有机溶剂行业职业危害现状调查及控制措施研究
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摘要
研究背景与目的
有机溶剂在工业生产中广泛应用,其对健康的危害问题日益突出。由于有机溶剂具有较强的挥发性、亲脂性,其产生的毒害作用多种多样,除了对皮肤、黏膜有不同程度的刺激作用外,许多有机溶剂能引起中枢神经系统的非特异性抑制、周围神经疾患和全身麻醉作用。某些有机溶剂可特异性地损害神经系统、血液系统和生殖系统以及肺脏、心脏、肝脏与肾脏等器官,造成特殊的损伤和化学源猝死,甚至具有致癌或潜在的致癌作用。有机溶剂行业的职业病危害已经严重影响到劳动者个人、家庭乃至国民经济的发展。
随着《中华人民共和国职业病防治法》的颁布实施,卫生部配套发布了《职业健康管理办法》、《职业病诊断目录》、职业病诊断标准及《工作场所有害因素职业接触限值》等一系列法规标准。在借鉴国外职业安全健康管理体系(OSHMS)的基础上,国内也制定了相应体系的标准规范,并在一些大型职业病危害企业开展上述体系认证,有效地解决了企业进行职业病防治管理的问题。但目前国内以中小企业为主,进行OSHMS体系认证,不但物质基础上达不到要求,而且人员素质等方面也远远存在差距,如何制定出符合这些中小企业实际的企业职业卫生自身管理体系,消除并防治职业病危害的发生,已显得非常重要。
本研究旨在通过调查了解当前某些有机溶剂行业职业病危害现状,明确有机溶剂的具体种类、化学特性、毒性、中毒表现、急救措施等,并掌握其对人体健康影响的因素,因地制宜采取相应职业病危害控制措施,以了解控制措施实施后的效果,从而探索适合我市企业实际的简便、实用、有效的职业病防治技术措施和管理措施,形成地方性行业规范,以指导企业科学地预防职业病危害。
方法
以嘉兴市合成革、工艺礼品、彩印等行业的41家企业为研究对象,对41家企业进行有机溶剂现状调查,了解挥发性有毒有害有机溶剂具体种类,工人接触机会;企业采取的防护措施,作业场所浓度;对接触者进行职业健康检查,掌握工人健康状况。
根据企业生产实际调整工艺布局,对固定和移动污染源的隔离、密闭通风的材料、方式、方法等工程技术进行探索,改善工作环境卫生状况;探讨个人防护用品选择、使用维护,防止毒物经呼吸道、皮肤、消化道进入人体;加强职业健康监护,早期发现病损和杜绝职业禁忌;建立有机溶剂行业组织制度、现场管理、宣传教育等职业卫生台帐管理措施。
控制措施实施后,分行业比较干预前后有机溶剂职业病危害因素监测合格率、职业病危害接触人员职业健康检查异常率。同时采用浙江省卫生厅设计的“用人单位职业卫生台帐管理评分表”对41家企业实施干预防措施前后评分比较。
所有数据录入使用Microsoft Excel2003,用SPSS13.0统计软件包进行χ~2检验、秩和检验和t-检验等统计学处理。
结果
合成革业:二甲基甲酰胺(DMF)监测合格率从整治前的60%上升到整治后的88.24%,劳动者职业健康检查异常率从整治前的43.98%下降到整治后的15.5%(P＜0.01);根据实际控制措施情况,形成了《嘉兴市合成革生产企业基本职业卫生规范》指导类似有机溶剂企业开展职业病防治工作;
工艺礼品业:苯、甲苯及二甲苯监测合格率从整治前的72.36%上升到整治后的88.57%(P＜0.01),劳动者职业健康检查异常率整治前为2.58%,整治后为9.07%;形成了《嘉兴市工艺礼品制造业职业卫生管理规范》指导类似有机溶剂企业开展职业病防治工作;
彩印业:“三苯”监测合格率整治前后均在90%左右,劳动者职业健康检查异常率从整治前的10.54%下降到整治后的2.32%(P＜0.01);
用人单位职业卫生台帐管理评分:评分表中企业职业卫生台帐管理措施、职业病危害状况、职业卫生管理有效性及合计评分四项内容平均评分分别由措施实施前的17.9、11.75、16.96、46.63,上升到措施实施后的33.51(P＜0.01)、12.56(P＜0.05)、22.83(P＜0.01)、68.90(P＜0.01)。
结论
通过研究,形成了适合我市某些有机溶剂企业实际的、有效的、实用的管理体系,建立了人造革业职业卫生规范和工艺礼品制造业职业卫生规范,对同类企业的职业病防治工作起到积极的指导作用。本研究提出的技术措施和管理措施简单、实用、有效,与当前我市大部分企业的实际相适应,采取三级预防综合措施,职业病危害是可以控制的。
通过在41家有机溶剂企业内推广开展用人单位职业卫生管理台帐,指导了企业简单、方便、全面地开展职业病防治的一系列工作,加强了企业职业卫生管理技能,提高了职业病防治水平,积极改善了企业职业病危害现状,结合卫生工程学等其他控制措施后,有效地降低了有机溶剂职业病危害浓度及其对劳动者的职业健康损害。
Background and Objective
With the organic solvent widely used in industry,the organic solvent health hazards have become acute.As the organic solvent is highly volatile and lipophilic, which have a wide range of the poisoning effect,in addition to the skin,mucous membrane,many organic solvents can cause central nervous system of non-specific suppression,peripheral neuropathy Disease and the role of general anesthesia.Some of the specific organic solvent can damage the nervous system,blood system and the reproductive system,as well as the lungs,heart,liver and kidneys and other organs, resulting in injury and a special chemical source of sudden death,carcinogenesis,or even have a potential role in cancer.Occupational hazards to workers in organic solvents industry has been severely affected individuals,families and even the national economy.
