天津市职业健康检查中发现疑似职业病情况分析
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摘要
目的分析天津市职业健康检查中发现疑似职业病的发病特征,为制定该市职业病预防控制措施提供科学依据。方法收集中国疾病预防控制信息系统2017年有毒有害作业人员职业健康监护资料和疑似职业病病例资料,对发病工龄及年龄、企业性质以及行业分布等信息进行统计分析。结果天津市2017年通过有毒有害作业人员职业健康检查共报告天津市疑似职业病病例215例,主要为疑似噪声聋,其次为疑似苯中毒,接触不同职业危害因素的作业工人疑似职业病的检出率有显著差异(χ~2=81.06,P<0.01);病例所属经济类型和企业规模主要为小型私有经济企业,所属行业主要为金属制品业,其经济类型(χ~2=19 240.00,P<0.01)、企业规模(χ~2=3 883.00,P<0.01)以及行业(χ~2=52 050.00,P<0.01)的构成比均存在显著差异。疑似苯中毒的平均发病年龄最小,为39.53岁,疑似噪声聋的平均发病工龄最短,为12.32年,不同经济类型(χ~2=11.42,46.89,P<0.01)、企业规模(χ~2=9.9,58.81,P<0.01)以及行业(χ~2=59.01,106.68,P<0.01)的疑似噪声聋平均发病年龄和发病工龄存在显著差异。结论天津市疑似职业病的发病特征提示本市的职业病危害构成正在发生变化,职业性噪声聋可能会成为未来本市职业病的防控重点,应尽早采取应对措施,加强小型私有制企业的职业病防控,同时应对金属制品业等重点行业采取针对性的防治措施,保护职业人群健康。
Objective To analyze the characteristics of suspected occupational diseases found in Tianjin occupational health examinations, and provide a scientific basis for the development of occupational disease prevention and control measures in this city. Methods The occupational health surveillance information and suspected occupational disease cases data of toxic and hazardous workers were retrieved from China′s disease prevention and control information system in 2017,and statistical analysis was conducted on age and age of illness, nature of the company, and industry distribution. Results In 2017, Tianjin City reported a total of 215 cases of suspected occupational diseases in Tianjin through occupational health examinations of toxic and hazardous workers. The suspected cases consisted mainly of noise deafness, followed by suspected benzene poisoning. The economic type and enterprise scale of the case were mainly small private economic enterprises, and the industry was mainly metal products. There was a significant difference in the detection rate of suspected occupational diseases among workers exposed to different occupational hazards(χ~2=81.06,P<0.01). The economic type(χ~2=19 240.00,P<0.01), enterprise size(χ~2=3 883.00,P<0.01), and the composition ratio of the industry(χ~2=52 050.00,P<0.01)were all significantly different. The average age of suspected benzene poisoning was the smallest, at 39.53 years old. The average onset age of suspected noise deafness was the shortest, at 12.32 years. There were significant differences in the average age and average onset age of suspected noise deafness among different economic types(χ~2=11.42,46.89,P<0.01), enterprise sizes(χ~2=9.9,58.81,P<0.01), and different industrial sectors(χ~2=59.01,106.68,P<0.01). Conclusion The characteristics of suspected occupational diseases in Tianjin suggest that the occupational hazard composition of this city is changing. Occupational noise deafness may become the focus of prevention and control of occupational diseases in the city in the future, and countermeasures should be taken as soon as possible. In particular, the prevention and control of occupational diseases in small private enterprises need to be strengthened. At the same time, special prevention and control measures should be taken to protect the health of the occupational population in some key industries such as the metal products manufacturers.
Objective To analyze the characteristics of suspected occupational diseases found in Tianjin occupational health examinations, and provide a scientific basis for the development of occupational disease prevention and control measures in this city. Methods The occupational health surveillance information and suspected occupational disease cases data of toxic and hazardous workers were retrieved from China′s disease prevention and control information system in 2017,and statistical analysis was conducted on age and age of illness, nature of the company, and industry distribution. Results In 2017, Tianjin City reported a total of 215 cases of suspected occupational diseases in Tianjin through occupational health examinations of toxic and hazardous workers. The suspected cases consisted mainly of noise deafness, followed by suspected benzene poisoning. The economic type and enterprise scale of the case were mainly small private economic enterprises, and the industry was mainly metal products. There was a significant difference in the detection rate of suspected occupational diseases among workers exposed to different occupational hazards(χ~2=81.06,P<0.01). The economic type(χ~2=19 240.00,P<0.01), enterprise size(χ~2=3 883.00,P<0.01), and the composition ratio of the industry(χ~2=52 050.00,P<0.01)were all significantly different. The average age of suspected benzene poisoning was the smallest, at 39.53 years old. The average onset age of suspected noise deafness was the shortest, at 12.32 years. There were significant differences in the average age and average onset age of suspected noise deafness among different economic types(χ~2=11.42,46.89,P<0.01), enterprise sizes(χ~2=9.9,58.81,P<0.01), and different industrial sectors(χ~2=59.01,106.68,P<0.01). Conclusion The characteristics of suspected occupational diseases in Tianjin suggest that the occupational hazard composition of this city is changing. Occupational noise deafness may become the focus of prevention and control of occupational diseases in the city in the future, and countermeasures should be taken as soon as possible. In particular, the prevention and control of occupational diseases in small private enterprises need to be strengthened. At the same time, special prevention and control measures should be taken to protect the health of the occupational population in some key industries such as the metal products manufacturers.
引文
[1] 孙金艳, 田丽萍. 2001—2010天津市职业病发病分析[J].环境与健康杂志, 2012, 29(8):742-743.
