摘要:

背景

汽車制造行業(yè)職業(yè)病危害因素復(fù)雜多樣，勞動者職業(yè)健康風(fēng)險較大。

目的

探討能準確反映汽車制造企業(yè)作業(yè)場所風(fēng)險水平的方法，指導(dǎo)企業(yè)進行風(fēng)險管理。

方法

采用綜合指數(shù)法、國際采礦與金屬委員會職業(yè)健康風(fēng)險評估法（ICMM法）和風(fēng)險指數(shù)法對湖南省3家汽車制造企業(yè)的電焊、打磨、噴漆等主要職業(yè)病危害因素接觸崗位進行風(fēng)險評估，用Kappa一致性檢驗三種評估方法的分級結(jié)果，用近三年的職業(yè)健康體檢復(fù)查和禁忌證檢出情況對評估結(jié)果進行驗證。

結(jié)果

綜合指數(shù)法評估結(jié)果顯示：A、B企業(yè)各崗位危害因素評估為2~3級，其中A企業(yè)二氧化氮為3級，B企業(yè)電焊煙塵、二氧化氮、甲醛均為3級；C企業(yè)各崗位危害因素為2~4級，C企業(yè)的二氧化氮、苯為4級，電焊煙塵、錳及其化合物、砂輪磨塵、二甲苯為3級。ICMM定量法評估各企業(yè)危害因素評估為2級和5級，其中A企業(yè)的錳及其化合物為5級，C企業(yè)的電焊煙塵、砂輪磨塵、苯系物為5級。風(fēng)險指數(shù)法評估各企業(yè)危害因素評估為1~4級，其中A、B企業(yè)錳及其化合物均為3級，C企業(yè)錳及其化合物、苯均為4級。綜合指數(shù)法與ICMM法、風(fēng)險指數(shù)法的Kappa值分別為0.084（P＞0.05）和?0.046（P＞0.05），ICMM法與風(fēng)險指數(shù)法的Kappa值為0.014（P＞0.05），一致性均較差。將職業(yè)健康監(jiān)護結(jié)果與評估結(jié)果進行比較，A企業(yè)發(fā)現(xiàn)錳作業(yè)職業(yè)禁忌證和發(fā)錳超標各1人，但綜合指數(shù)法對A企業(yè)錳及其化合物作業(yè)的風(fēng)險評估為低風(fēng)險，結(jié)果偏保守；ICMM識別出的關(guān)鍵崗位與體檢結(jié)果一致，但評估等級均為極高風(fēng)險，結(jié)果過于嚴格；C企業(yè)電焊崗位發(fā)現(xiàn)電焊煙塵作業(yè)禁忌證1人、打磨崗位發(fā)現(xiàn)重度混合型肺通氣功能障礙2人，各企業(yè)焊接、打磨均發(fā)現(xiàn)輕、中度肺通氣功能障礙多發(fā)，而風(fēng)險指數(shù)法對電焊煙塵、砂輪磨塵作業(yè)的評估結(jié)果均為可忽略風(fēng)險，與體檢結(jié)果不符。

結(jié)論

綜合指數(shù)法、ICMM法、風(fēng)險指數(shù)法均能基本識別出職業(yè)病危害嚴重崗位，但具有一定的局限性和適用性。綜合來看，綜合指數(shù)法其評估結(jié)果與職業(yè)健康監(jiān)護結(jié)果一致性更好，考慮較為全面、客觀，更適合汽車制造企業(yè)的風(fēng)險評估。

Abstract:

Background

The complex and diverse occupational disease hazards in automobile manufacturing industry pose high occupational health risks to workers.

Objective

To explore the methods that can accurately reflect the workplace health risk grade of automobile manufacturing enterprises, and to guide enterprises to practice risk classification management.

Methods

Comprehensive index method, International Commission on Mining and Metals occupational health risk assessment method (ICMM method), and risk index method were used toassess health risks of occupational disease hazards in major workstations such as welding, polishing, and painting in three automobile manufacturing enterprises in Hunan Province. Kappa consistency test was used to test the grading results of the three assessment methods. The re-examine results and detection rate of contraindications of occupational health examinations in the past three years were used to verify the assessment results.

