職(zhi)業性中暑及工傷認定

     炎熱(re)的(de)夏(xia)季是中(zhong)暑(shu)的(de)高(gao)發季節，人體(ti)為什么會(hui)中(zhong)暑(shu)？在正常生理情(qing)(qing)況下，人體(ti)的(de)產(chan)熱(re)與(yu)散熱(re)保持著(zhu)動態平(ping)衡，使體(ti)溫處(chu)于相(xiang)對穩定的(de)水平(ping)。高(gao)溫環境中(zhong)，當機體(ti)產(chan)熱(re)、獲熱(re)明顯大于散熱(re)的(de)情(qing)(qing)況持續存在，會(hui)使蓄熱(re)量不(bu)斷增加，一旦(dan)超出人體(ti)的(de)自身調(diao)節能(neng)力(li)，就會(hui)因為熱(re)平(ping)衡紊亂和水鹽代謝失調(diao)引起以中(zhong)樞神經系統和心血管(guan)系統功能(neng)障礙為主要表現的(de)中(zhong)暑(shu)性(xing)疾病。

     對于(yu)熱(re)環境(jing)，在(zai)專業(ye)(ye)層(ceng)(ceng)面有不(bu)同的(de)(de)(de)劃(hua)分(fen)方法，總體(ti)原則是以氣(qi)溫(wen)的(de)(de)(de)增高(gao)(gao)(gao)幅(fu)度、熱(re)輻射(she)的(de)(de)(de)強度以及(ji)對人(ren)體(ti)的(de)(de)(de)作(zuo)用特(te)點(dian)來劃(hua)分(fen)。根據工作(zuo)場所氣(qi)象條(tiao)件的(de)(de)(de)特(te)點(dian)，一(yi)(yi)般將(jiang)高(gao)(gao)(gao)溫(wen)作(zuo)業(ye)(ye)分(fen)為三種類(lei)型：高(gao)(gao)(gao)溫(wen)強輻射(she)作(zuo)業(ye)(ye)（干熱(re)環境(jing)）、高(gao)(gao)(gao)溫(wen)高(gao)(gao)(gao)濕作(zuo)業(ye)(ye)（濕熱(re)環境(jing)）和夏季露天(tian)作(zuo)業(ye)(ye)（復合熱(re)環境(jing)）。    中(zhong)暑(shu)性(xing)疾病(bing)(bing)(bing)是在(zai)高(gao)(gao)(gao)溫(wen)條(tiao)件下，因“熱(re)”的(de)(de)(de)作(zuo)用而發生的(de)(de)(de)一(yi)(yi)種急性(xing)疾病(bing)(bing)(bing)。也(ye)叫做急性(xing)熱(re)致(zhi)疾病(bing)(bing)(bing)，在(zai)診斷(duan)層(ceng)(ceng)面包括了熱(re)射(she)病(bing)(bing)(bing)、熱(re)痙(jing)攣(luan)和熱(re)衰竭。由于(yu)中(zhong)暑(shu)是機(ji)體(ti)內產(chan)熱(re)、獲熱(re)明顯大于(yu)散熱(re)過程不(bu)斷(duan)累(lei)積的(de)(de)(de)結(jie)果，在(zai)發生嚴重(zhong)中(zhong)暑(shu)前(qian)，患(huan)者多會經歷中(zhong)暑(shu)先兆的(de)(de)(de)過程，此時脫(tuo)離高(gao)(gao)(gao)溫(wen)環境(jing)癥狀有可能(neng)逐漸緩解。因此，高(gao)(gao)(gao)溫(wen)作(zuo)業(ye)(ye)人(ren)員保持(chi)對中(zhong)暑(shu)發病(bing)(bing)(bing)的(de)(de)(de)認知和警醒至關重(zhong)要，在(zai)中(zhong)暑(shu)先兆環節及(ji)時就醫，能(neng)夠有效防止中(zhong)暑(shu)的(de)(de)(de)進一(yi)(yi)步發展(zhan)，挽救患(huan)者生命。

