thtfc trang benh dau Idng d ngddi lao ddng Dung (2003), "Nghien edu thdc trang ganh N g i n h Det may d i l u trj tai benh vien Det may td nang lao ddng cua cdng nhan la hdi Cdng ty dd d l xuat d e giai p h l p dd phdng". Bio e l o cap may Ddc Giang - Gia Lam - Ha Ndi". Tap chi Y Tap d o l n , d l t l i nghien cdu khoa hoc, H I Ndi. hoc thdc hanh, sd 1, nam 2003, 36 - 39.
6. Nguyin Thj Bich Lien (2003), "Tinh trang 8. Nguyin Thj Bich Thu (2006), "Phat trien mdi trddng lao ddng va sdc khod cdng n h i n md hinh lien ket b i n vdng gida cd sd dad tao va Cdng ty Det 8/3". Tap ehi Y hoe thdc hanh, sd c i e Doanh nghiep Det may trong xu hddng hoi 2, nam 2003, 32 - 35. nhap WTO". Tap ehi Khoa hoc va Cdng nghe,
7. Nguyin Thj Bich Lien, Nguyin Dinh so 3 - 4/2006.
Summary
WORKER HEALTH OF HANOI INDUSTRIAL TEXTILE JOINT STOCK COMPANY IN 2009
Objectives: to discribe current worker health of Ha Noi Industrial Textile Joint Stock Company in 2009. Method: a erossecrinonal study of 136 worker. Results: In terms of worker health, most of worker health is 1, 11, III type. 11 type makes up 39.7%, III type makes up 3 3 . 1 % , IV type makes up 23.5% and I type only makes up 3.7%. In particuler, no woker health falls to V type. Workers usually suffer from some popular diseases such as stomatologic (56.6%), eyes (36.8%), ENT (ear, nose &
throari (22.9%), low blood pressure (16.2%) & mobilization system (14.7%). Rate of worker are diagnosed to suffer from occupational deafness makes up 7.35%. Rate of workers suffer from Dyspnea in the beginning of working week makes up 16.2%. Conclusions: It is needed to improve management of worker health including periodical health cheek to early detect occupational diseases.
Keywords: Occupational deafness. Symptom Dyspnea in the beginning of working week
THaC TRANG HOAT DONG Y TE TRLfOfNG HOC TAI
• • • • • •
QUAN THANH XUAN NAM 2009
A » 2
Tran Thj Kim O a n h \ Chu Van Thang^ Le thj Thanh Xuan
^Trung tim Y te dUphdng quan Thanh Xuan - Ha Ndi; ^TrUdng Dal hgc Y Hi Ngi
Nghien cifu dugc tien hanh tai 7 trudng pho thdng thudc quan Thanh Xuan - Ha Ndi. Muc tieu: mo ta thtfc trang boat dgng vi y ti trtfdng hgc (YTTH) tai cac trtfdng phd thdng quan Thanh Xuan nam hoc 2008 - 2009. Doi ttfgng va phtfang phap nghien cffu: ap dung nghien ctfu cit ngang (djnh tinh va dinh Itfgng) de phdng van 834 bgc sinh trtfdng tieu hgc (TH), trung bgc ca sd (THCS) va trung bgc pho thdng (THPT) tai 7 trtfdng nghien ctfu theo bg cau hdi. Toan bg bio cao, so' lieu so sach vi boat dgng YTTH tai cic trtfdng pho thdng diiu tra cung dtfgc thu thap. Ke't qua: cac hoat dgng da va dang thtfc bien la giao due sifc khde, td chtfc cac boat dgng YTTH (kham stfc khde djnh ky, sd cap ctfu ban diu, trien khai cic chuang tnnh CSSK ban diu) tuy nhien cac boat dgng nay khdng thudng xuyen nen mdi dat d hieu qua nhat djnh. Hoat ddng theo ddi stfc khde hgc sinh chtfa dtfgc tbtfc hien d tat ca cic trtfdng. Ty le hgc sinh tra Idi cd bd sa theo ddi sifc khde tai trtfdng THPT cao han khdi tiiu hgc va THCS. Trong dd,
TCNCYH PhtJ truang 70 (5) -2010
ty le cao nhai la hgc sinb Idp 12 (26,7%), khd'i 11 (22,6%) va Idp 3 (15,5%o). Khdng cd em hgc sinb Idp 8 nao ndi ring cd ho sa theo ddi sifc khde tai trtfdng Ke't luan: cin day manh boat ddng Y te trtfdng hgc tai quan Tbanb Xuan, nha't la hoat dgng theo ddi sifc khde hgc sinh va chat Itfgng cic hoat dgng da thtfc hien.
