ICMM职业健康风险评估模型在某金融机具工程项目职业病危害评价中的应用

目的探讨国际采矿与金属委员会（ICMM）职业健康风险评估模型在某金融机具工程项目职业健康风险评估中的适用性,为我国制定相关标准或规范以及职业卫生评价提供科学依据。方法运用该模型的矩阵法和定量法分别对某金融机具工程项目关键岗位的职业病危害进行职业健康风险评估,并对2种方法结果的一致性进行比较,同时运用现场检测结果和相关研究进行结果验证。结果该模型矩阵法和定量法得出结果一致的岗位有2个,不一致的岗位有5个。矩阵法将机加车间车工、铣工、磨工接触噪声所致噪声聋和组装车间装配接触手传振动所致手臂振动病定为中风险,与现场检测结果和相关研究一致。定量法将电子车间焊接岗位的二氧化锡和铅烟的健康风险定为潜在风险,与现场检测结果和相关研究一致。其他岗位职业健康风险2种评估方法基本一致。结论 ICMM职业健康风险评估模型可用于某金融机具工程项目职业健康风险评估,矩阵法和定量法各有优缺点。     

An epidemiologic surveillance program for evaluating occupational reproductive hazards

A noninvasive and inexpensive epidemiologic program for evaluating the possible effects of occupational exposures on fertility is proposed. This surveillance program utilizes reproductive information obtainable from a short questionnaire (1-2 pages in length) or directly from existing medical, employment, or insurance records, and results can be generated readily on a routine basis. This program examines the reproductive experience of the exposed workers in terms of live births compared with that of the US general population with the proper statistical adjustments. It calculates the standardized birth ratios (SBR), adjusting for maternal age, parity, calendar time, and race. Such an analysis will detect whether there is a significant decrease in fertility among a group of employees, and is, therefore, a useful surveillance tool. The proposed method should be viewed as a mechanism to provide an early signal for any potential hazard and to direct priority for other more in-depth epidemiologic or physiologic studies. The procedure is illustrated with data from individuals exposed to EDB, DBCP, and waste-water treatment plant processes. The method can be modified to compare the reproductive performance of an exposed group to that of an internal control group. With an internal control group, additional confounding factors can be taken into consideration. The relative merits of this approach compared to another method of fertility evaluation, semen analysis, are discussed.     

风险评估法结合类比法对建设项目职业病危害预评价探讨

目的探索风险评估法结合类比法在建设项目职业病危害预评价中的应用。方法风险评估方程式：R=MLSN。式中R为评价单元中某种有害因素（尘、毒、噪声等）危害风险值;M为危害因素防护措施权数;L为危害因素发生职业病危害的可能性量化值,等于有害因素超限倍数b与暴露时间t的乘积;S为有害因素可能导致职业病危害严重程度权数;N为暴露人数权数。根据R值划分风险等级,应用和计算各评价单元的风险等级,进而计算建设项目职业病危害风险等级。结果发电升压、锅炉、水处理、中控室等工作场所R值为1～48,风险度分级为Ⅰ级,属低风险;燃料、燃料灰渣处理、维修作业R值为72,属中等风险。项目职业病危害风险综合评估综合风险值33.6,拟建项目职业病危害属于低风险。结论风险评估法与类比法相结合,解决了单独用类比法没有解决的建设项目职业病危害风险程度问题。     

Occupational case-control studies: II. Recommendations for exposure assessment

Obtaining valid and reliable quantitative exposure estimates is a significant challenge in community-based case-control studies in part, because industrial hygiene monitoring data are usually not available and detailed information on the job and work environment is usually not systematically obtained or assessed. To improve the quality and credibility of disease risk information obtained from occupational case-control studies, we recommend that standardized exposure assessment methods be used to derive quantitative exposure estimates. We identify sources of variation inherent to the assessment process, including: the quality of the information reported on the job, industry, activities, and materials; the industrial hygienist's familiarity with the reported job/industry; the probability that the job/industry was exposed, which depends on plant preferences for particular substances, on process technology, and on customer specifications; and variability in workplace characteristics. To improve the reliability of estimating job-related exposures both within and between studies, we recommend that the epidemiologic analyses be conducted with and without data rated to be of poor quality; that contact be made with experts when the study industrial hygienist is unfamiliar with the manufacturing process in question; that existing data bases be used to estimate the probability of exposure; that a data base be developed that describes manufacturing processes; and that explicit criteria based on industrial hygiene principles be used to evaluate workplace characteristics. In addition, a procedure is described for deriving quantitative exposure estimates by using a reference scale of frequently monitored jobs with their associated mean exposure levels. Areas of research are identified to improve exposure assessment in community-based case-control studies.     

