This paper will introduce the background, purpose, content, methods and material source of the project which is called“Investigation and Analysis of Health Inspection Industry’s Situation in China”. The principle of“Struc?ture-Process-Outcome”and Macro Model of Health System were used in this research to show the situation of health in?spection industry, to evaluate the development of the health inspection system, to analyze the issues and challenges, and to give some suggestions. 611 health inspection institutions from 31 provinces, 142 cities and 438 counties were surveyed by questionnaires. 94 principals from health inspection institutions and health bureaus in 7 provinces were interviewed. This project mainly concerned about allocation of resources, implementation and adjustment of the functions, building of capaci?ties, utilization of technical support services, collaborative management and social evaluation in health inspection industry.

Objective This study analyzed health supervision agency funds in the process of health supervision system construction in different areas and levels from 2007 to 2012,including the funding of income , expenses, income and expen?diture proportion , as well as regional funding gap. Methods Questionnaires were surveyed based on Systematic Sampling. Excel 2007 and SPSS 18.0 software were applied to analysis the data. Results (1) The total funding increased significantly, compared with 3.14million yuan in 2007, the total funding of health supervision agency in2012 is 4.02million yuan, which increased28.27%. (2) Compared with2.64 million yuan in 2007, the financial provision in 2012 is 3.79 million yuan, which increased 43.91%. (3) The government attaches great importance to the investment funds of western region, in the aspects of total funding and financial provision ,the western region is close to the central region;(4)Compared with the actual work demand and spending of health supervision agency, the government’s investment was still not enough, leading to funding gap, especially the western region, which needs to be solved recently;(5) The health supervision agency funds were unrea?sonable, because there were still 7.34%of service revenues to supply agency funding.

Objective To define the problems in the field of health supervision and classify them according to the Mac?ro-Model of Health System, and then to define key issues according to the result consultation. Methods Literature review is done to collect issues of health supervision, and the Macro Model of Health System is used to classify issues. And intention investigation is used to define the focus of issues. Results The key problems of Health Supervision system include:Inade?quate number of personnel, the law enforcement agency is incompatible with the institution nature, the weakening of health supervision function resulted from functional adjustments, lack of financial investment, Health Supervision system reform lags behind the economic reform, which Problem 1, Problem 17 and Problem 34 are also among the problems that are diffi?cult to solve. Conclusion In order to solve the key issues in the field of health supervision, top-level design is very essen?tial, and multi-sectoral cooperation is also very important. Specifically, the nature of institutions and institutional functions should be defined clearly. And personnel building and financial investment should also be strengthened.

由于不同用人单位存在的职业病危害风险差异较大,卫生行政部门有必要对用人单位职业病危害进行分类,对重点职业病危害、重点行业企业、重点人群进行重点监管,提高监管的科学性和效率.国内深圳[1]、上海[2～3]等地已作了有益的探索.

Objective:To analyze the funds gap of health inspection and supervision institutions between 2001 and 2006.Method:By using national sampling survey,the data were obtained about institutions' income and payout and analyzed the change of the funds gap of health inspection and supervision institutions between 2001 and 2006.Results: The result shows that the ratio of total income to payout increased from 66.6%in 2001 to 70.7%in 2006,which only increased by 4.1 percents.Fore-and-aft three years' construction personnel funds expanded by 18.9%,while the daily work funds reduced by 11.9%.Even if all the service incomes were counted in,the gap cannot be filled up.So the government should do something to solve the problem immediately.

为更好地贯彻<中华人民共和国职业病防治法>,加强和规范职业卫生监督管理工作,掌握我市职业病的发生及发展情况,及时发现危害劳动者健康的职业病危害因素,以有效预防和控制职业病的发生,杭州市于2006年建立并开通了职业病危害因素监测与网络直报信息系统.

目的 通过调查了解杭州市农用杀菌剂的品种、使用量和监管现状,探索切实可行的管理对策.方法 随机抽查杭州市农药销售单位52家、农药使用者203家,对杀菌剂使用情况进行统计,同时调查农业、卫生等部门对杀菌剂残留的监管现状.结果 杭州市目前使用的杀菌剂品种多达69种,年使用量达到331.65吨,且存在有欧盟禁止使用的品种,但仅有22个品种有最高残留限量标准,3个品种纳入农药日常监测体系. 结论农药残留管理部门应充分认识杀菌剂的潜在风险,加快制定对杀菌剂残留使用标准,加强杀菌剂残留分析技术的科研公关,多部门联合加大对使用杀菌剂残留监管力度,建立完整的农药残留监测体系.

职业卫生示范企业评价体系的确立和应用,对提高用人单位职业卫生系统管理水平和宣传贯彻《职业病防治法》具有重要意义。作者在应用2005年版国家职业卫生示范企业评价体系的实践中,提出应进一步完善现行职业卫生示范企业评价体系,提高评价指标设置的科学性和合理性,建议建立四级职业卫生管理评价机制并将职业卫生示范企业评价工作制度化。

宾馆、饭店供餐规模较大,一旦发生食品安全事件,社会影响巨大.为了解宾馆、饭店的食品卫生状况,我们对宾馆、饭店较易出现卫生问题的冷盘菜的微生物污染情况进行了调查,重点从凉拌菜、卤味及餐具卫生状况等几个方面进行探讨与分析.

