合肥市2007-2009年职业性外伤危险因素的流行病学研究

发布时间：2018-06-23 22:40

本文选题：职业性外伤 + 流行病学　；参考：《安徽医科大学》2011年硕士论文

【摘要】：目的研究一:通过对合肥市企业2007-2009年间职业性外伤的描述性研究,了解本地区职业性外伤在人群、时间及空间的分布特征。研究二:研究与职业性外伤发生有关的影响因素,并重点探讨职业性紧张因素在职业性外伤发生中的作用。为职能部门和企业对职业性外伤的防控重点提供依据,最终达到降低职业性外伤发生率、减少伤害、减轻社会整体负担、提高职工职业生命质量的目的。材料与方法研究一 1.研究对象2007-2009年间合肥市企业发生的、在市人社局登记备案的职业性外伤职工。 2.研究内容内容主要包括:伤者所在单位、伤者姓名、性别、年龄、工种、工龄、职业性外伤发生的地点、时间、受伤方式、受伤程度、事故类别、事故原因和事故经过概要等。 3.统计方法职业伤害发生率、千人负伤率、千人重伤率、千人死亡率等指标描述职业伤害的发生密度。应用圆形分布原理,通过三角函数转换,对季节性资料计算均数、标准差,进行显著性检验。研究二 1.研究对象在详细研究人社局登记资料后,选择马钢集团、长源液压集团和佳通轮胎制造企业这3家职业性外伤发生发生人数最多的企业作为研究现场,采用病例-对照流行病学研究方法,以发生职业性外伤者为病例,按1:1频数匹配的方法从未发生职业性外伤的职工选择对照。 2.研究内容包括调查(1)对象一般情况,如性别、年龄、身高、体重、工龄、文化程度、平均月收入等社会人口学信息。(2)职业性外伤发生情况,如受伤地点、发生时间、受伤部位、伤害程度、职业伤害类别等。(3)职业伤害一般影响因素,如吸烟史、饮酒史、疾病史、工作满意度、职业卫生知信行、性格特征等。(4)职业紧张情况:采用修订版职业紧张目录问卷(occupational stress inventory - revised edition,OSI-R)测量调查对象的职业紧张情况。 3.统计方法用Epidata 3.0建立数据库,SPSS 11.5 for windows软件包对数据进行统计分析。病例组与对照组间一般情况的比较采用χ2检验;病例组与对照组之间的职业紧张状况比较采用t检验;用单因素Logistic回归以及多因素Logistic回归探讨职业性伤害的危险因素。结果研究一:每年职业伤害的千人死亡率呈下降趋势,职业性外伤千人负伤率和千人重伤率均呈逐年递增趋势。在职业伤害发生的时间分布中,轻伤在七月份发生的较多,但是重伤和死亡的分布没有明显特征。在一个月中,下旬发生伤害可能性最高。职业伤害的发生,男性远高于女性,男女之间的比例为3:1。职业伤害中,轻伤的年龄分布以26岁组及38岁组为主,重伤的年龄分布以36岁组以及40岁组为主。发生伤害危险性最大的是:驾驶员、钳工、焊工、维修工、服务员、成型工、车工、厨师、理货员、电工、保洁工、保安、操作工及其他。重伤和死亡的工种第一位是操作工。职业伤害其伤害类型主要有物体打击、触电、淹溺。受伤部位的排序是上肢及手、下肢及足、面颌部、胸腹部躯干、颅脑及其他。重伤的部位是胸腹部躯干排在第一位,死亡则是胸腹部躯干、及颅脑排在前两位。研究二:病例对照研究结果显示,职业伤害的发生与工人工资收入、健康状况以及婚姻状况有关联,工龄越长,工资越高、健康状况越好,发生伤害的可能性越小,离婚的职工发生职业伤害的可能性最大。病例组和对照组相比,病例组的职业任务总分(ORQ)、任务过重(RO)、任务不适(RI)、任务模糊(RA)、工作环境(PE)、业务紧张反应(VS)、人际关系紧张反应(IS)、躯体紧张反应(PHS)、紧张反应总分(PSQ)和自我保健(SC)得分较高;任务冲突(RB)、责任感(R)、心里紧张反应(PSY)、应对资源总分(PRQ)、娱乐休闲(RE)、社会支持(SS)以及理性处事(RC)得分较低。任务不适(RI)、应对资源总分(PRQ)、娱乐休闲(RE)以及理性处事(RC)得分差异有统计学意义,其中应对资源较高是职业伤害的保护因素。OSI-R各分量表及子项得分与技术工人常模比较,调查对象的职业任务总分、任务过重、任务不适、任务冲突、任务模糊、责任感、应对资源总分、娱乐休闲、自我保健、社会支持、理性处事得分较低;工作环境、紧张反应总分、业务紧张反应、躯体紧张反应得分较高;与心理紧张反应、人际关系紧张反应得分的差异没有统计学意义。与西南地区职业人群常模比较,调查对象责任感、应对资源总分、社会支持、娱乐休闲、理性处事得分较低;职业任务总分、任务不适、任务模糊、任务冲突、工作环境、紧张反应总分、业务紧张反应、人际关系紧张反应、躯体紧张反应得分较高;与任务过重、心理紧张反应、自我保健得分的差异没有统计学意义。职业任务适度/相对缺乏紧张者占89.4%,适度/相对缺乏紧张反应者占99.5%,适度/很强应对资源者占75.5%。但任务冲突、工作环境、责任感、业务紧张反应、心理紧张反应、躯体紧张反应高度/中度紧张者分别占13.4%、24.5%、6.6%、25.1%、14.6%和24.3%;理性处事、社会支持高度/中度缺乏者分别占28.5%和16.1%。工作满意度得分差异有统计学意义,OR值㩳1。本调查结果显示,工资收入、待遇满意、应对资源和工作时佩戴个人防护用品是职业伤害的保护因素。结论研究一:应重点保护工龄短的职工,在伤害高发时间应加大安全生产的宣传和监督,对于一些伤害高发岗位应该进行针对性培训,应比照不同行业工种的易受伤部位来佩戴个人安全防护用品。研究二:职工的业务培训、健康教育、心理疏导以及工效学等方面要进一步加强,在进行职业紧张干预时,要重视对高危人群的关注。
