公共场所卫生状况依法监管三十二年成效的分析与思考

Analysis and thinking on the effectiveness of legal supervision of the health status in public places in the past 32 years

目的了解自1987年《公共场所卫生管理条例》颁布实施以来我国公共场所卫生状况的变化,分析公共场所卫生监督管理中可能存在的问题,并提出相应的解决方案。方法采用计算机在各文献平台检索期限为1987年1月—2018年12月之间的以"公共场所"、"卫生状况"和相应的英语表达"公共建筑"作为搜索词的文献。结果选文涉及层面较广泛,通过纳入和排除标准的筛选,最终纳入文献107篇,文献反映了全国22个省市的公共场所的卫生状况,数据覆盖2711家公共场所。将入选的研究数据按照采样年份进行分层评价,从1987—2019年,办理公共场所卫生许可证率由67.58%(95%CI:61.58%73.82%)波动上升至89.33%(95%CI:74.91%96.33%),从事公共场所经营活动的人员持健康证率由71.57%(95%CI:62.34%82.35%)上升至92.85%(95%CI:86.27%97.16%)。公共场所和向顾客提供空气质量的比率由51.20%(95%CI:44.25%62.11%)上升至87.54%(95%CI:83.29%92.83%),出现公共场所卫生突发事件的概率由9.53%(95%CI:7.8211.33%)下降至5.76%(95%CI:4.37%7.58%)。结论目前,公共场所持照率较高,卫生状况较好,自1987年以来每年公共场所的卫生状况都有不同程度的改善,但也存在着一些不容忽视的问题。建议进一步修订公共场所卫生监督相关法律,增强卫生监督员业务水平;加强量化评级制度宣传,发动社会监督力量;提升执业者卫生健康意识,保障消费者身心健康。

Objective To understand the changes in the health status of public places in China since the promulgation and implementation of the Regulations on Health Management of Public Places in 1987,analyze the possible problems existing in the supervision and management of public places,and propose the corresponding solutions.Methods Computers were used to search documents on various literature platforms whose term was between January 1987 and December 2018 with"public places","health conditions"and the corresponding English expression"public buildings"as search terms.Results The papers covered a wide range of topics.Through the selection of inclusion and exclusion criteria,107 documents were finally included.The documents reflected the sanitation status of public places in 22 provinces and cities across the country,and the data covered 2711 public places.The selected research data was evaluated in a stratified manner according to the sampling year.From 1987 to 2019,the rate of obtaining health permits in public places increased from 67.58%(95%CI:61.58%-73.82%)to 89.33%(95%CI:74.91%-96.33%).The health certificate holding rate of people engaged in business activities in public places rose from 71.57%(95%CI:62.34%-82.35%)to 92.85%(95%CI:86.27%-97.16%).The rate of maintaining air quality in public places and providing the test report to customer increased from 51.20%(95%CI:44.25%-62.11%)to 87.54%(95%CI:83.29%-92.83%).The probability of occurrence of public health emergencies decreased from 9.53%(95%CI:7.82%-11.33%)to 5.76%(95%CI:4.37%-7.58%).Conclusion At present,the license rate in public places is relatively high,and the health status is better.Since 1987,the health status of public places has improved to varying degrees every year,but there are also some problems that cannot be ignored.It is recommended to further revise the laws related to health supervision in public places to enhance the professional level of health inspectors,strengthen the publicity of the quantitative rating system to mobilize social supervision forces,enhance the health awareness of practitioners and protect consumers’physical and mental health.