本文選題：有色金屬冶煉　切入點(diǎn)：職業(yè)健康損害　出處：《山西醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：通過(guò)12年回顧性隊(duì)列研究評(píng)估有色金屬冶煉廠的職業(yè)性有害因素所致職業(yè)健康危害風(fēng)險(xiǎn)，并通過(guò)評(píng)價(jià)生產(chǎn)工藝、生產(chǎn)環(huán)境和勞動(dòng)過(guò)程，結(jié)合現(xiàn)場(chǎng)監(jiān)測(cè)結(jié)果分析該廠職業(yè)危害的關(guān)鍵控制點(diǎn)。 方法：采用回顧性對(duì)列研究的設(shè)計(jì)及l(fā)ogistic回歸分析的方法，選擇1999年1月1日-2010年12月31日在冊(cè)滿1年的所有冶煉工人為隊(duì)列成員，以司爐工、收塵工、制酸工、行車工、剝鋅工、操作工、過(guò)濾工、鑄型工、電解出裝槽工人為接觸組,以該廠的輔助工種及職能科室工人為對(duì)照組�；仡櫺允占@12年期間職工的職業(yè)病與其他工作相關(guān)疾病資料，計(jì)算各種疾病人年發(fā)病率在接觸組與對(duì)照組的相對(duì)危險(xiǎn)度，再通過(guò)logistic回歸分析的方法，分析職工接觸因素與其他個(gè)人因素與塵肺病發(fā)病的相關(guān)關(guān)系，然后結(jié)合現(xiàn)場(chǎng)調(diào)查分析，定性地發(fā)現(xiàn)職業(yè)危害防護(hù)的關(guān)鍵控制點(diǎn)。 結(jié)果：（1）塵肺病例集中在司爐工及鑄型工，其中司爐工的塵肺發(fā)病風(fēng)險(xiǎn)高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義；塵肺病發(fā)病風(fēng)險(xiǎn)隨著工齡的增加而升高。（2）高血壓病、慢性砷中毒、慢性鎘中毒、肝膽疾病各工種發(fā)病風(fēng)險(xiǎn)均高于對(duì)照組，且有統(tǒng)計(jì)學(xué)意義；腎結(jié)石在司爐工及鑄型工中發(fā)病風(fēng)險(xiǎn)高于對(duì)照組，有統(tǒng)計(jì)學(xué)意義。司爐工此5類疾病的發(fā)病風(fēng)險(xiǎn)與對(duì)照組相比具有統(tǒng)計(jì)學(xué)差異。接觸組女性腎結(jié)石發(fā)病風(fēng)險(xiǎn)高于男性，有統(tǒng)計(jì)學(xué)意義。（3）司爐工與收塵工尿砷、鎘超標(biāo)的發(fā)生風(fēng)險(xiǎn)高于對(duì)照組且存在統(tǒng)計(jì)學(xué)意義。（4）進(jìn)行Logistic單因素回歸分析，得出塵肺病發(fā)病與工作環(huán)境矽塵的時(shí)間加權(quán)平均濃度（TWA）、工齡權(quán)重的粉塵濃度（TWA*工齡）、職工年齡、職工工齡呈正相關(guān)關(guān)系。（5）塵肺病的發(fā)病概率預(yù)測(cè)模型(其中a1代表年齡36-45歲，a2代表年齡46-60歲，a3代表年齡大于60歲，t*T代表工齡與TWA乘積） （6）硫酸車間的關(guān)鍵控制點(diǎn)為：司爐和收塵崗位，主要應(yīng)控制的職業(yè)病危害因素有粉塵、二氧化硫、氧化鋅、鎘和砷。粗煉車間的關(guān)鍵控制點(diǎn)為出裝槽、司爐和鑄型崗位，主要應(yīng)控制的職業(yè)病危害因素有硫酸、硫酸霧、氧化鋅、鎘和砷。精煉車間的關(guān)鍵控制點(diǎn)為：司爐和收塵崗位，，主要應(yīng)控制的職業(yè)病危害因素有粉塵、砷、鎘、一氧化碳、二氧化硫和氧化鋅。結(jié)論：該廠有色金屬冶煉作業(yè)促進(jìn)了肝膽疾病、腎結(jié)石與慢性砷鎘中毒在接觸組的發(fā)生；在其他變量年齡、工齡、性別、吸煙、飲酒不變的情況下，TWA每增加1個(gè)單位，接塵者塵肺病發(fā)病風(fēng)險(xiǎn)增加10倍，在其他變量年齡、性別、吸煙、飲酒不變的情況下，隨著工齡TWA乘積每增加1個(gè)單位，接塵者塵肺病發(fā)病風(fēng)險(xiǎn)增加0.32倍；該廠有色金屬冶煉作業(yè)防護(hù)關(guān)鍵點(diǎn)主要為司爐、收塵、鑄型、出裝槽等崗位。
[Abstract]:Objective: to evaluate the occupational health risk caused by occupational harmful factors in nonferrous metal smelters by 12 years retrospective cohort study, and to evaluate the production process, production environment and labor process.The key control points of occupational hazard in this factory are analyzed based on the monitoring results.Methods: by the method of retrospective analysis and logistic regression analysis, all smelting workers who had been listed for one year from January 1, 1999 to December 31, 2010 were selected as cohort members.The workers of zinc stripping, operation, filtration, mould casting and electrolytic discharge were the contact group, and the workers of auxiliary work and functional department of the factory were taken as the control group.The data of occupational diseases and other work-related diseases were collected retrospectively during the 12-year period, and the relative risk of the annual morbidity of various diseases in the exposure group and