电焊工高千伏胸片影像学分级评价

Grading evaluation of arc-welders HKV chest imaging

目的建立接尘作业人员高千伏胸片影像学改变的分级评价方法,通过记录尘肺病发生的过程,及早发现风险和评估风险的大小,为及早干预提供依据。方法收集某企业194例电焊工连续5年的高千伏胸片,对照国家尘肺病诊断标准进行分级评价;评价后结合现场进行病因学调查。结果 194例电焊工高千伏胸片分级范围为0～5级,0～3级为无尘肺,4级为观察对象,5级为尘肺壹期。高千伏胸片分级随着接尘工龄的增长而增高,发生尘肺病的可能性或风险在增大。该企业3～5级人员中大部分或全部分布在总成焊接作业点,分别占3～5级中各组总人数的46.15%、100.00%、71.43%,总成焊接为该企业尘肺病发病率最高、发生风险最大的作业点高千伏胸片分级能反映尘肺病影像学改变的发生发展过程,能及早发现尘肺病发生的风险,可作为尘肺病风险评估的一种简便可行的方法。另外,如能应用高千伏胸片分级评价的方法来制定体格检查周期可能更客观。

Objective To establish the method of grading evaluation of high kV （HKV） chest images for dust exposure workers. Through the recording of pneumoconiosis process, the risks were detected and assessed as early as possible in order to provide the basis for early intervention. Methods 5-year HKV chest radiographs were collected from 194 cases of welders work- ing in an enterprise. These cases were graded and evaluated based on the national diagnostic criteria of pneumoconiosis, and an etiology investigation at the evaluation site was carried out. Results Among 194 cases, chest radiographs were graded to the levels of 0 -5. Level 0 ~ 3 meant non-pneumoconiosis, level 4 for observation object, and level 5 for pneumoconiosis period I .The relationship between chest radiograph classification and the length of dust exposure showed that HKV chest radiograph gra- ding could subsequently rise with the extension of the length of dust exposure. Either the possibility of pneumoconiosis or the risk of the pneumoconiosis increased. In this enterprise, most or all the cases graded as level 3 （46.15%）, 4（ 100. 00% ）, and 5 （71.43% ） in each group were working in the assembly welding site, indicating the highest incidence and greatest risk of pneu- moconiosis in this enterprise located in the welding site. Conclusion Chest radiograph grading is a simple and feasible method for risk assessment of pneumoconiosis, for it can reflect the occurrence and development process of the imaging change and detect the early increased risk of pneumoconiosis. In addition, it may be more objective to design a physical examination cycle if the HKV grading evaluation method of chest radiograph is applied.