严重急性呼吸综合征爆发的大气环境和院内感染的职业卫生因素

Effect of environment and occupational hygiene factors of hospital infection on SARS outbreak

目的 探讨大气环境和医院职业卫生因素对非典型肺炎爆发的影响。方法 (1)对全球 9个城市 (广州、北京、天津、太原、香港、台北、新加坡、多伦多和河内 ) 2 0 0 3年严重急性呼吸综合征(SARS)爆发前后的气象参数进行分析 ;(2 )从职业卫生的角度分析医院院内感染的原因。结果 (1)大多数城市在SARS爆发前后 ,都出现气温、气压和气温日较差的大幅波动 ,风力微弱。在疫情最严重的城市 ,SARS爆发前大气悬浮物增多。各地SARS爆发前 10d的平均气温为 16 .6℃± 7.6℃ ,提示目前被认为造成SARS的冠状病毒可能在 9℃～ 2 4℃之间最活跃 ;(2 )医院的职业卫生是SARS爆发的重要社会行为因素 ,医院院内感染与职业卫生各个环节有密切关系。结论 冬春季节气温急剧变化、大气悬浮物增多和医院不良的职业卫生条件是SARS爆发的重要触发因素。加强天气变化和大气污染的预警 ,完善医院的职业卫生管理 ,对预防SARS爆发和季节性重现具有重大意义。

Objective To study the effects of weather conditions and occupational hygiene on SARS outbreak. Method (1)Meteorological parameters around SARS outbreaks in 2003 in 9 cities(Guangzhou,Beijing,Tianjin,Taiyuan,Hong Kong,Taipei,Singapore,Toronto and Hanoi) were analyzed;(2)Causes of hospital infection were also analyzed from an occupational hygiene point of view. Results (1)The amplitude of air temperature,air pressure and diurnal temperature difference were greater around SARS outbreaks in most of the cities.Higher airborne particles concentration and lower wind speed were measured prior to SARS outbreaks in the cities with the most serious epidemic situation.The ten-day mean value of air temperature before SARS outbreaks in 9 cities was 16.6 ℃±7.6 ℃,suggesting that coronary virus infection,which has been considered to cause SARS by now,may be most active at 9 ℃-24 ℃.(2)Occupational hygiene in hospital proved to be an important socio-behavior factor for SARS outbreak.All hospital infection could be attributed to defects in the key links of occupational hygiene. Conclusions Greater fluctuations of air temperature and higher airborne particles concentration in winter and spring,as well as poor occupational hygiene conditions are significant promoters of SARS outbreak.Warning of atmospheric conditions favorable to SARS,and improvement in occupational hygiene management is the key to prevention from SARS outbreak.