摘要
目的探讨GBZ 98-2020《放射工作人员健康要求及监护规范》的实施对放射工作人员职业健康检查结果的影响。方法于2022年4月,选取在合肥市职业病防治院进行放射工作人员职业健康检查者为研究对象。登记时间为2021年5月1日至2022年4月30日的放射工作人员为新规范组,其职业健康监护规范为GBZ 98-2020《放射工作人员健康要求及监护规范》;登记时间为2020年5月1日至2021年4月30日的放射工作人员为旧规范组,其职业健康监护规范为GBZ 98-2017《放射工作人员健康要求》和GBZ 235-2011《放射工作人员职业健康监护技术规范》。分析两组在检查项目缺检、复查及职业禁忌证检出率之间是否存在差异。职业健康检查结果中存在复查和(或)职业禁忌证的体检人员被判定为不合格组。通过单因素及多因素logistic回归分析寻找影响不合格组判定的因素。结果新规范组放射工作人员缺检检出率3.04%(63/2074),明显高于旧规范组的0.68%(14/2054)(P<0.05);新规范组复查及职业禁忌证检出率分别为5.93%(123/2074)、0.58%(12/2074),明显低于旧规范组的13.83%(284/2054)、2.34%(48/2054)(P<0.05)。新规范组男性缺检检出率2.78%(40/1440),明显高于旧规范组男性的0.72%(11/1536)(P<0.05);新规范组男性复查及职业禁忌证检出率分别为3.61%(52/1440)、0.21%(3/1440),明显低于旧规范组的12.17%(187/1536)、2.08%(32/1536)(P<0.05)。新规范组女性缺检检出率3.63%(23/634),明显高于旧规范组女性的0.58%(3/518)(P<0.05);新规范组女性复查检出率11.20%(71/634),明显低于旧规范组女性的18.73%(97/518)(P<0.05)。单因素logistic回归分析显示,性别、照射分类、判定依据、职业健康检查类别、登记类别均为放射工作人员职业健康检查结果不合格的影响因素(P<0.05)。多因素logistic回归分析显示,以旧规范为依据被判定为不合格的风险是新规范的2.466倍(95%CI:1.975~3.080,P<0.05),女性被判定为不合格的风险是男性的1.869倍(95%CI:1.498~2.333,P<0.05),在岗期间及离岗时的放射工作人员被判定为不合格的风险是上岗前人员的0.802倍(95%CI:0.650~0.989,P<0.05),复检人员被判定为不合格的风险是初检人员的4.056倍(95%CI:3.161~5.203,P<0.05)。结论放射工作人员职业健康检查结果与判定依据及受检者的性别、职业健康检查类别、登记类别有关,GBZ 98-2020《放射工作人员健康要求及监护规范》的实施降低了不合格人员的检出率。
ObjectiveTo investigate the impact of the implementation of GBZ 98-2020"Health Requirements and Surveillance Specifications for Radiation Worker"on the results of occupational health examination for radiation workers.MethodsIn April 2022,the subjects of the study were the radiation workers who underwent occupational health examination in Occupational Disease Prevention and Treatment Institute of Hefei.The radiation workers whose registration period was from May 1,2021 to April 30,2022 were the new standard group,and the occupational health surveillance standard was GBZ 98-2020"Health Requirements and Surveillance Specifications for Radiation Worker".The radiationl workers registered from May 1,2020 to April 30,2021 were the old standard group,whose occupational health surveillance standards were GBZ 98-2017"Health Requirements for Radiation Workers"and GBZ 235-2011"Specifications for Occupational Health Surveillance for Radiation Workers".To analyze whether there were differences between the two groups in the detection rate of missing items in the examination,re-examination,and the detection rate of occupational contraindications.The radiation workers whose occupational health examination results showed re-examination and/or occupational contraindications were judged to be in the unqualified group.Univariate and multivariate logistic regression analysis was used to find the factors affecting the determination of unqualified group.ResultsThe missing item detection rate of radiation workers in the new standard group was 3.04%(63/2074),significantly higher than that in the old standard group(0.68%,14/2054)(P<0.05).The re-examination and occupational contraindications detection rates in the new standard group were 5.93%(123/2074)and 0.58%(12/2074),respectively,which were significantly lower than those in the old standard group(13.83%,284/2054)and 2.34%(48/2054)(P<0.05).The missing item detection rate of males in the new standard group was 2.78%(40/1440),which was significantly higher than that in the old standard group(0.72%,11/1536)(P<0.05).The re-examination and occupational contraindications detection rates of males in the new standard group were 3.61%(52/1440)and 0.21%(3/1440),respectively,which were significantly lower than those in the old standard group(12.17%,187/1536)and 2.08%(32/1536)(P<0.05).The missing item detection rate of females in the new standard group was 3.63%(23/634),which was significantly higher than that in the old standard group(0.58%,3/518)(P<0.05).The re-examination detection rate of females in the new standard group was 11.20%(71/634),which was significantly lower than that of females in the old standard group(18.73%,97/518)(P<0.05).Univariate logistic regression analysis showed that gender,radiation classification,determination basis,occupational health examination category,and registration category were all influencing factors for the unqualified occupational health examination results of radiation workers(P<0.05).Multivariate logistic regression analysis showed that the risk of being judged as unqualified based on the old standard was 2.466 times that of the new standard(95%CI:1.975-3.080,P<0.05),and the risk of being judged as unqualified for females was 1.869 times that of males(95%CI:1.498-2.333,P<0.05),the risk of being judged as unqualified for radiation workers during and after employment was 0.802 times that of pre-employment individuals(95%CI:0.650-0.989,P<0.05),and the risk of being judged as unqualified for re-examined individuals was 4.056 times that of initial examinees(95%CI:3.161-5.203,P<0.05).ConclusionThe results of occupational health examination of radiation workers are related to the determination basis,gender,occupational health examination category,and registration category.The implementation of GBZ 98-2020"Health Requirements and Surveillance Specifications for Radiation Worker"may reduce the detection rate of unqualified personnel.
作者
周斌
张家祥
Zhou Bin;Zhang Jiaxiang(Department of Occupational and Environmental Health,School of Public Health,Anhui Medical University,Hefei 230032,China;Department of Ocuupational Disease,Hefei Third Clinical College of Anhui Medical University(the Third People's Hospital of Hefei),Hefei 230022,China)
出处
《中华劳动卫生职业病杂志》
CAS
CSCD
北大核心
2024年第5期370-374,共5页
Chinese Journal of Industrial Hygiene and Occupational Diseases
关键词
辐射
电离
放射工作人员
职业健康监护
适任性评价
Radiation,ionizing
Radiation worker
Occupational health surveillance
Judgment on worker fitness
作者简介
通信作者:张家祥,Email:jiaxiang5337@ahmu.edu.cn。