Results

The results of comprehensive index method showed that the hazards of each selected workstation in enterprises A and B were evaluated as grade 2-3, among which NO2 in enterprise A was grade 3, and welding fume, NO2, and formaldehyde in enterprise B were all grade 3. The hazards of each selected workstation in enterprise C were grade 3-4, among which NO2 and benzene in were grade 4, and welding fume, manganese and its compounds, grinding wheel dust, and xylene were grade 3. The hazards evaluated by ICMM quantitative method were grade 2 and grade 5, among which manganese and its compounds in enterprise A and welding fume, grinding wheel dust, and benzene series in enterprise C were graded as grade 5. The hazards evaluated by risk index method were grade 1-4, among which manganese and its compounds in enterprises A and B were grade 3, and manganese and its compounds and benzene in enterprise C were grade 4. The Kappa value between comprehensive index method and ICMM method was 0.084 (P>0.05), that between comprehensive index method and risk index method was ?0.046 (P>0.05), and that between ICMM method and risk index method was 0.014 (P>0.05), indicating poor consistency. By comparing the results of occupational health surveillance with the results of occupational health risk assessment, one worker was found to have occupational contraindication of manganese exposure and 1 worker was found to have excessive manganese in hair in enterprise A. However, the comprehensive index method graded low risk for manganese and its compounds in enterprise A and the result is conservative. The key workstations identified by ICMM method were consistent with the occupational health examination results, but the assessment grades were all extremely high risk, and the results were too strict. One worker was found to be contraindicated to welding fumes, and 2 polishers were found to have severe mixed pulmonary ventilation dysfunction in enterprise C. Mild and moderate pulmonary ventilation dysfunction was found to be common in welding and polishing workstations in each enterprise. The assessment results of welding fumes and grinding wheel dust by the risk index method were negligible risks, which were inconsistent with the occupational health examination results.

Conclusion

The comprehensive index method, ICMM method, and risk index method can basically identify workstations with serious occupational hazards, but they have certain limitations and applicability. In general, the evaluation results of the comprehensive index method were generates more consistent with the results with occupational health surveillance than the other two methods, is more comprehensive and objective in consideration, and is more suitable for health risk assessment of automobile manufacturing enterprises.

