4.6 Definition principle of occupational hazard factors for carrying out occupational health surveillance
Occupational hazard factors refer to various hazards that may cause diseases or other adverse health effects to workers engaged in occupational activities.
Elements, including all kinds of harmful chemicals, physical and biological factors and other occupational harmful factors produced in the process of operation. basis
Occupational health examination is divided into compulsory and recommended. Except for the items corresponding to various occupational hazards marked as recommended health examination, the rest are mandatory.
4.6. 1 The hazard factors listed in the Catalogue of Occupational Hazard Factors promulgated by the state shall be subject to compulsory occupation if they meet the following conditions.
Health check:
(1) This harmful factor has definite chronic toxicity and can cause chronic occupational diseases or chronic health damage; Or has definite carcinogenicity.
Occupational cancer caused by sex and exposed people has a certain incidence rate;
(2) The chronic toxic effect on human body, health damage or carcinogenic effect are uncertain, but there are evidence of animal experiments or epidemiological investigation and reliable technical methods. Systematic health monitoring can provide further clear basis for the implementation of compulsory occupational health.
Kang guardianship;
(3) There are a certain number of exposed people.
4.6.2 It has been listed in the classified catalogue of occupational hazard factors promulgated by the state, and it has only acute toxic effect on human health damage, but it is clear.
Occupational contraindications, compulsory health monitoring before taking up the post, and health monitoring during the post is recommended.
4.6.3 For health monitoring of hazardous factors other than the Classification Catalogue of Occupational Hazards, the evaluation objectives need to be determined after expert review.
Must be:
(1) The substance is being used or about to be used in China, and there are a certain number of exposed people;
(2) It is necessary to consult relevant literature, mainly toxicological research data, to determine whether it meets the classification standards of hazardous chemicals stipulated by the state and the characteristics and types of health damage;
(3) consulting epidemiological data and clinical data, there is evidence that it is possible or reasonable to suspect that it is harmful to the health of workers.
The intended use will harm the health of workers;
(4) Whether there is a correct, effective and credible method to monitor the health damage that may be caused by this substance needs to be confirmed.
Determine its sensitivity, specificity and positive predictive value;
(5) Health monitoring can produce favorable results for the health of individuals or groups. Individuals can find health damage early and take effective preventive or therapeutic measures; The evaluation of group health status can predict the degree of harm and development trend, and take effective measures.
Pre-measures;
(6) Health monitoring methods are accepted by workers, and the inspection results are clearly explained;
(7) Conforming to medical ethics.
4.6.4 Compulsory health monitoring should also be carried out for special operators with special health requirements.
4.7 Definition principle of occupational health monitoring population
4.7. 1 All personnel exposed to occupational hazard factors requiring compulsory health surveillance shall be subject to occupational health surveillance;
4.7.2 Personnel who come into contact with occupational hazard factors that need to be recommended for health monitoring shall, in principle, be connected according to the arrangement of the employer.
Accept health supervision;
4.7.3 Although it is not directly engaged in the operation of contacting the occupational hazard factors requiring occupational health monitoring, it is affected by the following.
The same or almost the same contact with direct contact personnel should be regarded as occupational contact and need to receive health care from direct contact personnel.
Kang guardianship;
4.7.4 The needs of exposed people or individuals should be determined according to the exposure and morbidity characteristics of different occupational hazard factors and the dose-effect relationship.
The minimum exposure level for health monitoring is mainly based on the concentration or intensity of harmful factors in the workplace and the degree of personal fatigue.
Statistical exposure time;
4.7.5 The follow-up time of health monitoring after leaving the post is mainly based on the cumulative personal exposure and the damage degree of occupational hazards to health.
Epidemiological and clinical characteristics determine.
4.8 Types and Periods of Occupational Health Surveillance
Occupational health monitoring is divided into pre-job inspection, regular inspection during on-job, off-job inspection, medical follow-up after off-job and emergency health.
Check five categories.
4.8. 1 Pre-job examination The main purpose of pre-job health examination is to find out whether there are occupational contraindications and establish the causes of occupational hazards.
Basic health records of ordinary people. Pre-job health examination is a compulsory occupational health examination. Before starting to engage in dangerous operations,
It's done. The following personnel shall undergo pre-job health examination:
(1) Newly hired personnel who intend to engage in occupational hazards, including those who have been transferred;
(2) Persons who intend to engage in operations with special requirements for health, such as working at heights, electrician operations and professional motor vehicle driving operations.
4.8.2 Have regular health check-ups during the on-the-job period, and be engaged in the work of occupational hazard factors requiring health supervision for a long time.
On-the-job regular health examination should be carried out. The purpose of regular health examination is mainly to find patients or suspected occupational diseases at an early stage.
Other abnormal health changes of occupational disease patients or workers; Timely discover the occupational contraindications of workers; By dynamically observing the health changes of workers, the control effect of occupational hazards in the workplace is evaluated. The cycle of regular health check-ups is based on different positions.
Determine the nature of occupational hazards, the concentration or intensity of harmful factors in the workplace, the incubation period of target diseases and protective measures.
4.8.3 Physical examination after leaving the post
(1) Laborers should undergo a physical examination before preparing to leave their posts or leaving jobs or posts with occupational hazards; owner
The main purpose is to determine their health status when they stop being exposed to occupational hazards.
(2) If the last physical examination during the on-the-job period is within 90 days before leaving the job, it can be regarded as a full-time physical examination.
4.8.4 Medical follow-up examination after leaving the post
(1) If the occupational hazards exposed have a chronic impact on health, or the onset has a long incubation period, it is still possible after separation.
Occupational diseases may occur and medical follow-up examination is needed.
(2) Patients with pneumoconiosis need medical follow-up examination after leaving their posts.
(3) The length of follow-up should be based on the epidemiological and clinical characteristics of harmful factors and the length of time workers have been engaged in the operation.
In short, the concentration of harmful factors in the workplace and other factors should be considered comprehensively.
Emergency inspection
(1) When an acute occupational hazard accident occurs, workers who have suffered or may suffer from acute occupational hazards shall be promptly released.
Organize health examination. According to the inspection results and on-site occupational hygiene investigation, the hazard factors are determined to provide basis for first aid and treatment.
It is reported that the continuous spread and development of occupational hazards should be controlled. Emergency health examination should be started immediately after the accident.
(2) Workers who are engaged in operations that may produce occupational infectious diseases and who are in close contact with the source of infection during or in the near future should leave in time.
Show an emergency health check and monitor the epidemic situation at any time.
4.9 Determination of Occupational Health Monitoring Methods and Inspection Indicators
4.9. 1 Occupational health monitoring is an important part of occupational health service, which should be based on the types of monitoring and different occupational hazard factors.
And the target diseases, determine the specific medical examination methods and indicators, as well as the provisions of this specification on various occupational disease hazards.
Is the minimum inspection standard. Occupational health professional service personnel can put forward suggestions to increase inspection indicators according to different situations, but they should have
Good reason.