Microclimate in the premises of healthcare institutions. The microclimate in the premises of the hospital and the systems that provide it (ventilation and heating). Microclimate in a medical institution

1. The master plan of the hospital addresses the following issues:

a) placement of the hospital complex on the territory of the hospital site;

b) location of the hospital on the territory of the settlement;

c) zoning of the hospital site, taking into account the functional significance
elements of the hospital complex;

d) building density of the hospital site;

e) placement of access roads on the hospital site.

2. The situational plan of the hospital addresses the following issues:

a) location of the hospital on the territory of the settlement;

b) the presence of a green area and favorable natural factors;

c) placement of the hospital and "harmful" enterprises, taking into account the wind rose;

d) good transport links between the population and the hospital;

e) location of the hospital on the territory of the hospital site.

3. Favorable medical and protective regime, effective prevention nosocomial infections, the availability of the use of the hospital park by patients is ensured by the hospital development system:

a) free;

b) decentralized;

c) polyblock;

d) block;

e) centralized.

4. On the territory of the hospital site are placed functional areas:

a) area of ​​the pathoanatomical building;

b) boiler room and laundry area;

c) zone of the main medical building;

d) zone of green spaces;

e) the area of ​​the household yard.

5. Sanitary standards provide for entrances to the territory of the hospital:

a) general entry and entry into the economic zone;

b) the number of entries is determined by the hospital administration;

c) no more than two entrances;

d) one central entrance;

d) for each building.

6. One ward section in therapeutic departments is designed for:

a) 60 beds;

b) 25-30 beds;

c) 50 beds;

d) regulated only in city hospitals;

d) not regulated.

7. The composition of the ward section includes:

a) corridor and hall;

b) rooms for medical personnel;

c) toilet rooms;

d) medical auxiliary premises;

d) chambers.

8. Good natural ventilation and illumination provides interior layout ward section:

a) two-corridor;

b) compact;

c) one-corridor one-way;

d) one-corridor two-way;
e) angular.

9. Do the four-bed ward for therapeutic patients with an area of ​​20 m 2 meet the hygienic standards:

c) corresponds only to rural hospitals;

d) corresponds to small-bed hospitals;

e) corresponds to multi-bed hospitals.

10. The microclimate of a hospital ward is determined by:

a) relative humidity;

b) air temperature;

c) barometric;

d) air mobility pressure;

e) natural light.

11. Optimal microclimate indicators for the wards of the therapeutic department:

a) air temperature 18°C, relative humidity 80%, air mobility 0.1 m/s;

b) air temperature 25°C, relative humidity 25%, air mobility 0.4 m/s;

c) air temperature 24°С, relative humidity 75%, air mobility 0.5 m/s;

d) air temperature 18°С, relative humidity 45%, air mobility 0.2 m/s.

12. When hygienic assessment of natural light hospital premises take into account:

a) the coefficient of deepening of the room;

b) coefficient of natural illumination;

c) the number of bacteria in 1 m 3 of air;

d) light factor.

a) in operating rooms;

b) in the preoperative;

c) in sanitation rooms;

d) in the wards of the rehabilitation department;

e) in intensive care units.

14. Optimal orientation of operating room windows:

d) east.

15. Sources of air pollution of hospital premises with gaseous substances:

a) people (anthropogenic factor);

b) medications and medicinal gases;

c) polymeric materials;

d) dry cleaning of premises;

e) disinfectants.

16. The maximum allowable content of carbon dioxide in the air of hospital wards:

17. There should be ventilation in infectious diseases departments:

a) mechanical supply;

b) supply and exhaust with a predominance of exhaust;

c) supply and exhaust with a predominance of inflow;

d) can be any, depending on design features department buildings;

e) natural through.

18. When assessing the quality of polymeric materials for medical purposes of the first group, it is necessary to apply:

a) sanitary-toxicological assessment of individual consequences;

b) sanitary and microbiological research;

c) sanitary-physical methods of sanitary-hygienic research;

d) assessment of biological compatibility with body tissues;

e) sanitary-chemical methods of sanitary-hygienic research.

19. The placement of the operating unit is rational:

a) in a separate building of the hospital;

b) on one of the floors of the ward department;

c) on the same floor with the medical and diagnostic department;

d) isolated from ward departments, in the form of an independent unit;

e) on the first floor of the reception building.

20. The following requirements apply to operating units:

a) isolation of the operating unit;

b) natural ventilation devices;

c) placement of anesthetic and sterilized rooms separately from operating rooms;

d) allocation of "clean" and "purulent" operating rooms;

e) all of the above except b).

