Article(id=1240413922822516780, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240413921266429979, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202503372, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1742400000000, receivedDateStr=2025-03-20, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773667324976, onlineDateStr=2026-03-16, pubDate=1754755200000, pubDateStr=2025-08-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773667324976, onlineIssueDateStr=2026-03-16, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773667324976, creator=13701087609, updateTime=1773667324976, updator=13701087609, issue=Issue{id=1240413921266429979, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='15', pageStart='2689', pageEnd='2880', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1773667324606, creator=13701087609, updateTime=1773667356299, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240414054267802325, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240413921266429979, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240414054267802326, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240413921266429979, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=2749, endPage=2754, ext={EN=ArticleExt(id=1240413923120312370, articleId=1240413922822516780, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Comprehensive quality evaluation of response work reports for non-occupational carbon monoxide poisoning incidents in Shandong Province, columnId=1228016570660745413, journalTitle=Modern Preventive Medicine, columnName=Environmental and Occupational Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To evaluate the quality of response reports for non-occupational carbon monoxide poisoning incidents in Shandong Province from 2019 to 2023.

Methods

Data were collected from the national “Public Health Emergency Reporting Management Information System” online reporting platform. An indicator system was constructed based on national policy documents and literature analysis, and the weights of indicators were calculated using the Analytic Hierarchy Process (AHP). The quality of the reports was further evaluated using the technique for order preference by similarity to an ideal solution (TOPSIS) method.

Results

The evaluation system consisted of 3 first-level indicators and 11 second-level indicators. The study evaluated a total of 8 612 cases. Temporally, the 2020 emergency response work reports demonstrated the highest comprehensive quality (Ci=0.777), while 2023 showed the lowest (Ci=0.272). At the prefecture-level city tier, Yantai City (Ci=0.778) and Jining City (Ci=0.679) ranked highest. In regional comparisons, the Jiaodong Urban Cluster achieved the best comprehensive quality (Ci=0.596), outperforming both the Provincial Capital Urban Cluster (Ci=0.553) and the Southern Shandong Urban Cluster (Ci=0.359). Evaluation of first-level indicators revealed that the Provincial Capital Urban Cluster excelled in event monitoring and reporting (Ci=0.646) as well as event investigation and handling (Ci=0.566), whereas the Jiaodong Urban Cluster showed significant advantages in post-event performance evaluation (Ci=0.963). The Southern Shandong Urban Cluster exhibited relatively weaker performance across all dimensions.

Conclusion

There are disparities in the performance of the Shandong Province non-occupational carbon monoxide response work report across different years, cities, and regions.

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目的

评价2019—2023年山东省非职业性一氧化碳中毒事件应对工作报告质量情况。

方法

数据来源于国家突发公共卫生事件报告管理信息系统网络直报平台,通过国家政策文件结合文献分析构建评价体系并利用层次分析法计算权重,进一步通过优劣解距离法(technique for order preference by similarity to an ideal solution,TOPSIS)法评价报告质量。

结果

评价体系共包含3个一级指标、11个二级指标。研究共评价8 612例事件,时间维度上,2020年应对工作报告综合质量最优(Ci=0.777),2023年最低(Ci=0.272);地市层面,烟台市(Ci=0.778)和济宁市(Ci=0.679)位列前茅;地区层面,胶东城市圈综合质量最佳(Ci=0.596),高于省会城市圈(Ci=0.553)和鲁南城市圈(Ci=0.359)。各一级指标评价显示,省会城市圈在事件监测与报告(Ci=0.646)、事件调查与处置(Ci=0.566)方面表现突出,而胶东城市圈在事件后期绩效评估(Ci=0.963)上具有显著优势,鲁南城市圈各维度质量均相对薄弱。

结论

山东省非职业一氧化碳应对工作报告质量在不同年份、地市及地区间的表现存在差异。

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姜晓林,E-mail:
孙成玺,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=g+usiczDCQQXxzyAxRcXAA==, magXml=QnupSmJjOcLKFB3qTdvlnQ==, pdfUrl=null, pdf=8k5IOVHVTNuXYaXBybrnrA==, pdfFileSize=665594, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=1zrHSKq7kZscDIo0NREX5g==, mapNumber=null, authorCompany=null, fund=null, authors=