Td khoa: Y te trddng hoc, quan Thanh Xuan
I. DAT VAN DE
Lda tudi hpe sinh ehiem g i n 1/3 dan so e l nddc, thude Ida tudi tre, la tddng lai cua da't nddc. Chinh vi the, sdc khde eua hoe sinh hdm nay ed y nghTa 11 sdc khde cua dan tde mai sau.
Mae du da cd n h i l u quan tam va nd life cua D i n g va N h i nddc, cua toan xa hdi trong thdi gian qua, nhdng cho den nay boat ddng y t l trddng hoc (YTTH) v i n cdn n h i l u van d l e i n dddc quan tam [4, 5, 6, 7, 8].
Theo bao d o tdng hcJp rinh hinh y te trddng hoe nam 2002 cua Bd Y te, chi cd 44/61 rinh/
thanh phd ed bao cao v l YTTH, trdng dd 40/61 tinh/thanh cd ban chi dao cap tfnh thee hddng dan cua lien Bd Y Te va Bd G i l o due v l D I o tao, 30/61 rinh cd van b i n lien nganh y te - gilo due hddng d i n e l c cap thdc hien [6].
Trong c l nddc, chda cd tinh nao cd du ban ehi dao YTTH cap huyen. C I c hoat ddng YTTH trien khai chda n h i l u , ndi cd trien khai cung ehi ed mdt Sd ndi dung nhd tao phong trao xanh sach dep, eung cap nddc ud'ng cho hpe sinh, d c edng trlnh ve sinh ed tien bd nhdng cdng ehi dat khoing 50% yeu c l u , cdng t i c kham sdc khoe djnh k'y, q u I n ly hd sd sdc khde h i u h i t chda thdc hien theo quy djnh [6].
Bai b i o nay nham muc tieu:
Mo ta thffc trang boat dgng ve y te trffdng bgc tai quan Thanh Xuan trong nam nam trd lai day (tff nam hgc 2004 - 2005 den nam bgc 2008 - 2009).
Tren ed sd dd d l xua't mdt sd k i l n nghi nham
day manh heat ddng YTTH tai quan Thanh Xuan nham nang eao sdc khde eho hoc sinh trong thdi gian tdi.
II. DOI TUONG VA PHLfONG PHAP NGHIEN CL/U
1 . Thiet ke nghien cii'u
Nghien edu md t l eat ngang (phd'i hop djnh IdcJng va djnh tfnh).
2. Dja diem va thdi gian nghien cii'u
Nghien cdu dddc tien hanh tai 3 trddng tieu hoc (Phan Dinh Gidt, Dang Tran Cdn B, Kim Giang)), 3 trddng trung hoe ed sd (Phan Dinh Gidt, Thanh Xuan Nam v l Kim Giang) va 1 trddng THPT (Tran Hdng Dao) tai quan Thanh Xuan, thanh phd H I Ndi.
Thdi gian nghien cdu td t h i n g 10/2008 den t h i n g 12/2009.
3. Dd'i tddng nghien ciifu
Hoc sinh tai d c trddng TH , THCS va THPT dddc d i l u tra.
Cac b i d e l o , nghien edu, sd lieu cd san v l y te trddng hoe v l phieu tdng hdp k h l m sdc khde tai quan Thanh Xuan td nam 2004 - 2009.
