上海市游泳场所双随机监督抽查中承检机构水质检验工作质量评估
Quality evaluation of water quality inspection service providers in double random supervision and inspection of swimming places in Shanghai
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摘要:
背景 游泳池水质卫生状况直接关系游泳者的健康。水质指标是反映水质卫生状况的直观指标，水质指标检验检测的准确性、规范性直接影响卫生监督抽检工作的质量。因此游泳场所卫生监督抽检工作中对水质检验开展质量控制非常重要。
目的 评估上海市游泳场所双随机监督抽查中承检机构水质检验的工作质量。
方法 针对上海市游泳池水双随机监督抽查工作，组织区卫健委监督所、区级疾病预防控制中心、社会第三方技术服务机构共20家承检机构随机派遣技术人员，对随机抽取的上海市32家游泳场所水质进行采样，并测定浑浊度、pH、游离性余氯、尿素、菌落总数、大肠菌群等水质指标。上海市公共卫生监督技术服务质量控制中心（简称质控中心）在现场开展同步采样、检测。结合现场过程评价、同步检验及结果评价、检测报告规范性评价三方面研究评估上海市游泳场所随机监督抽查游泳池水质检验的工作质量。
结果 承检机构在现场采样与检测过程中存在的问题集中在试剂检查、样品保存运输、原始记录、仪器操作等方面。承检机构与质控中心的同步检测结果中有13件样本25项次判定不一致，对于单项指标判定的总体一致率为94%（389/414），pH总体合格率差异有统计学意义（
χ 2=10.276，P =0.001）。区卫健委监督所、区疾病预防控制中心、社会第三方技术服务机构的检测报告总体规范性评价得分分别为98.3、95.5、88.3分。存在的问题主要集中在样品信息填写的完整性与规范性、检验原始记录信息的溯源性等方面。结论 在现有的双随机监督抽查工作模式下，承检机构给出的检测结果可信度较高。目前上海市游泳场所水质卫生检验质量控制关键点包括采样、检测过程和记录的规范性，监管部门应加强卫生检验的质量管理，建立健全更为系统科学的公共卫生监督技术服务质量控制模式，保障卫生监督抽检工作质量。
Abstract:Background The water sanitary condition of swimming pools is closely related to the health of swimmers. Water quality indexes are intuitive reflections of water sanitation. The accuracy and standardization of water quality index test directly affect the quality of random health supervision and inspection work. Therefore, it is very important to conduct quality control of water quality inspection in the sanitary supervision and inspection of swimming places.
Objective This study is conducted to assess the work quality of water quality inspection service providers in double random supervision and inspection of swimming places in Shanghai.
Methods Technicians from 20 institutions including district-level supervision agencies of health commission, district-level centers for disease control and prevention, and third-party technical service institutions were randomly dispatched to collect water samples of 32 randomly selected swimming places in Shanghai and determine the water quality indicators such as turbidity, pH, free residual chlorine, urea, total number of colonies, and total coliforms. The Shanghai Public Health Supervision Technical Service Quality Control Center (the quality control center) performed synchronous sampling and testing on site. Combined with process evaluation, synchronous testing result evaluation, and normative evaluation of test reports, the work quality of random supervision and inspection in Shanghai swimming places were evaluated.
Results The problems in the on-site sampling and testing process of the service providers were mainly reagent inspection, sample storage and transportation, original records, and instrument operation. The synchronous testing results showed that 25 items of 13 samples were inconsistent between the service providers and the quality control center; the overall consistent rate of single index was 94% (389/414); there were differences in the overall qualified rate of pH (
χ 2=10.276,P =0.001). The overall normative evaluation scores of test reports of the district-level supervision agencies of health commission, district-level centers for disease control and prevention, and third-party technical service institutions were 98.3, 95.5, and 88.3, respectively. The problems mainly focused on the integrity and standardization of sample information and the traceability of original inspection records.Conclusion Under the existing double random supervision and inspection mode, the test results given by the service providers are reliable. The key points of quality control of water quality inspection in swimming places in Shanghai include the standardization of sampling, testing, and records. Relevant supervision departments should strengthen the quality management of health inspection, establish and improve a more systematic and scientific quality control mode of public health supervision technical service, and ensure the quality of health supervision and inspection.
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