姜晓林与孙成玺为共同通信作者

马睿卿(1999—),男,硕士在读,研究方向:卫生应急管理

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马睿卿(1999—),男,硕士在读,研究方向:卫生应急管理

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马睿卿(1999—),男,硕士在读,研究方向:卫生应急管理

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Binzhou Municipal Center for Disease Control and Prevention delivered a keynote speech at the Shandong provincial symposium on non-occupational carbon monoxide poisoning reporting and management[EB/OL]. [2025-06-11]. http://wjw.binzhou.gov.cn/art/2023/10/25/art_164824_10303112.html.(In Chinese), articleTitle=Binzhou Municipal Center for Disease Control and Prevention delivered a keynote speech at the Shandong provincial symposium on non-occupational carbon monoxide poisoning reporting and management, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1240424343616942277, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, xref=1., ext=[AuthorCompanyExt(id=1240424343625330886, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, companyId=1240424343616942277, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Shandong Second Medical University, Weifang, Shandong 261053, China), AuthorCompanyExt(id=1240424343629525191, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, companyId=1240424343616942277, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.山东第二医科大学,山东 潍坊 261053)]), AuthorCompany(id=1240424343705022665, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, xref=2., ext=[AuthorCompanyExt(id=1240424343717605578, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, companyId=1240424343705022665, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.山东省疾病预防控制中心,山东 济南 250014)])], figs=[ArticleFig(id=1240424348301980031, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, language=EN, label=Table 1, caption=

Basic information of non-occupational carbon monoxide poisoning event reports in Shandong Province from 2019 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
山东省非职业性
一氧化碳中毒事
件报告
特征总计占比(%)
基本信息事件报告总数8 612100.00
报告年份(年)
20192 36427.45
20202 00623.29
20212 25326.16
20221 55318.03
20234365.06
报告地区报告地市
省会城市圈德州1 93922.52
济南1 33215.47
淄博8079.37
滨州1752.03
泰安1681.95
聊城300.35
东营20.02
胶东城市圈威海7999.28
潍坊7969.24
烟台6197.19
青岛5996.96
日照1011.17
鲁南城市圈菏泽5976.93
临沂4985.78
济宁1411.64
枣庄90.10
), ArticleFig(id=1240424348394254725, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, language=CN, label=表1, caption=

2019—2023年山东省非职业性一氧化碳中毒事件报告基本情况

, figureFileSmall=null, figureFileBig=null, tableContent=
山东省非职业性
一氧化碳中毒事
件报告
特征总计占比(%)
基本信息事件报告总数8 612100.00
报告年份(年)
20192 36427.45
20202 00623.29
20212 25326.16
20221 55318.03
20234365.06
报告地区报告地市
省会城市圈德州1 93922.52
济南1 33215.47
淄博8079.37
滨州1752.03
泰安1681.95
聊城300.35
东营20.02
胶东城市圈威海7999.28
潍坊7969.24
烟台6197.19
青岛5996.96
日照1011.17
鲁南城市圈菏泽5976.93
临沂4985.78
济宁1411.64
枣庄90.10
), ArticleFig(id=1240424348620747150, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, language=EN, label=Table 2, caption=

Consistency test of each matrix level

, figureFileSmall=null, figureFileBig=null, tableContent=
矩阵层级最大特征根λmax一致性比例CR
目标层3.0110.011
X1(Y1~Y3)3.1040.099
X2(Y4~Y9)6.0510.008
X3(Y10~Y11)2.0000.000
), ArticleFig(id=1240424348704633235, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, language=CN, label=表2, caption=

各矩阵层级一致性检验情况

, figureFileSmall=null, figureFileBig=null, tableContent=
矩阵层级最大特征根λmax一致性比例CR
目标层3.0110.011
X1(Y1~Y3)3.1040.099
X2(Y4~Y9)6.0510.008
X3(Y10~Y11)2.0000.000
), ArticleFig(id=1240424348838850970, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, language=EN, label=Table 3, caption=

