中小企业职业卫生服务模式探讨

<正>我国约2亿接触职业危害的劳动者集中在中小企业[1],探索适合中小企业尤其是偏远地区企业的职业卫生服务模式,对保护劳动者健康、促进地方经济良性发展有重要意义。1偏远地区职业卫生现状1.1县(乡)基层职业卫生服务机构服务能力低下职业卫生现场检测和健康监护工作无法开展。职业病防治机构萎缩,甚至无相应机构;职业卫生技术服务能力薄弱,或不具备开展相关工作的技术设备条件,无法进行职业卫生检测。十堰     

健康促进在职业卫生工作模式中的实用性探讨

在我国，健康促进作为一种提高国民健康水平的先进手段尚未形成社会与企业的迫切的自觉行为，但随着社会与经济的快速发展，健康促进必将成为“自愿的需求”。在职业卫生工作中，推广、渗透、使用健康促进是推进这种需求的重要途径。为此，我们对健康促进在职业卫生工作模...     

绍兴市中小企业职工职业卫生知识认知及需求状况

[目的]了解绍兴市中小企业职工对职业卫生知识的认知与需求情况,为进一步开展企业健康教育提供依据。[方法]采用整群抽样的方法抽取该市3家企业部分车间835名职工,用自行设计的调查表,以调查问卷的方式进行职业卫生相关问题调查。[结果]收回有效表格786份,回收率94.13%。786名调查对象职业卫生知识总知晓率78.54%,其中职业卫生法规知识知晓率82.27%,职业病防治知识知晓率74.81%;机械、化工、纺织行业职工的职业卫生知识知晓率分别为83.21%,79.27%和72.80%;97.58%的职工有职业健康教育需求;企业有组织的健康教育需求率最高,其中发放读本、在厂区张贴宣传资料的方法是中小企业广大职工最乐于接受的健康教育方式。[结论]绍兴市中小企业职工对职业卫生知识有一定的知晓率,对职业健康教育需求较高,应继续推行企业健康促进,加强企业职业健康教育工作。     

杭州市中小企业职业卫生管理体系调查及对策研究

目的为了解杭州市中小企业职业卫生管理体系现状及其基本特征,对辖区内已申报职业病危害的企业进行了职业卫生管理体系的调查和研究,为中小企业建立科学、有效的职业卫生管理机制提供依据。方法采取对企业职业卫生分管人员进行问卷调查的方式,了解企业的基本情况、管理体系认证、职业病危害特征,职业卫生管理机构、职业卫生分管人员业务素质和培训情况、以及企业医疗机构的设置等内容并进行统计分析。结果①杭州市中小企业的职业卫生管理机构形式多样,大型企业、外资和港澳台企业将职业卫生工作纳入安全、环保和职业健康部门管理的企业为最多,分别占57.1%和30.6%。小型企业则多数在企业行政部门分管;②被调查的186家企业,通过HSAS18001管理体系认证的仅为7.5%,小型企业为5.9%。小型企业未经管理体系认证的为最多,占36.3%。③企业职业卫生分管人员多数为兼职人员、占总数的80.5%。平均每千名职工拥有医务人员数为1.84.低于1992年全国乡镇企业调查的平均拥有数;④小型企业分管人员学历为高中或中专学历的占68.5%,无职称人员占71.2%。结论小型企业的职业卫生管理机构不健全、管理人员文化和业务素质较低。为促进中小企业的健康可持续发展,防治和降低职业病的发生,必须大力推进中小企业的HSAS18001管理体系的认证,帮助和指导小企业建立健全职业卫生管理工作机构和制度。同时国家应尽快建立企业职业卫生分管人员的入门资格考试和任职培训制度。     