With the "Occupational Disease Prevention Law in People's Republic of China" promulgated and implemented,the Ministry of Health in China issued a set of "occupational health management","occupational disease diagnosis directory",the diagnostic criteria of occupational diseases and "the workplace hazards of occupational exposure limit" and a series of laws and regulations Standard.China has developed a corresponding system of domestic standards on the basis of international occupational safety and health management system(OSHMS),and a number of large-scale enterprises have carried out the above-mentioned occupational hazard certification system.It is an effective solution to the enterprise management of occupational disease prevention and control.However,to the domestic medium and small enterprises, OSHMS certification system will not only fail on the basis of material,but also the quality of personnel.How to work out occupational health management system and the elimination of the incidence of occupational diseases prevention and control for these small and medium enterprises has become very important.
In accord to investigate status quo of occupational hazards in some organic solvents industry,this study aimed to definitude the specific types of organic solvents, chemical toxicity,the performance of poisoning,first aid measures,and grasp its impact on human health.Taking occupational diseases hazard control measures,the implementation of the results of the control measures can be known.According to control measures,the actual business of simple,practical and effective disease control measures and management measures in Jiaxing city has been explored.At last,the formation of local industry standards can guide the scientific enterprise to the prevention of occupational hazards.
Materials and Methods
On basis of the 41 companies about synthetic leather,craft gifts,color printing industry in Jiaxing City,the study investigated the status quo of the occupational hazards in 41 enterprises of organic solvents,in which the types of organic solvents have been found out.The study also investigated contracting opportunities of the workers in organic solvents industry.Before and after the actualizing of the control and management measures,surveyed the concentration of the organic solvents,and investigated health status of the workers contracting organic solvents.
According to the actual production process,adjusted the layout for fixed and mobile sources of isolation,explored the engineering and technology about the ventilation materials,methods and the methods and improved the working conditions of sanitation;explored the option and use of personal protective supplies,prevented organic solvents from the human with the skin,breathing and digestive system;To strengthen occupational health surveillance,early detected the early occupational hazards;Established the control and management measures including an organic solvent system,trade organizations,on-site management,publicity and education of occupational health management account,et al.
