Exner M, Gebel J, Heudorf U, Fischnaller E, Engelhart S
Institut für Hygiene und Offentliche Gesundheit der Universität Bonn, Bonn, BRD.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2008 Nov;51(11):1247-57. doi: 10.1007/s00103-008-0694-3.
Within the last two decades risks posed by infectious diseases outside of hospitals and nursing homes had no high significance in the public perception. The home environment is regarded as a save shelter from infectious risks. In the mean time there have been dramatic socio-demographic, health policy and technological changes which have increased infectious risks outside medical facilities. In Germany up to 1.4 million people with multiple morbidities are nursed at home. Technological changes with the aim to protect the environment, like reduction of water temperature and water volumes in washing processes has lowered the efficacy to control pathogens. Thus it is time to revise the process of risk assessment in which not only aspects of environmental protection but also those of health protection must be taken into account. The article gives an overview of new risks and epidemiological changes and discusses the necessity of a new risk assessment and risk management approach which hopefully will lead to a changing paradigm.
在过去二十年里,医院和疗养院之外的传染病所带来的风险在公众认知中并不十分显著。家庭环境被视为免受感染风险的安全庇护所。与此同时,社会人口统计学、卫生政策和技术发生了巨大变化,增加了医疗设施之外的感染风险。在德国,多达140万患有多种疾病的人在家中接受护理。旨在保护环境的技术变革,如降低洗涤过程中的水温及用水量,降低了控制病原体的效果。因此,是时候修订风险评估流程了,其中不仅要考虑环境保护方面,还要考虑健康保护方面。本文概述了新的风险和流行病学变化,并讨论了采用新的风险评估和风险管理方法的必要性,有望带来一种转变的范式。