4. Cd mau va each chon mau
Nghien cdu djnh lddng dddc tien hanh tren d c hpe sinh phd thdng theo 3 bac hoc (TH, THCS va THPT). Cd m l u eho nghien cdu d i l u tra d hoc sinh cho mdi bac hoe dddc tinh theo edng thdc tinh ed mau eho mot nghien cdu ty le trong q u I n t h i .
Q u I n the nghien edu la toan bd hoe sinh
phd thdng td tieu hoc tdi trung hoc phd thdng tai quan Thanh X u l n .
Ddn vj nghien cdu la hoc sinh pho thdng td Idp 1 den ldp 12.
Ddn vj chpn m l u 11 hoc sinh. So hoc sinh mdi bac ddcJc nghien cdu ia:
n = Z, p x q
--(1-0/2) / \2
(exp)
Trong dd:
Vdi do tin ciy 95%o: Z = 1,96;
p = 0,4 (la ty le hgc sinh mic benh hgc dtfdng, cin dtfgc cham sdc sffc khde, tfdc tinh tff nghien cffu cua Trin Van Din vi cdng sU nam 2005);
q= 1 -p;e=0,15;
1,96'X 0,4x0,6
n - •
( 0 , 1 5 x 0 , 4 ) '
= 300 (hoe sinh)
Nghien cdu tie'n hanh d ba khd'i trddng T H , THCS va THPT. Nhd vay mdi khd'i trddng se d i l u tra 300 hoc sinh. Thdc te da chon dddc 284 hoc sinh tieu hoe, 295 hoc sinh THCS va 255 hoe sinh THPT tham gia nghien cdu.
Cach chon mau: chon m l u theo n h i l u giai doan
Bddc 1: danh sleh eae trddng hien ed tai quan Thanh Xuan
Lap danh sleh ta't d e l e trddng TH, THCS v l THPT tai quan Thanh Xuan nam 2008 - 2009.
III. KETQUA
30 25 20 15 10 5 0
L a p l La'p 2 LffpS Lcfpi LcfpS L^p 6 L a p ? Lo^p 8 La'p 9 La'p 10 Lo-p 11 L^p 12
Biiu do 1. Ty le % HS co ho sa theo doi SK tai trtfdng theo ldp va bac hgc Bddc 2: Ida chpn trddng nghien cdu
Chon 3 trddng T H , 3 trddng THCS, 1 trddng THPT trong danh sach d c trddng bang phddng p h l p n g l u nhien ddn.
Bddc 3: Ida chpn hpe sinh d i l u tra tai mdi khd'i.
Tai mdi khdi trddng, Ida chon so hoe sinh theo khd'i ldp (bang tdng sd' hoc sinh can dieu tra 11 300/tdng sd khd'i ldp trong khd'i trddng). Sd hoe sinh dddc Ida ebon mdi khd'i ldp I I 60 hpe sinh d trddng T H , 75 hpe sinh d trddng THCS ( l l m trdn len 80 de Ida chon d i d nam va nd) va 100 hoc sinh d trddng THPT.
Lap danh sach hpe sinh cd trong tdng khd'i theo Idp v l theo v i n A,B,C (eho tdng gidi nam va nd). Sau dd hoc sinh d i u rien dddc Ida chpn theo phddng p h l p ngad nhien ddn v l d e hoc sinh edn lai dddc Ida chpn thee phddng phap ngiu nhien he thdng vdi khoing e l c h mau b i n g tdng so hoc sinh mdi khd'i/tdng so hoc sinh c i n dilu tra mdi khd'i. Lam rieng eho nam v l nd..
5. Ky thuat thu thap so' lieu:
Phdng van hoc sinh theo bd cau hdi thiet ke cd s i n .
Hdi edu lai toan bd sd sleh b i o d o v l y te trddng hoc theo nam hoc tai d c trddng TH, THCS v l THPT Ida ebon tai quan Thanh Xuan.
6. Xuf ly so' lieu: d e so lieu ddoe lam sach va nhap lied bang chddng trlnh Epi - info 6.04 va Phan tieh cac so lied thu ddc?e bang p h i n mem SPSS.
