国际航行船舶中国船员职业健康状况和职业健康教育需求研究
发布时间：2018-09-17 18:02
【摘要】：背景与目的：海洋运输是国际物流中最主要的运输方式,国际贸易总运量中的2／3以上,我国93%以上的外贸运输任务是通过海运完成的。中国海运事业发展迅猛,船队总吨位排行世界第九位,船舶数量排行世界第四位。中国有155万船员,其中海员65万人,是世界上拥有海员数量最多的国家,海员年培养规模达4.6万人,外派海员达10万多人次。 船员长时间的海上工作,无规律的海上生活,信息闭塞、新鲜食物缺乏、船体摇晃、长时间的噪音、持续的振动、电磁辐射环境和高温高湿、疲劳、特殊的职务岗位特点和值班制度等对船员职业健康造成多种损害。 本次调查主要对从宁波口岸入境国际航行船舶上的中国船员进行调查,通过调查了解国际航行船舶中国船员职业健康情况和职业卫生知晓率的一系列相关指标、变量数据的真实情况,具体地反映国际航行船舶中国船员生理和心理健康状况,掌握船员职业卫生知识知晓率和健康教育需求及其影响因素,从中分析出中国船员职业健康危害因素和职业卫生掌握的限制因素,对今后改善船员生活、工作环境提供数据资料,为制定针对船员的健康教育干预策略和职业性疾病控制提供依据,促进中国船员职业健康管理模式改进。 材料与方法 1.研究对象的选择 本次调查研究对象是国际航行船舶上的中国船员,在调查期内对通过宁波口岸入境船舶上中国船员进行随机抽样调查,共调查66艘次国际航行船舶(中国籍13艘次,外籍53艘次)上331名中国船员。 2.调查方法 采用调查表和现场访谈两种调查方式,调查内容包括船员个人资料、职业基本情况、船员健康状况和健康行为、职业卫生知晓率、健康教育需求五个部分。 3.资料统计分析 对调查表进行汇总,将调查表经统一编码,确定统计变量类型和名称,采用Epi data3.1中文版按照调查表编制数据录入界面和质量控制条件,由专业人员输入计算机建立数据库。采用SPSS17.0软件进行统计,并对船员身心健康、职业卫生知晓率、健康教育需求对比分析,进行综合评价,提出职业性疾病防控措施和船员健康教育干预策略。统计分析方法包括一般统计描述、两独立样本u检验. Pearson卡方检验、两独立样本Wilcoxon秩和检验、多个独立样本Kruskal-Wallis H检验、Spearman秩相关分析、非条件Logistic回归模型。统计推断的检验水准取α=0.05。 4.质量控制 设计阶段明确主观感受和客观情况定义,进行预调查验证调查表质量,-现场调查阶段注重调查员培训、选择偏倚和测量偏倚控制；数据处理阶段通过核查程序和人工静态检验确保数据准确。 结果 1.国际航行船舶中国船员基本情况 本次调查331名中国船员平均年龄37.5岁(37.5±10.9),全部为男性船员,汉族占95.8%,95.7%船员有宗教信仰,已婚占71.6%。船员文化程度以高中／中专所占比例最多,达41.5%,文化程度以初中至大专为主,文化程度形成两端少中间多的橄榄形态；船员月收入中2000-5000船员数最多。通过对船员文化程度和船员月收入分析,船员文化程度与月收入呈正相关(r=0.343,P0.01) 2.船员职业基本情况 74.0%船员属于自由船员,与公司有长期合同的占21.8%,表明我国随着船员市场化,自由船员已经占主体。本次调查有中国船员服务的外籍船舶占80.3%,船员劳务外派已成中国船员劳动关系的重要组成部分,94.2%船员可以接受与船公司之间的劳动关系,劳动关系签订过程中157名(47.4%)有中介机构参与,对缴纳费用船员和未缴纳费用船员对中介机构评价情况对比分析,发现缴纳费用船员对中介评价明显比未缴纳费用更差(Z=-3.863,P0.01)。船舶生活工作环境差,船员对工作生活环境评价不随收入增加而感受更好(H=7.042,P0.05)；37.2%船员无任何医疗保障。 3.中国船员健康状况和健康行为 与公司有长期合同船员自身健康状况评价好于自由船员和其他类型船员。中国船员1年内各类疾病患病率达到78.25%,船员意外伤害率为53.17%,甲板部船员更易受到意外伤害(χ2=7.42,P0.05),船员肝肠炎传染病患病率为8.76%,肿瘤患病率为2.11%,心血管疾病患病率为9.97%,呼吸系统患病率为22.66%,消化系统患病率为31.72%,泌尿生殖系统患病率为7.25%,神经精神系统疾病患病率为10.88%,内分泌系统疾病患病率为3.02%,其他疾病患病率为9.97%,均显著高于2010中国卫生统计年鉴及其他学者调查的居民各类疾病患病率。