巴中市原襄渝铁路西段民兵晚发性矽肺发病危险因素分析  

Risk Factors for Delayed Silicosis in Militia in Bazhong on the West Section of the Former Xiangyu Railway

作　　者：刘晓冬[1] 赵顺顺[1] 李勇[1] 

机构地区：[1]广元市疾病预防控制中心,四川广元628017

出　　处：《职业卫生与病伤》2016年第2期82-85,共4页Occupational Health and Damage

摘　　要：目的探讨原襄渝铁路西段铁路民兵发生晚发性矽肺的危险因素,为进一步指导防治,改善其生活质量提供依据。方法以2009-2011年于广元市疾控中心进行职业病健康监护和诊断的原5 074名铁路民兵为研究对象,根据诊断结果分为矽肺组（1 726人）和非矽肺组（3 348人）,采用卡方检验、t检验、多因素logistic回归分析矽肺发病的影响因素。结果 5 074名铁路民兵中,矽肺发生率为34.02%（1 726/5 074）,1 726名矽肺患者中合并肺结核的有27人（1.56%）。;单因素分析显示,两组人群性别（χ^2=19.99,P〈0.01）、岗位（χ^2=153.48,P〈0.01）、工作年限差异（t=-7.02,P〈0.01）具有统计学意义;Logistic回归分析显示,性别、不同岗位、工作年限为独立危险因素,如性别危险度3.69、工作年限危险度1.14,坑道作业危险度1.73,碎石危险度1.39。Logistic回归模型显示,不同岗位对同一工龄性别不同的民工患矽肺的影响也不同,如系数最高的坑道作业男性系数为-0.58,女性系数为-1.89,系数最低的搬运作业男性系数为-1.55,女性系数为-2.86。体检结果显示1 726名矽肺患者中合并肺结核的有27人（1.56%）。结论铁路民兵在民兵职业中,由于从事坑道作业、碎石作业、隧道作用、爆破作业、风钻作用、搬运作业等职业,在退伍后虽未在从事上述职业,但在相当长（≥35年）时间后,矽肺发生率仍然较高,属于晚发性矽肺,部分患者合并肺结核。针对这一情况,国家应加强对铁路退伍民兵的职业健康管理和保障工作制度,定期开展职业健康检查和医学筛查,对于已诊断患有矽肺病的民兵,采取对症治疗积极预防并发症的发生,从而保证铁道退伍兵良好的生活质量。Objective To investigate risk factors for delayed silicosis in militia on the west section of the former Xiangyu Railway and provide evidence for further guiding prevention and treatment and improving their quality of life. Methods There were 5 074 railway militia visited Guangyuan Provincial Center for Disease Control an d Prevention for occupational health monitoring and diagnosis during the period from 2009 to 2011 were recruited as study subjects and,based on the diagnostic results,divided into a silicosis group（ n = 1 762） and a non-silicosis group（ n = 3 348）. Factors for development of silicosis were analyzed using chi- square test,t test and multi-variate logistic regression. Results In the 5 074 railway militia,the incidence rate of silicosis was 34. 02%（ 1 726 /5 074）; 27（ 1. 56%） out of 1 726 silicosis patients had concomitant pulmonary tuberculosis. Univariate analysis showed that the two groups were statistically significantly different in terms of sex（ χ~2= 19. 99,P〈0. 01）,job post（ χ~2= 153. 48,P〈0. 01） and working years（ t =- 7. 02,P〈0. 01）. Logistic regression analysis showed that sex,job post and working years were independent risk factors. The degrees of risks of sex,working years,tunnel work and stone crushing work were 3. 69,1. 14,1. 73 and 1. 39,respectively. The logistic regression model also showed that different posts exerted different effects on militia of the same working length but different sexes; for example,the coefficient of tunnel work was -0. 58 and -1. 89 for males and females,respectively; the coefficient of carrying work was -1. 55 and -2. 86 for males and females,respectively. Physical examination results showed that 27（ 1. 56%） out of 1 726 silicosis patients had concomitant pulmonary tuberculosis. Conclusion In railway militia,the incidence rate of silicosis is still high even after they have retired from their posts for quite a long time（ ≥35years）. The silicosis is delayed silicosis in nature,and part patients have concomitant

关 键 词：晚发性矽肺 民兵 危险因素 LOGISTIC回归分析 

分 类 号：R135.21[医药卫生—劳动卫生]