职业健康教育在职业危害防治工作中的作用

通过对部分工业企业职业健康教育培训前后有关情况的调查，阐述了职业健康教育可促进职业危害防治工作，是一种经济、有效的职业危害防治方法。     

浅谈对深圳市开展职业人群健康促进工作的认识

目前 ,全世界都普通关心健康促进问题 ,健康促进已成为世界卫生组织敦促各国政府制定的健康政策中最为重要的内容。健康促进是指以教育、组织、政策 (法律 )和经济等手段干预那些对健康有害的生活方式、行为和环境 ,以促进健康。深圳是我国改革开放的窗口 ,是我国经济发达的地区 ,职业人群健康促进工作理应走在全国前列 ,本文就深圳工业企业和职业卫生工作现状 ,谈谈对深圳开展职业人群健康促进工作的认识。1　职业人群开展健康促进工作的必要性1 1　工业企业职业卫生现状不容乐观　深圳市现有工业企业几千家 ,职工 10 0多万人。存在有毒有…     

上海市普陀区中小企业职业卫生现状调查

[目的]了解上海市普陀区中小企业的基本职业卫生现状,探讨系统性的职业卫生监管模式的可行性,为提高职业卫生监管水平提供依据。[方法]采用对辖区内中小企业的普查、监督状况的抽样调查及查阅资料等方法,对2006年5月至2008年3月上海市普陀区378家中小企业职业卫生状况进行调查。[结果]该区职业卫生总体基础较好。具有中小型企业为主、职业危害多杂、单个企业危害轻等典型特征;企业申报率≥94%;职业健康监护率≥90%;企业检测率≥65%;但职业卫生预防宣教不足、农民工问题突出、少数机构存在就处罚而处罚的倾向。[结论]普陀区现有职业卫生监管有一定成效,但尚未达到法定要求,企业申报率、检测率低于国家要求,涉及职业卫生根本的预防工作仍开展不足。建议探索建立系统性的职业卫生体系,通过采取重新定位目标、从监管向服务倾斜、引入社会力量弥补自身不足等一系列措施,达到提高效率,促进职业卫生工作的目的。     

日本和芬兰中小企业职业卫生服务模式对我国的借鉴

目的分析日本和芬兰两国中小型规模企业职业卫生服务模式,建立适合我国国情的中小企业职业卫生服务体系。方法了解日本和芬兰两国的职业卫生服务模式,为我国中小规模企业建立有效的职业卫生服务提供参考依据。结果在芬兰,法律规定由公共卫生中心和私人医疗中心两方面提供中小企业的职业卫生服务;在日本,企业要为每50个工人指定1名以上的职业健康医生提供咨询服务,区域职业健康中心负责提供职业卫生服务及其他相关服务。结论芬兰、日本等发达国家不仅通过立法,而且还通过灵活的职业安全和健康服务模式提供服务,中小企业职业卫生服务方面覆盖面高,值得我国借鉴和学习。     

章丘市通过试点带动做好职业病防治工作

近年来,章丘市先后被确定为中小企业职业危害干预试点县(市)、工会主动参与职业病防治工作试点县(市)、健康促进企业试点县(市)、流动人员职业健康监护模式研究项目县(市).章丘市以此为契机,充分发挥试点带动作用,积极探索新形势下职业病防治工作的新思路、新方法,逐步形成了"政府主导,部门配合,技术支撑,执法监督,企业自律,职工参与"的工作模式,促进了职业病防治工作的开展.     

我国职业健康促进现状分析

目的了解我国职业健康促进现状,为企业开展健康促进工作提供依据。方法通过检索我国开展职业健康促进工作以来发表的文献,分类进行分析、汇总。结果我国20世纪90年代初开始在试点单位开展职业健康促进工作,通过各方面努力,职业健康促进工作进展顺利,取得了明显成效。由于企业缺乏专业职业卫生人员,企业自主开展职业健康促进工作尚存在一定困难。结论技术服务机构在为企业进行职业健康检查及日常监测等技术服务的同时,应帮助企业找出影响员工健康的主要危险因素,确定健康促进的重点和工作场所健康干预的目标,指导企业有针对性地开展健康促进工作。     

