Thực trạng an toàn vệ sinh thực phẩm tại bếp ăn tập thể của một số doanh nghiệp thành phố hải dương năm 2013

Y
HOC
VlfT
NAM
THANG 2 -
SO
2/2014
TAI
LIfU
THAM
KHAO
1.
Jha, A., Sayami,
G.,
Adhikari,
R.
C,
Panta, D.,
Jha,
R.
(2008). Bone marrow examination
in
cases
of pancytopenia. 3 Nepal Med
Assoc,
47, 12-17.
2.
Kibria, S. G., Islam, M. D. U. (2010).
Prevalence of Hematological Disorder: A Bone
MantJW
Study of

177
Cases In a Private Hospital
at Fandpur.
Farldpur
Med.
Coll J, S, 11-13.
3.
Knodke,
K.,
Marwah,
S (2001). Bone marrow
examination in cases of pancytopenia. J Academy
QinMed,!,
55-59.
4.
Levine, F. C. (1999). "Idiopathic"
thrombocytopenia. Arch Intern Med,
88,
701-728.
I 13. Levine, S. P. (2003). Thrombocytopenia:
pathophysiology and classification. In Greer
3P,
Foerster
J, Lukens
JN,
et al. (Eds.),
Wintrobe's
clinical hematology 11th ed. (vol. 2, pp. 1530-
1532). Philadelphia:
Lippincott

Williams
&
Wilkins.
MeKenzie
S.
B.
(Ed.), (1996). Textbook of
hematology, 2nd ed.
Painsylvania:
Willaims&
Wilkins.
Muhury, M., Mathai, A. M (2009).
Megakaryocytic
alterations in thrombocytopenia: A
bone marrow
aspirabon
study. Indian J
PatholMlcrobioi,
52,
490^94.
Pudasaini, S., Prasad, K. B. R (2002).
Interpretation of bone marrow aspirabon
in
hematological
disorder.
Journal of Pathology of
Nepal, 2, 309-312.
THirC
TRANG AN TOAN VE SINH THITC PHAM TAI
BEP

AN TAP THE
COA
MOT
"SO
DOANH
NGHIEP
-
THANH
PHO HAI
DiraNG
NAM 2013
TbM
TAT
Nghien
ciiff
thUe trang An toan ve sinh
thiTc
pham
t?i
cic
bep 3n tap the (BATT)
ciia
doanh nghiep tren
dja ban thanh phd Hai DUdng , ket qua cho thay : Dien
tich phong che bien <
lOOm^
chiem ty le nhieu nhat
(50%);
di?n
ti'ch phong an

200-500m^
chiem
t/
le
nhiSu
nhat (45%); Cdn ed 44% BATT chUa dat yeu
cau ve
thii
tuc hanh chinh; 17,5% khdng dat yeu cau
ve
CO
sd ha tang; 20% BATT
ngudi
phuc vu (NPV)
khdng mang day
dii
bao hp lao dpng
khi
lam
viec;
20%
NPV khong sff dung dung
cy
sach khi che
bien;
Tren cac mau xet nghiem deu thay co ty le nhiem
vi
sinh vat (VSV): tren
thi/c
pham

chin,
dung cu chira
(Jyhp
thu'c pham
chin,
ban tay NPV, Trong do ty le
nhiem VSV tren ban tay NPV la cao nhat: Coliform
(72,5%);
E.coli
(25,0%); S.aureus(32,0%).
SUMMARY
SAFETY
SITUAHON
IN FOOD HYGIENE AT
CANTEENS OF SEVERAL BUSINESSES -
HAI DUONG CITY IN 2013
Research the current status of food safety and
hygiene in the canteens of businesses
in
Hai
Duong
city,
the results show that processing room area <
lOOm^
acmunting
for largest proportion (50%), dining room
area of 200 - 500
m^
accounting for the largest
preiportion

(45%); there are 44% of the canteens is
'
SdYte tinh
Hal
DuVng
"
TnAlmg
Cao
dSng
Y
teHai
Phdng
Phin
b/^n
khoa hgc: GS.TSKH Nguyen VSn Hien
Dinh Huy
Hung*,
Vu
Due
Long**
unsatisfactorily on administrative procedures;
17.5%
is
unsatisfactorily on infrastructure, 20% waiters do not
carry adequate labor protection at work; 20% waiters do
not use clean utensils when processing; In the
specimens founded microorganism ratio on cooked
food,
containers of cooked food , hands of waiters. In which
the infection rates on the waiters' hands is the highest;

