中华劳动卫生职业病杂志
中華勞動衛生職業病雜誌
중화노동위생직업병잡지
CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES
2012年
1期
36-40
,共5页
关宏宇%张浩%苏良平%刘跃伟%翁少凡%陈卫红
關宏宇%張浩%囌良平%劉躍偉%翁少凡%陳衛紅
관굉우%장호%소량평%류약위%옹소범%진위홍
尘肺%职业暴露%队列研究%危险因素
塵肺%職業暴露%隊列研究%危險因素
진폐%직업폭로%대렬연구%위험인소
Pneumoconiosis%Occupational exposure%Cohort studies%Risk factors
目的 分析铁矿接尘工人尘肺的发病规律及影响因素,为铁矿工人尘肺防制提供依据.方法 以某铁矿1960年至1974年在册且工作1年以上的所有接尘工人建立队列,随访至2003年底.尘肺诊断由职业病诊断小组确定.采用Cox比例风险模型分析危险因素.结果 队列接尘工人3647名,累积接尘132 574.4人年.诊断尘肺316例,人年发病率为0.24％.1960年前开始接尘者中发现尘肺274例(86.7％),人年发病率为0.40％,明显高于1960年后开始接尘工人尘肺人年发病率(43例,0.07‰).尘肺发病平均潜伏期是(26.0±7.3)年.尘肺晋级年限分别为0+晋Ⅰ期(5.3士3.2)年,Ⅰ晋Ⅱ期为(6.6±5.2)年,Ⅱ晋Ⅲ期为(1 1.3±5.0)年,随诊断年代的推后,各期晋级年限均有延长趋势.164例尘肺为脱尘后诊断,平均脱尘8.3年.铁矿工尘肺发病危险度随累积接尘量增加而上升,呈明显的接触剂量-反应关系.尘肺患者年平均累积接尘量为(173.7±91.6)mg/m3,远高于非尘肺接尘工人(112.1±64.8)mg/m3.除累积接尘量外,影响尘肺发病风险因素包括肺结核(HR=5.9,P＜0.01)、吸烟(HR=1.7,P＜0.01).结论 累积接尘量与尘肺发病之间存在明显的剂量-反应关系,并发结核、吸烟是影响尘肺发病的危险因素.
目的 分析鐵礦接塵工人塵肺的髮病規律及影響因素,為鐵礦工人塵肺防製提供依據.方法 以某鐵礦1960年至1974年在冊且工作1年以上的所有接塵工人建立隊列,隨訪至2003年底.塵肺診斷由職業病診斷小組確定.採用Cox比例風險模型分析危險因素.結果 隊列接塵工人3647名,纍積接塵132 574.4人年.診斷塵肺316例,人年髮病率為0.24％.1960年前開始接塵者中髮現塵肺274例(86.7％),人年髮病率為0.40％,明顯高于1960年後開始接塵工人塵肺人年髮病率(43例,0.07‰).塵肺髮病平均潛伏期是(26.0±7.3)年.塵肺晉級年限分彆為0+晉Ⅰ期(5.3士3.2)年,Ⅰ晉Ⅱ期為(6.6±5.2)年,Ⅱ晉Ⅲ期為(1 1.3±5.0)年,隨診斷年代的推後,各期晉級年限均有延長趨勢.164例塵肺為脫塵後診斷,平均脫塵8.3年.鐵礦工塵肺髮病危險度隨纍積接塵量增加而上升,呈明顯的接觸劑量-反應關繫.塵肺患者年平均纍積接塵量為(173.7±91.6)mg/m3,遠高于非塵肺接塵工人(112.1±64.8)mg/m3.除纍積接塵量外,影響塵肺髮病風險因素包括肺結覈(HR=5.9,P＜0.01)、吸煙(HR=1.7,P＜0.01).結論 纍積接塵量與塵肺髮病之間存在明顯的劑量-反應關繫,併髮結覈、吸煙是影響塵肺髮病的危險因素.
목적 분석철광접진공인진폐적발병규률급영향인소,위철광공인진폐방제제공의거.방법 이모철광1960년지1974년재책차공작1년이상적소유접진공인건립대렬,수방지2003년저.진폐진단유직업병진단소조학정.채용Cox비례풍험모형분석위험인소.결과 대렬접진공인3647명,루적접진132 574.4인년.진단진폐316례,인년발병솔위0.24％.1960년전개시접진자중발현진폐274례(86.7％),인년발병솔위0.40％,명현고우1960년후개시접진공인진폐인년발병솔(43례,0.07‰).진폐발병평균잠복기시(26.0±7.3)년.진폐진급년한분별위0+진Ⅰ기(5.3사3.2)년,Ⅰ진Ⅱ기위(6.6±5.2)년,Ⅱ진Ⅲ기위(1 1.3±5.0)년,수진단년대적추후,각기진급년한균유연장추세.164례진폐위탈진후진단,평균탈진8.3년.철광공진폐발병위험도수루적접진량증가이상승,정명현적접촉제량-반응관계.진폐환자년평균루적접진량위(173.7±91.6)mg/m3,원고우비진폐접진공인(112.1±64.8)mg/m3.제루적접진량외,영향진폐발병풍험인소포괄폐결핵(HR=5.9,P＜0.01)、흡연(HR=1.7,P＜0.01).결론 루적접진량여진폐발병지간존재명현적제량-반응관계,병발결핵、흡연시영향진폐발병적위험인소.
Objective To analyze the prevalence characteristics and influence factors of pneumoconiosis of workers exposed to dusts in an iron mine,to provide the base of preventive measures for pneumoconiosis of iron mine.Methods The subjects of cohort study were all workers exposed to dusts for at least one year registered in an iron mine during 1960 to 1974,and followed-up to the end in 2003.The cases with pneumoconiosis were diagnosed by the local diagnosis group of pneumoconiosis,according to the national diagnostic criteria of pneumoconiosis.The risk factors were analyzed with Cox risk model.Results A total of 3647 miners were included in the cohort study and were followed up by 132 574.4 person years.There were 316 cases with pneumoconiosis,and the incidence of pneumoconiosis for a year was 0.24‰.There were 274 cases(86.7％)with pneumoconiosis in workers exposed to dusts before 1960,the incidence of pneumoconiosis for a year was 0.40‰,which was significantly higher than that(0.07‰)of workers exposed to dusts after 1960.The average latency of pneumoconiosis was 26.0±7.3 years.The average durations of upgrade from stage 0+ to Ⅰ,Ⅰ to Ⅱand Ⅱ to Ⅲ were 5.3±3.2,6.6±5.2 and 11.3±5.0 years,respectively.However,164 cases with pneumoconiosis were diagnosed after ceasing exposure to dusts for mean 8.3 years.The risk of pneumoconiosis in iron miners increased with exposure doses,and there was an obvious dose-effect relationship.The average cumulative exposure dose of cases with pneumoconiosis was173.7 ±91.6 mg/m3 ·y,which was significantly higher than that (112.1 ±64.8mg/m3 ·y)of workers without pneumoconiosis.Also the tuberculosis(HR =5.9,P＜0.001)and smoking(HR=1.7,P＜0.01)were the main risk factors.Conclusion There was an obvious dose-effect relationship between the cumulative exposure dose and pneumoconiosis incidence.Tuberculosis and smoking were the main risk factors influencing the pneumoconiosis incidence.
