doi:10.3969/j.issn.1005-3158.2011.04.021
浅述职业紧张对员工健康的影响及干预策略
西晓静 关晶萍 门晓棠
(中国石油安全环保技术研究院)
班会主持稿
摘 要 随着医学模式从生物医学模式向生物 心理 社会医学模式的转变,心理社会因素对健康的影响日益加重。文章探讨职业紧张与健康的关系及其可能会给作业员工健康造成的损害和相关干预措施。得出:职业紧张对健康的影响是较长时间内过大的压力所表现出来的累积性反应,其发展过程是缓慢和渐进的,可能会出现高血压、冠心病、中风、睡眠障碍等症状,在日常工作中,有必要采取有针对性的干预措施,其最基本的办法是干预生产活动中的紧张因素,提高作业员工的控制和适应能力,最终达到良性循环。 关键词 职业紧张 干预 健康 影响
中图分类号:B845.66 文献标识码:A 文章编号:1005-3158(2011)04-0068-02
0 引 言
随着生物医学模式的转变和现代企业制度的建立,受生产方式转变的影响,职业性疾患正由躯体性疾患
向精神心理疾病移行。职业紧张已成为职业医学领域中突出的问题之一,它的存在不仅会加重职业病的风险,而且会诱发其他身心相关疾病;目前流行的疾病中有80%与职业紧张有关,如冠心病、糖尿病、高血脂、肥胖等均是职业紧张诱导的典型疾病。适度紧张是必要的,而长期过度紧张对身心健康有害,严重者会出现创伤后紧张性精神病(PTSD)。职业紧张是个体特征与工作环境因素之间的相互作用,在职业条件下,机体与环境压力不能完全协调好所导致的心理、生理和行为表现;职业紧张有积极的作用,适度紧张有利于提高工作效率,增加工作积极性、满意度和工作能力;相反,过度紧张会降低工作效率,引起各种心理、生理功能紊乱,降低作业员工的职业寿命;紧张干预是通过各种行为学、心理学等手段,对承受职业紧张的相关职业者进行疏导的一种心理学治疗方法,是目前公认的缓解职业紧张较为有效的手段。
1 职业紧张对作业员工的影响1.1对生理机能的影响
当作业员工处于紧张环境中可能会产生急性紧张性反应,若紧张因素长期存在,则可导致心脑血管疾病、免疫功能内分泌系统受损、消化性溃疡等[1]。
1.1.1对心脑血管的影响
作业员工长期处于应激状态是导致高血压形成的重要因素,并继发一系列心脑系统疾病,如冠心病、心肌梗塞、脑卒中等[2]。将某油田公司168名作业员工所从事的10个工种分为职业紧张高暴露组、中
暴露组、低暴露组;职业紧张测试评分显示:在排除其他因素的影响以后,随着工龄的增加,高暴露组高血压发病率明显高于中、低暴露组,证实职业紧张是高血压发病的重要原因之一。1.1.2对免疫系统的影响
职业紧张者的炎性细胞因子过度分泌,与抗炎因子水平失衡,导致自身免疫系统疾病发病率增高;职业紧张者对糖皮质激素敏感性降低,亦造成体内免疫系统缺陷。
1.1.3对消化系统的影响
职业紧张或长期劳动缺乏必要的休息和调节均会引发消化性溃疡。
1.2对心理健康的影响
作业员工的心理卫生问题已经成为职业卫生工作的重要内容,工作环境中的社会心理紧张因素会引发个体心理卫生问题,职业任务过重和工作环境较差,都会造成个体紧张反应过度[3]
。
1.3对精神行为、社会功能的影响特别的朋友
诱发精神紧张的因素大致可以分为:生活满意
度、人际关系、生活方式、环境条件、担心下岗或失业、连续工作时间、工作超出能力承受的范围、上级领导
西晓静,1995年毕业于南京医科大学临床医学系,主治医师,现在中国石油安全环保技术研究院H SE 评价中心职评室从事职业病危害评价与研究工作。通信地址:北京市海淀区志新西路8号,100083
68 油 气 田 环 境 保 护
2011年8月
EN V IRO NM EN T A L PRO T ECT IO N OF OIL &G AS F IELD S Vo l.21 No.4
的关心支持、担心工作发生危险等;过度紧张可以导致疲劳、焦虑、压抑和工作能力下降。
