加油站职业卫生与从业人员健康状况的研究

发布时间：2018-01-15 23:19

本文关键词：加油站职业卫生与从业人员健康状况的研究　出处：《泰山医学院》2013年硕士论文　论文类型：学位论文

【摘要】：目的通过本项现况调查，了解加油站职业卫生与从业人员健康状况及影响因素，初步掌握在工作过程中经常接触汽油污染的危害现状，为加油站汽油暴露人群的作业环境危险性评价提供基线资料，对存在的职业卫生问题提出整改建议，为职业性汽油中毒和职业性皮肤病防治及监督管理提供科学依据。研究方法采用分层按比例随机抽取的方法，从泰安市所辖加油站中抽取114个站进行现状调查，依据国家职业卫生相关规范、标准及检测方法进行现场检测，，获得相关数据组资料；利用自行设计调查问卷，对观察组（114个加油站从业人员）、对照组（未接触汽油的超市服务员）两组人群进行职业健康查体并获得相关数据资料。所有数据进行统计分析，定量资料两组比较采用t检验，多组比较采用方差分析，定性资料采用卡方检验，采用logistic回归分析发现相关职业病危害因素。结果第一部分加油站现状分析 1、加油站职业卫生管理制度建立与实施情况所调查加油站大多未建立各种职业卫生管理制度，仅有2个（1.8%）的加油站有比较完善的职业卫生管理制度。有94.7%的从业人员未进行上岗前职业健康检查，在岗定期检查也是少之又少，仅有2个（1.4%）有定期检查。另外，有11个（9.6%）加油站的作业现场没有设置警示标识和职业病危害因素告知卡，从业人员缺乏相关职业卫生知识和防护意识。 2、现场汽油浓度检测本次检测溶剂汽油加油站114个，合格加油站112个(超限倍数)，合格率98.2%。由现场汽油浓度检测结果可见，瞬间质量浓度最大为426.2mg/m~3，98.2%的样品浓度均小于300mg/m~3，且92.7%样品小于100mg/m~3，据此估计其时间加权平均容许浓度可能也多在国家职业卫生接触限值内。正常工作时间，加油站从业人员属于低浓度长期接触。第二部分加油站从业人员职业健康状况及职业病危害因素对健康的影响 1、两组人群调查指标比较观察组头晕头痛、失眠多梦、记忆力减退、注意力不集中、皮肤干燥皲裂等方面的自我感知有疾患的比例均高于对照组（P0.01）。 2、对工作场所环境条件满意程度观察组有66.9%、对照组44.6%的人员对工作场所的环境条件表示不太满意或很不满意，两组比较差异有统计学意义（Z=11.984，P0.01）。 3、查体情况分析观察组各指标异常检出率分别为：血压（17.8%），白细胞（9.8%）、红细胞（12.7%）、血红蛋白（21.4%）、血小板（7.9%）等血液常规，肝功能（5.4%）、血脂（28.2%），尿常规（25.4%），脂肪肝（18.8%），神经衰弱综合征（16.8%），皮肤干燥皲裂（14.1%），上述指标异常检出率均高于对照组（P0.05）。 4、对职业病危害因素认知及其培训需求情况只有5.8%从业人员认为自己对工作场所的职业病危害因素认识比较多，还有33.2%的从业人员认为对工作场所的职业病危害因素认识很少，甚至不了解。有74.0%的从业人员认为非常需求职业病危害因素认知与防护措施相关内容的培训。 5、观察组职业病危害因素影响分析单因素分析影响从业人员健康的主要职业相关因素有：性别、工龄、工种、地理位置、汽油浓度是否达到国家规定的标准、工作期间平均每小时直接接触汽油时间（分钟）、从业人员对职业病危害因素的认知程度、个人防护措施的实施情况、从业人员对工作场所环境方面的满意度等。多因素分析logistic回归分析结果显示，影响从业人员健康的主要职业病危害因素是汽油达标情况、工作场所位置、工龄、对危害因素的认知情况、对工作场所是否满意等几个因素具有统计学意义（P0.05）。其中，汽油浓度不达标、工龄（10年及以上）是从业人员职业病危害因素中最主要的危险因素，OR分别是2.137、4.830。结论第一部分加油站基本情况 1、目前泰安市加油站职业卫生管理制度几乎没有，企业对从业人员的职业防护及管理上存在严重的缺陷。 2、泰安市还有1.8%的加油站检测溶剂汽油不符合国家卫生标准。需要职业卫生监督管理部门采取措施强制执行，并定期检查实施情况。第二部分加油站从业人员职业病危害因素及职业相关因素对健康的影响 1、本项研究显示，长期低浓度接触职业病危害因素（汽油），对人体的血液指标、尿常规、神经系统、皮肤等都会造成一定的损害。目前国内很少有对加油站从业人员的健康状况进行系统的流行病学研究，尤其是对工龄长的加油站从业人员健康状况、潜在的危害、易患的疾病进行系统的检测和随访观察性研究是十分必要的。 2、分析结果表明，对工作中有毒有害因素的认知及防护措施等职业相关因素也会对健康产生影响。从业人员的健康还可能与对工作场所、工作性质、加油工作量和暴露汽油的时间的及自我防护等相关因素有关。
[Abstract]:objective
Through the investigation of the current situation, understand the health status and influencing factors of occupation health practitioners and gas station, preliminary master hazards often exposed to gasoline pollution in the work process, and provide baseline data for the risk assessment of gas station operation environment exposure, put forward improvement suggestions on occupation health problems, and provide scientific basis for occupation and occupation of gasoline poisoning skin disease prevention and supervision and management.
research method
According to the method of stratified random sampling proportion, from Tai'an city gas station 114 stations from the investigation, according to the national occupation health related norms, standards and methods of field detection, to obtain the relevant data sets of data; using the self-designed questionnaire, the observation group (114 gas station employees). The control group (not exposed to gasoline supermarket attendant) two groups of occupation health examination and obtain the relevant data.
All data were statistically analyzed. Quantitative data were compared between the two groups by t test. Multiple groups were compared by ANOVA, qualitative data were analyzed by chi square test and logistic regression analysis was used to identify occupational hazards.
Result
The analysis of the status of the first part of the gas station
1, the establishment and implementation of the occupational health management system in gas stations
The investigation of gas station are not set up the management system of occupation health, only 2 (1.8%) of the gas station has occupation health management system is more perfect. There are 94.7% employees without pre post occupation health examination, regular inspection is less and less, only 2 (1.4%) are regularly checked.
In addition, there were 11 (9.6%) gas stations with no warning signs and occupational hazards notification cards, and employees lacked occupational health knowledge and awareness.
2, detection of gas concentration in the field
