半定量风险评估接触指数法在汽车制造业中的应用探讨

目的 探讨半定量接触指数法在汽车制造业中的适用性与局限性。方法 选取某整车制造厂为研究对象，对其职业接触进行指数法风险评估，结合工人毒物接触浓度（计算检测浓度与容许浓度的比值）和人群职业健康检查结果，分析与风险等级结果的一致性。计数资料间比较采用Fisher确切概率法。结果 低、中等、高风险评估结果对应的接触浓度，小于0.1倍职业接触限值的个数分别为75、8、1，在0.1～0.5倍职业接触限值的个数分别为10、6、0，仅1个中等风险评估结果对应的检测结果是大于0.5倍职业接触限值的，呈评估风险越大则检测浓度越高的趋势，且差异有统计学意义（P＜0.05）。29名职业健康异常人员（1名刺激性气体作业职业禁忌证，28名白细胞或中性粒细胞减少），1名为高风险工种，28名为中等风险工种。结论 汽车制造业接触指数法风险等级结果与现场检测浓度有较好的一致性。然而，28名白细胞或中性粒细胞减少的人员评为中等风险不妥当，对应的健康影响风险等级可能偏低。

Discussion on the application of semi-quantitative risk assessment contact index method in automobile manufacturing industry

Objective The study aimed to explore the applicability and limitation of semi-quantitative contact index method in automobile manufacturing industry. Methods A vehicle manufacturer was selected as the research object to assess the effects of occupational exposure, using semi-quantitative risk assessment contact index method. Then this study combined on-site toxicant detection concentration(calculated the ratio of test concentration to allowable concentration) and population occupational health checkup results to analyze the consistency with risk level results. Fisher exact probability method was used for the statistical analysis of enumeration data. Results The results suggested that the number of on-site toxicant detection concentration, which was less than 0.1 times the occupational exposure limit, corresponding to the low, medium and high risk levels was respectively 75, 8 and 1. The number of on-site toxicant detection concentration, which range from 0.1 to 0.5 times the occupational exposure limit, was respectively 10, 6 and 0. Only one ratio corresponding to medium risk assessment result was greater than 0.5. It indicated that the higher the risk of assessment, the higher on-site toxicant detection concentration, and the difference was statistically significant(P<0.05). There were 29 occupational health checkup abnormalities(1 occupational contraindication for irritating gas operation, 28 leukopenia or neutropenia), 1 of which was high-risk job and 28 were medium-risk jobs. Conclusion The risk level results of the automobile manufacturing industry contact index method are in good agreement with the on-site detection concentration. However, it is not appropriate to evaluate 28 cases of white blood cell or neutropenia as medium risk, as the corresponding health impact risk level may be underestimated.