2 职业紧张的干预措施
怎么做外贸随着用工制度的不断变化,职业紧张的影响越来越强,职业紧张往往是持续的、动态的、多方位的。因此,预防和减少职业紧张的措施必须是综合性的,是整个社会参与的结果。根本的解决方法是控制劳动过程中和劳动环境中的紧张因素,提高作业员工的控制力和适应能力。职业紧张干预的措施分为群体干预和个体干预[4]。
群体干预措施 群体干预是根据群体分析结果,进行有针对性的干预,具体由组织和参与者共同进行;主要形式为管理培训和组织活动,扩大人际交流沟通,工作重组,提高控制能力等,必要时还需要通过立法的形式保证干预措施的有效实施。
个体干预措施 个体干预是针对每个作业员工的职业紧张源,进行咨询和健康促进教育。干预过程使作业员工采取积极应对代替消极应对。加强心理咨询,增强作业员工的自我保健技能等[5]。目前国内外针对个体的心理、行为,干预常用的方法有以下五种:现实疗法、心理危机干预、关键事件应激报告法、灾后心理卫生工作策略以及其他心理健康干预方法(如精神分析、行为治疗、森田疗法、认知治疗、支持疗法、生物反馈技术等)[6],这些干预措施主要是针对较轻的心理健康问题而采取的措施,对于长期的紧张反应引起的症状必须要采取药物治疗。
WH O(联合国世界卫生组织)对健康的定义是生物、心理和社会三个层面同时处于完好状态。研究表明,职业紧张对作业员工健康的危害是全方位的,对作业员工的心理、生理和社会三方面的影响均不容忽视[7]。将职业紧张控制在可承受范围内,控制健康危险因素,从而促进作业员工健康,提高作业员工的生命质量,提高劳动生产率才是行之有效的方法。
3 结束语
随着职业紧张逐渐扩展到不同行业的各个领域,职业紧张也将引起越来越多的关注。进一步研究职业误差线
紧张与健康的关系并制定出相应的预防对策,将有助于提高生活质量和工作效率。相信在不远的将来,可以使劳动者获得更人性化的职业环境,逐步实现 健康的工人,健康的工作场所 的目标。
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(收稿日期 2011-05-24)
(编辑 王蕊)
减排指标为什么具有约束性?
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重要意义 十一五 减排指标是约束性的,经由全国人民代表大会审议通过,具有法律效力。减排指标从预期性向约束性转变,是因为我国经济社会已经不能再承受污染之重。我国大凡高耗能、高污染的主要产品都居世界第一位或前列。巨大的污染背后意味着巨大的排放量,巨大的排放量则折射出日益增加的环境污染事件和污染纠纷。不转变发展方式,不加快调整结构、不进行污染减排,资源就会支撑不住,环境就容纳不下,社会就承受不起,经济发展就难以持续,现代化进程就会严重受阻。党和政府要对人民负责,对历史负责。因此,约束性指标必须完成。为了完成指标,必须进一步强化政府责任,重点是建立问责制度、目标责任考核制度等。约束性指标的提出,改变了以前有总量、无控制、不考核的局面,以必要的行政手段带动了各项经济、法律等方面政策、措施的到位。
(摘编自 中国环保网 2011-06-18)
69
2011年8月 西晓静等:浅述职业紧张对员工健康的影响及干预策略
KEY W ORDS o il sto rag e;unex pected cur ity incident; envir onment risks;emerg ency measures
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史记读后感
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Vo l.21 No.4 EN VIRONM ENTAL PROT ECT ION OF OIL&GAS FIELDS ABSTRACT