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目的建立接尘作业人员高千伏胸片影像学改变的分级评价方法,通过记录尘肺病发生的过程,及早发现风险和评估风险的大小,为及早干预提供依据。方法收集某企业194例电焊工连续5年的高千伏胸片,对照国家尘肺病诊断标准进行分级评价;评价后结合现场进行病因学调查。结果 194例电焊工高千伏胸片分级范围为0～5级,0～3级为无尘肺,4级为观察对象,5级为尘肺壹期。高千伏胸片分级随着接尘工龄的增长而增高,发生尘肺病的可能性或风险在增大。该企业3～5级人员中大部分或全部分布在总成焊接作业点,分别占3～5级中各组总人数的46.15%、100.00%、71.43%,总成焊接为该企业尘肺病发病率最高、发生风险最大的作业点高千伏胸片分级能反映尘肺病影像学改变的发生发展过程,能及早发现尘肺病发生的风险,可作为尘肺病风险评估的一种简便可行的方法。另外,如能应用高千伏胸片分级评价的方法来制定体格检查周期可能更客观。
Objective To establish a grading evaluation method for the imaging changes of high kV chest radiographs in dust-exposed workers. By recording the process of pneumoconiosis, early detection of the risk and assessment of risk, it provides the basis for early intervention. Methods A total of 194 cases of high-kilowatts chest radiographs of welders for 5 consecutive years were collected and classified according to the diagnostic criteria of national pneumoconiosis. After the evaluation, etiological investigation was conducted in combination with the field investigation. Results 194 cases of high-kV welder chest radiography grades range from 0 to 5, 0 to 3 for the pneumoconiosis, 4 for the observation object, 5 for pneumoconiosis. High kilovoltage chest grading increases with the increase of the length of service, the possibility of pneumoconiosis or increased risk. Most or all of the 3 ~ 5 staff members in the enterprise are distributed in the assembly welding operation point, accounting for 46.15%, 100.00% and 71.43% respectively of the total number of each group in grades 3 to 5, and welding of the assembly is the enterprise’s pneumoconiosis Highest-rated, Most-at-Risk Locations High kV chest radiographs reflect the development of imaging changes in pneumoconiosis and early detection of the risk of pneumoconiosis can be used as a simple and viable method for risk assessment of pneumoconiosis. In addition, if the application of high-kV chest grading evaluation methods to develop physical examination cycle may be more objective.