广州市职业健康监护和职业病发病状况分析

Analysis of the situation of occupational health surveillance and the morbidity of occupational diseases in Guangzhou

目的分析广州市职业健康监护工作和职业病发病的特点。方法对1993至2002年全市劳动卫生工作情况汇总资料进行职业健康监护和职业病发病状况的回顾性研究。职业健康监护体检资料按时间顺序每5年分一组,共分两组,即1993至1997年为第1组,1998至2002年为第2组。结果10年职业健康监护体检年平均受检率均在75%以上。第2组噪声听力损伤、观察对象、物理因素重点监护人员和粉尘、化学因素禁忌证人员明显高于第1组,差异有统计学意义(P<0.01)。第1组新发慢性职业病共91例,第2组181例,两组发病率的差异有统计学意义(P<0.05),其中化学中毒和噪声听力损伤的发病率上升明显,两组尘肺的发病率差异无统计学意义(P>0.05)。10年共发生各类职业病581例,其中急性中毒309例,占53.18%,慢性职业病272例,占46.82%;慢性职业病中尘肺占16.70%,铅和苯化学中毒占16.87%。随着时间的推移,尘肺、化学因素中毒和总职业病患者发病工龄趋于年轻化,发病工龄也明显缩短,差异均有统计学意义(均P<0.01)。结论广州市初步建立了一个较规范的职业健康监护体系。体检中检出的噪声职业性重点监护和粉尘、化学因素禁忌证人员明显上升;职业病发病明显上升,以急性职业中毒和尘肺、铅和苯中毒为主;慢性职业病患者发病年龄趋于年轻化,发病工龄缩短。

Objective To analyze the situation of occupational health surveillance and the characteristics of occupational diseases in Guangzhou. Methods The situation of occupational health surveillance and the morbidity of occupational diseases were studied retrospectively by use of the physical examination data collected from the labour hygienic reports of the city from 1993 to 2002 .The data were divided into two groups：the first group from 1993 to 1997, and the second from 1998 to 2002. Results Annual average of occupational health examination in the past 10 years was over 75% . The data in the second group（1998-2002） showed that the number of hearing loss observed subjects, noise surveilled personnels, dust and chemicals contraindicated personnels were significantly higher than those in the 1st group（ P 〈 0.01 ） .The morbidity of chronic occupational disease newly occurred was 91 cases in 1st group,and 181 cases in 2nd group （ P 〈 0.05） ,in which the incidence of chemical poisoning and noise induced heating loss increased significantly but that of pneumoconiosis between two groups was not significantly different（ P 〉 0.05 ）. In the past 10 years, 581 cases of occupational diseases were diagnosed, of which ,309 cases（53.18 % ） were acute poisonings, while 272 cases （46.82 % ） were chronic occupational diseases. Pneumoconiosis,lead and benzene poisoning were common in chronic occupational diseases（ 16.70 %, 16.87 % respectively）. With the passage of time, the incidence ages of pneumoconiosis, chemical poisoning and total occupational diseases tended towards younger. The difference was statistically significant（ P 〈 0.01 ）. Conclusion A normal system for occupational health surveillance has been developed in Guangzhou. Detectable rates in focused surveillance and contraindication have been obviously increasing. The incidence of occupational disease （mainly including acute occupational poisoning, pneumoconiosis, lead and benzene poisonings） is also going up. The incidence age of chronic occupational diseases tends to be younger accompanied with a shorter work history.