( 3 ..

2558)

( 3 .. 2558)

( 3 .. 2558)

 : :
( 3 ..2558)

02-590 4292 , 02-590 4514
02-590 4388

3 2558
1,000

2556

:
( 2557)
, /
2,
(OCC- 01),
(OCC- 02)

2557

:
( 3 .. 2558)
( )
2558
13 11


(OCC- 01 Rev.58)
(OCC- 02 Rev.58)

2558

1
2
3
1
1
2
6
3

9
-
14
-

16
-
19
4
26
-
26
-
31

36
1 (Reactive paper)
38
2
43
2.1
2.2
(.1-56)
2.3
(OCC- 01 REV.58)
2.4
(OCC- 02 REV.58)

.. 2555
24.8 62.6 39.6
14.8 37.4
15.5 62.5
28.3 9.2
.. 2555 4.0

67.9 14.63 8.0

4.0 2.7
1.8 0.6
()
48.2 17.6 16.4
66.8
20.0

(Insecticide) 1.1 .. 2545
9,046 .. 2554
34,672 .. 2550
T60.0
3,538 7.5
30 (UC) 100,000

(Insecticide)

(Fungicide)

(Herbicide)

2545
9,046
2,931
5,681
1,444
22,670
4,349
2,237
392
39,634
9,116
2546
9,790
3,136
6,732
1,678
31,879
6,101
1,930
426
50,331
11,341
2547
16,731
2,835
10,108
1,719
55,649
6,080
4,417
502
86,905
11,135
2548
18,529
3,322
9,052
1,716
48,841
5,806
3,744
516
80,166
11,360
2549
20,487
3,856
9,383
1,722
62,129
6,821
3,764
499
95,763
12,899
2550
21,590
3,746
10,626
1,833
79,239
8,914
4,869
533 116,323
15,026
2551
25,332
4,577
11,255
2,537
68,825
11,487
4,497
580 109,908
19,182
2552
24,680
3,972
10,367
2,968
97,957
9,338
4,590
537 137,594
16,816
2553
23,417
4 ,669
9,670
3 ,859
80,278
8 ,845
4,332
549 117,697
14,448
2554
34,672
5 ,938
12,178
3 ,875
112,176
11,479
4,855
750 163,881
12,229
2555
16,797
3,686
6,972
3,883
106,860
11,294
3,748
494 134,377
19,357
2556
21,486
4,201
10,350
1,828
137,049
14,873
3,789
466 172,674
24,369
2557
13,911
4,014
10,988
4,708
117,645
13,436
4,726
631 174,570
22,789
: 1.

:

1.1 2545-2557
: , :







(Reactive paper)



.. 2535 2557
20.41 38.52
2 6 100,000
1.2
1.2 Cholinesterase
.. 2535 .. 2557
..

2535
2536
2537
2538
2539
2540
2541
2542
2543
2544

Cholinesterase

()

()

42,471
242820
411998
460521
156315
563354
369573
360411
278612
89945

8,669
48500
72590
78481
40520
89926
77789
48217
52604
21758

20.41
19.97
17.62
17.04
25.92
15.96
21.05
13.38
18.88
24.19

() ()
3599*
3299*
3143*
3398*
3196*
3297*
4398*
4169*
3109*
2652*

31***
44***
41***
21***
31***
27***
15***
31***
21***
15***

100,000
6.23*
5.65*
5.32*
5.71*
5.32*
5.42*
7.16*
6.78*
5.03*
4.27*

..

2545
2546
2547
2548
2549
2550
2554
2555
2556
2557

Cholinesterase

()

()

115105
N/A
N/A
84046
133255
89376
533,524
244,822
314,805
314,603

33858
N/A
N/A
26034
36776
34428
173,243
75,749
96,227
107,989

29.4
N/A
N/A
31.0
27.6
38.52
32.47
30.94
30.57
34.33

() ()
2571*
2342*
1864*
1321*
1183*
1452*
3753**
7806**
7506**
7954**

14***
9***
9***
0
0
0
N/A
N/A
N/A
N/A

100,000
4.11*
3.72*
2.98*
2.12*
2.0*
2.31*
5.86**
12.11**
11.59**
12.21**

: 1. 2551-2553
2.
: * 2535-2550 )

** 2554-2557 43

***

- 2551-2553

- N/A

.. 2554
4

(..)