5.5
n
11.£
15.{
12.:
n n 11 " r^
11.1 22.f
26.-7-
TCNCYH PhtJ truang 70 (5) -2010
Theo ke't qua phdng van 834 hgc sinh tai 7 trUdng nghien cffu thi hgc sinh khdi THPT tra ldi cd ho Sd theo ddi sffc khde tai trffdng cao han khdi tieu hgc vi THCS. Trong dd, ty le cao nha't la hgc sinh Idp 12 (26,7%o), khdi 11 (22,6%o) va Idp 3 (15,5%o). Khdng cd em hgc sinh Idp 8 nao ndi rang cd ho sd theo ddi sffc khoe tai trffdng.
120 100 80 60 40 20
87.2 82.8 89.5 89.3 93.2 95.9
69.5
84.2 86.1
60.3 66.7 46.7
Lap 1 Lap 2 Lap 3 Lap 4 Lap 5 Lap 6 Lap 7 Lap 8 Lap 9 Lap 10 Lap 11 Lap 12 Bieu do 2. Ty le % HS dtfgc KSK djnb ky tai trtfdng theo Idp va bac bgc
Kit qua d bieu do tren cho tha'y ty le hgc sinh khdi THCS va TH tra Idi da dtfgc khim sffc khde dinh ky cao hdn khdi THPT. Trong dd, ty le nay cao nha't d hgc sinh Idp 8 va hgc sinh Idp 6 (95,5%o va 93,2%o). Ty le dtfdc khim sffc khoe dinh ky tai trffdng tha'p nha't d hgc sinh Idp 12 (46,7%o).
100 80 60 40 20 0
88.9
61.8
54.4 62.5 39 41.4
80.3 82.3 81.9
66.7 50.8
60
L a p 1 Lap 2 Lap 3 Lap 4 Lap 5 Lap 6 Lap 7 Lap 8 Lap 9 Lap 10 Lap 11 Lap 12 Bieu do 3. Ty le % bgc sinb co dtfgc kham phat bien can thj trong nam bgc 2008 - 2009 theo Idp va
bacbgc
Trong nam hgc 2008 - 2009, ty le % hgc sinh khdi THCS dtfgc khim phit hien can thi cao hdn khdi tieu hgc vi THPT. Trong dd, ty le nay cao nha't d hgc sinh Idp 6 (88,9%o) va hgc sinh Idp 8 '82,3%), thi'p nha't d hgc sinh Idp 2 (39%o) vi hgc sinh Idp 10 (40,7%o).
70 60 50 40 30 20 10 0
58.2 63
35.1 38.4 38.2
32.1 20.7
10.5
36.6
15.7 9.5
4.4
L a p l L a p 2 L a p S L6'p4 Lap 5 L a p 6 Lap 7 L a p 8 Lap 9 L a p I O L a p l l L a p 1 2
Bieu do 4. Ty le % bgc sinb co dugc kham phat hien cong veo cot sdng trong nam hgc 2008 - 2009 theo ldp va bac bgc
Ket qua d bieu do 4 cho tha'y ty le % hgc sinh khdi THCS va tieu hgc dtfdc kham phat hien cong veo cot sdng cao hdn khdi THPT.
Trong. dd, hgc sinh Idp 8 va hgc sinh Idp 1 dtfdc kham nhiiu nha't (63%o va 58,2%o). Ty le nay thi'p nha't d hgc sinh Idp 10 va hgc sinh Idp 12(9,5%o va4,4,%o).
