医疗废物焚烧过程脱硫机理和试验

医疗废物中包括含有硫分的橡胶,焚烧时会产生SO2从而污染环境,因此医疗废物在焚烧处理时需要进行脱硫。应用HSC热力学软件计算可知,医疗废物焚烧炉内喷入脱硫剂在燃烧过程脱硫,脱硫效果最好的脱硫剂是CaO,然后是Ca(OH)2,CaCO3。综合各种因素,选用CaCO3做脱硫剂进行焚烧过程脱硫试验。试验结果表明:温度对脱硫有着重要的影响,最佳脱硫温度为830～870℃左右;随着Ca/S摩尔比的增大脱硫率增大,但增加的速度却趋于平缓,所得最佳Ca/S摩尔比为2.5。     

Social and hospital costs of patients admitted to a university hospital in Brazil due to motorcycle crashes

Objective: This study aimed to investigate the social and hospital costs of patients treated at a public hospital who were motorcycle crash victims.

Method: This prospective study was on 68 motorcycle riders (drivers or passengers), who were followed up from hospital admission to 6 months after the crash. A questionnaire covering quantitative and qualitative questions was administered.

Results: Motorcycle crash victims were responsible for 12% of the institution's hospital admissions; 54.4% were young (18–28 years of age); 92.6% were the drivers; 91.2% were male; and 50% used their motorcycles as daily means of transportation. Six months afterward, 94.1% needed help from someone; 83.8% had changed their family dynamics; and 73.5% had not returned to their professional activities. Among the injuries, 94.7% had some type of fracture, of which 53.5% were exposed fractures; 35.3% presented temporary sequelae; and 32.4% presented permanent sequelae. They used the surgical center 2.53 times on average, with a mean hospital stay of 18 days. The per capita hospital cost of these victims’ treatment was US$17,481.50.

Conclusion: The social and hospital costs were high, relative to the characteristics of a public institution. Temporary or permanent disability caused changes to family dynamics, as shown by the high numbers of patients who were still away from their professional activities more than 6 months afterward.     

Understanding traffic crash under-reporting: Linking police and medical records to individual and crash characteristics

Objective: This study aligns to the body of research dedicated to estimating the underreporting of road crash injuries and adds the perspective of understanding individual and crash factors contributing to the decision to report a crash to the police, the hospital, or both.

Method: This study focuses on road crash injuries that occurred in the province of Funen, Denmark, between 2003 and 2007 and were registered in the police, the hospital, or both authorities. Underreporting rates are computed with the capture–recapture method, and the probability for road crash injuries in police records to appear in hospital records (and vice versa) is estimated with joint binary logit models.

Results: The capture–recapture analysis shows high underreporting rates of road crash injuries in Denmark and the growth of underreporting not only with the decrease in injury severity but also with the involvement of cyclists (reporting rates of about 14% for serious injuries and 7% for slight injuries) and motorcyclists (reporting rates of about 35% for serious injuries and 10% for slight injuries). Model estimates show that the likelihood of appearing in both data sets is positively related to helmet and seat belt use, number of motor vehicles involved, alcohol involvement, higher speed limit, and females being injured.

Conclusions: This study adds significantly to the literature about underreporting by recognizing that understanding the heterogeneity in the reporting rate of road crashes may lead to devising policy measures aimed at increasing the reporting rate by targeting specific road user groups (e.g., males, young road users) or specific situational factors (e.g., slight injuries, arm injuries, leg injuries, weekend).     

医疗垃圾焚烧飞灰重金属形态分析

利用原子吸收光谱仪分别对医疗垃圾焚烧飞灰重金属含量和重金属形态及其随颗粒度分布特性进行了分析,结果表明,飞灰中Cd、Zn、Pb等的浸出浓度远超标与这些重金属的可交换态和碳酸盐态含量较高有关;飞灰颗粒度主要在96 μm以下,96～150 μm的颗粒中Cd、Pb含量最高,且Zn、Cd的形态以可交换态为主.     

基于环境保护理念的医院废弃物管理研究

针对环境保护理念的医院废弃物管理研究,介绍了环境保护理念的对象与方法,主要包括:调查对象、调查内容,主要是医院人员管理和废弃物管理,利用统计学方法进行探讨,讨论了医务管理人员对医疗废弃物的认知原因,探讨了不同岗位的认知情况、不同年龄的认知情况和不同科室的认知情况,最后提出建议,主要是提高医疗废弃物管理相关法律法规、建立有效的组织系统、加强对医务人员的培训和加大医疗废弃物处理设施,促进医院的发展.     

