【摘要】：背景與目的：海洋運(yùn)輸是國(guó)際物流中最主要的運(yùn)輸方式,國(guó)際貿(mào)易總運(yùn)量中的2／3以上,我國(guó)93%以上的外貿(mào)運(yùn)輸任務(wù)是通過(guò)海運(yùn)完成的。中國(guó)海運(yùn)事業(yè)發(fā)展迅猛,船隊(duì)總噸位排行世界第九位,船舶數(shù)量排行世界第四位。中國(guó)有155萬(wàn)船員,其中海員65萬(wàn)人,是世界上擁有海員數(shù)量最多的國(guó)家,海員年培養(yǎng)規(guī)模達(dá)4.6萬(wàn)人,外派海員達(dá)10萬(wàn)多人次。 船員長(zhǎng)時(shí)間的海上工作,無(wú)規(guī)律的海上生活,信息閉塞、新鮮食物缺乏、船體搖晃、長(zhǎng)時(shí)間的噪音、持續(xù)的振動(dòng)、電磁輻射環(huán)境和高溫高濕、疲勞、特殊的職務(wù)崗位特點(diǎn)和值班制度等對(duì)船員職業(yè)健康造成多種損害。 本次調(diào)查主要對(duì)從寧波口岸入境國(guó)際航行船舶上的中國(guó)船員進(jìn)行調(diào)查,通過(guò)調(diào)查了解國(guó)際航行船舶中國(guó)船員職業(yè)健康情況和職業(yè)衛(wèi)生知曉率的一系列相關(guān)指標(biāo)、變量數(shù)據(jù)的真實(shí)情況,具體地反映國(guó)際航行船舶中國(guó)船員生理和心理健康狀況,掌握船員職業(yè)衛(wèi)生知識(shí)知曉率和健康教育需求及其影響因素,從中分析出中國(guó)船員職業(yè)健康危害因素和職業(yè)衛(wèi)生掌握的限制因素,對(duì)今后改善船員生活、工作環(huán)境提供數(shù)據(jù)資料,為制定針對(duì)船員的健康教育干預(yù)策略和職業(yè)性疾病控制提供依據(jù),促進(jìn)中國(guó)船員職業(yè)健康管理模式改進(jìn)。 材料與方法 1.研究對(duì)象的選擇 本次調(diào)查研究對(duì)象是國(guó)際航行船舶上的中國(guó)船員,在調(diào)查期內(nèi)對(duì)通過(guò)寧波口岸入境船舶上中國(guó)船員進(jìn)行隨機(jī)抽樣調(diào)查,共調(diào)查66艘次國(guó)際航行船舶(中國(guó)籍13艘次,外籍53艘次)上331名中國(guó)船員。 2.調(diào)查方法 采用調(diào)查表和現(xiàn)場(chǎng)訪談兩種調(diào)查方式,調(diào)查內(nèi)容包括船員個(gè)人資料、職業(yè)基本情況、船員健康狀況和健康行為、職業(yè)衛(wèi)生知曉率、健康教育需求五個(gè)部分。 3.資料統(tǒng)計(jì)分析 對(duì)調(diào)查表進(jìn)行匯總,將調(diào)查表經(jīng)統(tǒng)一編碼,確定統(tǒng)計(jì)變量類型和名稱,采用Epi data3.1中文版按照調(diào)查表編制數(shù)據(jù)錄入界面和質(zhì)量控制條件,由專業(yè)人員輸入計(jì)算機(jī)建立數(shù)據(jù)庫(kù)。采用SPSS17.0軟件進(jìn)行統(tǒng)計(jì),并對(duì)船員身心健康、職業(yè)衛(wèi)生知曉率、健康教育需求對(duì)比分析,進(jìn)行綜合評(píng)價(jià),提出職業(yè)性疾病防控措施和船員健康教育干預(yù)策略。統(tǒng)計(jì)分析方法包括一般統(tǒng)計(jì)描述、兩獨(dú)立樣本u檢驗(yàn). Pearson卡方檢驗(yàn)、兩獨(dú)立樣本W(wǎng)ilcoxon秩和檢驗(yàn)、多個(gè)獨(dú)立樣本Kruskal-Wallis H檢驗(yàn)、Spearman秩相關(guān)分析、非條件Logistic回歸模型。統(tǒng)計(jì)推斷的檢驗(yàn)水準(zhǔn)取α=0.05。 4.