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目的分析总结职业性重症中暑(热射病)的成因及职业病诊断。方法对近2年接受诊断的热射病7例临床资料进行分析,依据相关法律法规和技术规范,对热射病的诊断进行探讨。结果 7例临床诊断为热射病,高温环境作业4.3~9.0h后突发意识障碍,中深度昏迷,送当地医院急救,死亡3例。患者均为农民工,22~55岁。职业卫生调查:患者均为体力劳动(Ⅲ级6例),工龄26~152d,发病月份6~8月,5例在≥35℃的户外作业,2例户内作业现场检测WBGT指数超过职业限值。职业病诊断:根据患者职业病危害因素接触史、作业场所的危害因素检测、作业时的气象条件及现场调查结果,结合相关国标规定,明确判定7名劳动者属于高温作业,患者临床表现及辅助检查结果均符合“职业性重症中暑(热射病)”的诊断。结论职业病诊断结论应科学分析,综合判定。用人单位应采取综合性防护措施,预防职业性重症中暑的发生。
Objective To analyze and summarize the causes of occupational severe heat stroke (heat stroke disease) and the diagnosis of occupational diseases. Methods The clinical data of 7 cases of diagnosed fever were analyzed in the past 2 years. According to the relevant laws and regulations and technical specifications, the diagnosis of the disease was discussed. Results 7 cases of clinical diagnosis of heat-ray disease, high temperature environment operation 4.3 ~ 9.0h after sudden disturbance of consciousness, moderate coma, sent to the local hospital emergency, 3 died. Patients are migrant workers, 22 to 55 years old. Occupational Health Survey: All patients were manual labor (Grade Ⅲ, 6 cases), the length of service was 26 to 152 days, the month of onset was from June to August, five patients were working outdoors at ≥35 ℃, and the other two were testing the indoor WBGT index over occupational limits value. Occupational disease diagnosis: According to the history of exposure to occupational hazards, detection of workplace hazards, meteorological conditions and field survey results, combined with the relevant national standard, clearly determine the seven workers belonging to the high temperature operation, clinical manifestations and auxiliary examination results Are in line with “occupational severe heat stroke (heat stroke disease) ” diagnosis. Conclusion Conclusion of occupational disease diagnosis should be scientifically analyzed and synthetically determined. Employers should take comprehensive protective measures to prevent occupational severe heat stroke.