北京实施禁烟政策后部分餐饮场所二手烟暴露评价

【作者】 逯延敏；

【导师】 姜垣；

【作者基本信息】 中国协和医科大学 ， 流行病与卫生统计， 2009， 硕士

【摘要】 背景餐饮场所二手烟暴露普遍,给公众的健康带来了极大的威胁。国外经验表明无烟立法是消除二手烟危害,保护公众健康的有效措施。2008年奥运会在我国举办,我国公开承诺把这届奥运会办成“无烟奥运”。为了保护公众健康和兑现“无烟奥运”的承诺,2008年3月31日,北京市人民政府公布了《北京市公共场所禁止吸烟范围若干规定》,5月1日开始实施,要求10类场所完全禁止吸烟,5类场所（包括餐饮场所）采取禁烟措施,但可以设立吸烟区。目的收集有关北京市餐饮场所禁烟规定执行情况和空气中细颗粒物浓度的信息,以评价《北京市公共场所禁止吸烟范围若干规定》在餐饮场所的执行效果,为制定适合我国国情的餐饮场所禁烟政策提供依据。方法通过方便抽样的方法,在考虑不同类型餐饮场所的基础上,适当考虑餐饮场所的禁烟政策和规模,在北京市共选择了94家餐饮场所进行细颗粒物(空气动力学直径≤2.5μg,即PM_2.5)浓度监测,其中包括了2007年监测过的52家餐饮场所与2006、2007年监测两次的18家餐饮场所。结果1)在已公布的42家“无烟餐饮单位”中,39家完全禁烟,3家部分禁烟;在随访52家餐饮场所中,13家完全禁烟,13家部分禁烟。2008年现场观察的52家完全禁烟的餐饮场所中,24.52%存在着违规吸烟现象;15家部分禁烟的餐饮场所中,33.33%非吸烟区有人吸烟:在这些违规吸烟的餐饮场所中,90%以上的餐馆无人劝阻。2)2008年监测的94家餐馆室内PM_2.5浓度平均值为103.89μg/m³,室外的为87.38μg/m³。对室内外PM_2.5浓度的对数值进行配对t检验,发现室内PM_2.5浓度高于室外的。3) 16家没有禁烟标志的室内PM_2.5平均浓度为130.15μg/m³,78家有禁烟标志的为115.89μg/m³。协方差分析结果表明,在控制了室外浓度影响后,禁烟标志对室内PM_2.5浓度的影响没有统计学差异。4)协方差分析结果表明,在控制室外浓度影响后,采取了禁烟规定的餐饮乘夷赑M_2.5浓度低于无禁烟规定的,但完全禁烟与部分禁烟餐馆的室内浓度之间却没有差别。5)15家部分禁烟的餐饮场所中,吸烟区与非吸烟完全隔开的餐饮场所室内PM_2.5浓度并不比没有隔开的低,使用通风设备的也不比没有使用的低。6)协方差分析结果表明,在控制了室外浓度的影响后,燃料类型和厨房与餐厅是否完全分开并没有对餐饮场所室内PM_2.5浓度产生显著性的影响。7)对随访调查的52家餐饮场所PM_2.5浓度对数值进行协方差分析,结果表明在控制室外PM_2.5浓度影响后,2008年餐饮场所的室内PM_2.5平均浓度低于2007年的。8)对随访调查了3年的18家餐饮场所的PM_2.5浓度对数值进行协方差分析,结果表明在控制室外PM_2.5浓度影响后,三次调查的室内PM_2.5平均浓度并没有区别。结论本次调查的餐饮场所室内二手烟暴露水平明显降低,但与国际其他类似研究结果有一定的差距,并且没有达到相应的卫生标准要求;北京市餐饮场所禁烟政策的监督力量薄弱,执行力度不够;餐饮单位采取禁烟措施的积极性不高;通风设备等措施不能解决二手烟暴露问题;完全禁烟是消除餐饮场所二手烟危害的关键措施。更多还原

【Abstract】 BackgroundSecondhand smoke（SHS） exposure of hospitality venues is prevalent,which has lead to great health hazards.The experience from other countries tells us that smoke-free law is the key to eliminate SHS exposure and protect people from SHS risk.As the host of 2008 Olympic Games,China had made a publicly promise that the Games would be smoke-free.Thus the People’s Government of Beijing City promulgated Administrative Regulation about smoke-free rules in public places on 31 March 2008 which came into effect on 1 May 2008.The New Regulation prohibits smoking in 10 categories of public places,but 5 categories of public places,including hospitality venues can keep smoking areas.ObjectiveTo collect information on the execution of partial smoking-free policy in hospitality venues as well as levels of particulate matters less than 2.5 microns in diameter(PM_2.5); To evaluate the effectiveness of partial smoking-free policy in hospitality venues.MethodsA total number of 94 hospitality venues were conveniently sampled in Beijing, considering the proportion of different types,smoking policy and their holding capacity. The SHS exposure was assessed by observation and measuring the level of particulate matters using TSI Sidepak in these hospitality venues.94 hospitality venues were tested about their PM_2.5 level in 2008,18 of which were tested for three times,and 52 of which tested for two times,together with another 42 venues which had been promulgated "smoke-free hospitality venues".Results1) 39 of smoke-free hospitality venues which had been promulgated completely banned smoking and 3 venues partially banned smoking.13 of Follow-up survey of 52 venues completely banned smoking and 13 venues partially banned smoking.There are 13 venues existing smoking in the 52 completely banned smoking venues conducted in 2008,and 5 venues existing smoking in the 15 partially banned smoking venues. During these venues where people run counter to smoking policy,there were 90%no people stopping it.2) The average indoor PM_2.5 level of 94 venues was 103.89μg/m³,and outdoor 87.38μg/m³.The average indoor PM_2.5 level is higher than outdoor.3) The average indoor PM_2.5 level of 16 venues with no sign of banning smoking was 130.15μg/m³,and the other was 115.89μg/m³.The SHS exposure changed little in the venues with sign of banning smoking comparing with that no smoking banning sign.4) Analysis of covariance implies that the indoor PM_2.5 level of completely and partially banning smoking venues was lower than that in the venues with no smoking regulation, however,there was no difference in the indoor PM_2.5 level between completely and partially banning smoking venues.5) The indoor PM_2.5 level has no notable association with the situation about smoking and non-smoking area.The ventilation facilities also can’t reduce the SHS exposure.6) The fuel type and conditions of separation of dinning room from kitchen have on a noticeable influence on the indoor PM_2.5 level.7) Evaluation of banning smoking policy in hospitality venues indicates that the indoor PM_2.5 concentration of 52 venues in 2008 is lower than that in 2007.8) Analysis of covariance of 18 venues surveying for three years shows that the indoor PM_2.5 level had changed little in the past three years.ConclusionThe average indoor PM_2.5 level of hospitality venues has obviously declined after implementation of Beijing’s partial smoke-free policy,but this degree is not so distinct as that of other countries which had done such research,and the average indoor PM_2.5 concentration higher than the health standard of SHS exposure;The supervision of partial smoke-free policy of hospitality venues in Beijing is weak,and execution is not enough; The proportion of venues which have taken such policy is small;The ventilation facilities can not eliminate the SHS exposure;The smoke-free policy is the key to solve SHS exposure problems.更多还原