MO TA THUC TRANG VIEC CUNG CAP CAC DjCH VU Y TE LAO DONG CU BAN TAI CAC DOANH NGHIEP SAN XUAT VAT UEU X A Y O U N G VQA VA NHO
TAI THANH PHO HOA BlNH
TOM T A T
Ngadi lao di^ng tai cac ca sd sin xuSt vat lieu xay dung vCfa va nhd dang phai tiep xOc vdi nhiiu nguy ca v§ sOC khoi va an toan nghi nghi$p. Biiu n^y xuit phat tit vi$c thuc hien cac dich vu y i&' lao ddng ca bin tai cac ca sd nay cdn nhiiu han chi. D4 thuc hien tdt nhiem vu chSm sOc bao ve sOC Iihoi nhan din chUng tdi tiin hinh nghidn cCru tJS tii:"Md ti thuc trang vi§c cung cip cac djch vu y te lao ddng cd bin tai cac doanh nghiep sin xuit vat lieu xay dung nho va vHa tai Thanh phd Hda Binh tinh Hda Binh nSm 2011".
Nghien cUu duac thuc hien vdi phuang phap md ta cat ngang, tirthang 10/2011 din thing 10 nBm 2012 vdi doi tuang la chO sd hOu lao ddng ho$c ngudi quin ly cOa toan bd 106 doanh nghiep san xuit vat lidu xay dung vi/a va nho trdn dja ban.
Kit qua trong nghien cUu cho thiy phan Idn cac doanh nghiep khdng thuc hien hoSc thuc hien khdng day dd cac quy dinh ve viec cung cap dich vu y te lao dgng ca ban cho ngudi lao ddng. Phan ldn cac doanh nghiep chua cd can bo y ti lam cdng tac y te lao ddng hoac cd can bd nhung chua dOng thanh phan va trinh do phu hap. Diiu nay ddn tdi cac doanh nghiep nay chua thi cung cap cac dich vu y ti lao ddng ca bin cQa ngudi lao ddng nhu trang bi cac phuang tien sa cap cUu, quin ly sOc khoe ngudi lao ddng, quan ly moi trudng lao ddng, trang bi bio hd lao ddng, huan luyen viATVSLD.'
Khuyen nghj: Vdi chQ si? dung lao ddng can thuc hien mpt each nghiem tuc vide thuc hien cac quy dinh cOa phap luat ve cung cap dich vu y titao ddng ca bin tai DN. Vdi cac cip quan ly can tBng cudng cdng tac chi dao, kiim tra giam sat ddi vdi DN. Xi^ /y nghiim khac vdi cac trudng hap vi pham.
Tir klioa: Ngudi lao ddng, ca sd san xuat vat lieu xay dung
SUMMARY
Workers in factones producing construction matenals are small and are exposed to many health hazards and occupational safety. This is because the provision of BOHS in these plants is limited. To do good work to protect health care workers we conduct research topic: "Describe the situation of BOHS provision In small and medium enterprise In Hoa Blnh city".
The study was carried out with the cross sectional research method, from December 2011 to October 2012. The research objects are the owner or manager of the entire 106 small and medium construction materials enterprise in the area.
Results of the study showed that the majorily of businesses do not provide or do not adequately
PHAM CdNG TUAN - Trudng Dai hpc Y t§c6ng cpng HOANG DiNH HAO - Trung tSm y tid^rphong huypn Hod Binh
provide basic occupational health services for employees. Most businesses do not have medical staff working as health care workers, or the health staffs are not suitably qualified. This has led to these enterprises can not provide medical services for workers such as first aid facilities, health management for workers, working environment management, protective equipment, training on OSH.
Recommendation: All employers should implement In eamest the Implementation of the provisions of law, providing occupational health services. The OHS management agencies need to strengthen the management of the direction, control and supervision of enteiprises.
Keywords: Workers, factories.
DAT VAN DE
Tai Viet Nam, theo thong ke, toe dp tang trifclng cua nganh vat iieu xay dung dat tren 17%/nSm. cao hdn toe dp tang taring chung eua cong nghiep ca ni/dc [3].
Tuy nhien nganh nay ton tai nhieu yeu to gay 6 nhilm moi truOng lao dong [4]. Tinh trang benh tat thifdng gap trong nganh xay difng la bui dac biet la bui c6 ham luUng silic tu do eao, nguyen nhan ehCi yeu gay nen benh bui phoi, Tiep theo ia tieng on, hdi \(t\\ doc, tai nan lao dpng, nhiet dp, do am...[2]
San xuat vat lieu xay dong ia mot cdng viee mang tinh dac thu cOa nganh xay difng. Hien nay cac cong ty san xuat vat lieu xay difng ngay cang gia tSng. He thdng cac cd sd san xuat nay da gop phan I<h6ng nho lam thay ddi bo mat dat nu'dc [4][5].
