安康市1例职业性重度爆震聋分析  

Analysis on one case of occupational severe blast deafness in Ankang City

作　　者：杨晓燕[1] YANG Xiao-yan(Health Department,Ankang Center for Disease Control and Prevention,Ankang Shaanxi,725000,China)

机构地区：[1]安康市疾病预防控制中心卫生科,陕西安康725000

出　　处：《职业与健康》2020年第7期979-981,共3页Occupation and Health

摘　　要：目的分析职业性爆震聋诊断资料及实践中遇到的问题,为修订职业病诊断标准提供参考依据。方法2018年6月依据GBZ/T 238-2011《职业性爆震聋的诊断》,对安康市某外包施工单位1例申请职业病诊断病例进行介绍和分析。结果该患者工种是凿岩工,收工时兼装药放炮(无爆破证),放炮后双耳被炮震,听力下降,左耳"轰隆样"耳鸣音,伴头晕。多次复查纯音气导听阈测试双耳听力损害严重,语频段与高频段听力同时受损,出现感音神经性聋。分别计算左右耳500、1000、2000 Hz平均听阈值,职业性爆震聋诊断分级为重度爆震聋。外包施工单位最初拒绝提供爆破接触史,在职业病诊断机构及主管部门的多次督促下,用人单位才出具爆破接触史。结论该职业性重度爆震聋患者的工种为凿岩工,建议标准修订时增加其他工种范畴。Objective To analyze the diagnostic data of occupational severe blast deafness and the problems encountered in practice,provide reference for revising the diagnostic criteria of occupational diseases.Methods In June 2018,one case applying for occupational disease diagnosis in an outsourcing construction company of Ankang City was introduced and analysed according to the Diagnosis of Occupational Detonation Deafness(GBZ/T 238-2011).Results The patient’s type of work was roc k driller,who charged the blasting(without blasting certificate)when finished the work.After blasting,both ears were shocked,the hearing was lowered.The left ear had"booming"tinnitus,accompanied by dizziness.The repeated pure tone air conduction threshold tests showed that binaural hearing was severely impaired,with both speech and high frequency hearing impaired,and sensorineural hearing loss occurred.The average hearing thresholds of 500,1000 and 2000 Hz were calculated respectively.The diagnosis of occupational blast deafness was classified as severe blast deafness.The outsourcing construction company initially refused to provide blasting contact history.Under the supervision of occupational disease diagnosis institutions and competent departments,the employing unit issued blasting contact history.Conclusion This patient with severe occupational blast deafness is a rock driller,so it is suggested that other categories of work should be added in occupational severe blast deafness when the standard is revised.

关 键 词：职业性耳鼻喉口腔疾病 凿岩工 爆震聋 

分 类 号：R135.8[医药卫生—劳动卫生]