摘 要: 目的 调查119家煤矿企业肺结核体检管理和煤矿工人肺结核发病情况,探讨我国煤矿工人肺结核纳入职业健康体检情况和存在的主要问题。方法 对全国9省54家国有重点煤矿、24家地方国有煤矿和41家乡镇煤矿共119家煤矿企业开展问卷调查,对资料进行统计分析。结果 国有重点煤矿、地方国有煤矿肺结核体检的主要管理部门为企业附属医院(33.3%和41.7%),乡镇煤矿为企业行政管理部门(68.3%)。51.9%的国有重点煤矿和41.7%的地方国有煤矿制定了肺结核体检管理制度,乡镇煤矿均未制定相关制度。109家煤矿(91.6%)无肺结核专职管理人员,31家(26.1%)无肺结核兼职管理人员。2010—2012年,17.3%的国有重点煤矿、33.3%的地方国有煤矿和62.6%的乡镇煤矿未开展岗前职业健康体检,国有重点煤矿岗前肺结核检出率年均47.53/10万人,其他煤矿均未检出病例。国有重点煤矿、地方国有煤矿和乡镇煤矿工人年均在岗体检率分别为51.7%、37.4%和25.0%,肺结核检出率分别为134.86/10万人、472.27/10万人、1 816.75/10万人,未开展在岗体检的企业比例分别为9.3%、27.8%、47.2%。结论 乡镇煤矿缺乏结核病管理制度及管理人员,与地方结核病防治机构缺乏业务联系,工人体检率低,但肺结核检出率高,是煤矿企业肺结核防控的最薄弱之处。相关部门需加强对煤矿工人肺结核的防治管理。 |
关键词: 煤矿工人 肺结核 管理 |
中图分类号: R135.2;R521
文献标识码: A
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基金项目: 中国全球基金结核病项目——煤矿工人结核纳入职业病体检和患病情况的调查(编号:TB12-008) |
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Pulmonary tuberculosis management and incidence survey in 119 coal mining enterprises |
LV Xiang-pei,WANG Li-li,ZHANG Jian-fang,WANG Huan-qiang
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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 To investigate the management of health examination on pulmonary tuberculosis (PTB) and the incidence of PTB among coal mine workers in 119 coal mining enterprises in China, and to discuss the status and main problems of PTB detection being included in occupational health examination among coal mine workers in China. Methods A questionnaire survey was conducted on 119 coal mining enterprises from 54 state-owned key coal mines, 24 state-owned local coal mines and 41 township and village coal mines in 9 provinces of China, and the data were statistically analyzed. Results The administrative departments of PTB examination in state-owned key coal mines and state-owned local coal mines were mainly affiliated hospitals of the enterprises (33.3% and 41.7%), and administrative service divisions of enterprises for township and village coal mines (68.3%). There were 51.9% of state-owned key coal mines and 41.7% of state-owned local coal mines had developed the health examination management system on PTB, but no relevant system was established in township and village coal mines. One hundred and nine coal mines (91.6%) had no full-time managers for PTB, and 31 coal mines (26.1%) had no part-time managers for PTB. From 2010 to 2012, 17.3% of state-owned key coal mines, 33.3% of state-owned local coal mines and 62.6% of township and village coal mines did not carry out pre-employment occupational health examination. The annual incidence rate of pre-employment PTB detection for coal mine workers in state-owned key coal mines was 47.53/100 000, and no cases were detected in other coal mines. The average annual incidence rate of periodic employment health examination among coal mine workers in state-owned key coal mines, state-owned local coal mines and township and village coal mines was 51.7%, 37.4% and 25.0%, respectively. The incidence rate of PTB of the periodic employment health examination among coal mine workers in these mining enterprises was 134.86/100 000, 472.27/100 000 and 1 816.75/100 000, respectively, and the proportion of enterprises without periodic employment health examination was 9.3%, 27.8% and 47.2%, respectively. Conclusion It is the weakest point for the prevention and control of PTB in township and village coal mines, for being lack of tuberculosis management system, management personnel and business connection with the local institutions for tuberculosis control, with lower rate of health examination and higher incidence of PTB of coal mine workers. The relevant departments need to strengthen the prevention and control of PTB among coal miners. |
Keywords: coal mine workers pulmonary tuberculosis management |