隧道建设接尘人员矽肺合并肺结核调查研究  

Study on Pulmonary Silicosis-tuberculosis in Dust-exposed Workers for Tunnel Construction

作　　者：曾庆明[1] 罗招福[1] 梁立徽 谢德兴[1] 王治国 黄清垣[1] 刘玉贵[1] 

机构地区：[1]龙岩市疾病预防控制中心,福建364000 [2]福建省职业病与化学中毒控制中心,福建350001 [3]龙岩市卫生局卫生监督所,福建364000

出　　处：《海峡预防医学杂志》2007年第5期7-8,共2页Strait Journal of Preventive Medicine

基　　金：福建省科技厅计划基金重点研究项目(项目编号:2002Y019-2)

摘　　要：[目的]了解35年前的隧道建设接尘人员矽肺与结核发病状况,分析患者发现延迟及误诊原因,探讨矽肺合并肺结核发病规律及防治对策。[方法]用现状调查方法对62个乡镇参加建设的2 840名现存接尘人员进行调查。[结果]检出矽肺患者458人(Ⅰ期376人、Ⅱ期75人、Ⅲ期7人),患病率16.1%;矽肺合并肺结核95人,合并率20.7%(Ⅰ期合并率18.1%、Ⅱ期32.0%、Ⅲ期42.9%);在无尘肺的接尘人员中,肺结核检出率5.6%(133/2382)。肺结核病人发现延迟23.2%,矽肺病人发现延迟82.5%;矽肺误诊为肺结核76人,误诊率16.6%。[结论]矽肺病患者和粉尘作业人员是结核病易感人群,肺结核是矽肺病的主要并发症及死亡原因之一,应加强矽肺结核的预防控制工作。[Objective] To study on pulmonary silicosis-tuberculosis （TB） in dust-exposed workers for tunnel construction 35 years ago, analyze the causes of case finding delay and misdiagnosis for the disease control and prevention. [Methods] Totally 2 840 dust-exposed workers in for the construction from 62 towns were investigated by using prevalence survey. [Results] Totally 458 cases of silicosis were found （including 376 for stage Ⅰ , 75 for stage Ⅱ and 7 cases for stage Ⅲ ）, the prevalence rate was 16.1%; 95 cases were complicated by pulmonary TB and complication rate was 20.7% （18.1%, 32.0% and 42.9% for silicosis stage Ⅰ , Ⅱ and Ⅲ ）. The prevalence rate of pulmonary TB was 5.6% （133/2382） in dust-exposed workers who didn＇t suffer from pneumoconiosis. The TB finding delay was 23.2% and silicosis finding delay was 82.5%. 76 silicosis cases were misdiagnosed as TB and the rate was 16.6% （76/458）. [Conclusion] The eases of silicosis and the dust-exposed workers are susceptible to TB, pulmonary TB is the main complication of silicosis and the one of the important death causes. And the disease control and prevention of pulmonary silicosis-TB should be strengthened.

关 键 词：职业卫生 尘肺 肺结核 粉尘暴露 疾病控制 

分 类 号：R135.2[医药卫生—劳动卫生] R521[医药卫生—公共卫生与预防医学]