跨領域分析職場健康潛在危害以優化艾灸治療場域

To Optimize Moxibustion Treatment Room by Interdisciplinary Analysis of the Workplace Health Hazards

前言／目的：現今空氣品質日漸備受重視，艾灸治療過程中病人有空汙疑慮，治療區空氣瀰漫著白色煙霧，雖然時間很短暫（6-15分鐘），但是有些病人偶會抱怨喉嚨緊緊不舒服感；本門診有50％護理師（3位）因為長期在有艾煙的環境下工作，也引起身體不適，包含皮膚過敏、夜間及半夜咳嗽、慢性支氣管炎反覆發作等現象，轉換了單位後這些不適確實有好轉，可能真的在長期暴露下會影響部分人員的健康。環保署也將二氧化碳（CO2）與細懸浮粒（PM 2.5）列為空氣品質控管重要指標，目前本院中醫部所使用之艾灸經燃燒5-15分鐘的過程，其散布於空氣中的粒子可能包含CO2與PM 2.5，對於治療室內之醫護人員不管是短中長期暴露，皆可能有健康上的危害，藉由此次專案做一系列評估改善以優化中醫職場環境。方法：1.艾粒材質差異分析與挑選。2.重組抽風機，增加抽風功率。3.專責人員定期檢查設備與監測空氣品質。4.制定艾灸治排床標準。結果：艾灸材質的轉換再加上進氣量與排氣量的改善，讓本部治療室空氣品質大幅改善，CO2平均值從1089 ppm降至834 ppm，超過標準發生率從62.5％降低到25％、進步率60％、達成率150％；PM 2.5平均濃度從28.25μg/m^3降低為24.25μg/m^3，濃度超標的比率從25％降低到12.5％、進步率50％、達成率125％；空氣品質有感改善感受性達93％，成功優化中醫職場環境空氣品質。

Air quality is gaining more attention nowadays. Patients who come to outpatient departments (OPDs) of traditional Chinese medicine (TCM) have doubts with air pollution while doing moxibustion therapy with burning wormwood. Although the treatment time is very short, about 6-15 minutes, the air in the treatment area is usually filled with white smoke. Some patients complain that their throat is tight and uncomfortable while doing moxibustion therapy. 50% of nurses (3 people) in TCM clinics had caused physical discomfort due to long-term work in the environment of moxibustion smoking, including skin allergies, night and midnight cough, and repeated exacerbation of chronic bronchitis. These discomfortable symptoms did improve when they changed clinic units. It may actually affect the health state of people under long-term moxibustion smoke exposure. The Taiwan Environmental Protection Agency (EPA) lists CO_2 and fine suspension particles (PM 2.5) as important indicators for air quality control. This project is aim to improve our OPDs environment for patients and medical staff by a series of air quality evaluations. Here are the improve results. Air quality of the treatment room has greatly improved after changing the moxibustion materials and reorganizing exhaust ventilation air flow. The average of CO_2 value had dropped from 1089 ppm to 834 ppm. The incidence rate of over-standard has decreased from 62.5% to 25%. The progressive rate is 60%, and the achievement rate is 150%. The average concentration of PM 2.5 had reduced from 28.25μg/m^3 to 24.25 μg/m^3. The ratio of excessive concentration reduced from 25% to 12.5%. The progressive rate is 50%, and the achievement rate is 125%. Feelings of improvement of the air quality is up to 93%. The air quality of traditional Chinese medicine workplace is successfully optimized.