【作者】 于丹；

【导师】 石东风；

【作者基本信息】 吉林大学 ， 社会医学与卫生事业管理， 2014， 硕士

【摘要】 X射线自1895年被发现后，便被广泛地应用在了医学领域。现今，放射诊疗工作被分为放射诊断和治疗、核医学与介入放射学等四类来管理。随着X射线在医学领域应用的不断加深，放射诊疗设备不断涌现，接受放射诊疗的患者、受检者逐渐增多，接触放射性操作的医生、护士、技术人员等工作人员的数量也在逐年上涨。如何更好地保护医疗机构放射工作人员的职业健康权益，也越发地重要起来。本文从对国外放射卫生防护制度的分析入手，对我国医疗机构放射工作人员的职业健康管理体制进行了阐述，分析了医疗机构放射工作人员的主要的职业健康权，即职业卫生教育培训权、职业健康检查权、职业卫生防护权、知情权的内涵，目的是通过对资料的收集和整理，对医疗机构的放射工作人员参加职业健康检查、放射防护与有关法律知识培训和进行个人剂量监测情况进行分析，找出其职业健康管理存在的问题，提出相应对策性建议。本文收集资料的方法有以下两种：收集卫生行政部门的数据和发放调查问卷的形式。收集2011年某省医疗机构的放射工作人员参加上岗前和在岗期间放射防护和相关法律知识培训的档案分别为159份和771份；上岗前职业健康检查档案158份、在岗期间档案878份；个人剂量监测档案788份。向医疗机构的放射工作人员随机发放并收回120份调查问卷，实现了100%的回收率。采用SPSS16.0统计软件和Excel2003统计软件、一般描述性统计分析法和卡方检验法对数据进行统计分析。调查结果显示：放射防护和有关法律知识培训方面：培训的内容、形式、考核及放射工作人员对培训的态度都有待改善；职业健康检查方面：体检结果一般发现慢性病和常见病，介入放射工作人员职业健康检查结果异常情况较多，实习学生、研究生、进修人员的职业健康管理情况亟待改善；个人剂量监测方面：从事临床介入工作的人员的人均年剂量当量较高；职业健康档案方面：放射防护和相关法律知识培训、职业健康检查和个人剂量监测的档案并未获得良好的建立和利用；保健休假方面：医疗机构放射工作人员的保健休假并未得到良好的执行。综上，医疗机构放射工作人员的职业健康权益并未得到充分的保障，放射工作人员的职业健康管理工作需要得到进一步的改善。建议通过以下方面加强医疗机构放射工作人员的职业健康管理工作，保障放射工作人员的健康权益。提高职业健康权利保护意识，完善职业健康管理制度建设，强化职业健康管理制度的落实，加强卫生行政部门的监督管理，并处理好多方面的关系，来促进放射工作人员职业健康管理工作的加强和职业健康权益的保护。更多还原

【Abstract】 X-ray has been widely used in the medical field since it was discovered in1895.Nowadays, work of radiodiagnosis and radiotherapy was divided into diagnosis andtreatment of radiation, nuclear medicine and interventional radiology to manage. With thedeepening of application of X-ray in the medical field, emergence of radiation diagnosisand therapy equipment, increasing of patients, the number of doctors, nurses, technicianswho conducts radioactive operation rises year by year. It became more and more importantthat to protect the occupational health rights of radiation workers in medical institutions. Inthis paper, foreign radiological protection system was analyzed, the occupational healthmanagement system of radiation workers in medical institutions of our country wasexplained. Their main occupational health rights, namely the right of occupational healtheducation and training, occupational health examination, occupational health protection,informed consent right was analyzed. The purpose is to research the situation ofparticipating occupational health examination, participating radiological protection and therelevant legal knowledge training, personal dose monitoring. The author tries to investigatethe existing problems of occupational health management of radiation workers in medicalinstitutions, and propose the corresponding suggestions.The method of collecting data is two kinds as follows: to collect data of healthadministrative departments and to issue questionnaire. The files of radiation workers inmedical institutions who received pre-employment training and training after employmentin2011were collected. The numbers are159and771. The files of radiation workers whoreceived pre-employment and regular examination after employment were collected. Thenumbers are158and878.788personal dose monitoring files were collected, too. We select120radiation workers in medical institutions to fill out and retrieve questionnaires. SPSS16.0and Excel statistical software, and descriptive analysis and chi-square test wereadopted for statistical analysis.Results: The content, form, assessment, radiation workers’ attitudes of radiologicalprotection and the relevant legal knowledge training need to be improved. Chronic diseasesand common diseases are often found among the results of occupational health examination.More abnormal examination results of interventional radiation workers are found. Thesituation of occupational health management of interns, post graduates, training personnelneeds to be improved. The per capita annual dose equivalent of interventional radiationworkers is high. The files were not set up and used properly. The system of health carevacation was not carried out properly. Above all, occupational health rights of radiationworkers in medical institutions were not guaranteed fully. Radiation workers’ occupationalhealth management should be further improved.It is suggested that people’s consciousness of occupational health rights should be raised, occupational health management system be completed, the implementation ofoccupational health management system be strengthened. To promote the occupationalhealth management of radiation workers and the protection of their occupational healthrights, health administrative departments’ supervision and management should bestrengthened, and several aspects relationship should be handled appropriately.更多还原