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Exposure to airborne asbestos in Jamaican hospitals.

機(jī)譯：在牙買加的醫(yī)院中暴露于空氣中的石棉。

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Asbestos is a crystalline mineral that is found naturally in almost two-thirds of the earths' crust and it is an established human carcinogen. Occupational exposure to asbestos may be responsible for 5-20% of lung cancers and 80-90% of pleural mesothelioma in developed countries. Asbestos-related diseases account for some 100,000 deaths annually worldwide. Few cases of asbestos-related diseases are reported in Jamaica but two asbestos-cement product manufacturing plants operated in Jamaica during the period 1965-1985. Asbestos was identified in some Jamaican hospitals in 1999. This study was conducted in 2005-2007 to identify asbestos containing material (ACM), its characteristics and its determinants in Jamaican hospitals; to determine if current asbestos exposure in Jamaican hospitals differs by job category; and to assess the knowledge, attitudes and practices of hospital employees/workers with respect to asbestos. It was hypothesized that current exposure to asbestos was related to job type and exposure among maintenance workers was greater than exposure among other workers. 152 bulk samples of suspected ACM was collected and analyzed by polarized light microscopy (PLM). Based on the results the two largest hospitals with ACM were selected for air sampling and interview of selected employees. 131 personal air samples and 32 area samples were collected and analyzed by phase contrast microscopy (PCM). Half of the personal air samples that tested positive for fibers were subjected to transmission electron microscopy (TEM) to confirm if the fibers were asbestos. In addition, 277 hospital employees stratified into three groups according to work performed responded to an interviewer administered questionnaire. The response rate was 90%. Two focus group discussions (FGD) were held with heads of departments (HOD) at both hospitals. Sixteen (61.5%) of the 26 hospitals had ACM and 67 (44.07%) of the 152 bulk samples contained ACM. The predominant ACM was thermal system insulation which was generally in a poor condition indicative of fiber release. Amosite was the most common fiber detected in the samples. Of the 163 air samples analyzed, 24 (14.7%) had fiber concentrations above the LOD ranging from 0.002 to 0.013 f/cc. Fiber concentrations were significantly associated with hospital (p=0.0263). There was no difference in the median fiber concentration (0.0015 f/cc) to which the three groups of employees were exposed. Further analysis of samples that tested positive for fibers by transmission electron microscopy (TEM) confirmed that the fibers detected by PCM were not asbestos fibers. Sixty two (22.4%) of respondents had never heard of asbestos and having heard about asbestos was significantly associated with group of employee (p=0.0001). Gender, age, education, marital status, and duration of employment were all significantly associated with group of employee. Correct responses to knowledge questions on asbestos ranged from 41% to 98.5%. Generally, respondents' attitudes towards asbestos were positive. Based on our study, there were no airborne asbestos fibers with any immediate threat to workers' exposures. The JMOH/hospital management should institute asbestos abatement/management programs in hospitals as a proactive measure against future exposure. This will require manpower, resources and assistance from national and international agencies.
機(jī)譯：石棉是一種晶體礦物質(zhì)，天然存在于近三分之二的地殼中，是公認(rèn)的人類致癌物。在發(fā)達(dá)國(guó)家，職業(yè)性接觸石棉可能導(dǎo)致5-20％的肺癌和80-90％的胸膜間皮瘤。全球每年與石棉有關(guān)的疾病導(dǎo)致10萬(wàn)人死亡。牙買加報(bào)告的石棉相關(guān)疾病病例很少，但在1965-1985年期間，牙買加有兩家石棉水泥制品生產(chǎn)廠。 1999年在牙買加的一些醫(yī)院中發(fā)現(xiàn)了石棉。這項(xiàng)研究于2005-2007年進(jìn)行，目的是確定牙買加醫(yī)院中含有石棉的物質(zhì)（ACM），其特性及其決定因素。確定牙買加醫(yī)院當(dāng)前的石棉暴露量是否因工作類別而異；并評(píng)估醫(yī)院?jiǎn)T工/工人在石棉方面的知識(shí)，態(tài)度和做法。據(jù)推測(cè)，當(dāng)前接觸石棉與工作類型有關(guān)，維修工人的接觸比其他工人的接觸要大。收集了152份可疑ACM樣品，并通過(guò)偏振光顯微鏡（PLM）進(jìn)行了分析。根據(jù)結(jié)果??，選擇了兩家擁有ACM的最大醫(yī)院進(jìn)行空氣采樣和對(duì)選定員工的采訪。收集了131個(gè)個(gè)人空氣樣本和32個(gè)區(qū)域樣本，并通過(guò)相差顯微鏡（PCM）進(jìn)行了分析。對(duì)一半測(cè)試為纖維陽(yáng)性的個(gè)人空氣樣本進(jìn)行了透射電子顯微鏡（TEM），以確認(rèn)纖維是否為石棉。此外，按所進(jìn)行的工作，將277名醫(yī)院?jiǎn)T工分為三類，對(duì)訪調(diào)員管理的問(wèn)卷進(jìn)行了回應(yīng)?；貞?yīng)率為90％。與兩家醫(yī)院的部門(mén)負(fù)責(zé)人（HOD）進(jìn)行了兩次焦點(diǎn)小組討論（FGD）。 26家醫(yī)院中有16家（61.5％）裝有ACM，在152個(gè)大樣本中有67家（44.07％）裝有ACM。主要的ACM是熱系統(tǒng)絕緣，通常處于不良狀態(tài)，表明纖維釋放。鐵石棉是樣品中最常見(jiàn)的纖維。在分析的163個(gè)空氣樣本中，有24個(gè)（14.7％）的纖維濃度高于LOD，范圍為0.002至0.013 f / cc。纖維濃度與醫(yī)院顯著相關(guān)（p = 0.0263）。三組員工所接觸的纖維中位濃度（0.0015 f / cc）沒(méi)有差異。通過(guò)透射電子顯微鏡（TEM）對(duì)測(cè)試?yán)w維陽(yáng)性的樣品的進(jìn)一步分析證實(shí)，通過(guò)PCM檢測(cè)到的纖維不是石棉纖維。六十二（22.4％）的受訪者從未聽(tīng)說(shuō)過(guò)石棉，并且聽(tīng)說(shuō)過(guò)石棉與員工群體有顯著相關(guān)性（p = 0.0001）。性別，年齡，受教育程度，婚姻狀況和工作時(shí)間都與員工群體顯著相關(guān)。對(duì)石棉知識(shí)的正確回答范圍為41％至98.5％。通常，受訪者對(duì)石棉的態(tài)度是積極的。根據(jù)我們的研究，沒(méi)有空氣中傳播的石棉纖維會(huì)對(duì)工人的暴露造成直接威脅。 JMOH /醫(yī)院管理部門(mén)應(yīng)在醫(yī)院制定石棉消減/管理計(jì)劃，以作為預(yù)防未來(lái)暴露的積極措施。這將需要國(guó)家和國(guó)際機(jī)構(gòu)的人力，資源和協(xié)助。

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  • 作者

    Scarlett, Henroy P.;

  • 作者單位

    The University of Alabama at Birmingham.;

  • 授予單位 The University of Alabama at Birmingham.;
  • 學(xué)科 Occupational safety.;Environmental science.;Public health.
  • 學(xué)位 Dr.P.H.
  • 年度 2007
  • 頁(yè)碼 230 p.
  • 總頁(yè)數(shù) 230
  • 原文格式 PDF
  • 正文語(yǔ)種 eng
  • 中圖分類
  • 關(guān)鍵詞

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