探討醫護人員於毒化物除污時之暴露評估

西元1995年在日本東京因奧姆真理教教徒在地鐵施放沙林毒氣事件，造成大量病患湧入醫院求醫而導致院內多名醫護人員產生中毒症狀，由此可見醫護人員於除污時也同樣暴露在由病患身上所揮發出的化學物質中；本篇研究主要目的為利用化學物質來模擬毒化災發生時醫護人員於毒化災除污室內除污時的暴露情形，藉著醫護人員呼吸帶採樣來取得不同時段的濃度變化情形並進行暴露評估及探討。本研究方式為將化學物質潑灑在穿著純棉之衣物塑膠人體模型上後模擬除污，此時進行醫護人員呼吸帶採樣，採樣分析方法為參考國內環檢所公告的「空氣中揮發性有機化合物檢測方法-不銹鋼採樣筒/氣像層析質譜法」。實驗結果顯示除污室內化學物質所發散之濃度成一曲線上升，在進入除污室10分鐘後現場除污之醫護人員之暴露已超過八小時容許濃度，當潑灑面積加大時，在相同時間內醫護人員之暴露濃度已超過短時間容許濃度。影響醫護人員暴露情形的原因為：所接觸之化學物質、溫度、排氣裝置及工作認知，其中以除污時室內溫度高低、排氣裝置及工作認知為主要影響暴露濃度高低的因素。

關鍵字

醫護人員；除污；溫度；化學物質；排氣裝置

並列摘要

The sarin release in the Tokyo subway system at 1995 resulted in many hospital workers reporting the same symptoms of exposed. Therefore the hospital emergency worker may be exposed the chemical from the patient whose skin and/or clothing contaminated. The goal of this research is to investigate the breathing-zone level from hospital emergency workers during decontamination of hazard material exposed patient. The research is using an adult sized model that dressed clothes made by 100% cotton. Then splashed the chemical on the model. (The chemical which splash on the model is assay toluene) and started taking the hospital emergency workers breathing-zone sampling. The method of sampling and analysis referred to EPA NIEA 715.11B. Result showed concentration curve increased at few minutes then means it will change to stable. After expose in the decontamination room, hospital worker’s breathing-zone concentrations are over TWA and STEL-TWA. When splashing zone getting bigger, the breathing-zone concentrations are significantly over PEL-TWA and PEL-STEL. Many factors influenced the hospital emergency workers exposure, such as chemicals、temperature、size of the decontamination room、ventilation system and work attitudes. The main effect factors are temperature、ventilation system and work attitudes.

並列關鍵字

Hospital emergency workers ； Decontamination ； Temperature ； The kind of Chemicals ； Ventilation system

參考文獻

1.John l. Hick, Dan Hanfling, Jonathan L. Burstein, Joseph Markham, Anthony G. Macintyre, Joseph A. Barbera. Protective equipment for health care facility decontamination personnel:Regulations, risk, and recommendation. Annals of Emergency Medicine;2003;42;370-380