面对的一道难题。增强危险货物水运污染事故预防与应急响应能力已成为保障城市安全和上海国际航运中心建设的重要环节,也是贯彻科学发展观和以人为本、预防为主原则的具体体现。据此,就上海市水运污染事故的应急处置问题作初步探讨,并提出若干建议,供政府有关部门参考。危险化学品的水运事故主要发生于散装液体化学品船(简称散化船)和集装箱船。危险货物集装箱船内的危险化学品均有严格包装要求(按危险性大小分为Ⅰ、Ⅱ、Ⅲ类),只要合理科学包装,即使发生水上泄漏事     

我国危险化学品事故应急救援的基本原则

1危险化学品事故应急救援的定义危险化学品事故应急救援是指危险化学品由于各种原因造成或可能造成众多人员伤亡及其他较大社会危害时,为及时控制危险源,抢救受害人员,指导群众防护和组织撤离,清除危害后果而组织的救援活动。2危险化学品事故应急救援的基本任务①控制危险源;②抢救受害人员;③指导群众防护,组织群众撤离;④排除现场灾患,消除危害后果。     

危险化学品泄漏事故现场洗消

随着我国经济建设的快速发展,作为化工生产的原料、中间体及产品的危险化学品(以下简称危化品)种类不断增加,在生产、经营、储存、运输和使用过程中发生的危化品泄漏事故也在不断增多。化学事故发生后,有毒有害物质可污染空气和土壤表层,有毒气体可滞留污染区内任何位置,而有毒液体则能渗透到地表造成深度污染,持续时间少则几个小时,多则数日、数月甚至更长时间,生态环境将受到严重污染。因此化学事故发生后,需要及时、快速、高效的洗消。     

The use of a GIS-based malaria information system for malaria research and control in South Africa

The paper aims to outline the innovative development and application of a Geographical Information System based Malaria Information System for malaria research and control in South Africa. This system is a product of collaboration between the Malaria Control Programmes and the Malaria Research Programme of the Medical Research Council of South Africa. The ability of such a system to process data timeously into a usable format is discussed, as well as its relevance to malaria research, appropriate malaria control measures, tourism, and social and economic development.     

核与辐射突发事件卫生应急辅助指挥系统研究与设计

目的：研究核与辐射突发事件卫生应急指挥关键技术,为决策人员和技术人员提供一套辅助指挥工具。方法：根据国内外有关技术规范,结合本课题组研究成果,利用现代信息技术,通过编写计算机程序方式完成该系统的设计。结果：设计完成了集技术支持、辅助指挥、核应急资料管理、健康基线地理信息、损伤人员后果评价、放射损伤救治咨询和现场快速剂量估算为一体的计算机软件。结论：该系统将在核与辐射突发事件卫生应急救援中发挥积极的作用。     

Seasonal variation and weather effects on road traffic accidents in Riyadh City

The monthly variation of Road Traffic Accidents (RTAs) in Riyadh city in the period 1989–1993 has been studied with reference to time of day, lighting conditions and prevalent weather conditions.Total RTA accidents were significantly more common, being directly correlated, with increased dry and wet bulb temperatures and significantly less common, being inversely correlated, with increased relative humidity and amount of precipitation of rain, snow, hail etc. However, RTAs recorded on rainy days only were significantly more common and directly correlated with precipitation (Note days of snow and hail are very rare in Riyadh city).Seasonal variation in RTAs was evident being maximal during the summer season particularly between 12 noon and 3 pm. This period is characterized by heavy traffic and intense sunlight. The role of hot weather prevalent in Saudi Arabia, where average temperatures of 34.4–34.7°C with maximum of 40–42.7°C are common in summer, have been suggested to be an important factor leading to increased stress and decreased performance of intellectual tasks which require considerable physical effort and motor skills. Increased heart rates, exacerbation of existing pathologic conditions such as heart disease and emphysema and loss of visual acuity have been reported. Consequently, prolonged exposure to heat must be considered as a hazard to the safety and health of drivers and a factor leading to an increased incidence of RTAs.     