表  1   職業(yè)衛(wèi)生調(diào)查及檢測結(jié)果

Table  1   Occupational health survey and test results

企業(yè)
(Enterprise)崗位
(Workstation)勞動定員
(Manpower quota)日接觸時間/h
(Daily
exposure
hours)危害因素
(Hazard)檢測崗位數(shù)
(Detected position)檢測濃度/
(mg·m?3)
(Concentration)職業(yè)接觸限值/(mg·m?3)
(Occupational
exposure limits)工程防護措施
(Engineering protection
measure)個體防護措施
(Personal protective
measure) A企業(yè)(A enterprise)點焊(Spot welding)1507.5電焊煙塵(Welding fume)170.5~1.04全室通風(fēng)+移動除塵器
(General ventilation+mobile dust collector)防塵毒半面罩(Dust-proof half-face mask)二氧化氮(Nitrogen dioxide)30.25同上同上MIG焊/MAG焊(MIG welding/MAG welding)1247.5電焊煙塵(Welding fume)270.5~1.44全室通風(fēng)+上吸罩或移動除塵器(General ventilation+upper suction hood or mobile dust collector)防塵毒半面罩(Dust-proof half-face mask)錳及其化合物(Manganese and its compounds)21＜0.004~0.0240.15同上同上二氧化氮(Nitrogen dioxide)130.25同上同上打磨(Polishing)1147.5砂輪磨塵(Grinding wheel dust)130.4~1.68全室通風(fēng)+移動除塵器(General ventilation+mobile dust collector)防塵口罩(Dust mask)噴漆(Spraying)227.5二甲苯(Xylene)2＜3.350全室通風(fēng)及崗位送風(fēng)系統(tǒng)+每個噴漆房各設(shè)有一套單獨漆霧凈化系統(tǒng)(General ventilation and local air supply system+a separate paint mist purification system in each painting room)防毒面罩、防護服(Gas mask, protective clothing)乙苯(Ethyl benzene)2＜1.3100同上同上乙酸丁酯(Butyl acetate)2＜0.3200同上同上丁醇(Butyl alcohol)2＜0.2100同上同上丙醇(n-Propyl alcohol)2＜0.6200同上同上B企業(yè)(B enterprise)點焊(Spot welding)3037.5電焊煙塵(Welding fume)210.4~1.74全室通風(fēng)+局部通風(fēng)除塵設(shè)施(General ventilation+local ventilation with dust removal facilities)防塵毒半面罩(Dust-proof half-face mask)二氧化氮(Nitrogen dioxide)20.095同上同上二氧化碳氣體保護焊(Carbon dioxide arc welding)387.5電焊煙塵(Welding fume)90.2~1.14全室通風(fēng)+局部通風(fēng)除塵設(shè)施(General ventilation+local ventilation with dust removal facilities)防塵毒半面罩(Dust-proof half-face mask)錳及其化合物(Manganese and its compounds)7<0.004~0.0130.15同上同上二氧化氮(Nitrogen dioxide)40.008~0.15同上同上打磨(Polishing)347.5砂輪磨塵(Grinding wheel dust)30.4~0.68全室通風(fēng)+局部通風(fēng)除塵設(shè)施(General ventilation+local ventilation with dust removal facilities)防塵口罩(Dust mask)噴漆(Spraying)327.5甲苯(Toluene)3<1.250通風(fēng)凈化處理裝置+水旋式洗滌器吸收漆霧(Ventilation with purification treatmente+water rotary scrubber to absorb paint mist)防毒面罩、防護服(Gas mask, protective clothing)二甲苯(Xylene)3<3.350同上同上乙酸乙酯(Ethyl acetate)3<0.3200同上同上乙酸丁酯(Butyl acetate)3<0.3200同上同上甲醇(Methyl alcohol)3<1.325同上同上異丙醇(Isopropyl alcohol)3<0.7350同上同上甲醛(Formalde)3<0.070.5同上同上丙酮(Acetone)3<0.5300同上同上C企業(yè)(C enterprise)點焊(Spot welding)1437.5電焊煙塵(Welding fume)20.24移動式通風(fēng)除塵設(shè)施(Mobile ventilation with dust removal facilities)防塵毒半面罩(Dust-proof half-face mask)二氧化氮(Nitrogen dioxide)20.02~0.035同上同上二氧化碳氣體保護焊(Carbon dioxide arc welding)827.5電焊煙塵(Welding fume)100.2~0.74移動式通風(fēng)除塵設(shè)施(Mobile ventilation with dust removal facilities)防塵毒半面罩(Dust-proof half-face mask)錳及其化合物(Manganese and its compounds)10＜0.007~0.0080.15同上同上二氧化氮(Nitrogen dioxide)60.1~0.25同上同上打磨((Polishing)377.5砂輪磨塵(Grinding wheel dust)60.4~1.68移動式通風(fēng)除塵設(shè)施(Mobile ventilation with dust removal facilities)防塵口罩(Dust mask)噴漆(Spraying)697.5苯(Benzene)80.3~1.16通風(fēng)排毒系統(tǒng)(Ventilation with detoxification system)防毒面罩、防護服(Gas mask, protective clothing)甲苯(Toluene)8＜0.3~4.850同上同上二甲苯(Xylene)8＜0.3~26.750同上同上乙酸乙酯(Ethyl acetate)8＜0.3200同上同上乙酸丁酯(Butyl acetate)8＜0.3200同上同上丁醇(Butyl alcohol)8＜0.2100同上同上

