职业病诊断医师常见职业性放射性疾病诊断标准实施评价

Evaluation on implementation of diagnostic standards for common occupational radiation diseases by occupational disease diagnosis

采用网上问卷方式,调查了5个常用职业性放射性疾病诊断标准在职业病诊断医师实施现况,分析了标准实施效果和诊断医师实施能力。结果表明:(1)共调查了87名职业病诊断医师,平均工作年限为15.4±11.9年;(2)标准的掌握率、培训率和应用率分别为82.8%~88.5%、73.6%~85.1%和46%~70.1%;(3)标准培训部门诊断医师构成比中,卫生部门40%~67.1%、环保部门0.6%~6.4%、安监部门8.7%~51.5%、本单位2.8%~23.6%;(4)诊断医师所在诊断机构中,标准制度建立率51.7%~92%,标准经费配套率25.3%~51.7%;(5)诊断医师判定的标准可行率88.5%~97.7%;(6)诊断医师对标准修订的建议主要集中在剂量阈值和剂量估算;(7)诊断医师建议政府相关部门应加强职业病诊断标准培训,提高对标准技术条款的理解和执行力。本研究为5个标准的实施效果评价和制修订提供了技术依据。

An online questionnaire was used to investigate the current status of the implementation of five commonly used diagnostic standards for occupational radiation diseases by occupational diagnostic physicians,in order to analyze the implementation effect of the standards and the ability of diagnostic physicians to implement the standards.The results showed that:(1)A total of 87 occupational disease diagnostic physicians were investigated,and the average working years were 15.4±11.9 years;(2)The mastery rate,training rate and application rate of the standard were 82.8%-88.5%,73.6%-85.1%and 46%-70.1%,respectively;(3)The proportion of diagnostic physicians in standard training departments was 40%-67.1%in health departments,0.6%-6.4%in environmental protection departments,8.7%-51.5%in safety supervision departments,and 2.8%-23.6%in our own organization;(4)In diagnostic institutions,the standard system establishment rate was 51.7%-92%,and the standards funds supporting rate was 25.3%-51.7%;(5)The feasible rate of standards determined by diagnosticians was 88.5%-97.7%;(6)Diagnostic physicians’recommendations on standard revision mainly focused on dose threshold and dose estimation;(7)Diagnostic physicians suggested that the relevant government departments should strengthen the training of occupational disease diagnostic standards and improve the understanding and implementation of the standard technical provisions.This study will provide technical basis for the evaluation and revision of the implementation effect of the five standards.