公共场所中央空调系统冷却塔水及气溶胶军团菌污染的风险评估和预警研究  

Risk Evaluation and Warning of Legionella Contamination in Aerosols and Cooling Towers in Centralized Air Conditioning System in Public Places

作　　者：陈健[1] 赵志荣[2] 施明美[3] 彭志行[4] 董坤[1] 张大伟[1] 刘洋[1] 赵锴[1] 陈道利[2] 

机构地区：[1]马鞍山市卫生局卫生监督局,安徽243000 [2]马鞍山市疾病预防控制中心 [3]马鞍山十七冶医院 [4]南京医科大学公共卫生学院流行病与卫生统计学系

出　　处：《环境与健康杂志》2011年第6期529-531,共3页Journal of Environment and Health

基　　金：安徽省卫生厅医学科研立项课题(09C195)

摘　　要：目的构建中央空调系统冷却塔水及气溶胶军团菌污染的风险评估指标体系和风险预警模型。方法于2008、2009年的5—9月采集马鞍山市16户宾馆、商场、公共浴室冷却塔水样70份,冷却塔气溶胶样品110份,分别进行军团菌分离培养和嗜肺军团菌mip基因的PCR检测。分析冷却塔水军团菌检出与气溶胶军团菌检出之间的关系,筛选可能影响冷却塔水及气溶胶受军团菌污染的18个现场易测的变量,运用有序结果的累积比数Logistic回归方法构建模型。结果用冷却塔水军团菌分离培养结果(Ty)、冷却塔水军团菌PCR检测结果(Tr)和冷却塔气溶胶中军团菌PCR检测结果(Qr),构建综合评估冷却塔水及气溶胶军团菌污染风险的指标体系。根据三者的不同检测结果,将军团菌污染风险等级划分为4级:无风险、轻度风险、中度风险和高度风险。构建中央空调系统冷却塔水及气溶胶军团菌污染的风险预警模型,模型包括冷却塔水水温、余氯、pH值和气溶胶采集点相对湿度4个变量指标。结论通过现场易测、敏感指标的快速监测,可快速判断冷却塔水及气溶胶军团菌污染的风险等级,模型预测的灵敏度和特异度符合风险预警的要求。Objective To develop risk evaluation index system and warning model of Legionella contamination in aerosols and cooling towers in centralized air conditioning systems in public places.Methods During May-Sep.2008 and 2009,70 water samples and 110 aerosol samples were collected from cooling towers for isolated culture and PCR of Legionella.The relationships between Legionella detection from cooling waters and from aerosols were analyzed.Eighteen variables of affecting Legionella contamination of cooling waters and aerosols were screened,the cumulative odds models were constructed by ordinal logistic regression.Results Integrated risk evaluation index system of Legionella contamination was constructed based on the results of isolated culture and PCR of Legionella for water samples from cooling towers and PCR of Legionella for aerosol samples from cooling towers.According to the three indexes mentioned above,Legionella contamination risk levels were divided into four ranks,such as none,low,moderate and high risk level.The risk warning model had been constructed,which included 4 variables,such as water temperature of cooling tower,residual chlorine,pH value and relative humidity of aerosols sampling points.Conclusion The model has formed scientific evaluation of Legionella contamination risk in cooling waters and aerosols,completes quick field monitoring with sensitive and simple measure indexes,decides risk levels of Legionella contamination of cooling waters and aerosols.The sensitivity and specificity of the model prediction attains to the demand of risk precaution.

关 键 词：气溶胶 军团菌 风险预警 

分 类 号：R122.2[医药卫生—环境卫生学] R117[医药卫生—公共卫生与预防医学]