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[目的]调查某机械制造企业粉尘作业人员尘肺危害状况,对尘肺发病的风险进行评估,探讨有效的职业病防控对策。[方法]2009年对粉尘作业车间进行现场职业卫生调查、对216名粉尘作业接触工人进行职业健康检查及问卷调查。[结果]粉尘作业地点工程防护设施不完善,作业工人个人呼吸防护情况不佳。职业健康检查结果显示,未发现尘肺患者,胸片有异常表现者66人,占总人数的30.56%,其中观察对象有6人。与上年胸片对比,有16人肺部损害呈现加重的趋势。随着接尘工龄的延长,粉尘作业工人胸片有异常表现的比例明显增高(P<0.001)。[结论]该企业粉尘作业工人尘肺发病的风险增加,应及早建立职业病防控管理体系,通过多种技术手段加强职业病预防控制。对胸片表现异常,包括出现小阴影改变,未达到观察对象标准的粉尘作业人员进行监测和动态观察,可以早期评估尘肺发病的风险。
[Objective] To investigate the status of pneumoconiosis of dust workers in a machinery manufacturing enterprise, evaluate the risk of pneumoconiosis and discuss the effective prevention and control measures of occupational diseases. [Method] On-site occupational health survey was conducted on the dust workshop in 2009, and occupational health examination and questionnaire survey on 216 dust exposed workers were conducted. [Result] The engineering protective facilities of dust work site were not perfect, and the personal respiratory protection of workers was poor. Occupational health examination results show that no patients with pneumoconiosis, chest X-ray abnormalities were 66 people, accounting for 30.56% of the total number, of whom 6 were observed. Compared with the chest film of the previous year, 16 patients showed a tendency of pulmonary damage. With the extension of the service life of dust, the proportion of abnormal performance of the dust workers’ chest radiographs was significantly increased (P <0.001). [Conclusion] The risk of pneumoconiosis in Dust-exposed workers in this enterprise is increasing. A management system for prevention and control of occupational diseases should be established as early as possible, and prevention and control of occupational diseases should be strengthened through various technical means. The performance of abnormal chest X-ray, including small changes in the shadow of the dust, did not meet the standards of observation dust monitoring and dynamic observation staff can early assessment of the risk of pneumoconiosis.