ITltNGQIIAH&NGHIENCtiUI
Khao sat mu'c do hut thudc la thu dong tai cac dia di^m cdng cong 8 Ha Noi
Dgng Thu Trang (*); Pham Thai HSng (**); Nguyin VSn Huy (***)
Nghiin cdu duqc tie'n hdnh de cung cdp nhiing ki't qud ban ddu vi miic do hut thudc thu dong d cdc dia diem cong cdng tqi Hd Nqi. tU dd ldm co sd ho trq xdy dung cdc chinh sdch phdng chdng hiit thudc Id. Nghiin ciiu duqc tii'n hdnh tqi 35 dia diem cqng cqng gdm cdc cO quan nha nudc, benh viin, trudng phd thong CO sd,nh& hdng vd cdc dia diem vui choi gidi tri ta thdng 1/2010. Ki'l qud cho thdy nong do PM2.5 trong khong khi d Irong nhd vd ngodi trdi tm td't cd cdc dia diim trong mdu nghien Cliu deu cao hon tiiu chudn cua Td chtic Ytd thd gidi (WHO) ((25 pg/m3), ndng dd PM2.5 dqc biit cao tqi cdc dia diem vui choi gidi tri. nhd hdng.
TU khoa: hut thudc Id thu d0ng
Survey on second hand smoke exposure in pubhc places in Ha Noi
Dang Thu Trang (*); Fham Thai Hang (»*); Nguyen Van Huy (***)
This study is conducted and focused on indoor air quality and second hand smoke in public areas in Hanoi. Vietnam in order to establish baseline levels of SHS exposure to support more progressive smoke-free policies and to monitor and evaluate progress towards smoke-free countries. Data are collected in 35 public places, including government offices, hospitals, secondary schools, restaurants and entertainment venues from 01/2010. The findings from this study indicate that PM2.5 levels of outdoor air and indoor places are alt greater than the WHO daily acceptable standard (25 pg/m3), PM2.5 level is especially high at entertainment venues and restaurants.
Keywords: Second hand smoke
Tic gii:
(•) ThS. Dang Thu Trang, Nghifin crfu vifin, Trung tim Nghien crfu vi phit trien Y tfi^ c0ng dong (CCRD) Email: [email protected]
(**) ThS. Ph%m Thii King, Tnfdng pbong ttuyin thfing, Trung tam Nghifin cffu vi Phat Triln Y te' cpng ddog (CCRD)
(••) ThS. NguySn VSn Huy, Giing vifin, Tnfdng Dai hoc Y Hi ndi.
Tap chi Y td Cdng cdng, 10.2011, So 21 (21) 61
ITdNGIVflN&NGHrENCirUI
1. Dat vSn dd va muc tifiu
Vifit Nam hifin vin li mfil trong nhffng nrfdc cd t\ le hiit thudc cao tdiat trfin thfi' gidi. Sd' lieu rfdc tinh nim 2006 cho thay ly lfi hut diudc d nam gidi d Viet Nam li hdn 49%. Mac du ty Ifi hiit thud'c la thap d nff gidi, drfdi 2%, nhtfhg nff gidi Iai phai chiu nhffng lic hai cua hiil ihudc thu ddng [2], Nhffng anh hrfdng srfc khde ddi vdi tre em do hut ihud'c thu ddng giy ra eung li vi'n de can drfdc quan tam khi ma rfdc tinh 41-53.4% tre em thtfdng xuyfin tie'p xuc vdi hrft thud'c thu ddng[3].
Kiem soit thudc la la mot trong nhifng van de dtfdc Viet Nam quan tim. Viet Nam k^' Cdng tfdc khung ve kie'm soil thud'c la vi vdi Quye't dinh 1315/QD-TTg ciia Thff ttfdng Chinh phu ve viec phe duyfit Ke' hoach thtfc hifin Cdng tfdc khung vd kiem soit thudc li, tff ngiy 01/01/2010, hdt thud'c li bi ci'm tai cac ndi cdng cpng [1].
Nghien crfu nay dtfdc tie'n hanh nham cung cap nhffng kfi'l qua ban d^u ve mrfc dp hdt thudc thu dfing d cic dia difi'm cdng cdng tai Ha Nfii, trf do lam cd sd hd trd xiy dUiig cic chinh sich Phdng chd'ng hut thudc la tai Viet Nam.
2. Phtftfng phap nghign cihi
Thiet ke nghifin cffu: nghifin cff^ mo ta cat ngang
Thdi gian vi dia diem nghifin culi: nghifin cffu dtfdc tifi'n hanh tai 35 dia diem cdng cfing tai cic quin. huyfin tai Hi Npi trf thing 1/2010 de'n thing 9/2010.