21. Arrangement of a common admission department for therapeutic and surgical patients:

a) not allowed;

b) allowed;

c) is allowed in multi-bed hospitals;

d) is allowed after thorough disinfection;

e) is allowed only in low-bed hospitals.

22. The infectious disease department of a multi-bed hospital should be located:

a) on any floor of any building in the presence of a gateway from the side of the corridor and a separate elevator;

b) in an independent building;

c) in the main building;

d) in a separate wing of the medical building;

e) on the upper floors of the medical building.

23. The most rational layout of the hospital section for infectious patients:

a) one-way one-way;

b) box;

c) two-corridor;

d) compact;

e) one-corridor two-way.

24. Boxing differs from a half-box:

a) the presence of a common entrance from the department of personnel and the patient;

b) the presence of a sanitary room;

c) the presence of a lock for personnel;

d) the presence of an entrance from the street for patients;

d) is no different.

25. Premises intended for the reception of non-communicable patients should be used for discharge of patients:

a) it is impossible;

c) it is possible in multi-bed hospitals;

d) it is possible in low-bed hospitals;

e) it is possible on different days of the week according to the schedule of the administration.

26. Chambers for the joint stay of puerperas and newborns may be provided in the postnatal departments:

a) physiological;

b) pathology of pregnancy;

c) observational;

d) in all the listed departments.

27. Occupational hazards in the work of medical personnel are associated with:

a) with the features of treatment technology;

b) with an insufficient set of premises for doctors and medical staff;

c) in violation of hygienic conditions;

d) with the peculiarities of labor processes;

e) in violation of the working regime.

28. Occupational diseases medical personnel related to the peculiarities of work:

a) diseases of cardio-vascular system;

b) chronic inflammatory diseases organs of the gastrointestinal

c) drug allergy;

d) diseases of the musculoskeletal system;

d) fatigue.

29. Radiologist for 10 years of work can receive the maximum total dose of radiation:

30. In the departments of open sources, the protection of medical personnel should be carried out in the following areas:

a) monthly medical monitoring of the health of personnel;

b) application individual means protection;

c) the correct planning decision of the department;

d) protection from external radiation;

e) protection of the respiratory organs and skin from the ingress of radioactive substances.

31. Basic principles for the protection of medical personnel from external exposure:

a) use of protective suits;

b) distance protection;

c) protection by quantity;

d) screen protection;

e) time protection.

Answers:

1. a, c, d, e;

2. a, b, c, d;

4. a, c, d, e;

7. a, b, c, d, e;

15. a, b, c, e;

18. a, b, c, d, e;

27. a, c, d, e;

30. b, c, d, e;

31. b, c, d, e.

Application No. 1

Very great importance microclimatic conditions have a healing factor, and in the winter and transitional periods of the year, the temperature in the wards should be in the range of 18-21 ° C, and in summer the upper limit of the comfort zone should not exceed 24 ° C. To do this, the heating devices located there must have devices for their regulation. In particular, special devices have already been developed for conventional radiators, which automatically maintain the set air temperature.

To prevent overheating in the hot summer months, the only radical remedy is the installation of air conditioners, which should first of all be equipped in wards for patients suffering from severe disorders of the cardiovascular system.

As palliative measures, it is advisable to use the correct orientation of windows according to the cardinal points, the coloring of the outer walls in White color, vertical gardening, installation of shutters, blinds and curtains, the use of special types of heat-retaining glass, increasing the speed of air movement using room fans, etc.

Given the beneficial biological and psycho-physiological effects of solar radiation, it is necessary to ensure sufficient insolation of the ward rooms, and their best orientation is considered to be south. It has been established that even a weakened ultraviolet irradiation that has penetrated ordinary glass can have a detrimental effect on pathogenic flora. At the same time, the rays of the sun penetrating the ward raise the mood of patients to some extent and improve their well-being.

Finally, the proper orientation of windows is one of the prerequisites for the sufficiency of natural light, the indicators of which for ward rooms are equal to the light coefficient 1:5 - 1:6 and KEO not less than 1.0.

Sections for drip and intestinal infections are distinguished by specific features, where boxes, semi-boxes and boxed wards should be equipped. Of these, the first have an external entrance with a vestibule, a bath, a toilet bowl, a ward for 1 bed, a gateway for staff and a transfer locker for transferring dishes and food. Semi-boxes usually consist of two compartments, united by a common bath-shower room.

