Practise Of Classified Supervision Model In Occupational Health Supervision And Management In Songjiang, Shanghai

Practise of Classified Supervision Model in Occupational Health Supervision and Management in Songjiang, ShanghaiObjective:To discuss the effect of personalized occupational health service based on the quantitative and gradation management model and to form a reasonable and effective mechanism of occupational health supervision and management.Methods:By randomly stratified cluster sampling, the intervention group including 207 enterprises and control group including 181 enterprises were selected respectively from three kinds of area in Shanghai Songjiang district which economic development level were high, medium, and low. Before intervention, all selected enterprises were graded quantitatively according to the score sheets of occupational health quantitative and gradation management in Shanghai Songjiang district. Both the intervention group and the control group were received regular occupational health interventions for 6 months. In addition, the intervention group enterprises were also accepted personalized services according to the occupational health personalized instruction manual. After intervention, all chosen enterprises were graded quantitatively again and 15% of them were selected to survey their satisfaction on occupational health personalized instruction, demand, and occupational behavior change. Before and after intervention quantitative scores and grades, score deducting of occupational health evaluation, enterprise satisfaction scores of occupational health personalized instruction, demands items and workers'occupational behavior change scores between two groups were analyzed by Statistical description, one-way ANOVA, chi-square test, and covariance analysis.Results:Before intervention, the quantitative scores between groups were no statistically significant differences (one-way ANOVA:76.24 vs.74.79, F=1.451, P=0.229), and then, after intervention, the scores of intervention group were statistically higher than control group both by one-way ANOVA (F=36.154, P＜0.001) and covariance analysis (adjusted mean 84.30 vs.79.53, F=38.792, P<0.001) adjusted by "regional economic development", "harmful factors" and "ownership of enterprises". Before and after intervention, the quantitative grading qualified rates were improved from 92.27% to 98.97% in intervention group, and from 87.17% to 93.37% in control group. Although the total scores of workers'occupational health behavior change between two groups were no significant differences(9.43 vs.9.38, F=0.050, P=0.823), the scores in the subgroups including "domestically funded enterprises (including collective enterprises, joint-stock cooperative enterprises, joint venture, limited liability company, company limited by shares, and other enterprises)", "foreign investment enterprises", and the workers younger than 20 years old or whose working time between 25 to 45 years, were significant differences between groups (P<0.05). Before intervention, the scores deducted entries (The scores deducted entries are evaluated content in the quantitative and gradation management model and the full marks constituent ratios of which less than 50%) in the two groups are similar which mainly focused on "formulation of occupational disease prevention and control program", "establishment of occupational health management system and post operation procedures", and "establishment of the occupational-disease-inductive accident emergency plan". After intervention, the improved scores mainly concentrated on "establishment of occupational health management system and post operation procedures", "establishment of the occupational-disease-inductive accident emergency plan",and "available Chinese instruction for use, production and management the occupational-disease-inductive chemical" in intervention group, while focused on "establishment of occupational health management system and post operation procedures" and "available Chinese instruction for use, production and management the occupational-disease-inductive chemical" in control group. The scores increase entries in intervention group are more than control group.Conclusion:Quantitative and gradation management model combined personalized service can effectively promote enterprises' occupational health. It helps the supervision departments to allocate resources reasonably and improve supervision effectively with more focused and targeted work, and is beneficial to the enterprises in self-management and self-improvement.