广州市重点职业病危害作业工人职业健康状况及职业病发病风险研判  

Occupational health status and occupational disease risk assessment of workers in key occupational disease hazardous operations in Guangzhou

作　　者：荣幸 廖阳[1,2] 周海林 何易楠[1,2] 张玉侠 王致 RONG Xing;LIAO Yang;ZHOU Hailin;HE Yinan;ZHANG Yuxia;WANG Zhi(Guangzhou Twelfth People’s Hospital,Guangzhou Occupational Disease Prevention and Treatment Hospital,Guangzhou,Guangdong 510620,China;Institute of Occupational and Environmental Health,Guangzhou Medical University,Guangzhou,Guangdong 511436,China)

机构地区：[1]广州市第十二人民医院(广州市职业病防治院),广东广州510620 [2]广州医科大学职业与环境卫生研究所,广东广州511436

出　　处：《职业卫生与应急救援》2024年第5期605-610,共6页Occupational Health and Emergency Rescue

基　　金：广东省医学科学技术研究基金项目(A2023406);广州市科技计划项目(2024A03J0432);广州市科学技术局重点研发计划项目(202206010061);广州市医学重点学科建设项目(2021—2023年)。

摘　　要：目的了解广州市重点职业病危害作业工人的职业健康状况,为制定广州市职业健康保护策略提供依据。方法采用描述性流行病学方法对广州市2016—2023年矽尘、苯、铅和噪声作业工人在岗期间职业健康状况进行分析。结果2016年1月1日—2023年12月31日广州市开展矽尘、苯、铅和噪声作业工人在岗期间职业健康检查共798869人次,其中矽尘作业14072人次(占1.76%),苯作业99046人次(占12.40%),铅作业10441人次(占1.31%),噪声作业675310人次(占84.53%)。8年共检出疑似职业病566例,检出率为0.07%;疑似职业病检出率依次为:疑似职业性矽肺的0.09%(13/14072)、疑似职业性噪声聋的0.07%(501/675310)、疑似职业性苯中毒的0.05%(50/99046)和疑似职业性慢性铅中毒的0.02%(2/10441)。检出职业禁忌证13619例,检出率为1.70%;检出率较高的为:噪声作业的1.86%(12556/675310)、苯作业的1.11%(1101/99046)和矽尘作业的0.50%(71/14072)。2016—2023年关键性指标异常检出率从高到低依次为:噪声作业的8.04%(57917/720802)、苯作业的1.54%(1503/97488)、铅作业的1.31%(79/6028)、矽尘作业的0.50%(61/12189);苯作业劳动者白细胞减少检出率、铅作业劳动者血铅升高检出率随着时间的推移,均呈现出上升的趋势(P<0.05)。此外,制造业、中小微型、内资企业劳动者职业健康损害的检出率较高。结论广州市目前接触矽尘、苯、铅和噪声的劳动者健康状况尚可。但仍有部分劳动者存在疑似职业病和职业禁忌证,尤其是噪声作业劳动者。因此,需要通过规范开展职业健康检查来精准识别和及早预防各类职业病。Objective To understand the occupational health status of workers in selected industries with key occupational hazards in Guangzhou and to provide a basis for formulating occupational health protection strategies in Guangzhou.Methods A descriptive epidemiological method was used to analyze the occupational health status of workers working with silica dust,benzene,lead,and noise during their on-the-job period in Guangzhou from 2016 to 2023.Results There were 798869 records of occupational health examinations during this period among the examined workers exposed to silica dust,benzene,lead,and noise in Guangzhou from January 1,2016 to December 31,2023.Of them,there were 14072 examinations for silica dust exposure(1.76%),99046 for benzene exposure(12.40%),10441 for lead exposure(1.31%),and 675310 for noise exposure(84.53%).Over the eight years,566 suspected cases of occupational diseases were detected,with a detection rate of 0.07%.The detection rates of suspected occupational diseases were,in order,0.09%(13/14072)for suspected occupational silicosis,0.07%(501/675310)for suspected occupational noise-induced hearing loss,0.05%(50/99046)for suspected occupational benzene poisoning,and 0.02%(2/10441)for suspected occupational chronic lead poisoning.A total of 13619 cases of occupational contraindications were detected,with a detection rate of 1.70%;of these,the higher detection rates were in noise exposure(1.86%,12556/675310),benzene exposure(1.11%,1101/99046),and silica dust exposure(0.50%,71/14072).The detected abnormal rates of critical effect indicators in 2016-2023 were as follows:8.04%for noise exposure(57917/720802),1.54%for benzene exposure(1503/97488),1.31%for lead exposure(79/6028),and 0.50%for silica dust exposure(61/12189).The detection rates of leukopenia in benzene-exposed workers and elevated blood lead levels in lead-exposed workers showed an upward trend over time(P<0.05).Additionally,the exposed workers in manufacturing,small and medium-sized microenterprises,and domestic enterprises had higher rates

关 键 词：重点职业病 广州市 职业健康监护 矽尘 苯 铅 噪声 

分 类 号：R135[医药卫生—劳动卫生]