質(zhì)量控制 設(shè)計(jì)階段明確主觀感受和客觀情況定義,進(jìn)行預(yù)調(diào)查驗(yàn)證調(diào)查表質(zhì)量,-現(xiàn)場(chǎng)調(diào)查階段注重調(diào)查員培訓(xùn)、選擇偏倚和測(cè)量偏倚控制；數(shù)據(jù)處理階段通過(guò)核查程序和人工靜態(tài)檢驗(yàn)確保數(shù)據(jù)準(zhǔn)確。 結(jié)果 1.國(guó)際航行船舶中國(guó)船員基本情況 本次調(diào)查331名中國(guó)船員平均年齡37.5歲(37.5±10.9),全部為男性船員,漢族占95.8%,95.7%船員有宗教信仰,已婚占71.6%。船員文化程度以高中／中專所占比例最多,達(dá)41.5%,文化程度以初中至大專為主,文化程度形成兩端少中間多的橄欖形態(tài)；船員月收入中2000-5000船員數(shù)最多。通過(guò)對(duì)船員文化程度和船員月收入分析,船員文化程度與月收入呈正相關(guān)(r=0.343,P0.01) 2.船員職業(yè)基本情況 74.0%船員屬于自由船員,與公司有長(zhǎng)期合同的占21.8%,表明我國(guó)隨著船員市場(chǎng)化,自由船員已經(jīng)占主體。本次調(diào)查有中國(guó)船員服務(wù)的外籍船舶占80.3%,船員勞務(wù)外派已成中國(guó)船員勞動(dòng)關(guān)系的重要組成部分,94.2%船員可以接受與船公司之間的勞動(dòng)關(guān)系,勞動(dòng)關(guān)系簽訂過(guò)程中157名(47.4%)有中介機(jī)構(gòu)參與,對(duì)繳納費(fèi)用船員和未繳納費(fèi)用船員對(duì)中介機(jī)構(gòu)評(píng)價(jià)情況對(duì)比分析,發(fā)現(xiàn)繳納費(fèi)用船員對(duì)中介評(píng)價(jià)明顯比未繳納費(fèi)用更差(Z=-3.863,P0.01)。船舶生活工作環(huán)境差,船員對(duì)工作生活環(huán)境評(píng)價(jià)不隨收入增加而感受更好(H=7.042,P0.05)；37.2%船員無(wú)任何醫(yī)療保障。 3.中國(guó)船員健康狀況和健康行為 與公司有長(zhǎng)期合同船員自身健康狀況評(píng)價(jià)好于自由船員和其他類型船員。中國(guó)船員1年內(nèi)各類疾病患病率達(dá)到78.25%,船員意外傷害率為53.17%,甲板部船員更易受到意外傷害(χ2=7.42,P0.05),船員肝腸炎傳染病患病率為8.76%,腫瘤患病率為2.11%,心血管疾病患病率為9.97%,呼吸系統(tǒng)患病率為22.66%,消化系統(tǒng)患病率為31.72%,泌尿生殖系統(tǒng)患病率為7.25%,神經(jīng)精神系統(tǒng)疾病患病率為10.88%,內(nèi)分泌系統(tǒng)疾病患病率為3.02%,其他疾病患病率為9.97%,均顯著高于2010中國(guó)衛(wèi)生統(tǒng)計(jì)年鑒及其他學(xué)者調(diào)查的居民各類疾病患病率。心理方面除社會(huì)功能外船員活力和心理健康比正常人群差,39.3%船員在海上服務(wù)期間碰到過(guò)因生病而離船的船員,21.2%船員在海上服務(wù)期間碰到過(guò)精神失常和感覺(jué)其明顯有心理障礙的船員。船員健康相關(guān)行為主要有對(duì)家思戀、吸煙、缺乏規(guī)律鍛煉和娛樂(lè)文化活動(dòng)貧乏。 4.職業(yè)衛(wèi)生知識(shí)知曉情況 船員接觸職業(yè)有害因素知曉依次為噪音(74.0%)、風(fēng)浪(68.6%)、高溫(45.9%)、振動(dòng)(44.7%)、工作外傷(37.5%)、輻射(22.7%)、中毒(20.8%)、化學(xué)腐蝕(19.0%)、其他傷害(18.1%)、灼傷(16.9%)、電擊傷(12.1%)。 船員對(duì)職業(yè)衛(wèi)生知識(shí)知曉率為48.4%,船員文化程度、職務(wù)、月收入、中介機(jī)構(gòu)參與程度、船上娛樂(lè)活動(dòng)、人際關(guān)系和不同職業(yè)病防范知識(shí)獲取途徑是船員職業(yè)衛(wèi)生知曉率影響因素。