     職(zhi)(zhi)業(ye)(ye)性中(zhong)暑屬于(yu)國家法定(ding)(ding)(ding)(ding)(ding)(ding)職(zhi)(zhi)業(ye)(ye)病，發生(sheng)職(zhi)(zhi)業(ye)(ye)性中(zhong)暑需首先(xian)進(jin)行(xing)工(gong)(gong)傷(shang)(shang)認(ren)(ren)定(ding)(ding)(ding)(ding)(ding)(ding)。治療病情(qing)穩(wen)定(ding)(ding)(ding)(ding)(ding)(ding)后，如(ru)遺留有影響(xiang)勞(lao)(lao)動(dong)能(neng)力(li)的(de)后遺癥，應當再次申請進(jin)行(xing)勞(lao)(lao)動(dong)能(neng)力(li)鑒(jian)定(ding)(ding)(ding)(ding)(ding)(ding)。依據《工(gong)(gong)傷(shang)(shang)保險條(tiao)例(li)》第(di)(di)四條(tiao)規(gui)定(ding)(ding)(ding)(ding)(ding)(ding)：職(zhi)(zhi)工(gong)(gong)發生(sheng)工(gong)(gong)傷(shang)(shang)時(shi)，用人單位(wei)應當采(cai)取措施使工(gong)(gong)傷(shang)(shang)職(zhi)(zhi)工(gong)(gong)得(de)到(dao)及時(shi)救治。第(di)(di)十(shi)四條(tiao)規(gui)定(ding)(ding)(ding)(ding)(ding)(ding)：職(zhi)(zhi)工(gong)(gong)有下列情(qing)形之一的(de)，應當認(ren)(ren)定(ding)(ding)(ding)(ding)(ding)(ding)為工(gong)(gong)傷(shang)(shang)，而患職(zhi)(zhi)業(ye)(ye)病的(de)屬于(yu)工(gong)(gong)傷(shang)(shang)認(ren)(ren)定(ding)(ding)(ding)(ding)(ding)(ding)范圍。第(di)(di)十(shi)七條(tiao)規(gui)定(ding)(ding)(ding)(ding)(ding)(ding)，職(zhi)(zhi)工(gong)(gong)發生(sheng)事(shi)故(gu)傷(shang)(shang)害或者(zhe)按(an)照職(zhi)(zhi)業(ye)(ye)病防(fang)治法規(gui)定(ding)(ding)(ding)(ding)(ding)(ding)被診斷、鑒(jian)定(ding)(ding)(ding)(ding)(ding)(ding)為職(zhi)(zhi)業(ye)(ye)病，所在單位(wei)應當自事(shi)故(gu)傷(shang)(shang)害發生(sheng)之日(ri)或者(zhe)被診斷、鑒(jian)定(ding)(ding)(ding)(ding)(ding)(ding)為職(zhi)(zhi)業(ye)(ye)病之日(ri)起30日(ri)內，向統籌(chou)地區社會保險行(xing)政部門(men)提出工(gong)(gong)傷(shang)(shang)認(ren)(ren)定(ding)(ding)(ding)(ding)(ding)(ding)申請。第(di)(di)二(er)十(shi)一條(tiao)規(gui)定(ding)(ding)(ding)(ding)(ding)(ding)：職(zhi)(zhi)工(gong)(gong)發生(sheng)工(gong)(gong)傷(shang)(shang)，經治療傷(shang)(shang)情(qing)相對穩(wen)定(ding)(ding)(ding)(ding)(ding)(ding)后存在殘(can)疾、影響(xiang)勞(lao)(lao)動(dong)能(neng)力(li)的(de)，應當進(jin)行(xing)勞(lao)(lao)動(dong)能(neng)力(li)鑒(jian)定(ding)(ding)(ding)(ding)(ding)(ding)。

     職(zhi)(zhi)業(ye)性中暑(shu)重在預防。用人(ren)單位需要(yao)不(bu)斷改善生產(chan)環境，在生產(chan)現場采取隔熱、降溫措施(shi)。合(he)理(li)安排(pai)作業(ye)時(shi)間(jian)，提(ti)供保健飲料。勞動者需加強個體防護，穿防熱服裝(zhuang)。勞動者就(jiu)業(ye)前(qian)需進行上崗前(qian)和定期的(de)職(zhi)(zhi)業(ye)健康(kang)檢(jian)查，防止(zhi)患(huan)有(you)職(zhi)(zhi)業(ye)禁忌(ji)證的(de)人(ren)員從事高溫作業(ye)。