Trong nhifng nam gan day, lanh dao cac doanh nghiep san xuat vat lieu xay diing nho va vCfa tren dja ban Thanh pho Hoa Binh da eo nhiing chi!i truang, chien lUdc nham nang cao sCfc Ithoe cho nguSi lao dpng thdng qua cac buoi l<ham sifc khoe djnh ky hang nam, kiem tra mdi tnfdng lao ddng, dau tif cong nghe mdi. Tuy nhien sifc I<h6e ngu'di lao dong va MTLD chu'a du'pc cai thien.
Dich vu Y te lao ddng cd ban (BOHS) la ifng dung chinh sach cham sdc sij'c I<h6e ban dau trong ITnh vtie Y te lao ddng, la mot bien phap cd ban va tdng the de tang euiSng bao ve sifc l<hoe eCia nguSi lao dong [1].
Ngtiien cifu duac tnen kha\ nham mo ta thifC trang viec cung cap cae dich vu Y te lao dong cO ban tai eae doanh nghiep san xuat vat lieu xay difng nhd va wila tai Thanh phd Hda Binh - tinh Hda Binh nam 2011 va cung cap cac thdng tin cho cac cd quan quan ly dia phuong trong xay dung cac chinh sach cham sdc sifc khoe nguGi lao ddng trong nganh san xuat vat lieu xay difng tai ^ a phifdng.
Y HOC THlTC HANH (878) - SO 8/2013
D6| TJpNG VA PHUONG PHAP NGHIEN cOU
Doi tiTdng nghien c d u : Nghidn cCfu duac tl^n hdnh tren cac ehu sif dung lao dpng hoSc ngu&i duBc chO sCf dung lao ddng Oy quyen (Giam ddc, phd giam ddc) ciia cac doanh nghiep san xuSt vSt lidu x3y dung vita vh nhd tren dja bSn thdnh phd Hda Binh. Cac hoat ddng cita cac doanh nghidp vd tdi liSu cOng duac s ^ dung trong quan sdt vd ddnh gid.
Dia diim vd ffidf gian nghiin ctiu: Nghidn cijru dupc ti^n hdnh tif thdng 10/2011 ddn thdng 10/2012 Tai cac doanh nghidp Scin xuit vdt lidu xdy dung nh6 vd vCia tai thdnh phd Hda Blnh.
771/^^ ki nghi&n cihi. Nghidn cOu md ta cSt ngang.
CQ miu vd cdch chgn miu nghiin ciiU dfnh lu^g. Nghidn ciiru tri^n khai trdn todn bd 106 doanh nghidp s i n xuSt vdt lidu xdy dung vHa vd nhd tai Thdnh phd Hda Blnh. Danh sdch cac doanh nghidp dUdc idp dua vdo bao cdo ket quS cap giay chiimg nhdn ddng ky l<inh doanh cac doanh nghidp vd bdo cdo tdng hdp doanh nghidp tfnh den thdi diem thdng 10 ndm 2011 cilia s d k d hoach vd dau t u tinh Hda Binh.
Phuong phdp, c6ng cy thu thip sdlieu - Phdng vSn chCi silr dung lao ddng tai cac doanh nghidp san xud't va^ lieu xdy dUng vCfa vd nhd theo bd cau hdi xdy dung san.
- S^ dung bang kiem ddnh gid cdng tdc thUc hidn BOHS (Dua theo bang kiem danh gia cdng tac cham sdc sij'c khoe ngudi lao ddng tai doanh nghiep vCi^ vd nhd, nam 2000 cCia Bd Y te) de dieu tra tiien trang cdng tac y te tai cac doanh nghiep.
X&lj^ vd phdn tich sdliiu: Tat ca phieu nhan ve duac ldm sach; ma hda vd nhap vao may tfnh bang phan mem Epidata 3.0 va phan tfch bang phan mem SPSS 16,0.
KET QUA VA BAN LUAN 1. Thdng tin chung.
