本文選題：過氧乙酸 + 空氣消毒��； 參考：《華中科技大學(xué)》2006年碩士論文

【摘要】： 目的了解在SARS爆發(fā)流行期間大規(guī)模使用過氧乙酸空氣消毒之后,對人群健康產(chǎn)生的潛在不良影響,為今后過氧乙酸的安全使用提供依據(jù)。 方法經(jīng)醫(yī)學(xué)倫理委員會同意之后,招募29名志愿者,按照衛(wèi)生部疾病控制司二OO三年四月二日發(fā)布的《各種污染對象的常用消毒方法(試行)》標(biāo)準(zhǔn)噴灑過氧乙酸進(jìn)行室內(nèi)空氣消毒,在噴灑結(jié)束后開門窗透氣。受試者于透氣30分鐘后進(jìn)入消毒場所,暴露于消毒后氣體。每天暴露兩次,連續(xù)暴露兩天。受試者分別在試驗前、接觸消毒劑一次、兩次和脫離暴露一周后分別抽取5毫升,共四次20毫升的外周靜脈血,檢測血常規(guī)、肝功能、腎功能、IgE、組胺、血清SOD、MDA和外周血淋巴細(xì)胞DNA損傷(彗星試驗)等指標(biāo),并且在第三次抽血和最后一次抽血后對志愿者不良反應(yīng)進(jìn)行量表調(diào)查。其中IgE的檢測使用的是ELISA雙抗夾心法,組胺的檢測使用熒光法,SOD的檢測則使用的羥胺法,MDA則使用的硫代巴比妥酸(TBA)法,DNA損傷的檢測使用的是單細(xì)胞凝膠電泳法。量表的設(shè)計主要根據(jù)過氧乙酸空氣消毒后,對接觸者皮膚、眼部、呼吸道和消化道黏膜產(chǎn)生刺激而設(shè)計的。具體的指標(biāo)包含:呼吸道刺激癥狀、消化道刺激癥狀、咽部刺激癥狀、皮膚刺激癥狀等。各項指標(biāo)按照程度的不同,從低到高依次為:無、輕微、一般、較重(能忍受)、嚴(yán)重(無法忍受)。另設(shè)一欄填寫其他的不適反應(yīng)。通過對所測指標(biāo)和調(diào)查量表的分析,綜合評價過氧乙酸空氣消毒對人群不良健康的影響,從而提出相應(yīng)的建議和采取措施,以減輕或避免這種不良反應(yīng)。 結(jié)果人群接觸消毒劑后,29人未有人出現(xiàn)皮膚紅斑、斑疹、丘疹、水腫和紫紺。但觀均感到不同程度的不適,所有的志愿者在進(jìn)入消毒劑噴灑后的試驗室均感覺到程度不等的異味,伴有其他各種輕微不適:呼吸道刺激感17人;咳嗽8人;1人氣喘、呼吸困難和胸悶6人;眼部疼痛、流淚11人,其中兩人出現(xiàn)畏光和紅腫;消化道(胃腹部)不適7人。休息一周后,無人出現(xiàn)異常和不適。血常規(guī)中,除白細(xì)胞和單核細(xì)胞外,其他指標(biāo)均無明顯異常改變(P0.05)。白細(xì)胞計數(shù)有增多的趨勢(P0.05),單核細(xì)胞計數(shù)也有增大的趨勢(P0.01);脫離接觸消毒劑一周后,白細(xì)胞回復(fù)到接觸前水平,而單核細(xì)胞則持續(xù)增高。SOD早期受到抑制活性減小,接觸消毒劑一天后期活性增加(P0.01),此后則一直穩(wěn)定在同一水平;MDA的濃度隨著接觸時間的延長而增加(P0.01);彗星試驗顯示過氧乙酸可致DNA損傷。脫離接觸消毒劑一周后,SOD活性恢復(fù)到接觸前水平,而血清MDA水平和DNA損傷外雖然有所恢復(fù),但是仍然沒有恢復(fù)到接觸前水平。在本次實驗條件下,肝、腎功能和免疫指標(biāo)則未見明顯異常改變。 結(jié)論按照衛(wèi)生部的院感控制指導(dǎo)使用過氧乙酸進(jìn)行空氣消毒,暴露人群會出現(xiàn)多種主觀不適癥狀,會致一過性炎癥反應(yīng)(白細(xì)胞和單核細(xì)胞計數(shù)上升),引起接觸人群血清脂質(zhì)過氧化的改變,并致DNA損傷。脫離暴露一周之后,各種不良反應(yīng)基本消失,僅單核細(xì)胞、MDA和DNA改變?nèi)晕赐耆謴?fù)到接觸前水平。對此采取的預(yù)防措施主要有:(1)有人在場時不易進(jìn)行過氧乙酸噴灑消毒;(2)在保證消毒效果的前提下,盡可能降低過氧乙酸消毒時的濃度和消毒次數(shù);(3)在噴灑消毒劑并密閉作用30min后,應(yīng)開門窗透氣,加快過氧乙酸的稀釋和分解;(4)過氧乙酸得家庭使用尤其要謹(jǐn)慎;(5)對有既往過敏體質(zhì)的人應(yīng)做好防護(hù);(6)做好消毒人員的防護(hù)工作。
[Abstract]:Objective to understand the potential adverse effects of peroxy acetic acid on the health of the population after the large-scale use of peracetic acid air during the outbreak of SARS outbreak, and to provide a basis for the safe use of peracetic acid in the future.
Methods after the consent of the medical ethics committee, 29 volunteers were recruited to disinfect indoor air in accordance with the common disinfection methods (trial run) > standard spraying peracetic acid, which was released by the Department of disease control and Disease Control Department of the Ministry of health of the Department of disease control, two OO, three years, April 2nd, and open doors and windows after the spray ended. The subjects entered the disinfectant after 30 minutes of air permeability. The sites were exposed to the sterilized gas after exposure for two times a day for two days. The subjects were exposed to a disinfectant once, two times and 5 milliliters after one week of exposure, and four times of 20 ml of peripheral venous blood respectively. The blood routine, liver function, renal function, IgE, histamine, serum SOD, MDA, and peripheral blood lymphocyte DNA damage were detected. (comet test) and other indicators, and a scale survey of adverse reactions to volunteers after third blood pumping and final blood extraction. The test used for IgE was ELISA double anti sandwich, histamine detection and use of fluorescence, SOD assay using hydroxylamine method, MDA used thiobarbituric acid (TBA), DNA damage detection and use. It was designed by single cell gel electrophoresis. The design of the scale was designed to stimulate the skin, eye, respiratory, and digestive