As for the boxed wards, they have only glass partitions between the beds, which to a certain extent protect against infection.

"Hygiene", V.A. Pokrovsky

See also:

Temperature changes must not exceed:

In the direction from inner to outer wall- 2°C

In the vertical direction - 2.5°C per meter of height

During the day at central heating- 3°С

Relative humidity should be 30-60% Air speed - 0.2-0.4 m/s

Methods for a comprehensive assessment of the influence of the microclimate on the body.

A separate consideration of the microclimate factors does not allow an objective assessment of the influence of the microclimate on the body, since all factors are interconnected and can weaken or strengthen each other (temperature and air velocity, temperature and humidity, etc.).

The microclimate of hospital premises is determined by the thermal state of the environment, which determines the heat sensation of a person and depends on temperature, humidity, air velocity, and the temperature of the building envelope. Comfortable microclimate conditions are provided by heating and ventilation systems, air conditioning devices in individual rooms. Various types microclimate:

1) comfortable type - thermal comfort is provided most physiologically, without functional overloads.

2) Heating and cooling types of microclimate - thermoregulation mechanisms are in a state of tension.

Evaluate the influence of the microclimate on the org-m of a person (determine the temperature of the skin, examine sweating, evaluate the thermal sensation of a person)

To assess the parameters of the microclimate, they use: mercury and alcohol thermometers; thermometers are divided into station and aspiration, minimum and maximum (T air) Relative humidity is measured by a hygrometer or psychometer (station and aspiration (Assmann)) ) and anemometers (for high speeds)

2. There are methods for a comprehensive assessment of the microclimate and its effect on the body:

1) Assessment of the cooling capacity of the air. The cooling capacity is determined using a catathermometer and is measured in mcal / cm "s. The norm (thermal comfort) for a sedentary lifestyle is 5.5-7 mkal / cm2-s. With a mobile lifestyle - 7.5-8 mkal / cm2-s. For large rooms , where heat transfer above the rate of cooling capacity is approximately 4-5.5 µcal/cm s.

2) Determination of EET (equivalent effective temperature), radiation temperature and RT (result temperature).

1. The equivalent effective temperature (EET) is determined from the table, taking into account the air velocity and relative humidity.

2. The average radiation temperature characterizes the thermal effect of solar radiation. It is determined using a balloon thermometer. The average radiation temperature can be used as an independent indicator characterizing thermal radiation, or it can be used to determine the resulting temperature.

3. The resulting temperature (RT) allows you to determine the total thermal effect on a person of temperature, humidity, air velocity and radiation. The determination of RT is made according to nomograms, after the values ​​of all four of the above microclimate factors (humidity, air velocity, air temperature, radiation temperature) are determined. There are nomograms for determining RT in light and heavy physical labor. Comfortable RT at rest is 19°C, for light physical labor - 16-17°C

3) Objective methods:

Determination of skin temperature

Examination of the intensity of perspiration

Investigation of pulse rate, blood pressure, etc.

Cold test - the study of the body's adaptation to cold. The principle is that the temperature is measured on a selected area of ​​the skin with an electrothermometer, then ice is applied for 30 seconds, after which the skin temperature is measured every 1-2 minutes for 20-25 minutes. After that, adaptation to cold is assessed:

Normal - temperature returns to baseline after 5 minutes

Satisfactory adaptation - after 10 minutes

Negative result - 15 minutes or more.

3,6. Hygiene requirements for heating, ventilation and lighting of hospital premises. Hygienic characteristics of various central heating systems.

1. Air heating.

Outside air is heated up to 45-50 degrees in the chambers and is supplied to the room through the channels in the walls, from where it is taken through the exhaust channels.

Disadvantages:

1) High temperature and low humidity of the supply air

2) Uneven room heating

3) Possibility of contamination of supply air with dust

It is indicated for rooms with high humidity, but in general it is not practical for heating residential premises.

2. Steam heating system.

Device:

Available steam boilers, where steam is formed, which goes through the pipes and, passing through the heater, condenses, giving off heat and filling the batteries, the resulting water returns back.

Steam heating, although widely used until the 70s, did not find distribution in the future. And although it was economically advantageous, it was everywhere replaced by water heating.

Disadvantages of steam heating

1) Practically unregulated, since the steam always has a temperature of about 100 fadus. Therefore, this heating system cannot create a different temperature in the room depending on the outdoor temperature.- .

2) Products of incomplete combustion give off an odor in the room.