表  2   3種職業(yè)健康風(fēng)險評估方法的結(jié)果

Table  2   Results of three occupational health risk assessment methods

企業(yè)
(Enterprise)崗位
(Workstation)危害因素
(Hazard)綜合指數(shù)法
(Comprehensive
index method)ICMM法
(International Council
on Mining and
Metals model)風(fēng)險指數(shù)法
(Risk index
method)HRERR風(fēng)險等級
(Risk
grade)CPrEPeEUR風(fēng)險等級
(Risk
grade)健康效應(yīng)
(Health
effect)接觸水平
(Level of
exposure)作業(yè)條件
(Operating
condition)RR風(fēng)險等級
(Risk
grade) A企業(yè)(A enterprise)點焊(Spot welding)電焊煙塵(Welding fume)31.95221310130211.142.592.951二氧化氮(Nitrogen dioxide)51.80331310130221.032.595.331MIG焊/MAG焊(MIG welding/MAG welding)電焊煙塵(Welding fume)31.95221310130211.162.593.001錳及其化合物(Manganese and its compounds)22.0422153101450581.042.5921.503二氧化氮(Nitrogen dioxide)51.80331310130221.032.595.331打磨(Polishing)砂輪磨塵(Grinding wheel dust)31.95221310130211.082.592.791噴漆(Spraying)二甲苯(Xylene)31.90221310130221.002.635.261乙苯(Ethyl benzene)31.84221310130221.002.635.261乙酸丁酯(Butyl acetate)21.90221310130211.002.632.631丁醇(Butyl alcohol)21.84221310130211.002.632.631丙醇(n-Propyl alcohol)21.90221310130221.002.635.261B企業(yè)(B enterprise)點焊(Spot welding)電焊煙塵(Welding fume)32.10331310130211.142.592.951二氧化氮(Nitrogen dioxide)51.95331310130221.032.595.331二氧化碳氣體保護焊(Carbon dioxide arc welding)電焊煙塵(Welding fume)32.10331310130211.092.592.831錳及其化合物(Manganese and its compounds)21.95221310130281.052.5921.703二氧化氮(Nitrogen dioxide)51.95331310130221.012.595.251打磨(Polishing)砂輪磨塵(Grinding wheel dust)31.95221310130211.052.592.711噴漆(Spraying)甲苯(Toluene)22.05221310130221.002.635.261二甲苯(Xylene)32.05221310130221.002.635.261乙酸乙酯(Ethyl acetate)22.10221310130211.002.632.631乙酸丁酯(Butyl acetate)22.05221310130211.002.632.631甲醇(Methyl alcohol)22.10221310130221.002.635.261異丙醇(Isopropyl alcohol)22.05221310130221.002.635.261甲醛(Formalde)51.89331310130241.002.6310.532丙酮(Acetone)22.10221310130211.002.632.631C企業(yè)(C enterprise)點焊(Spot welding)電焊煙塵(Welding fume)32.81331310130211.043.313.431二氧化氮(Nitrogen dioxide)52.81441310130221.033.316.812二氧化碳氣體保護焊(Carbon dioxide arc welding)電焊煙塵(Welding fume)32.8133153101450511.063.313.501錳及其化合物(Manganese and its compounds)23.17331310130281.053.3127.734二氧化氮(Nitrogen dioxide)52.81441310130221.013.316.702打磨(Polishing)砂輪磨塵(Grinding wheel dust)33.0333153101450511.053.313.491噴漆(Spraying)苯(Benzene)53.1944153101450581.092.7824.344甲苯(Toluene)22.8622153101450521.012.785.641二甲苯(Xylene)33.1933153101450521.082.785.991乙酸乙酯(Ethyl acetate)22.86221310130211.002.782.781乙酸丁酯(Butyl acetate)22.96221310130211.002.782.781丁醇(Butyl alcohol)22.94221310130211.002.782.781

表  3   職業(yè)健康風(fēng)險評估結(jié)果驗證

Table  3   Verification of occupational health risk assessment results

企業(yè)
(Enterprise)危害因素
(Hazard)風(fēng)險等級
(Risk grade)體檢人次
(No. of physical examinations)復(fù)查
(Re-examine)職業(yè)禁忌證
(Occupational contraindications) 綜合指數(shù)法
(Composite index method)ICMM法
(ICMM method)風(fēng)險指數(shù)法
(Risk index method)人數(shù)
(No. of cases)復(fù)查率/%
(Rate of
re-examine)/%人數(shù)
(No. of cases)檢出率/%
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