重点职业病监测现状及问题对策分析

目的 明确广东省重点职业病危害因素、重点职业病的分布和风险等级,提出重点防控的行业、企业和人群。 方法 2017年对广东省21个地市121个县区接触重点职业病危害因素的劳动者和企业进行监测。收集广东省重点职业病危害相关信息、重点职业病危害因素职业健康检查情况和重点职业病报告情况。 结果 共收集存在5种重点职业病危害因素的企业职业病危害项目申报表61 758份,接触5种重点职业病危害因素的劳动者为1 521 464人次。检测岗位超标率为22.1 %。接触重点职业病危害因素的劳动者接受在岗职业健康检查为597 602人次,疑似职业病检出率为0.51 %,职业禁忌证检出率为2.62 %。矽尘作业工人胸片呈尘肺样改变率为0.43 %,苯作业工人白细胞 < 4 × 10⁹/L者占1.81 %,中性粒细胞 < 2 × 10⁹/L占1.93 %,血小板 < 80 × 10⁹/L占0.14 %。噪声作业工人双耳高频平均听阈 ≥ 40 dB检出率为10.59 %,高温作业工人血糖偏高占5.99 %。局部振动作业工人神经传导速度减慢者占3.00 %。全省共报告职业性矽肺95例,职业苯中毒126例,苯所致白血病29例,职业性噪声聋409例,中暑29例,手臂振动病70例。 结论 职业性噪声聋、苯中毒、矽肺、手臂振动病等4种职业病为重点关注的职业病,接触重点职业病危害因素的劳动者应为重点防护对象。     

Use of qualitative methods to map job tasks and exposures to occupational hazards for commercial fishermen

BACKGROUND: Understanding job tasks and estimating occupational exposures is difficult for self-employed or autonomous workers, who tend to be dispersed, with no fixed workplace, employment records, or historical exposure measurements. METHODS: We used ethnographic methods to collect work information for southern commercial fishermen. Major activities were mapped using the seasonal round, an anthropological tool that records activities of groups whose lifeways depend on natural cycles. RESULTS: Fishermen's work schedules depended on boat size, gear, market fluctuations, and regulations, as well as season. The seasonal round guided the analysis of qualitative data on annual cycles of activities increasing understanding of exposures and their variation. CONCLUSIONS: Combined with detailed exposure information this framework for organizing and categorizing seasonal activities could improve accuracy of exposure information and guide quantitative analysis in work settings that challenge standard exposure assessment methods.     

中山市家具行业职业病危害风险评估

目的了解中山市家具行业目前状况下职业病发生的可能性及危险度,通过风险评估模型分析该行业存在的职业病危害风险程度,为监管机构和企业减少或避免职业病的发生提供对策依据。方法采用MES评价法与量化评分法,对中山市50家家具企业进行固有风险因素与风险抵消因素评估、分析,最后确定其整体危险度。结果对收集到的50家家具企业职业病调查表汇总分析后得出：在固有风险评估中,R1级的为零,R2级的占10％,R3级的占10％,R4级的占66％,R5级的占14％;在风险抵消评估中,不及格的占100％;作整体危险度评估中,14％是中危险度,66％是高度危险,20％是极高度危险。结论中山市家具行业职业病危害风险较高,政府部门必须有针对性地采取控制措施,提高企业对职业病危害的认知程度,加强组织管理,采取预防措施,落实健康监护政策,督导监督监测的完成,保障家具行业从业人员的身体健康。     

