粉尘作业工人肺功能异常风险预测模型构建与验证  

Study on risk factors of abnormal pulmonary function among dust-exposed workers and prediction model

作　　者：付强[1] 汪国海[1] 朱建全[1] 潘国才[1] 靳松 Fu Qiang;Wang Guohai;Zhu Jianquan;Pan Guocai;Jin Song(Department of Occupational and Radiational Health,Changzhou Center for Disease Control and Prevention,Changzhou 213022,China;Department of Health,Changzhou Xinbei District Center for Disease Control and Prevention,Changzhou 213022,China)

机构地区：[1]常州市疾病预防控制中心职业与放射疾病科,常州213022 [2]常州市新北区疾病预防控制中心卫生科,常州213022

出　　处：《中华劳动卫生职业病杂志》2023年第1期31-35,共5页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：常州市卫健委科技项目(QN202132)。

摘　　要：目的探讨粉尘作业工人肺功能异常的影响因素,构建肺功能异常的风险预测模型。方法于2021年4月,选取2020年常州市工作场所职业病危害因素监测项目中涉及粉尘的47家企业的4255名工人,采用logistic回归对作业工人肺功能异常的影响因素进行分析并建立其相应的列线图预测模型,采用ROC曲线、校正曲线和决策分析曲线对模型进行评价。结果年龄(OR=1.03,95%CI=1.02~1.05,P<0.001)、体检类别(OR=4.52,95%CI=1.69~12.10,P=0.003)、粉尘类别[与煤尘比较,水泥粉尘(OR=3.45,95%CI=1.45~8.18,P=0.005);矽尘(OR=2.25,95%CI=1.01~5.03,P=0.049)]、血压(OR=1.63,95%CI=1.22~2.18,P=0.001)、红细胞(OR=1.94,95%CI=1.08~3.48,P=0.027)、肌酐(OR=0.08,95%CI=0.05~0.12,P<0.001)、日接触时间(OR=1.06,95%CI=1.01~1.12,P=0.034)以及总尘浓度(OR=1.29,95%CI=1.08~1.54,P=0.005)是肺功能异常的影响因素,风险预测列线图ROC曲线下面积为0.764。决策分析曲线结果显示,当列线图模型阈值概率超过0.05时进行肺功能异常干预具有更好的效果。结论通过logistic回归构建的列线图模型在对粉尘作业工人肺功能异常进行风险预测时具有一定的准确性。Objective To explore the influencing factors of abnormal pulmonary function in dust-exposed workers and establish the risk prediction model of abnormal pulmonary function.Methods In April 2021,a total of 4255 dust exposed workers from 47 enterprises in 2020 were included in the study.logistic regression was used to analyze the influencing factors of abnormal pulmonary function in dust-exposed workers,and the corresponding nomogram prediction model was established.The model was evaluated by ROC curve,Calibrationpolt and decision analysis curve.Results logistic regression analysis showed that age(OR=1.03,95%CI=1.02~1.05,P<0.001),physical examination type(OR=4.52,95%CI=1.69~12.10,P=0.003),dust type Comparison with coal dust,Cement dust,OR=3.45,95%CI=1.45~8.18,P=0.005,Silica dust(OR=2.25,95%CI=1.01~5.03,P=0.049),blood pressure(OR=1.63,95%CI=1.22~2.18,P=0.001),creatinine(OR=0.08,95%CI=0.05~0.12,P<0.001),daily exposure time(OR=1.06,95%CI=1.10~1.12,P=0.034)and total dust concentration(OR=1.29,95%CI=1.08~1.54,P=0.005)were the influencing factors of abnormal pulmonary function.The area under the ROC curve of risk prediction nomogram model was 0.764.The results of decision analysis curve showed that the nomogram model had reference value in the prevention and intervention of abnormal pulmonary function when the threshold probability exceeded 0.05.Conclusion The accuracy ofthe nomogram model constructed by logistic regression werewell in predicting the risk of abnormal lung function of dust-exposed workers.

关 键 词：粉尘 肺功能 影响因素 列线图 预测模型 

分 类 号：R135.2[医药卫生—劳动卫生]