摘要
目的分析职业性爆震聋诊断实践中遇到的问题,为修订其职业病诊断标准提供参考依据。方法采用GBZ/T 238—2011《职业性爆震聋的诊断》(以下简称"GBZ/T 238—2011"),对某热电厂发电部1例疑似职业性爆震聋患者进行职业病诊断。结果该患者在巡检工作过程中,因其所持对讲机受区域电磁信号干扰突然发出刺耳啸叫声造成其左耳突发性感音性耳聋。根据GBZ/T 238—2011有关"本标准适用于爆破作业近距离暴露或工作场所中易燃易爆化学品、压力容器等发生爆炸导致的爆震聋的诊断及处理"的适用范围及相关诊断原则,该患者没有确切的职业性爆震接触史,因此不能诊断为职业性爆震聋。但其左耳耳聋确实是因工作遭受事故伤害所致,因此建议用人单位安排患者到当地社会保险行政部门申请进行工伤认定,以获得相应的工伤保险待遇。结论建议对GBZ/T 238—2011的适用范围进行相应修订,增加"其他各种原因瞬间产生短暂而强烈的冲击波或强脉冲噪声导致的爆震聋"的适用条款,以维护劳动者合法健康权益。
Objective To analyze the problems encountered in the diagnosis of occupational explosive deafness and to provide guidelines for revising and improving its diagnostic criteria. Methods A case of suspected occupational explosive deafness,who came from the power generation sector of a thermal power plant,was diagnosed as occupational disease or not by using GBZ / T 238-2011 Diagnosis of Occupational Explosive Deafness（ GBZ / T 238-2011）. Results When the patient was polling at work,earpiercing scream came out of his interphone suddenly caused by certain electromagnetic signals interference and led to the sensor neural deafness in his left ear. According to the GBZ / T 238-2011,with the scope of application and related diagnosis principle quoted as ＂the standard is applicable to the diagnosis and treatment of explosive deafness caused by explosive operation in close range of exposure or explosive chemicals,pressure vessel and so on＂in the criteria,this case had no exact occupational explosive exposure history,therefore he could not be diagnosed as occupational explosive deafness. However, the patient＇s left ear did suffer from accident injury at work. It was recommended that the employer company should handle the case to the local social insurance administrative department to apply for work-related injury certification for him, in order to obtain the corresponding injury insurance benefits.Conclusion The amendment for the scope of application in GBZ / T 238-2011 is recommended. An item such as＂all other sorts of sudden short and strong shock waves or strong impulse noise resulted in explosive deafness＂should be added,in order to protect the workers＇ legal healthy rights and interests.
出处
《中国职业医学》
CAS
北大核心
2015年第6期633-635,共3页
China Occupational Medicine
基金
国家科技支撑计划项目(2014BAI12B03)
国家自然科学基金(81372940)
关键词
爆震聋
诊断标准
爆震接触史
适用条件
Explosive deafness
Diagnostic criteria
Explosive exposure history
Application condition