[Abstract]:Objective: To study the occupational trauma in Hefei in the past 2007-2009 years, to understand the distribution characteristics of occupational trauma in the population, time and space. Study two: the factors related to occupational trauma and the role of occupational stress in occupational trauma. The functional departments and enterprises provide the basis for the prevention and control of occupational trauma, and finally achieve the goal of reducing the incidence of occupational trauma, reducing the injury, reducing the burden of the whole society and improving the quality of life of the workers.
Materials and methods
Research one
1. in the 2007-2009 years of study, occupational injury workers registered in Hefei City People's social Bureau were recorded.
2. the contents of the study include the unit of the injured, the name of the injured, the name of the injured, the sex, the age, the work, the working age, the location of the occupational injury, the time, the way of injury, the degree of injury, the category of the accident, the cause of the accident and the summary of the accident.
3. the incidence of occupational injury, the rate of 1000 people's injury, the rate of 1000 people's serious injury, and the mortality of thousands of people describe the density of occupational injuries. The principle of circular distribution is used to calculate the average number of seasonal data and the standard deviation, and the significant test is carried out.
Study two
1. after a detailed study of the registration data of the social Bureau, the subjects selected Masteel group, Changyuan hydraulic group and Giti tire manufacturing enterprise as the research site, and used the case control epidemiological study method to take cases of occupational trauma, which matched the frequency of 1:1 frequency. The law did not choose occupational controls.
2. the content of the study included the survey (1) the general situation of the subjects such as sex, age, height, weight, age, education, average monthly income and other social demography information. (2) the occurrence of occupational injuries, such as the location of the injury, the time of occurrence, the site of injury, the degree of injury, the category of occupational injuries, etc. (3) the general influence factors of occupational injury, such as the history of smoking, drinking Wine history, disease history, job satisfaction, occupational health information, personality characteristics, and so on. (4) occupational stress: using the revised version of the occupational stress directory questionnaire (Occupational Stress Inventory - Revised Edition, OSI-R) to measure the occupational stress of the subjects.
