1963-2020年石嘴山市职业性尘肺病生存状况及疾病负担变化趋势分析  

Survival and disease burden trend analysis of occupational pneumoconiosis from 1963 to 2020 in Shizuishan City

作　　者：佟岩 孔云燕[2] 边浩[2] 郑建中[1] 吴永军[2] 张悦[1] Tong Yan;Kong Yunyan;Bian Hao;Zheng Jianzhong;Wu Yongjun;Zhang Yue(School of Public Health,Shanxi Medical University,Taiyuan 030000,China;Shizuishan City Center for Disease Control and Prevention,Shizuishan 753000,China)

机构地区：[1]山西医科大学公共卫生学院,太原030000 [2]石嘴山市疾病预防控制中心,石嘴山753000

出　　处：《中华劳动卫生职业病杂志》2022年第5期341-347,共7页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的:了解石嘴山市职业性尘肺病患者的生存状况及影响因素,分析其疾病负担水平和变化趋势,为制定全面的职业性尘肺病防治措施提供依据。方法:于2020年7至12月,对1963-2020年石嘴山市报告的职业性尘肺病开展回顾性调查,了解患者的生存状况,采用Kaplan-Meier法和寿命表法进行生存分析,采用Cox比例风险回归模型分析患者生存时间的影响因素,使用伤残调整寿命年(DALY)分析职业性尘肺病引起的疾病负担水平及其时间变化趋势。结果:1963-2020年,石嘴山市累计报告职业性尘肺病3 263例,其中1 467人死亡(44.96%),中位生存时间为26.71年,平均死亡年龄为(70.55±10.92)岁。不同种类、诊断年龄、接尘工龄、行业、初次诊断期别以及是否晋级的职业性尘肺病患者生存率差异均有统计学意义( P<0.05)。随着生存时间的增加,患者生存率逐渐降低,当生存时间≥50年时,患者累积生存率为4.20%。Cox回归分析提示,尘肺病种类、行业、诊断年龄、接尘工龄、初次诊断期别和是否晋级是职业性尘肺病患者生存时间的影响因素( P<0.05)。1963-2020年石嘴山市归因于职业性尘肺病的DALY为48 026.65人年,其中因早死所致的寿命损失年(YLL)为15 155.39人年,平均YLL为10.33年/人,疾病所致伤残引起的健康寿命损失年(YLD)为32 871.26人年,平均YLD为10.07年/人。归因于煤工尘肺、矽肺的DALY分别为39 408.51人年(82.06%)、6 565.02人年(13.67%),诊断年龄40~49岁组、初次诊断Ⅰ期的职业性尘肺病患者造成的DALY较高,分别为20 899.71、36 231.97人年。随着时间推移,职业性尘肺病平均YLL、平均YLD呈波动下降趋势。 结论:石嘴山市由职业性尘肺病造成的疾病负担不容忽视,对重点人群、重点行业应及时采取针对性措施,建议为患者实施全生命周期的健康管理和分级诊疗,以提高患者生命质量、延长寿命。Objective To understand the survival status and its influencing factors of occupational pneumoconiosis patients in Shizuishan City,and to analyze the disease burden of occupational pneumoconiosis and its trend,so as to provide scientific basis for formulating comprehensive prevention and treatment measures of occupational pneumoconiosis.Methods A retrospective survey was conducted during July to December 2020 to explore the survival status of occupational pneumoconiosis patients who had been reported from 1963 to 2020 in Shizuishan City.The Kaplan-Meier method and Life-table method were used for survival analysis,and Cox proportional hazards regression model was used to analyze the influencing factors of survival time.The disability adjusted life years(DALY)was applied to analyze the disease burden of occupational pneumoconiosis and its temporal trend.Results From 1963 to 2020,a total of 3263 cases of occupational pneumoconiosis were reported in Shizuishan City,of which 1467 died,so that the fatality rate was 44.96%.The median survival time was 26.71 years,average age of death was(70.55±10.92)years old.There were significant differences in the survival rates of occupational pneumoconiosis patients among different types,diagnosis age,exposure time,industry,initial diagnosis stage and whether upgraded(P<0.05).As the survival time increased,the survival rate of patients decreased gradually.When the survival time was≥50 years,the cumulative survival rate of patients was 4.20%.Cox regression analysis suggested that the type of pneumoconiosis,industry,diagnosis age,exposure time,initial diagnosis stage and whether upgraded were the influencing factors for the survival time of patients with occupational pneumoconiosis(P<0.05).The total DALY attributable to occupational pneumoconiosis from 1963 to 2020 in Shizuishan City was 48026.65 person years,of which the years of life lost(YLL)was 15155.39 person years,and the average YLL was 10.33 years/person,and the years lost due to disability(YLD)was 32871.26 person years,an

关 键 词：尘肺 职业病 生存分析 伤残调整寿命年 疾病负担 

分 类 号：R135.2[医药卫生—劳动卫生]