北京市海淀区某建筑节能制品有限公司职业病危害现况评价

目的分析北京市海淀区某建筑节能制品企业职业病危害现况,评价企业职业病防治措施效果,提出改进措施,以保护劳动者健康。方法对工作场所进行现场职业卫生学调查,分析作业场所存在的职业病危害因素,并检测其浓度。结果该企业在建设地点、总平面布置、生产工艺和设备布局、车间建筑设计、应急救援措施等方面符合相关的标准规范要求。主要职业病危害因素是木粉尘、噪声和苯系物。木加工车间东和西打磨操作位粉尘检测时间加权平均（TWA）浓度分别为3.5和2.5 mg/m^3,超过国家职业卫生限值;木加工车间周边铣、圆棒榫打孔机操作位和组装车间仿型铣床操作位噪声检测结果 8小时等效声级分别为89.4、90.3和95.5 dB（A）,超过国家职业卫生限值;其余检测浓度均符合国家职业卫生限值。结论该企业职业病危害现状不容乐观,职业病危害防治措施部分需要改进,建议对超标点的防噪声和防尘措施进行改进,加强个体防护,使职业病防治措施符合相关法规标准的要求。     

职业危害风险评估与预警研究

探讨国内外的职业危害风险评估模型和预警系统,比较评估模型和预警系统的优点和局限性,分析职业危害风险评估模型和预警系统的关系,确定与国情相适应的职业危害风险评估方法,构建与经济发展相适应的职业危害监测预警与防控体系。     

苯职业暴露健康风险评价研究及应用

目的对苯暴露的非致癌效应与致癌效应进行职业健康风险的定量评价,为我国职业病危害因素的控制以及职业性肿瘤等严重职业病的预防和管理提供科学依据。方法以某大型化工企业苯乙烯装置为研究对象,采用美国环境保护署(EPA)推荐的健康风险评价四步法,即危害辨识、暴露评价、剂量-反应评价和风险表征,对苯乙烯装置作业工人的苯职业暴露进行健康风险评价。分别以吸入单位风险、参考浓度表示化学毒物的致癌效应、非致癌效应的剂量-反应关系,以危害指数HI(hazard index)、致癌超额风险值(Risktumor)分别对非致癌风险、致癌风险进行表征;针对暴露与风险的不确定性,采用水晶球软件蒙特卡洛模拟方法分析概率分布规律。结果该装置工人84.65%情况下苯导致淋巴细胞计数减少的非致癌效应危害指数HI高于安全阈值1;69.37%的情况下苯导致白血病的超额风险超过了可接受风险水平1.0×10-4。提示风险不可接受,需要采取相应的风险应对措施,降低工人职业健康风险。结论利用职业健康风险评价四步法及蒙特卡洛模拟可以得到非致癌风险、致癌风险值的概率分布及其统计学分布特征,从而为风险管理者提供更准确的信息。     

石油化工行业主要职业危害现状分析

石油化工行业生产工艺复杂、产品种类繁杂，生产过程可产生诸多有毒有害化学物质，对从业者健康造成许多不良影响。本文从石油化工行业化学物质对人体皮肤的损害、生殖和遗传毒性、致癌性危害及职业紧张和压力危害等方面进行综述，为开展进一步的职业防护提供参考。     

Improving the linkages between air pollution epidemiology and quantitative risk assessment

Background: Air pollution epidemiology plays an integral role in both identifying the hazards of air pollution as well as supplying the risk coefficients that are used in quantitative risk assessments. Evidence from both epidemiology and risk assessments has historically supported critical environmental policy decisions. The extent to which risk assessors can properly specify a quantitative risk assessment and characterize key sources of uncertainty depends in part on the availability, and clarity, of data and assumptions in the epidemiological studies.Objectives: We discuss the interests shared by air pollution epidemiology and risk assessment communities in ensuring that the findings of epidemiological studies are appropriately characterized and applied correctly in risk assessments. We highlight the key input parameters for risk assessments and consider how modest changes in the characterization of these data might enable more accurate risk assessments that better represent the findings of epidemiological studies.Discussion: We argue that more complete information regarding the methodological choices and input data used in epidemiological studies would support more accurate risk assessments—to the benefit of both disciplines. In particular, we suggest including additional details regarding air quality, demographic, and health data, as well as certain types of data-rich graphics.Conclusions: Relatively modest changes to the data reported in epidemiological studies will improve the quality of risk assessments and help prevent the misinterpretation and mischaracterization of the results of epidemiological studies. Such changes may also benefit epidemiologists undertaking meta-analyses. We suggest workshops as a way to improve the dialogue between the two communities.     

