CAJ | 학술논문

目的　寻求高炉锰铁冶炼致职业暴露人群锰中毒的防治对策。方法　用职业流行病学的方法对某公司高炉锰铁冶炼的职业卫生监督监测和职业暴露人群追踪35年的资料进行分析研究。结果　车间空气中锰浓度最高199.4 mg/m3，最低0.034 mg/m3，平均2.046 mg/m3。随着技术改造的不断深入，车间空气中锰浓度呈显著下降趋势。累计追踪观察1 555例锰暴露人群，共诊断锰中毒39例，患病率2.508%。发病工龄最短3年，最长34年，平均14年。采取依地酸二钠钙(CaNa2EDTA)、二巯基丁二酸(DMSA)、对氨基水杨酸(PAS)等驱锰，辅以能量合剂、维生素和普鲁卡因封闭，中药扶正、助阳、补气及调离锰暴露岗位等综合措施，疗效肯定；脑血流图(REG)、脑多普勒(TCD)、神经行为功能等检验指标，对锰中毒的诊断有一定参考价值。结论　改善生产环境，加强健康监护，积极治疗中毒患者，将有助于预防锰中毒的发生，有助于锰中毒患者的康复。
목적　심구고로맹철야련치직업폭로인군맹중독적방치대책。 방법　용직업류행병학적방법대모공사고로맹철야련적직업위생감독감측화직업폭로인군추종35년적자료진행분석연구。 결과　차간공기중맹농도최고199.4 mg/m3，최저0.034 mg/m3，평균2.046 mg/m3。수착기술개조적불단심입，차간공기중맹농도정현저하강추세。루계추종관찰1 555례맹폭로인군，공진단맹중독39례，환병솔2.508%。발병공령최단3년，최장34년，평균14년。채취의지산이납개(CaNa2EDTA)、이구기정이산(DMSA)、대안기수양산(PAS)등구맹，보이능량합제、유생소화보로잡인봉폐，중약부정、조양、보기급조리맹폭로강위등종합조시，료효긍정；뇌혈류도(REG)、뇌다보륵(TCD)、신경행위공능등검험지표，대맹중독적진단유일정삼고개치。 결론　개선생산배경，가강건강감호，적겁치료중독환자，장유조우예방맹중독적발생，유조우맹중독환자적강복。
Objective　To seek the measures for prophylaxis and treatment of occupational manganism among high furnace ferromanganese-smelting workers. Methods　Data of 35 year occupational health supervision,and clinical therapy and prevention of manganism among workers exposed to manganese were analyzed with the method of occupational epidemiology. Results　In the workplace,the maximum manganese content in the air was 199.4 mg/m3,minimum 0.034 mg/m3 and average 2.046 mg/m3.As the techology continuously improved,the manganese content in the air was gradually decreasing.Of 1*!555 followed up Mn exposed workers,the incidence was 2.508%.The shortest diseased work-year was 3 a,the longest 34 a,average 14 a.Using disodium coolium ethylene diamine tetraacetate(CaNa2EDTA),2,3-dimercaptosuccinic acid(DMSA),p-aminosalicylic acid(PAS) etc to scavenge Mn,supplemented with ATP mixture,vitamin,procaine block,traditional Chinese medicine and moving the patients away from the manganese exposed spot etc were effective therapy.Rheoencephalography(REG),transcranial doppler(TCD) and neurobehavioral function were of certain reference value for diagnosis. Conclusion　Improving the workplace environment,strengthenning health monitor and actively treating manganism patients,will help prevent the occurrence of manganism and recover from manganism.