Cd miu nghifin crfu: dff lieu ve cha't Itfdng khfing khi vi mrfc dp hiit diudc li ihu dfing dtfdc thu thap tai 5 bfinh vifin, 5 tnfdng phd Ihong cd sd, 5 cd quan nhi ntfdc, 10 nha hang va 10 dia diem vui chdi giai iri.
Phuong phdp thu thdp da liiu:
180 miy do ndng dp nicotin trong khdng khi di dtfdc dat trong vdng 1 tuan tai cae vi tri khac nhau tai mdi dia die'm nghifin cffu nhtf; phdng chd/ hanh Iang, phdng lam vific, eing tin, nhi vfi sinh, cau thang, khu \-tfc phong in chinh tai nha hang, nhflng ndi dtfdc hut ihufi'c va ci'm hut thud'c ,
May TSI SidePak dtfde sff dung de do ndng do PM2.5 trong khdng khi trong khoang 30 phut, dff lifiu dtfdc thu thap tai ndi cd ngtfdi hien hfft thudc cung nhtf nhrfng ndi khfing cd ngtfdi hui vio thdi difim dd.
Quan sit sfi dtfdc cic nghifin crfu vifin tifi'n hanh
trong sud't thdi gian dit cic may do ndng dd nicoun tai dia diem nghifin crftf va thdi gian may do PM2.5 hoat ddng.
Phan u'ch vi xrf I^ sd'lifiu: Toan bp dff lieu ve chit Iffdng khdog khi sau khi thu thip dtfdc phan tieh trong phdng lhi nghifim cua Trung tam dinh gia phdi nhilm, Dai hpc Y tfi'Cfing cpng Johns Hopkins Bloomberg. Kfi't qua dtfdc phan tich, so sinh theo tffng nhdm dia diem nghifin ciirf. Trong nghien crfu nay, dia diem cd dau hifiu ciia hrft thufi'c dtfdc dinh nghia li nhrfng dia didm ma didu tra vifin quan sil cd ngtfdi hut thudc, hoac cd diu loc va lin thudc hole nhin thi'y cd mui thudc l i .
3. Kd't qua nghien cihi
Ngoai M i Tron^nhA, Trong rti*, (r*-34) laOmt CO dSa co cdj Niu cua
llWu ciHa hot IrOtOiuAc ^4B13)
«««(N-211
Bieu dd I. Miic dg PM2.5 tqi cdc dia diem trong nhd va ngoai trdi Iheo dd'u hipu cda hut thudc tqi Hd Nqi
3.1. Ndng ddPM2.5
Kfit qua nghifin crfu cho thay ndng dfi PM2.5 tai cic khu Vrfc trong nha vi ngoii trdi ddu eao hdn so vdi tieu chu^n cho phfip cua WHO (25 pg/mS).
Trong vdng 30 phiit, khich den cac dia difi'm trong nhi CO d^u hifiu eiia hfft thudc se phdi nhifim nhidu hdn 4 lan so vdi mffc dp cho phfip hing ngay crfa WHO. Ndng do PM2.5 cao nhi'l tai cac dia difi'm vui chdi giai tri (ntji cd di'u hifiu cua hut thu^c la 102 Mg/m3, ndi khdng cd di'u hieu cua hut ihu^c li 50.1% pg/m3), tidp theo la nha hang (ndi cd di'u hieu cua hrft thuoc li 83.8 Mg/m3, ndi khdng cd da'u hjeu cua hfft Ihud'c la 63.5% Mg/m3), cp quan ehinh phu (ndi CO diu hieu cua hfft thudc la 48 5 pg/mS ndi khdng cd dau hifiu cua hrft thudc la 40 2 ufi/m3l' Ndi khdng cd da'u hifiu hrft thudc tai bfinh v , e n \ n l ' CO nfing dp PM2.5 thi'p nhi't trong cic dia d "
nghifin crfu (27 Mg/m3), tuy nhifin ndng dfi niy v ^ 62 Tap chi 'i te Cong cpng, 10.2011, Sd 21 (21)
ITfi'NGQUAK&NGHIlHeaul
cao hdn mrfc dd cho phep hang n g i y c u a W H O . 3.2. Ndng dd Nicotin trong khong khi
Bdng 1. Nong dg nicotine trong khong khi tqi cdc dfa diem trong nhd tqi Ha N$i B\iAim
T r r i n g b v c Bfok t l f D
D . , » o n W - - f c N b i U D E Khu lire
Khu viTc hiJI IhuSc DiudUfnivuicbO!