Weights of evaluation indicators for quality of response to non-occupational carbon monoxide poisoning events in Shandong Province

, figureFileSmall=null, figureFileBig=null, tableContent=
目标层准则层X(一级指标)准则层X(一级指标)措施层Y(二级指标)二级指标初始权重二级指标组合权重
山东省非职业性一氧
化碳中毒事件应对工作事件监测与报告X10.483 8事件监测敏感性Y10.540 90.261 7
报告质量评价体系
事件报告及时性Y20.323 60.156 6
事件报告规范性Y30.135 60.065 6
事件调查与处置X20.378 1事件认定与核实Y40.136 20.051 5
基本情况调查Y50.086 10.032 6
中毒情况调查Y60.216 10.081 7
患者医疗救治调查Y70.152 70.057 7
高危人群保护Y80.193 70.073 2
现场处置Y90.215 10.081 3
事件后期绩效评估X30.138 1事件责任及影响评定Y100.469 00.064 8
事件结果评估Y110.531 00.073 3
), ArticleFig(id=1240424348943708579, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, language=CN, label=表3, caption=

山东省非职业性一氧化碳中毒事件应对工作报告质量评价指标及权重

, figureFileSmall=null, figureFileBig=null, tableContent=
目标层准则层X(一级指标)准则层X(一级指标)措施层Y(二级指标)二级指标初始权重二级指标组合权重
山东省非职业性一氧
化碳中毒事件应对工作事件监测与报告X10.483 8事件监测敏感性Y10.540 90.261 7
报告质量评价体系
事件报告及时性Y20.323 60.156 6
事件报告规范性Y30.135 60.065 6
事件调查与处置X20.378 1事件认定与核实Y40.136 20.051 5
基本情况调查Y50.086 10.032 6
中毒情况调查Y60.216 10.081 7
患者医疗救治调查Y70.152 70.057 7
高危人群保护Y80.193 70.073 2
现场处置Y90.215 10.081 3
事件后期绩效评估X30.138 1事件责任及影响评定Y100.469 00.064 8
事件结果评估Y110.531 00.073 3
), ArticleFig(id=1240424349056954795, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, language=EN, label=Table 4, caption=

Comprehensive quality evaluation of response work reports in different years

, figureFileSmall=null, figureFileBig=null, tableContent=
年份(年)D+D-Ci排序
20190.5560.7360.5703
20200.2490.8650.7771
20210.4800.6680.5822
20220.5470.6170.5304
20230.9130.3420.2725
), ArticleFig(id=1240424349153423798, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, language=CN, label=表4, caption=

不同年份应对工作报告综合质量评价

, figureFileSmall=null, figureFileBig=null, tableContent=
年份(年)D+D-Ci排序
20190.5560.7360.5703
20200.2490.8650.7771
20210.4800.6680.5822
20220.5470.6170.5304
20230.9130.3420.2725
), ArticleFig(id=1240424349291835843, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, language=EN, label=Table 5, caption=

Comprehensive quality evaluation of response work reports in different cities

, figureFileSmall=null, figureFileBig=null, tableContent=
地区D+D-Ci排序
德州市0.3710.7420.6674
济南市0.6250.5170.45316
淄博市0.4860.6750.5828
威海市0.4530.7330.6186
潍坊市0.4660.6280.5749
烟台市0.2420.8470.7781
青岛市0.6720.6070.4751
4
菏泽市0.5570.5610.50212
临沂市0.6810.5930.46615
滨州市0.3820.7980.6763
泰安市0.4490.7440.6245
济宁市0.3970.8400.6792
日照市0.5640.7290.5641
0
聊城市0.4560.7340.6177
枣庄市0.6480.6200.4891
3
东营市0.6040.6940.53511
), ArticleFig(id=1240424349392499146, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, language=CN, label=表5, caption=

