职业有害因素接触或(和)吸烟对死亡的影响——广州165660名职工队列的前瞻性研究  

The effect of occupational exposure and smoking on mortality——a prospective cohort study on 165 660 workers in Guangzhou,China

作　　者：江朝强[1] Lam TH 刘薇薇[1] 张维森 Ho SY AJ Hedley 何健民[1] 曹民[1] 朱昌淇[1] 

机构地区：[1]广州市职业病防治院,510620 [2]香港大学社会医学系

出　　处：《中华劳动卫生职业病杂志》2001年第5期339-343,共5页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：广东省卫生厅"五个一"科教兴医工程重点研究项目 (粤卫 96 186);广州市科委重点研究项目 (96 Z 65 );广东省卫生厅;广州市科委;香港研究资助局 (RGC;HKU 466/ 96M);香港健康服务研究委员会 (HSRC ;5 3 10 3 6)提供资助;英国牛津大学资助本研究预试验

摘　　要：目的　研究职业有害因素接触或 (和 )吸烟对死亡的影响。方法　利用 1989～ 1992年广州市实施职业健康监护系统建立的 16 5 6 6 0名年龄≥ 30岁的工厂职工和司机的个体健康档案为基础资料 ,填入光学扫描直读表 (ICR)并建立基线数据库 ,随访至 1998年 12月 31日 ,了解队列中职工生存状态和死亡原因 ,计算RR(95 %CI) ,绘制产生职业有害因素接触或吸烟的累积生存曲线。结果　 (1)16 5 6 6 0名队列职工 ,平均年龄 (4 2 .0± 6 .3)岁 ,30～ 49岁占 87% ;37.3%的职工接触职业有害因素 ,工厂男职工吸烟率为 70 .8% ,男司机吸烟率为 5 4.8% ,全部女职工吸烟率不足 2 .0 % ;(2 )平均随访时间为 (7.6± 1.1)年 ,共随访 12 5 2 16 8人年 ,总死亡人数为 2 437人 ,有 5 1名死因不明 (占 2 .1% ) ,总死亡率为 194.6 /10万人年 ;(3)调整相关因素后 ,职业有害因素接触对总死亡、中风和其他原因的死亡 ,其RR(95 %CI)分别为 1.11(1.0 2～ 1.2 0 )、1.30 (1.0 1～ 1.6 8)和 1.2 7(1.0 6～ 1.5 1) ;吸烟对男职工总死亡、恶性肿瘤和肺癌死亡 ,其RR(95 %CI)分别为 1.2 3(1.11～ 1.35 )、1.34 (1.16～ 1.5 4)和 2 .5 1(1.81～3.48) ;职业有害因素接触并吸烟者 ,总死亡和恶性肿瘤死亡的RR(95 %CI)增至 1.32 (1.16～ 1.5 1)和1.Objective To study the effects of exposure to occupational hazards and smoking on mortality. Methods Based on the Guangzhou Occupational Health Surveillance Record System established in 1989～1992,165 660 factory workers and drivers(aged≥30)were included.Baseline information was retrieved from individual health records onto computer by Intelligent Character Recognition technology.Vital status and causes of death were followed up until 31 December 1998. RR (95% CI ) were calculated and survival curves for occupational exposure and smoking were developed with Cox proportional hazards models by SPSS 10.0. Results There were 165 660 subjects(129 155 men,36 505 women) in the study with mean age of (42.0±6.3)years,and 87% of them were 30～49.Of them,37.3% had been exposed to occupational hazards.In men,70.8% of factory workers and 54.8% of drivers were smokers,but only less than 2.0% of the women had ever smoked in.The mean follow up time was (7.6±1.1)years with 1 252 168 person years in total 2 437 subjects died during the time,51(2.1%) of whom had unknown cause of death.Crude death rates were 194.6 per 100 000 person year for all subjects with factory workers 241.5 per 100 000 person year,drivers 143.1 per 100 000 person year,all men 225.0 per 100 000 person year and all women 92.6 per 100 000 person year.For occupational exposure,significant adjusted RR (95% CI ) of deaths from total causes,stroke,and other causes were 1.11(1.02～1.20),1.30(1.01～1.68) and 1.27(1.06～1.51);and for smoking, RR (95% CI ) of deaths from total causes,malignant neoplasms and lung cancer were 1.23(1.11～1.35),1.34(1.16～1.54) and 2.51(1.81～3.48),respectively.Higher risks were observed in smokers with occupational exposure,showing RR (95% CI ) of 1.32(1.16～1.68) for all causes and 1.35 (1.12 ～1.62) for malignant neoplasms.Furthermore,the RR of all causes,malignant neoplasms,lung cancer and stomach cancer increased with the increasing of pack years of smoking( P <0.01). Conclusion

关 键 词：职业接触 吸烟 死亡 前瞻性队列研究 

分 类 号：R195[医药卫生—卫生统计学]