某省级职业病诊断机构2016—2020年职业性噪声聋诊断情况分析

Analysis on occupational noise deafness in a provincial occupational disease diagnosis institution from 2016 to 2020

目的分析广东省职业病防治院(GDHOD)2016—2020年诊断的的职业性噪声聋(ONID)病例流行病学特征和非ONID不能诊断为职业病的原因。方法通过“中国疾病预防控制信息系统”子系统“职业病与职业卫生信息监测系统”中的《职业病报告卡》收集2016—2020年在GDHOD诊断的ONID病例资料;并通过该院职业病诊断档案收集非ONID病例资料,对有关资料进行回顾性分析。结果1432例中,确诊ONID病例有824例,以轻度为主(占86.0%);男性占88.0%;诊断年龄中位数(M)为45.0岁,诊断工龄M为8.3年。ONID病例集中分布于珠江三角洲地区的中山市、东莞市、珠海市、江门市和广州市,共占67.6%;共分布于519家企业,以制造业为主(占90.2%);139家企业5年内各发生2~11例病例,共占53.9%;91.1%的病例分布于大、中、小型企业;非公有制类型企业占91.3%。不能诊断为ONID者606例,不能确诊的主要原因有较好耳听阈加权值<26 dB(占34.8%)、职业性噪声作业史不足3.0年(占31.5%)、较好耳听阈加权值<26 dB且双耳高频平均听阈<40 dB(占16.2%)。结论ONID新发病例具有聚集性、群体性发病特点;珠江三角洲地区、制造业、大中小型非公有制企业是ONID防治重点。职业性噪声作业史不足3.0年、较好耳听阈加权值<26 dB与双耳高频平均听阈<40 dB是未被诊断为ONID的主要原因。

Objective To analyze the epidemiological characteristics of occupational noise-induced deafness(ONID)diagnosed by Guangdong Province Hospital of Occupational Disease Prevention and Control(GDHOD)from 2016 to 2020 and the reasons non-ONID diagnosis.Methods The data of ONID patients diagnosed in GDHOD from 2016 to 2020 were collected from the Occupational Disease Report Card in the“Occupational Disease and Occupational Health Information Monitoring System”subsystem of the“China Disease Prevention and Control Information System”.The data of non-ONID subjects were collected from the occupational disease diagnosis archives in the same hospital,and the relevant data were analyzed retrospectively.Results Of the 1432 subjects,824 subjects were diagnosed as ONID patients,mainly of mild ONID(86.0%).Male patients accounted for 88.0%.The median(M)of diagnosis age was 45.0 years old,and M of length of employment of diagnosis was 8.3 years.ONID patients were mainly found in Zhongshan,Dongguan,Zhuhai,Jiangmen and Guangzhou City in the Pearl River Delta,accounting for 67.6%.The cases distributed in 519 enterprises,mainly on manufacturing(90.2%).Among the 139 enterprises,each enterprise had 2-11 patients worked within five years,accounting for 53.9%;91.1%of the ONID patients were distributed in large-,medium-and small-enterprises.ONID patients mainly worked in non-public enterprises that accounted for 91.3%.There were 606 subjects could not be diagnosed as ONID.The main reasons for not being diagnosed were that the weighted value of better ear hearing threshold was less than 26 dB(34.8%),the working history of occupational noise exposure was less than three years(31.5%),the weighted value of better ear hearing threshold was less than 26 dB and the average hearing threshold of binaural high-frequency was less than 40 dB(16.2%).Conclusion The ONID patients have the characteristics of group aggregation.The Pearl River Delta,manufacturing industry,large-,medium-and small-non-public enterprises are the key points of ONID prevention.The main reasons for not being diagnosed as ONID were:the working history of occupational noise exposure was less than three years,the weighted value of better ear hearing threshold was less than 26 dB,and the average high-frequency hearing threshold of both ears was less than 40 dB.