卫生研究

目的 比较4种风险评估方法在金属矿山开采企业中噪声致听力损失风险评估中的应用。方法 于2019—2021年，采用典型抽样法选取广东、山东、辽宁省27家金属矿山开采企业，通过职业卫生现场调查及岗位噪声检测，收集企业基本信息及岗位噪声暴露数据。采用职业危害风险指数法、噪声有害作业分级法、噪声职业病危害风险管理指南和国际采矿和金属委员会(International Council on Mining and Mentals, ICMM)风险评级表法对金属矿山开采企业噪声接触岗位开展噪声致听力损失风险评估。结果 金属矿山开采岗位总体噪声水平(中位数)为83.0 dB(A),36.5%(70/192)的检测值超过85dB(A)。掘进工、磨工和破碎工的噪声暴露剂量较高，岗位噪声水平分别为93.5 dB(A)、90.4 dB(A)和86.2 dB(A)。开采方式(井下与露天)不同对劳动者噪声暴露影响有统计学差异(P<0.05),井下开采的噪声超标率较高(42.4%)。对4种风险评估方法进行加权计分评估，ICMM风险评级表法评估噪声致听力损失的整体职业健康风险等级为中等风险(加权评分1.98),职业危害风险指数法、噪声有害作业分级法、噪声职业病危害风险管理指南评估整体职业健康风险等级均为低风险(加权评分分别为1.98、1.73和1.86)。掘进工和磨工为极高风险，破碎工为高风险，空压工、筛分工、中控工、维修工、泵工岗位风险为低风险或极低风险。四种评估方法一致性程度中等(W=0.300,P<0.001),噪声有害作业分级法与噪声职业病危害风险管理指南具有较强的一致性(Kappa=0.789,P<0.001)。结论 2019—2021年三省金属矿山开采企业噪声致听力损失的整体职业健康风险等级为低风险，掘进工和磨工的岗位风险最高。噪声有害作业分级法与噪声职业病危害风险管理指南可高估个体防护佩戴较好的企业劳动者的噪声危害风险；ICMM风险评级表法可有效区分不同岗位风险级别，预警高风险岗位；职业危害风险指数法考虑全面，实用性好。

OBJECTIVE To compare the application of four risk assessment methods in the noise-induced hearing loss risk assessment of metal mining enterprises.METHODS Using typical sampling method, 27 metal mining enterprises were selected in Guangdong, Shandong and Liaoning Provinces. Enterprises basic information and noise exposure data of key positions were collected by using on-site hygiene investigation and noise detecting method. Occupational hazard risk index method, classification of occupational exposure to noise, guidelines for risk management of occupational noise hazard, the International Council on Mining and Mentals'(ICMM) risk rating table method were used to analyze the risk of noise-induced hearing loss in metal mining enterprises.RESULTS The median individual noise exposure of metal mining positions was 83.0dB(A), and 36.5%(70/192) of the measured values exceeded 85 dB(A). The noise exposure levels of excavation workers(93.5 dB(A)), mill operators(90.4 dB(A)) and crusher operators(86.2 dB(A)) were higher relatively. Different mining method(underground and surface) had significant effects on noise exposure of workers(P<0.05), and the noise exceeding standard rate of underground mining was higher(42.4%). According to the result of four risk assessment method, The overall occupational health risk level of noise-induced hearing loss was medium(weighted score 1.98) by ICMM risk rating table method, while the overall occupational health risk level of noise-induced hearing loss was low by occupational hazard risk index method, classification of occupational exposure to noise and guidelines for risk management of occupational noise hazard(weighted score 1.98, 1.73 and 1.86, respectively). The risk of excavation workers and mill operators were the highest, the risk of crusher operators was high, and the risk of air compressor operators, Screening operators, control workers, maintenance workers and pump operators were low or very low. The consistency of four risk assessment method was moderate(W=0.300, P<0.001), The classification of occupational exposure to noise and the guidelines for risk management of occupational noise hazard showed that these two risk assessment method had strong consistencies(Kappa=0.789, P<0.001).CONCLUSION The overall occupational health risk level of noise-induced hearing loss in metal mining enterprises in three provinces was low, and the highest risk positions were excavation workers and mill operators in 2019-2021. The classification of occupational exposure to noise and the guidelines for risk management of occupational noise hazard might overestimate the noise hazard risk when workers were equipped personal protection well. ICMM risk rating table method can distinguish the risk levels of different positions effectively and identify the high-risk hearing loss position as early warning. Occupational hazard risk index method was comprehensive and practical.