Pollution levels and characteristics of phthalate esters in indoor air in hospitals

The concentrations of phthalate esters(PAEs) in Chinese hospitals were investigated by simultaneously determining concentrations of gas- and particle-phase PAEs. PAEs were detected in two third-class first-grade hospitals, two second-class first-grade hospitals, and a community health service center. Hospital drugstores had the highest concentration(24.19 μg/m3), which was 1.54 times that of newly decorated houses. The second highest concentration was found in the transfusion rooms, averaging 21.89 μg/m3; this was followed by the concentrations of PAEs in the nurse's workstations, the wards, and the doctor's offices, with mean concentrations of 20.66, 20.0, and 16.92 μg/m3, respectively. The lowest concentrations were found in the hallways(16.30 μg/m3). Of the six different kinds of PAEs found, major pollutants included diethyl phthalates, dibutyl phthalates, butylbenzyl phthalates and di(2-ethylhexyl) phthalates, comprising more than 80% of all PAEs present.Meanwhile, a comparison between different wards showed that PAE concentrations in the maternity wards were 1.63 times higher than in the main wards. Based on known health hazards, our results suggest that the PAEs seriously influence the health of the pregnant women and babies; therefore, it is of great importance to take the phthalate concentrations in hospitals into consideration. In addition, hospital indoor air was more seriously contaminated than the air of newly decorated houses.     

Determination of anti-anxiety and anti-epileptic drugs in hospital effluent and a preliminary risk assessment

In this study, an analytical methodology was developed for the determination of psycho-active drugs in the treated effluent of the University Hospital at the Federal University of Santa Maria, RS – Brazil. Samples were collected from point A (Emergency) and point B (General effluent). The adopted methodology included a pre-concentration procedure involving the use of solid phase extraction and determination by liquid chromatography coupled to mass spectrometry. The limit of detection for bromazepam and lorazepam was 4.9 ± 1.0 ng L⁻¹ and, for carbamazepine, clonazepam and diazepam was 6.1 ± 1.5 ng L⁻¹. The limit of quantification was 30.0 ± 1.1 ng L⁻¹, for bromazepam, clonazepam and lorazepam; for carbamazepine was 50.0 ± 1.8 ng L⁻¹ and was 40.0 ± 1.0 ng L⁻¹ for diazepam. The mean concentrations in the Emergency and General effluent treated currents were as follows: for bromazepam, 195 ± 6 ng L⁻¹ and 137 ± 7 ng L⁻¹; for carbamazepine, 590 ± 6 ng L⁻¹ and 461 ± 10 ng L⁻¹; for diazepam, 645 ± 1 ng L⁻¹ and 571 ± 10 ng L⁻¹; for lorazepam, 96 ± 7 ng L⁻¹ and 42 ± 4 ng L⁻¹; and for clonazepam, 134 ± 10 ng L⁻¹ and 57 ± 10 ng L⁻¹. A preliminary risk assessment was conducted: carbamazepine and diazepam require considerable attention owing to their environmental toxicity. The occurrence of these psychoactive-drugs and the environmental risks that they pose demonstrated the need for a more efficient treatment system. As far we are aware, there have been no comparable studies to this on the hazards of hospital effluents in Brazil, and very few that have carried out a risk assessment of psycho-active drugs in hospital effluent in general.     

Users' views of hospital environmental quality: Validation of the Perceived Hospital Environment Quality Indicators (PHEQIs)

Environmental Quality Perception (EQP) is an important construct used to help to understand the relationship between people and the hospital environment. From a patient-centered care perspective, it is important that hospital design take into account the patients' (and other users') point of view. This paper presents the adaptation and validation of a measure of hospital EQP, the Perceived Hospital Environment Quality Indicators (PHEQIs; Fornara, Bonaiuto, & Bonnes, 2006), and seeks to confirm the factor structure of this construct in a different cultural context. Three scales, two focusing on physical environments and one evaluating the social environment, were completed by 562 users of four orthopedic units in Portuguese hospitals, two older and two recently built or renovated. To assess criterion validity, hospital physical environments were also objectively evaluated by two architects. Using a confirmatory factor analysis the three validation procedures produced acceptable fit indices in the final measurement models. Overall reliability values were satisfactory, as was the evidence for criterion validity. PHEQIs scales and factors correlated with global evaluation of the environment, supporting concurrent criterion validity; and predictive criterion validity was demonstrated given that users of older and newer hospitals differed significantly on the perception of quality of hospital EQP, and that high congruence between users' and experts' evaluations was found. Discriminant construct validity was supported, and some difficulties in showing convergent validity are discussed in terms of item formulation adequacy. Implications for research and practice are described.     

