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目的探讨职业性慢性1-溴丙烷(1-BP)中毒事故的职业病危害因素识别、事故处置和职业病诊断的思路。方法采用现场职业卫生调查和应急职业健康检查相结合的方法,对某五金真空镀膜企业发生的群体性职业性1-BP中毒事故进行职业病危害因素识别,对患者进行职业病诊断。结果该企业由于使用含1-BP的清洗剂替代三氯乙烯进行超声波清洗作业,导致4名清洗房作业工人在接触1-BP清洗剂11~13个月后,均出现周围神经系统损害。在企业已经对清洗房进行改造的前提下,事后应急检测结果显示:清洗房空气中1-BP的短时间接触浓度为1 038.800~1 466.100 mg/m3,时间加权平均浓度为371.500~654.100 mg/m3;1-BP清洗剂顶空气中1-BP相对百分比为97.1%。清洗房作业工人班后尿中1-BP水平为25.50~155.64μg/L。4例患者均被诊断为职业性慢性1-BP中毒性周围神经病。结论快速识别中毒事故的职业病危害因素,早期明确职业病诊断,有利于做好1-BP所致职业危害的防治工作。
Objective To investigate the identification of occupational hazards in occupational chronic 1-bromopropane (1-BP) poisoning accidents and the treatment of accidents and occupational diseases. Methods A combination of on-the-spot occupational health survey and emergency occupational health examination was used to identify occupational hazards in group occupational 1-BP poisoning accidents in a vacuum metallization enterprise and to diagnose the occupational diseases. As a result, the company used ultrasonic cleaning using 1-BP-containing cleaning agent instead of trichlorethylene and resulted in peripheral nervous system damage in four cleaning room workers exposed to 1-BP cleaning agents for 11 to 13 months. In the enterprise has been on the premise of the transformation of the cleaning room, after the emergency test results show: 1-BP in the air cleaning room short-term exposure concentration of 1 038.800 ~ 1 466.100 mg / m3, the time-weighted average concentration of 371.500 ~ 654.100 mg / m3; the relative percentage of 1-BP in the 1-BP washer top air was 97.1%. The level of urinary 1-BP in the cleaning room workers was 25.50 ~ 155.64μg / L. All 4 patients were diagnosed as occupational chronic 1-BP toxic peripheral neuropathy. Conclusion Rapid identification of occupational hazards of poisoning accidents, early diagnosis of occupational diseases, is conducive to do a good job of prevention and control of occupational hazards caused by 1-BP.