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目的调查某太阳能电池生产企业一起以发热、咳嗽、胸闷为主要症状的暴发事件的病因,为现场处置和预防此类事件再次发生提供依据。方法对所有病例的临床表现和流行病学特征进行描述性分析;对作业场所环境及工业生产“三废”处置情况开展卫生学调查;对病例咽拭子及生产过程使用的循环水开展军团菌检测;采用便携式GC-MS检测仪对固废焚烧产生有毒气体进行现场模拟实验查找并确认病因。结果共发现52例病例,罹患率为42.76%,其分布符合同源一次暴露暴发特征;病例临床表现符合烟尘热特点;采集的所有标本军团菌检测均为阴性;在事件发生车间的12个生产岗位中,岗位压缩空气使用量越大罹患率越高(P<0.01)。在事件发生的前一天傍晚该企业曾大量焚烧含氟固废物,生产厂房的压缩空气站进风口正处于焚烧点位置的下风侧,模拟实验检测结果显示,现场固废物焚烧后,周围环境空气中氟苯和二氟苯的检测值分别高达435 mg/m3和513 mg/m3。结论该事件系企业违规焚烧含氟固废物产生的有毒烟尘,经生产厂房的压缩空气站输入厂房,造成厂房内的作业工人吸入较高浓度的有机氟引起氟聚合物烟尘热暴发。
Objective To investigate the etiopathogenisis of a solar cell manufacturer with the main symptoms of fever, cough and chest tightness, and to provide a basis for site disposal and prevention of recurrence of such events. Methods Descriptive analysis of the clinical manifestations and epidemiological characteristics of all cases was carried out. Hygiene investigation was conducted on the disposal of workplace environment and industrial wastes and the disposal of “three wastes”. The regiment of throat swabs and circulating water used in the production process was carried out Bacteria detection; using portable GC-MS detector on solid waste incineration of toxic gases field simulation experiments to find and confirm the cause. Results A total of 52 cases were found with an attack rate of 42.76%. The distribution was in line with the same primary exposure characteristics. The clinical manifestations of the cases were consistent with the characteristics of dust and soot; all the samples collected were negative for Legionella; Post, the use of post compressed air higher attack rate (P <0.01). In the evening before the incident, the company had a large number of incineration of fluorine-containing solid waste, the air inlet of the compressed air station of the production plant is on the leeward side of the incineration point. Simulation results show that after solid waste is burned in the surrounding air Fluorobenzene and difluorobenzene were detected as high as 435 mg / m3 and 513 mg / m3, respectively. Conclusion The incident was caused by the illegal burning of toxic fumes from flue-cured solid wastes by factories and compressed air stations in the production plant. As a result, workers in the plant inhaled higher concentrations of organic fluorine and caused thermal outbreaks of fluoropolymer soot.