發(fā)布時間：2018-06-23 22:40

  本文選題：職業(yè)性外傷 + 流行病學(xué)�。� 參考：《安徽醫(yī)科大學(xué)》2011年碩士論文

【摘要】：目的研究一:通過對合肥市企業(yè)2007-2009年間職業(yè)性外傷的描述性研究,了解本地區(qū)職業(yè)性外傷在人群、時間及空間的分布特征。研究二:研究與職業(yè)性外傷發(fā)生有關(guān)的影響因素,并重點探討職業(yè)性緊張因素在職業(yè)性外傷發(fā)生中的作用。為職能部門和企業(yè)對職業(yè)性外傷的防控重點提供依據(jù),最終達(dá)到降低職業(yè)性外傷發(fā)生率、減少傷害、減輕社會整體負(fù)擔(dān)、提高職工職業(yè)生命質(zhì)量的目的。 材料與方法 研究一 1.研究對象2007-2009年間合肥市企業(yè)發(fā)生的、在市人社局登記備案的職業(yè)性外傷職工。 2.研究內(nèi)容內(nèi)容主要包括:傷者所在單位、傷者姓名、性別、年齡、工種、工齡、職業(yè)性外傷發(fā)生的地點、時間、受傷方式、受傷程度、事故類別、事故原因和事故經(jīng)過概要等。 3.統(tǒng)計方法職業(yè)傷害發(fā)生率、千人負(fù)傷率、千人重傷率、千人死亡率等指標(biāo)描述職業(yè)傷害的發(fā)生密度。應(yīng)用圓形分布原理,通過三角函數(shù)轉(zhuǎn)換,對季節(jié)性資料計算均數(shù)、標(biāo)準(zhǔn)差,進行顯著性檢驗。 研究二 1.研究對象在詳細(xì)研究人社局登記資料后,選擇馬鋼集團、長源液壓集團和佳通輪胎制造企業(yè)這3家職業(yè)性外傷發(fā)生發(fā)生人數(shù)最多的企業(yè)作為研究現(xiàn)場,采用病例-對照流行病學(xué)研究方法,以發(fā)生職業(yè)性外傷者為病例,按1:1頻數(shù)匹配的方法從未發(fā)生職業(yè)性外傷的職工選擇對照。 2.研究內(nèi)容包括調(diào)查(1)對象一般情況,如性別、年齡、身高、體重、工齡、文化程度、平均月收入等社會人口學(xué)信息。(2)職業(yè)性外傷發(fā)生情況,如受傷地點、發(fā)生時間、受傷部位、傷害程度、職業(yè)傷害類別等。(3)職業(yè)傷害一般影響因素,如吸煙史、飲酒史、疾病史、工作滿意度、職業(yè)衛(wèi)生知信行、性格特征等。(4)職業(yè)緊張情況:采用修訂版職業(yè)緊張目錄問卷(occupational stress inventory - revised edition,OSI-R)測量調(diào)查對象的職業(yè)緊張情況。 3.統(tǒng)計方法用Epidata 3.0建立數(shù)據(jù)庫,SPSS 11.5 for windows軟件包對數(shù)據(jù)進行統(tǒng)計分析。病例組與對照組間一般情況的比較采用χ2檢驗;病例組與對照組之間的職業(yè)緊張狀況比較采用t檢驗;用單因素Logistic回歸以及多因素Logistic回歸探討職業(yè)性傷害的危險因素。 結(jié)果研究一:每年職業(yè)傷害的千人死亡率呈下降趨勢,職業(yè)性外傷千人負(fù)傷率和千人重傷率均呈逐年遞增趨勢。在職業(yè)傷害發(fā)生的時間分布中,輕傷在七月份發(fā)生的較多,但是重傷和死亡的分布沒有明顯特征。在一個月中,下旬發(fā)生傷害可能性最高。職業(yè)傷害的發(fā)生,男性遠(yuǎn)高于女性,男女之間的比例為3:1。職業(yè)傷害中,輕傷的年齡分布以26歲組及38歲組為主,重傷的年齡分布以36歲組以及40歲組為主。發(fā)生傷害危險性最大的是:駕駛員、鉗工、焊工、維修工、服務(wù)員、成型工、車工、廚師、理貨員、電工、保潔工、保安、操作工及其他。重傷和死亡的工種第一位是操作工。職業(yè)傷害其傷害類型主要有物體打擊、觸電、淹溺。受傷部位的排序是上肢及手、下肢及足、面頜部、胸腹部軀干、顱腦及其他。重傷的部位是胸腹部軀干排在第一位,死亡則是胸腹部軀干、及顱腦排在前兩位。