目的了解北京市33家医院门诊大厅、候诊区和手术室等候区三类场所的烟草烟雾暴露情况。方法采用现场观察法观测96个监测点的控烟环境、吸烟现象,并使用国际上通用的Side Pak AM 510个人型气溶胶监测仪对各监测点的细颗粒物(PM2.5)浓度进行监测。结果 80个监测点观察到禁烟标识,31家医院有2个以上的监测点张贴禁烟标识;12家医院观察到吸烟现象;7.1%的城区监测点和37.5%的郊区监测点观察到吸烟者,差异有统计学意义(P<0.05)。96个室内监测点PM2.5浓度的几何均数为28.84μg/m3。其中,30个(31.3%)点的PM2.5浓度高于40μg/m3,63个(65.6%)监测点室内外PM2.5浓度比(I/O)大于1。门诊大厅、候诊区和手术室等候区观察到吸烟现象的比例分别为18.2%(6/33)、6.1%(2/33)和36.7%(11/30),差异有统计学意义(P<0.05)。3类场所中,手术室等候区PM2.5浓度>40μg/m3的比例最高。结论为了保护就诊者及医务工作者免受烟草烟雾危害,需要院方进一步加大控烟工作的力度,更需要政府在出台控烟立法、加大控烟宣传等方面做出努力,以提高吸烟者对“室内公共场所禁止吸烟”的认识,并增强公共场所控烟的约束力。 Objective To understand the tobacco smoke exposure in three types of places in the outpatient service lobby, waiting area and operating room waiting area in 33 hospitals in Beijing. Methods The environment of tobacco control and smoking in 96 monitoring sites were observed by on-site observation method. The concentrations of PM2.5 in each monitoring site were monitored by the internationally-used Side Pak AM 510 personal aerosol monitor. Results No smoking signs were observed in 80 monitoring sites, no smoking signs were posted in more than two monitoring sites in 31 hospitals, smoking was observed in 12 hospitals, smokers were observed in 7.1% of urban monitoring sites and 37.5% of rural monitoring sites, The difference was statistically significant (P <0.05). The geometric mean concentration of PM2.5 in 96 indoor monitoring sites was 28.84 μg / m3. Among them, PM2.5 concentration was higher than 40μg / m3 at 30 (31.3%) points and 63 (65.6%) at monitoring points with PM2.5 concentration ratio (I / O) greater than 1 at monitoring points. The rates of smoking observed in waiting room, waiting room and operating room waiting area were 18.2% (6/33), 6.1% (2/33) and 36.7% (11/30), respectively, with significant differences (P < 0.05). In the three categories of places, the highest proportion of PM2.5 concentration> 40μg / m3 in the operating room waiting area. Conclusions In order to protect medical staff and medical workers from the harmful effects of tobacco smoke, it is necessary for the hospital to further intensify tobacco control efforts. It also requires the government to make efforts to introduce tobacco control legislation and increase publicity on tobacco control so as to raise the awareness of smokers on “No Smoking in Indoor Public Places” and enhance the binding effect of tobacco control in public places.