( .1)
Cholinesterase


7 30

Cholinesterase
Cholinesterase
.. 2554
3,796 74
527,144
172,286 32.68

368
T60.0 .. 2554 2,584
5.4 30 (UC) 100,000

.. 2555

3
11 .. 18
..

.. 2556-2557


1 12

(../PCU . )

(.)

(..)

15

WHO/European on Occupatonal Health Service (WHO, 1989)


1.

2.

3.

4.

5.

(ILO) ILO Convention 161 (1985)

1.

2.

3.


4.

5.

6.

7.

8.


9.

10.

11.

.
(..)

1.

1.1 / .
-

-
-

-
.1-56,


1.2
.. ..

1.3

1.4 .

1.5

1.6



2. 1 12

2.1

2.2 .

2.3 / .
.

2.4 . ..

2.5

2.6
. ./.

2.7 .




2.8

10


1.

1.1


1.2 /
..

1.3 .. .
. ./.
.

1.4 ..

1.5

1.6


. 1

2. /

2.1

2.2 . .
.

2.3

2.4

11

3.

3.1


3.2
CUP

3.3

3.4 ., .
4.

4.1


4.2

4.3 . . . .
5.

5.1


5.2

5.3

5.4


1 .

12


5.5



5.6


5.7

1.

-


-

-


-

13

-


-

10 2557-2561

1.



. .
. . . .. .

(ICD10 T60.0)
5.0 (
2554)

14


30 2555

.. 2556

1) Service plan

2)

2.


./



.

15


3.

(.) PP
PP

(.)
.

3
1

1.
. 1-56

16


2. (Cholinesteres
reactive paper) 1

3.

4.

5.

6. .
2

2554

1.
.1-56

2. (Cholinesteres
reactive paper) 1

3.

4.

5.

6.
(Cholinesteres reactive paper)
30
(.1-56)

17


7. (.)
(.)

8. 1 .



1
3

(.)

18



1.

2.
1 1 ..

3.
-
-
.1-56,

-
(organophosphate) (carbamate)
(Cholinesteres reactive paper) 10

-

-
-
-
- . 1

4.


5.
- .

- (..) .

19

-


(Cholinesteres reactive paper)
30

-

20

(OCC- 01) ( 2.4)

( OCC- 01)

(OCC- 02) ( 2.5)
15

1 12



31

21


()
.. 2556 - 2557

13

( 2556-2557)
/







3
1 - 6

6



7 - 9


10 - 13
/
1. 1
2.
3. /
4.
5. /
6.
1
22

7.
8.
/ 1
9. . 1
10. /

11. /.
12.

13.

( 2558)
2556- 2557
1,855

13

()
11

3 4

2558

()



2558

23

()
()
4
- 1 - 6 1 6
- 6 ( 1 - 6)

- +
7 - 11 7 - 9
- +
7 - 11 10 - 11

( 2558)

1.


2.
(.1-56) test kit
/

3. /
4. ///
ICD 10
5.

6.



(.)
1

24

7.
(..)

1
8.
. .

9.

( ., ., .,
)
10.

. . .
11.
/ /
. , .,

()
1.
11 ,

2. 1 OCC
-01 Rev.58

3.
OCC 02 Rev.58 ..

25

1.

//

.1-56

/
/

NCD

/
/

26

(./././
)

..

. 1-56

30

30
6

1)


2)

3)

4) /

27


1.



OPD

2.

? ? ( )
l
l
l

l


l /
l

28

(
2.1) OPD card

3.


( .1-56) ( 2.2)

(Cholinesterase reactive paper)
1 .1-56

/ 7 14
2

4.

29

5.


JHCIS HOSxP_PCU
ICD-10

6.

7.




