| Background:In recent years,with the increasing number of swimming pools,the sanitary condition of swimming pools has attracted more and more attention.How to formulate regulatory strategies scientifically,efficiently and rationally requires the attention of health supervision institutions.Delphi method uses the way of anonymous opinions,through questionnaires of experts,collects and collates their opinions,and draws conclusions.Objective:The purpose of this study is to introduce Delphi method,based on the monitoring results of the water quality of various swimming places in Suzhou from 2015 to 2017,to construct the evaluation system of the health indicators of swimming places,and to provide reasonable supervision methods and strategies for the first-line public places health supervisors.Objects and methods:During 2015-2017 years and 3 years,the health inspectors randomly sampled the swimming pool water operating normally in the large city of Suzhou.The water samples were collected in accordance with the public places hygienic inspection method(GBT18204.6-2013):the pool area less than 1000m 2 was arranged 2 sampling points,and the swimming pool area>1000m2 was arranged for 3 sampling points,in the swimming pool.Water sample 500xnL is collected at 30cm below the pool water.Among them,the microbial indicators were collected by aseptic glass bottles,and the physical and chemical indicators were collected by a clean plastic bottle.Samples were collected and sent to the laboratory as soon as possible.On the other hand,the free residual chlorine index was detected in the field.Water samples were tested in accordance with "swimming pool water microbiological test method"(GBT18204-2000),"standard test method for drinking water"(GBT5750-2016)and "public place sanitary inspection method,(GBT18204-2014).The results were evaluated according to the sanitary standard for swimming pool(GB 9667-1996).Combined with the results of water quality hygiene analysis,two rounds of questionnaire survey were conducted by Delphi method.The first round of surveys was conducted in the form of an email questionnaire,and the first level indicators and the two level indicators were preliminarily evaluated.The second round of survey is also carried out in the form of e-mail questionnaire,and will feed back the results of the first round of the questionnaire,adjust the relevant indexes according to the results,evaluate the adjusted index,and finally determine the quantitative evaluation index system of sanitary supervision in the swimming place.The research projects of the two rounds of investigation include the positive coefficient of the experts,the authority of the experts,the coordination degree of the experts on each two level index and the opinion of the experts,and the weight coefficient of each two level index.All data were set up by Excel software and analyzed by SPSS.22 software package,and the significant difference between Kendall coordination coefficient(W)was tested by ?2 test.Results:1.The quality of the water quality of the swimming pool was qualified in the past 3 years.There were 673 monitoring samples in 2015-2017 years,and the qualified rates of water samples were 63.3%,59.7%and 65%respectively.There was no significant difference in the pass rate between three years(?2=l.451,P=0.484).The three year qualification rates of free residual chlorine(?2=10.35,P<0.05),total bacterial count(?2=6.365,P<0.05),coliform group(?2=8.256,P<0.05)and urea(?2=12.82,,P<0.05)were statistically significant,and the qualified rate of urea index decreased year by year.There was no significant dieberence in the 3 year pass rate between the two indexes of pH value(?2=2.198,P=0.333)and turbidity(?2=1.283,P=0.526).The sanitary condition of water quality is not optimistic.2.The qualification rate of different types of swimming pool is compared.The qualified rates of the water samples of gymnasium,outdoor and hotel affiliated swimming pools were 58.7%,49.4%and 71.4%,respectively,and the difference was statistically significant(?2=15.92,P<0.001).3.The peak period of the peak period of qualified rate is compared.7 and August were the peak of swimming season,the pass rate was 59.3%,the rest months were flat peak period,and the pass rate was 71.6%,the difference was statistically significant(?2=7.728,P=0.005).4.The basic situation of Delphi law experts:The average length of service of 16 experts who participated in two rounds of consultation was(18.58±5.60)years;75%of them were public health experts who participated in health supervision or disease prevention and control,and 25%were swimming place management experts.The expert consultation form issued in the two rounds was fully recovered and the positive coefficient of the experts was 100%.16 experts were judged on the basis of 0.87±0.03 and 0.88±0.03,familiarity was 0.87 ± 0.09 and 0.89±0.10,authority coefficient was 0.87±0.06 and 0.89±0.06,respectively.Formula calculation shows that the coordination coefficient of the first round of questionnaire survey is 0.388.The rank sum test of multiple correlation samples(2=99.37,P<0.001)shows that the coordination coefficient has statistical significance.The coordination coefficient of the second round questionnaire survey is 0.567.The rank sum test of multiple correlation samples(?2-76.38,P<0.001)shows that the coordination coefficient is unified,which is of statistical significance.5.Establishment of evaluation index system of swimming place hygiene:After the second round of Delphi expert consultation,three first-level indicators and 16 second-level indicators of swimming place hygiene management,hygiene operation and public goods were determined.Among them,seven second-level indicators were hygiene management indicators,five hygiene operation indicators and four public goods indicators.The first five weighting coefficients of secondary indicators from big to small ranks are "with swimming pool water circulating disinfection equipment and mandatory foot soaking pool","with health management organization and full-time(part-time)health safety management personnel","with sound health management system and implementation in place","specialcleaning for non-disposable slippers ","hold valid health permit and publicize it","daily and timely publicity of swimming pool room temperature,water temperature,residual chlorine,PH value and other water quality conditions".These 5 two level indicators should be focused on daily supervision.6.The application results of Delphi health index evaluation system[plus the application results]were as follows:10 units were randoily selected to carry out on-site health evaluation within the scope of Suzhou,scored according to the importance assignment of each index,and rarked the scoring results of each unit.The ranking results were compared with the water quality hygiene testing,complaints and administrative penalties of swimming pools from 2015 to 2017.It was found that the higher the ranking of swimming pools,the better the water quality hygiene in the past years,and the fewer times of complaints and administrative penalties.Conclusions:In 2015-2017,the hygienic qualification rate of swimming pool water in Suzhou was not high.By introducing Delphi method to construct the evaluation system of health indicators in swimming places and applying it to on-site health supervision,health supervisors can improve their ability of health supervision and the level of health management in swimming places. |
PDF Full Text Request