中毒现场卫生应急人员个体防护评价研究

发布时间：2018-04-21 09:58

  本文选题：中毒现场 + 应急救援　； 参考：《中国疾病预防控制中心》2012年硕士论文

【摘要】：研究背景： 个体防护是预防危害、保护人员健康与安全的重要措施和最后防线。突发事件应急专项条例和预案中明确卫生部门在应急救援中承担相应的职责和任务,要求进入现场参与医疗卫生救援的人员,要了解各类防护装备的性能和局限性,根据毒物种类及危害水平选择适宜的个体防护装备,在没有适当个体防护的情况下不得进入现场工作。近年来国内外多次发生救援人员在化学事故实施救援过程中发生中毒的报道。个体防护关系到救援人员自身安全和执行任务的总体效率,越来越受到重视。个体防护装备对生理健康影响及使用安全性、可接受性以及佩戴的舒适性等是其综合质量特性的体现。 研究目的： 救援人员穿戴个体防护装备在现场作业时,防护装备的配备对人员作业能力的影响非常突出,也是国内外评价实践活动的关键点。本研究结合中毒事件疾控卫生应急人员现场工作实际,通过实验室和现场模拟试验探讨人体生理影响和实用性,探讨典型个体防护装备对中毒现场卫生应急人员人体生理影响及对作业的限制,指导专业人员正确选择、使用适合现场的个体防护装备,为制定我国卫生应急人员个体防护储备、使用等技术方案提供依据,提升我国卫生应急救援水平。 研究方法： 参考GJB3664-1999个人防护器材生理评价的实验方法及步骤,测试穿着进口和国产A、C级两类个体防护装备的受试者在设定常温常湿及高温高湿作业环境实验室,呼吸、体温、心率等相关生理指标。 参考GB/T23465-2009呼吸防护用品实用性评价的实验方法,专家评分法对各项指标进行权重,结合受试者现场模拟中毒事件应急现场工作对个体防护装备的实用性评分结果,采用综合法评价进口和国产A、C级两类个体防护装备的实用性。 结果： 高温高湿的现场作业时,穿戴进口A级防护装备体热积蓄(133.40±21.53W)低于国产防护装备(137.79±25.82W),差异无显著性(t0.05(5)=2.571)。 穿戴A级防护装备在高温高湿环境中的摄氧量约为17.2ml/(min-kg),穿戴C级防护装备后高温高湿环境下摄氧量约为13.7ml/(min-kg)。 专家评分权重反映出实际工作中更重视防护装备安全性相关指标,A级防护装备在安全性内容中重要性居前三位分别是呼吸、报警装置和视觉,C级防护装备在安全性指标中重要性居前三位分别是面具各零部件稳固性、呼吸和视觉,在使用方便内容里将穿防护服便利性排在首位。 现场模拟试验过程中,穿着进口A级、国产A级、进口C级、国产C级防护装备人员的最大心率均值分别为：158次/min、157次/min、143次/min、145次/min。 国产A级防护装备实用性评分74.93±10.88,进口A级防护装备实用性评分79.78±5.81,但两类装备评分差别无统计学意义(P=0.063)。头部活动自由度、低头转动的自由度和下肢活动自由度进口装备优于国产装备,且具有统计学意义(P=0.034,P=0.011,P=0.030)。进口A级个体防护装备非安全性相关内容评分高于国产装备,具有统计学意义(P=0.048)。 国产C级防护装备评分(80.65-4-9.38)分,进口C级防护装备评分(86.40±9.92)分,两类装备评分差异有统计学意义(P=0.00099)。安全性相关内容评分分值最高的为稳固性,最低的为调节装置。进口装备安全性评分及非安全性评分均高于国产装备,有统计学意义(P=0.005,P=0.048)。 结论： 高温高湿的作业环境穿着A级防护装备,至警报器报警时受试者的热应激已达到危险限值,应急救援人员在工作时间尽量控制到30min以内为宜。 常温舒适的作业环境穿着C级防护装备,工作时间控制到60min以内为宜,高温高湿环境中穿着C级防护服工作时,工作时间控制到40min以内。 降温背心对于人体的体热蓄积非但没有改善,反而增加,不适用于高温高湿穿戴A级防护装备作业。 卫生应急救援时更重视防护装备的安全性,A级防护状态下现场模拟执行应急任务虽然为重度体力劳动,但受试人员能够在规定时间内能完成整套工作任务,A级防护装备的实用性基本能满足卫生应急现场工作需要。 为适应现场工作需要,迫切需要提升应急救援人员的通讯能力和通话效果,可采用无线操作。通过改良个体防护设计、材质等,提升防护装备的舒适性,减少对现场应急工作的限制。加强应急救援人员的防护培训,提高防护装备的实用性。深入开展对应急救援人员健康监护的研究。
[Abstract]:Research background:
Individual protection is an important measure to protect the health and safety of the personnel and the final defense line. In the special regulations and plans for emergency emergency, the health department assumes the corresponding duties and tasks in the emergency rescue, and requires the personnel involved in the field to participate in the medical and health rescue, to understand the performance and limitations of all kinds of protective equipment. According to the species of poison and the level of harm, the appropriate individual protective equipment should be selected, and no proper individual protection should be used. In recent years, reports of poisoning occurred in the process of rescue workers in the process of chemical accidents. Individual protection relates to the overall safety of rescue personnel and the overall implementation of the task. Efficiency is becoming more and more important. The effects of individual protective equipment on physical health, safety, acceptability, and comfort are the embodiment of its comprehensive quality.
The purpose of the study is:
When the rescue workers wear the individual protective equipment in the field operation, the effect of the equipment is very prominent, and it is also the key point to evaluate the practical activities at home and abroad. It is practical to discuss the physiological effects of the typical individual protective equipment on the body physiology of the health emergency personnel in the poisoning scene and the restrictions on the operation, to guide the professional personnel to choose correctly, to use the individual protective equipment suitable for the field, to provide the basis for the formulation of the individual protective reserve and the use of the health emergency personnel in our country, and to improve the emergency medical emergency in China. Aid level.
Research methods:
With reference to the experimental methods and steps of the GJB3664-1999 personal protective equipment physiological evaluation, the subjects of two types of individual protective equipment wearing imported and domestically made A and C class were tested for the physiological indexes such as breathing, body temperature, heart rate and so on in the Environment Laboratory of normal temperature and high temperature and high humidity and high humidity.
According to the experimental method of the practical evaluation of GB/T23465-2009 respirator, the expert scoring method is used to weigh all the indexes, and the practicability of the two types of individual protective equipment of the imported and national A and the C class is evaluated by combining the results of the field work of the subjects to simulate the practical score of the individual protective equipment.
Result锛，

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