不同地市应对工作报告综合质量评价

, figureFileSmall=null, figureFileBig=null, tableContent=
地区D+D-Ci排序
德州市0.3710.7420.6674
济南市0.6250.5170.45316
淄博市0.4860.6750.5828
威海市0.4530.7330.6186
潍坊市0.4660.6280.5749
烟台市0.2420.8470.7781
青岛市0.6720.6070.4751
4
菏泽市0.5570.5610.50212
临沂市0.6810.5930.46615
滨州市0.3820.7980.6763
泰安市0.4490.7440.6245
济宁市0.3970.8400.6792
日照市0.5640.7290.5641
0
聊城市0.4560.7340.6177
枣庄市0.6480.6200.4891
3
东营市0.6040.6940.53511
), ArticleFig(id=1240424349547688408, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, language=EN, label=Table 6, caption=

Comprehensive quality evaluation of response work reports in different regions

, figureFileSmall=null, figureFileBig=null, tableContent=
地区D+D-Ci排序
省会城市圈0.5670.7030.5532
胶东城市圈0.5400.7960.5961
鲁南城市圈0.8120.4550.3593
), ArticleFig(id=1240424349677711843, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, language=CN, label=表6, caption=

不同地区应对工作报告综合质量评价

, figureFileSmall=null, figureFileBig=null, tableContent=
地区D+D-Ci排序
省会城市圈0.5670.7030.5532
胶东城市圈0.5400.7960.5961
鲁南城市圈0.8120.4550.3593
), ArticleFig(id=1240424349790958062, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240413922822516780, language=EN, label=Table 7, caption=

Quality evaluation of comprehensive indicators in different regional response work reports

, figureFileSmall=null, figureFileBig=null, tableContent=
一级指标地区D+D-Ci排序
事件监测与报告X1省会城市圈0.4240.7740.6461
胶东城市圈0.5690.8220.5912
鲁南城市圈0.8280.3410.2923
事件调查与处置X2省会城市圈0.5620.7310.5661
胶东城市圈0.5980.6670.5272
鲁南城市圈0.7660.6210.4483
事件后期绩效评估X3省会城市圈0.9150.1320.1263
胶东城市圈0.0380.9870.9631
鲁南城市圈0.8740.1860.1762
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不同地区应对工作报告综合各一级指标质量评价

, figureFileSmall=null, figureFileBig=null, tableContent=
一级指标地区D+D-Ci排序
事件监测与报告X1省会城市圈0.4240.7740.6461
胶东城市圈0.5690.8220.5912
鲁南城市圈0.8280.3410.2923
事件调查与处置X2省会城市圈0.5620.7310.5661
胶东城市圈0.5980.6670.5272
鲁南城市圈0.7660.6210.4483
事件后期绩效评估X3省会城市圈0.9150.1320.1263
胶东城市圈0.0380.9870.9631
鲁南城市圈0.8740.1860.1762
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山东省非职业性一氧化碳中毒事件应对工作报告综合质量评价研究
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马睿卿 1 , 温子萱 1 , 杨靖涵 1 , 张艺馨 2 , 郑文贵 1 , 孙成玺 2 , 姜晓林 2
现代预防医学 | 环境与职业卫生 2025,52(15): 2749-2754
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现代预防医学 | 环境与职业卫生 2025, 52(15): 2749-2754
山东省非职业性一氧化碳中毒事件应对工作报告综合质量评价研究
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马睿卿1, 温子萱1, 杨靖涵1, 张艺馨2, 郑文贵1, 孙成玺2 , 姜晓林2
作者信息
  • 1.山东第二医科大学,山东 潍坊 261053
  • 2.山东省疾病预防控制中心,山东 济南 250014
  • 马睿卿(1999—),男,硕士在读,研究方向:卫生应急管理

通讯作者:

姜晓林,E-mail:
孙成玺,E-mail:
Comprehensive quality evaluation of response work reports for non-occupational carbon monoxide poisoning incidents in Shandong Province
Rui-qing MA1, Zi-xuan WEN1, Jing-han YANG1, Yi-xin ZHANG2, Wen-gui ZHENG1, Cheng-xi SUN2 , Xiao-lin JIANG2
Affiliations
  • Shandong Second Medical University, Weifang, Shandong 261053, China
出版时间: 2025-08-10 doi: 10.20043/j.cnki.MPM.202503372
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目的