Nghien ciiru da tien hanh dieu tra tren 104 ngUdi quan ly ciia 104 doanh nghiep. Cdc chu doanh nghiep thudc nhdm tudi tre. nhdm tuoi tif 40 - 49 chiem tf le eao nhat 33,02% va nhdm tren 60 tudi chi chiem t j Id thap nhat 4,72%. Cac chu doanh nghiep hodc can bo quan ly doanh nghiep nay cd 31 ngifdi Id nU, 75 ngifdi la nam.
Cac ed sd san xuat ndy thude loai hinh Cdng ty co phan 46, cdng ty TNHH 35 cac ca sd san xuat tu nhdn thap nhat-25 DI^. Cac doanh nghiep cd thdi gian hoat ddng eua cac DN; Tren 10 nam cd sd luang cao nhat 51. Dudi 1 ndm cd sd luang thap nhat 08. Phan Idn eac DN cd thdi gian san xuat vat lieu xay dung tren 10 ndm la cac cdng ty cd phan va cdng ty TNHH.
2. To chdc y te'CSSK cho ngifdi lao d^ng.
Chi cd 12 DN cd can bo Y te lam cdng tde chdm sdc sCfe khde cho ngudi lao ddng chiem t^ le rat thap 11,32%. Trong dd. cd 04 DN (3,77%) cd" trang bj phdng rieng cho can bd Y te lam viec. Chi cd 09 cd sd cd can bd Y te dUdc tham gia vao Hdi ddng bao hd lao ddng chiem t;/ Id 8,49%. Ve sd lUpng va trinh dd can bd Y te trong cac DN thue can bd Y te, ch? cd
04 DN thuc hidn dOng theo quy djnh chidm ty Id rat thSp 3,77%.
Ph^in ldn cdc doanh nghidp (60,38%) chua thyte hidn vide ldp kd hoach d i o cdc hoat ddng y td lao ddng. Chl cd 07 DN c6 ldp kd hoach day dfi cho hoat ddng Y td. Cd 35 DN cd thUC hidn nhung chite dung, Sit vd ndi dung. Nguydn ntidn cda thuc trang ndy Id vide cdc doanh nghidp thieu can bd Idm vi Y te tao ddng, vd cdc doanh nghidp cd cdn bd chuyen trdch thi ktidng dat trinh dd theo quy djnh.
3. Trang bj thu5c cap curu va d y n g cv cap cdu, thudc d v n g cu dieu tr} b f n h thong thudng.
Chi cd 12 DN thuc hien trang bj tiii thudc vd dung eu Ccfp ciiru. Trong dd sd DN thUc hidn dOng vd dd theo ydu c5u 05 chidm t f Id r^t th^p (4,72%). 33/106 DN co thudc vd DCYT td didu tri cdc bdnh thdng thudng chidm 31,13%. Trong dd thuc hidn diing vd dO theo quy (^nh Id 6.60%, khdng dung vd dii theo quy dinh la 24,53%. Khdng cd thudc vd DCYT Id 73/106 chien 86,87%. 29/106 DN cd gdc tuydn tmydn siiC khde, chidm 27,62% sd doanh nghidp duac didu tra, sd DN khdng thuc hidn quy dinh ndy la 77 chidm 72,38%.
L'ji do cd ti Id cao eac doanh nghidp khdng thuc hidn cdc quy dinh nay vi khdng cd ngudi biet s^ dung thude va cdc phifdng tidn c^p ciru vd cd mdt sd DN co trang bj nhung khdng s& dung den nen kht thudc h€i han va dung cu bi hdng thi khdng trang bi lai. Vd van de trang bj thudc thdng thudng vd DCYT tlidng thudng da phan cac c h i DN cho rang da mua BHYT cho ngudi LD ndn khdng trang bj. Mdt sd chii doanh nghiep cdn quan nidm rang ngudi lao ddng bj dm thi tU mua thudc dieu trj. Ngudi lao ddng khdng bidt quyen ldi cilia minh mdt phdn cd tam ly e ngai, phien hd den ngUdi khac, nguac lai chill DN cung khdng thuc hidn nghTa vu cCia minh vi ldi nhudn cua DN.
4. Quan ly MTLD lap ho stf ve sinh.
27/106 DN thuc hien lap ho sd VSLD chiem 25,47% sd doanh nghiep. sd khdng thuc hien la 79/106 chidm 74,53%. 21 DN c6 thuc hidn cac teen phap cai tao dieu kidn lao ddng chidm 25,47%. Phdn ldn cac doanh nghidp san xuat vdt lieu xdy dung d TP Hoa Binh khdng thUC hidn do MTLD, chiem 76,42% sd doanh nghidp tham gia vdo nghidn cCru. Chl cd 10 DN td chiiC do MTLD dung theo quy dmh chiem 9,43% va 15 DN (14,15%) thuc hidn do MTLD nhung khong diing ttieo quy djnh.