深圳市2006-2013年恙虫病时空分布特征

目的 了解深圳市2006-2013年恙虫病流行病学特点,利用地理信息系统(GIS)技术探索2006-2013年深圳市恙虫病的空间分布特征,为恙虫病的防控工作提供科学依据。 方法 描述深圳市2006-2013年恙虫病流行病学分布特征,利用空间自相关性分析确定恙虫病的高风险地区。 结果 2006-2013年全市共报告恙虫病病例127例,其中死亡1例,年均报告发病率0.15/10万,历年发病率呈增高趋势(P<0.05);2013年发病率最高,达0.43/10万;2006-2013年各区中南山区年均发病率最高,达0.593/10万;发病主要集中在5-11月份,占86.6%;男女比为1.17:1;职业以工人和家务及待业人员为主,共报告68例(占53.54%); Moran’s I全局统计量为0.548(P=0.05),局部自相关系数大于1的地区包含西乡、西丽、桃源、新安、南头、沙河、粤海、南山、招商、蛇口等10个街道,这些街道是深圳市恙虫病发病数的高聚集区域。 结论 2006-2013年深圳市恙虫病的发生存在逐年增高趋势,具有明显的季节差异,运用空间自相关分析及时发现疾病的聚集情况,确定高发和危险地区,在流行季节应针对重点人群加强健康教育,减少感染机会,控制恙虫病的发生和流行。     

Estimating the spatial distribution of acute undifferentiated fever (AUF) and associated risk factors using emergency call data in India. A symptom-based approach for public health surveillance

The System for Early-warning based on Emergency Data (SEED) is a pilot project to evaluate the use of emergency call data with the main complaint acute undifferentiated fever (AUF) for syndromic surveillance in India. While spatio-temporal methods provide signals to detect potential disease outbreaks, additional information about socio-ecological exposure factors and the main population at risk is necessary for evidence-based public health interventions and future preparedness strategies. The goal of this study is to investigate whether a spatial epidemiological analysis at the ecological level provides information on urban–rural inequalities, socio-ecological exposure factors and the main population at risk for AUF. Our results displayed higher risks in rural areas with strong local variation. Household industries and proximity to forests were the main socio-ecological exposure factors and scheduled tribes were the main population at risk for AUF. These results provide additional information for syndromic surveillance and could be used for evidence-based public health interventions and future preparedness strategies.     

南昌市县级疾病控制机构应急演练活动评估分析

目的 根据2010-2011年南昌市县级疾病预防控制(简称疾控)机构开展的应急模拟演练活动,对综合实战演练、单项实战演练、桌面演练3种演练模式进行分析评估,探讨一种适用于县级疾控机构操作的应急模拟演练模式及科学的评估方法.方法 应用描述性分析方法对2010-2011年南昌市11个县级疾控机构开展的20场应急模拟演练资料进行统计分析.结果 3种演练方式具有各自的特点和不足,均能取得演练的预期效果;结论 桌面演练更适合县级疾控机构的开展;建立演练评估指标评分细则和量化指标能促进卫生应急大练兵活动的有效开展.     

Relationship between accessibility and resources to treat acute ischemic stroke. Hokkaido,Japan: Analysis of inequality and coverage using geographic information systems

ObjectivesThis study aimed to clarify the relationship between the institution and resident with respect to accessibility to acute ischemic stroke (AIS) treatment in Hokkaido and to propose new methodology monitoring for accessibility to healthcare resources.MethodsThis study involves the use of geographic information system (GIS) network analysis. We established hospital/clinic with one of the following conditions as resources for AIS treatment: (1) medical facility practicing AIS treatment, (2) having computed tomography (CT) equipment, (3) having angiography equipment, and (4) having AIS specialists (neurosurgeons). We evaluated the coverage of population resources using transport time between ambulance departure and arrival at the healthcare facility. Furthermore, we compared the population coverage rate using available resources and calculated a Gini coefficient to analyze its relation with inequality. Empirical analysis was performed, and public database for data collection was utilized. We calculated the rate of population coverage with a transport time within 10 min as an indicator of accessibility to medical resources by GIS.ResultsThe Gini coefficients of practicable facilities, CT, angiography, and neurosurgeons are 0.35, 0.16, 0.18, and 0.30, respectively. The inequality of accessibility differs depending on the resources, and Gini coefficients indicate that hospital/clinic and neurosurgeons were considered to have higher allocation inequalities than CT and angiography.ConclusionsCombining Gini coefficient and GIS network analysis in accessibility can be useful in quantifying and monitoring variation by region. We propose this combination as a new method for helping the government to make evidence-based healthcare planning.     