After the implementation of control measures,the eligible rate of organic solvents occupational hazards was compared with before and after the intervention,so was the abnormal rate of occupational health surveillance for the workers contracting organic solvents occupational hazards.At the same time,the score of "Score table for the account of occupational health management in enterprise" designed by Zhejiang Province Health Department was compared in the 41 enterprises before and after the intervention.
All data entry used Microsoft Excel2003 and SPSS13.0.One-way Analysis of Variance,χ~2test,t-test,and rank-sum test were used in statistical analysis of the data by SPSS 13.0 software.
Results
Synthetic leather industry:the eligible rate of the dimethylformamide(DMF) concentration in the air of the worksites was risen from 60%(before the reform) to 88.24%(after the reform),and the abnormal rate of occupational health surveillance for the workers contracting DMF was descended from 43.98%to 15.5%(P＜0.01); According to the actual control measures,formed "Occupational Health Norms of synthetic leather manufacturers in Jiaxing" to guide the similar enterprises to prevent and treat the occupational diseases;
Craft gifts industry:The eligible rate of benzene,toluene and xylene("BTX") the concentration in the air of the worksites was risen from 72.36%(before the reform) to 88.57.24%(after the reform)(P＜0.01),and the abnormal rate of occupational health surveillance for the workers contracting "BTX" was risen from 2.58%to 9.07%;Formed a "Occupational Health Norms of Craft Gift Industry in Jiaxing " to guide the similar enterprises to prevent and treat the occupational diseases;
Color printing industry:The eligible rate of "BTX" the concentration in the air of the worksites both was about 90%before and after the reform;The abnormal rate of occupational health surveillance for the workers contracting "BTX" was descended from 10.54%to 2.32%(P＜0.01);
Score for the account of occupational health management in enterprise:The score of occupational health management measure,the situation of occupational diseases, occupational health and management effectiveness and the whole score in score table scale all was risen respectively from 17.9,11.75,16.96,46.63(before the reform) to 33.51(P＜0.01 ),12.56(P＜0.05 ),22.83(P＜0.01 ),68.90(P＜0.01 )(after the reform).
Conclusions
This study combined the traditional occupational disease control measures,soft science of management,health engineering research,which brought cross-subject strengths into play.
To control occupational hazards,improving the operating environment is fundamental,strengthening health surveillance and personal protection is an important measure,and rising awareness,strict management is a long-term security.Through research,formed the occupational health system and norms of organic solvents industry in Jiaxing,which is actual,effective and practical management system and to adapt most organic solvents industry in Jiaxing.In accord to three-level prevention measures, the occupational hazards can be controlled.
Carrying out the account of occupational health management in 41 enterprises, guided the enterprises to simply,expediently,roundly perform a series of legal works about "Occupational Disease Prevention Law in People's Republic of China".It strengthened the enterprises' skills and enhanced their level of occupational disease prevention,which was conductive to improve the status of occupational hazards. Combining with engineering and other health control measures,effectively reduced the concentration of organic solvents occupational hazard for workers and protected the workers' health.