Coliform (72.5%), E,
coli
(25,0%), S, aureus (32,0%),
I.
OAT VAN
OE
An toan ve
sinh
thffc pham(ATVSTP) hien
dang la mdi quan tam
Idn
ciia
nhieu Qudc gia
tren the
gidi,
Tren the gidi ffdc
tfnh,
hang nam cd
khoang 3 - 5 ty ngu'di bj tieu ehay, ed 3-5
trieu
ngLfdi
tff vong, khoang 1.400 trieu
Iffpt
tre
em/nam bi mac benh tieu chay
,trong
sd dd 70
% nguyen nhan do an, udng thi/e pham bj d
nhiem [5],[6]. Tai Viet Nam, sd trffdng hdp ngd
ddc thffc pham cd xu hffdng ngay cang

gia
tang[l],
Theo thdng ke chffa day du
ciia
cue
ATVSTP
trong cac nam
2007-2011,
toan qudc da
ghi nhan 927 vu
NOTP
vdi 30.733 ngu'di mac va
299 ngffdi chet. Trung binh cd 185 vu/nam, trong
dd sd vu ngd ddc tai bep an tap the chiem tff
12,7 den 20,6% tong sd vu moi nam, Tuy nhien
day chi la sd iieu thdng ke chu'a day du
,thffc
te
con sd ngd dpc thffe pham hang nam cdn eao
hdn rat nhieu[2]. Theo ffdc tinh
eiia
WHO, d Viet
Nam con sd ngd dpc thffe pham hang nam
khoang tren 8 trieu ngffdi [5]. Hai Dffdng la mdt
Y HOC VIET NAM THANG 2 -
SO
2/2014
trong nhffng thanh phd dang trong tinh trang
bao ddng ve van de ATVSTP, Trong dd ATVSTP
tai cae bep an tap the (BATT) cua cac doanh

nghiep phuc vu eho ngffdi lao ddng rat can dffdc
quan tam. Do vay chiing tdi nghien effu de ta
nay nham mue
tieu:
'Wo
ta
thu'c
trang
ve
sinh
an toan thdc pham tai bep an tap the d mot
so
doanh nghiep tren dia ban thanh pho
Hai
Du'dng
nam
2013."
11.
DOI TypNG
VA PHU'aNG
PHAP NGHIEN CLTU
2.1.
Odi tffdng nghien cu'u
- Cac bep an tap the eua doanh nghiep tren dja
ban thanh phd Hai Dffdng tinh Hai Dffdng .
- Ngffdi phuc
vy
(NPV) tai cac
BATTciia
doanh

nghiep.
2.2.
Oja dlem va thdi gian nghien cu'u
- Dia diem nghien
cffu:
Cac doanh nghiep ed BATT
tren dia ban thanh phd Hai Dffdng, tinh Hal Dffdng.
-
Thdi'
gian
nghien
cffu:
01/2013
- 10/2013
2.3.
Pliffdng
phap nghien cu'u
2.3.1. Thiet ke
nghien
cu'u:
mo
ta cat ngang
2.3.2.
Cd mau: Cd mau nghien cffu BATT
dffdc lay toan bd
2.3.3.
Cach
chgn
mau:
- Tai thdi diem tien

lianh
nghien cffu tren dja ban
thanh phd Hai Du'dng cd 40 bep an tap the ciia
doanh nghiep, chiing tdi lay toan bd cd mau la
40 BATT dffa vao nghien
cffu.
- Danh gia dieu kien ve sinh qua eac mau xet
nghiem de tim
si/
cd mat
eiia
vi sinh vat gay
benh:
Mdi
bep
aji
tap the lay 04 mau xet nghiem
bao gom: 01 mau thffe pham
chin,
01 mau ban
tay
ngu'di
che
bien,
01 mau dung eu
chu^
dutig
thffc pham
chin,
01 mau xet nghiem nffde su'

dung trong che bien (td'ng sd 160 mau).
2.4. Phu'dng phap thu thap so
lieu:
Thanh lap nhdm dieu tra gom eac can bd
ciia
chi
cue ATVSTP
ciia
tinh Hai Dffdng, tien hanh tap
huan eho nhdm dieu tra, thffc hien dieu tra theo
mau phieu dffdc lap
san_^
.Lay
mau xet nghiem
theo thffdng qui va
gffl
mau ve thffc hien tai Labo
xet nghiem ATVSTP - Trffdng Dal hpc ky
thuat y
te Hal Dffdng theo cac qui chuan.
2.5.
Xir ly so
lieu:
Sff dung phan mem
SPSS 16,0 de xff ii va phan tich so
lieu.
It.
KET QUA NGHIEN CLTU VA BAN
LU/^N
Bang