心理方面除社会功能外船员活力和心理健康比正常人群差,39.3%船员在海上服务期间碰到过因生病而离船的船员,21.2%船员在海上服务期间碰到过精神失常和感觉其明显有心理障碍的船员。船员健康相关行为主要有对家思恋、吸烟、缺乏规律锻炼和娱乐文化活动贫乏。 4.职业卫生知识知晓情况 船员接触职业有害因素知晓依次为噪音(74.0%)、风浪(68.6%)、高温(45.9%)、振动(44.7%)、工作外伤(37.5%)、辐射(22.7%)、中毒(20.8%)、化学腐蚀(19.0%)、其他伤害(18.1%)、灼伤(16.9%)、电击伤(12.1%)。 船员对职业卫生知识知晓率为48.4%,船员文化程度、职务、月收入、中介机构参与程度、船上娱乐活动、人际关系和不同职业病防范知识获取途径是船员职业卫生知晓率影响因素。卫生培训、健康检查、健康监护档案、工会等覆盖率不高,职业病防治法等法律法规的规定未得到全面落实,船员获取知识途径最多的是报纸电视等新闻媒体,最少的为政府或社会团体的宣传和培训,139名船员(42.0%)通过两种以上途经该获得职业病防范知识和技术。52.3%能正确面对职业病,通过正确途径维护权益。有毒物质进入人体途径正确率为71.0%,高级船员对有毒物质进入人体途径知晓率高于低级船员。 5.船员职业健康教育需求 船员总体职业健康需求平均为9.50分,船员文化程度、船员类型、中介机构参与程度、定期卫生培训制度、职业卫生知晓率是船员职业健康需求水平的影响因素,无生理疾病是减少职业健康需求因素；船员对安全生产相关知识希望率达到89.7%,对工作压力缓解卫生服务为89.4%,希望获得个人卫生防护用品使用方法服务的为87.9%,87.0%希望获得职业病防治法规条例知识,86.3%希望获得职业中毒症状及应急救援方法,82.2%希望知道职业性和工作相关疾病防治,希望获得职业危害因素种类及对人体危害为77.0%。健康教育方式47.1%船员认为现场宣讲的方式效果明显,49.5%船员认为职业健康教育应在证书培训时进行,船员最感兴趣的健康知识是身体保健知识(56.5%)和疾病预防知识(55.6%),高级船员在靠泊港国际疫情信息、伤害紧急救助、身体保健、疾病预防知识、运动健身知识、心理疾病知识等方面兴趣程度均高于低级船员。 结论 331名船员1年内患病率为78.25%；其中,意外伤害的患病率最高(53.17%),甲板部船员的意外伤害患病率高于其他部门船员(P0.05)。船员职业卫生知识知晓率为48.4%,其影响因素包括文化程度、职务、月收入、中介机构参与的劳动关系签订、穿上娱乐活动情况、人际关系、同事告知、媒体宣传、政府宣传培训等。船员接触的职业有害因素包括噪音、风浪、高温、振动、工作外伤、辐射、中毒、化学腐蚀、灼伤、电击伤等；其中,轮机部船员高温、振动、灼伤的发生率高于其他船员(P0.05)。船员文化程度、船员类型、中介机构参与程度、定期卫生培训制度、职业卫生知晓率是船员职业健康需求水平的影响因素；船员各类职业健康教育需求高,形成了高需求和低职业卫生服务覆盖率之间的矛盾。
[Abstract]:BACKGROUND & OBJECTIVE: Marine transport is the most important mode of transport in international logistics. Over two-thirds of the total volume of international trade is carried out by sea. More than 93% of the foreign trade tasks in China are carried out by sea. Among them, 650,000 are seafarers, the largest number of seafarers in the world. The annual training scale of seafarers is 46,000, and more than 100,000 seafarers are sent abroad.
