一起电镀槽清理发生的急性铬中毒事故的调查

Investigation on acute chromium poisoning accident occurred in process of electroplating tank cleaning

  • 摘要:
    背景 电镀工艺被广泛运用于机械制造行业,电镀作业可接触到铬、锌、氰化物、硫酸等职业病危害因素,随着防护条件的不断改善,职业病危害得到有效控制,但目前较少关注电镀作业过程中可能发生的急性职业病危害事故。
    目的 通过调查一起某五金加工厂电镀槽清理过程中发生的急性铬中毒事故,查明事故原因,采取有效预防措施,避免类似中毒事故再次发生。
    方法 详细询问中毒病人的职业史、病史及就诊经过,查阅病人住院病历记录,对病人血样本进行检测;对中毒事故现场进行职业卫生学调查、检测。
    结果 作业场所铬及其化合物峰接触浓度(CPE)及时间加权平均容许浓度(CTWA)分别为0.49、0.31 mg·m−3。辅助检查:血铬4175.85 μg·L-1,血清肌酐1370.2 μmol·L−1,尿素42.28 mmol·L−1,尿渗透压248 mosm·L−1。诊断为:职业性急性重度中毒性肾病(铬及其化合物)、职业性化学性皮肤中度灼伤(铬酸、硫酸)。患者经右下肢扩创植皮术、血透、对症支持等治疗,病情稳定,逐步好转出院。
    结论 用人单位负责人职业病防治意识薄弱,未依法落实职业病防治主体责任和有效的职业病防护措施,未按要求对劳动者进行职业卫生培训并配备有效的个人防护用品,是导致本次中毒事故发生的主要原因。政府有关部门和用人单位应引起高度重视,加强职业病防治知识培训教育,加大职业卫生监管力度,督促用人单位依法落实各项职业病预防措施,切实保护劳动者的身体健康。

     

    Abstract:
    Background Electroplating technology is widely used in the mechanical manufacturing industry. Electroplating workers may be exposed to occupational hazards such as chromium, zinc, cyanides, and sulfuric acid. With the continuous improvement of protective conditions, occupational hazards have been effectively controlled, but there is less focus on the potential acute occupational poisoning that may occur during the electroplating process.
    Objective To identify causes of an acute chromium poisoning accident occurred during the cleaning process of electroplating tank in a hardware processing plant, and to formulate relevant prevention and control measures to avoid similar poisoning accidents.
    Methods Occupational history, medical history, and treatment process of the poisoned worker were inquired in detail, his inpatient medical records were consulted , and his blood samples were tested. Occupational health investigation and testing were carried out at the scene of the poisoning accident.
    Results The air concentration of peak exposure (CPE) and permissible concentration-time weighted average (CTWA) of chromium and its compounds in the workplace were 0.49 mg·m−3 and 0.31 mg·m−3 respectively. The results of auxiliary test were Serum chromium 4175.85 μg·L−1, serum creatinine 1370.2 μmol·L−1, urea 42.28 mmol·L−1, and urine osmotic pressure 248 mosm·L−1. The final diagnosis was occupational acute severe toxic nephropathy (chromium and its compounds) and occupational chemical skin moderate burn (chromic acid, sulfuric acid). The prescribed treatment included right lower limb expansion skin grafting, hemodialysis and symptomatic support. The patient’s condition was stable and gradually improved after the treatment.
    Conclusion The main causes of the poisoning accident include weak awareness of the employer of occupational disease prevention and control; failures in fulfilling legal obligations of occupational disease prevention and control, implementing effective occupational disease prevention measures, and providing proper occupational health and safety training and effective personal protective equipment. In order to protect the health of workers, the relevant government departments and employers should attach great importance to the prevention and control of occupational diseases, such as strengthening training and education, increasing the intensity of occupational health supervision, and urging employers to implement occupational disease prevention measures in accordance with the law.

     

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