集成电路芯片生产的职业病危害特点

目的 研究集成电路芯片制造中作业人员的操作特点、接触职业病危害种类以及事故类型。方法 对集成电路芯片制造的生产流程、职业病危害及接触状况的资料进行收集整理。结果 根据生产流程中使用的设备及芯片制造所用原辅材料，论述了生产过程中各设备和操作工序涉及的各类高度、中度毒性化学物质、工艺特殊气体以及电离辐射和非电离辐射等职业病危害因素、作业人员操作特点和易发事故种类。结论 集成电路芯片制造中职业病危害问题值得关注。     

某润滑脂企业职业病危害情况调查

目的 明确某润滑脂企业存在的职业病危害因素及关键控制点,提出合理可行的职业病防护对策。方法 对某润滑脂生产企业下属的润滑脂生产中心3个工段(共20条生产线)、1个成品工段进行了现场职业卫生学调查,并对工人作业过程中接触的化学物质、粉尘、噪声作了检测、分析和评价。结果 劳动者接触的正己烷、环己烷、戊烷、甲苯、二甲苯、苯胺、二苯胺、环己胺、二苯基甲烷二异氰酸酯、石墨粉尘、炭黑粉尘、其他粉尘(轻质碳酸钙)等检测结果均低于10%职业接触限值(OELs);灌装工接触的苯检测结果达到10%OELs;配料工/炼制工接触的苯检测结果达到50%OELs;37%的岗位噪声声级不符合国家职业接触限值。结论 该企业应改进作业现场职业卫生防护设施,加强个体防护用品佩戴管理,完善职业病危害因素检测及职业健康检查工作。     

职业卫生风险评价在某化工企业建设项目职业病危害预评价中的应用

目的对某化工企业建设项目产生的职业病危害进行识别及风险分级,提出职业病危害防护及职业卫生管理建议。方法采用风险评估对该建设项目职业病危害种类、接触、防护、管理等方面进行定性和半定量分析。结果对该建没项目产生的职业病危害因素如氨、异丁烯、叔丁胺及二氧化氮进行风险分级,确定风险水平,分别为中等、低等、低等、中等风险水平,并提出了相应的防护和管理建议。结论该企业拟实施的职业病危害控制措施可行有效。     

基于工作场所中职业病危害作业分级的某蒸压粉煤灰砖厂新建项目职业病危害控制效果评价

目的通过对某新型蒸压粉煤灰砖厂项目产生的职业病危害因素进行检测和对工作场所中职业病危害作业进行分级,了解其用于职业病危害控制效果评价的可行性。方法采用职业卫生现场调查、检测检验法、定量分级法和职业健康检查法相结合的方法进行评价。结果生产过程中工人接触的主要职业病危害因素为粉尘和噪声,搅拌机、轮碾机等工作场所中粉尘作业分级结果为Ⅰ级,制砖机工作场所中粉尘作业分级结果为Ⅱ级,球磨机、轮碾机、制砖机等工作场所中噪声作业分级均为Ⅰ级。结论现场检测法和工作场所职业病危害作业分级相结合,能够更科学地对建设项目的职业病危害控制效果做出综合评价,为企业职业卫生日常管理工作提供依据。     

Scientific basis for an occupational standard for cadmium.

The U.S. Occupational Safety and Health Administration (OSHA) has proposed a revised 8-hour permissible exposure limit (PEL) for cadmium in air of either 1 or 5 micrograms/m3, based upon the prevention of lung cancer and kidney dysfunction. To evaluate the scientific basis for these alternative standards, we compare the OSHA estimates of risk, derived from mathematical modelling of selected studies, to empirical data on lung cancer and kidney dysfunction in the published literature. At least seven epidemiologic studies examine renal tubular proteinuria by cumulative cadmium exposure. Three suggest increased proteinuria at cumulative exposures below 500 micrograms/m3-year (equivalent to a PEL of 11.1 micrograms/m3 over 45 working years). One shows prevalence increasing at cumulative exposures between 100 and 299 micrograms/m3 (equivalent to a PEL between 2.2 and 6.6 micrograms/m3). Insufficient data exist to estimate a no-effect level for kidney toxicity. For lung cancer, qualitative evidence of carcinogenicity in humans is seen in four of five occupational cohorts. Quantitative estimates of risk based on epidemiologic data provide lower and more plausible estimates of lifetime risk than do estimates from a rodent bioassay. The data overall suggest that the PEL for cadmium should not exceed 5 micrograms/m3 to protect workers from kidney dysfunction and lung cancer over a working lifetime.