Seafarers'long-term work at sea, irregular life at sea, information blockage, lack of fresh food, hull shaking, long-term noise, continuous vibration, electromagnetic radiation environment and high temperature and humidity, fatigue, special job characteristics and duty system have caused a variety of damage to their occupational health.
This survey mainly investigates the Chinese seafarers on ships entering international navigation from Ningbo Port. Through the investigation, a series of related indexes of occupational health status and occupational health awareness rate of Chinese seafarers on international navigation ships are obtained. The real situation of variable data reflects the physiological and psychological health of Chinese seafarers on international navigation ships. Health status, awareness rate of occupational health knowledge and health education needs of seafarers and their influencing factors were mastered. Occupational health hazards and restrictive factors of mastering occupational health of Chinese seafarers were analyzed. Data and information were provided for improving seafarers'life and working environment in the future, and health education intervention strategies and occupational diseases for seafarers were formulated. Provide basis for disease control, and promote the improvement of Chinese seafarers' occupational health management mode.
Materials and methods
1. choice of research objects
During the investigation period, 331 Chinese sailors from 66 international ships (13 Chinese and 53 foreign ships) were investigated by random sampling.
2. survey methodology
The questionnaire and on-the-spot interview were used to investigate the personal data, basic occupational conditions, health status and health behavior of seafarers, occupational health awareness rate and health education needs of seafarers.
3. statistical analysis
The questionnaires were collected and coded to determine the types and names of statistical variables. The data entry interface and quality control conditions were compiled according to the questionnaires in Epi data 3.1 Chinese version. The database was established by professional input computer. Statistical analysis methods include general statistical description, two independent samples u test, Pearson chi-square test, two independent samples Wilcoxon rank sum test, multiple independent samples Kruskal-Wallis H test, Spearman rank correlation. Analysis of the unconditional Logistic regression model. The statistical inference level is alpha =0.05..
4. quality control
Definitions of subjective feelings and objective conditions are made clear in the design phase, and the quality of the questionnaire is verified by pre-investigation. - Training of investigators is emphasized in the field investigation phase, and bias and measurement bias are controlled. Data processing phase ensures data accuracy through verification procedures and manual static testing.
Result
1. basic situation of Chinese crew members for international sailing ships
The average age of 331 Chinese seafarers was 37.5 years (37.5+10.9). All of them were male seafarers. The Han nationality accounted for 95.8%, 95.7% of the seafarers had religious beliefs and 71.6% were married. The highest monthly income was 2000-5000. According to the analysis of the crew's educational level and monthly income, there was a positive correlation between the crew's educational level and monthly income (r = 0.343, P 0.01).
2. basic conditions of crew occupation
74.0% of the seafarers are free sailors and 21.8% of them have long-term contracts with the company, indicating that with the marketization of the seafarers, free sailors have become the main body in China. In labor relations, 157 (47.4%) of the seafarers who paid fees and those who did not pay fees participated in the process of signing labor relations. A comparative analysis of the evaluation of intermediaries between the seafarers who paid fees and those who did not pay fees showed that the evaluation of intermediaries by the seafarers who paid fees was significantly worse than that of the seafarers who did not pay fees (Z = - 3.863, P 0.01). Environmental assessment does not feel better with increasing income (H=7.042, P0.05); 37.2% crew members have no medical insurance.