3. the statistical method used Epidata 3 to establish a database, SPSS 11.5 for Windows software package for statistical analysis of the data. The general situation of case group and the control group was compared by chi square test; the occupational stress between the case group and the control group was compared with the t test; the occupation with the single factor Logistic regression and the multiple factor Logistic regression were used to explore the occupation. Risk factors for sexual injury.
Results 1: the mortality of thousands of people with occupational injuries was declining every year, the rate of occupational trauma and the rate of heavy injuries were increasing year by year. In the time distribution of occupational injury, the light injuries occurred more in July, but the distribution of heavy injuries and deaths was not obvious. In the middle of the month, the injury occurred. The possibility is the highest possibility. The incidence of occupational injury is far higher than that of women. The proportion of men and women is 3:1. occupational injury. The age distribution of light injuries is mainly 26 years old and 38 years old. The age distribution of serious injuries is 36 years old and 40 years old. The biggest risk of injury is driving driver, fitter, welder, maintenance worker, molding worker, car Job, chef, taller, electrician, electrician, cleaning worker, security, operator and other. The first job of heavy injury and death is the operator. The main injury types are body strike, electric shock, drowning. The injured parts are the upper limbs and hands, lower limbs and feet, facial jaw, chest and abdomen, craniocerebral and other. The site of serious injury is thoracic and abdominal torso. In the first place, the death was the chest and abdomen torso and the top two. Study two: the case control study showed that occupational injuries were associated with wages, health and marital status of workers, the longer the work age, the higher the wages, the better the health, the less possible injury, and the occupational injury to the divorced workers. The case group was most likely to be harmful. Compared with the control group, the occupational task score (ORQ), task discomfort (RO), task discomfort (RI), task ambiguity (RA), work environment (PE), business tension response (VS), interpersonal tension response (IS), body tension reaction (PHS), tension reaction (PSQ) and self-health (SC) were higher; task conflict (R) B), sense of responsibility (R), psychological stress response (PSY), coping with resource total score (PRQ), entertainment and leisure (RE), social support (SS) and rational execution (RC) with low score. Task discomfort (RI), coping with total score of resources (PRQ), recreational (RE), and rational (RC) scores are statistically significant, in which the higher resource is the protection factor of occupational injury. The scores of I-R components and subitems were compared with those of the technical workers. The total scores of the subjects, the heavy tasks, the task discomfort, the task conflict, the task blur, the sense of responsibility, the total score of the resources, the entertainment and leisure, the self health care, the social support, the rational service score were lower, the working environment, the tension reaction total score, the business tense reaction and the body tight. The score of tension reaction was higher, and the difference of interpersonal tension reaction score was not statistically significant with the psychological stress reaction. Compared with the professional crowd in the southwest, the sense of responsibility, the total score of the resources, the social support, the entertainment and leisure were lower, the total score of the job, the task discomfort, the task blurry, the task conflict, and the work. The total score of stressful response, stressful reaction, stressful response, and somatic stress score were higher in the environment. There was no significant difference in the score between the heavy task, the psychological stress reaction and the self health care. The moderate / relative lack of tension accounted for 89.4%, the moderate / relative lack of tension responders accounted for 99.5%, moderate / strong coping. The resource holders accounted for 75.5%. but the task conflict, working environment, responsibility, business tension reaction, psychological stress reaction, high / moderate strain of somatic tension reaction were 13.4%, 24.5%, 6.6%, 25.1%, 14.6% and 24.3%, rational and social support high / moderate lack of 28.5% and 16.1%. work satisfaction score difference was statistically significant, OR 1.. The survey results show that wage income, treatment satisfaction, coping with resources and wearing personal protective equipment at work are protective factors of occupational injuries.
Conclusion Study 1: should focus on the protection of workers with short work age, should increase the publicity and supervision of safety production in the time of high incidence of injury, should carry out specific training for some high incidence of injuries, and should wear personal safety protection articles compared to the vulnerable parts of different industries. Research two: staff training, health education, and psychology Counseling and ergonomics should be further strengthened. Attention should be paid to high-risk groups when intervening in occupational stress.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R135;R181.3

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