自贡市极薄煤层煤矿煤工尘肺X射线影像分析

X-ray Images of Pneumoconiosis Among Zigong Coal Miners Working in Extra-thin Coal Seams

目的了解极簿煤层煤矿工作场所职业卫生状况并探讨其与煤工尘肺X射线影像特征的关系。方法对15家煤矿井下、地面作业岗位开展职业病危害因素检测,对确诊的672例煤工尘肺病例的X射线胸片进行影像表现的统计分析。结果采煤、掘进、地面卸煤(岩石)岗位游离二氧化硅含量最低5.9%,最高58.4%,平均含量大于10%。极薄煤层煤矿工人工作场所接触的粉尘应为煤矽混合尘,工作场所粉尘浓度最低1.05 mg/m3,最高16.04 mg/m3。所测定的104份煤矿井下、地面工作场所粉尘样品浓度平均值均超过了国家职业卫生标准的限值。672份煤工尘肺X射线胸片表现形态为圆形小阴影的病例占90.18%。以圆形小阴影为主的X线胸片中q型占71.12%,p型25.41%r,型3.47%。Ш期煤工尘肺均表现为大阴影。Ⅰ期煤工尘肺小阴影主要分布于中下肺区的占67.33%;Ⅱ期煤工尘肺小阴影主要分布于上中下肺区的95.80%。Ш期煤工尘肺大阴影主要分布于上肺区和上中肺区。结论自贡市煤矿工人接触的粉尘为煤矽混合尘,煤工尘肺病患者X线影像形态大小以q型为主。

Objiective To comprehend the occupational hygienic situation of coal miners working in the extra-thin coal seams and discuss the relevance between the workplace and X-ray images about pneumoconiosis.Methods To detect the occupational hazards of underpit and on-the-ground operation posts in 15 coal mines,and to carry on statistical analysis on X-ray images about 672 definited pneumoconiosis samples.Results The minimum and maximum content of free silicon dioxide in coal mining,coal roadway driving and coal/rock dischargeing posts were 5.9% and 58.4%,and the average content is above 10%.The dust in extra-thin coal seams was coal silicon mixing dust.The minimum and maximum consistence of dust in work place were 1.05 mg/m3 and 16.04 mg/m3.The average dust consistence of 104 samples from underpit and on-the-ground workplaces exceeded current national occupational health standard.Small-round-shadow-in-lung expression of X-ray images among 672 pneumoconiosis cases was 90.18%.Q-pattern,p-pattern and r-pattern among the small-round-shadow-in-lung expression of X-RAY images were respectively 71.12%,25.41%,3.47%.The 3rd-level-type of pneumoconiosis was dislayed as big shadow in lung.Small shadow distributed in middle-lower part of lung among 1st-level-type pneumoconiosis cases was 67.33%;small shadow distributed in upper-middle-lower part of lung among 2nd-level-type pneumoconiosis cases was 95.80%.The big shadow of 3rd-level-type pneumoconiosis is distributed in upper and upper-middle part of lung.Conculsion The dust contacted by Zigong coal miners is coal silicon mixing dust.Q-pattern was the majority shape among all X-ray images of pneumoconiosis cases.