利用二氧化氯复合消毒剂处理医院污水

在实验研究基础上,成功利用二氧化氯复合消毒剂处理医院污水。处理结果证明该工艺具有处理效果好、运行稳定、费用低、可操作性强等优点。     

Stabilization and utilization of hospital waste as road and asphalt aggregate

This article reports the operational results of the effective utilization of hospital waste molten slag produced using a high-temperature melting system, and being operated at a hospital in Selangor, Malaysia. The hospital waste is incinerated and subsequently melted at 1200°C. Scanning election microscope (SEM)/EDX results showed that the slag produced after melting contained amounts of SiO₂, CaO, and Al₂O₃ in excess of 53%, 9%, and 16%, respectively. The results from a leaching analysis on the slag produced proved that the melting process had successfully stabilized the heavy metals. The use of this slag as an alternative material to replace conventional aggregates for road construction was studied. The results from aggregate and asphalt mix tests showed that the slag produced fulfills all the requirements of an alternative aggregate. The average asphalt content, or the optimum asphalt content to be mixed with hospital waste molten slag, was found to be about 5.53%.     

医院安全保障中的技术因素

医院安全保障体系的技术构成包括安全的诊疗救护技术、后勤供养技术和安全保卫技术。其技术特点是以人为本 ,服务健康 ,应急性强 ,发展迅速 ,互相影响。本文提出了医院安全保障体系改革的构想和建立医院安全保障体系中应考虑的技术因素。     

医院传染病污水处理技术探讨

以杭州市第六人民医院的污水处理设施为例，阐述了医院传染病污水处理技术的基本思路，并进而探讨了其消毒参数选择和处理的经济性，总结了还存在的问题及解决途径。     

阳极材料对医院污水电化学消毒处理效果的研究

分析了三维电极法处理医院污水的影响因素，探讨了阳极材料、电流密度．水力停留时间、空气流量、极水比等因素对消毒效果的影响，确定在不加化学药剂、不影响水质和低耗能条件下电化学消毒试验的最佳使用条件。结果表明，在用涂有贵金属（钌、铂、铱）氧化物的钛板作阳极，不锈钢板作阴极，电流密度为6mA／cm^2、水力停留时间为15min、空气流量为40L／h、极水比为1．0的试验条件下，消毒后污水中总大肠菌群数〈500CFU／L。电化学法消毒处理医院污水方法简单有效、运行费用低，无二次污染．处理后的污水达到国家一级排放标准（GB8978—1996）。     

加强乡镇医院污水排放的环境监督管理

以镇江市医院为例，分析了医院污水的排放和净化处理现状，提出了治理医院污水的对策措施。     

Using data linkage to assess the impact of motorized recreational vehicle-related injuries in Ohio

Problem

Motorized recreational vehicle (MRV)-related injuries can result in severe medical and financial consequences. The objective of this study was to describe the epidemiology, and clinical and financial impact of MRV-related injuries in Ohio.

Method

Probabilistically linked statewide Emergency Medical Services (EMS) and hospital (inpatient and emergency department) data for 2003 and 2004 were examined. Record pairs with a MRV-related E-code (E821-E823, E825) were included in this study.

Results

There were 2,893 patients with MRV-related injuries, who had linked EMS and hospital records, resulting in more than $15 million in hospital charges and 1,921 inpatient days of hospitalization. The male-to-female ratio was nearly 4:1, and 19% were younger than 16. Almost 82% of cases were not wearing a helmet; there was a trend of decreasing helmet use with increasing age. Mean (SE) inpatient hospital charges and length of stay (LOS) were $22,218 ($1,290) and 3.8 (0.2) days, respectively. The mean (SE) Injury Severity Score (ISS) for inpatients was 9.2 (0.4). Individuals injured on a street/highway were 3.20 times more likely to sustain an ISS ≥ 16 (95% CI: 1.03, 9.88; p = 0.044) and 3.05 times more likely to sustain a traumatic brain injury (TBI) (95% CI: 1.17, 7.94; p = 0.024) than those who were injured at a place designated for sport or recreation. Children aged 12 to 15 and young adults aged 16 to 25 were 2.47 and 2.14 times more likely, respectively, to sustain a TBI than adults aged 36 or older (aged 12 to 15: 95% CI: 1.13, 5.38; p = 0.024; aged 16 to 25: 95% CI: 1.26, 3.64; p = 0.005). Higher ISS was associated with both higher total charges (p < 0.001) and longer LOS (p < 0.001).

Discussion

This study demonstrates that MRV-related injuries are an important public health problem in Ohio, with a substantial clinical and financial impact.

Impact on Industry

Enactment and enforcement of statewide MRV safety legislation and training of MRV users offer valuable opportunities to prevent these costly injuries.