【作者】 吴昊；

【导师】 金明华； 杨平；

【作者基本信息】 吉林大学 ， 公共卫生（专业学位）， 2022， 硕士

【摘要】 目的:通过分析2019年度长春市135家企业在岗职工的职业健康检查结果,了解企业主要经济类型、规模以及职工身体健康状况,明确不同企业存在的不同职业危害因素,为长春市各企业及有关部门制定有效职业病防治措施提供理论依据。方法:采用回顾性调查的方法,收集2019年度长春市135家企业13695名在岗职工的职业健康检查体检资料进行数据的分类汇总和整理,包括血压、心电图、听力、血常规、胸片、肺功能检测、肝功能检测。利用IBM SPSS 24.0软件和Excel2019进行整理与分析,计数资料用率或构成比表示。差异比较采用卡方检验,检验水准为α=0.05。结果:1.长春市135家企业构成情况及参检人数135家企业分布在长春市7个区,南关区企业数最多为57家(42.22%),经济技术开发区39家(28.89%)、高新技术产业开发区10家(7.41%)、绿园区13家(9.63%)、宽城区8家(5.93%)、长春汽车经济开发区7家(5.19%)、双阳区1家(0.74%),参加健康检查人数分别为2069(15.1%)、687(5%)、737(5.4%)、644(4.7%)、3850(28.1%)、5618(41%)、90(0.7%)。其中大型企业8家(5.93%)、中型企业41家(30.37%)、微小型企业86家(63.70%)。参加体检人数分别为5910人(43.15%)、5089人(37.16%)、2696人(19.70%)。国有、集体企业25家(18.52%)、外商及港澳台13家(8.89%)、私有企业97家(71.85%),参加体检人数分别为8718人(63.7%)、1073人(7.8%)、3904人(28.5%)。2.135家企业参检职工行业分布情况13695名职工中汽车制造行业参加体检人数最多共有7686人(56.12%),其他行业参检人数占比分别为通用机械设备等制造业7.65%、矿物及金属品加工制造业2.83%、木制品等加工制造业5.87%、采矿业13.75%、农副食品加工业4.69%、纺织业1.02%、服务业3.18%、电力热力燃气及水生产和供应业3.46%、批发零售业1.42%。3.长春市135家企业职工健康检查基本情况135家企业共13695名在岗职工参加健康检查,平均年龄为(39.53±9.51)岁,其中最小18岁,最大为68岁。其中女性1622名(11.84%),男性12073名(88.16%)。4.135家企业职工接触有害因素情况接触的主要职业有害因素有噪声、粉尘和苯。其中噪声组参加体检人数为9418人(68.77%)、粉尘组2001人(14.61%)、苯组1714人(12.52%);接触危害因素平均工龄为(6.47±7.79)年,其中接触有害因素职工的工龄在2～10年组别有7657人(55.91%),≤1年组别占25.36%、2～10年龄组别占55.91%、11～20年组别占10.78%、21～30年组别占有5.78%、≥31年组别占2.26%。5.135家企业参检职工职业禁忌证和疑似职业病检出情况本次职业健康检查共有13695人,其中目前未见异常有10709人(78.20%)、需复查238人(2.07%)、疑似职业病有3人(0.02%)、职业禁忌证有22人(0.16%)、其他疾病或异常1897人(13.85%)。疑似职业病与职业禁忌证者主要集中在绿园区和南关区,这两个地区的总检出率分别为0.54%,0.52%;疑似职业病和职业禁忌证总检出率微小型企业>中型企业>大型企业,分别为0.34%、0.26%、0.05%。外商企业>私营企业>国有、集体企业,分别为0.46%、0.25%、0.11%。职业禁忌证和疑似职业病的总检出率女性>男性,分别为0.24%和0.18%。>55岁年龄组总检出率最高占0.47%。苯与噪声混合暴露组总检出率占0.94%,粉尘与噪声混合组占0.29%、噪声暴露组占0.19%、苯暴露组占0.12%、粉尘接触组占0.1%。疑似职业病与职业禁忌证总检出率较高的是纺织业0.71%、通用机械设备制造业0.67%、批发零售业0.51%。6.各项异常指标检出结果13695名职工均参加血压与心电图的体检项目,异常检出率分别为25.60%、12.38%。参加听力体检人数共有9980人,检出人数1864人(18.68%)。参加血常规项目体检人数为1927人血常规总异常率为7.06%,其中白细胞、红细胞、血红蛋白、血小板、中性粒细胞异常率分别为1.45%、0.88%、4.2%、0.31%、1.4%。尿常规、肝功能(谷丙转氨酶)、胸片、肺功能检出率分别为11.31%、20.73%、7.14%、5.10%。综合分析以上结果显示,比较不同行业职工的血压、心电图、听力、血常规、胸片异常率差异均具有统计学意义(P<0.05)。不同年龄、接触有害因素和工龄的职工检测的血压、听力、血常规、心电图、胸片异常率比较差异均具有统计学意义(P<0.05)。不同性别职工的血压、听力异常率比较差异具有统计学意义(P<0.05)。结论:1.本次职业健康检查共检出疑似职业病者3人,职业禁忌证有22人。血压、谷丙转氨酶、听力、心电图异常率较高,135家企业参检职工总体健康状况不容乐观。2.不同行业、年龄、性别、接触有害因素和工龄的参检职工的各项指标异常率存在不同程度的差异。3.本次职业健康检查的企业主要以微小型企业、私营企业为主。135家企业存在的主要职业危害因素是噪声。更多还原

【Abstract】 Objective:Through the occupational health examination results of on-the-job workers in 135 enterprises in Changchun in 2019,understand the scale of the main economic types of these enterprises,the health and differences of employees,and clarify the main occupational hazard factors in different enterprises.To provide a theoretical basis for enterprises and relevant departments in Changchun to take effective occupational disease prevention and control measures.Methods:A retrospective survey was used to collect data on the 2019 occupational health examination medical examinations of 13,695 employees on duty in 135 enterprises in Changchun for the classification and collation of data,including blood pressure,electrocardiogram,hearing,blood routine,chest X-ray,lung function test and liver function test.IBM SPSS 24.0 software and Excel 2019 were used for