Lap hd sd VSLD cilia cdc diO DN cho thay hien nay van de ldn nhat la khd khdn vd vdn de dau tu vao san xuat kinh doanh nhu mua sam may mdc, xay difng nha xudng, quat thdng gid. Neu cd von thi MTLD xe dUdc cai thidn rat nhieu, khi MTLD an todn cho ngudi lao ddng thi chii DN khdng ne tranh do kiem MTLD hang ndm ttieo quy flnh cila nhd nUdc.
Mdi trudng lao ddng vuat qua TCCP cd anh hudng den sCrc khoe cOa ngodi lao ddng, ngudi lao ddng se mac phai cac t>enh nghd nghiep. Nhimg hien nay do khd khdn ve vdn, do lai nhuan cDa DN va do y VnOc ciia chil sit dung lao ddng, do khdng duac kiem tra
Y HOC THVC HANH (878) - S6 8/2013
i i
thudng xuydn, do che tdi sit phat khdng di!i sCrc rdn de, do tidu cue xa hdi nen da sd cac DN v i n khdng thuc hien nghidm tiie vdn de nay.
5. Chdm sdc vd quan ly sdc khoe ngudi lao ddng.
Trong tdng sd 106 DN chi cd 39 DN thuc hien chiem 36.79%, sd khdng thuc hidn la 67 chien 63,21%.
TJ le giQa thuc hien vd khdng ttiuc hidn chenh Idch rdt Idn trdn 2/3 Id cac DN khdng thuc hidn.
Khdm si:rc khoe djnh ky va khdm phdt hidn BNN, Cd 32 DN thuc hidn chiem 30,02%. Sd khdng thUC hien 74 chiem 69,98%. Khdm silte khde ^ n h ky va kham phat hidn BNN Id mdt trong nhtJing yeu cdu bat budc phai thuc hidn nhUng do kiem tra ci!ia cac ca quan chCrc nang khdng thudng xuyen, do cac doanh nghiep ne trdnh sd b| mang tieng cd ngudi lao ddng mac BNN, do tra chi phi cho hoat ddng nay la khdng nho, do ngudi lao ddng khdng biet tinh trang bdnh tdt ciia minh.
Bd tri eong viec phiJ hop vdi ttnh trang cfla ngudi lao dfing cung duae mdt sd DN tridn khai xong tJ Id rat thap chidm 17,92%. So DN khdng thifc hien chidm 82.08%. Bd tri cdng vide phii hdp vdi tinh hinh siic khde ciia ngudi lao ddng phu thudc rat Idn vao cdng tac khdm sCrc khde djnh ky hang ndm. T^ le nay thap truang ddng vdi ty Id khdm sifc khde djnh ky eOa cac DN. Mot phin nho Id sap xep dua vao giay khdm sut khoe tuyen dung.
Lap hd sa quan ly siic khoe ngifdi lao ddng. Cd 12 DN thue hidn Lap hd sd quan ly sifc khde ngUdi lao ddng tif 80-i00% cdng nhdn chidm tJ le 11,32%.
Phan ldn cac DN cd mua BHYT cho ngudi iao ddng viA cdc sd luong khac nhau. Trong do mua cho 80- 100% cdng nhan 38/106 chiem 35,85%; mua cho 50- 80% cdng nhan 22/106 chiem 20,75%; mua cho <
50% cong nhan 26/106 chiem 24,53%; Khdng mua 20/106 chiem ty le thap nhat 18,87%. Vdi ket qua trdn cho thay day la mdt dau hieu dang mCmg vi cac DN mua BHYT cho ngirdi lao ddng rat cao. Chl cd 20/106 DN khdng thUd hien.
6. Huan luyen VSATLD.
Ti Id tham gia tap huan ve VSATLD do tuyen tren to chiic cd tJ Id thap chiem 32,58%, sd cd sd khong tham gia tap huan la 81 ca sd, chiem 76,42%.