g i l l trf Khu viK kUint hill ihufc Khu V1/C hilt ihulTc
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* LOD = 0/0062 f]g/m3
Tuy r i n g bi'l crf mffc dp phdi n h i e m n i o vdi nicotin trong khdng khi ddu ed the gay nguy hifi'm cho sffc khde ngrfdi Idn v i tre em, ke't qua nghifin cffu cho thi'y ndng dd nicotin trong khfing khi tdn lai d li't ea c i c dia diem nghifin cffrf. Ndng dfi nicotin trong khdng khi cao nha't la tai c i c dia die'm vui chdi giai tri (2.5 p g / m 3 tai khu vtfc hut ihufi'c v i 1.3 jig/m3tai khu vtfc khdng hiil ihudc) va tha'p nhi't l i t£ii trtfdng hoc (0.03 Mg/tn3)
4. B a n l u § n
Do hifin tai chtfa cd nghifin crfu n i o trfdng trf dtfdc cdng bdnfin khdng thd so s i n h vd ndng do PM2,5 v i nong dd nicotin irong khdng khi tai H i Ndi noi rieng
va cac Ihanh p h d k h i c d Vifii Nam ndi chung.
K e t q u a nghifin crfu cho thay mrfc dp hut thud'c cung nhtf tifi'p xrfc vdi hut thudc thu dfing cua ngtfdi d i n tai c a c dia diem cdng cpng cdn cao. Dieu n i y h o i n toan phu hdp vdi kfi't qua cffa nhieu nghifin crfu tnfdc d a y v e tinh hinh srf dung ihudc l i va thai dd cua ngrfdi d a n dd'i vdi viec srf dung ihufi'c l i . So' lifiu rfdc tinh n i m 2006 eho thay ly lfi hut thudc d nam gidi d Viet N a m la hdn 4 9 % , trong sd nhflng ngrfdi tre (tff 25 dfi'n 4 5 tudi) ty Ifi hui thudc t h i m chi cdn cao hdn, k h o a n g 6 5 % [2],
M a c dff nghifin cffu drfdc tifi'n h a n h sau khi quy dinh vd vific xrf phat hrft thufi'c I i lai ndi cdng cpng cd hifiu Irfc (01/01/2010), cac kfi't qua nghifin crfu cho thi'y co da'u hifiu cua hfft thudc lai li't ca c i c dia diem edng cdng, bao g d m ca bfinh vifin, ndi l i m viec cua c i c cd quan chinh phii, trrfdng hpe v i c i e cd sd vui chdi giai iri cdng cfing. Didu nay gdi y rang viec thrfc hifin chinh s i c h va quy dinh vd kiem s o i t thude la chtfa Ihrfc stf cd hifiu qua va can cd t h e m nhrfng chtfdng trinh truydn thdng cung nhrf chrfdng Irinh giam s i t viec thrfc hien nhffng chinh sach v i quy dinh n i y . Ben canh dd, Luft Phdng chdng thud'c la can drfde ban hanh dd ed can cff p h i p ly cho edng tac phdng chdng lac hai cua thudc Ii lai Viet N a m .
D o k d i qua nghifin crfu d i chi ro vifie hfft thud'c la tai nhffng ndi cdng cfing v i n cdn ton lai ri't nhidu, d i e biel la ddi vdi nhffng ndi nhtf benh vien, irtfdng hoc va e i e cd quan n h i nrfdc nfin c£n xem xfit c i c giai p h i p trien khai viec thrfc hien c i e quy dinh ve k i e m s o i l thud'c I i nghiem tuc va chat chfi hdn nffa d e dtfa v i o i p dung n h a m ban c h d ldi da viec hui thud'c tai ndi eong cpng, drfa tifiu chi moi trtfdng khfing khdi ihudc l i mfit irong nhflng tieu chuan bai budc dd d i n h g i i mdi trtfdng l i m vifie tai bfinh vifin, irtfdng hpc v i cd quan chinh phii.
Til Ii$u tbam khao:
TifiiigVi^t
1. Chrfdng trhih ph6ng chd'ng tic bai thufi'c la quoc gia (2009). Tilr ngiy 01/01/2010 cam hiit diuoc tai ndi ikm vific va ndi cfing c0ng trong nha [Internet], [trich din ngay 15/4/2011] Lfy tff: URL http://w WW. vinacosh,gov.VQ/?mPage=0AN80C01T223 Tifi^ng Anfa
2. Dang V.T, Guindon G.E, Hoang V.K. McGirr E, Nguyen
T.T.H, Nguyen T.L (2010). Tobacco Taxation in Vietnam.
Intemational Union Against Tuberculosis and Lung Diseases, Paris. 03- 04.
3. HealthBridge Canada in Vietnam (2007). Mainsrfeaming Tobacco Control in Viemam: Final Narrative Report [Intemet], [cited 2011 April 15]; Available from: URL:
hiip://www.healthbridge.ca/assetsflmages/pdf/Tobacco/Ma instreaming%20Tobacco%20Control%20in%20Viemam,%
20Final%20Report%20March%202007.pdf
T a p chl Y te C6ng cfing, 10.2011, Sd 21 (21) 63