有限空间作业中毒缺氧窒息危险因素的系统分析  

Systematic analysis of risk factors of poisoning,oxygen deficiency or asphyxia in confined spaces

作　　者：巩泉泉 谢连科 窦丹丹 王坤 张国英 GONG Quan-quan;XIE Lian-ke;DOU Dan-dan;WANG Kun;ZHANG Guo-ying(Electric Power Research Institute,State Grid Shandong Electric Power Company,Jinan Shandong,250003,China)

机构地区：[1]国网山东省电力公司电力科学研究院,山东济南250003

出　　处：《职业与健康》2023年第7期970-976,983,共8页Occupation and Health

基　　金：国家电网有限公司科技项目(52060021004Q)。

摘　　要：目的系统梳理在有限空间中作业发生人员中毒、缺氧窒息等事故的危险因素。方法以“有限空间”“中毒”“缺氧”“窒息”等为检索词,系统检索中国生物医学文献服务系统、中国知网、万方、维普、Pubmed、Embase和Cochrane数据库中,检索截至2021年3月1日有限空间中毒、缺氧窒息危险因素相关的文献,研究设计不限。提取合格文献中报道的有限空间特征、事故风险因素等,并汇总分析。结果纳入163篇个案报告,共报告中毒事故155起,722例;缺氧窒息事故97起,327例。事故多发于池、罐、井、管道内,硫化氢、氮气、一氧化碳是导致中毒、缺氧窒息最常见的物质。共梳理出36个危险因素,可分为管理、设备设施、人员、环境相关4类因素;“无个体呼吸防护”“作业人员安全意识不足”“作业前未通风换气或通风换气不彻底”“作业前未进行气体检测”等是最常见的危险因素。结论有限空间作业中毒、缺氧窒息的危险因素分布于作业各环节,常见的危险因素可通过前期的培训、教育、规范管理等措施规避。Objective To systematically review the risk factors of poisoning,oxygen deficiency or asphyxia during operation in confined spaces.Methods With the keywords of"confined space","poisoning","oxygen deficiency"and"asphyxia",the databases of Sinomed,CNKI,Wanfang,VIP,Pubmed,Embase and Cochrane Library were systematically searched for the literatures about risk factors of poisoning,oxygen deficiency or asphyxia in confined spaces from inception to March 1st,2021,with all types of research design.The limited space characteristics and accident risk factors reported in the qualified documents were extracted and analyzed.Results A total of 164 case reports were included,which reported 156 poisoning accidents involving 722 workers and 97 oxygen deficiency or asphyxia accidents involving 327 workers.The pool,tank,well and pipeline were the most common confined spaces where accidents happened.The hydrogen sulfide,nitrogen,carbon monoxide were the most common substances that cause poisoning,hypoxia or suffocation.A total of 36 risk factors have been sorted out,which can be divided into four types of factors related to management,equipment and facilities,personnel and environment.The most common risk factors were"no personal respiratory protection","insufficient safety awareness of workers","no ventilation or incomplete ventilation before working","no gas detection before working".Conclusion The risk factors of poisoning,hypoxia or asphyxia exists through all periods of working in confined spaces,and the common risk factors could be avoided by sufficient training,education,standardized management and other measures.

关 键 词：有限空间 中毒 缺氧 窒息 危险因素 

分 类 号：R181.31[医药卫生—流行病学]