Cd 23 DN td chCrc huan luydn ATVSLD chiem 21,70% vd 83 DN khdng thuc hidn chiem ty td rat cao 78,30%. Van de nay phan nao phan anh dupc DN ndo tich cue tham gia tap hudn do tuyen trdn td ehifC thi khi ve DN ho sd to chiirc tap huan cho ngUdi lao ddng. Cdc DN khdng tham gia tap huan do tuydn tren td ehifc rd rdng la ho khdng cd kien thiic ve ATVSLD de tap huan cho ngudi lao ddng
7. Trang bj BHLD.
Phan ldn cac DN cd trang bi BHLD cho cdng nhan lao ddng d cac mite khdc nhau; Sd cd sd trang bj cho 80 -100% ngudi lao ddng chiem 31,13%; Trang bj cho
50- 80% ngudi lao ddng chidm 21,7%; Trang bj cho dudi 50% ngudi lao ddng chidm 26,42%; Khdng trang bj chiem 20,75%. Ket qua trdn cho thay van de ndy cung da dupc chii DN quan tdn den. Trang bj BHLD phiJ hdp vdi cdng vide duac 34 DN thuc hien chiem 32%. Sd DN khdng thUC hidn 72 ehiem 67,92%. Neu trang bj BHLD phD hpp vdi cdng vide thi ngudi lao ddng sd duac bao vd trdnh dupe cdc yeu dde hai do mdi trudng lao ddng gdy ra.
8. Ddnh gia hi^u qua viec cung cap cdc djch vu YTLDGB.
T^ chiirc ddnh gid vide eung cap djeh vu Y td lao ddng CO ban. cd 17 DN ttiifc hien danh gid chidm 16,04%. Sd khong thuc hidn Id 89 chiem 83,96%. Hien nay hoat ddng ndy cQng chUa dupc cdc chii siJr dung iao ddng quan tdm. Hp cho rang khi ddu tu mua sam lap ddt mdt hd thdng day truydn san xuat mdi hodc khi lap them quat thdng gid d mdt vj tri ndo dd thi dieu kidn lam vide va mdi trudng lam viec dd duac cai thidn.
K £ T L U A N V A K H U Y E ' N NGHj
Ket qua trong nghien ciru cho thay phdn tdn cac doanh nghiep khdng thifc hien hodc thifc hien khdng day dCi cac quy dinh ve viec cung cap djch vu y te lao ddng ed ban eho ngudi lao ddng, Phan idn cac doanh nghidp chUa cd can bd y te lam eong tac y te lao ddng hoac cd can bd nhung chu^ dCing thdnh phan va trinh dp phu hpp. Didu nay dan tdi cdc doanh nghiep nay chua the cung cap cde dich vu y te iao ddng cd ban ciia ngudi lao ddng nhu trang bi cac phuang tidn sd cap ciru, quan ly sdc khoe ngudi lao ddng, quan ly mdi trudng lao ddng, trang bi bao hd lao dong, huan luyen ve ATVSLD.
Dua vao ket qua nghien ciru cho thay vdi chd sii dung lao ddng can thuc hien mdt each nghiem tuc viec thuc hien cac quy djnh eiia phap luat ve cung cap djch vu y td lao dfing ca ban tai DN. Vdi cde cap quan ly can tdng cudng cdng tac chl dao, kiem tra gidm sdt ddi vdi DN. Sit ly nghiem khac vdi cdc trudng hpp vi pham.
TAI LIEU THAM KHAO
1. Tran Thj Ngoc Lan & Chu Thiiy Quynh (2010) Djch vu y te lao dong cd ban (BOHS), Nha xuat ban Lao dpng.
2. Le van Trung va Cs (1999), Khao sat diiu kien lao ddng va anh hudng tdi sOc khde cda cdng nhan nginh vat liiu xiy dung. Be tai hpp tac qudc te vdi IDRC.
3. L 6 van Trung va Cs (1999), Nghien cOu danh gia hiin trang mdi trudng, Oe tai khoa hoc cap bo.
4. Le van Trinh va Cs (2000), ThUc trang d nhiim mdi trudng lao ddng 6 nudc ta hien nay vi mdt sd kien nghi nh^m cai thiin mdi trudng lao ddng trong giai doan CNH - HDH dit nudc, Hpi thao ATVSLD va CSSK ngUPi lao dong khu vifc san xuat cong nghiep va tieu thCi cong nghiep ngoai qudc doanh ndm 2000.
5. Khuc Xuyen va Cs (1994), Budc dau khao sat tinh hinh binh ngoai da cOa cdng nhan tai cic nhi miy bi tdng Ha Ndi, Ky yeu cfing trinh nghien cifu khoa hoc - Nha xuat ban y hoc.
Y HOC THirC H A N H (878) - SO 8/2013
