某高尔夫球杆生产企业93例职业性手臂振动病调查报告

目的 对某高尔夫球杆生产企业在投产期间出现的93例职业性手臂振动病(HAVD)进行分析,寻找发病原因,为该行业职业卫生监督管理和HAVD控制提供科学依据。 方法 通过现场职业卫生学调查,查阅该企业日常职业卫生监测、职业健康检查等档案以及HAVD诊断和鉴定结果并进行分析。 结果 对27个手传振动操作岗位进行4 h等能量频率计权振动加速度[a_{hw (4)}]检测,其中位数M50、M25和M75分别为7.68、3.09和15.6 m/s2。其中17个点(占62.96%)的a_{hw (4)}超过GBZ 2.2-2007规定限值(5 m/s2)。3种作业a_{hw (4)}的M50比较,差异有统计学意义(H=229.52,P<0.01),进一步两两比较,3种岗位M50值大小依次为:细磨 > 粗磨 > 抛光。2010-2013年共检出观察对象和疑似HAVD 198例。其中107例次申请职业病诊断,诊断鉴定为HAVD的病例93例。接触人群发病率为32.07%(93/290)。病例诊断分级:轻度46例(49.46%)、中度42例(45.16%)、重度5例(5.38%);发病年龄为(37.6±4.7)岁,接触工龄(9.5±3.6)年。轻度、中度、重度患者接触振动工龄的中位数差异无统计学意义(H=1.60,P>0.05)。3种振动作业间的发病率差异有统计学意义(χ2=20.00,P<0.01),进一步两两比较,不同工种的发病率依次为:细磨>粗磨>抛光。 结论 该企业工作场所手传振动岗位超标严重。工人超标超时接触手传振动是导致职业病的主要原因。职业卫生监管部门应高度重视该行业手传振动的危害,督促相关企业改善劳动条件并开展职业健康监护。

Investigation on occupational hand-arm vibration disease in a golf club manufacturing company

Objective To explore the etiology of 93 cases of occupational hand-arm vibration disease(HAVD) in a golf club manufacturer, so as to provide scientific basis for hazard control of HAVD. Methods The investigation on occupational hazards and occupational health work was made. The records of regular monitoring and health examination in this enterprise, the original data of identification and diagnosis of HAVD were evaluated. Results The examination of 4-hour energy-equivalent frequency-weighted vibrating acceleration[a_hw(4)] showed that the percentile 25, 50 and 75 for 27 hand-transmitted vibration posts, were 3.09,7.68 and 15.6 m/s2,respectively. The a_hw(4) for 17 points(62.96%) were higher than the national occupational exposure limits(5 m/s2)in GBZ 2.2-2007. The variation of median value of a_hw(4) for 3 kinds of operations, fine grinding, rough grinding and polishing were significant(H=229.52,P<0.01); Further pair comparison showed the value was in the order:fine grinding > rough grinding > polishing. From 2010 to 2013, 198 cases were found as the observed objects and suspected HAVD. Ninety-three cases were diagnosed as HAVD among 107 cases who applied for the occupational disease diagnosis. The incidence rate of exposed workers was 32.07%(93/290). The characterizations of these cases were:46 cases with mild(49.46%),42 cases with moderate(45.16%)and 5 cases with severe degree; the average age of onset, 37.6±4.7 (25.2 to 49.1)years old; the average exposure time, 9.5±3.6 (0.8 to 19) years. The incidence of HAVD was positively related to αhw(4)values at different processing positions, in the order:fine grinding > rough grinding > polishing. Conclusion The hand-transmitted vibration in this workplace was serious. The main cause of HAVD was the excessive and overtime exposure to variation. It was obvious that there was insufficient or lack of service on detection of vibration at workplaces and early examination and treatment of hand-arm vibration disease in Guangdong Province. The related enterprises and government should recognize such hazards through improving working conditions and carrying out the occupational health surveillance.