摘 要: 目的 对重点职业病监测现状、存在问题和对策进行分析,为持续开展监测工作和改进监测方案提供参考。方法 对2015年《重点职业病监测与职业健康风险评估工作方案》的具体实施情况,包括病种和模式,监测点设置,监测的范围、内容、方法、目标和功能等关键项目的现状进行分析。 结果 重点职业病监测现为“7+3”模式,即各辖区在监测国家卫生计生委规定的煤尘(煤矽尘)、矽尘、石棉、苯、铅、噪声、布鲁氏菌等7种职业病危害因素所致的煤工尘肺、矽肺、石棉肺及石棉所致肺癌和间皮瘤、苯中毒及苯所致白血病、铅中毒、噪声聋及布鲁氏菌病等10种职业病的同时,当地可根据实际情况自选3种其他职业病开展监测。监测点由县级行政区调整为市级行政区,监测工作覆盖所辖的所有县级行政区,新监测模式以加强能力建设为主要目的。2015年全国重点职业病监测地市级开展率为95%、区县覆盖率为81%;结果显示,开展职业病危害项目申报的用人单位有31%存在重点职业病危害因素,职业病病人工伤保险待遇落实率约64%,接触7种重点职业病危害因素作业工人在岗期间关键指标异常检出率1.79%~14.04%。在实施过程中,存在信息化水平低、数据处理技术落后、多种来源数据无法关联和贯通、部分收集的数据质量欠佳、自选监测病种分散等问题。结论 应合理界定本工作与职业健康监护、职业病报告等的关系,厘清基于重点职业病监测收集的 “防、治、保”数据开展职业健康风险评估的思路,提高数据质量,加快大数据的信息化建设和数据处理技术,进一步发挥监测和预警功能。 |
关键词: 重点职业病监测 职业健康风险评估 职业病报告 职业健康监护 |
中图分类号: R135
文献标识码:
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基金项目: |
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Analysis on current situation in key occupational disease monitoring and countermeasure to problem |
ZHU Xiao-jun, LI Tao, WANG Dan, XIAO Pei
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National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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Abstract: Objective Analyze the current situation, problems and countermeasures in key occupational
disease monitoring providing reference for its sustainable practice and improvement. Methods The
implementation present status in 2015 according to “Executive Plan on Key Occupational Disease
Surveillance and Occupational Health Risk Assessment”, including some key projects such as species and pattern of disease, setting of monitoring point, range and method of monitoring and its objective and
function, etc. was analyzed. Results The monitoring mode on the key occupational diseases is “7 plus 3”, that means besides coal workers’ pneumoconiosis, silicosis, asbestosis lung cancer or mesothelioma
by asbestos, poisoning and leukemia by benzene, lead poisoning, noise-induced deafness, brucellosis
which all were caused by the seven principal occupational hazards as coal dusts (coal silica dusts),
silica dusts, asbestos, benzene, lead, noise and brucella, etc. according to regulations by national health and Family Planning Commission were monitored, the local authorities might selected three
other occupational diseases to carry out monitoring according to their actual situation. Surveillance sites
were adjusted to municipal level from county level, all the county administrative regions were covered. The new surveillance mode took strengthening the ability as main purpose. The results showed that in
2015, 95% of municipal units carried out the national key occupational diseases surveillance and 81%
counties were covered in China, among the employers declared occupational disease hazard projects, 31% had key occupational disease hazards, about 64% occupational disease patients received their
occupational injury insurance compensation, and the positive rate of key indicators of workers exposed to the 7 key occupational hazards was only 1.79%~14.04% during the post. There were some not a few
problems including poor informatization, behindhand data processing technology, poor quality of some
data, diversity of self-defined monitoring diseases, and etc.. Conclusion The results suggested that the
relationship between key occupational diseases monitoring and occupational health surveillance or
occupational disease reporting should be defined reasonably; the idea on occupational health risk
assessment based on the data from key occupational diseases monitoring needs clarification; the quality of data and the statistics technology for big data should be further improved for better play the
function of monitoring and early warning in the future. |
Keywords: key occupational diseases monitoring occupational health risk assessment occupational disease reporting occupational health surveillance |