高颖, 谭强, 巫一芳, 刘江辉, 孟琪, 聂云峰. 三种职业健康风险评估方法在汽车制造企业的应用与比较[J]. 环境与职业医学, 2023, 40(6): 625-633. DOI: 10.11836/JEOM22434
引用本文: 高颖, 谭强, 巫一芳, 刘江辉, 孟琪, 聂云峰. 三种职业健康风险评估方法在汽车制造企业的应用与比较[J]. 环境与职业医学, 2023, 40(6): 625-633. DOI: 10.11836/JEOM22434
GAO Ying, TAN Qiang, WU Yifang, LIU Jianghui, MENG Qi, NIE Yunfeng. Application and comparison of three occupational health risk assessment methods in automobile manufacturing enterprises[J]. Journal of Environmental and Occupational Medicine, 2023, 40(6): 625-633. DOI: 10.11836/JEOM22434
Citation: GAO Ying, TAN Qiang, WU Yifang, LIU Jianghui, MENG Qi, NIE Yunfeng. Application and comparison of three occupational health risk assessment methods in automobile manufacturing enterprises[J]. Journal of Environmental and Occupational Medicine, 2023, 40(6): 625-633. DOI: 10.11836/JEOM22434

三种职业健康风险评估方法在汽车制造企业的应用与比较

Application and comparison of three occupational health risk assessment methods in automobile manufacturing enterprises

  • 摘要: 背景

    汽车制造行业职业病危害因素复杂多样,劳动者职业健康风险较大。

    目的

    探讨能准确反映汽车制造企业作业场所风险水平的方法,指导企业进行风险管理。

    方法

    采用综合指数法、国际采矿与金属委员会职业健康风险评估法(ICMM法)和风险指数法对湖南省3家汽车制造企业的电焊、打磨、喷漆等主要职业病危害因素接触岗位进行风险评估,用Kappa一致性检验三种评估方法的分级结果,用近三年的职业健康体检复查和禁忌证检出情况对评估结果进行验证。

    结果

    综合指数法评估结果显示:A、B企业各岗位危害因素评估为2~3级,其中A企业二氧化氮为3级,B企业电焊烟尘、二氧化氮、甲醛均为3级;C企业各岗位危害因素为2~4级,C企业的二氧化氮、苯为4级,电焊烟尘、锰及其化合物、砂轮磨尘、二甲苯为3级。ICMM定量法评估各企业危害因素评估为2级和5级,其中A企业的锰及其化合物为5级,C企业的电焊烟尘、砂轮磨尘、苯系物为5级。风险指数法评估各企业危害因素评估为1~4级,其中A、B企业锰及其化合物均为3级,C企业锰及其化合物、苯均为4级。综合指数法与ICMM法、风险指数法的Kappa值分别为0.084(P>0.05)和−0.046(P>0.05),ICMM法与风险指数法的Kappa值为0.014(P>0.05),一致性均较差。将职业健康监护结果与评估结果进行比较,A企业发现锰作业职业禁忌证和发锰超标各1人,但综合指数法对A企业锰及其化合物作业的风险评估为低风险,结果偏保守;ICMM识别出的关键岗位与体检结果一致,但评估等级均为极高风险,结果过于严格;C企业电焊岗位发现电焊烟尘作业禁忌证1人、打磨岗位发现重度混合型肺通气功能障碍2人,各企业焊接、打磨均发现轻、中度肺通气功能障碍多发,而风险指数法对电焊烟尘、砂轮磨尘作业的评估结果均为可忽略风险,与体检结果不符。

    结论

    综合指数法、ICMM法、风险指数法均能基本识别出职业病危害严重岗位,但具有一定的局限性和适用性。综合来看,综合指数法其评估结果与职业健康监护结果一致性更好,考虑较为全面、客观,更适合汽车制造企业的风险评估。

     

    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.

     

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