上海市医院口腔综合诊疗台水污染状况

Contamination of Dental Unit Waterlines in Shanghai Hospitals

[目的]了解上海市医院口腔综合诊疗台水污染现况,为公共卫生干预提供数据支持。[方法]2014年8—11月期间在全市选取189家具口腔诊疗资质的医院,采用现场采样的方式采集到2 330份口腔综合诊疗台水路各类水样,并检测其中细菌菌落总数、铜绿假单胞菌和嗜肺军团菌等指标;同时通过问卷调查收集相关基础资料,分析口腔水路污染的影响因素。[结果]口腔综合诊疗台水源水、储水罐水、漱口水、冲洗水和手机喷水的合格率分别为84.1%(318/378)、53.7%(151/281)、69.5%(387/557)、67.9%(378/557)、53.1%(296/557),其中检出3株铜绿假单胞菌和6株嗜肺军团菌。采用独立水源水、过滤式自来水、自制蒸馏水及其他类型供水方式时的水源水合格率分别为84.6%(22/26)、74.8%(77/103)、100.0%(3/3)、98.4%(61/62)。无附加管道净化处理的水样合格率为64.1%(1 356/2 115);使用滤膜过滤的水样合格率为76.7%(23/30);采用化学消毒剂处理的水样合格率为81.6%(151/185)。手机喷水在悬挂和倾斜放置时的合格率分别为58.7%(212/361)和42.9%(84/196)。[结论]上海市医院口腔综合诊疗台水路污染情况普遍。建议医院加强水源水控制力度,并对诊疗台水路进行及时有效的消毒处理。

[Objective] To investigate the contamination status of dental unit waterlines（DUWLs） in Shanghai hospitals, and to provide data support for public health intervention. [Methods] A total of 2 330 water samples were collected on site from DUWLs in 189 hospitals with dental practice license from August to November 2014 to detect total bacteria counts, Pseudomonas aeruginosa, and Legionella. Basic information were collected by questionnaire and the risk factors of contamination of DUWLs were analyzed. [Results] The qualification rates of source water, storage tank water, gargle water, oral washing water, and dental hand-piece water were 84.1%（318/378）, 53.7%（151/281）, 69.5%（387/557）, 67.9%（378/557）, and 53.1%（296/557）, respectively. Three strains of Pseudomonas aeruginosa and six strains of Legionella were detected. The qualification rates of source water by supply of independent source water, filtered tap water, homemade distilled water, and others were 84.6%（22/26）, 74.8%（77/103）, 100.0%（3/3）, and 98.4%（61/62）, respectively. The qualification rates of non-purified, filter-membrane treated, and chemically disinfected water samples were 64.1%（1 356/2 115）, 76.7%（23/30）, and 81.6%（151/185）, respectively. The qualification rate of dental hand-piece placed hanging [58.7%（212/361）] was higher than that inclining [42.9%（84/196）]. [Conclusion] DUWLs contamination is common in Shanghai hospitals. Quality control of source water should be strengthened and DUWLs should be disinfected promptly and effectively.