3. crew health and health behaviors in China
The morbidity rate of various diseases was 78.25%, the accidental injury rate was 53.17%, the deck crew was more susceptible to accidental injury (2 = 7.42, P 0.05), the morbidity rate of hepatoenteritis infectious diseases was 8.76%, and the morbidity rate of tumor was 2.11%. The prevalence of cardiovascular disease, respiratory system, digestive system, urogenital system, neuropsychiatric system, endocrine system and other diseases was 9.97%, 22.66%, 31.72%, 7.25%, 10.88%, 3.02% and 9.97%, respectively, which were significantly higher than those in the 2010 China Health Statistics Yearbook and other subjects. In addition to social function, 39.3% of the seafarers met the seafarers who left the ship because of illness during the service at sea, 21.2% of the seafarers had experienced mental disorders and felt obvious psychological disorders during the service at sea. Behavior is mainly about family love, smoking, lack of regular exercise and entertainment and cultural activities.
4. knowledge of occupational health knowledge
The knowledge of occupational hazards was noise (74.0%), wind and wave (68.6%), high temperature (45.9%), vibration (44.7%), work injury (37.5%), radiation (22.7%), poisoning (20.8%), chemical corrosion (19.0%), other injuries (18.1%), burns (16.9%) and electric shock (12.1%).
The occupational health awareness rate was 48.4%. The occupational health awareness rate was influenced by the crew's educational level, position, monthly income, the participation of intermediaries, recreational activities on board, interpersonal relationship and different ways of obtaining occupational disease prevention knowledge. The provisions of laws and regulations such as disease prevention and control law have not been fully implemented. The most accessible way for seafarers to acquire knowledge is news media such as newspapers and television. The least is propaganda and training for the government or social organizations. 139 seafarers (42.0%) can acquire knowledge and technology of occupational disease prevention through two or more routes. 52.3% can face occupational disease correctly and correctly. The correct rate of poisonous substances entering human body was 71.0%. The awareness rate of senior crew to poisonous substances entering human body was higher than that of junior crew.
5. occupational health education needs of seafarers
The average occupational health requirement of seafarers was 9.50 points, including seafarers'educational level, seafarers' type, the degree of participation of intermediaries, regular health training system and occupational health awareness rate, which were the influencing factors of seafarers'occupational health requirement, and no physiological diseases were the reducing factors of occupational health requirement. 9.7%, 89.4%, 87.9%, 87.0%, 86.3%, 89.2% and 82.2% wanted to know the prevention and treatment of occupational and work-related diseases, and wanted to obtain the knowledge of occupational disease prevention and control regulations, the symptoms of occupational poisoning and emergency rescue methods, and the occupational hazards. 47.1% of the seafarers believed that the effect of on-site publicity was obvious, 49.5% of the seafarers believed that vocational health education should be carried out during certificate training. The most interesting health knowledge of the seafarers was health care knowledge (56.5%) and disease prevention knowledge (55.6%). Information, emergency rescue, health care, disease prevention knowledge, exercise and fitness knowledge, psychological disease knowledge and other aspects of interest than junior crew.
conclusion
The prevalence rate of accidental injuries was the highest (53.17%) among 331 seafarers in one year, and the incidence of accidental injuries in deck crew was higher than that in other departments (P 0.05). Occupational harmful factors of seafarers'exposure include noise, wind and wave, high temperature, vibration, work injury, radiation, poisoning, chemical corrosion, burns, electric injury, etc. Among them, the incidence of high temperature, vibration and burns of seafarers in engine department is higher than that of other seafarers (P 0.05). Degree, type of crew, degree of participation of intermediaries, regular health training system and occupational health awareness rate are the influencing factors of the occupational health needs of seafarers.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R13
本文编号：2246694
[Abstract]:BACKGROUND & OBJECTIVE: Marine transport is the most important mode of transport in international logistics. Over two-thirds of the total volume of international trade is carried out by sea. More than 93% of the foreign trade tasks in China are carried out by sea. Among them, 650,000 are seafarers, the largest number of seafarers in the world. The annual training scale of seafarers is 46,000, and more than 100,000 seafarers are sent abroad.