[2] 中华人民共和国家国统计局,国家工商行政管理总局.关于划分企业登记注册类型的规定调整的通知[S].2011.
[3] GB/T 4754-2011.国民经济行业分类[S].2011.
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[5] 中华人民共和国国家卫生健康委员会.《2017年我国卫生健康事业发展统计公报》[Z].2017.
[6] 黄永顺.关于疑似职业病病人相关问题的初步探讨[J].中国工业医学杂志,2009,22(5):390-391.
[7] XIAOWEN L, MEIQIONG G, DEXIANG Z,et al.Investigation on anxiety and depression status of patients with suspected occupational disease[J].Occupational Health & Emergency Rescue, 2018,36(6):1725-1735.
[8] Jahani L, Mehrparvar AH, Esmailidehaj M,et al.The Effect of Atorvastatin on Preventing Noise-Induced Hearing Loss:An Experimental Study[J]. International Journal of Occupational & Environmental Medicine, 2016,7(1):15.
[9] YU P, JIAO J, CHEN, et al.Effect of GRM7, polymorphisms on the development of noise-induced hearing loss in Chinese Han workers: a nested case-control study[J]. RevEsp Fisiol, 2018, 19(3):285-294.
[10] 张敏,王丹,郑迎东,等.中国1997—2009年报告尘肺病发病特征和变化趋势[J].中华劳动卫生职业病杂志,2013,31(5):321-334.
[11] 王欣,曾强,唐慧晶,等.2006—2015年天津市职业性噪声聋流行趋势及影响因素[J].公共卫生与预防医学,2017,28 (2):38-41.
[12] 王欣,马金安,叶健. 深圳市南山区重点行业员工的职业健康状况[J].公共卫生与预防医学,2017,28 (3):99-102.
[13] Carugno M, Pesatori AC, Dioni L, et al.Increased Mitochondrial DNA Copy Number in Occupations Associated with Low-Dose Benzene Exposure[J]. Environmental Health Perspectives, 2012, 120(2):210-215.
[14] Salemi R, Marconi A, Di Salvatore V,et al.Epigenetic alterations and occupational exposure to benzene,fibers,and heavy metals associated with tumor development (Review)[J].Molecular Medicine Reports,2017,15(5):2100-2250.
[15] 杨雪莹,刘静,田丽萍,等.2005—2014 年天津市部分职业病流行病学特征分析[J]. 职业与健康, 2016,32(116):2181-2186.
[16] 段传伟,刘移民,肖吕武. 2006—2010 年广州市接触职业病危害因素人群职业健康状况分析[J]. 职业与健康,2011,27(18):2077-2079.
[17] 罗琼, 陈晓梅, 孙伟. 2009—2011年宁夏部分企业有毒有害作业工人职业健康监护分析[J]. 现代医药卫生,2014,30(1):48-50.
[2] 中华人民共和国家国统计局,国家工商行政管理总局.关于划分企业登记注册类型的规定调整的通知[S].2011.
[3] GB/T 4754-2011.国民经济行业分类[S].2011.
[4] 中华人民共和国家国统计局.统计上大中小型企业划分办法(暂行) [S].北京: 中华人民共和国家国统计局,2003.
[5] 中华人民共和国国家卫生健康委员会.《2017年我国卫生健康事业发展统计公报》[Z].2017.
[6] 黄永顺.关于疑似职业病病人相关问题的初步探讨[J].中国工业医学杂志,2009,22(5):390-391.
[7] XIAOWEN L, MEIQIONG G, DEXIANG Z,et al.Investigation on anxiety and depression status of patients with suspected occupational disease[J].Occupational Health & Emergency Rescue, 2018,36(6):1725-1735.
[8] Jahani L, Mehrparvar AH, Esmailidehaj M,et al.The Effect of Atorvastatin on Preventing Noise-Induced Hearing Loss:An Experimental Study[J]. International Journal of Occupational & Environmental Medicine, 2016,7(1):15.
[9] YU P, JIAO J, CHEN, et al.Effect of GRM7, polymorphisms on the development of noise-induced hearing loss in Chinese Han workers: a nested case-control study[J]. RevEsp Fisiol, 2018, 19(3):285-294.
[10] 张敏,王丹,郑迎东,等.中国1997—2009年报告尘肺病发病特征和变化趋势[J].中华劳动卫生职业病杂志,2013,31(5):321-334.
[11] 王欣,曾强,唐慧晶,等.2006—2015年天津市职业性噪声聋流行趋势及影响因素[J].公共卫生与预防医学,2017,28 (2):38-41.
[12] 王欣,马金安,叶健. 深圳市南山区重点行业员工的职业健康状况[J].公共卫生与预防医学,2017,28 (3):99-102.
[13] Carugno M, Pesatori AC, Dioni L, et al.Increased Mitochondrial DNA Copy Number in Occupations Associated with Low-Dose Benzene Exposure[J]. Environmental Health Perspectives, 2012, 120(2):210-215.
[14] Salemi R, Marconi A, Di Salvatore V,et al.Epigenetic alterations and occupational exposure to benzene,fibers,and heavy metals associated with tumor development (Review)[J].Molecular Medicine Reports,2017,15(5):2100-2250.
[15] 杨雪莹,刘静,田丽萍,等.2005—2014 年天津市部分职业病流行病学特征分析[J]. 职业与健康, 2016,32(116):2181-2186.
[16] 段传伟,刘移民,肖吕武. 2006—2010 年广州市接触职业病危害因素人群职业健康状况分析[J]. 职业与健康,2011,27(18):2077-2079.
[17] 罗琼, 陈晓梅, 孙伟. 2009—2011年宁夏部分企业有毒有害作业工人职业健康监护分析[J]. 现代医药卫生,2014,30(1):48-50.