3.1. Dien tich
eae
bep an tap the
ciia doanh
nghiep
Tieu chi
Dien
tich
phong che
bien
Dien
ticti
<100m'
100-200
m^
>200
m^
Tong
Dien tich phong an
<200
m^
200-500
m'
>500
m^
Tong
n
20
15
5

40
5
18
17
40
Tv
le (»/o)
50
38
12
100
12
45
43
100
Nhan xet: Sd bep an cd dien tieh phdng che
bien <
lOOm^
chiem ti le cao nhat (50%), bep an
dien tieh
>200m^
ehi chiem
12%.Phan
Idn dien
tich phdng an
ciia
cac BATT tffdng ddi rdng, sd
phdng an cd dien tich tren
500
m^

chiem ty le
eao nhat 43%, phdng an cd dien tieh nhd hdn
200
m^
chiem ty le thap nhat 12%. Bang 3.2 cho
thay dien tich phdng an va khu che bien
ciia
BATT la kha rdng d ea 2 loai hinh doanh nghiep.
Ket qua nghien cffu
ciia
chung tdi cung phu hdp
vdi ket qua nghien cffu
ciia Biii
Vi The nghien
cffu tai cac BATT
eiia
huyen Thuy Nguyen - Hai
Phdng ( 2012) [2].
Bang
3.2. Tv ie BATT
thu'c
hien qu
~~ "^ ^Tieu
chuan
Quy mo
DN " —— __^
DN*
icin
(1)
DN

vira
va nho (2)
P
dinh ve
Oat
n
20
4
(%)
80,0
26,7
P,,2<0,05
hii
tuc hanh chinh theo qui
Chap nhan
n
4
5
(%)
16,0
33,3
Pi!<0,05
mo
doani'
Khong dat
n
1
6
(%)
4,0

40,0
Pij<0,05
nqhiep
Tong
25
15
40
*= Doanh
nghi^
Nhan xet: Ket qua bang tren cho thay ed 80% DN Idn dat tieu chuan ve
thii
tuc hanh chi'nh,
cd
40%
DN
VLJ^
va nhd khdng dat tieu chuan ve
thii
tuc hanh chinh, cd sff khac biet co y nghTa thong
ke
giiJ^
Y HQC
VlgT
NAM THANG 2 - SO
2/2014
DN Idn va DN vifa va nho ve thu tuc hanh chinh (P<0,05). Chung toi cho rang
d
nhifng DN
ISn difOc
cac nha quan ly

cO
sd quan tam dau
tu"
hdn nen thiic hien tot hon.
Bang
3.3.
Tylet
Cat
Chap nhan
Khong
dat
tap the theo qui mo doanh nqhiep ve
cO
sd ha tanq
DN Idn
(1)
18
(%)
72,0
20,0
DN
vCra
va nho (2)
(%)
46,7
20,0
Tong
(%)
20,0
17,5

<0,05
Tong I 25 I 100,0 J 15 | 100,0 | 40 100,0
, ,
/VAan xet:Jy
le BATT cua DN idn dat tieu chuan ve cd sd ha tang cao hdn so vdi DN vira va nho,
su'
khac biet cd y nghia thong l<e vdi P<0,05. chung toi cho rang
nhUng
doanh nghiep idn co nguon lu'c
tot hdn nen du'dc dau tu' nhieu hdn.
Bang
3.4. Ty ie cac BATT cd du tranq
b\
bao hp iao
d6ng(BHLB)
cho NPV
Siydyng^^
BHLS
Quy mo
DN
DO 4 bao ho
DN
Idn(l)
(%)
DN
vifa
va nho
11)
(%)
Tong