Seafarers'long-term work at sea, irregular life at sea, information blockage, lack of fresh food, hull shaking, long-term noise, continuous vibration, electromagnetic radiation environment and high temperature and humidity, fatigue, special job characteristics and duty system have caused a variety of damage to their occupational health.
This survey mainly investigates the Chinese seafarers on ships entering international navigation from Ningbo Port. Through the investigation, a series of related indexes of occupational health status and occupational health awareness rate of Chinese seafarers on international navigation ships are obtained. The real situation of variable data reflects the physiological and psychological health of Chinese seafarers on international navigation ships. Health status, awareness rate of occupational health knowledge and health education needs of seafarers and their influencing factors were mastered. Occupational health hazards and restrictive factors of mastering occupational health of Chinese seafarers were analyzed. Data and information were provided for improving seafarers'life and working environment in the future, and health education intervention strategies and occupational diseases for seafarers were formulated. Provide basis for disease control, and promote the improvement of Chinese seafarers' occupational health management mode.
Materials and methods
1. choice of research objects
During the investigation period, 331 Chinese sailors from 66 international ships (13 Chinese and 53 foreign ships) were investigated by random sampling.
2. survey methodology
The questionnaire and on-the-spot interview were used to investigate the personal data, basic occupational conditions, health status and health behavior of seafarers, occupational health awareness rate and health education needs of seafarers.
3. statistical analysis
The questionnaires were collected and coded to determine the types and names of statistical variables. The data entry interface and quality control conditions were compiled according to the questionnaires in Epi data 3.1 Chinese version. The database was established by professional input computer. Statistical analysis methods include general statistical description, two independent samples u test, Pearson chi-square test, two independent samples Wilcoxon rank sum test, multiple independent samples Kruskal-Wallis H test, Spearman rank correlation. Analysis of the unconditional Logistic regression model. The statistical inference level is alpha =0.05..
4. quality control
Definitions of subjective feelings and objective conditions are made clear in the design phase, and the quality of the questionnaire is verified by pre-investigation. - Training of investigators is emphasized in the field investigation phase, and bias and measurement bias are controlled. Data processing phase ensures data accuracy through verification procedures and manual static testing.
Result
1. basic situation of Chinese crew members for international sailing ships
The average age of 331 Chinese seafarers was 37.5 years (37.5+10.9). All of them were male seafarers. The Han nationality accounted for 95.8%, 95.7% of the seafarers had religious beliefs and 71.6% were married. The highest monthly income was 2000-5000. According to the analysis of the crew's educational level and monthly income, there was a positive correlation between the crew's educational level and monthly income (r = 0.343, P 0.01).
2. basic conditions of crew occupation
74.0% of the seafarers are free sailors and 21.8% of them have long-term contracts with the company, indicating that with the marketization of the seafarers, free sailors have become the main body in China. In labor relations, 157 (47.4%) of the seafarers who paid fees and those who did not pay fees participated in the process of signing labor relations. A comparative analysis of the evaluation of intermediaries between the seafarers who paid fees and those who did not pay fees showed that the evaluation of intermediaries by the seafarers who paid fees was significantly worse than that of the seafarers who did not pay fees (Z = - 3.863, P 0.01). Environmental assessment does not feel better with increasing income (H=7.042, P0.05); 37.2% crew members have no medical insurance.
