發(fā)布時間：2018-01-15 23:19

  本文關(guān)鍵詞：加油站職業(yè)衛(wèi)生與從業(yè)人員健康狀況的研究　出處：《泰山醫(yī)學(xué)院》2013年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 加油站 職業(yè)病危害因素 職業(yè)衛(wèi)生 影響因素 汽油

【摘要】：目的 通過本項現(xiàn)況調(diào)查，了解加油站職業(yè)衛(wèi)生與從業(yè)人員健康狀況及影響因素，初步掌握在工作過程中經(jīng)常接觸汽油污染的危害現(xiàn)狀，為加油站汽油暴露人群的作業(yè)環(huán)境危險性評價提供基線資料，對存在的職業(yè)衛(wèi)生問題提出整改建議，為職業(yè)性汽油中毒和職業(yè)性皮膚病防治及監(jiān)督管理提供科學(xué)依據(jù)。 研究方法 采用分層按比例隨機抽取的方法，從泰安市所轄加油站中抽取114個站進行現(xiàn)狀調(diào)查，依據(jù)國家職業(yè)衛(wèi)生相關(guān)規(guī)范、標準及檢測方法進行現(xiàn)場檢測，，獲得相關(guān)數(shù)據(jù)組資料；利用自行設(shè)計調(diào)查問卷，對觀察組（114個加油站從業(yè)人員）、對照組（未接觸汽油的超市服務(wù)員）兩組人群進行職業(yè)健康查體并獲得相關(guān)數(shù)據(jù)資料。 所有數(shù)據(jù)進行統(tǒng)計分析，定量資料兩組比較采用t檢驗，多組比較采用方差分析，定性資料采用卡方檢驗，采用logistic回歸分析發(fā)現(xiàn)相關(guān)職業(yè)病危害因素。 結(jié)果 第一部分加油站現(xiàn)狀分析 1、加油站職業(yè)衛(wèi)生管理制度建立與實施情況 所調(diào)查加油站大多未建立各種職業(yè)衛(wèi)生管理制度，僅有2個（1.8%）的加油站有比較完善的職業(yè)衛(wèi)生管理制度。有94.7%的從業(yè)人員未進行上崗前職業(yè)健康檢查，在崗定期檢查也是少之又少，僅有2個（1.4%）有定期檢查。 另外，有11個（9.6%）加油站的作業(yè)現(xiàn)場沒有設(shè)置警示標識和職業(yè)病危害因素告知卡，從業(yè)人員缺乏相關(guān)職業(yè)衛(wèi)生知識和防護意識。 2、現(xiàn)場汽油濃度檢測 本次檢測溶劑汽油加油站114個，合格加油站112個(超限倍數(shù))，合格率98.2%。由現(xiàn)場汽油濃度檢測結(jié)果可見，瞬間質(zhì)量濃度最大為426.2mg/m~3，98.2%的樣品濃度均小于300mg/m~3，且92.7%樣品小于100mg/m~3，據(jù)此估計其時間加權(quán)平均容許濃度可能也多在國家職業(yè)衛(wèi)生接觸限值內(nèi)。正常工作時間，加油站從業(yè)人員屬于低濃度長期接觸。 第二部分加油站從業(yè)人員職業(yè)健康狀況及職業(yè)病危害因素對健康的影響 1、兩組人群調(diào)查指標比較 觀察組頭暈頭痛、失眠多夢、記憶力減退、注意力不集中、皮膚干燥皸裂等方面的自我感知有疾患的比例均高于對照組（P0.01）。 2、對工作場所環(huán)境條件滿意程度 觀察組有66.9%、對照組44.6%的人員對工作場所的環(huán)境條件表示不太滿意或很不滿意，兩組比較差異有統(tǒng)計學(xué)意義（Z=11.984，P0.01）。 3、查體情況分析 觀察組各指標異常檢出率分別為：血壓（17.8%），白細胞（9.8%）、紅細胞（12.7%）、血紅蛋白（21.4%）、血小板（7.9%）等血液常規(guī)，肝功能（5.4%）、血脂（28.2%），尿常規(guī)（25.4%），脂肪肝（18.8%），神經(jīng)衰弱綜合征（16.8%），皮膚干燥皸裂（14.1%），上述指標異常檢出率均高于對照組（P0.05）。 4、對職業(yè)病危害因素認知及其培訓(xùn)需求情況 只有5.8%從業(yè)人員認為自己對工作場所的職業(yè)病危害因素認識比較多，還有33.2%的從業(yè)人員認為對工作場所的職業(yè)病危害因素認識很少，甚至不了解。有74.0%的從業(yè)人員認為非常需求職業(yè)病危害因素認知與防護措施相關(guān)內(nèi)容的培訓(xùn)。 5、觀察組職業(yè)病危害因素影響分析 單因素分析影響從業(yè)人員健康的主要職業(yè)相關(guān)因素有：性別、工齡、工種、地理位置、汽油濃度是否達到國家規(guī)定的標準、工作期間平均每小時直接接觸汽油時間（分鐘）、從業(yè)人員對職業(yè)病危害因素的認知程度、個人防護措施的實施情況、從業(yè)人員對工作場所環(huán)境方面的滿意度等。 多因素分析logistic回歸分析結(jié)果顯示，影響從業(yè)人員健康的主要職業(yè)病危害因素是汽油達標情況、工作場所位置、工齡、對危害因素的認知情況、對工作場所是否滿意等幾個因素具有統(tǒng)計學(xué)意義（P0.05）。其中，汽油濃度不達標、工齡（10年及以上）是從業(yè)人員職業(yè)病危害因素中最主要的危險因素，OR分別是2.137、4.830。 結(jié)論 第一部分加油站基本情況 1、目前泰安市加油站職業(yè)衛(wèi)生管理制度幾乎沒有，企業(yè)對從業(yè)人員的職業(yè)防護及管理上存在嚴重的缺陷。 2、泰安市還有1.8%的加油站檢測溶劑汽油不符合國家衛(wèi)生標準。需要職業(yè)衛(wèi)生監(jiān)督管理部門采取措施強制執(zhí)行，并定期檢查實施情況。 第二部分加油站從業(yè)人員職業(yè)病危害因素及職業(yè)相關(guān)因素對健康的影響 1、本項研究顯示，長期低濃度接觸職業(yè)病危害因素（汽油），對人體的血液指標、尿常規(guī)、神經(jīng)系統(tǒng)、皮膚等都會造成一定的損害。目前國內(nèi)很少有對加油站從業(yè)人員的健康狀況進行系統(tǒng)的流行病學(xué)研究，尤其是對工齡長的加油站從業(yè)人員健康狀況、潛在的危害、易患的疾病進行系統(tǒng)的檢測和隨訪觀察性研究是十分必要的。 2、分析結(jié)果表明，對工作中有毒有害因素的認知及防護措施等職業(yè)相關(guān)因素也會對健康產(chǎn)生影響。從業(yè)人員的健康還可能與對工作場所、工作性質(zhì)、加油工作量和暴露汽油的時間的及自我防護等相關(guān)因素有關(guān)。
[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.

【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R131

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本文編號：1430527