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目的了解锡冶炼工工作场所粉尘危害状况,从而为制定锡冶炼工尘肺病的防治对策提供科学依据。方法收集某企业锡冶炼车间历年来职工职业健康体检和尘肺病诊断及工作场所粉尘浓度、游离二氧化硅含量测定等资料,对工作场所进行粉尘成分及粉尘分散度分析,并通过粉尘接触剂量与尘肺发病率的分析,评价锡冶炼工尘肺的剂量-反应关系。结果 1999—2010年间共对粗炼车间512名和精炼车间273名工作1年以上的作业工人进行了职业健康体检,确诊尘肺病9例(7例在粗炼车间,占77.78%),平均发病年龄(39.0±5.1)岁,平均发病工龄为(15.7±3.0)年。尘肺小阴影形态以q影为主,总体密度集1级,分布范围达2～4个肺区,仅1例有限制型肺通气功能轻度障碍,无合并肺结核病例。锡冶炼生产粉尘主要由SnO2、SiO2、Sn、SnS、Fe3O4、Fe2O3、FeS等物质组成,粗炼车间冶炼工工作场所粉尘浓度为0.67～36.13 mg/m3,TWA为5.92 mg/m3,最大超限倍数为6.3倍,粉尘SiO2平均含量为22.43%;精炼车间冶炼工作业场所粉尘浓度为0.90～95.44 mg/m3,TWA为4.17 mg/m3,最大超限倍数为11.9倍;粉尘SiO2平均含量为24.72%,粉尘累计接尘量与尘肺患病率之间呈高度正相关(r=0.93,P<0.05)。结论锡冶炼生产车间存在含游离二氧化硅的可吸入混合性粉尘,可能是导致锡冶炼工尘肺病发生的主要原因。
Objective To understand the status of dust hazard in tin smelters and provide a scientific basis for the prevention and treatment of tin smelters pneumoconiosis. Methods To collect information on workers’ occupational health examination and pneumoconiosis diagnosis, workplace dust concentration and free silica content determination in a tin smelting plant in a certain enterprise over the years, analyze the dust composition and dust dispersibility in the workplace, Analysis of the incidence of pneumoconiosis, evaluation of tin-smelting workers pneumoconiosis dose-response relationship. Results During 1999-2010, occupational health examinations were conducted on 512 workers in crude workshops and 273 workers in refining workshops for more than one year. Nine pneumoconiosis diagnoses were confirmed (7 in crude workshops, 77.78%), and the average age of onset (39.0 ± 5.1) years, the average length of service was (15.7 ± 3.0) years. The main form of pneumoconiosis was q-ray, with a total density of 1 grade and a distribution range of 2-4 pulmonary areas. Only 1 case had limited pulmonary ventilation mild dysfunction without pulmonary tuberculosis. The soot production dust is mainly composed of SnO2, SiO2, Sn, SnS, Fe3O4, Fe2O3, FeS and other substances. The concentration of dust in the smelting workshop smelter is 0.67-36.13 mg / m3, TWA is 5.92 mg / m3, The average dust content is 22.43%; the smelting workshop smelting workshop dust concentration is 0.90 ~ 95.44 mg / m3, TWA is 4.17 mg / m3, the maximum limit of multiple is 11.9 times; the average content of dust SiO2 is 24.72 %, The cumulative amount of dust dust exposure and pneumoconiosis prevalence was highly positively correlated (r = 0.93, P <0.05). Conclusions There is respirable mixed dust containing free silica in the tin smelting workshop, which may be the main reason for tin smelting pneumoconiosis.