IV. B A N L U A N
Trong nam nam vda qua d c trddng bpc tai quan Thanh Xuan da trien khai d c chddng trinh y te trddng hoe gdm chin chddng trinh (theo thu thap so lieu cd sin) nhd: Cham sdc sdc k h o i ban d i u , Phdng chd'ng benh truyin n h i l m , Phdng chdng thieu m l u , Phdng chd'ng suy dinh dddng, Chddng trlnh nha hpe dddng, Chddng trlnh mat hoe dddng, Chddng trinh phdng chd'ng HIV/AIDS, Chddng trinh phdng chd'ng tai nan thddng tich, Chddng trinh nddc sach - ve sinh mdi trddng. Ben canh dd, 100% sd trddng da thdc hien tuyen t r u y i n g i i e due sdc khde, tuyen truyin phdng chd'ng benh can thj va benh cong veo cdt sd'ng. Ket q u i nay td't hdn e l e ket q u i nghien cdu trddc dd, dac biet la hai chddng trinh phdng chd'ng benh can thj v l eong veo cdt sd'ng cdn ra't it ddcJc quan tam thdc hien trong d c trddng phd thdng [ 1 , 2, 3,4,5]. Tuy nhien, ty le trddng cd hd sd theo ddi sdc khde, dae biet d d c trddng tieu bpc va trung hoe ed sd cdn chda dddc day du. K i t q u i so lieu cd san nay cung rat phu hdp vdi ket q u i d i l u tra phdng van hpe sinh khi hoc sinh khd'i THPT t r i ldi la ho cd hd sd theo ddi sdc khde tai trddng cao hdn khd'i tieu hoc va THCS (bieu do 1) nhdng ty le hoc sinh t r i Idi cd hd sd theo ddi sdc khde cua hoc sinh rat tha'p (cao nhat ldp 12 chi cd 26,7%). Died nay p h i n anh khach quan chat lddng cua hoat ddng nay hoac cd the la do chinh b i n than hoc sinh chda quan tam tdi viec nay nen khdng biet.
Ket q u i nay gdi y boat ddng theo ddi sdc khde eua hoc sinh c i n p h i i dddc tie'p tuc tang cddng
ve lddng va chat trong thdi gian tdi.
Nhd vay, cac boat ddng YTTH da trien khai tai quan Thanh Xuan da d i m b i o thdc hien d i y dd theo quy djnh cda lien Bd Y te - G i l o dgc va d I o tao (03/2000/TTLT - BYT - BGD&DT ngay 1/3/2000) v l viee hddng d i n thdc hien cdng t i e YTTH. Tuy nhien, khdng p h i i ta't c l d e trddng tren dja ban quan d i u thdc hien ddng nha't tat c l eac hoat ddng tren. N g o l i e l c boat ddng mang tinh thddng xuyen nhd sd cap cdu ban d i d , kham sdc khde djnh ky (1 nam/lln), phdng chd'ng benh tat thddng gap d Ida tudi hoe dddng (mat hpe dddng, nha hoe dddng), ve sinh mdi trddng, an t o l n thdc pham ... dddc t r i l n khai 6 h i d khap d e trddng. Cdn nhdng boat ddng mang tinh Idng ghep trong d e chddng trlnh ngoai khda nhd g i l o due sdc khde, truyen thdng....tuy thudc vao sd nang ddng trong elch thdc trien khai eua d n bd d e trddng. Dac biet la 100% d e trddng d i u td ehde k h l m sdc khde djnh ky cho hoe sinh nhdng ehi cd 46,7% - 95,7% hoc sinh t r i ldi la ed dddc k h l m sdc khde d trddng (rat k h i c biet theo tdng ldp hoe, b i l d dd 2). V I mac dd chddng trlnh can thj va cong veo cot sd'ng dddc trien khai d tat c l ele trddng nhdng khdng p h i i ta't c l hpe sinh d i u dddc k h l m phat hien d e benh hoc dddng nay hang nam (bieu dd 3 v l 4). Mac du ty le hoc sinh dddc k h l m p h l t hien e l e benh hpe dddng theo nghien cdu cua chung tdi cao hdn d e t i c g i l trddc dd nhdng k i t q u i nay gdi y d c hoat ddng YTTH d quan Thanh Xuan mac du da bam s i t djnh hddng theo thdng td eua Bd g i l o due va dao tao, Bp Y te nhdng ve cha't lddng edn p h i i xem xet lai va c i n p h i i day manh hdn nda trong thdi gian tdi.