3) Generates noise as steam bubbles make metallic sounds.

4) If a micro-hole has formed, then steam fills the room. Humidity rises to 100%

5) High humidity indoors and during normal operation.

3. Water heating system.

The device is similar to a steam heating system, but not steam, but hot water flows through the pipes.

Heating must maintain a constant comfortable temperature in room. Therefore, the temperature of the water flowing through the pipes must depend on the outdoor temperature:

Thus, the great advantage of water heating is the ability to adjust, that is, the ability to different temperature provide outdoor air optimal temperature in room. Heating must operate in strict accordance with the ambient temperature.

Water heating most common at present.

4. Radiant (panel) heating.

The principle is - in heating the internal surfaces of the outer walls (the panel part of the building). Pipes of water or steam heating are laid in the walls. In the event that the walls are colder than the human body (which usually happens), then the person loses heat by radiation to these cold surfaces due to the temperature difference. With panel heating, the walls heat up to 35-45 degrees, so heat loss by radiation is sharply reduced, moreover, the walls themselves radiate heat that is absorbed by the human body. In this regard, a person feels the same thermal comfort at an air temperature in the room of 17-18 degrees, as at 19-20 degrees under normal conditions.

Finally, another advantage of radiant heating is the possibility of using it to cool the air while passing, for example, water from an artesian well (10-15 degrees).

Purpose of the lesson:

1. To study the influence of microclimate factors on the human body (atmospheric pressure, temperature, relative humidity, air velocity) and master the methods for their determination.

2. Analyze the results obtained and give a hygienic conclusion about the microclimate of the training room.

Location of the lesson: educational profile laboratory of atmospheric air hygiene.

Modern man, due to objective and subjective reasons, spends most of the time (up to 70%) of the day indoors (industrial premises, housing, medical institutions, etc.). The indoor environment has a direct impact on people's health.

Microclimate - state environment in a limited space (room), determined by a complex of physical factors (temperature, humidity, atmospheric pressure, air velocity, radiant heat) and affecting the heat exchange of a person.

The influence of the microclimate on the body is determined by the nature of heat transfer to the environment. The release of heat by a person in comfortable conditions occurs due to heat radiation (up to 45%), heat conduction - convection, conduction (30%), sweat evaporation from the skin surface (25%). Most often, the adverse effect of the microclimate is due to an increase or decrease in temperature, humidity or air velocity.

High air temperature combined with high humidity and low air velocity makes it difficult to release heat by convection and evaporation, resulting in possible overheating of the body. At low temperature, high humidity and air velocity, the opposite picture is observed - hypothermia. At high or low temperatures of surrounding objects, walls, heat transfer by radiation decreases or increases. The increase in humidity, i.e. saturation of the room air with water vapor, leads to a decrease in heat transfer by evaporation.

Characteristics of individual categories of work

¨ category Ia - work with an intensity of energy consumption up to 120 kcal / h (up to 139 W), performed while sitting and accompanied by slight physical stress (a number of professions in precision instrumentation and engineering enterprises, in watchmaking, clothing production, in management, etc. .)

¨ category Ib - work with an energy intensity of 121-150 kcal / h (140-174 W), performed while sitting, standing or walking and accompanied by some physical stress (a number of professions in the printing industry, in communication enterprises, controllers, masters in various types production, etc.)

¨ category IIa - work with an energy intensity of 151-200 kcal / h (175-232 W), associated with constant walking, moving small (up to 1 kg) products or objects in a standing or sitting position and requiring a certain physical exertion (a number of professions in machine-assembly shops of machine-building enterprises, in spinning and weaving production, etc.).

¨ category IIb - work with an intensity of energy consumption of 201-250 kcal / h (233-290 W), associated with walking, moving and carrying loads up to 10 kg and accompanied by moderate physical stress (a number of professions in mechanized foundry, rolling, forging, thermal, welding shops of machine-building and metallurgical enterprises, etc.).

¨ category III - work with an intensity of energy consumption of more than 250 kcal / h (more than 290 W), associated with constant movement, moving and carrying significant (over 10 kg) weights and requiring great physical effort (a number of professions in blacksmith shops with hand forging, foundry workshops with manual stuffing and filling of molding boxes of machine-building and metallurgical enterprises, etc.).

The doctor should be able to assess the microclimate of the room, predict possible changes in the thermal state and well-being of persons exposed to an unfavorable microclimate, assess the risk of colds and exacerbation of chronic inflammatory processes.