The test of gasoline gas station gas station 114, qualified 112 pass rate (exceeded multiples), 98.2%. by the gasoline concentration detection results show that the instantaneous concentration maximum concentration of 426.2mg/m~3,98.2% was less than 300mg/m~3, and 92.7% samples of less than 100mg/m~3, which estimates the time weighted average concentration may also in the national occupation health exposure limit. The normal working hours, gas station employees belong to the long-term exposure to low concentration.
The occupational health status of the second gas station employees and the impact of occupational hazards on health
1, two groups of population survey index comparison
The self perception of dizziness, headache, insomnia, dreaminess, memory loss, attention deficit, dry and chapped skin in the observation group were higher than those in the control group (P0.01).
2, the degree of satisfaction to the environmental conditions in the workplace
66.9% of the observation group and 44.6% of the control group were not satisfied with or satisfied with the environmental conditions of the workplace. The difference between the two groups was statistically significant (Z=11.984, P0.01).
3, analysis of physical examination
The observation group each index respectively: the detection rate of abnormal blood pressure (17.8%), white blood cells, red blood cells (9.8%) (12.7%), hemoglobin (21.4%), (7.9%) and platelet blood routine, liver function, blood lipid (5.4%) (28.2%), urine (25.4%), fatty liver (18.8%), nerve weak syndrome (16.8%), dry chapped skin (14.1%), the detection rate of abnormal indicators were higher than the control group (P0.05).
4, the cognition of occupational hazards and the training needs
Only 5.8% of employees think of themselves in the workplace occupation hazards know more, there are 33.2% employees that occupation hazards in the workplace know little, don't even know. There are 74% employees that very demand occupation hazards and protective measures of cognition related content of the training.
5, analysis of the influence factors of occupational disease in the observation group
Univariate analysis of factors related to the main occupation health practitioners are: gender, age, type, location, whether the concentration of gasoline reached the national standard, the average per hour during the work time in direct contact with gasoline (minutes), practitioners of cognitive degree of occupation disease harms factors, the implementation of personal protective measures, employees staff of the workplace environment in terms of satisfaction.
Multivariate analysis of logistic regression analysis showed that the main occupation disease practitioners health hazard factors affecting gasoline standards, workplace location, seniority, cognition of risk factors, in the workplace are satisfied with statistical significance (P0.05). Several factors including gasoline, concentration of non-compliance, age (10 years and above) is the most important risk factors of employees in occupation disease harm factors, OR is 2.137,4.830.
conclusion
The basic situation of the first part of the gas station
1, at present, there are almost no occupational health management systems in Tai'an gas stations, and there are serious defects in the occupational protection and management of the employees.
2, 1.8% of the gas stations in Tai'an have tested that solvent gasoline is not in line with national health standards. Occupational health supervision and management departments need to take measures to enforce them and check regularly.
Effects of occupational hazards and occupational related factors on health in the second part of gas station employees
1, this study shows that long-term exposure to low concentration occupation hazards (gasoline), on blood indexes, human urine, nervous system, skin will cause certain damage. At present, there are few domestic epidemiological study of the health of employees of the gas station, especially for service the health status of gas station employees, potential hazards, detection and follow-up observational system for disease susceptibility is very necessary.
2, analysis results show that will have an impact on the health of the poisonous and harmful factors in cognition and protective measures of occupation related factors. Health practitioners may also and in the workplace, the nature of the work, the relevant factors related to workload and exposure time of gasoline fuel and self protection.

【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R131

【参考文献】