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目的探讨干预措施对企业职业危害风险的影响。方法于2003—2009年期间采用问卷调查、现场检查、现场检测等方法对珠三角地区(广州、惠州)的84家化工企业进行职业危害风险预评估、干预及其效果评价。采用风险评价法,建立可行性评价模型(包括危害等级的判定、职业卫生管理的考评评定、工人接触职业病危害因素剂量水平的评定、职业病发生风险评定),分析其干预前后职业危害风险的变化。结果干预前84家企业危害等级从低至高依次为:极低~极高5级,构成比分别为2.4%、7.1%、20.2%、31.0%、39.3%;职业卫生管理风险等级评定干预前、后各年份比较差异均有统计学意义(P(0.01),其中干预后第5年为低风险(3级及以下)的企业82家,比干预前(30家)增多,高风险(4级及以上)的企业从干预前的54家减少至2家,比干预后第1年(0家)有所增加;接触职业病危害因素剂量水平风险等级干预前、后各年份比较差异均有统计学意义(P(0.01),其中干预后第5年为低风险(3级及以下)的企业77家,比干预前(39家)增多,高风险(4级及以上)企业7家,比干预前(45家)减少,比干预后第1年(0家)有所增加。结论实施干预措施能明显降低化工企业在职业卫生管理与劳动者接触剂量水平方面的职业危害风险,但须防止高风险的回归。
Objective To explore the impact of interventions on the occupational hazards of enterprises. Methods During the period of 2003-2009, 84 chemical enterprises in the Pearl River Delta (Guangzhou, Huizhou) were pre-assessed, intervened and their effects evaluated by questionnaires, on-site inspections and on-site tests. The risk assessment method was used to establish the feasibility evaluation model (including the judgment of the hazard level, the appraisal and evaluation of occupational health management, the assessment of dose level of workers exposed to occupational hazards and the risk assessment of occupational diseases), and the changes of occupational hazards before and after the intervention were analyzed. Results The hazard rankings of 84 enterprises before intervention were as follows: extremely low to very high grade 5, with the proportions of 2.4%, 7.1%, 20.2%, 31.0% and 39.3%, respectively; Occupational Health Management Risk Assessment Before intervention, (P <0.01). Among them, there were 82 low-risk (grade 3 and below) enterprises in the fifth year after intervention, which was higher than that before the intervention (30), high risk (grade 4 And from the 54 pre-interventions to 2, an increase from the first year after the intervention (0). Exposure to occupational disease risk factors Dose level Risk level Before and after intervention, there were statistically significant differences between years (P <0.01). Among them, 77 were low-risk (grade 3 and below) in the fifth year after intervention, which was higher than that before the intervention (39) and seven were high-risk (grade 4 and above) (45) decreased, which was higher than that in the first year (0) after the intervention.Conclusion The implementation of interventions can significantly reduce the risk of occupational hazards of chemical enterprises in occupational health management and workers exposure dose levels, but should prevent high Return of risk.