评价2019—2023年山东省非职业性一氧化碳中毒事件应对工作报告质量情况。

方法

数据来源于国家突发公共卫生事件报告管理信息系统网络直报平台,通过国家政策文件结合文献分析构建评价体系并利用层次分析法计算权重,进一步通过优劣解距离法(technique for order preference by similarity to an ideal solution,TOPSIS)法评价报告质量。

结果

评价体系共包含3个一级指标、11个二级指标。研究共评价8 612例事件,时间维度上,2020年应对工作报告综合质量最优(Ci=0.777),2023年最低(Ci=0.272);地市层面,烟台市(Ci=0.778)和济宁市(Ci=0.679)位列前茅;地区层面,胶东城市圈综合质量最佳(Ci=0.596),高于省会城市圈(Ci=0.553)和鲁南城市圈(Ci=0.359)。各一级指标评价显示,省会城市圈在事件监测与报告(Ci=0.646)、事件调查与处置(Ci=0.566)方面表现突出,而胶东城市圈在事件后期绩效评估(Ci=0.963)上具有显著优势,鲁南城市圈各维度质量均相对薄弱。

结论

山东省非职业一氧化碳应对工作报告质量在不同年份、地市及地区间的表现存在差异。

非职业性一氧化碳中毒事件  /  AHP  /  TOPSIS
Objective

To evaluate the quality of response reports for non-occupational carbon monoxide poisoning incidents in Shandong Province from 2019 to 2023.

Methods

Data were collected from the national “Public Health Emergency Reporting Management Information System” online reporting platform. An indicator system was constructed based on national policy documents and literature analysis, and the weights of indicators were calculated using the Analytic Hierarchy Process (AHP). The quality of the reports was further evaluated using the technique for order preference by similarity to an ideal solution (TOPSIS) method.

Results

The evaluation system consisted of 3 first-level indicators and 11 second-level indicators. The study evaluated a total of 8 612 cases. Temporally, the 2020 emergency response work reports demonstrated the highest comprehensive quality (Ci=0.777), while 2023 showed the lowest (Ci=0.272). At the prefecture-level city tier, Yantai City (Ci=0.778) and Jining City (Ci=0.679) ranked highest. In regional comparisons, the Jiaodong Urban Cluster achieved the best comprehensive quality (Ci=0.596), outperforming both the Provincial Capital Urban Cluster (Ci=0.553) and the Southern Shandong Urban Cluster (Ci=0.359). Evaluation of first-level indicators revealed that the Provincial Capital Urban Cluster excelled in event monitoring and reporting (Ci=0.646) as well as event investigation and handling (Ci=0.566), whereas the Jiaodong Urban Cluster showed significant advantages in post-event performance evaluation (Ci=0.963). The Southern Shandong Urban Cluster exhibited relatively weaker performance across all dimensions.

Conclusion

There are disparities in the performance of the Shandong Province non-occupational carbon monoxide response work report across different years, cities, and regions.