Documents regulating the parameters of the indoor microclimate

When assessing microclimate parameters, the following documents are used:

¨ SanPiN 2.2.4.548-96 "Hygienic requirements for the microclimate of industrial premises".

¨ SanPiN 2.1.2.1002-00 "Sanitary and epidemiological requirements for residential buildings and premises".

Sanitary regulations establish hygienic requirements for indicators of the microclimate of workplaces in industrial and other premises, taking into account the intensity of energy consumption of workers, the time of work and periods of the year. Microclimate factors should ensure the preservation of the thermal balance of a person with the environment and the maintenance of an optimal or acceptable thermal state of the body.

Optimal microclimatic conditions provide a general and local feeling of thermal comfort during an 8-hour work shift with minimal stress on thermoregulation mechanisms, do not cause deviations in health status, create prerequisites for a high level of performance and are preferred at workplaces.

Vertical and horizontal air temperature fluctuations, as well as air temperature changes during the shift, should not exceed 2 ° C and go beyond the values ​​\u200b\u200bspecified in tables 1, 2.

Table 1

Microclimate parameters in the premises of medical institutions

table 2

Microclimate parameters in residential premises

Classification of microclimate types

Optimal- a microclimate in which a person of the appropriate age and state of health is in a sense of thermal comfort.

Permissible- a microclimate that can cause transient and rapidly normalizing changes in the functional and thermal state of a person.

Heating- microclimate, the parameters of which exceed the permissible values ​​and can cause physiological changes, and sometimes cause the development of pathological conditions and diseases (overheating, heat stroke, etc.).

Cooling- microclimate, the parameters of which are below the permissible values ​​​​and can cause hypothermia, as well as related pathological conditions and diseases.

RESEARCH PROCEDURE

Definition atmospheric pressure

Barometric pressure on the Earth's surface is uneven and unstable. As you go up to a height, there is a decrease in pressure, when you go down to a depth - an increase. A change in pressure in one and the same place depends on various atmospheric phenomena and serves as a well-known harbinger of a change in the weather.

Under normal conditions, fluctuations in atmospheric pressure (10–30 mm Hg) are easily and imperceptibly tolerated by healthy people. However, some patients (people with minor and significant health disorders) are very sensitive to even small changes in atmospheric pressure - those suffering from rheumatic diseases, nervous diseases, some infectious diseases: the exacerbation of the course of pulmonary tuberculosis coincided with sharp fluctuations in barometric pressure.

In special conditions of life and work, deviations from normal atmospheric pressure can serve as a direct cause of a violation of people's health. Let's consider some of them.

In mountainous regions located at an altitude of 2500–3000 m above sea level and above, a significant decrease in barometric pressure is observed, accompanied by a corresponding decrease in the partial pressure of oxygen. This circumstance is the main reason for the mountain (altitude) illness, expressed in the appearance of shortness of breath, palpitations, dizziness, nausea, nosebleeds, pallor of the skin, etc. The clinical signs of mountain sickness are based on hypoxia.

Increased atmospheric pressure is found in caissons (fr. caisson letters. box) - special devices for diving operations. If the necessary preventive measures are not observed, high blood pressure can cause dramatic physiological changes in the body, which can take on a pathological character with the development decompression sickness: during a rapid transition from the atmosphere with high blood pressure in an atmosphere with ordinary pressure, an excess amount of nitrogen dissolved in the blood and tissue fluids (mainly in adipose tissue and in the white matter of the brain) does not have time to be released through the lungs and remains in them in the form of gas bubbles. The latter are carried by the blood throughout the body and can cause gas embolisms in various parts of the body. Clinical manifestations of decompression sickness are musculo-articular and retrosternal pain, skin itching, coughing, vegetative-vascular and cerebral disorders. The entry of a gas embolus into the coronary vessels of the heart can cause death.

Thus, barometric pressure measurements are of great practical importance in preventing the serious consequences of these changes for human health.

Atmospheric pressure is measured using mercury barometer or aneroid barometer. For continuous recording of atmospheric pressure fluctuations, barograph(Fig. 1). Atmospheric pressure fluctuates on average within 760±20 mm Hg.

Fig 1. Barograph

Determination of air temperature

Air temperature has a direct effect on human heat transfer. Its fluctuations significantly affect the change in the conditions of heat transfer: high temperature limits the possibility of heat transfer by the body, low temperature increases it.

