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目的对某高尔夫球杆生产企业在投产期间出现的93例职业性手臂振动病(HAVD)进行分析,寻找发病原因,为该行业职业卫生监督管理和HAVD控制提供科学依据。方法通过现场职业卫生学调查,查阅该企业日常职业卫生监测、职业健康检查等档案以及HAVD诊断和鉴定结果并进行分析。结果对27个手传振动操作岗位进行4 h等能量频率计权振动加速度[ahw(4)]检测,其中位数M50、M25和M75分别为7.68、3.09和15.6 m/s2。其中17个点(占62.96%)的ahw(4)超过GBZ 2.2-2007规定限值(5 m/s2)。3种作业ahw(4)的M50比较,差异有统计学意义(H=229.52,P<0.01),进一步两两比较,3种岗位M50值大小依次为:细磨>粗磨>抛光。2010—2013年共检出观察对象和疑似HAVD 198例。其中107例次申请职业病诊断,诊断鉴定为HAVD的病例93例。接触人群发病率为32.07%(93/290)。病例诊断分级:轻度46例(49.46%)、中度42例(45.16%)、重度5例(5.38%);发病年龄为(37.6±4.7)岁,接触工龄(9.5±3.6)年。轻度、中度、重度患者接触振动工龄的中位数差异无统计学意义(H=1.60,P>0.05)。3种振动作业间的发病率差异有统计学意义(χ2=20.00,P<0.01),进一步两两比较,不同工种的发病率依次为:细磨>粗磨>抛光。结论该企业工作场所手传振动岗位超标严重。工人超标超时接触手传振动是导致职业病的主要原因。职业卫生监管部门应高度重视该行业手传振动的危害,督促相关企业改善劳动条件并开展职业健康监护。
OBJECTIVE To analyze 93 cases of occupational arm vibration disease (HAVD) occurring during the putting into operation of a golf club manufacturer and find out the cause of the disease and provide a scientific basis for occupational health supervision and management and HAVD control in the industry. Methods Through on-the-spot occupational hygiene survey, the routine occupational health monitoring, occupational health examination and other files of the enterprise were reviewed, and the results of HAVD diagnosis and identification were analyzed and analyzed. Results A total of 27 hand vibration transmission operation positions were tested for 4h energy weighted vibrational acceleration [ahw (4)]. The median M50, M25 and M75 were 7.68, 3.09 and 15.6 m / s2, respectively. Among them, ahw (4) of 17 points (62.96%) exceeded the limit of GBZ 2.2-2007 (5 m / s2). The M50 values of three jobs ahw (4) were statistically significant (H = 229.52, P <0.01). For further comparison, the M50 values of the three jobs were as follows: fine grinding> rough grinding> polishing. From 2010 to 2013, a total of 198 cases of subjects and suspected HAVD were detected. Among them, 107 cases applied for diagnosis and diagnosis of 93 cases of HAVD. The incidence of contact with the population was 32.07% (93/290). The diagnosis and grading of cases were mild in 46 cases (49.46%), moderate in 42 cases (45.16%) and severe in 5 cases (5.38%). The age of onset was (37.6 ± 4.7) years and the contact length of service (9.5 ± 3.6) years. There was no significant difference in the median length of exposure to vibration among mild, moderate and severe patients (H = 1.60, P> 0.05). The morbidity rates of the three kinds of vibrating operations were statistically significant (χ2 = 20.00, P <0.01). For further comparison, the morbidity rates of different types of jobs were as follows: fine grinding> rough grinding> polishing. Conclusion The hand-vibration positions in the workplace exceeded the standard seriously. Workers overtime contact hand vibration is the leading cause of occupational diseases. Occupational health regulators should attach great importance to the industry hand vibration hazards, urging related businesses to improve working conditions and carry out occupational health guardianship.