基于公共卫生视角的生物因子安全风险评估  

Biosafety risk assessment based on the perspective of public health

作　　者：张放[1] 徐方[1] 陆殷昊[1] 黄晓燕[1] 陈蓉[1] ZHANG Fang;XU Fang;LU Yin-hao;HUANG Xiao-yan;CHEN Rong(Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China)

机构地区：[1]上海市疾病预防控制中心,上海200336

出　　处：《上海预防医学》2021年第7期605-611,共7页Shanghai Journal of Preventive Medicine

基　　金：上海市科委项目(20492420100);上海市公共卫生体系建设三年行动计划(2020—2022)优秀人才培养计划(GWV-10.2-YQ52)。

摘　　要：【目的】从公共卫生视角评估各类生物安全风险,为各地防疫部门制订多样化的防疫策略及高效率的资源配置方案提供理论依据。【方法】全球范围搜集整理可能对人使用的病原微生物信息,挑选并组建具有相关资质和背景的公共卫生专家团队,使用德尔菲法向专家组进行多轮咨询。根据专家评价结果与可信度检验,从致死率、生物因子安全事件实施容易程度、短期发生可能性、长期发生可能性、救助难度、早期发现可能性和公共卫生系统处置能力7个维度,形成对各类病原微生物安全风险的一致性评价。【结果】专家整体意见趋向一致,结果可信;炭疽芽孢杆菌的威胁风险综合得分最高,远高于第二、三名的肉毒杆菌毒素和鼠疫耶尔森菌,在各考察方面均需要重点盯防;出血热家族的多类病毒均有较高的风险。【结论】基于公共卫生视角,可以合理对生物安全风险进行评估;具有人畜共患特征和潜伏期较长的病原微生物较难在环境中提前检测到,具有较高威胁风险;公共卫生资源匮乏地区的防疫策略制定尤需关注高危生物安全事件的发生。[Objective]To assess the biosafety risk from a public health perspective and provide scientific evidence for centers for disease control and prevention to formulate diversified strategies and well-organized resource allocation.[Methods]Based on the global summary of pathogenic microorganism which might be used against human beings intentionally,we performed a multi-round consultation to the expert team with a scientific background and professional qualification,using a Delphi method.According to the consultation and reliability test,a consistent evaluation was conducted from seven dimensions,including fatality rate,implementation of biosafety-related events,short-term probability,long-term probability,difficulty of rescue,early detection,and response capacity of the public health system.[Results]The overall opinions of the experts tended to be consistent.Bacillus anthracis had been scored the highest in the comprehensive biosafety risk,which was much higher than the second(botulinum toxin)and third places(Yersinia pestis),raising a significant public health concern.In addition,multiple hemorrhagic fever viruses had a higher biosafety risk.[Conclusions]Based on the perspective of public health,the biosafety risk can be evaluated reasonably.Pathogenic microorganisms with zoonotic characteristics and long incubation periods are more difficult to detect in advance in the environment,posing a higher risk.The formulation of disease control and prevention strategies in public health resource-limited areas warrants particular attention to high-risk biosafety events.

关 键 词：生物安全 公共卫生 德尔菲法 病原微生物 风险评估 

分 类 号：R1[医药卫生—公共卫生与预防医学] E931[军事—军事装备学]