研究二:病例對照研究結(jié)果顯示,職業(yè)傷害的發(fā)生與工人工資收入、健康狀況以及婚姻狀況有關(guān)聯(lián),工齡越長,工資越高、健康狀況越好,發(fā)生傷害的可能性越小,離婚的職工發(fā)生職業(yè)傷害的可能性最大。病例組和對照組相比,病例組的職業(yè)任務(wù)總分(ORQ)、任務(wù)過重(RO)、任務(wù)不適(RI)、任務(wù)模糊(RA)、工作環(huán)境(PE)、業(yè)務(wù)緊張反應(yīng)(VS)、人際關(guān)系緊張反應(yīng)(IS)、軀體緊張反應(yīng)(PHS)、緊張反應(yīng)總分(PSQ)和自我保健(SC)得分較高;任務(wù)沖突(RB)、責(zé)任感(R)、心里緊張反應(yīng)(PSY)、應(yīng)對資源總分(PRQ)、娛樂休閑(RE)、社會支持(SS)以及理性處事(RC)得分較低。任務(wù)不適(RI)、應(yīng)對資源總分(PRQ)、娛樂休閑(RE)以及理性處事(RC)得分差異有統(tǒng)計學(xué)意義,其中應(yīng)對資源較高是職業(yè)傷害的保護因素。OSI-R各分量表及子項得分與技術(shù)工人常模比較,調(diào)查對象的職業(yè)任務(wù)總分、任務(wù)過重、任務(wù)不適、任務(wù)沖突、任務(wù)模糊、責(zé)任感、應(yīng)對資源總分、娛樂休閑、自我保健、社會支持、理性處事得分較低;工作環(huán)境、緊張反應(yīng)總分、業(yè)務(wù)緊張反應(yīng)、軀體緊張反應(yīng)得分較高;與心理緊張反應(yīng)、人際關(guān)系緊張反應(yīng)得分的差異沒有統(tǒng)計學(xué)意義。與西南地區(qū)職業(yè)人群常模比較,調(diào)查對象責(zé)任感、應(yīng)對資源總分、社會支持、娛樂休閑、理性處事得分較低;職業(yè)任務(wù)總分、任務(wù)不適、任務(wù)模糊、任務(wù)沖突、工作環(huán)境、緊張反應(yīng)總分、業(yè)務(wù)緊張反應(yīng)、人際關(guān)系緊張反應(yīng)、軀體緊張反應(yīng)得分較高;與任務(wù)過重、心理緊張反應(yīng)、自我保健得分的差異沒有統(tǒng)計學(xué)意義。職業(yè)任務(wù)適度/相對缺乏緊張者占89.4%,適度/相對缺乏緊張反應(yīng)者占99.5%,適度/很強應(yīng)對資源者占75.5%。但任務(wù)沖突、工作環(huán)境、責(zé)任感、業(yè)務(wù)緊張反應(yīng)、心理緊張反應(yīng)、軀體緊張反應(yīng)高度/中度緊張者分別占13.4%、24.5%、6.6%、25.1%、14.6%和24.3%;理性處事、社會支持高度/中度缺乏者分別占28.5%和16.1%。工作滿意度得分差異有統(tǒng)計學(xué)意義,OR值㩳1。本調(diào)查結(jié)果顯示,工資收入、待遇滿意、應(yīng)對資源和工作時佩戴個人防護用品是職業(yè)傷害的保護因素。 結(jié)論研究一:應(yīng)重點保護工齡短的職工,在傷害高發(fā)時間應(yīng)加大安全生產(chǎn)的宣傳和監(jiān)督,對于一些傷害高發(fā)崗位應(yīng)該進行針對性培訓(xùn),應(yīng)比照不同行業(yè)工種的易受傷部位來佩戴個人安全防護用品。研究二:職工的業(yè)務(wù)培訓(xùn)、健康教育、心理疏導(dǎo)以及工效學(xué)等方面要進一步加強,在進行職業(yè)緊張干預(yù)時,要重視對高危人群的關(guān)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.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R135;R181.3

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