1990年至2017年中国人群尘肺病的疾病负担分析  

Analysis on disease burden of pneumoconiosis in Chinese population from 1990 to 2017

作　　者：朱晓俊 肖培[3] 王丹 王鸿飞[2] 王艳华[2] 余悦[2] 殷鹏 李婕[4] 李珏[1] 周脉耕 李涛[2] ZHU Xiao-jun;XIAO Pei;WANG Dan;WANG Hong-fei;WANG Yan-hua;YU Yue;YIN Peng;LI Jie;LI Jue;ZHOU Mai-geng;LI Tao(Beijing Institute of Occupational Disease Prevention and Treatment,Beijing 100093,China)

机构地区：[1]北京市职业病防治研究院,北京100093 [2]中国疾病预防控制中心职业卫生与中毒控制所,北京100050 [3]北京协和医学院研究生院,北京100730 [4]中国疾病预防控制中心慢性非传染性疾病预防控制中心,北京100050

出　　处：《中国工业医学杂志》2019年第5期341-346,共6页Chinese Journal of Industrial Medicine

基　　金：国家重点研发计划(项目编号:2018YFC1315303)

摘　　要：目的分析1990-2017年中国人群尘肺病疾病负担水平及其变化趋势,为制定尘肺病防控对策和建议提供参考。方法利用全球疾病负担2017年(GBD 2017)研究结果,分析1990-2017年中国人群尘肺病的疾病负担状况并与全球人群进行比较。按年份、病种、年龄、性别分析中国人群尘肺病的发病数、死亡数、伤残调整寿命年(DALY)、过早死亡损失寿命年(YLL)、伤残损失寿命年(YLD);同时采用2000-2025年世界人口的平均年龄结构作为标准人口计算中国和全球人群尘肺病的标化发病率、标化死亡率、标化DALY率、标化YLL率、标化YLD率。计算2017年与1990年的变化幅度,分析疾病负担指标的变化。结果 2017年中国人群因尘肺病造成的DALY为247 619人年,占中国总DALY 371 485 307人年的0.067%,在169类疾病中排名第112位,较1990年(115位)上升了3位;占全球人群因尘肺病造成DALY 507 425人年的48.8%,在195个国家和地区中排名第1位。2017年中国人群尘肺病的发病数、死亡数分别为32 205例、8 901例,较1990年分别增长67.2%、8.0%;DALY为247 619人年,较1990年下降1.2%,但较2009年增长了15.6%。标化发病率、死亡率、DALY率分别为1.66/10万、0.48/10万、12.57/10万,较1990年分别下降22.4%、51.5%、52.0%。2017年中国人群矽肺和煤工尘肺合计的发病数、死亡数、DALY分别占尘肺病的79.7%、86.4%、83.3%,矽肺的YLL/DALY值最大(为90.5%),煤工尘肺的YLD/DALY值最大(为38.1%);<65岁年龄阶段的发病数、死亡数、DALY、YLL、YLD分别占相应总数的42.9%、40.4%、57.7%、62.2%、36.2%。结论中国在尘肺病防治方面取得了积极成果,但中国人群尘肺病引起的疾病负担近年仍有上升趋势,并占全球较大比重。应采取积极防控措施重点降低矽肺、煤工尘肺及<65岁年龄阶段的疾病负担;同时,建议加强粉尘作业场所源头控制和治理,构建接尘人员和尘肺病人全流程监测管理体系。Objective To analyze the disease burden of pneumoconiosis in Chinese population and its trend from 1990 to 2017,thereby provide reference for formulating the prevention and control countermeasures and suggestions of pneumoconiosis.Methods The data of Global Burden of Disease study 2017(GBD 2017)was used for analyzing the disease burden of pneumoconiosis in Chinese population from 1990 to 2017 and compared with the result from global analysis in the same period according to year,disease type,age and gender,the indicators including incidence number,death number,disability-adjusted life years(DALY),years of life lost(YLL),and years lived with disability(YLD).The average age structure of world population from 2000 to 2025 was used as the standard population to calculate the standardized morbidity,standardized mortality,standardized DALY rate,standardized YLL rate and standardized YLD rate of pneumoconiosis in both China and global population. The amplitude of change for these indicators were compared during 2017 and 1990.Results In 2017,the DALY due to pneumoconiosis in Chinese population was 247 619 person years,accounting for 0.067% of the total DALY of China(371 485 307 person years),it ranked 112 out of 169 diseases in China,it moved up by 3 places compared to 1990(115),that accounted for 48.8% of the DALY of global population due to pneumoconiosis(507 425 person years),ranking 1 st among 195 countries and regions. The incidence number and death number of pneumoconiosis in Chinese population were respectively 32 205 cases and 8 901 cases,increased by 67.2% and 8.0% respectively,compared with that of 1990. The DALY number was 247 619 person years,decreased 1.2% compared with that of 1990,but increased 15.6% compared with that of 2009.The standardized morbidity,mortality and DALY rate of pneumoconiosis in Chinese population were 1.66/100 000,0.48/100 000 and 12.57/100 000,which decreased by 22.4%,51.5% and 52.0% respectively,compared with that of 1990. In 2017,the total incidence number,death number and DALY number

关 键 词：尘肺病 疾病负担 伤残调整寿命年(DALY) 

分 类 号：R135.2[医药卫生—劳动卫生]