张家港市高危儿童管理网络建立及干预模式的探讨

目的探讨建立高危儿管理网络对高危儿早筛查、早诊断、早干预的必要性及可行性。方法与残疾人联合会合作成立早期干预中心,利用高危儿管理网络的模式（三级妇幼保健网络和妇幼卫生信息系统）,对纳入的2140例高危儿进行专案管理;并及时在康复基地进行早期干预和评估。结果在2140例高危新生儿中通过脑损伤五项筛查发现无高危因素的异常婴儿45人;经不同阶段的随访评估诊断为可疑或异常儿童248人,均在张家港市儿童康复基地进行了综合干预,其中196例儿童通过评估已达正常发育水平。结论利用高危儿童管理网络对高危儿进行早筛查、早诊断、早干预,可优化医疗资源,值得在基层推广应用。     

Breaking Out of Surveillance Silos: Integrative Geospatial Data Collection for Child Injury Risk and Active School Transport

The preponderance of active school transport (AST) and child injury research has occurred independently, yet they are inherently related. This is particularly true in urban areas where the environmental context of AST may pose risks to safety. However, it can be difficult to make these connections due to the often segregated nature in which these veins of research operate. Spatial video presents a geospatial approach for simultaneous data collection related to both issues. This article reports on a multi-sector pilot project among researchers, a children’s hospital, and a police department, using spatial video to map child AST behaviors; a geographic information system (GIS) is used to analyze these data in the environmental context of child pedestrian injury and community violence.     

Intra-urban variability of air pollution in Windsor, Ontario--measurement and modeling for human exposure assessment

There are acknowledged difficulties in epidemiological studies to accurately assign exposure to air pollution for large populations, and large, long-term cohort studies have typically relied upon data from central monitoring stations. This approach has generally been adequate when populations span large areas or diverse cities. However, when the effects of intra-urban differences in exposure are being studied, the use of these existing central sites are likely to be inadequate for representing spatial variability that exists within an urban area. As part of the Border Air Quality Strategy (BAQS), an international agreement between the governments of Canada and the United States, a number of air health effects studies are being undertaken by Health Canada and the US EPA. Health Canada's research largely focuses on the chronic exposure of elementary school children to air pollution. The exposure characterization for this population to a variety of air pollutants has been assessed using land-use regression (LUR) models. This approach has been applied in several cities to nitrogen dioxide (NO2), as an assumed traffic exposure marker. However, the models have largely been developed from limited periods of saturation monitoring data and often only represent one or two seasons. Two key questions from these previous efforts, which are examined in this paper, are: If NO2 is a traffic marker, what other pollutants, potentially traffic related, might it actually represent? How well is the within city spatial variability of NO2, and other traffic-related pollutants, characterized by a single saturation monitoring campaign. Input data for the models developed in this paper were obtained across a network of 54 monitoring sites situated across Windsor, Ontario. The pollutants studied were NO2, sulfur dioxide (SO2) and volatile organic compounds, which were measured in all four seasons by deploying passive samplers for 2-week periods. Correlations among these pollutants were calculated to assess what other pollutants NO2 might represent, and correlations across seasons for a given pollutant were determined to assess how much the within-city spatial pattern varies with time. LUR models were then developed for NO2, SO2, benzene, and toluene. A multiple regression model including proximity to the Ambassador Bridge (the main Canada-US border crossing point), and proximity to highways and major roads, predicted NO2 concentrations with an R2=0.77. The SO2 model predictors included distance to the Ambassador Bridge, dwelling density within 1500m, and Detroit-based SO2 emitters within 3000m resulting in a model with an R2=0.69. Benzene and toluene LUR models included traffic predictors as well as point source emitters resulting in R2=0.73 and 0.46, respectively. Between season pollutant correlations were all significant although actual concentrations for each site varied by season. This suggests that if one season were to be selected to represent the annual concentrations for a specific site this may lead to a potential under or overestimation in exposure, which could be significant for health research. All pollutants had strong inter-pollutant correlations suggesting that NO2 could represent SO2, benzene, and toluene.