煤工尘肺死亡的回顾性队列研究  

A retrospective cohort study of mortality from patients with coal workers′ pneumoconiosis

作　　者：任爱国[1,2] 刘玲[1,2] 井丽荣 杨俊芬 胡秀霞 韩向午 

机构地区：[1]华北煤炭医学院 [2]开滦矿务局职业病防治所

出　　处：《中华劳动卫生职业病杂志》1997年第4期214-217,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：为探索煤工尘肺病人的主要死因以及煤工尘肺与恶性肿瘤死亡之间的关系，采用流行病学回顾性队列研究方法对开滦矿务局１９５２～１９９５年诊断的３２２８例煤工尘肺患者（全部为男性）的结局进行了调查。队列观察从１９７０年１月１日开始，至死亡病例的死亡日期或１９９５年１２月３１日终止，以全国男性人群为参照。用标化死亡比（ＳＭＲ）作为统计指标，并计算９５％可信区间（９５％ＣＩ）。结果：全死因ＳＭＲ较全国人群高１１％（ＳＭＲ＝１．１１，９５％ＣＩ：１．０４～１．１８）。其中肺心病死亡（ＳＭＲ＝５．９７，９５％ＣＩ：５．２３～６．７７）、肺结核死亡（ＳＭＲ＝３．６８，９５％ＣＩ：３．０１～４．４６）均高于全国人群。全癌死亡低于全国人群（ＳＭＲ＝０．８１，９５％ＣＩ：０．７１～０．９２），但肺癌死亡高于全国人群（ＳＭＲ＝１．３６，９５％ＣＩ：１．１０～１．６６）。按不同死亡年代及粉尘种类进一步分析，均发现肺癌高发。结果表明：煤工尘肺病人的全死因死亡比稍高于全国人群，其中，肺心病和肺结核有明显的超额死亡。煤工尘肺病人中肺癌死亡超高。提示：煤工尘肺与肺癌的发生有关。To investigate the mortality of patients with coal workers′ pneumoconiosis(CWP) and to explore the relationship between CWP and cancer risk,a retrospective cohort study was conducted in 3 228 patients with coal workers′ pneumoconiosis .Observation began on January 1,1970,or the date of the diagnosis of CWP,which occurred later;and observation ended on December 31,1995 or the date of death,which occurred earlier.Mortality of the general population from small and medium sized cities in China was used as reference.Standardized mortality ratio( SMR ) was calculated based on the observed and the expected number.The results showed that the mortality from all causes( SMR =1.11),corpulmonale( SMR =5.97),and pulmonary tuberculosis( SMR =3.68) were higher,while mortality from all cancers was lower than the general population( SMR =0.81), mortality from lung cancer was higher( SMR =1.36) too. Further analyses by death years and type of dust exposed showed elevated risk of lung cancer among patients with CWP.So,patients with CWP have slightly excess mortatlity from all causes and elevated risk of death from corpulmonale,pulmonary tuberculosis and lung cancer.It is suggested that CWP may be related to lung cancer.

关 键 词：煤工 尘肺 死亡比 回顾性队列研究 

分 类 号：R135.2[医药卫生—劳动卫生] R563.01[医药卫生—公共卫生与预防医学]