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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 detonation deafness and provide reference for revising the diagnostic criteria of occupational diseases. Methods GBZ / T 238-2011 “diagnosis of occupational deafness deafness” (hereinafter referred to as “GBZ / T 238-2011”) was used to diagnose occupational diseases in a suspected occupational deafness patient in power generation department of a thermal power plant. Results The patient in the inspection process, because of its interphone radio signal interference by the regional suddenly issued a whistling caused by the left ear sudden sensual deafness. According to GBZ / T 238-2011 on “This standard applies to blasting operations close range exposure or workplace flammable chemicals, pressure vessels explosion detonation caused by the detonation diagnosis and treatment ” of the scope of application and Relevant diagnostic criteria, the patient did not have a clear history of occupational exposure to knock, and therefore can not be diagnosed as deafness of occupational detonation. However, the deafness of the left ear is indeed caused by the accidental injury caused by work. Therefore, it is suggested that the employer arrange the patients to apply to the local social insurance administrative department for identification of work-related injuries so as to obtain the corresponding work injury insurance benefits. Conclusions It is suggested that the applicable scope of GBZ / T 238-2011 should be revised accordingly to add the applicable clause of “detonation deafness caused by transient and strong shock waves or strong impulsive noise instantaneously for a variety of other reasons” so as to safeguard the legal rights of laborers Health rights.