{%)
P(.,2
Khonq du
40,0
<0,05
Tong 25
100,0
Nhfin
xet: Trong 40 BATT con co 20% BATT ,
ngu'di phuc vu khong sir dung
dii
bao hp. Tai DN
viia va nho cd 40% BATT ngu'di phuc vu khong
diJ
bao
hp
va DN Idn la 8%,
su"
khac biet co
y
nghia vdi P<0,05. Sd
dl
co ket qua nhu vay theo
chiing toi ia do d nhu'ng doanh nghiep idn cd to
chu'c lao
dpng
va chap hanh iuat tdt
hdn.Ciing
vdi
npi

dung nghien cii'u nay theo tac gia Nguyen
15 100,0
40
100,0
Thj Van (2012), tai Hai Phong thi ti ie sir dung
bao ho lao dong ia 62,5% [4];
ciia
Pham buy
Tuyen (2010) tai Hai
Du'dng
thi ty
lenay
la
60,4%
[3]. Nhu vay ket qua nghien ciru cua
chung toi co cao
hdn,chLing
tdi cho rang cong
tac quan iy, hu'dng dan cua cac
cO
quan quan iy
nha
nUdc
trong
ilnh
vuc y te trong nhdng nam
sau
dUdc
thuc hien tot hdn.
Bang

3.5,
Ty le BATT theo qui mo doanh nghiep dat ve trang thiet bj, dung cu sach ndi che
bien va phan phoi
tliij'c
an
chi'n
Tieu
chuarT ~-^——.__
eat
Chap nhan
Khdnq dat
TSng
DN Idn
(1)
n
23
0
2
25
(%)
92,0
0,0
8,0
100,0
DN vira va nhd (2)
n
9
0
6
15

(%)
60,0
0,0
40,0
100,0
Tdng
n
32
0
8
40
(%)
80,0
0,0
20,0
100,0
•"(l,!)
<0,01
Nh$n
xit: Ket qua bang
tr^n
cho
thgy
trong 40 BATT cd 20% BATT khong dat tieu chuan , trong dd
BATT
ciia
DN nho va vira chiem 40% va DN idn chiem 8,0%, su khac biet cd y nghia
thong
ke vdi
P<0,01.

Chung tdi cho rang ty ie nay la kha cao va tuong dUdng vdi ket qua nghien ciru cua
Biii
Vi The
(2013) tai Hai Phdng: 82,4% va cao hdn cua Nguyen Thj Van (2012) cung tai Hai Phong ia: 62,5%.
Bang
3.6. Ket qua xet nqhiem VSV tren cac mau
E.coli
Coliform
Khdng
dat(n)
Khdng dat (n)
Khonq dat (n)
Ban
tay
NPV (n
=
40)
29
25,0
Thi/c
pham
chin
(n
=
40)
Dgng cu
chu^
dirng thu'c
phamchin(n
=

40)
20,0
Nu'dc (n
=
40)"
0,0
0,0
Nh$n
xit: l<et qua bang
trSn
cho thay cac mau xet nghiem ban tay NPV,
thUc
pham
chin,
dung cu
Mi dung
thuc pham chin deu cd nhiem VSV, cao nhat tren ban tay
NPVj
Coiiform 72,5%; S.aureus
32,5%.'Ttieo
ket qua nghien ciru
ciia
Nguyen
Thi
Van (2012) thi ty le mau dat ve chi
Ueu
vi sinh doi
vdi
E.coli
la 90%, Coiiform ia 70% tddng

dUdng
ket qua nghien ciru
ciia
chung toi.
Y HOC VIET NAM THANG 2 -
SO
2/2014
IV. KET LUAN
Qua nghien
cffli
ve thffc trang ATVSTP tai
eac bep an tap the eua doanh nghiep d Hai
Dffdng ket qua eho thay:
- Dien tich cac bep an :
Chiem
50% cac phdng
che bien cd dien
tich
<iOOm^;
chi cd 12% dien
tich
>200m^;
Dien tich phdng an tff
200-500m^
chiem ty le nhieu nhat (45%).
- Chiem 44% cac BATT chu'a dat yeu eau ve
nhffng qui dmh
thii
tuc hanh chinh .
- Cd tdi 17,5% cae BATT khdng dat yeu cau ve

cd sd ha tang ; 20% cac BATT ed NPV khdng
mang day
dii
bao hd lao ddng khi lam viee ; 20%
BATT ngffdi
phyc
vu khdng sff dung dung cu
sach khi che
bien.
-tren cac mau xet nghiem deu thay cd ty ie
nhiem VSV trong dd ty le nhiem VSV tren ban tay
NPV la cao nhat: Coliform (72,5%);
E.coli
(25,0%);
S.au reus (32,5%).
TAI UEU THAM
KHAO
1.
Cue
An toan thu'c pham - Bp Y te
(2005);
"Mdt so cong trinh nghien cffu ve ve sinh an toan
thu'c pham. Bp Y te. HNKH an toan ve sinh thifc
pham lan thff
ill.
Ha Ndi.
2.
Bui Vi The
(2013),
Tht/c

trang an toan ve smh
thUc
pham,
cdng
tac quan ly va kien thffc,
thi/c
hanh
ciia
nhan vien
tai
cac bep an tap the huyen
Thuy Nguyen,
Hai
Phong nam 2012, Luan van
1^
nghiep bac sT chuyen khoa II,
trUcfng (3ai
hpc Y
khoa Hai Phong,
Hai
Phong.
J.
Pham Duy Tuyen (2010), thUc trang an toan
v^
smh thu'c pham va cong tac quan ly mpt so
cd sd
djch
vu an uong cong cpng tren dja ban thanh
ph6
Hai

