2014至2019年广州市疑似职业病的诊断情况分析

Analysis on the diagnosis of suspected occupational diseases in Guangzhou from 2014 to 2019

目的了解2014至2019年广州市报告疑似职业病诊断情况,为疑似职业病监管提供数据依据。方法于2020年7至10月,采取整群抽样的方法,收集《职业病与职业卫生信息监测系统》中广州市2014至2019年报告的《疑似职业病报告卡》、《职业病报告卡》和《尘肺病报告卡》,进行匹配分析,了解疑似职业病病人的诊断及确诊情况。结果2014至2019年广州市共报告疑似职业病例7大类32种1426例,每年报告例数平均约240例,疑似职业病主要病种为噪声聋(68.44%,976/1426)、慢性苯中毒(16.48%,235/1426)、其他尘肺病(4.84%,69/1426)、矽肺(3.23%,46/1426)以及电焊工尘肺(1.82%,26/1426)。要求进入职业病诊断程序诊断率为36.61%(522/1426),确诊率为59.20%(309/522)。2019年疑似职业病诊断率最低(23.92%,61/255),花都区诊断率最低(8.33%,9/108),疑似职业性尘肺病诊断率最低(28.03%,44/157),疾控中心报告的疑似职业病诊断率最低(17.43%,19/109),广州市外机构报告的疑似职业病均没有进入诊断程序。疑似职业性皮肤病、物理因素所致职业病及职业性肿瘤均确诊,职防机构确诊率最高(94.87%,37/39)。结论2014至2019年报告的疑似职业病主要病种为噪声聋、苯中毒及尘肺病,疑似职业病总体诊断率及确诊率均不高,建议完善疑似职业病网络直报系统并加强疑似职业病的后续管理及监督。

Objective To understand the diagnosis of suspected occupational diseases reported in Guangzhou from 2014 to 2019,so as to provide theoretical basis and technical support for the supervision of suspected occupational disease reports.Methods By cluster sampling,the suspected occupational disease report card,occupational disease report card and pneumoconiosis report card reported by Guangzhou from January 1,2014 to December 31,2019 in the occupational disease and occupational health information monitoring system were collected for matching analysis to understand the diagnosis of suspected occupational disease patients.Results From 2014 to 2019,a total of 1426 suspected occupational cases in 7 categories and 32 species were reported in Guangzhou.The average number of reported cases per year was about 240.The main diseases of suspected occupational diseases were suspected occupational noise deafness(68.44%,976/1426),suspected occupational chronic benzene poisoning(16.48%,235/1426),suspected occupational other pneumoconiosis(4.84%,69/1426),suspected occupational silicosis(3.23%,46/1426)and suspected occupational welder pneumoconiosis(1.82%,26/1426).The diagnostic rate required to enter the occupational disease diagnostic program is 36.61%(522/1426),and the diagnostic rate is 59.20%(309/522).In 2019,the diagnosis rate of suspected occupational diseases was the lowest(23.92%,61/255),Huadu District was the lowest(8.33%,9/108),suspected occupational pneumoconiosis was the lowest(28.03%,44/157),the diagnosis rate of suspected occupational diseases reported by the Centers for Disease control and prevention was the lowest(17.43%,19/109),and the diagnosis rate of suspected occupational diseases reported by outpatient treatment was the lowest(22.22%,2/9).The suspected occupational diseases reported by institutions outside Guangzhou did not enter the occupational disease diagnosis procedure.Suspected occupational skin diseases,suspected occupational diseases caused by physical factors and suspected occupational tumors were diagnosed,and the diagnosis rate of occupational disease prevention and control institutions was the highest(94.87%,37/39).Conclusion The main types of suspected occupational diseases reported during these six years are noise deafness,chronic benzene poisoning and pneumoconiosis.The overall diagnosis rate and diagnosis rate of suspected occupational diseases are not high.It is suggested to improve the network direct reporting system of suspected occupational diseases and strengthen the follow-up management and supervision of suspected occupational diseases.