职业性慢性1-溴丙烷中毒事故处置

Management of occupational chronic 1-Bromopropane poisoning accident

目的探讨职业性慢性1-溴丙烷（1-BP）中毒事故的职业病危害因素识别、事故处置和职业病诊断的思路。方法采用现场职业卫生调查和应急职业健康检查相结合的方法,对某五金真空镀膜企业发生的群体性职业性1-BP中毒事故进行职业病危害因素识别,对患者进行职业病诊断。结果该企业由于使用含1-BP的清洗剂替代三氯乙烯进行超声波清洗作业,导致4名清洗房作业工人在接触1-BP清洗剂11-13个月后,均出现周围神经系统损害。在企业已经对清洗房进行改造的前提下,事后应急检测结果显示：清洗房空气中1-BP的短时间接触浓度为1 038.800-1 466.100 mg/m^3,时间加权平均浓度为371.500-654.100 mg/m^3;1-BP清洗剂顶空气中1-BP相对百分比为97.1%。清洗房作业工人班后尿中1-BP水平为25.50-155.64μg/L。4例患者均被诊断为职业性慢性1-BP中毒性周围神经病。结论快速识别中毒事故的职业病危害因素,早期明确职业病诊断,有利于做好1-BP所致职业危害的防治工作。

Objective To discuss occupational hazard factor recognition,disposal method and diagnostic strategy for occupational chronic 1-Bromopropane（ 1-BP） poisoning accident. Methods By occupational health investigation and emergency occupational physical examination,the occupational hazard factors were identified in a mass 1-BP poisoning accident happened in a hardware vacuum coating enterprise. The patients were provided with occupational disease diagnosis. Results Four workers were detected suffering from peripheral nerve system damage after exposure to 1-BP for11-13 months,due to using cleaning agent containing 1-BP instead of trichloroethylene for ultrasonic cleaning operation in an enterprise. After cleaning room was reformed,the emergent testing results showed that the short-time exposure concentration and time-weighted average concentration of 1-BP were 1 038. 800-1 466. 100 and 371. 500-654. 100 mg / m^3,respectively in the air of cleaning room. The top-air 1-BP relative percentage of 1-BP cleaning agent was 97. 1%. The offpost urine 1-BP levels of workers in the cleaning room were 25. 50-155. 64 μg / L. All 4 workers were diagnosed as occupational chronic toxic peripheral neuropathy caused by 1-BP. Conclusion Rapid identifying the occupational hazard factors of 1-BP poisoning accidents and making confirmation of occupational disease diagnosis are beneficial for prevention and treatment of occupational diseases caused by 1-BP.