深圳市两工业区中小企业职业卫生的基本状况

目的为中小企业职业卫生工作进行合理有效的监督管理和服务指导提供线索。方法以日常职业卫生监督的形式,对深圳市宝安区2个工业区内所有企业2009年度的基本情况、主要存在的职业病危害因素及职业卫生基本状况进行调查分析。结果 2个工业区58家企业主要涉及电子、五金模具、表业、塑胶模具、纸品包装、机械等行业,存在的职业病危害因素主要有三氯乙烯、苯系物、正己烷、粉尘等化学有害因素及噪声、高温等物理有害因素;58家企业共有职工6120人,接触职业病危害因素人数共计2106人,占职工总人数的34.4%;58家企业在组织机械和规章制度建设、原辅材料和设备管理、职业病危害事故的应急救援、职业卫生培训、履行告知义务方面不符合要求比例均超过50%;其他各项调查中不符合要求的企业均低于25%。结论中小企业的职业卫生基本状况的形势严峻,职业卫生的安全隐患极大,在卫生资源有限的情况下,推行基本职业卫生服务如中小企业外聘职业卫生专家指导作业模式,可能降低企业职业病事故发生的风险。     

Health literacy: addressing the health and education divide

Health literacy as a discrete form of literacy is becoming increasingly important for social, economic and health development. The positive and multiplier effects of education and general literacy on population health, particularly women's health, are well known and researched. However, a closer analysis of the current HIV/AIDS epidemics, especially in Africa, indicates a complex interface between general literacy and health literacy. While general literacy is an important determinant of health, it is not sufficient to address the major health challenges facing developing and developed societies. As a contribution to the health literacy forum in Health Promotion International, this paper reviews concepts and definitions of literacy and health literacy, and raises conceptual, measurement and strategic challenges. It proposes to develop a set of indicators to quantify health literacy using the experience gained in national literacy surveys around the world. A health literacy index could become an important composite measure of the outcome of health promotion and prevention activities, could document the health competence and capabilities of the population of a given country, community or group and relate it to a set of health, social and economic outcomes.     

中国农村社区健康教育模式研究报告

通过在全国１２省（市）的１４个小区开展的农村社区健康教育模式研究，我们总结出了中国农村社区健康促进的基本框架：社会诊断、流行病学诊断→确定优先解决的公共卫生问题→分析影响健康的社会、经济、文化、政治及生物、环境、行为因素→选出重要、可改变的因素→制定适合的干预策略→开展具体的传播活动→实施调整。同时，我们在开发领导、社区资源的开发与利用、传播方法与策略，以及经费的筹集等方面总结了成功的经验。     

Statement on national worklife priorities

The National Institute for Occupational Safety and Health (NIOSH) WorkLife Initiative (WLI) [http://www.cdc.gov/niosh/worklife] seeks to promote workplace programs, policies, and practices that result in healthier, more productive employees through a focus simultaneously on disease prevention, health promotion, and accommodations to age, family, and life stage. The Initiative incorporates the Institute's foundational commitment to workplaces free of recognized hazards into broader consideration of the factors that affect worker health and wellbeing. Workplace hazards, such as physical demands, chemical exposures, and work organization, often interact with non-work factors such as family demands and health behaviors to increase health and safety risks. New workplace interventions being tested by the first three NIOSH WLI Centers of WorkLife Excellence are exploring innovative models for employee health programs to reduce the human, social, and economic costs of compromised health and quality of life. Many parties in industry, labor, and government share the goals of improving employee health while controlling health care costs. NIOSH convened a workshop in 2008 with representatives of the three Centers of Excellence to develop a comprehensive, long-range strategy for advancing the WorkLife Initiative. The recommendations below fall into three areas: practice, research, and policy. Responding to these recommendations would permit the WorkLife Center system to establish a new infrastructure for workplace prevention programs by compiling and disseminating the innovative practices being developed and tested at the Centers, and elsewhere. The WLI would also extend the customary scope of NIOSH by engaging with multiple NIH Institutes that are already generating research-to-practice programs involving the working-age population, in areas such as chronic disease prevention and management. Research to Practice (r2p) is a concept focused on the translation of research findings, technologies, and information into evidence-based prevention practices and products that are adopted in the workplace or other "real-world" settings. NIOSH's goal is to overcome the translational issues that now prevent state-of-the-art occupational health, health promotion, and chronic disease research findings from benefiting working age populations immediately, regardless of workplace size, work sector, or region of the country.     