衛(wèi)生培訓(xùn)、健康檢查、健康監(jiān)護(hù)檔案、工會(huì)等覆蓋率不高,職業(yè)病防治法等法律法規(guī)的規(guī)定未得到全面落實(shí),船員獲取知識(shí)途徑最多的是報(bào)紙電視等新聞媒體,最少的為政府或社會(huì)團(tuán)體的宣傳和培訓(xùn),139名船員(42.0%)通過(guò)兩種以上途經(jīng)該獲得職業(yè)病防范知識(shí)和技術(shù)。52.3%能正確面對(duì)職業(yè)病,通過(guò)正確途徑維護(hù)權(quán)益。有毒物質(zhì)進(jìn)入人體途徑正確率為71.0%,高級(jí)船員對(duì)有毒物質(zhì)進(jìn)入人體途徑知曉率高于低級(jí)船員。 5.船員職業(yè)健康教育需求 船員總體職業(yè)健康需求平均為9.50分,船員文化程度、船員類型、中介機(jī)構(gòu)參與程度、定期衛(wèi)生培訓(xùn)制度、職業(yè)衛(wèi)生知曉率是船員職業(yè)健康需求水平的影響因素,無(wú)生理疾病是減少職業(yè)健康需求因素；船員對(duì)安全生產(chǎn)相關(guān)知識(shí)希望率達(dá)到89.7%,對(duì)工作壓力緩解衛(wèi)生服務(wù)為89.4%,希望獲得個(gè)人衛(wèi)生防護(hù)用品使用方法服務(wù)的為87.9%,87.0%希望獲得職業(yè)病防治法規(guī)條例知識(shí),86.3%希望獲得職業(yè)中毒癥狀及應(yīng)急救援方法,82.2%希望知道職業(yè)性和工作相關(guān)疾病防治,希望獲得職業(yè)危害因素種類及對(duì)人體危害為77.0%。健康教育方式47.1%船員認(rèn)為現(xiàn)場(chǎng)宣講的方式效果明顯,49.5%船員認(rèn)為職業(yè)健康教育應(yīng)在證書培訓(xùn)時(shí)進(jìn)行,船員最感興趣的健康知識(shí)是身體保健知識(shí)(56.5%)和疾病預(yù)防知識(shí)(55.6%),高級(jí)船員在靠泊港國(guó)際疫情信息、傷害緊急救助、身體保健、疾病預(yù)防知識(shí)、運(yùn)動(dòng)健身知識(shí)、心理疾病知識(shí)等方面興趣程度均高于低級(jí)船員。 結(jié)論 331名船員1年內(nèi)患病率為78.25%；其中,意外傷害的患病率最高(53.17%),甲板部船員的意外傷害患病率高于其他部門船員(P0.05)。船員職業(yè)衛(wèi)生知識(shí)知曉率為48.4%,其影響因素包括文化程度、職務(wù)、月收入、中介機(jī)構(gòu)參與的勞動(dòng)關(guān)系簽訂、穿上娛樂(lè)活動(dòng)情況、人際關(guān)系、同事告知、媒體宣傳、政府宣傳培訓(xùn)等。船員接觸的職業(yè)有害因素包括噪音、風(fēng)浪、高溫、振動(dòng)、工作外傷、輻射、中毒、化學(xué)腐蝕、灼傷、電擊傷等；其中,輪機(jī)部船員高溫、振動(dòng)、灼傷的發(fā)生率高于其他船員(P0.05)。船員文化程度、船員類型、中介機(jī)構(gòu)參與程度、定期衛(wèi)生培訓(xùn)制度、職業(yè)衛(wèi)生知曉率是船員職業(yè)健康需求水平的影響因素；船員各類職業(yè)健康教育需求高,形成了高需求和低職業(yè)衛(wèi)生服務(wù)覆蓋率之間的矛盾。
[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.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R13

【引證文獻(xiàn)】

相關(guān)期刊論文 前1條

1 鄭春梅;伊向仁;李元;;健身鍛煉對(duì)不同職業(yè)國(guó)民多維壓力與心理健康影響的分析研究——以山東省不同職業(yè)人員為例[J];北京體育大學(xué)學(xué)報(bào);2013年01期

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本文編號(hào)：2246694