为充分了解中小企业的分布和职业病危害状况,以便采取切实可行的职业卫生监督管理对策。作者对杭州市2004年底的职业病危害项目申报资料进行了统计和分析。对中小企业的行业分布、产业集聚特征以及使用高毒物品的企业、种类等方面进行了分析和描述,对目前存在的问题进行了讨论,提出了对本市中小企业职业卫生监督管理的对策和建议。

建立完善应对突发职业中毒事件的应急预案,形成统一指挥、职责分明、反应灵敏、运转高效的突发职业中毒事件应急机制,提高处置突发职业中毒事件的能力,是各级卫生监督部门加强社会管理和公共服务职能的一项重要工作,也是构建和谐社会的一项重要任务.为检验各地应急预案的有效性和处置突发职业中毒事件的实际能力,帮助各辖区卫生监督机构完善应急预案,提高救援人员应急指挥管理水平和专业技能,于2004～2005年对辖区5个卫生监督所开展了突发职业中毒事件应急处置演练考核,并对应急处置能力作出总体评估.

卫生监督体系存在的根本在于其职能的落实。作者通过文献评阅、层次分析法、意向论证等方法综合推论出卫生监督体系现存的首要问题,即卫生监督职能难以落实。在此基础上,论述了卫生监督职能难以落实的具体表现,并用现实数据进行了论证。

通过对一起违反消毒产品管理案的评析,试图找出消毒产品卫生管理相关规定、技术规范与实际运用的联系和关键环节,供卫生监督人员参考.

本研究采用分层整群抽样方法选取样本,通过对我国东、中、西部11省共209个样本卫生监督机构收入情况的调查,分析我国卫生监督机构业务收入构成的现状和存在的问题。结果提示:机构业务收入占机构总收入的四分之一之多,说明业务收入仍然是卫生监督机构的一项重要收入来源。分析其构成和近年来发展趋势来看呈现三个特点:一是县级机构对业务收入的依赖性要高于市级机构,省级卫生监督机构依赖性相对较弱;二是机构业务收入的来源主要是执法监督收入(占业务收入的62.2%),其次是证照管理收入(占业务总收入18.6%);三是近年来,业务收入中执法监督收入比重基本呈现逐年增多的趋势,而证照管理收入所占比重则逐年降低。

作者提出并论证解决我国卫生监督体系监督职能难以落实的治本策略和重塑我国卫生监督体系的改革步骤。运用边界分析法和专家咨询法,结合卫生监督体系监督职能难以落实的根源和作用机制,提出治本策略和配套的改革步骤,并进一步运用意向问卷调查了209所省、市、县卫生监督机构对治本策略和改革步骤的意见。为解决我国卫生监督体系监督职能难以落实的治本策略是保证政府财政投入的稳定和明确界定卫生监督职能;重塑我国卫生监督体系的改革步骤:(1)前提是明确卫生监督的职能;(2)关键在明确政府的投入标准;(3)加快立法进程是重要举措;(4)改革劳动人事制度稳定和吸引高素质人才;(5)明确技术和管理规范提高卫生监督机构的运作效率。

明确了卫生监督体系长足发展的羁绊,则应"对症下药"。科学的职能界定是首要问题的解决之道,也是探索治本策略时亟待确定的第一要务。课题组通过专家咨询和机构多重论证相结合的方法研制界定了我国卫生监督机构的职能和主要任务,分别为11职能、58类别、166内容、457项目。对209家样本机构的意向调查结果显示,课题组界定的卫生监督职能被普遍认可。

为适应杭州市社会经济快速发展的需要,满足人们日益增长的公共卫生需求,研究杭州地区近几年公共卫生体系涵盖的疾病控制、卫生监督、妇幼保健、精神卫生、医疗救治、基层防保等方面的运行机制和效果进行比较全面的回顾性调查。通过研究分析发现存在的问题,从而提出相应的对策,为构建良好的新型公共卫生运行机制提供参考依据。

为进一步完善与健全公共卫生体系,通过对杭州地区公共卫生体系建设的现状分析和探索,提出公共卫生体系建设的基本构架设想,为相关部门提供参考和决策依据。

Objective To investigate the status of 48 acute occupational poisoning accidents from 1984 to 2003 in Hangzhou and analyze the causes and rules,thereby provide a scientific basis for effective prevention or control of the accident.Method Collect the investigation data of the acute occupational poisoning accidents,analyze the detail items such as the occurrence time,vocation distribution,poison category,accident cause,rescue level and so on.Result ①The acute occupational poisoning accident in Hangzhou city presents somewhat ascendant trend during recent 10 years.②The accidents mainly happened in such vocations as chemistry industry,light industry and public utilities.③Extremely toxic and high toxic chemicals are the leading causes to induce the accident,and the poisoning happened in rescue persons are more than that of the workers in scene of accident.④The main reasons of acute occupational poisoning accidents are lack of security education and acting against the safe operational rules.Conclusion The attention must be put on the study of the countermeasures on poisoning accident control,especially the hydrogen sulfide poisoning and other high toxic chemicals poisoning accidents control in Hangzhou.

笔者根据电子自旋共振(ESR)仪可测定自由基含量的原理[1],研究了未辐照和经(3～20)×103 Gy辐照的奶粉、面粉、大米、辣椒的ESR谱特征及不同贮存期(3～102 d)ESR峰值的变化规律.