某钢铁集团公司职业病病例分析

Analysis of the occupational diseases in iron and steel group corporations

目的分析某钢铁集团公司职业病病种的分布规律及变化趋势,找出高发行业及岗位,增强职业卫生管理工作的针对性和可靠性,促进钢铁行业职工职业健康全面提升。方法收集职业病报告系统中上报的1966—2017年确诊的该集团的电子版职业病病例及现存的纸质版职业病确诊病历,对收集到的历史病例进行全面的分类汇总及统计分析。结果共收集到职业病病例4 810例,涉及9类29种职业病。病例分布于1953—2017年,职业病种类和数量总体呈先增后减、前高后低趋势。1953—1979年确诊数量呈逐渐增加趋势,确诊332例,占总病例数的6.9%,共确诊2类职业病;1980—1989年是确诊高峰期,确诊2 347例,占职业病总数的49.1%,共确诊8类职业病;1989年之后呈逐渐下降趋势。尘肺病(4 164例,占病例总数的86.6%)和职业性化学中毒(343例,占病例总数的7.2%)的确诊例数在各行业、各年代均居前两位。尘肺(1 331例)、噪声聋(58例)以采矿行业高发;职业性肿瘤(108例)以焦化行业高发。各类职业病高发岗位:尘肺病为凿岩工(945例),锰及其化合物中毒为电焊工(136例),焦炉逸散物所致肺癌为扫炉盖工(54例)。结论尘肺病仍然是该集团职业病防治重点,其他职业病时有发生。采矿行业是职业病关键控制行业,焦化行业的职业肿瘤防护应引起重视。该集团应严格进行岗位职业健康风险评估,保护职工的健康。

Objective To analyze the distribution and trends of occupational diseases in an iron and steel group corporation, and identify factories and positions with high morbidity, in order to find the real need and priority of occupational health management, and to promote the overall occupational health of employees in the iron and steel industries. Methods The electronic-based and the existing paper-based records of occupational diseases which had already been diagnosed in the occupational disease report system between 1966 to 2017 were collected and comprehensively classified and statistically analyzed. Results A total of 4810 cases of occupational diseases were collected, involving 9 types of 29 occupational diseases.The time of diagnosis covered from 1953 to 2017. The types and numbers of occupational diseases showed the trend that increased firstly, and then decreased in the last few years. The number of diagnosed cases increased gradually from 1953 to1979, 332 cases in 2 types were diagnosed, accounting for 6.9% of the total number of cases. The number of diagnosed occupational disease reached the peak between 1980 to 1989, 2347 cases in 8 types were diagnosed, accounting for 49.1% of the total occupational diseases. After 1989, the data showed a slight decline. Pneumoconiosis（4164 cases, accounting for 86.6%of the total number of cases） and occupational chemical poisoning（343 cases, accounting for 7.2% of the total number of cases）were the top two occupational diseases in all industries and every years. Pneumoconiosis（1331 cases） and noise sputum（58 cases） were highly happened in the mining industries; occupational tumors（108 cases） were highly happened in the coking industry. The positions with high risks to get occupational diseases were： pneumoconiosis-rock driller（945 cases）, manganese and its compound poisoning-electric welders（136 cases）, lung cancer caused by coke oven escape-sweepers（54 cases）.Conclusions Pneumoconiosis is the priority of occupational disease prevention and control for the iron and steel group corporations, and other occupational diseases occur from time to time. The group corporations should monitor more to the mining industries, and pay more attention to avoid occupational cancer happen in the coking industries. The group corporations should strictly implement job occupational health risk assessment standard to protect the health of employees.