有机溶剂在工业生产中广泛应用,其对健康的危害问题日益突出。由于有机溶剂具有较强的挥发性、亲脂性,其产生的毒害作用多种多样,除了对皮肤、黏膜有不同程度的刺激作用外,许多有机溶剂能引起中枢神经系统的非特异性抑制、周围神经疾患和全身麻醉作用。某些有机溶剂可特异性地损害神经系统、血液系统和生殖系统以及肺脏、心脏、肝脏与肾脏等器官,造成特殊的损伤和化学源猝死,甚至具有致癌或潜在的致癌作用。有机溶剂行业的职业病危害已经严重影响到劳动者个人、家庭乃至国民经济的发展。
随着《中华人民共和国职业病防治法》的颁布实施,卫生部配套发布了《职业健康管理办法》、《职业病诊断目录》、职业病诊断标准及《工作场所有害因素职业接触限值》等一系列法规标准。在借鉴国外职业安全健康管理体系(OSHMS)的基础上,国内也制定了相应体系的标准规范,并在一些大型职业病危害企业开展上述体系认证,有效地解决了企业进行职业病防治管理的问题。但目前国内以中小企业为主,进行OSHMS体系认证,不但物质基础上达不到要求,而且人员素质等方面也远远存在差距,如何制定出符合这些中小企业实际的企业职业卫生自身管理体系,消除并防治职业病危害的发生,已显得非常重要。
本研究旨在通过调查了解当前某些有机溶剂行业职业病危害现状,明确有机溶剂的具体种类、化学特性、毒性、中毒表现、急救措施等,并掌握其对人体健康影响的因素,因地制宜采取相应职业病危害控制措施,以了解控制措施实施后的效果,从而探索适合我市企业实际的简便、实用、有效的职业病防治技术措施和管理措施,形成地方性行业规范,以指导企业科学地预防职业病危害。
方法
以嘉兴市合成革、工艺礼品、彩印等行业的41家企业为研究对象,对41家企业进行有机溶剂现状调查,了解挥发性有毒有害有机溶剂具体种类,工人接触机会;企业采取的防护措施,作业场所浓度;对接触者进行职业健康检查,掌握工人健康状况。
根据企业生产实际调整工艺布局,对固定和移动污染源的隔离、密闭通风的材料、方式、方法等工程技术进行探索,改善工作环境卫生状况;探讨个人防护用品选择、使用维护,防止毒物经呼吸道、皮肤、消化道进入人体;加强职业健康监护,早期发现病损和杜绝职业禁忌;建立有机溶剂行业组织制度、现场管理、宣传教育等职业卫生台帐管理措施。
控制措施实施后,分行业比较干预前后有机溶剂职业病危害因素监测合格率、职业病危害接触人员职业健康检查异常率。同时采用浙江省卫生厅设计的“用人单位职业卫生台帐管理评分表”对41家企业实施干预防措施前后评分比较。
所有数据录入使用Microsoft Excel2003,用SPSS13.0统计软件包进行χ~2检验、秩和检验和t-检验等统计学处理。
结果
合成革业:二甲基甲酰胺(DMF)监测合格率从整治前的60%上升到整治后的88.24%,劳动者职业健康检查异常率从整治前的43.98%下降到整治后的15.5%(P＜0.01);根据实际控制措施情况,形成了《嘉兴市合成革生产企业基本职业卫生规范》指导类似有机溶剂企业开展职业病防治工作;
工艺礼品业:苯、甲苯及二甲苯监测合格率从整治前的72.36%上升到整治后的88.57%(P＜0.01),劳动者职业健康检查异常率整治前为2.58%,整治后为9.07%;形成了《嘉兴市工艺礼品制造业职业卫生管理规范》指导类似有机溶剂企业开展职业病防治工作;
彩印业:“三苯”监测合格率整治前后均在90%左右,劳动者职业健康检查异常率从整治前的10.54%下降到整治后的2.32%(P＜0.01);
用人单位职业卫生台帐管理评分:评分表中企业职业卫生台帐管理措施、职业病危害状况、职业卫生管理有效性及合计评分四项内容平均评分分别由措施实施前的17.9、11.75、16.96、46.63,上升到措施实施后的33.51(P＜0.01)、12.56(P＜0.05)、22.83(P＜0.01)、68.90(P＜0.01)。
结论
通过研究,形成了适合我市某些有机溶剂企业实际的、有效的、实用的管理体系,建立了人造革业职业卫生规范和工艺礼品制造业职业卫生规范,对同类企业的职业病防治工作起到积极的指导作用。本研究提出的技术措施和管理措施简单、实用、有效,与当前我市大部分企业的实际相适应,采取三级预防综合措施,职业病危害是可以控制的。
通过在41家有机溶剂企业内推广开展用人单位职业卫生管理台帐,指导了企业简单、方便、全面地开展职业病防治的一系列工作,加强了企业职业卫生管理技能,提高了职业病防治水平,积极改善了企业职业病危害现状,结合卫生工程学等其他控制措施后,有效地降低了有机溶剂职业病危害浓度及其对劳动者的职业健康损害。
Background and Objective
With the organic solvent widely used in industry,the organic solvent health hazards have become acute.As the organic solvent is highly volatile and lipophilic, which have a wide range of the poisoning effect,in addition to the skin,mucous membrane,many organic solvents can cause central nervous system of non-specific suppression,peripheral neuropathy Disease and the role of general anesthesia.Some of the specific organic solvent can damage the nervous system,blood system and the reproductive system,as well as the lungs,heart,liver and kidneys and other organs, resulting in injury and a special chemical source of sudden death,carcinogenesis,or even have a potential role in cancer.Occupational hazards to workers in organic solvents industry has been severely affected individuals,families and even the national economy.