空调病房真菌气溶胶浓度及粒径分布特征

医院室内空气真菌污染会影响医护人员、病人及陪护人员的健康,其影响程度不仅与空气真菌的种类和浓度有关,还与真菌气溶胶粒径及分布特征有关,不同粒径的真菌气溶胶影响人体健康的作用机制不同.本研究对重庆某综合医院的普通病房进行空气真菌取样,系统分析了病房空气真菌浓度、种属及粒径分布特征.通过分析实验数据,发现病房空气真菌浓度与病人患病类型及人员密度无关,主要影响因素为温湿度与季节变化.冬夏各科室病房真菌粒径分布特征大致呈正态分布,粒径的百分比从Ⅰ级~Ⅲ级各级所占比例逐渐增大,Ⅲ级~Ⅴ级所占比例总体最大,Ⅴ级~Ⅵ级所占比例逐渐降低.冬夏不同科室病房的空气真菌孢子中值直径没有显著差异,真菌孢子的中值直径小于3.19μm.病房冬夏优势菌属基本相同,主要为青霉属、曲霉属及交链孢霉属,与其它建筑相比并无显著性差异.因此,病房空调系统设计应提高对粒径为1.1~4.7μm真菌孢子的过滤效率,病房的日常卫生维护与空调系统运行管理时应有针对性地选择适宜的抑菌除菌方法和设备.     

Risk factors in urban road traffic accidents

INTRODUCTION: The urban road traffic accident (RTA) risks for the city of Zagreb, Croatia, from 1999 through 2000 were analyzed with the aim of reducing the increasing injury incidence. METHOD: Simple and bivariate analysis using chi(2), odds ratio, and confidence interval of 95% was used to determine risks in three outcome groups: killed, severely, and mildly injured. RESULTS: There were 528 RTA victims consisting of 260 severely, 213 mildly injured, and 55 killed at the scene of an accident and during transportation. More fatal accidents occurred during night hours (OR=3.78; 95% CI, 2.08-6.85), on urban road links (OR=2.33; 95% CI, 1.30-4.19), and at exceeding speed limit (OR=2.56; 95% CI, 1.43-4.61). More people were injured than killed on urban junctions (OR=5.27; 95% CI, 2.21-12.57). The highest combined risk of dying or being severely injured was found in males, driving at excessive speed, on urban links, and during bad visibility (OR=16.15; 95% CI, 3.901-66.881). CONCLUSION: These results will influence the urban traffic police enforcement measures, which will change inappropriate behavior of drivers and protect the least experienced road users.     

Balance the Paradox between Limited Health Resources and Growing Demands for Medical Services

Health institutions in the People＇s Republic of China are under considerable challenge. Innovations in management systems may support the challenge to increase both efficiency and effectiveness. The balanced scorecard （BSC） is one such innovation. We have used a model to explore the factors that may impact the diffusion of the BSC in Chinese government hospitals. In particular, we concentrate on three factors - the outer context, the nature of the innovation and the communication and influence. The outer context and the nature of the innovation do provide an inducement to implement a BSC. The strength of the communication and influence may affect the level of take-up. However, we recognise that they may choose ＂the BSC not for any apparent technical excellence but for the legitimation that Western management practices may bring to local managers.     

综合性医院建设项目环境影响评价要点分析

综合性医院的医疗废水要分一般废水和特殊废水，在坚持全过程控制原则、减量化原则、就地处理等原则的同时，根据需要进行一级处理和二级处理；按要求将医疗垃圾分类、包装、存放、处理；对水处理污泥应按危险废物进行处理。建设项目的水环境影响评价应进行详细的预测评价、一般专项评价或一般性分析；在医疗废物处理设施的环境影响评价中，医疗废物焚烧应作为评价重点，做到社会效益、环境效益和经济效益相统一。     

An earthquake disaster in Turkey: an overview of the experience of the Israeli Defence Forces Field Hospital in Adapazari

On 17 August 1999 at 3:04 a.m., an earthquake of 7.4 magnitude (Richter scale) struck the Marmara region in Turkey. The city of Adapazari suffered 2,680 fatalities with approximately 5,300 injured. The Israeli Defence Forces (IDF) field hospital arrived at Adapazari, on day four after the quake. The team consisted of 102 personnel. The field hospital acted as a secondary referral centre. A total of 1,205 patients were treated in the field hospital between day four and day 14 of the earthquake. The frequency distribution of the medical problems seen in the field hospital was 32 per cent internal medicine, 13 per cent general surgery including plastic, 21 per cent orthopaedic surgery, 23 per cent paediatric disease, 10 per cent obstetrics and gynaecology and 1 per cent major psychiatric disorders. A mean number of 35 patients per day were hospitalised in the field hospital for between 24 hours to one week. The rapid establishment of the field hospital enabled the local medical facilities to 'buy time' in order to organise and restore surgical and hospitalisation abilities in this disastrous situation.