优化正己烷作业人群职业健康监护技术方案研究  

Study on optimization of technical program of occupational health surveillance for workers exposed to n-hexane

作　　者：陈嘉斌[1] 黄汉林[1] 李宏玲[1] 江嘉欣[1] 

机构地区：[1]广东省职业病防治院,广东省职业病防治重点实验室,广东广州510300

出　　处：《中国职业医学》2014年第5期513-517,共5页China Occupational Medicine

基　　金：十二五国家科技支撑计划项目(2014BAI12B01);国家临床重点专科建设项目(2011-09);卫生部公益项目(200902006);2014年卫生标准制(修)订项目(20140716);广东省职业病防治重点实验室(2012A061400007)

摘　　要：目的建立正己烷作业人群职业健康监护(OHS)优化方案和应用指南,提高职业健康监护的可操作性。方法从循证医学角度出发,对GBZ 188《职业健康监护技术规范》规定的对正己烷作业人群开展上岗前、在岗期间和离岗时OHS的目标疾病、健康检查内容和周期等内容进行分析,以OHS工作中的常见问题为线索,通过中国期刊全文数据库(CNKI)、万方数据库和Pub Med进行文献检索,筛选优化指标,提出正己烷作业人群OHS技术优化方案和应用指南,初步推广应用。结果成功建立正己烷作业人群OHS技术优化方案和应用指南。其中,选择神经传导速度、血清神经元特异性烯醇化酶作为生物效应标志物,选择尿2,5-己二酮作为生物接触标志物;鉴别指标增加尿糖检测;职业禁忌证增加伴有周围神经损害表现的糖尿病、维生素B缺乏症、未成年工和孕期、哺乳期女职工。结论优化方案合理可行,实用性较强,适用于正己烷作业人群的OHS实际工作。Objective To carry out an optimization of technical program of occupational health surveillance（ OHS）for workers exposed to n-hexane,and to improve its accessibility. Methods According to the theory of evidence-based medi-cine,this research analyzed the target diseases,screening items and interval period of the pre-employment/on-job/off-post physical examination required by GBZ 188 Technical Specifications of Occupational Health Surveillance,and reviewed the collected articles on common issues of OHS from literature database,such as the China National Knowledge Internet （ CNKI）,WanFang and PubMed,in order to select proper indicators,promote an optimization and guideline of OHS for workers exposed to n-hexane with primary application. Results The optimization of technical program and application guide of OHS for workers exposed to n-hexane was established by altering nerve conduction velocity and serum neuron-specific enolase as biomarkers of effect,urine 2,5-hexanedione as biomarkers of exposure;adding urine glucose as identifi-cation indicators;adding diabetes complicated with peripheral nerve damage,vitamin B deficiency,minors and female employees with pregnancy or lactation as occupational contraindications. Conclusion The optimization is practical and proved to be applicable in OHS for workers exposed to n-hexane.

关 键 词：正己烷 职业健康监护 职业病危害 职业中毒 技术 优化 

分 类 号：R135[医药卫生—劳动卫生]