某机械制造企业粉尘作业人员尘肺危害现状调查

A Survey on the Status and Risk of Pneumoconiosis among Workers Exposed to Dust in A Machinery Plant

[目的]调查某机械制造企业粉尘作业人员尘肺危害状况,对尘肺发病的风险进行评估,探讨有效的职业病防控对策。[方法]2009年对粉尘作业车间进行现场职业卫生调查、对216名粉尘作业接触工人进行职业健康检查及问卷调查。[结果]粉尘作业地点工程防护设施不完善,作业工人个人呼吸防护情况不佳。职业健康检查结果显示,未发现尘肺患者,胸片有异常表现者66人,占总人数的30.56%,其中观察对象有6人。与上年胸片对比,有16人肺部损害呈现加重的趋势。随着接尘工龄的延长,粉尘作业工人胸片有异常表现的比例明显增高(P<0.001)。[结论]该企业粉尘作业工人尘肺发病的风险增加,应及早建立职业病防控管理体系,通过多种技术手段加强职业病预防控制。对胸片表现异常,包括出现小阴影改变,未达到观察对象标准的粉尘作业人员进行监测和动态观察,可以早期评估尘肺发病的风险。

[ Objective ] To investigate occupational hazards of workers exposed to dust in a machinery plant, and to assess the risk of pneumoconiosis so as to explore an effective strategy for the control and prevention of occupational diseases. [ Methods ] A field survey of occupational health was conducted in the dust workshops of a machinery plant in 2009, in combination with physical examination and questionnaires among 216 workers exposed to dust. [ Results ] Protection facilities at the worksite were inadequate, and the personal respiratory protection provided to the workers was poor. Occupational health examination found no cases of pneumoconiosis, but there were 66 （30.56%） with chest radiograph abnormalities, with 6 subjects categorized under the group that need medical surveillance. Compared with last year, there were 16 chest radiographs indicating progression of lung damages. With the extension of dust exposure, duration, the percentage with chest radiograph abnormalities of workers went significantly higher （P〈0.001）. [ Conclusion ] The risk of pneumoconiosis among the workers exposed to dust in this plant is increasing. The establishment of occupational disease prevention and management system, as well as other techniques, is imperative. Furthermore, an early risk assessment of pneumoconiosis can be conducted through the monitoring and dynamic observation among the dust-exposed workers with abnormal chest radiographic images, including those with small opacities though not qualified to be involved into group of medical surveillance.