浙西地区316例职业性氢氟酸灼伤病例流行病学分析
Epidemiological analysis on 316 cases of occupational hydrofluoric acid burns in western Zhejiang Province
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摘要:
目的 研究浙西地区职业性氢氟酸灼伤病例的流行病学特征, 为企业安全生产管理和有关部门制定防控对策提供依据。
方法 利用回顾性流行病学方法调查2004年1月—2016年12月浙江衢化医院烧伤科和眼科收治的316例职业性氢氟酸灼伤住院病例, 收集一般人口学特征、企业特征和发病特征等资料, 进行流行病学描述, 并比较化工企业和非化工企业病例灼伤部位和中毒程度的分布差异。
结果 2004—2016年浙西地区职业性氢氟酸灼伤的病例数有逐年上升趋势。30~50岁年龄段病例比例最高(64.9%)。半数以上(53.8%)病例来源于氟化工企业, 装卸与运输、金属铸造、玻璃和水晶加工等非化工企业也占较高比例(46.2%)。民营企业所占比例较高(64.2%)。病例中, 64.2%未穿戴有效防护用品, 32.9%防护用品破损或穿戴不到位, 2.9%穿戴沾有氢氟酸的防护用品。绝大多数是小面积灼伤, 化工企业病例的灼伤部位常见于头面颈部(27.9%)、臂部和腿部(19.5%), 非化工企业则以手部(24.0%)多见, 两者差异有统计学意义(χ2=154.95, P < 0.01)。化工企业中毒严重程度与非化工企业相比, 总体上更为严重, 差异有统计学意义(χ2=67.70, P < 0.01)。
结论 氟化工企业的氢氟酸灼伤发生率高于非氟化工企业, 建议加强高危职业人员的职业卫生安全教育和防护用品配备。
Abstract:Objective To study the epidemiological characteristics of cases of occupational hydrofluoric acid burns in western Zhejiang Province, and to provide evidence for safety production management and formulating prevention and control measures.
Methods Retrospective epidemiological analysis was performed to collect data of 316 occupational hydrofluoric acid burn cases treated in the Department of Burns and Department of Ophthalmology in Zhejiang Quhua Hospital from January 2004 to December 2016.Information on patient general demographic characteristics, enterprise characteristics, and relevant incidence features were collected and analyzed, and the distribution of burn sites and poisoning degrees between patients from chemical enterprises and nonchemical enterprises were compared.
Results The incidence of occupational hydrofluoric acid burns in western Zhejiang Province was increasing annually from 2004 to 2016.When stratified by age, the highest incidence rate was found in the 30-50 year-old age group (64.9%).More than half (53.8%) of the patients were from fluorine chemical enterprises, and the others were from non-chemical enterprises such as handling and transportation, metal casting, and glass and crystal work (46.2%).A high incidence rate was found in private enterprises (64.2%).As to protective equipment, 64.2% of the patients didn't wear effective protective equipment, 32.9% were dressed in damaged protective equipment or not properly dressed, and 2.9% wore protective equipment contaminated with hydrofluoric acid.Most of the burns were small.Burns on head-neck (27.9%) and haunch-leg (19.5%) were common in the chemical enterprises, while hand burns (24.0%) were common in the non-chemical enterprises (χ2=154.95, P < 0.01).The severity of burns was higher in the chemical enterprises than in the non-chemical enterprises (χ2=67.70, P < 0.01).
Conclusion The incidence rate of occupational hydrofluoric acid burns is higher in the fluorine chemical enterprises than the non-fluorine chemical enterprises.It is suggested to strengthen occupational health and safety education and protective equipment allocation for high-risk workers.
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