The perfection of thermoregulatory mechanisms, the activity of which is carried out under constant and strict control by the central nervous system, allows a person to adapt to various environmental temperature conditions and to endure significant deviations in air temperature from the usual optimal values ​​for a short time. However, the limits of thermoregulation are by no means unlimited and their transition causes a violation of the thermal balance of the body, which can cause significant harm to health.

Prolonged stay in a highly heated atmosphere causes an increase in body temperature, an acceleration of the pulse, a weakening of the compensatory ability of the cardiovascular apparatus, a decrease in the activity of the gastrointestinal tract due to a violation of heat transfer conditions. In such conditions of the external environment, rapid fatigue and a decrease in mental and physical performance are noted: attention, accuracy and coordination of movements decrease, which can cause traumatic injuries when performing work in production, etc.

Low temperature air, increasing heat transfer, creates the danger of hypothermia of the body. As a result, prerequisites for colds are created, which are based on a neuroreflex mechanism that causes certain dystrophic changes in tissues due to an imbalance in the regulation of metabolic processes.

Moderate fluctuations in temperature can be considered as a factor that provides the physiologically necessary training of the body as a whole and its thermoregulatory mechanisms.

The most favorable air temperature in residential premises for a person at rest is 20–22 ° C in the cold season and 22–25 ° C in the warm season at normal humidity and air speed.

Assessment methodology temperature regime

Air temperature is measured with mercury and alcohol thermometers.

To determine the temperature regime of the room, the air temperature is measured vertically and horizontally at three points: at the outer wall (10 cm from it), in the center and at inner wall(10 cm from her). Measurements are carried out at a level of 0.1–1.5 m from the floor. Readings are taken 10 minutes after the thermometer is installed. The arithmetic mean value is calculated from the six obtained temperature values, which are recorded in the protocol and analyze the temperature drops vertically and horizontally.

The horizontal average room temperature is calculated from three measurements at different points taken at a height of 1.5 m.

The change in temperature horizontally from the outer wall to the inner wall should not exceed 2 ° C, and vertically - 2.5 ° C for each meter of height. Temperature fluctuations during the day should not exceed 3 ° C.

Determination of air humidity

Each air temperature corresponds to a certain degree of saturation with water vapor: the higher the temperature, the greater the degree of saturation, since warm air holds more water vapor than cold air.

The following concepts are used to characterize humidity.

Absolute humidity- the amount of water vapor in g in 1 m 3 of air.

Maximum humidity- the amount of water vapor in g required to completely saturate 1 m 3 of air at the same temperature.

Relative Humidity- the ratio of absolute humidity to maximum, expressed as a percentage.

saturation deficit is the difference between maximum and absolute humidity.

Dew point- the temperature at which water vapor in the air saturates the space.

Relative humidity and saturation deficiency are of the greatest hygienic importance, which give a clear idea of ​​the degree of saturation of the air with water vapor and the rate of evaporation of moisture from the surface of the body at a given temperature.

Absolute humidity gives an idea of ​​the absolute content of water vapor in the air, but does not show the degree of its saturation, and therefore is a less indicative value than relative humidity.

Humidity is determined by devices called psychrometers. They are of two types: August psychrometer and Assmann psychrometer.

To determine air humidity with the August psychrometer, the device should be installed at a level of 1.5 m from the floor and observations should be made for 10–15 minutes.

When using the August psychrometer, the absolute humidity is calculated using the Regnot formula:

To = f – a (t-t 1) AT, where

To is the absolute humidity in mm. rt. Art.;

f- maximum humidity at wet bulb temperature (its value is taken from table 4);

a– psychrometric coefficient (for room air 0,0011);

t- dry bulb temperature;

t1 is the temperature of the wet bulb;

AT- Atmosphere pressure.

Relative humidity is calculated using the formula:

R– relative humidity in %;

To– absolute humidity;

F-maximum humidity at dry bulb temperature (taken from table 4).

Example: during the study it was found that the temperature of a dry thermometer is 18 o C, and a wet one 13 o C; barometric pressure - 762 mm Hg. According to table 4 "Maximum water vapor pressure at different temperatures(mm Hg) "we find the value f - the maximum voltage of water vapor at 13 ° C, which is equal to 11.23 mm Hg, and substitute the found values ​​​​in the formula:

To= 11.23–0.0011 (18–13) 762 = 7.04 mmHg

We will convert absolute humidity into relative humidity using the formula:

R = (K/ F) 100,

In our example F at 18 ° C according to Table 4 it is equal to 15.48 mm Hg, from where:

R = (7,04 / 15,48) 100 = 45%

For more accurate measurements, an Assmann aspiration psychrometer is used (Fig. 2). The Assmann psychrometer has two mercury thermometer enclosed in a metal case that protects the device from exposure to thermal radiation. One of the thermometers (its lower part) is covered with matter and requires humidification before the device works. A mechanical aspiration device - a fan located in the upper part of the psychrometer, provides a constant air velocity near the thermometers, which allows measurements to be taken under constant conditions.