Non-occupational carbon monoxide poisoning incident  /  AHP  /  TOPSIS
马睿卿, 温子萱, 杨靖涵, 张艺馨, 郑文贵, 孙成玺, 姜晓林. 山东省非职业性一氧化碳中毒事件应对工作报告综合质量评价研究. 现代预防医学, 2025 , 52 (15) : 2749 -2754 . DOI: 10.20043/j.cnki.MPM.202503372
Rui-qing MA, Zi-xuan WEN, Jing-han YANG, Yi-xin ZHANG, Wen-gui ZHENG, Cheng-xi SUN, Xiao-lin JIANG. Comprehensive quality evaluation of response work reports for non-occupational carbon monoxide poisoning incidents in Shandong Province[J]. Modern Preventive Medicine, 2025 , 52 (15) : 2749 -2754 . DOI: 10.20043/j.cnki.MPM.202503372
非职业性一氧化碳中毒特指日常环境中发生的一氧化碳暴露事件,是非药物性中毒致死的主要诱因[1]。该类型事件具有显著季节性、地域聚集性和群体性特征,是我国北方冬季重点防控的突发公共卫生事件。山东省作为人口基数超1亿的供暖核心区域,受冬季逆温气象频发、传统燃煤取暖比例较高及建筑通风条件局限等多因素影响,非职业性一氧化碳中毒事件年均报告数持续位居全国首位[2-3],其防控质量提升已成为山东省公共卫生治理的关键议题[4]。本研究整合《非职业性一氧化碳中毒事件应急预案》(简称《预案》)操作框架与其他类别突发公共卫生事件应对工作报告质量相关文献,综合运用文献研究法与层次分析法(analytic hierarchy process,AHP),构建山东省非职业性一氧化碳中毒事件应对工作报告质量综合评价体系,并引入优劣解距离法(technique for order preference by similarity to an ideal solution,TOPSIS),对2019—2023年全省16地市8 612例非职业性一氧化碳中毒事件报告进行系统评估,揭示当前应对工作中的现存问题,为优化省内非职业性一氧化碳中毒事件应急管理体系提供循证决策依据与科学建议。
本研究以山东省2019—2023年非职业性一氧化碳中毒事件报告为研究对象,数据来自国家突发公共卫生事件报告管理信息系统网络直报平台。纳入标准:(1)事件发生时间在2019年1月1日—2023年12月31日;(2)事件发生地属于山东省行政辖区;(3)已完成终审流程的正式报告。事件按首报单位所属地级市进行区域归属,根据《山东省新型城镇化规划(2021—2035年)》分为省会城市圈(济南、淄博、泰安、聊城、德州、滨州、东营)、胶东城市圈(青岛、潍坊、烟台、威海、日照)以及鲁南城市圈(临沂、枣庄、济宁、菏泽),以进一步评估分析[5]
(1)构建评估体系:根据国家相关政策,梳理构建山东省非职业性一氧化碳中毒应对工作报告质量评价指标。解析《预案》等政策文件,非职业一氧化碳中毒事件应急工作主要包括“监测、报告和预警”“应急响应”“后期绩效评估”等,结合预案中医疗机构与公共卫生机构负责的报告工作内容,确定了评价体系的3个一级指标为“事件监测与报告”“事件调查与处置”“事件后期绩效评估”。在CNKI、万方、维普等平台以一级指标为关键词,收集相关文献,提炼初始指标。文献梳理发现,刘碧瑶等[6]、马晓洁等[7]及詹钦勇[8]通过“事件监测敏感性”“报告及时性”“报告规范性”等指标评价突发公共卫生事件报告中事件监测与报告工作质量;刘丽珍[9]、孙成玺[10]及章宝丹等[11]应用“健康教育”“保护高危人群”“事件情况调查”等指标评价突发公共卫生事件报告中事件调查与处置工作质量;刘珏等[12]、陈柏妍[13]及李永红等[14]则以“控制效果评估”“疫情影响评估”“传染病防控经费投入”等指标评价突发公共卫生事件报告中事件后期绩效评估工作质量。参考梳理结果,依据SMART原则标准化处理指标:具体性(specific)要求评价目标明确;可衡量性(measurable)强调有明确数据衡量评价目标;可实现性(achievable)即评估标准的设定具有适当;相关性(relevant)即指标与实际效果相关;时限性(time-bound)结合最新版《突发公共卫生事件与传染病疫情监测信息报告管理办法》动态更新数据标准,最终形成3个一级指标与11个二级指标的评价体系。