河南省某市放射工作人员职业健康检查项目未检率调查分析

Investigation on non-coverage rate of occupational health examinations for radiation workers in a city of Henan province

目的了解放射工作人员职业健康检查项目未检情况。方法选取2019年河南省平顶山市1019名放射工作人员职业健康检查资料,对各检查项目[个人基本信息资料采集、血压、内科常规、皮肤科、眼科(色觉、视力,眼晶状体裂隙灯检查、玻璃体、眼底)、DR胸片、彩超(腹部及甲状腺)、心电图、血液检查(血常规、生化检验、甲状腺功能、外周血淋巴细胞微核试验或外周血淋巴细胞染色体畸变分析)、尿常规]未检率及按照不同职业受照类别、性别、年龄组、不同级别医疗机构的各检查项目未检率进行统计分析。结果1019名放射工作人员各检查项目未检率差异有统计学意义(χ2=2580.657,P<0.05),其中DR胸片未检率最高,为46.0%,其次为尿常规(9.3%),只有血液检查未检率最低为0。就不同分类来说,放射工作人员各检查项目总体未检率,医学应用高于工业应用(χ2=93.969,P<0.05);女性高于男性(χ2=24.228,P<0.05);不同年龄组中,<30岁最高,其次≥50岁,40~岁最低(χ2=12.623,P<0.05);医疗机构单位级别越高总体未检率越高(χ2=24.725,P<0.05);医学应用不同职业受照类别中,放射诊断学>介入放射学>放射诊疗(χ2=23.263,P<0.05)。不同分类中各检查项目未检率,医学应用高于工业应用的有DR胸片、腹部彩超、甲状腺彩超、心电图、尿常规(χ2=141.776、13.801、11.228、5.465、4.825,P<0.05);女性高于男性的有DR胸片、尿常规(χ2=43.032、23.247,P<0.05);不同年龄组中,色觉及视力、DR胸片、甲状腺彩超、尿常规未检率差异均有统计学意义(χ2=14.285、9.519、7.958、16.656,P<0.05);不同级别医疗机构中,色觉及视力、DR胸片、心电图未检率差异均有统计学意义(χ2=12.328、29.831、15.342,P<0.05);医学应用不同职业受照类别中,DR胸片、尿常规未检率差异均有统计学意义(χ2=46.519、14.109,P<0.05)。结论应继续加强放射工作人员健康管理,严格按照国家相关要求进行职业健康检查。

Objective To explore the non-coverage rate(NCR)of occupational health examination for radiation workers.Methods The occupational health examination data of 1019 radiation workers were selected in 2019 in Pingdingshan City,Henan Province.Statistical analyses were performed,on the one hand,based on the NCR of different examinations,including collection of personal basic information,blood pressure,internal medicine routine,dermatology,ophthalmology(color sensation,visual acuity,lens slit,vitreum,ocular fundus),DR chest X-ray,color B-ultrasound of abdomen and thyroid,ECG,blood(blood routine,biochemical test,thyroid function,micronucleus test or chromosomal aberrations analysis of peripheral blood lymphocytes)and urine routine.On the other hand,the analyses were also based on the NCR of various examinations for different occupational radiation categories,genders,age groups and medical institutions at different levels.Results There were statistically significant differences in the NCR for 1019 radiation workers(χ2=2580.657,P<0.05),with the highest value of 46.0%in DR chest X-ray examination,followed by urinary routine of 9.3%,and the lowest value of 0 in blood examination.The trend in NCR for radiation workers of different categories was higher in medical application than in industrial application(χ2=93.969,P<0.05),and higher in women than in men(χ2=24.228,P<0.05).Among different age groups,the NCR under the age of 30 was the highest,followed by above the age of 50,and the lowest over 40 years old(χ2=12.623,P<0.05).As a whole,the higher the level of medical institutions was,the higher the overall NCR was(χ2=24.725,P<0.05).Among different occupational groups of medical applications,the trend in NCR of each examination was:radiodiagnosis>interventional radiology>radiodiagnosis(χ2=23.263,P<0.05).The NCR of the various examinations were higher in medical applications than in industrial applications including DR chest X-ray,color B-ultrasound of abdomen and thyroid,ECG,urine routine(χ2=141.776,13.801,11.228,5.465,4.825,P<0.05)and higher in female than male including DR chest X-rays and urine routine(χ2=43.032,23.247,P<0.05).Among different age groups,statistically significant differences in NCR were found(χ2=14.285,9.519,7.958,16.656,P<0.05)in color sensation and visual acuity,DR chest X-ray,color B-ultrasound of thyroid,urine routine.Between medical institutions at different levels,the NCR in color sensation and visual acuity,DR chest X-ray,ECG undetected rate were statistically significant(χ2=12.328,29.831,15.342,P<0.05).There were statistical significance in NCR of DR chest X-ray and urine routine between different occupational groups of medical applications(χ2=46.519,14.109,P<0.05).Conclusions Continued effort should be made to strengthen the health management of radiation workers and carry out occupational health examinations in strict accordance with the relevant national requirements.