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目的了解深圳市罗湖区珠宝首饰加工业接触职业病危害因素作业工人的健康情况,为该行业职业病防制提供科学依据。方法通过便利抽样的方法选择54家罗湖区珠宝首饰加工企业,对其接触职业病危害因素作业的工人进行在岗期间职业健康检查,检查内容主要有内科常规、血常规、尿常规、血清ALT、心电图、肝脾B超、纯音测听等,并分析检查结果。结果职业健康检查共1 367人,异常检出率为66.93%。主要职业病危害因素是有机溶剂(包括苯系物、正己烷、甲醇等)、噪声、粉尘、酸雾或酸酐;其中有机溶剂、粉尘、噪声作业接触率分别为58.38%(798人)、34.60%(473人)和28.16%(385人),目标疾病检出率分别为2.38%(共19人,其中有2例疑似职业性慢性苯中毒)、0.21%(1人)和4.42%(17人);整体目标疾病检出率为2.71%;有机溶剂、噪声、整体目标疾病检出率均高于2012年全区职业人群(均P<0.05)。按危害因素分类,接触苯系物作业工人的血常规、肝脾B超异常检出率,接触噪声作业工人纯音测听异常检出率,接触粉尘作业工人心电图异常检出率,以及整体工人的纯音测听、心电图、肝脾B超异常检出率均高于2012年全区职业人群(均P<0.05)。结论罗湖区珠宝首饰加工业职业病危害较大,特别是有机溶剂(主要是苯系物)、噪声对作业工人的健康影响最大。职业卫生监管部门应该加强监督管理,而企业自身则应加强职业卫生管理,改善作业环境,定期给作业工人做职业健康检查等以防止职业病的发生。
Objective To understand the health status of workers exposed to occupational hazards in the jewelry processing industry in Luohu District, Shenzhen, and provide a scientific basis for the prevention of occupational diseases in this industry. Methods 54 samples of jewelry processing enterprises in Luohu District were chosen by means of convenience sampling. Occupational health examination was conducted during their occupational exposure to workers exposed to occupational hazards. The main contents of the examination included medical routine, routine blood tests, urine tests, serum ALT, electrocardiogram, Liver and spleen B, pure tone audiometry, etc., and analyze the test results. Results A total of 1 367 occupational health examination, the detection rate was 66.93%. The main occupational hazards were organic solvents (including benzene, n-hexane, methanol, etc.), noise, dust, acid mist or acid anhydride. The contacting rates of organic solvent, dust and noise were 58.38% (798), 34.60% (473) and 28.16% (385) respectively. The prevalences of the target diseases were 2.38% (19 of them, 2 of them suspected of occupational chronic benzene poisoning), 0.21% (1 person) and 4.42% (17 persons ). The overall detection rate of target diseases was 2.71%. The detection rates of organic solvents, noise and overall target diseases were all higher than those of occupational groups in 2012 (all P <0.05). According to the classification of the hazard factors, the blood routine, the abnormal detection rate of liver and spleen B-, the detection rate of pure tone audiometry of workers exposed to noise, the detection rate of electrocardiogram abnormality of workers exposed to dust, and the overall workers’ Pure tone audiometry, electrocardiogram, liver and spleen B-wave abnormalities were higher than the occupational rate in 2012 (P <0.05). Conclusion Luohu District jewelery jewelery processing industry occupational hazards, especially organic solvents (mainly benzene series), the noise on the health workers have the greatest impact. Occupational health supervision departments should strengthen supervision and management, and enterprises themselves should strengthen occupational health management, improve the operating environment, regular workers to do occupational health checks to prevent occupational diseases.