With the "Occupational Disease Prevention Law in People's Republic of China" promulgated and implemented,the Ministry of Health in China issued a set of "occupational health management","occupational disease diagnosis directory",the diagnostic criteria of occupational diseases and "the workplace hazards of occupational exposure limit" and a series of laws and regulations Standard.China has developed a corresponding system of domestic standards on the basis of international occupational safety and health management system(OSHMS),and a number of large-scale enterprises have carried out the above-mentioned occupational hazard certification system.It is an effective solution to the enterprise management of occupational disease prevention and control.However,to the domestic medium and small enterprises, OSHMS certification system will not only fail on the basis of material,but also the quality of personnel.How to work out occupational health management system and the elimination of the incidence of occupational diseases prevention and control for these small and medium enterprises has become very important.
In accord to investigate status quo of occupational hazards in some organic solvents industry,this study aimed to definitude the specific types of organic solvents, chemical toxicity,the performance of poisoning,first aid measures,and grasp its impact on human health.Taking occupational diseases hazard control measures,the implementation of the results of the control measures can be known.According to control measures,the actual business of simple,practical and effective disease control measures and management measures in Jiaxing city has been explored.At last,the formation of local industry standards can guide the scientific enterprise to the prevention of occupational hazards.
Materials and Methods
On basis of the 41 companies about synthetic leather,craft gifts,color printing industry in Jiaxing City,the study investigated the status quo of the occupational hazards in 41 enterprises of organic solvents,in which the types of organic solvents have been found out.The study also investigated contracting opportunities of the workers in organic solvents industry.Before and after the actualizing of the control and management measures,surveyed the concentration of the organic solvents,and investigated health status of the workers contracting organic solvents.
According to the actual production process,adjusted the layout for fixed and mobile sources of isolation,explored the engineering and technology about the ventilation materials,methods and the methods and improved the working conditions of sanitation;explored the option and use of personal protective supplies,prevented organic solvents from the human with the skin,breathing and digestive system;To strengthen occupational health surveillance,early detected the early occupational hazards;Established the control and management measures including an organic solvent system,trade organizations,on-site management,publicity and education of occupational health management account,et al.
After the implementation of control measures,the eligible rate of organic solvents occupational hazards was compared with before and after the intervention,so was the abnormal rate of occupational health surveillance for the workers contracting organic solvents occupational hazards.At the same time,the score of "Score table for the account of occupational health management in enterprise" designed by Zhejiang Province Health Department was compared in the 41 enterprises before and after the intervention.
All data entry used Microsoft Excel2003 and SPSS13.0.One-way Analysis of Variance,χ~2test,t-test,and rank-sum test were used in statistical analysis of the data by SPSS 13.0 software.
