Occupational Medicine Quarterly Journal
فصلنامه علمی تخصصی طب کار
tkj
Medical Sciences
http://tkj.ssu.ac.ir
1
admin
2251-7189
2251-8274
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7
14
8888
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fa
jalali
1403
7
1
gregorian
2024
10
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online
1
fulltext
fa
بررسی غلظت و ارزیابی ریسک سلامتی بیوآئروسل ها در اتاق های عمل مراکز جراحی و بیمارستان های دانشگاه علوم پزشکی شهید بهشتی
Investigating the concentration and health risk assessment of bioaerosols in the surgery centers and hospital operating rooms of Shahid Beheshti University of Medical Sciences
عوامل شیمیایی
Chemical agents
پژوهشي
Research
<span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><a name="_Hlk166190152"><b><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">مقدمه:</span></span></b></a><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"> به­دلیل شرایط خاص اتاق­های عمل، کنترل عفونت جهت حفظ سلامت افراد، در این مکان­ها مهم است. لذا این مطالعه با هدف بررسی نرخ تبادل هوا و ارزیابی ریسک سلامتی بیوآئروسل</span></span><span lang="FA" style="font-size:11.0pt"><span cambria="" style="font-family:">­</span></span><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">های هوابرد، در اتاق</span></span><span lang="FA" style="font-size:11.0pt"><span cambria="" style="font-family:">­</span></span><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">های عمل مراکز جراحی و بیمارستان</span></span><span lang="FA" style="font-size:11.0pt"><span cambria="" style="font-family:">­</span></span><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">ها انجام شد.</span></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="tab-stops:list 22.25pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">روش بررسی:</span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"> در این مطالعه از نتایج سنجش تراکم بیوآئروسل­ها، توسط شرکت­های آلاینده­سنجی در سال 1401استفاده گردید. با کمک نرمافزار اکسل، به صورت تصادفی، تعداد 10 اتاق عمل انتخاب و مجدد در سال 1402 پایایی نتایج این دو سال مورد بررسی قرار گرفت. در تمام گزارشات شرکتهای پایش نمونه­برداری و آنالیز نمونه­ها براساس روش </span></span>NIOSH 0800<span style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"> بود. تعداد دفعات تعویض هوا با کمک آنمومتر حرارتی تعیین شد. در نهایت ریسک سلامتی محاسبه و پیش­بینی احتمال ریسک با شبیه</span></span><span lang="FA" style="font-size:11.0pt"><span cambria="" style="font-family:">­</span></span><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">سازی مونت کارلو، در </span></span><span b="" lang="FA" nazanin="" style="font-family:">نرم</span><span cambria="" lang="FA" style="font-family:">­</span><span b="" lang="FA" nazanin="" style="font-family:">افزار</span>Crystal Ball <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"> انجام شد. ضریب همبستگی پیرسون جهت تعیین</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">ارتباط بین تعداد بیوآئروسل­ها و نرخ تعویض هوا و آزمون </span></span>ICC<span style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"> جهت بررسی پایایی بین نتایج دو سال استفاده شد. </span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="tab-stops:list 22.25pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">نتایج:</span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"> در بین </span></span><span lang="FA" style="font-size:11.0pt"><span b="" style="font-family:" zar="">62</span></span><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"> اتاق عمل، میانگین تعداد کلونی­های باکتریایی و قارچی، به ترتیب</span></span> CFU<span dir="LTR" style="font-size:11.0pt">/m<sup>3</sup></span><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">73/69 </span></span>±59/14<span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#010205">و </span></span></span>CFU<span dir="LTR" style="font-size:11.0pt">/m<sup>3</sup></span><span style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"> 67/21</span></span>±52/4 <span lang="AR-SA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#010205">بود، که </span></span></span><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">کمتر از حد توصیه شده سازمان بهداشت جهانی</span></span> <span lang="AR-SA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#010205">می­باشند. میانگین </span></span></span><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">نرخ تعویض هوا </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#010205">برابر 67/19 </span></span></span>±<span style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#010205"> 18/2به دست آمد.