DUPng
nam 2010, Luan van thac
sT
y te cong
cpng,
tn/dng dai hpc Y khoa
Hai
Phong, Hal Phong.
4.
Nguyen Thj Van (2012), thifc trang an toan ve
sinh thUc pham,
kien
thffc, thai dp
eiia
ngffdi phyc
vu tai nha hang an udng quan Le Chan, Hal Phong
nam 2012, luan van thac
sT
y te eong cong, tru'dng
dai
hoc Y khoa Hai Phong,
Hai
Phdng.
5. CDC (2000) Foodborne illness,
p.
1-17.
6. WHO (1997) Epidemiological Surveillance of
Foodborne Diseases, Geneva.
CHi
so

HUYET AP VA LIPID MAU
6'
BENH NHAN DAI
THAO
DU'O'NG TYP
2 DIEU TRI NGOAI TRU TAI BENH VIEN KIEN AN
HAI
PHONG
T6M
TAT
Nghien cffu du'dc tien hanh tren 123 benh nhan
dai
thao dudng typ 2 dieu tri ngoai
trii
tai benh vien
kien An
Hai
Phong tff 01/2011 den
06/2011.
Ket qua: Nhdm nghien cffu cd
tuoi
trung binh la
60,4
-I-
9,7; nff chiem 66,7%. Ti le
dai
thao dUdng typ
2
CO
tang huyet ap la

48,8%,
fang huyet ap gd I:
28,5%,
tang huyet ap
giai
doan II: 14,6%, tang huyet
ap giai doan III: 5,7%, Ti le nam
bi
tang huyet ap
nhieu hdn nff (63,4% so
vdi
58,2%).
Tuoi
cang eao ti
le
t§ng
huyet ap cang nhieu; d benh nhan tren 70
tud'i,
t9
le tang huyet ap la 60%. Thdi
gian
mac dai thao
dudng cang dai thi ti le bi THA cang cao; d benh nhan
mac benh tren 10 nam co ty le tang huyet ap la
66,7%.
52,8% dai thao dirdng typ 2 cd tang
Cholesterol; 60,2% cd tang Tryglycerit; 32,5% cd tang
LDL;
39,2% benh nhan cd tang Cholesterol va
Tryglycerit; 25% benh nhan cd tang Cholesterol,

Tryglycerit va LDL. Nhom
dai
thao
dUdng
typ 2 ket
hdp tang huyet ap cd ty le rdi loan chuyen hoa Lipid
mau cao hdn nhom khong cd tang huyet ap.
* SdYte
Hai Phdng
Phan
bi0n
khoa hgc: PGS.TS. Do Thj Tinh
Trinh
Thi Ly* va
cdng
sif
SUMMARY
BLOOD PRESSURE AND
LIPIDEMIA
IN OUTPATIENT WITH TYPE II
DIABETES TREATED IN KIEN AN
HOSPITAL HAI PHONG
The study was conducted on 123 outpatient with
type 2 diabetes treated in Kien An hospital from
01/2011 to
06/2011.
Results: The team has an average age of 50.4 +
9.7; women accounted for 66.7%. The rate of type 2
diabetes have hypertension was 48.8%. Hypertension
stage I: 28.5%, hypertension stage II: 14.6%,

hypertension stage III: 5.7%. Percentage of men with
hypertension is more than women (63.4% versus
58.2%).
As the older patients are, as the rate of
hypertension is higher; in patients over 70 years of
age,
the rate of hypertension
is
60%. As the duration
of diabetes is longer, as the rate of hypertension is
higher; in patients over
10
years of diabetes, the rate
of hypertension
is
66,7%. In patients had type 2
diabetes: 52.8% have Cholesterol increased; 60.2%
have
Triglycent
increased; 32,5% have LDL increased;
39.2%
have Triglycerit and Cholesterol increased; 26%
have cholesterol, Triglycerit and LDL increased. The