两种方法在石油炼制企业职业健康风险分级分类管理中的应用

Practice of two methods in occupational health risk grading and classification management in petroleum refining enterprises

  • 摘要:
    背景 用人单位职业健康综合风险分级分类研究目前大多仍停留在方法学的建立和描述,实际应用研究少见报道。
    目的 探讨国家疾控局联合国家卫生健康委员会发布的职业病危害综合风险评估法以及自行开发的职业健康分级分类法在石油炼制企业中的应用情况,为相关监管部门实施差异化执法提供实践经验。
    方法 采用两种职业健康分级分类方法在广东省3家石油炼制企业进行应用。职业病危害综合风险评估法是为贯彻落实国家疾控局、国家卫生健康委《关于开展职业卫生分类监督执法试点工作的通知》,其原理是根据用人单位劳动者接触职业病危害因素性质、接触水平、接触人数等指标得出职业健康风险等级,再结合职业卫生管理状况等级划分为甲类、乙类和丙类。职业健康分级分类法是根据国内外职业健康风险评估方法自行开发的,其原理是根据化学毒物的致癌性分级或LD50/LC50、噪声的健康危害程度、职业病危害因素的暴露资料,如暴露量、暴露频率等指标计算用人单位各岗位风险等级,利用罗马尼亚综合风险计算方法求得用人单位的综合风险Ro,再计算出经用人单位职业健康管理指数加权后的综合风险R o',并将其分为甲类、乙类和丙类。最后,对两种分级分类方法的评估结果、适用范围、需收集的指标、专业能力要求、优缺点等进行定性比较。
    结果 本研究中3家企业重点评估的职业病危害因素有苯、甲苯、二甲苯、汽油、硫化氢和噪声;苯、甲苯、二甲苯、汽油的接触水平均低于10%职业接触限值(OEL),硫化氢和噪声均存在超标情况。3家企业存在的职业病危害因素如苯、硫化氢为严重的职业病危害因素,接触人数分别为461、912和224人;苯、甲苯、二甲苯、汽油、硫化氢和噪声的固有危害等级(HR)分别为5、3、2、3、5和3级。职业病危害综合风险法评出3家企业的职业卫生管理状况等级分别为B、A和B级;职业健康分级分类法评出3家企业的职业健康管理指数等级分别为B、A和A级。综合风险评估结果显示,职业病危害综合风险评估法将2家企业的综合风险类别评为最高等级丙类,1家评为乙类,而职业健康分级分类法将3家企业的综合风险类别均评为乙类。
    结论 两种分级分类方法在炼油企业的评估结果并不一致,且在评估范围、需收集的指标、专业性等方面存在差异。建议职业卫生监管部门充分考虑两种方法的优劣并结合实际监管目的选择合适的监管方法。

     

    Abstract:
    Background Most of the studies on grading and classification of occupational health compre-hensive risks for specific employers still remain in the establishment and description of methodology, and practical application studies are rarely reported.
    Objective To explore the application of an occupational disease hazards comprehensive risk assessment method issued by the National Disease Control and Prevention Bureau in conjunction with the National Health Commission and a self-developed occupational health grading and classification method in petroleum refining enterprises, and to provide practical experience for the implementation of differentiated law enforcement by relevant regulatory authorities.
    Methods Two occupational health grading and classification methods were practiced in three petroleum refining enterprises in Guangdong Province. The occupational hazards comprehensive risk assessment method was provided by the Notice on Carrying out Pilot Work of Occupational Health Classification Supervision and Law Enforcement of the National Disease Control and Prevention Bureau and the National Health Commission. The principle was to derive the occupational health risk level according to nature of occupational hazards, exposure level, and number of workers exposed to them in an employer, and then to classify them into Class A, Class B, and Class C by combining with local occupational health management status level. The occupational health grading and classification method was self-developed according to available domestic and foreign occupational health risk assessment methods. Its principle was to calculate the risk level of each workstation in an employer based on published carcinogenicity classification or LD50/LC50 of chemical toxicants, level of noise, exposure parameters such as exposure level and exposure frequency, estimate the comprehensive risk Ro of the target employer by the Romanian comprehensive risk calculation method, and then calculate a comprehensive risk Ro' weighted by the occupational health management index of the target employer and classify it into class A, class B, and class C. Finally, assessment results, scope of application, inquired indicators, advantages,disadvantages and professional competence requirements of the two grading and classification methods were compared.
    Results The occupational hazards that were evaluated in three enterprises in this study were benzene, toluene, xylene, gasoline, hydrogen sulfide, and noise. The exposure levels of benzene, toluene, xylene, and gasoline were all below 10% OEL (occupational exposure limit), and hydrogen sulfide and noise were disqualified. Occupational hazards such as benzene and hydrogen sulfide were serious occupational hazards in the three enterprises, and the number of workers exposed was 461, 912, and 224, respectively; the HRs (hazard ratings) of benzene, toluene, xylene, gasoline, hydrogen sulfide, and noise were level 5, 3, 2, 3, 5, and 3 respectively. The occupational health management status of the three enterprises was graded as B, A, and B, respectively by the occupational disease hazards comprehensive risk assessment method. The occupational health management index of the three enterprises was graded as B, A, and A, respectively by the occupational health grading and classification method. The comprehensive risk assessment results showed that two enterprises classified into as the highest class C and one into class B by the occupational disease hazards comprehensive risk assessment method, while all three enterprises were classified into class B by the occupational health grading and classification method.
    Conclusion The two grading and classification methods are not consistent in the evaluation results of petroleum refining enterprises, and there are differences in the evaluation scope, indicators to be collected, and professionalism. It is recommended that occupational health regulators should fully consider the advantages and disadvantages of the two methods and choose the appropriate assessment method according to the actual regulatory purpose.

     

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