使用AHP确定评价体系的权重。AHP是一种用于处理复杂决策的定量技术,通过多个决策者评分赋予权重,在医学领域广泛应用[15]。首先建立包含目标层、准则层和措施层的层次结构模型。进一步构建两两比较的权重判断矩阵,使用Saaty 1~9标度设计评分问卷,邀请山东省20位从事非职业性一氧化碳事件及突发公共卫生事件应急工作的专家参与权重决策,对判断矩阵进行比较并打分。应用Yaahp 12.9软件,根据矩阵计算权重w并检验一致性(一致性比例CR值<0.1)。
(2)评价应对能力:根据评价体系及AHP获得的权重,使用TOPSIS法分析评价山东省非职业性一氧化碳中毒事件应对工作报告质量。TOPSIS法是依据有限个方案与正理想解之间的接近程度,给出各方案的优劣排序,并从中选出接近程度最大的方案作为目标方案的评价方法。首先,根据体系中的指标定义从个案报告中提取数据,根据年份、地市或地区整理数据,进一步结合研究目的构建n×m指标评价矩阵,矩阵中Xij表示第i年(地市、地区)第j个指标数据(i=1,2,3,...,nj=1,2,3,...,m);采用min-max标准化公式将数据作同趋势化与归一化处理,高优指标公式为Zij=Xij-Xmin/Xmax-Xmin),低优指标公式为Zij=Xmax-Xij/Xmax-Xmin);再基于归一化矩阵Zij和各指标权重wj,构建加权评价矩阵Y:Y=(yij)n×m=(wj×zij)n×m;确定最优向量和最劣向量,即最佳和最差报告质量得分;进一步计算各评价对象指标值与最优、最劣方案的距离及综合得分指数Ci(0≤Ci≤1),值越大证明报告质量越优,计算公式为:
2019—2023年山东省非职业性一氧化碳中毒事件报告共计8 612例,其中,2019年报告的事件最多,为2 364例;报告事件最多的地级市为德州市,共计报告1 939例;报告事件最多的地区为省会城市圈,共计报告4 453例。见表1
本研究通过政策解析和文献梳理,基于SMART原则最终确定了3个一级指标与11个二级指标的评价体系,结合AHP理论,根据评价体系建立层次结构模型,分别为:目标层为评价体系;中间的准则层为X层3个一级指标(X1-3),措施层为Y层11个二级指标(Y1-11)。分析得到所有判断矩阵的一致性比例。所有矩阵CR值均<0.100,符合标准,说明本次AHP赋权结果可靠,见表2。进一步根据分析结果计算出各层级要素的权重及不同层级相对于目标层的组合权重(为本层级初始权重×对应的上一层级权重),见表3。指标定义为:事件监测与报告X1中,Y1为接到报告与事件首例病例发病的时间差,Y2为网络直报时间与接到报告的时间差,Y3为包括事件初次、进程和结案报告的完整性;事件调查与处置X2中,Y4为事件核实认定与接到报告的时间差,其他指标为报告中相关调查或处置情况质量;事件后期绩效评估X3中,所有指标为报告中相关评估分析情况质量。
经过对不同角度指标数据的处理和相关运算,结果评估了2019—2023年山东省非职业性一氧化碳中毒事件不同年份综合报告质量(Ci=0.272~0.777),不同地市综合报告质量(Ci=0.453~0.778),不同地区综合报告质量(Ci=0.359~0.596),以及不同地区的事件监测与报告工作报告质量(Ci=0.292~0.646)、事件调查与处置工作报告质量评价结果(Ci=0.448~0.566)和事件后期绩效评估工作报告质量(Ci=0.126~0.963)。
不同年份综合质量评价结果见表4。结果表明:不同年份综合质量评价结果以2020年(Ci=0.777)最好,其次为2021年(Ci=0.582),最差是2023年(Ci=0.272)。
不同报告地市综合质量评价结果见表5。结果表明:在2019—2023年五年合计综合质量的评价结果最好的地市为烟台市(Ci=0.778),其次为济宁市(Ci=0.679)。
不同报告地区综合质量评价结果见表6。结果表明:胶东城市圈综合质量最佳(Ci=0.596),其次为省会城市圈(Ci=0.553),鲁南城市圈的综合质量相对其他地区略显不足(Ci=0.359)。
不同报告地市各一级指标质量评价结果见表7。结果表明:事件监测与报告X1指标评价结果最好的是省会城市圈(Ci=0.646),其次是胶东城市圈(Ci=0.591),而鲁南城市圈得分较低,Ci小于0.5;事件调查与处置X2指标评价结果最好的地区为省会城市圈(Ci=0.566),其次为胶东城市圈(Ci=0.527)、鲁南城市圈(Ci=0.448);事件后期绩效评估X3指标评价结果最好的鲁东地区(Ci=0.963),其他地区Ci均小于0.5。
