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。

Surveillance and occupational health risk assessment for major occupational diseases in Guangdong province, 2017

Objective To examine the prevalence and risk level of major occupational diseases in Guangdong province for identifying industries, enterprises, and workers at high risk of the diseases. Methods We collected and analyzed surveillance data (including hazards exposure, physical examination and disease report) of 2017 on major occupational diseases in enterprises and among workers in 121 counties of 21 municipalities of Guangdong province. Results Totally 61 758 report forms for hazards related to 5 major occupational diseases were submitted and 1 521 464 person times of exposures to the hazards were reported during the year in the province. Higher levels of hazards than national standards were detected for 22.1% of all the samples collected at monitoring sites. For a total of 597 602 person-times of occupational health examination conducted among the workers exposed to risk factors of the 5 major occupational diseases, the detection rate of suspected occupational diseases was 0.51% and that of occupational contraindications was 2.62%. Of the workers exposed to silicon dust, 0.43% showed pneumoconiosis-like changes by chest radiography. For all the benzene-exposed workers, 1.81%, 1.93% and 0.14% were detected with the leukocyte count less than < 4 × 10⁹/L, the neutrophil count < 2 × 10⁹/L and the thrombocyte count < 80 × 10⁹/L. The detection rate of the high frequency average hearing threshold of greater than 40dB was 10.59% in noise-exposed workers. The proportion of high blood glucose was 5.99% among the high temperature-exposed workers. Decreased velocity of nerve conduction was detected among 3.00% of vibration-exposed workers. In the province during the year, the total number of occupational disease cases regiestered was 95 for occupational silicosis, 126 for benzene poisoning, 29 for benzene-related leukemia, 409 for hearing loss, 29 for heatstroke, and 70 for hand-arm vibration disease, respectively. Conclusion Special attention should be paid to the prevention and control of occupational hearing loss, benzene poisoning, silicosis, hand-arm vibration disease among workers with related hazards exposure.