家庭一氧化碳中毒事件聚集性暴发的流行病学调查

Epidemiological Investigation on the Factors of Family Acute Carbon Monoxide Poisoning Accident

目的 研究家庭一氧化碳中毒事件聚集性发生的流行病学因素，探讨预防此类中毒事件的控制措施。方法 采用病例对照研究方法，对2006年2月14日1同一天发生的家庭一氧化碳中毒病例进行调查，并选取与病例同样使用煤炉的邻居29户67人为对照组。调查其发病及自救情况、家庭住房情况、燃煤情况等。同时了解中毒发生前后当地气压、气湿、风向情况。调查结果进行单因素logistic回归分析。结果中毒者居住区域呈散在分布，居住场所多为面积6～15m^2的一楼或者平房，通风不畅；家庭使用煤球炉，并有将其放置卧室内的习惯。聚集性事故发生当天气压低、湿度大、微风。同住人数少、采取有效自救是影响中毒程度的保护因素；救治时间晚、年龄大、中毒时所处房间居整栋房屋中间或朝北、中毒前封炉时间晚、被发现的时间晚、窗户朝西及朝北、烟囱朝西均是导致中毒程度加重的危险因素。结论家庭一氧化碳中毒聚集性发生与温湿度、风向、居住条件、房屋方位和门窗、烟囱朝向等有关。加强气象因素与中毒伤害关系研究，开展中毒监测预警、对居民进行中毒预防健康教育、改善居住环境可以控制家庭一氧化碳中毒事件的聚集性发生。

Objective To study the epidemiological factors of family carbon monoxide poisoning accident and explore the prevention and control measure for this kind of event. Method Case - control study was used to this investigation which involved poisoning and treatment, the inhabited environment, briquette furnace using and so on. Cases included the poisoned families on Feb. 14, 2006 while the controls were the neighbors who used the same coal furnace as the case family. The results were calculated by logistic regression. Meteorological condition material of the event day, including air pressure, wind velocity, wind direction, and so on were collected simultaneously. Results The cases were distributed sporadically. They were living the small house without ventilation, using the coal furnace in bedroom. It was low air pressure, high humidity and breeze in the event day. Logistic regression showed that the few people living together, taking effective selfaid were the protection factors to poisoning degree. Delayed treatment, elder, the room toward north or in center of whole house, stopping to use the coal furnace late, being found late, windows and chimney toward west or north were the risk factors to the poisoning degree. Conclusion The family carbon monoxide poisoning accident which occurred together was concemed with humidity, wind direction, the room position, the windows and chimney orientation. Researching the relationship of the poisoning and meteorological factors, carrying on the poisoning monitoring and early warning, and educating the people about the knowledge of poisoning, improving the situation of living could prevent this kind event.