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目的建立禽职业暴露人群H5N1禽流感风险评估模型,筛选高危风险因素,为制定禽流感风险管理措施提供参考依据。方法通过查阅文献梳理出人感染H5N1禽流感风险因素列表,咨询20位专家获得评分与建议后采用层次分析法建立模型并计算权重,并通过查阅档案、现场调查获得浙江省金华市各评估指标实际评分,引入模型计算风险评估得分。结果经过3轮风险识别,专家意见达成一致;建立的模型,其准则层(b)包括“b1家禽高致病性禽流感H5N1流行形势”等9项,指标层(c)包括“c1域内高致病性禽流感H5N1疫情”等30项;各风险矩阵的一致性指数(CI值)和一致性比率(CR值)均<0.10,指标层各指标组合权重显示,c1域内高致病性禽流感H5N1疫情(0.151 3)、c26跨种属(禽-人)间传播能力(0.138 7)、c20最近1周内病死禽暴露率(0.119 3)、c27致病力(0.092 5)和c29特殊暴露者所占比例(0.067 2)为重要指标;金华市禽职业暴露人群2011—2014年风险评估得分分别为0.46、0.47、0.35、0.31分,主要获分项有“b2禽饲养风险”、“b3禽交易风险”、“b6人群暴露状况”、“b7人群防护状况”、“b8新发H5N1禽流感病毒株特征”、“b9暴露人群特征”等6项。结论禽职业暴露人群H5N1禽流感风险评估模型可行、实用;金华市禽职业暴露人群存在一定程度H5N1禽流感感染风险,加强该人群人禽流感风险管理十分必要。
Objective To establish a risk assessment model of H5N1 bird flu in the occupationally exposed population of poultry and screen high risk risk factors to provide a reference for the development of risk management measures for avian influenza. Methods By consulting the literature, we combed the list of human risk factors for H5N1 avian influenza infection, consulted 20 experts to obtain the scores and suggestions, then used AHP to establish the model and calculate the weights. The indexes of Jinhua City, Zhejiang Province, Score, introduce model to calculate risk assessment score. Results After three rounds of risk identification, the experts agreed on the opinions. The model (b) included 9 items such as “epidemic situation of HPAI H5N1”, “indicator layer (c) c1 domain H5N1 outbreak of the highly pathogenic avian influenza ”and other 30 items; the consistency index (CI value) and consistency ratio (CR value) of each risk matrix were <0.10, the index layer combination weight of each indicator showed that c1 domain high The pathogenic avian influenza H5N1 outbreaks (0.151 3) and c26 across the species (avian-human) were 0.138 7 (p 0.138 7) ) And c29 (0.067 2), respectively. The risk assessment scores of occupational exposure groups in Jinhua between 2011 and 2014 were 0.46, 0.47, 0.35 and 0.31, respectively, and the main items were “b2 Breeding risk ”,“ Risk of b3 poultry trade ”,“ Exposure of b6 population ”,“ Prevention status of b7 crowd ”,“ Characteristics of b8 new strain of H5N1 avian influenza virus ”,“ Exposure of b9 Crowd characteristics ”6 items. Conclusion The H5N1 bird flu risk assessment model in poultry occupational exposure groups is feasible and practical. There is a certain risk of H5N1 bird flu exposure among occupational exposure groups in Jinhua poultry and it is necessary to strengthen the risk management of bird flu in this population.