本研究构建了山东省非职业性一氧化碳中毒事件应对工作报告质量评价体系,并系统分析了2019—2023年山东省16地市的8 612例事件数据。以下结合研究结果与现有文献,对评价体系的意义、评价结果质量差异的潜在原因及改进方向进行深入探讨。
从评价体系上看,一级指标中,“事件监测与报告”(0.483 8)对应对工作报告质量的影响最大,这与《预案》中“反应及时、处置有效”的原则高度契合。具体而言,三级指标中“事件报告及时性”(0.156 6)和“事件监测敏感性”(0.261 7)的突出权重表明,快速发现与报告是控制事件危害的核心环节,与周亚霖等[16]提到的“早期响应能力决定应急效果”观点相符。此外,“事件调查与处置”(0.378 1)中“中毒情况调查”与“现场处置”的较高权重(分别为0.081 7和0.081 3)反映了追溯中毒原因和现场急救的重要性,这与章宝丹等[11]在职业中毒处置中提出的“现场控制关键性”论一致。而“高危人群保护”(0.073 2)的权重提示健康教育在预防二次伤害中的作用[17]。“事件后期绩效评估”(0.138 1)权重虽较低,但其二级指标“事件责任及影响评定”(0.064 8)和“事件结果评估”(0.073 3)仍具有较高比重。这表明,尽管当前应急工作可能对事后评估的重视程度不足,但具体环节中对责任追溯、影响分析和措施效果的评估仍是优化应急体系的关键。
从评价结果上看,山东省非职业性一氧化碳中毒事件应对工作报告质量排序以2020年报告质量最优,可能得益于新冠疫情期间卫生应急体系的强化[12];而2023年质量显著下降,可能受数据截止时部分报告未完成终审的影响,应规范事件报告的结案时限以提高工作效率。而在不同地市上看,多数地市报告质量较高,烟台市、济宁市以及滨州市分别作为其所属综合质量评价最优的城市,得益于各自在加强应急服务体系建设、系统工作创新等方面的探索与实践[18-20]。在报告地区方面,胶东城市圈在全环节高质量运作,这可能得益于该地区内的城市大多数为沿海经济发达城市,地方政府对应急管理专项资金投入力度较大以及公众教育等方面的积极举措有效提升了工作质量。相比之下,省会城市圈的薄弱环节为事件后期绩效评估,鲁南城市圈各环节质量均相对薄弱,可能受两地区人口密集、基层资源配置不均、“重处置轻评估”等问题的影响。建议参照《预案》进一步加强“事件处置-效果评估-预案优化”联动机制,通过优化监测与响应效率、强化调查处置专业化能力等方式,系统性提升非职业性一氧化碳中毒事件应对工作报告质量。
综上所述,山东省非职业性一氧化碳中毒事件应对工作报告质量存在时空异质性,不同年份、地市及地区间的表现差异显著。未来应以烟台市、济宁市及滨州市等优质案例为标杆,推广其网格化管理与宣教经验;针对薄弱地区,需强化基层能力建设与全周期评估机制,同时推动省级数据平台的实时监控与预警功能升级,以实现应急管理质量的整体提升。但本研究存在一定局限性,因评价研究和信息有限,本研究反映的是报告信息质量,实际应急质量可能存在差距。未来工作可寻找更好指标完善评价体系,实现客观、科学、全面的评价。
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2025年第52卷第15期
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doi: 10.20043/j.cnki.MPM.202503372
  • 接收时间:2025-03-20
  • 首发时间:2026-03-16
  • 出版时间:2025-08-10
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  • 收稿日期:2025-03-20
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    1.山东第二医科大学,山东 潍坊 261053
    2.山东省疾病预防控制中心,山东 济南 250014

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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