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目的通过对硫化氢、一氧化碳、氰化氢三种化学窒息性气体职业性急性中毒事故的案例分析,探寻发生事故的主要原因,提出针对性措施。方法检索2004年以来关于硫化氢、一氧化碳、氰化氢三种化学窒息性气体急性中毒的相关文献,对中毒事故发生和伤亡的主要原因及其应对措施进行统计分析。结果化学窒息性气体急性中毒事故病死率为29.7%,其中因盲目施救导致中毒的病死率为31.6%;工人违规作业的占47.9%;属于有限空间作业的占74.0%。事故现场均未设置气体检测报警仪和通讯救援设备,其余防护措施的设置率均低于9.6%。事发单位均未落实个人防护用品管理制度和应急救援预案,其余制度和培训的落实率均在16.4%以下。结论化学窒息性气体中毒事故的发生和伤亡主要是由于存在有限空间、违规作业、盲目施救所造成。增强作业人员的安全意识,加强用人单位的应急救援能力和职业卫生管理制度的落实力度是防止事故发生的重要手段。
OBJECTIVE Through the case analysis of occupational acute poisoning cases of three kinds of chemical asphyxiating gases such as hydrogen sulfide, carbon monoxide and hydrogen cyanide, the main causes of accidents were explored and targeted measures were put forward. Methods The literature about the acute poisoning of three kinds of chemical asphyxiating gases, such as hydrogen sulfide, carbon monoxide and hydrogen cyanide, was retrieved from 2004, and the main causes of poisoning accidents and casualties were analyzed statistically. Results The mortality rate of chemical asphyxial gas acute poisoning accidents was 29.7%, of which 31.6% was caused by blind rescue; 47.9% of them were irregular workers; and 74.0% of them were workers in limited space. No gas detection alarm and communication rescue equipment were set up at the scene of the accident, and the remaining protective measures were set at a rate lower than 9.6%. The units that failed to implement the personal protective equipment management system and emergency rescue plan, the implementation rate of the remaining systems and training are below 16.4%. Conclusions The occurrence and casualties of chemical asphyxiation gas poisoning are mainly caused by the limited space, illegal operation and blind rescue. To enhance the safety awareness of workers, to strengthen employers’ emergency rescue capabilities and implementation of occupational health management system is an important means to prevent accidents.