张岩松, 张小梅, 冯灵云, 张颖琳, 张伟军. 我国职业病诊断机构现状与对策[J]. 环境与职业医学, 2022, 39(6): 690-694, 700. DOI: 10.11836/JEOM21603
引用本文: 张岩松, 张小梅, 冯灵云, 张颖琳, 张伟军. 我国职业病诊断机构现状与对策[J]. 环境与职业医学, 2022, 39(6): 690-694, 700. DOI: 10.11836/JEOM21603
ZHANG Yansong, ZHANG Xiaomei, FENG Lingyun, ZHANG Yinglin, ZHANG Weijun. Present situation and countermeasures of occupational disease diagnosis institutions in China[J]. Journal of Environmental and Occupational Medicine, 2022, 39(6): 690-694, 700. DOI: 10.11836/JEOM21603
Citation: ZHANG Yansong, ZHANG Xiaomei, FENG Lingyun, ZHANG Yinglin, ZHANG Weijun. Present situation and countermeasures of occupational disease diagnosis institutions in China[J]. Journal of Environmental and Occupational Medicine, 2022, 39(6): 690-694, 700. DOI: 10.11836/JEOM21603

我国职业病诊断机构现状与对策

Present situation and countermeasures of occupational disease diagnosis institutions in China

  • 摘要: 背景 当前我国职业病防治形势依然严峻,职业病呈高发势头。职业病诊断是职业病防治的重要环节,然而我国职业病诊断服务体系现状不容乐观。国家有关法规、政策和规划等要求完善职业病诊断防治技术支撑体系,并依托现有的医疗卫生机构建立健全职业病诊断救治康复网络。

    目的 分析我国职业病诊断机构发展现状和存在的问题,提出发展措施与建议。

    方法 采用全面普查的方法,对全国所有职业病诊断机构进行问卷调查。国家卫生健康委职业卫生中心组织编制调查问卷,并组织所有相关机构参与调查。各类调查数据均为2020年度情况,数据统计截至2020年12月31日。主要调查各类职业病诊断机构的整体情况、业务范围、职业病诊断资格医师配备、仪器设备配备的情况。

    结果 截至2020年12月,全国共有587家职业病诊断机构,重庆市的企业机构数量比高达3.9万,从业人员机构数量比高达215.0万。全国共有5 809名职业病诊断资格医师,各级职业病防治院配置情况为20.4人·家−1,各级综合医院为9.5人·家−1,各级疾控中心仅为8.3人·家−1。87.7%的机构配置了数字X射线摄影(DR),58.1%的机构配置了X射线计算机体层摄影(CT),96.4%的机构配置了肺功能仪;各级疾控中心的计算机X射线摄影(CR)的配置率仅为6.5%,CT仅为14.6%;45家疾控中心未配置普通X光机、CR、DR、CT中的任何一种设备。

    结论 本次调查发现,面对依然严峻的职业病防治形势,我国各地职业病诊断机构整体分布不平衡,部分地区机构数量相对不足,同时各级疾控中心的综合能力有待提升。应进一步加强机构综合能力建设和诊断医师业务培训,确保诊断的准确性和科学性。国家层面应进一步加大政策引导和经费投入,帮助职业病诊断机构提升技术水平和服务能力,保障劳动者职业健康权益。

     

    Abstract: Background China is facing enormous challenges of occupational disease prevention and control and high incidences of occupational diseases. Occupational disease diagnosis is an important part of occupational disease prevention and control. However, the current situation of occupational disease diagnosis service system in China is not optimistic. Relevant national laws, regulations, policies, and plans require to improve the current technical support system of occupational disease diagnosis and treatment, and to establish a sound occupational disease diagnosis, treatment, and rehabilitation network on the foundation of existing medical and health institutions.

    Objective To analyze the development status and existing problems of occupational disease diagnosis institutions in China, and propose countermeasures and suggestions.

    Methods All occupational disease diagnosis institutions in China were surveyed by questionnaire using comprehensive census. The Occupational Health Center of the National Health Commission organized the preparation of the questionnaire and the participation of all relevant institutions in the survey. All data collected in the survey were for the year 2020 and available as of December 31, 2020. The questionnaire covered the overall situation, service provided, staffing of certified physicians for providing occupational disease diagnosis, and instruments in selected categories of occupational disease diagnosis institutions.

    Results As of December 2020, there were 587 occupational disease diagnosis institutions in China; the highest average number of enterprises served by an occupational disease diagnosis institution was 39000, and that of employees served by an occupational disease diagnosis institution was 2.15 million in Chongqing. There were a total of 5809 physicians certified to diagnose occupational diseases in China, with 20.4 doctors per specified occupational disease prevention and treatment hospital, 9.5 doctors per general hospital, and 8.3 doctors per disease control and prevention center. Only 87.7% of the institutions were equipped with digital radiography (DR), 58.1% with computed tomography (CT), and 96.4% with pulmonary function meters; the equipment rate of computed radiography (CR) was only 6.5%, and that of CT was only 14.6% in all-level disease control and prevention centers; 45 disease control and prevention centers were not equipped with any common x-ray machine, CR, DR, or CT.

    Conclusion In the face of the still serious situation of prevention and treatment of occupational diseases, the overall distribution of institutions is uneven around China, the number of institutions in some regions is relatively insufficient, and the comprehensive capacity of centers for disease control and prevention at all levels needs to be improved. Strengthening comprehensive capacity building of occupational disease diagnosis institutions and training of relevant physicians would be helpful to ensure the accuracy and scientificity of diagnosis. At the national level, further increasing policy guidance and financial input would help occupational disease diagnosis institutions upgrade their techniques and service capacity, and protect workers' occupational health rights.

     

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