某省级职业病诊断机构2011—2022年职业性中暑诊断情况分析  

Analysis on diagnosis of occupational heat illness in a provincial occupational disease diagnosis institution from 2011 to 2022

作　　者：徐琳[1] 梁伟辉[1] 郑倩玲[1] 黄莉[1] 李斌[1] XU Lin;LIANG Weihui;ZHENG Qianling;HUANG Li;LI Bin(Guangdong Province Hospital for Occupational Disease Prevention and Treatment,Guangzhou,Guangdong 510300,China)

机构地区：[1]广东省职业病防治院,广东广州510300

出　　处：《中国职业医学》2024年第3期325-330,共6页China Occupational Medicine

基　　金：国家临床重点专科建设项目(2011-09);广东省医学科学技术研究基金(B20230465,A2020319);广东省职业健康工程技术研究中心(D:2019A069)。

摘　　要：目的 分析广东省职业病防治院(GDHOD)2011—2022年诊断的职业性中暑(OHI)病例流行病学特征和相关职业性诊断情况。方法 采用回顾性分析方法,以2011—2022年在GDHOD进行OHI诊断的203例病例为研究对象,通过“中国疾病预防控制中心信息系统”子系统“职业病及健康危害因素监测信息系统”收集诊断为OHI的病例资料,并通过GDHOD的职业病诊断档案收集不能诊断为OHI的病例资料,进行回顾性分析。结果 (1)203例病例中,174例诊断为OHI,确诊率为85.7%。(2)174例OHI病例中,热射病占72.4%,病死率为7.5%;男性占86.2%;发病年龄中位数为47岁,45~60岁者占56.3%;发病工龄中位数为80 d,在入职1、30、90、365 d内发病者依次占20.1%、40.8%、53.4%和70.1%。OHI病例集中分布于珠江三角洲地区,占93.1%。OHI病例在5—9月发病者占96.6%,高峰期在7月;OHI病例发病当天最高气温≥35.0℃者占67.3%;发病时段在12:00—18:00者占74.1%,在工作8 h内发病者占75.2%。发病时在非热源车间内作业者占43.7%,在户外作业者占39.7%。分布于制造业和小型私营企业的OHI病例分别占55.2%和62.6%。工种主要为车间操作工、装卸搬运工和环卫保洁员,共占63.2%。(3)29例不能诊断为OHI病例中,有高温作业史但临床表现不符合或达不到中暑诊断标准者占86.2%,以临床上诊断为中暑先兆者多见。结论 广东省OHI病例多发生于夏季和秋季,以热射病为主,中年男性和户外作业人员为高危人群,并呈一定的地区和企业聚集性的特征。应加强对珠江三角洲地区、制造业、小型私营企业高危人群的OHI防治工作。Objective To analyze the epidemiological characteristics and related occupational diagnosis situations of occupational heat illness(OHI) diagnosed by Guangdong Province Hospital for Occupational Disease Prevention and Treatment(GDHOD) from 2011 to 2022. Methods A total of 203 patients who applied for OHI diagnosed in GDHOD from 2011 to 2022were recruited as research subjects using the retrospective analysis method. Clinical data of OHI diagnosed cases was collected from "Occupational Diseases and Hazards Monitoring Information System" under "China Disease Prevention and Control Information System", and data of cases that diagnosed as non-OHI were collected from the occupational disease diagnosis file of GDHOD for retrospective analysis. Results i) The number of OHI diagnosed patients was 174 among 203 cases, with a rate of 85.7%. ii) The heat stroke accounted for 72.4% with a mortality rate of 7.5%, male patients accounted for 86.2% among the 174OHI diagnosed cases. The median age of onset was 47 years, and patients aged 45-60 years accounting for 56.3%. The median working period of onset of illness was 80 days, with 20.1%, 40.8%, 53.4% and 70.1% of cases occurring within 1, 30, 90 and 365 days of working, respectively. The patients were concentrated in the Pearl River Delta region, accounting for 93.1%. The peak incidence of OHI occurred from May to September, accounted for 96.6%, with the highest incidence occurred in July.About 67.3% of cases occurred on days when the maximum temperature was ≥35.0 ℃. Cases occurred between 12:00 and 18:00accounting for 74.1%, and cases occurred within 8 hours of work accounting for 75.2%. OHI of patients occurred during operations in non-heat-source workshops accounted for 43.7% of cases, while outdoor operations accounted for 39.7%. OHI patients in manufacturing and small private enterprises accounted for 55.2% and 62.6%, and the main occupations were workshop operators, loaders/unloaders, and sanitation workers, comprising 63.2% of cases. iii) Among the 29 cases diagnose

关 键 词：职业性中暑 热射病 诊断 高危人群 珠江三角洲 制造业 企业 

分 类 号：R135.99[医药卫生—劳动卫生]