Liu W J, Wang Z P, Zhang H D
Department of Labor Hygiene and Environmental Hygiene, School of Public Health, Shandong University, Jinan 250012, China.
Division of Emergency Safety and Equipment Protection, Shandong Institute of Occupational Health and Prevention of Occupational Diseases, Jinan 250002, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2024 Mar 20;42(3):161-168. doi: 10.3760/cma.j.cn121094-20221019-00503.
To further study the causes of acute occupational poisoning accidents, and to provide scientific basis and decision support for the prevention of accidents in advance. From September 2022 to May 2023, the literature was searched and 232 cases of acute occupational poisoning cases occurred from 2013 to 2022 were collected. The causal nodes of the accident were determined according to the expert score, and the interpretative structural model (ISM) was used to construct the correlation model between the causal nodes to obtain the hierarchical relationship between the factors. The influence of each causal node on the occurrence of acute occupational poisoning accidents was studied by using Bayesian network (BN), and the relationship and influence among the causal nodes were analyzed by Netica 5.18 software to establish the pre-prevention model of acute occupational poisoning accidents and identify the key causal factors. A total of 23, 203, and 6 cases of significant, large, and medium acute occupational poisoning accidents were included, of which 179, 29, and 24 cases were asphyxiating gas, irritating gas, and mixed gas, respectively. ISM of acute occupational poisoning accidents divided the causal factors into a 7-layer and 3-level hierarchical structure model. Among them, operation conditions, protective measures, ventilation equipment, hidden trouble investigation, emergency management, illegal operation, equipment and facilities, and blind rescue were the direct causes of the occurrence and expansion of accidents. Warning devices, inspection situation, safety education situation, safety operation procedures, and technology in the production process were indirect influences that lead to the occurrence and expansion of accidents. Safety production responsibility system, enterprise supervision and management and government supervision were the deep-rooted influences. BN reasoning showed that the maximum probability causal chain of acute occupational poisoning accidents was as follows: safety production responsibility system→enterprise supervision and management→safety education and training→protective measures→accident occurrence. The key factors leading to the occurrence of acute occupational poisoning accidents were inadequate protective measures, equipment and facility failures, operational errors, ventilation equipment not being used properly and improper emergency management. In the prevention of acute occupational poisoning accidents, it is necessary to correctly use protective measures, test equipment and facilities before operation, operate according to regulations, ensure the normal use of ventilation equipment, and strengthen emergency management, so as to reduce the incidence of acute occupational poisoning accidents.
为进一步研究急性职业中毒事故的原因,为提前预防事故提供科学依据和决策支持。于2022年9月至2023年5月进行文献检索,收集2013年至2022年发生的232起急性职业中毒案例。依据专家评分确定事故的因果节点,运用解释结构模型(ISM)构建因果节点间的关联模型,以获取各因素间的层次关系。采用贝叶斯网络(BN)研究各因果节点对急性职业中毒事故发生的影响,借助Netica 5.18软件分析因果节点间的关系及影响,构建急性职业中毒事故的预预防模型并识别关键因果因素。共纳入重大、较大和一般急性职业中毒事故23起、203起和6起,其中窒息性气体中毒事故179起、刺激性气体中毒事故29起、混合气体中毒事故24起。急性职业中毒事故的ISM将因果因素划分为一个7层3级的层次结构模型。其中,作业条件、防护措施、通风设备、隐患排查、应急管理、违章作业、设备设施、盲目施救是事故发生及扩大的直接原因。警示装置、检查情况、安全教育情况、安全操作规程、生产过程中的技术是导致事故发生及扩大的间接影响因素。安全生产责任制、企业监管和政府监管是深层次影响因素。BN推理显示,急性职业中毒事故的最大概率因果链如下:安全生产责任制→企业监管→安全教育培训→防护措施→事故发生。导致急性职业中毒事故发生的关键因素为防护措施不到位、设备设施故障、操作失误、通风设备使用不当、应急管理不善。在预防急性职业中毒事故时,需正确使用防护措施,作业前对设备设施进行检测,依规操作,确保通风设备正常使用,并加强应急管理,以降低急性职业中毒事故的发生率。