2015-2023年黔东南州疑似职业病流行病学特征及诊断情况分析

Epidemiological characteristics and diagnosis tracking of suspected occupational diseases in Qiandongnan from 2015 to 2023

目的了解黔东南州2015-2023年疑似职业病的流行病学特征及后续诊断情况,为疑似职业病监管提供数据依据。方法收集黔东南州2015-2023年报告的疑似职业病和职业病病例,分析疑似职业病的分布和诊断情况,并电话追踪未进行诊断的疑似职业病患者。结果2015-2023年黔东南州共报告疑似职业病3大类10种共424例,主要为尘肺病和职业性耳鼻喉口腔疾病,尘肺病以矽肺为主,职业性耳鼻喉口腔疾病为噪声聋。报告重点地区为天柱县、凯里市和镇远县;报告重点行业为采矿业和制造业,采矿业主要以其他采矿业、其他未列明非金属矿采选和粘土及其他土砂石开采为主,制造业主要以采矿、冶金、建筑专用设备制造和水泥制造为主;重点报告经济类型为私有经济;重点报告企业规模为小型和微型企业;报告的疑似职业病诊断率为7.31%,确诊率为67.74%,不同报告机构类别、不同接害类别、不同报告年份、不同企业规模疑似职业病的诊断率均有统计学差异(P<0.05)。未进入诊断程序的主要原因为岗前体检发现未被录用、尚在职业病诊断流程中、到其他职业体检机构进行复查、本人不愿意申请职业病诊断和未被告知自己是疑似职业病。结论矽肺和职业性噪声聋是黔东南州疑似职业病主要病种,疑似职业病的诊断率较低,应加强疑似职业病重点病种、重点地区和重点行业的监督管理工作,同时加强疑似病例报告和管理,提高疑似职业病的诊断率。

Objective To investigate the epidemiological characteristics and subsequent diagnosis of suspected occupational diseases in Qiandongnan from 2015 to 2023,and provide data basis for the supervision of suspected occupational diseases.Methods The suspected occupational diseases and occupational disease cases reported in Qiandongnan from 2015 to 2023 were collected,the distribution and diagnosis of suspected occupational diseases were analyzed,and the patients with suspected occupational diseases who were not diagnosed were tracked by telephone.Results From 2015 to 2023,a total of 424 cases of suspected occupational diseases were reported in three categories and 10 types in Qiandongnan,mainly pneumoconiosis and occupational ENT and oral diseases.The main form of pneumoconiosis was silicosis,and the main form of occupational ENT and oral diseases was noise deafness.The key reporting areas were Tianzhu County,Kaili City and Zhenyuan County.The key reporting industries were mining industry and manufacturing industry.The mining industry was mainly composed of other mining,other unlisted non-metallic mineral mining and clay and other earth sand mining.The manufacturing industry was mainly composed of mining,metallurgy,construction special equipment manufacturing and cement manufacturing.The key reporting economic type was private economy.The key reporting enterprise scale was small and micro enterprises.The diagnosis rate of suspected occupational diseases was 7.31%,and the confirmed rate was 67.74%.There were statistically significant differences in the diagnosis rates of suspected occupational diseases among different reporting agencies,different types of exposure,different reporting years,and different enterprise scales(P<0.05).The main reasons for not entering the diagnostic procedure were pre-job physical examination,not being employed,still in the process of occupational disease diagnosis,to other occupational physical examination institutions for review,not willing to apply for occupational disease diagnosis,and not being informed of suspected occupational diseases.Conclusion Silicosis and occupational noise deafness are the main suspected occupational diseases in Qiandongnan,and the diagnosis rate of suspected occupational diseases is low.The supervision and management of key diseases,key regions and key industries of suspected occupational diseases should be strengthened,and suspected case reporting and management should be strengthened to improve the diagnosis rate of suspected occupational diseases.