collation and analysis,and the count data were expressed as rates or composition ratios.Differences were compared using the chi-square test with a test level of α=0.05.Results:1.Composition of 135 enterprises in Changchun and number of participantsThe 135 enterprises were distributed in 7 districts of Changchun,with the highest number of 57(42.22%)in Nanguan District,39(28.89%)in Economic and Technological Development Zone,10(7.41%)in High-tech Industrial Development Zone,13(9.63%)in Green Park,8(5.93%)in Kuancheng District,7(5.19%)in Changchun Automobile Economic Development Zone and 1(0.74%)in Shuangyang District.0.74%),with the number of participants in health checks being 2069(15.1%),687(5%),737(5.4%),644(4.7%),3850(28.1%),5618(41%)and 90(0.7%)respectively.Of these,8(5.93%)were large enterprises,41(30.37%)were mediumsized enterprises and 86(63.70%)were micro and small enterprises.The number of participants in medical examinations was 5910(43.15%),5089(37.16%)and 2696(19.70%)respectively.There were 25 state-owned and collective enterprises(18.52%),13 foreign and Hong Kong,Macao and Taiwan enterprises(8.89%)and 97 private enterprises(71.85%),with 8718(63.7%),1073(7.8%)and 3904(28.5%)participants in the medical examinations respectively.2.Industrial distribution of participating workers in 135 enterprisesAmong the 13695 employees,7686(56.12%)participated in the physical examination in the automobile manufacturing industry,accounting for 7.65% of the general machinery and equipment manufacturing industry,2.83% of the mineral and metal products processing and manufacturing industry,5.87% of the wood products processing and manufacturing industry,13.75% of the mining industry,4.69% of the agricultural and sideline food processing industry,1.02% of the textile industry,3.18%of the service industry,3.46% of the power,heat,gas and water production and supply industry,and 1.42% of the wholesale and retail industry.3.Basic information on health examination of employees in 135 enterprises in ChangchunA total of 13695 on-the-job employees in 135 enterprises participated in health examination,with an average age of(39.53 ± 9.51)years,of which the minimum age is18 years and the maximum age is 68 years.There were 1622 women(11.84%)and12073 men(88.16%).4.Exposure of employees to harmful factors in 135 enterprisesThe main occupational harmful factors are noise,dust and benzene.Among them,9418 people(68.77%)participated in the physical examination in the noise group,2001people(14.61%)in the dust group and 1714 people(12.52%)in the benzene group;The average length of service of workers exposed to hazardous factors is(6.47 ± 7.79)years,of which 7657(55.91%)have been exposed to hazardous factors for 2 ～ 10 years,25.36%for ≤ 1 year group,55.91% for 2～10 years group,10.78% for 11 ～ 20 years group,5.78%for 21 ～ 30 years group and 2.26% for ≥ 31 years group.5.Detection of occupational contraindications and suspected occupational diseases of employees participating in the inspection in 135 enterprisesThere were 13695 people in the occupational health examination,of which 10709(78.20%)had no abnormality,238(2.07%)needed to be rechecked,3(0.02%)suspected occupational diseases,22(0.16%)occupational