the control group was calculated, and then the logistic regression analysis was used.The relationship between workers' contact factors and other personal factors and the incidence of pneumoconiosis was analyzed, and the key control points of occupational hazard protection were found qualitatively.Results (1) the pneumoconiosis cases were concentrated in the stoveworkers and cast workers, and the risk of pneumoconiosis in the stoker workers was higher than that in the control group, the difference was statistically significant, and the risk of pneumoconiosis increased with the increase of the length of service) hypertension, chronic arsenic poisoning, and chronic arsenic poisoning were the main causes of pneumoconiosis.The risk of chronic cadmium poisoning and hepatobiliary diseases was higher than that of the control group, and the risk of kidney stones was higher than that of the control group.The risk of these five diseases was statistically different from that of the control group.The risk of renal calculi in the exposed group was higher than that in the male (P < 0.05). The risk of urinary arsenic and cadmium exceeding the standard was higher in the exposed group than that in the control group (P < 0.05). The Logistic univariate regression analysis was carried out.The time weighted average concentration of pneumoconiosis and silica dust in the working environment was obtained, the weight of dust concentration of working age was TWA*, the age of workers,The probability prediction model of pneumoconiosis (where a 1 represents age 36-45 years old and a 2 represents age 46-60 years old A3 represents age greater than 60 years old and T represents the product of age and TWA)The key control points of sulphuric acid workshop are as follows: stoves and dust collecting positions. The main occupational hazard factors to be controlled are dust, sulfur dioxide, zinc oxide, cadmium and arsenic.The key control points of the roughing workshop are discharge tank, furnace and casting position. The main occupational hazard factors to be controlled are sulfuric acid, sulfuric acid mist, zinc oxide, cadmium and arsenic.The key control points of refining workshop are as follows: furnace and dust collecting position. The main occupational hazard factors to be controlled are dust, arsenic, cadmium, carbon monoxide, sulfur dioxide and zinc oxide.Conclusion: the nonferrous metal smelting operation in this plant promoted the occurrence of hepatobiliary diseases, renal calculi and chronic arsenic-cadmium poisoning in contact group, and increased TWA by 1 unit per unit under the condition of other variables such as age, length of service, sex, smoking and drinking.The key points of protection for non-ferrous metal smelting operation are furnace, dust collection, mold casting, discharge tank and so on.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R13

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