醫療作業環境空氣中生物性及化學性因子暴露評估－以一大型教學醫院之調查為例

Airborne Microbial and Chemical Exposure Assessment in a Hospital Environment

吳佩芝(Pey-Chih Wu) ； 蘇慧貞(Huey-Jen Su) ； 黃金鳳(Chin-Feng Huang) ； 林佳瑩(Chia-Ying Lin) ； 李俊璋(Ching-Chang Lee)

《中華公共衛生雜誌》 17卷2期 (1998/04) Pp. 93-102

https://doi.org/10.6288/CJPH1998-17-02-03

摘要

不同環境污染物，因其特性不同及人體對其暴露時間之長短，故而所引致之健康影響亦可能有別。本研究以一使用中央空調系統之大型醫院為對象，針對院內醫療從業人員可能暴露的生物性及化學性因子進行偵測及調查，以了解其在工作環境中之成分含量及分佈，以進一步探討從業人員之暴露程度與健康影響之可能相關。
在生物性因子暴露評估上，主要以一階空氣採樣器(Andersen sampler)銜接培養皿直接採集空氣中之真菌及細菌，另外以濾紙匣銜接幫浦採樣器，採集空氣中細菌內毒素之濃度。在化學性因子評估方法上，針對本類型作業環境空氣中之乙醇、甲基異丁酮及二甲苯，以標準方法利用活性碳管採樣，再經氣相層析儀／火焰離子化分析儀(GC/FID)加以分析。此外，另以Bruel &Kjar之毒性氣體監測儀，以定點方式，監測作業環境中甲酫之含量，每30秒監測一次。
分析結果發現，空氣中生物性氣膠的濃度，以院內之洗縫組、急診處較高。至於空氣中之乙醇、甲基異丁酮及二甲苯時量平均濃度均較勞委會規定之容許濃度標準100DPPm、50PPm、100Ppm低。然而病理部標本室中所測得之甲酫濃度卻較規定之容許濃度1PPm，高出2~3倍。由於甲酫為動物性致癌物，建議應加號改善通風設施及個人防護措施。
本暴露評估調查結果發現，以中央空調系統為主之現代化醫院，除少數特殊地點外，應較無產生高濃度生物氣膠危害之可能，但應以改善區域性通風設施及配戴個人防護器具來加強對特殊化學暴露之防護。

關鍵字

醫療作業環境 ； 生物性氣膠 ； 化學性因子 ； 暴露評估

並列摘要

The characteristics of a hospital environment easily potentiate health hazards resulting from microbial and chemical air pollution. This project was conducted to evaluate the airborne microbial and chemical concentrations in a modern hospital environment with central air-conditioning.
The bioaerosol exposure was assessed by sampling viable fungi and bacteria using a single stage/N6 Andersen impactor with Malt and Nutrient agar. After incubation and morphological identification, concentrations of airborne fungi and bacteria were expressed as CFU/m^3 (colony forming units/m^3). Airborne endotoxin was collected by filter cassettes connected with personal pump. Limulus amebocyte lysate test and KLARE method was applied for analysis calculation of concentrations. Airborne chemical concentrations were examined according to the SOP (Standard Operating Procedures) published by the Council of Labor Affairs, Taiwan, ROC. Ethanol, MIBK, and xylene were analyzed by GCJFID. Formaldehyde was measured by a Bruel & Kjar Toxic Gas Monitor with data taken every 30 seconds.
The preliminary data analyses showed that there was no particularly high bioaerosol concentrations observed in the modern hospital environment in this study other than the Washing Department and the Emergency Room. Most of the chemical exposure did not appear to be of concern. However, the formaldehyde concentration was about 2 to 3 times above the Permissible Exposure Level (1ppm). Considering the animal carcinogenicity of formaldehyde, special improvement of local ventilation and enforcement of personal respiratory protection is highly recommended.

並列關鍵字

hospital environment ； bioaerosols ； chemicals ； exposure assessment