/
/


30


l
l

l

8.
(OCC- 01)

2.

-


-

-

-

31

.1-56,

Mapping /

/
.

32



1.

-


-
30

-
(.1-56)


-



(.)

2

1
/

33

2. Mapping

2

3.

(.1-56)

34


4.
4.1
.1-56

(Cholinesterase reactive paper)

4.2

4.2.1
(.)

4.2.2

4.2.3 .

.
4.2.4 /

35


2555 .
, . (2554). 2551 2553.

( 1). : .
.

4 (.. 2555-2564)
, , .

(..2554-2563)
. (2553).

( ).

: .
. (2553).



( 1). :

.
. (2551).

( 3 ).:

.
. (2549).

/.

: .
. (2548).

( 1)

.
. (2550).

. .
World Health Organization (WHO). (1989). European on Occupational Health Service.

Retrieved October 1, 2012. http://www.euro.who.int/occhealth.
Internationnal Labour Organization. (1985). ILO Convention 161. Retrieved October 1, 2012.

Form http://ilo.org/ilolcx/egi-lex/convde.pl?c161.
36

37

(Reactive paper)

1.

2.

3.

4.
1-

5.

6.

7.

38

.. 2530
Bigg method
(Psuedocholinesterase)
(Cholinesterase reactive paper)
7

(capillary tube) heparin



7
4

1.
100

2.
87.5

39


3.
75 87.5

4.
75

1. Dropper ()



2. 7


7 false positive () 7 30
false negative ()

3.
3.1 30-34
Reactive paper 6
3.2 35-45
Reactive paper 5
3.3 > 45
Reactive paper 4

4.


Pyridostigmine ( Mastinon)



5.

40

1
Lancet

4
/
15,000 /

1
7 .
25 29 C

41






1.

2.

3. 7 14

2

1
3

2
30 1

2
1 1 () 2
() () 30
1
6

42

2.1
2.2

2.3

2.4

(.1-56)

(OCC- 01 REV. 58)

(OCC- 02 REV. 58)

43

OPD
( 15 )


R Y 96 Y 97
OPD / 2 ........
HN.............

( //) ..........................................................................
............................................ .........................................................
................................................/.........................................
........... .......... / ............./

.................................................................................

.................................................................................

....................................................................
...................................................................

.......................................................................

Y96 =
Y97 =

44

.................................................
............................................................

.1-56

.............................................................
-- ...................... ....................................................................

3 1 2
3
4, 5

1
1.
2. (//)....................................................................................
3. 1.
2.
4. ................................
5. .........................................................................................................................
6. 1. ()
2. ()

( 9)
3.

4. .......................( 8)
7.

1. ...

2. ..

3. ....
2
8. ( 1 )



................................................................
9-17 1 2 3

9.
1.
2.
3.
10.
1.
2.
3.
11.
1.
2.
3.

45



12. 1.
2.
3.

13. 1.

2.

14 . 1.
2.

15. /
1.
2.
16. /
1.
2.
17. // 1.
2.

9 -17 ....................... (A)

3.
3.
3.
3.
3.

18-23 3 2 1

18.
1.
2.
3.
19. 1.
2.
3.

20. 1.
2.
3.
21.
1.
2.
3.
22. 1.
2.
3.
.
23. 1.
2.
3.
.

18 -23 ....................... (B)
9 - 23 (A+B) .......................

46

 3
24. 1
1.
2. (
)
1
2
3

/



/


/
/

4
9 23

1.
2.
3.
(15 24 ) (25 30 ) (31 45 )

1 (1 )

2 (1 )

3 (1 )

: 1 2
2 matrix
(
)
1.
2.
3.
4.
5.

47

 5 :
(
)
1. ( 1 )




2. pyridostigmine ( Mastinon)


3. //
1-2 3-7 >7-14
14
4.
< 7 > 7
5.

()..
6. 5

()

1
2
3
4

48

1.

2. 3.

4.

OCC- 01 REV.58

.......................................... .....................
:
( )

------------------------------------------------------------------------------------------------------- 1

1.1
........

