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J Zhejiang Univ (Med Sci)  2018, Vol. 47 Issue (2): 118-123    DOI: 10.3785/j.issn.1008-9292.2018.04.02
    
Establishment and application of public health risk assessment indexes for flood disaster
WU Jiabing(),GONG Lei*(),CHEN Fang,SONG Dandan,MA Wanwan,HOU Sai
Department of Health Emergency Management and Acute Infectious Disease Prevention, Anhui Center for Disease Control and Prevention, Hefei 230601, China
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Abstract  

Objective: To establish a public health risk assessment indexes for flood disaster. Methods: Delphi method and expert consultation were used to establish the public health risk assessment index system and scoring criteria, and the analytic hierarchy process (AHP) method was used to obtain the weight of the indexes. Then, the established index system was applied to evaluate the public health risk of the flood disaster in Anhui province, 2016. Results: A public health risk assessment system consisting of 5 categories and 17 indexes was constructed. The assessment result of the flood disaster in Anhui province of 2016 showed that the public health risk score was 0.26, suggesting that "the health emergency measures were effective, and the public health risks were effectively controlled". Conclusion: The established indexes can effectively assess the health risk of flood disaster and also can provide the reference for other disaster assessment.



Key wordsNatural disasters      Public health      Risk assessment      Delphi technique     
Received: 15 November 2017      Published: 24 July 2018
CLC:  R18  
Corresponding Authors: GONG Lei     E-mail: wjb0386@126.com;gong0516@sina.com
Cite this article:

WU Jiabing,GONG Lei,CHEN Fang,SONG Dandan,MA Wanwan,HOU Sai. Establishment and application of public health risk assessment indexes for flood disaster. J Zhejiang Univ (Med Sci), 2018, 47(2): 118-123.

URL:

http://www.zjujournals.com/med/10.3785/j.issn.1008-9292.2018.04.02     OR     http://www.zjujournals.com/med/Y2018/V47/I2/118


洪涝灾害公共卫生风险评估指标体系的构建及应用

目的: 构建洪涝灾害公共卫生风险评估指标体系,为灾害期间公共卫生风险等级评估提供定量化判断依据。方法: 采用德尔菲法和专家会商法构建洪涝灾害公共卫生风险评估相关指标及其评分标准,运用层次分析法获得指标的权重,并进一步应用于安徽省2016年洪涝灾害公共卫生风险评估中。结果: 构建并确定了五大类17个洪涝灾害公共卫生风险评估指标、评分标准及其权重。根据构建的指标体系,2016年安徽省洪涝灾害公共卫生风险总分为0.26分,风险判断结果为"灾害期间卫生应急措施有效,公共卫生风险有效控制"。结论: 本研究构建的洪涝灾害公共卫生风险评估指标体系可为灾害现场开展定量评估提供技术支持,同时也可为其他类型灾害现场评估提供参考。


