沙尘天气PM10对多种心血管疾病日门诊人数的影响

为研究沙尘天气大气可吸入颗粒物(PM10)与心血管系统疾病每日门诊人数的联系,采用半参数广义相加泊松回归模型(GAM),在排除了混杂因素如季节趋势、日历效应、气象因素和时间长期趋势等作用的前提下,分析2004年3月1日~5月31日沙尘暴频发区——甘肃省武威市大气PM10与多种心血管疾病每日门诊相对危险度(RR)的关系.结果表明,PM10与男、女总心血管系统疾病门诊RR均在滞后第2d(lag2)的联系有统计学意义.PM10分别在lag3和lag4对男、女性风湿性心脏病门诊RR的影响有统计学意义; PM10(lag2)与男性高血压门诊RR的联系有统计学意义.PM10在lag2对男性缺血性心血管疾病门诊RR的影响有统计学意义;PM10对男、女性心律失常以及充血性心力衰竭门诊RR的影响均无统计学意义.在调整了SO2和/或NO2后,PM10对男、女性心血管系统疾病门诊RR的作用有所下降,但在统计学上仍有意义.然而在分别调整了其他污染物后,SO2和NO2变得无统计学意义.沙尘天气PM10浓度分类模型分析表明,从正常清洁天、轻度污染天到扬沙天气、沙尘暴天气,随着PM10浓度水平的增大,心血管系统疾病(缺血性心血管疾病、充血性心力衰竭、心律失常、高血压、风湿性心脏病)门诊RR也随之增高,呈现一定的剂量效应关系.沙尘天气可吸入颗粒物可引起暴露居民多种心血管系统疾病(缺血性心血管疾病、充血性心力衰竭、心律失常、高血压、风湿性心脏病)门诊人数增多,且均呈现滞后效应. PM10浓度与心血管系统疾病门诊RR表现为一定的剂量效应关系.PM10浓度与沙尘天气强度有密切关系, 随着PM10浓度与沙尘天气强度的增大,暴露居民心血管系统多种疾病日门诊RR也增大,具体为:正常清洁天＜轻度污染天＜扬沙天＜沙尘暴天.     

北京市医院候诊区空气中VOCs的污染特征

对北京市3家医院9个候诊区室内空气进行采样,样品采用预浓缩仪与GC-MS联用系统进行定量分析,共检测出65种挥发性有机物(VOCs).医院室内外VOCs的平均浓度为123.64~713.22μg/m3,其中烷烃、烯烃、芳香烃约占61%~98%.烷烃以乙烷、丙烷、正丁烷、异丁烷、异戊烷为主,占50%以上.烯烃的主要成份为乙烯、丙烯、异戊二烯,约占总烯烃的53%~83%.芳香烃以苯、甲苯、乙苯、二甲苯、苯乙烯为主,约占79%~98%.不同的候诊区芳香烃的组成差异大,病理科候诊区F的芳香烃主要来自二甲苯的贡献(58%±24%),而挂号处G和口腔科候诊区H的甲苯所占芳香烃的比例最大(34%±26%).绝大多数采样点的室内和室外VOCs浓度的比值(I/O)大于1.0,一些候诊区中芳香烃、卤代烃和环烷烃的I/O远大于1.0,表明这些污染物存在一定的室内来源.     

生物接触氧化+混凝沉淀工艺处理医院综合污水

利用生物接触氧化、混凝沉淀工艺改造原处理工艺,处理中型医院综合污水,设计能力100 m3/d,处理效果显著且稳定达标。废水进水水质ρ(COD)为408~594 mg/L、ρ(SS)为211~280 mg/L;调试稳定后,出水水质ρ(COD)为12~40 mg/L、ρ(SS)为11~18 mg/L,COD、SS去除率分别为90.2%~97.9%、91.5%~96.1%,出水水质达山东省DB37/596-2006《医疗污染物排放标准》的二级排放标准。     

医院收费危机成因及管理机制的探讨

通过分析医院收费危机的成因,应用危机管理的一般理论与方法,对医院收费出现的危机进行分析评估,调动有关资源,果断做出评判,迅速采取措施,最大限度地减少医院损失和影响．同时建立医院收费危机管理机制,使医院收费规范化、合理化,从而从危机中受益．图1,参5．     

Modelling coordination in hospital emergency departments through social network analysis

Coordination theory provides a theoretical framework for analysing complex processes of project groups working towards a common goal. In this study, we explore the relationship between coordination and social networks for the development of a network-based coordination model. This model is applied to measure the performance and quality of complex and dynamic project coordination such as in hospital emergency departments. The dataset used for the study was collected by the 2004 National Hospital Ambulatory Medical Care Survey--a national probability sample survey of visits to emergency and outpatient departments of non-Federal, short-stay and general hospitals in the United States. Using social network analysis, this study allows us to understand the possible causes of inefficient coordination performance and coordination quality resulting in access blocks.     