Results
Synthetic leather industry:the eligible rate of the dimethylformamide(DMF) concentration in the air of the worksites was risen from 60%(before the reform) to 88.24%(after the reform),and the abnormal rate of occupational health surveillance for the workers contracting DMF was descended from 43.98%to 15.5%(P＜0.01); According to the actual control measures,formed "Occupational Health Norms of synthetic leather manufacturers in Jiaxing" to guide the similar enterprises to prevent and treat the occupational diseases;
Craft gifts industry:The eligible rate of benzene,toluene and xylene("BTX") the concentration in the air of the worksites was risen from 72.36%(before the reform) to 88.57.24%(after the reform)(P＜0.01),and the abnormal rate of occupational health surveillance for the workers contracting "BTX" was risen from 2.58%to 9.07%;Formed a "Occupational Health Norms of Craft Gift Industry in Jiaxing " to guide the similar enterprises to prevent and treat the occupational diseases;
Color printing industry:The eligible rate of "BTX" the concentration in the air of the worksites both was about 90%before and after the reform;The abnormal rate of occupational health surveillance for the workers contracting "BTX" was descended from 10.54%to 2.32%(P＜0.01);
Score for the account of occupational health management in enterprise:The score of occupational health management measure,the situation of occupational diseases, occupational health and management effectiveness and the whole score in score table scale all was risen respectively from 17.9,11.75,16.96,46.63(before the reform) to 33.51(P＜0.01 ),12.56(P＜0.05 ),22.83(P＜0.01 ),68.90(P＜0.01 )(after the reform).
Conclusions
This study combined the traditional occupational disease control measures,soft science of management,health engineering research,which brought cross-subject strengths into play.
To control occupational hazards,improving the operating environment is fundamental,strengthening health surveillance and personal protection is an important measure,and rising awareness,strict management is a long-term security.Through research,formed the occupational health system and norms of organic solvents industry in Jiaxing,which is actual,effective and practical management system and to adapt most organic solvents industry in Jiaxing.In accord to three-level prevention measures, the occupational hazards can be controlled.
Carrying out the account of occupational health management in 41 enterprises, guided the enterprises to simply,expediently,roundly perform a series of legal works about "Occupational Disease Prevention Law in People's Republic of China".It strengthened the enterprises' skills and enhanced their level of occupational disease prevention,which was conductive to improve the status of occupational hazards. Combining with engineering and other health control measures,effectively reduced the concentration of organic solvents occupational hazard for workers and protected the workers' health.
引文
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[1]刘珍兴,陈美玉,李素梅.放射作业人员健康监护档案计算机管理的初步研究.海峡预防医学杂志,2001;7(6),39-40.
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[3]王焕强,李涛,张敏,等.1989至2003年全国有机溶剂重大急性职业中毒的特征.中华劳动卫生职业病杂志,2006,24(12):720-722
[4]赵秀华,刘葵花,杨公炜,等.有机溶剂中毒事故严重肝损害1例.实用医学杂志,2004,20(7):807
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[6]菅向东,郭广冉,孙磊,等.混合性有机溶剂中毒1例报告.中国工业医学杂志,2008,21(3):170-171
[8]杨光,朱素蓉,汪小平,等.一起有机溶剂中毒案件的调查处理.上海预防医学杂志,2008,20(2):99-101
[9]Davis LE,Hudson A,Benson BE,et al.Methanol poisoning exposures in the United States:1993-1998.J toxicol clin toxicol,2002,40(4):499-505
[10]Burgaz S,Erdem O,Cakmak G,et al.Cytogenetic analysis of buccal cells from shoe-workers and pathology and anatomy laboratory workers exposed to n-hexane,toluene,methyl ethyl ketone and formaldehyde[J].Biomarkecs.2002,7(2):151-161
[11]Vincent JH.lnternationl Occupational Exposure Standardss:A review and Commentary.AIHA J,1998,59:729-742
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[13]顾友多.美国和欧洲的职业病诊断标准体系.职业卫生与应急救援,2007,25(6):283-284
[14]岳辉,查京民.企业职业安全健康管理体系策划研究[硕士学位论文].天津.天津大学.2003:1-3
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[20]中华人民共和国卫生部.GBZ94-2002.职业性肿瘤诊断标准.北京:人民卫生出版社,2003,1-6
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