</span></span></span> <span lang="AR-SA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"><span style="color:black">بین تعداد تعویض هوا و تعداد کلونی­ها، ارتباط معنی­داری آماری مشاهده نشد(05/0</span></span></span><span dir="LTR" style="font-size:11.0pt"><span style="color:black">(p-</span></span>value<span dir="LTR" style="font-size:11.0pt"><span style="color:black"> ≥</span></span><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">. سطح ریسک بهداشتی بیوآئروسل­ها در سطح قابل­قبول بود و غلظت بیوآئروسل­ها به عنوان، حساس­ترین متغیر تاثیرگذار بر سطح ریسک شناخته­شد. </span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:">نتیجهگیری:</span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" nazanin="" style="font-family:"> بررسی نتایج نشان داد؛ که در مقطع زمانی سال1401 و 1402، افزایش تعداد تعویض <span style="color:black">هوا، نمی­تواند منجر به کاهش بار آلودگی بیوآئروسل­ها در اتاق­های عمل شود. شاید دلیل این امر، </span>عدم همزمانی در اندازه­گیری­ها باشد. لذا برای شفاف­سازی این موضوع، انجام مطالعات بیشتر در آینده <span style="color:black">ضروری است.</span></span></span></span></span></span></span></span></span></span><br>
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<span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span dir="LTR" style="font-size:11.0pt"></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span></span></span>
<span style="font-size:10pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><em><b><span style="border:none windowtext 1.0pt; font-size:11.0pt; padding:0cm"><span style="background:white"><span style="color:black">Introduction</span></span></span></b></em><b><span style="font-size:11.0pt">:</span></b><span style="font-size:11.0pt"> Due to the special conditions in operating rooms, infection control is important to maintain health. So, the aim of this study was to survey of air exchange</span><span style="font-size:11.0pt"> rate/changes per hour (ACH) and health risk assessment of bioaerosols in the surgery center or hospital operating rooms.</span></span></span></span></span><br>
<span style="font-size:10pt"><span style="unicode-bidi:embed"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><em><b><span style="border:none windowtext 1.0pt; font-size:11.0pt; padding:0cm"><span style="background:white"><span style="line-height:115%"><span style="color:black">Materials and Methods: </span></span></span></span></b></em><span style="font-size:11.0pt"><span style="line-height:115%">The results of measuring of bioaerosols by pollution measurement companies were used, in 1401. In 1402, 10 operating rooms were randomly selected and the reliability of the results was examined for these two years. Sampling and analysis of the samples was provided based on the NIOSH 0800 method and ACH were measured by a anemometer. The relationship between the number of bioaerosols and ACH, and also, the reliability between results were calculated with the PCC and the ICC test, respectively, in SPSS-V22 software. The health risk assessment and the probability of risk were estimated by Monte Carlo simulation, in Crystal Ball software.</span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="unicode-bidi:embed"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><em><b><span style="border:none windowtext 1.0pt; font-size:11.0pt; padding:0cm"><span style="background:white"><span style="line-height:115%"><span style="color:black">Results:</span></span></span></span></b></em><span style="font-size:11.0pt"><span style="line-height:115%"> Among 62 operating rooms, the average number of bacterial and fungal colonies was 69.73±14.59 CFU/m<sup>3</sup> and 21.67±4.52 CFU/m<sup>3</sup>, respectively, which is less than the recommended limit of WHO. The average ACH was 19.67±2.18 per hour. No significant relationship was observed between ACH and the number of colonies (p-value ≥ 0.05). Risk assessment for bacteria and fungi were at an acceptable level and the concentration of bioaerosols was recognized as the most sensitive variable influencing the risk.</span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt">Conclusion:</span></b><span style="font-size:11.0pt"> Increasing ACH will not lead to a reduction in the load of bioaerosol pollution in operating rooms, which can be very important in the management of reducing energy consumption.</span></span></span></span></span><br>
بیوآئروسلها, باکتری, قارچ, نرخ تبادل هوا, ارزیابی ریسک
Bioaerosols, Bacteria, Fungus, Air exchange rates, Risk assessment
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http://tkj.ssu.ac.ir/browse.php?a_code=A-10-1325-1&slc_lang=fa&sid=1
Abbas
Shahsavani
عباس
شاهسونی
nafisehnasirzadeh@gmail.com