Occupational health monitoring of workers exposed to harmful physical factors
Occupational contraindications of target diseases:
(1) Permanent sensorineural hearing loss caused by various reasons (pure tone air conduction hearing threshold at any frequency of 500Hz, 1000Hz and 2000Hz > > 25dBHL)
(2) Moderate or above conductive deafness
(3) The average hearing threshold of binaural high frequency (3000Hz, 4000Hz, 6000Hz) is ≥40dB.
(4) stage Ⅱ and Ⅲ hypertension
(5) Organic heart disease
Check content
(1) The key point of symptom inquiry is whether there are symptoms such as external auditory canal pus, earache, tinnitus, deafness, dizziness, headache, dreaminess, memory loss, poor sleep, palpitation, chest tightness, chest pain, hyperhidrosis and fatigue.
At the same time, you should also ask about the history of injury, explosion and medication (such as streptomycin, gentamicin, kanamycin, neomycin, tobramycin, vancomycin, polymyxin, nitrogen mustard, carbofuran, cisplatin, uric acid, salicylic acid, arsenic-containing agents, antimalarial drugs, etc. ), poisoning (such as alcohol, tobacco, carbon monoxide poisoning) and infections that may affect hearing.
(2) Physical examination
A. The routine examination of internal medicine should pay attention to the examination of thyroid and cardiovascular system.
B. Otological examination mainly includes coarse hearing, external ear examination and tympanic membrane examination, such as whether the conversation is affected by hearing reasons, whether there is deformity of bilateral auricles, whether there is deformity, stenosis, atresia and obstruction of external auditory canal, and whether there is perforation, hypertrophy, calcification, invagination, adhesion and overflow of tympanic membrane.
(3) Laboratory and other inspections
A. Required items include pure tone hearing threshold test, electrocardiogram, blood routine, urine routine and serum ALT.
B. Acoustic immittance and otoacoustic emission of selected inspection items
Occupational health examination during working period
Target disease
(1) Occupational occupational hearing loss (see GBZ49)
(2) noise susceptibility of occupational contraindications (working in a noisy environment 1 year, hearing loss at any frequency of 3000Hz, 4000Hz and 6000Hz in both ears ≥65dBHL).
Check content
(1) The focus of symptom inquiry is whether there are ear symptoms such as external auditory canal bleeding, earache, tinnitus, deafness, dizziness and noise exposure history.
(2) Physical examination is the same as before taking up the post.
(3) Laboratory and other inspections
A. Required items: pure tone hearing threshold test and electrocardiogram.
B blood routine, urine routine, acoustic immittance (ipsilateral and contralateral tympanogram and stapedial reflex threshold at 500Hz and 1000Hz) and otoacoustic emission (distortion product otoacoustic emission or transient evoked otoacoustic emission).
The period of health examination is 1 year. Occupational health examination is required when leaving the post. The target disease is occupational hearing loss, and the examination content is the same as that during the on-the-job period.
Extended data:
Occupational health monitoring occupational health care
For the purpose of prevention, according to the workers' occupational contact history, through regular or irregular medical health examination and health-related data collection, the health status of workers is continuously monitored, and the relationship between workers' health changes and occupational hazards exposed to them is analyzed, and the results of health examination and data analysis are reported to employers and workers themselves in time, so as to take timely intervention measures to protect workers' health.
Occupational health monitoring mainly includes occupational health examination and occupational health monitoring file management. Occupational health examination includes medical follow-up and emergency health examination before, during and after employment.
Occupational contraception
It refers to a special physiological or pathological state in which workers are more prone to occupational hazards and occupational diseases than the general occupational population when they are engaged in specific occupations or exposed to specific occupational hazard factors, or may aggravate the original diseases, or induce diseases that may endanger the lives and health of others during the operation.
industrial disease
Refers to the diseases caused by workers of enterprises, institutions and individual economic organizations (hereinafter referred to as employers) who are exposed to dust, radioactive substances and other toxic and harmful substances in their professional activities.
1 responsibilities and obligations of employers
(1) Employers are obliged to monitor the occupational health of workers exposed to occupational hazards. The employing unit shall, in accordance with the relevant laws and regulations of the state, establish an occupational health monitoring system in combination with the occupational hazards existing in production and labor, so as to ensure that workers can get health monitoring corresponding to the occupational hazards they are exposed to.
(2) The employing unit shall establish occupational health monitoring files, which shall be managed by special personnel and properly kept within the prescribed time limit, and ensure the confidentiality of medical data, and safeguard the occupational health privacy and confidentiality rights of workers.
(3) The employing unit shall ensure that the workers engaged in operations with occupational hazards can attend the arranged occupational health examination on time, and the time when the workers receive the health examination shall be regarded as normal attendance.
(4) The employing unit shall arrange for the workers who are about to engage in occupational hazards to undergo pre-job health examination, but shall ensure the fairness of their employment opportunities.
(5) Employers should encourage the formulation of detailed rules for the implementation of health monitoring higher than this standard according to the corporate culture concept and business operation, so as to promote the sustainable development of enterprises, especially the sustainable development of human resources.
References:
Baidu Encyclopedia-Technical Specification for Occupational Health Surveillance