上海市部分地区针灸医护人员艾烟暴露现状及影响因素分析

Analysis of the current situation of moxa smoke exposure and influencing factors in acupuncture-moxibustion medical workers in some regions of Shanghai

目的了解上海市部分地区针灸医护人员接触艾烟后出现的健康问题及所具备的职业卫生防护措施,探索针灸医护人员接触艾烟后出现的健康问题与各影响因素的关联。方法自制针灸医护人员健康问题与艾烟暴露关系调查表,采用自填问卷法对针灸医护人员进行调查,运用Logistic回归模型分析影响针灸医护人员发生眼部或呼吸系统不适症状的因素。结果共收回99份有效问卷。针灸医护人员中出现眼干涩发痒有60.6%,眼部刺激有57.6%,咽喉干燥发痒有55.6%,鼻干鼻痒喷嚏有52.5%。Logistic回归分析结果显示,高艾烟浓度是眼干涩发痒、眼部刺激、鼻干鼻痒喷嚏、咽喉干燥发痒、咽喉痛、咳嗽和胸闷气短的危险因素(P<0.05);相对于诊室面积仅20 m^(2)以下,诊室面积为21~30 m^(2)是眼部刺激、流泪和咳嗽的保护因素;诊室面积大于30 m^(2)是流泪、咽喉干燥发痒、咳痰和胸闷气短的保护因素(P<0.05);相对于1次诊疗通风时间不足60 min,1次诊疗通风时间大于60 min是眼干涩发痒、鼻干鼻痒喷嚏、咽喉干燥发痒和咳嗽的保护因素(P<0.05)。结论针灸医护人员接触艾烟后24 h内的眼部不适和呼吸系统不适症状与艾烟浓度、诊室面积和通风时间有关,医院管理层在对医护人员的职业健康进行管理时应该重点关注这些影响因素,采取针对性措施更有效地保护医护人员的健康。

Objective To understand the health concerns and occupational health protection measures of acupuncture-moxibustion healthcare workers in several areas of Shanghai exposed to moxa smoke and explore the association between these health issues and influencing factors.Method A self-developed and self-administered questionnaire on the association between the health issues of acupuncture-moxibustion healthcare workers and moxa smoke exposure was used for the investigation.The logistic regression analysis was used to analyze the factors affecting eye or respiratory discomforts in acupuncture-moxibustion healthcare workers.Result A total of 99 valid questionnaires were returned.Among the acupuncture-moxibustion healthcare workers,60.6%reported dry itching eyes,57.6%reported eye irritation,55.6%reported dry itching throat,and 52.5%had dry itching nose and sneezing.The logistic regression analysis showed that a high moxa smoke concentration was the risk factor for dry itching eyes,eye irritation,dry itching nose and sneezing,dry itching throat,sore throat,cough,and chest tightness and shortness of breath(P<0.05).Compared with a room of≤20 m^(2),a room of 21-30 m^(2)was a protective factor for eye irritation,tears,and cough;a room of>30 m^(2)was a protective factor for tears,dry itching throat,expectoration,and chest tightness and shortness of breath(P<0.05).Compared with a treatment session with a continuous ventilation time of less than 60 min,a continuous ventilation time of longer than 60 min was a protective factor for dry itching eyes,dryitching nose and sneezing,dry itching throat,and cough(P<0.05).Conclusion The eye and respiratory discomforts within 24 h after the exposure to moxa smoke in acupuncture-moxibustion healthcare workers are associated with moxa smoke concentration,treatment room size,and ventilation duration.Hospital management should focus on these influencing factors when managing the occupational health of medical staff and take targeted measures to protect the health of medical staff more effectively.