1.2

.........
2

11
...................... ( ) (
1 6 (1-6))

( ) ( 1- 6 )

( ) ( 7 9 ( 1 - 6))

( ) ( 8 11 ( 1 - 6))

49

OCC- 01 REV.58
3.

Reactive paper

( . / . / /
........................
/
(. /..)

(. 1-56 )
. 1-56

. 1-56

. 1-56

. 1-56

. 1-56

10

50

OCC- 01 REV.58

11

12

13

14

15

16

5
........................................................................................................................................................
........................................................................................................................................................
........................................................................................................................................................
.......................................................................................................................................................
6
........................................................................................................................................................
........................................................................................................................................................
........................................................................................................................................................
.......................................................................................................................................................
*************************************

51

OCC- 01 REV.58

(OCC- 01)
1. (OCC- 01)
1.
2.
2. 5
1
2
3
4
5
6
3.
1.
(OCC- 01)
1
2.
(OCC- 01)

(OCC- 02)
15 1
4.
1

52

1.1

...

( )

OCC- 01 REV.58

1.2

.........

2
3
4

/ 15




( , ,)

/ /

. .

11
....
/
( ) ( ./.
1
6 (1-6))
( ) ( 1- 6
)
( ) ( 7 9
( 1 - 6))
( ) ( 8 11
( 1 - 6))

53

OCC- 01 REV.58
3

Reactive
paper

(Reactive Paper)

(Reactive Paper)

(Reactive Paper)

(Reactive Paper)

(Reactive Paper)

./
./

, ,
,

/./
/

54

( ./
.//

..............................

/

(.
/..)

OCC- 01 REV.58
4

( . 1-56 )

.1-56

.1-56

10

. 1-56
(.
1-56) 4
. 1-56

. 1-56

. 1-56

. 1-56

. 1-56

11
12
13
14
15
16

(.1-56) 2

18- 23 ()

55

OCC- 01 REV.58

56

OCC- 02 REV.58

..................................................... .. ...............................
:
()


------------------------------------------------------------------------------------------------ 1

( 1
6 (1-6))

( 1-6 )

( 7 9 ( 1 - 6))

( 8 11 ( 1 - 6))

57

OCC- 02 REV.58
2

(Reactive Paper)

( . / . / /
...........................
/
(./..)

58

(. 1-56 )
. 1-56

. 1-56

. 1-56

. 1-56

. 1-56

OCC- 02 REV.58

10

11

. 1-56

12

13

14

15

16

4
........................................................................................................................................................
........................................................................................................................................................
........................................................................................................................................................
..........................................................................................................................................................
5
........................................................................................................................................................
........................................................................................................................................................
........................................................................................................................................................
.......................................................................................................................................................
*************************************

59

OCC- 02 REV.58

(OCC- 02)
1.
(OCC- 02)
1.
2.
2. 5
1
2
3
4
5
3.
1.
(OCC- 01)

(OCC- 02)
15 1
2.
(OCC- 02)
31
1
4.
1

60

/..,

, ., ., .

(OPD)

OCC- 02 REV.58

1 6 (
1-6)

/ . .
1-6

( 1-6 )

/ . .
7 9 (
1 - 6)


/ . .
8 11
( 1 - 6)


/ . .
/ 15




Occ- 01
(,,)

Occ- 01
/
/

.. Occ- 01

/ /
. .

61

OCC- 02 REV.58
2

Reactive paper (Reactive Paper)

(Reactive Paper)

(Reactive Paper)

(Reactive Paper)

(Reactive Paper)
. /./

( . / . / , ,
/
.......... ,
.........................

/ /./ /


(./..)

( . 1-56 )

. 1-56

.1-56

10

62

.
1-56
(.1-56) 4

OCC- 02 REV.58

11
12
13
14
15
16

. 1-56

. 1-56

. 1-56

. 1-56

. 1-56

(.1-56) 2
18- 23 ( )

63


:
..
..

02-590 4292, 02-590 4380
02-590 4388

3 2558

64