V . KET L U A N
Cac boat ddng da va dang thdc hien l l g i l o dgc sdc khde, td chdc cae hoat ddng YTTH ( k h l m sdc khde djnh ky, sd cap cdu ban d i u .
trien khai eae chddng trinh CSSK ban diu) tuy nhien eae heat ddng nay khdng thddng xuyen nen mdi dat d hieu q u i nha't djnh. C i e heat ddng trien khai chda ddng be va thd'ng nhat gida d e trddng phd thdng trong dja ban quan.
Hoat ddng theo ddi sdc khde hpe sinh chda ddcjc thdc hien d ta't c l eae trddng
T A I LIEU THAiVI K H A O
1. Dao Thj Mui (2009), Tinh hinh cong veo cot sd'ng d hoc sinh phd thdng thanh phd Ha Ndi: thdc trang v l giai p h l p phdng ngda, Luan van Tien sy y hoc, vien Ve sinh Djch t l Trung ddng.
2. Chu Van Thang (2009), Bao d o k i t q u i nghien edu d l tai cap Bd "Nghien cdu thdc trang edng tac y te trddng hoc d Viet Nam hien nay va de xua't md hinh q u I n ly phu hdp", ma s d 4 1 1 3 / Q D - BYT, 110.
3. Chu Van Thang, Le thj Thanh Xuan, Le Thj Hddng (2008), Thdc trang hoat ddng Y te trddng hoe qua phdng van hoc sinh tai huyen
TCNCYH PhtJ truang 70 (5)- 2010
Tam Ndng, rinh Phu Thp nam 2008, Tap chi Y hoc Thdc h i n h sd 634 - 2008, 11 5 - 1 20.
4. To chu'c Plan tai Viet Nam (2004) "Fhde trang hoat ddng y te trddng hoc va djnh hddng x l y ddng md hinh nang cao sdc khde trddng hoc". B i d d d k i t q u i nam 2004, 97.
5. Vu Y te dd phdng. Bo Y te (2000), Ve sinh hoe dddng, Nha xuat b i n Y hoe H I Ndi, 25 - 62.
6. Vu Y te dd phdng. Bo Y te (2002), Bio d o tdng hdp rinh hinh y te trddng hoe.
7. Le Thj Thanh Xuan, Chu Van Thang, Nguyen Tua'n Linh (2008), Nang ldc eua ddi tddng thdc hien cdng tac Y te trddng hoc tai rinh Phu Tho nam 2007, Tap ehi Y hoc Thdc hanh sd 634 - 2008, 40 - 4 4 .
8. Le Thj Thanh Xuan, Chu Van Thang, Nguyen Tuan Linh (2008), Thtfc trang ngudn nhan ldc thdc hien cdng t i e Y te trtfdng hoe tai rinh Phu Tho nam 2007, Tap chf Y hoc Thdc hanh sd 634 - 2008, 9 6 - 1 0 1 .
Summary
SITUATION OF SCHOOL HEALTH ACTIVITIES IN THANH XUAN DISTRICT IN 2009
A study was carried out in seven primary, secendary and high schools in Thanh Xuan district, HaNoi. Objective: To analyse the shool health situation in those schools in Thanh Xuan district of school year 2008 - 2009. Methods: A cross - sectional study (both quantitative and qualitative) was applied to interview 834 pupils of seven primary, secondary and high schools using structured questionnaire. All secondary data on school health was also collected. Results: The most common activities have been doing in studied school including health education, provided health services (such as periodical health exams, first - aids) and implementation of primary health care program. However, the effectiveness of those activities has been not good as expected. The action of following up pupils' health was limited. The percentage of pupils responded having health records at school among high school was higher than that of primary and secondary schools. In w h i c h , the highest popularity was in grade - 12 pupils (26.7%), grade - 11 (22.6%) and grade -"3 (15.5%). None of grade - 8 pupils reported that they had health records at school. Conclusion: School health activities in Thanh Xuan district need to be improved, particularly health record skills and the quality of school health activities performed.
Keywords: School health, Thanh Xuan district