Before determining the air humidity, the matter on the tank of one of the thermometers (“wet”) is moistened with water, then the fan clock mechanism is started for 3–4 minutes. Thermometer readings are taken at the moment when the temperature of the wet bulb becomes minimal.

Fig 2. Assmann psychrometer

Absolute humidity is calculated using the Shprung formula:

(Notation and formula for determining relative humidity, see above).

Example: Let's assume that after the operation of the device for 3–4 minutes, the temperature of the dry thermometer was 18 ° C, and that of the wet thermometer was 13 ° C. The barometric pressure at the time of the study was 762 mm Hg. According to table 4 "Maximum elasticity of water vapor at different temperatures (mm Hg)" we find the value F- the maximum elasticity of water vapor at 13 ° C, which is equal to 11.23 mm Hg, and, substituting the found value into the formula, we obtain:

To\u003d 11.23 - 0.5 (18-13) (762/755) \u003d 8.71 mm Hg.

We translate the found absolute humidity into relative humidity using the formula:

R = (To/ F) 100,

In our example:

R = (8,71 / 15,48) 100 = 56,3%

In addition to the calculated determination of relative humidity by formulas, it can be found directly from psychrometric tables 5 and 6, using the data obtained using the August and Assmann psychrometer.

Relative humidity in residential and industrial premises allowed in the range from 30 to 60%.

Determining the speed of air movement

The speed of air movement has a certain effect on the heat balance of the human body. In addition, the high mobility of air in hospital rooms contributes to the rise of settled dust into the air, its movement and, together with microorganisms, creates conditions for possible infection of people.

Anemometers are used to determine high air velocities in the open atmosphere (Fig. 3). They measure the speed of air movement in the range from 1 to 50 m / s.

Fig 3. Anemometer

The determination of low air velocities from 0.1 to 1.5 m / s is carried out using a catathermometer (from the Greek kata - movement from top to bottom) - a special alcohol thermometer (Fig. 4). This device allows you to determine the amount of heat loss by a physical body, depending on the temperature and speed of the surrounding air.

In this case, the cooling capacity of the air is first determined. To do this, immerse the device in hot water until the alcohol rises to half of the top expansion of the capillary. Then it is wiped dry and the time in seconds of the decrease in the alcohol level from 38 ° C to 35 ° C is determined.

Figure 4. Catathermometer

Calculation of the cooling capacity of air in millicalories from 1 cm 2 per second ( H) is carried out according to the formula:

F- device factor - a constant value showing the amount of heat lost from 1 cm 2 of the catathermometer surface during the lowering of the alcohol column from 38 ° C to 35 ° C (indicated on the back of the device);

a- the number of seconds during which the alcohol column drops from 38 ° C to 35 ° C.

Air speed in m/s. ( V) is determined by the formula:

, where

H is the cooling capacity of the air.

Q- the difference between the average body temperature of 36.5 ° C and the ambient air temperature;

0.2 and 0.4 are empirical coefficients.

The air velocity can also be determined from Table 7.

The normal speed of air movement in residential and educational premises is considered to be 0.2–0.4 m/s. The speed of air movement in the wards of medical institutions should be from 0.1 to 0.2 m/s.

Table 3

Summary data of conducted studies

Hygienic conclusion. Based on the results obtained, the compliance of microclimate factors is assessed optimal conditions. In case of deviation from the standards, recommendations are made for their improvement.

Test questions:

1. Microclimate. The concept, the factors that determine it.

2. Weather-dependent diseases.

3. The influence of low and high atmospheric pressure on the human body.

4. The influence of low and high air temperature on the human body.

5. Air humidity. hygienic value.

6. Optimal values temperature, relative humidity and air velocity in medical institutions. Documents regulating them.

7. Instruments for assessing the indoor microclimate.

8. Advantages of the Assmann aspiration psychrometer over the August psychrometer.

9. Devices for continuous, long-term recording of temperature, humidity and atmospheric air pressure.

Table 4

Maximum water vapor pressure at different temperatures (mmHg)

Table 5

Determination of relative humidity according to the readings of the August psychrometer at an air velocity in the room of 0.2 m / s

Table 6

Determination of relative humidity according to the readings of the Assmann psychrometer

Table 7

Air velocity less than 1 m/s (adjusted for temperature), H=F/a

Air value:

Participation in oxidative processes in the body

Heat production and heat regulation

In health measures aimed at the prevention of certain diseases

negative impact:

Pollution by chemical factors

Adverse physical factors

Adverse weather conditions

Rationing the microclimate

The microclimate of enclosed spaces is determined by temperature, humidity, air velocity. Weather - the state of the atmosphere or state physical properties air in the place in question at a given time.