contraindications and 1897(13.85%)other diseases or abnormalities.Suspected occupational diseases and occupational contraindications were mainly concentrated in Lvyuan District and Nanguan District,with the total detection rates of 0.54% and 0.52% respectively;The total detection rates of suspected occupational diseases and occupational contraindications were 0.34%,0.26%and 0.05% respectively.Foreign enterprises > private enterprises > State-owned and collective enterprises,0.46%,0.25% and 0.11% respectively.The total detection rates of occupational contraindications and suspected occupational diseases were 0.24% and 0.18%,respectively The total detection rate of55 year old age group was the highest,accounting for 0.47%.The total detection rate of benzene and noise exposure group was 0.94%,dust and noise exposure group was0.29%,noise exposure group was 0.19%,benzene exposure group was 0.12%,and dust exposure group was 0.1%.The total detection rates of suspected occupational diseases and occupational contraindications were 0.71% in textile industry,0.67% in general machinery and equipment manufacturing industry and 0.51% in wholesale and retail industry.6.Detection results of various abnormal indicators13695 employees participated in the physical examination of blood pressure and ECG,and the abnormal detection rates were 25.5% and 12.38% respectively.The total abnormal rate of blood routine examination was 7.06%,of which the abnormal rates of leukocytes,erythrocytes,hemoglobin,platelets and neutrophils were 1.45%,0.88%,4.2%,0.31% and 1.4% respectively.The detection rates of routine urine,alanine aminotransferase,chest film and pulmonary function were 11.31%,20.73%,7.14% and5.10% respectively.A total of 9980 people participated in the hearing examination,and1864(18.68%)were detected.Comprehensive analysis of the above results showed that there were significant differences in different regions,enterprise economic types,enterprise scale,employees’ blood pressure,ECG and hearing abnormality rate(P < 0.05).The blood pressure,ECG,hearing,blood routine and chest film of employees in different industries were statistically significant(P < 0.05).There were significant differences in the abnormal rates of blood pressure,hearing,blood routine,ECG and chest film among workers of different ages,exposed to harmful factors and working years(P < 0.05).There were significant differences in blood pressure and abnormal hearing rate between workers of different genders(P < 0.05).Conclusions:1.A total of three suspected occupational diseases were detected in the occupational health examination,and there were 22 occupational contraindications.The rates of blood pressure,glutathione transaminase,hearing and ECG abnormalities were high,and the overall health condition of the workers participating in the 135 enterprises was not optimistic.2.The abnormality rate for each indicator varies by industry,age,gender,exposure to harmful factors and length of service of the participating workers.3.This occupational health inspection is mainly carried out by micro and small enterprises and private companies.The main occupational hazard present in 135 enterprises was noise.更多还原