Percutaneous Exposure Incidents Among Australian Hospital Staff

We investigated all reported percutaneous exposure incidents (PEI) among staff from a large Australian hospital in the 3-year period, 2001-2003. There were a total of 373 PEI, of which 38.9% were needlestick injuries, 32.7% were cutaneous exposures and 28.4% sharps-related injuries. Nurses were the most commonly affected staff members, accounting for 63.5% of the total, followed by doctors (18.8%) and other staff ( 17.7%). Needlestick injuries were responsible for the majority of nurses’ PEI (44.7%). Sharps injuries constituted the major category for doctors (44.3%). Most needlestick injuries (67.6%) were caused by hollow-bore needles, while the majority of cutaneous exposures involved blood or serum (55.8%). Most sharps injures were caused by unknown devices (35.9%) or suture needles (34.9%). Overall, our investigation suggests that PEI is a considerable burden for health care workers in Australia. Further research is now required to determine the relationships, if any, between workers who suffer PEI and those who do not.     

Determining the level and cost of sickness presenteeism among hospital staff in Turkey

Objective. This study aimed to determine the associations between sickness presenteeism and socio-demographic factors, perceived health status and health complaints among hospital staff and to calculate the cost burdens and productivity losses attributed to presenteeism. Methods. A cross-sectional study was conducted using 951 hospital staff, including physicians, nurses, midwives, other health personnel and administrative staff working in two hospitals located in K?r?kkale province in Turkey. The health and work performance questionnaire developed by Kessler et al. was revised to measure sickness presenteeism. Results. After performing Student’s t test and a one-way analysis of variance, presenteeism was mostly observed in women, nurse-midwives, young employees, university health staff and health workers with low health status. Average productivity loss and cost of lost productivity per staff member were calculated as 19.92?h/TRY 315.57 for 2 weeks and 478.08?h/TRY 7573.68 for 1 year. Conclusions. The problem of sickness presenteeism is mostly observed in women and nurses. It causes both financial burdens and productivity losses for hospitals. These survey results are thus expected to provide critically important information on presenteeism for decision-makers and healthcare managers.     

Analysing workplace violence towards health care staff in public hospitals using alternative ordered response models: the case of north-eastern Turkey

The main objective of this article is to determine key factors that may have a significant effect on the verbal abuse, emotional abuse and physical assault of health care workers in north-eastern Turkey. A self-administered survey was completed by 450 health care workers in three well-established hospitals in Erzurum, Turkey. Because of the discrete and ordered nature of the dependent variable of the survey, the data were analysed using four distinctive ordered response models. Results revealed that several key variables were found to be a significant determinant of workplace violence, such as the type of health institution, occupational position, weekly working hours, weekly shift hours, number of daily patient contacts, age group of the respondents, experience in the health sector, training against workplace violence and current policies of the hospitals and the Turkish Ministry of Health.     

医院项目在环保验收监测中应关注的重点问题——以昆山宗仁卿纪念医院一期工程为例

本文依据项目竣工环保验收规范性文件、医院污水处理技术指南、医疗废物管理条例等相关规定和要求,论述了此类项目环保验收监测工作中应关注的重点问题,以及目前存在的问题及解决方案,并以工程实例进行了说明。     

医院污水处理中可吸附有机卤化物（AOX）及其毒性研究

对序批式膜生物反应器（MBR）处理前后医院污水中的AOX进行了比较,分析了c_Rt值对不同水质中AOX生成量的影响及相应的生物毒性.结果表明,序批式MBR对医院污水中AOX的去除率达到63.6％,其中膜截留占14.5％;要获得相同的c_Rt值,原污水所需的投氯量显著高于MBR出水,相应生成的AOX浓度也较高;通过曲线拟合发现,随着c_Rt的增长,医院原污水中AOX浓度呈指数增长,而MBR出水呈线性关系.以粪大肠杆菌为指示微生物,要达到医院污水微生物排放标准（GB 18466-2005）,医院原污水所需c_Rt为5.5 (mg·h)/L,而MBR出水只需c_Rt为0.007 5 (mg·h)/L,其相应的生物毒性分别为40.39 μg/L和8.96 μg/L (以K₂Cr₂O₇计),AOX浓度分别为607.1 μg/L和102.5 μg/L.