tract mucosa of the contact person after disinfection of peracetic acid air. Specific indicators included respiratory irritation symptoms, digestive irritation symptoms, pharynx irritation symptoms, skin irritation symptoms, and so on. Different, from low to high in turn: No, slight, general, heavy (tolerable), serious (intolerable). Another column fill in other discomfort reactions. Through the analysis of the measured index and survey scale, the effect of peracetic acid air disinfection on the bad health of the population is evaluated and the corresponding suggestions and measures are put forward to reduce or avoid. Avoid this adverse reaction.
Results there was no skin erythema, rash, papules, edema, and cyanosis in 29 people after exposure to the disinfectant. But all of them felt different degrees of discomfort. All the volunteers in the test room after the disinfectant sprayed all felt different degrees of odor, with other light and micro discomfort, respiratory irritation of 17 people, 8 people coughing and 1 asthma, 6 people with dyspnea and chest distress, 11 people with eye pain and tears, two of them were photophobia and redness, and 7 were discomfort in the digestive tract (stomach and abdomen). No abnormality and discomfort occurred after a week of rest. In the blood routine, there were no obvious abnormal changes (P0.05) except for leukocytes and mononuclear cells. The trend of white blood cell count increased (P0.05), mononuclear thin The cell count also has an increasing trend (P0.01). After a week of disengagement disinfectant, the leukocytes revert to the pre contact level, while the mononuclear cells continue to increase in the early stage of.SOD, and the activity of the contact disinfectant increases (P0.01) in the later day (P0.01), and then has been stable at the same level, and the concentration of MDA increases with the prolongation of the contact time. Addition (P0.01); comet test showed that peroxy acetic acid could cause DNA damage. After a week, the activity of SOD recovered to the level of pre contact, while the serum MDA level and DNA damage recovered, but still did not recover to the pre contact level. In this experiment, the liver, renal function and immune index were not obviously abnormal.
Conclusion the use of peracetic acid for air disinfection according to the hospital sense control of the Ministry of health, the exposed population will have a variety of subjective discomfort symptoms, causing an excessive inflammatory response (the increase of leukocyte and monocyte count), causing changes in serum lipid peroxidation in the contact population and causing DNA damage. Only mononuclear cells, only monocytes, MDA and DNA changes are still not fully restored to pre contact level. The main preventive measures are: (1) when someone is present, peroxy acetic acid spraying is not easy to be carried out; (2) the concentration and disinfection times of peracetic acid are reduced as much as possible under the premise of ensuring the disinfection effect; (3) the disinfectant is sprinkled and dense. After closing the 30min, we should open doors and windows to breathe in, speed up the dilution and decomposition of peroxy acetic acid; (4) the peracetic acid should be used with caution in family use; (5) people who have previously allergic constitution should be well protected; (6) do a good job for the protection of the disinfectant.

【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2006
【分類號】：R187

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本文編號：1890328