The temperature in the wards is 20 degrees C

The temperature in the doctor's office is 20 degrees C

The temperature in the doctor's office - 20 degrees C

Ward for premature babies and burns ward - 25 degrees C

Dressing room and operating room - 22 degrees C

Residential apartments -18 degrees C

Bathroom - at least 22 degrees C

The assessment of the bacterial composition of the air is carried out according to 2 indicators:

1. The total number of microorganisms contained in 1 m 3 of air.

2. The number of pathogenic microorganisms.

Clean air is considered if summer time year it contains 1500 microorganisms and no more than 16 streptococci.

Polluted air in summer - not > 2500 microorganisms and not > 30 streptococci.

Fresh air in winter period up to 4500 microorganisms and up to 36 streptococci. Contaminated - not > 7000 and containing streptococci not > 124.

For health facilities, apart from the season, the purpose of the premises is taken into account.

Operating room: before surgery not > 500; after surgery not
Resuscitation: not > 750; should not be pathogenic

Maternity(operating): not > 1000; should not be pathogenic
delivery room(postpartum): not > 2500; should not be pathogenic
Wards for newborns: not > 1500; streptococci - not > 12
Postpartum: not > 2000; streptococci - not > 16

Methods for determining bacterial air pollution:

1) Aspiration;

2) Sedimentation.

Air purification methods

1. Irradiation with bactericidal lamps (calculation per cubic capacity of the room).

2. Treatment with chemical bactericides

Neutralization of air by improving the ventilation of the room.

No. 64 Hygienic requirements for lighting hospital premises for various purposes

Rational organization of natural lighting, both parties are interested in this: staff (quality of performance of duties), patients (improvement of hygienic conditions of stay, as well as an increase in mood.

II ???(daylight)

1. Sufficient intensity for the staff. Illumination intensity is divided into 8 categories and classes
accuracy, based on the division of the size of the details and the contrasting background (each class has its own indicators, for example:
operating room - class 1, receptionist - class 6).

2. Must be uniform

3. No glare

4. Do not create glitter

III (???artificial lighting)

1. The spectrum should be close to natural

2. Should not give shadows

3. Must be constantly on time

Factors that determine the level of natural light

1. Factors due to light climate

Geographic latitude

Height of the sun

Presence of clouds
- the presence of pollution

2. External factors - time of year and day

Orientation of the light-bearing wall to the cardinal points
- the presence of shading buildings and trees
3. Internal factors

Size of window openings

Window opening configuration

Frame design

Placement of windows on a light-bearing wall (the distance from the upper edge of the window to the ceiling should not be > 30 cm.

Painting interior surfaces (walls and ceiling should be light colors)

Glass cleanliness

Room layout

Methods for assessing natural light

Geometrically- are laid during the projection and for their determination we use geometric functions

1. Light coefficient (SC) - the ratio of the area of ​​​​glazing to the area of ​​\u200b\u200bthe room, while

the glazing area is taken as a unit, for doctors' offices 1/4, 1/5, corridors, stairs 1/12, 1/15.

2. Angle of incidence - formed by two lines, one of which is drawn horizontally from the point of the working
place to the window frame, and the other from the same point to the top edge of the window (not< 27 градусов)

3. Opening angle - determined in cases where there are shading buildings or trees and light
the flow does not enter the room through the entire area of ​​​​the window. Formed by two lines, one of which goes from the point
workplace to the upper edge of the window, and the second from the same point to the projection point of the highest point
of the opposite building onto the plane of the window (not< 5 градусов)

4. Laying length - the ratio of the depth of the room (the distance from the light-bearing wall to
opposite) to the height of the upper edge of the window to the floor. Not > 2.

Lighting -

KEO - daylight factor interior, to simultaneously measured outdoor lighting (1% for wards and doctor's offices, 2.5% for operating rooms)

67. Hygienic requirements for the placement, layout, equipment and organization of work of hospitals