关键词: 自然灾害,  公共卫生,  风险评估,  德尔菲技术 
一级指标 二级指标
B1主要公共卫生风险要素控制状况 C1食品卫生状况
C2饮用水卫生状况
C3环境卫生状况
C4虫媒控制状况
B2基本公共卫生服务恢复状况C5受损医疗卫生机构恢复状况
C6网络直报能力恢复状况
C7实验室检测能力恢复状况
C8计划免疫恢复状况
C9妇幼保健恢复状况
C10卫生防疫能力恢复状况
B3重大传染病疫情概况C11霍乱疫情概况
C12其他感染性腹泻疫情概况
C13血吸虫病疫情概况
C14流行性出血热疫情概况
C15钩端螺旋体病疫情概况
B4灾害相关突发公共卫生事件 C16突发公共卫生事件及相关信息概况
B5食源性疾病暴发事件概况 C17食源性疾病暴发事件概况
Tab 1 The index system of public health risk assessment for flood disaster
评估指标(权重) 指标解释和评分标准
C1食品卫生状况(0.06) ①食品种类(方便食品或烹饪食品=0,未烹饪食品=1);②是否有加热食物的炊具和燃料(是=0,否=1)。每项满分1分,总计2分。
C2饮用水卫生状况(0.08) ①饮用水类型(集中式供水=0,分散式供水=1);②是否有条件烧开水(是=0,否=1);③是否有消毒剂对饮用水进行消毒(是=0,否=1)。每项满分1分,总计3分。
C3环境卫生状况(0.06) ①居民随地倾倒生活污水(否=0,是=1);②是否看见居民随地大小便(否=0,是=1);③垃圾是否统一回收(是=0,否=1);④是否有大量垃圾没有清运(否=0,是=1);⑤开展环境消毒(是=0,否=1)。每项满分1分,总计5分。
C4虫媒控制状况(0.06) ①是否看见苍蝇(否=0,有但不多=1,到处都可看见=2);②居民反映被蚊虫叮咬(没有=0,很少=1,经常=2);③居民反映有老鼠出没(没有=0,很少=1,很多=2)。每项满分2分,总计6分。
C5受损医疗卫生机构恢复状况(0.05) ①医疗机构恢复正常诊疗服务(完全恢复=0,部分恢复=1,未恢复=2);②卫生服务机构恢复正常诊疗服务(完全恢复=0,部分恢复=1,未恢复=2)。每项满分2分,总计4分。
C6网络直报能力恢复状况(0.05) ①网络直报设备是否更新或修复(是=0,否=1);②灾后直报医疗机构数或灾害期间直报医疗机构数(1个或以上=0,少于1个=1)。每项满分1分,总计2分。
C7实验室检测能力恢复状况(0.03) ①实验室检测设备、仪器修复或更新(是=0,否=1);②检测项目恢复到灾害发生前水平(是=0,否=1)。每项满分1分,总计2分。
C8计划免疫恢复状况(0.04) ①灾后或灾害期间接种百白破疫苗针次(1次或以上=0,少于1次=1);②灾后或灾害期间接种甲型肝炎疫苗针次(1次或以上=0,少于1次=1)。每项满分1分,总计2分。
C9妇幼保健恢复状况(0.02) ①孕妇正常孕检(是=0,否=1);②产妇正常产检(是=0,否=1);③产妇正常获得分娩服务(是=0,否=1);④产妇正常获得剖腹产(是=0,否=1)。每项1分,总计4分。
C10卫生防疫能力恢复状况(0.04) ①卫生防疫工作恢复(恢复=0,部分恢复、未恢复=1);②艾滋病患者管理与治疗恢复(是=0,否=1);③结核病患者管理与治疗恢复(是=0,否=1);④高血压、糖尿病等慢性病患者管理恢复(是=0,否=1)。每项满分1分,总计4分。
C11霍乱疫情概况(0.06) 灾害发生日至评估日霍乱发病数与前三年同期平均发病数的比值(≤1=0,1~2=1,≥2=2)。每项满分2分,总计2分。
C12其他感染性腹泻疫情概况(0.06) 灾害发生日至评估日其他感染性腹泻发病数与前三年同期平均发病数的比值(≤1=0,1~2=1,≥2=2)。每项满分2分,总计2分。
C13血吸虫病疫情概况(0.05) 灾害发生日至评估日血吸虫病发病数与前三年同期平均发病数的比值(≤1=0,1~2=1,≥2=2)。每项满分2分,总计2分。
C14流行性出血热疫情概况(0.05) 灾害发生日至评估日流行性出血热发病数与前三年同期平均发病数的比值(≤1=0,1~2=1,≥2=2)。每项满分2分,总计2分。
C15钩端螺旋体病疫情概况(0.05) 灾害发生日至评估日钩端螺旋体病发病数与前三年同期平均发病数的比值(≤1=0,1~2=1,≥2=2)。每项满分2分,总计2分。
C16突发公共卫生事件及相关信息概况(0.12) ①灾民安置点报告突发公共卫生事件及其相关信息(否=0,是=1.5);②返家灾民报告突发公共卫生事件及其相关信息(否=0,是=15)。每项满分1.5分,总计3分。
C17食源性疾病暴发事件概况(0.12) ①灾民安置点报告食源性疾病暴发事件(否=0,是=1.5);②返家灾民报告食源性疾病暴发事件(否=0,是=1.5)。每项满分1.5分,总计3分。
Tab 2 The weights, interpretation and scoring criteria of public health risk assessment indexes for blood disaster
评估指标 实际得分 风险分值
“—”无相关数据.
C1食品卫生状况 0 0.00
C2饮用水卫生状况 1 0.08
C3环境卫生状况 1 0.06
C4虫媒控制状况 1 0.06
C5受损医疗卫生机构恢复状况 0 0.00
C6网络直报能力恢复状况 0 0.00
C7实验室检测能力恢复状况 0 0.00
C8计划免疫恢复状况 0 0.00
C9妇幼保健恢复状况 0 0.00
C10卫生防疫能力恢复状况 0 0.00
C11霍乱疫情概况 0 0.00
C12其他感染性腹泻疫情概况 1 0.06
C13血吸虫病疫情概况 0 0.00
C14流行性出血热疫情概况 0 0.00
C15钩端螺旋体病疫情概况 0 0.00
C16突发公共卫生事件及相关信息概况 0 0.00
C17食源性疾病暴发事件概况 0 0.00
合计 0.26
Tab 3 The public health risk assessment result of flood disaster of Anhui province in 2016
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