广州市职业卫生技术服务工作回顾与展望

广州市1990～2000年职业卫生技术服务工作，主要是经常性监督、检测和定期职业性体检，在此基础上，还建立了职业健康监护系统。如为2686家企业建立职业卫生档案，为424843名工人及365597名机动车驾驶员建立了职业健康档案，建立了部分数据库，开展了一些追踪研究。通过对965家乡镇企业和768家“三资”企业的劳动卫生抽样调查，基本上掌握了7万多家乡镇企业和3000多家“三资”企业职业卫生状况，实施了劳动卫生许可证制度；对10234个职业危害作业点进行了分级评价、挂警示牌，并推行告示周知卡制度，使劳动者享有知情权。职业病发病率由80年代初的16／10000下降至6／10000。其主要缺陷是：监督与技术服务混为一体、建设项目职业病危害评价未得到有效实施、政府尚未真正把职业卫生纳入公共卫生范畴。因此，未来10年应根据《职业病防治法》，从源头上控制和消除职业病危害，目标是使广州市职业病发病率控制在5／10000以下、突发性职业中毒事故下降50％以上，并在2010年杜绝矽肺病新发病例。

Review and outlook on technical services of occupational health in Guangzhou

The technical services of occupational health in the past years in Guangzhou,mainly were usual inspection,monitoring and occupational physical examination.The major achievements included:(1)setting up occupational health surveillance system;(2)establishing occupational health records for 2 686 factories and individual health records for 424 843 workers and 365 597 drivers-some of them were used as the objects of a cohort study;(3)completing a sampling survey on industrial hygiene situation in 965 village-township factories (small scale factories) and 768 foreign enterprises;(4)practicing the institution of labor hygiene license,occupational hazard classification of worksite,warning cards and notice boards of occupational hazards.As a result,the incidence of occupational diseases dropped from 16/10 000 in early 1990's to 6/10 000.The major defect in the past decade seems that the occupational health inspection was not separated from technical services,and the occupational hazard evaluation for construction projects was not implemented.Therefore,during the coming decade,the occupational hazard must be controlled or eliminated from their start stage,the expectant incidence of occupational diseases in Guangzhou would be reduced as low as less than 5/10 000,and no new case of silicosis occurs since 2010.