不同通风方式对消化内镜清洗消毒室气溶胶净化效果的研究

 目的 评价轴流风柜机械通风、排风扇机械通风和自然通风3种方式净化消化内镜清洗消毒室气溶胶的效果。方法 试验分为轴流风柜机械通风(A组)、排风扇机械通风(B组)、自然通风(C组)3组。采集某院两个病区3组通风方式下消化内镜清洗消毒室静态环境(清洗消毒工作停止12 h)通风2 h前后,动态环境(清洗消毒工作进行中)工作起始状态0 h以及持续通风1、2、4、6 h的空气,检测空气气溶胶中颗粒物、微生物、戊二醛的含量,比较3种通风方式净化消化内镜清洗消毒室气溶胶的效果。结果 消化内镜清洗消毒室在静态环境下,3组通风方式通风2 h后,空气中颗粒物、微生物和戊二醛含量均呈下降趋势,其中A、B组通风2 h前后比较,差异具有统计学意义(P＜0.05)。清洗消毒室在工作起始状态0 h时,3组空气中颗粒物、微生物和戊二醛含量比较,差异均无统计学意义(均P>0.05)。持续通风1、2、4、6 h时,总体及任意两组间空气中颗粒物、微生物和戊二醛含量比较,差异均有统计学意义(均P＜0.01),且A组低于B、C组,B组低于C组。A组在动态环境下空气中颗粒物、微生物和戊二醛含量较低且波动范围小,其中颗粒物含量在100万级洁净室规定范围内。B、C组在持续通风1、2、4 h时戊二醛含量均超出最大安全接触限值0.175 mg/m³,其中C组在4~6 h (午休期间)的戊二醛含量仍超出最大安全限值。结论 3种通风方式中,轴流风柜机械通风方式能有效净化消化内镜清洗消毒室的气溶胶,建议引入轴流风柜通风方式,以保障工作人员的职业安全。

Effect of different ventilation methods on aerosol purification of digestive endoscope cleaning and disinfection room

Objective To evaluate the effect of axial-flow cabinet mechanical ventilation, exhaust fan mechanical ventilation and natural ventilation on cleaning and disinfecting aerosol in digestive endoscope cleaning and disinfection room. Methods The experiment was divided into three groups: Axial flow cabinet mechanical ventilation (group A), exhaust fan mechanical ventilation (group B) and natural ventilation (group C). Air in digestive endoscope cleaning and disinfection rooms in two wards of a hospital under three ventilation modes were collected: before and after 2 hours of ventilation in the static environment (the cleaning and disinfection work was stopped for 12 hours), 0 hour in the initial state of the dynamic environment (the cleaning and disinfection work was in progress) and 1, 2, 4, 6 hours of continuous ventilation, contents of particulate matter, microorganisms, glutaraldehyde in air aerosol were detected, effect of three ventilation modes on purifying the aerosol in digestive endoscope cleaning and disinfection room were compared. Results In static environment, contents of particulate matter, microorga-nism and glutaraldehyde in the cleaning and disinfection endoscope room showed a downward trend after 2 hours ventilation, differences between group A and B before and after 2 hours of ventilation were statistically significant (P < 0.05). At 0 hour of initial working state of cleaning and disinfection room, contents of particulate matter, microorganism and glutaraldehyde in air among three groups were not significantly different (all P>0.05). After continuous ventilation for 1, 2, 4 and 6 hours, contents of particulate matter, microorganism and glutaraldehyde in air among all groups and between any two groups were significantly different (all P < 0.01), group A was lower than group B and C, and group B was lower than group C. In group A, contents of particulate matter, microorganism and glutaraldehyde in dynamic environment was low and the fluctuation range was small, and content of particulate matter reached the specified range of class 1 million clean room. Contents of glutaraldehyde in group B and C exceeded the maximum safe exposure limit of 0.175 mg/m³ at 1, 2 and 4 hours of continuous ventilation, content of gluta- raldehyde in group C still exceeded the maximum safe exposure limit during the lunch break of 4-6 hours. Conclusion Among three ventilation modes, axial flow cabinet mechanical ventilation mode can most effectively purify the aerosol in air of digestive endoscope cleaning and disinfection room, and it is recommended to introduce axial flow cabinet ventilation mode to ensure the occupational safety of staff.