3. crew health and health behaviors in China
The morbidity rate of various diseases was 78.25%, the accidental injury rate was 53.17%, the deck crew was more susceptible to accidental injury (2 = 7.42, P 0.05), the morbidity rate of hepatoenteritis infectious diseases was 8.76%, and the morbidity rate of tumor was 2.11%. The prevalence of cardiovascular disease, respiratory system, digestive system, urogenital system, neuropsychiatric system, endocrine system and other diseases was 9.97%, 22.66%, 31.72%, 7.25%, 10.88%, 3.02% and 9.97%, respectively, which were significantly higher than those in the 2010 China Health Statistics Yearbook and other subjects. In addition to social function, 39.3% of the seafarers met the seafarers who left the ship because of illness during the service at sea, 21.2% of the seafarers had experienced mental disorders and felt obvious psychological disorders during the service at sea. Behavior is mainly about family love, smoking, lack of regular exercise and entertainment and cultural activities.
4. knowledge of occupational health knowledge
The knowledge of occupational hazards was noise (74.0%), wind and wave (68.6%), high temperature (45.9%), vibration (44.7%), work injury (37.5%), radiation (22.7%), poisoning (20.8%), chemical corrosion (19.0%), other injuries (18.1%), burns (16.9%) and electric shock (12.1%).
The occupational health awareness rate was 48.4%. The occupational health awareness rate was influenced by the crew's educational level, position, monthly income, the participation of intermediaries, recreational activities on board, interpersonal relationship and different ways of obtaining occupational disease prevention knowledge. The provisions of laws and regulations such as disease prevention and control law have not been fully implemented. The most accessible way for seafarers to acquire knowledge is news media such as newspapers and television. The least is propaganda and training for the government or social organizations. 139 seafarers (42.0%) can acquire knowledge and technology of occupational disease prevention through two or more routes. 52.3% can face occupational disease correctly and correctly. The correct rate of poisonous substances entering human body was 71.0%. The awareness rate of senior crew to poisonous substances entering human body was higher than that of junior crew.
5. occupational health education needs of seafarers
The average occupational health requirement of seafarers was 9.50 points, including seafarers'educational level, seafarers' type, the degree of participation of intermediaries, regular health training system and occupational health awareness rate, which were the influencing factors of seafarers'occupational health requirement, and no physiological diseases were the reducing factors of occupational health requirement. 9.7%, 89.4%, 87.9%, 87.0%, 86.3%, 89.2% and 82.2% wanted to know the prevention and treatment of occupational and work-related diseases, and wanted to obtain the knowledge of occupational disease prevention and control regulations, the symptoms of occupational poisoning and emergency rescue methods, and the occupational hazards. 47.1% of the seafarers believed that the effect of on-site publicity was obvious, 49.5% of the seafarers believed that vocational health education should be carried out during certificate training. The most interesting health knowledge of the seafarers was health care knowledge (56.5%) and disease prevention knowledge (55.6%). Information, emergency rescue, health care, disease prevention knowledge, exercise and fitness knowledge, psychological disease knowledge and other aspects of interest than junior crew.
conclusion
The prevalence rate of accidental injuries was the highest (53.17%) among 331 seafarers in one year, and the incidence of accidental injuries in deck crew was higher than that in other departments (P 0.05). Occupational harmful factors of seafarers'exposure include noise, wind and wave, high temperature, vibration, work injury, radiation, poisoning, chemical corrosion, burns, electric injury, etc. Among them, the incidence of high temperature, vibration and burns of seafarers in engine department is higher than that of other seafarers (P 0.05). Degree, type of crew, degree of participation of intermediaries, regular health training system and occupational health awareness rate are the influencing factors of the occupational health needs of seafarers.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R13
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1 郑春梅;伊向仁;李元;;健身锻炼对不同职业国民多维压力与心理健康影响的分析研究——以山东省不同职业人员为例[J];北京体育大学学报;2013年01期
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