健康优先的基本内涵与实践经验

健康优先是“健康中国”战略的基本要求和核心理念,其产生与发展有着深刻的经济社会、思想文化、国际交往背景,是政府将健康作为国家或区域整体发展进程中的优先事项加以安排的一系列理念、制度、发展模式的集合,具有全局性、基础性、战略性、一惯性和规制性的显著特征。目前,各地在发展理念、发展规划、公共政策、财政投入、考核问责等五大健康优先领域开展了探索,但面临制度保障、协调联动、路径设计等问题挑战,建议聚焦治理体系、推进与实施机制、监测考核以及宣传引导,推动健康优先落实落地。     

卫生与经济协调发展辨议

卫生与经济协调发展是卫生与经济这两大不同范畴系统在发展中的互动、适应、配合与促进。经济发展与卫生发展具有关联性，但不具有必然性，一定程度的卫生发展也不代表已与经济协调发展。卫生与经济协调发展要以政府计划调控为主．实行计划调节与市场调节相结合。实现卫生与经济协调发展必须不断增加对卫生的投入，增加的投入不是单一的经济投入，而是包括经济投入在内的综合投入。     

自我效能感在职业健康与安全促进领域的研究进展（英文）

提升工人的自我效能感对职业安全与健康的积极作用得到越来越多的重视。本文介绍了自我效能的来源,通过实例,综述了近年来自我效能对职业人群的健康促进与工厂生产安全的影响、作用和研究方法。提示应结合自我效能感的多个来源对影响职业发展的健康与安全的关系进行深入的研究。     

What would the Ottawa Charter look like if it were written today?

The Ottawa Charter has been a phenomenal influence guiding the development of the concept of health promotion, and in shaping public health practice in the past 20 years. The world has changed somewhat since 1986 in many ways that could not have been anticipated by those drafting the Charter. Substantial social and economic changes have occurred, and continue to occur. These include the globalization of trade, the invention and development of the internet and mobile communications, as well as the emergence of new threats to health such as HIV/AIDS. Such profound changes require adaptations to established health promotion strategies and the development of new strategies. This paper considers the origins, describes changes and suggests adaptations to the five strategies of the Ottawa Charter - build healthy public policy; create supportive environments for health; strengthen community actions; develop personal skills; and reorient health services - that now routinely provide the framework for consideration of any major public health challenge.     

Dilemmas of health promotion and political changes in Eastern Europe

Mortality and morbidity trends in the Western and the Easternparts of Europe have differed considerably during the past threedecades. The ‘socialist’ political regimes havebeen largely responsible for the deterioration of health ofthe population. The main features of this unfavourable situationcan be summarized as follows: low value set on man, on humanlife and health; extreme tensions between depressed living standards,aspirations and their gratification; negative effects of thereproduction of the social structure; chronic lack of genuinehuman communities, human relationships and social support, disordersof the value system. The author presents in case study the dilemmasthe Hungarian health promotion programme has to face. In the1990s in Eastern Europe health promotion has to face the followingchallenges: How is it possible to carry out effective preventiveactivities under circumstances of economic crisis, lack of resourcesand the population's declining living standards? What will bethe new responsibilities in prevention related to poverty, deprivationand unemployment? What will the new health care system be like?How should health be promoted in reorganizing local societies,communities? In the Eastern Europe of today, there is a greaterneed than ever before for health promotion.     

Emergence of occupational medical services outside the workplace

A new type of occupational medicine clinic has recently emerged in the United States. These clinics are multispecialty in staffing, are located in hospital outpatient departments, and are affiliated with academic medical centers. Their primary goal is to provide personal health and medical services including diagnosis, treatment, and follow-through of occupationally related diseases. Approximately 15 such clinics have been established in the last several years. A review of the medical, economic, and social forces that have historically shaped the content and scope of occupational medical and health services for workers explains in large part the reasons why many of these clinics have now come into being. Characteristics of eight of these clinics are reviewed in detail. These clinics provide a setting for inter-disciplinary and interspecialty education of personnel and offer the medical community a demonstration of a means for better recognition and treatment of occupationally related illnesses.