甘肃省2010至2020年职业性尘肺病的疾病负担分析

Analysis of disease burden of occupational pneumoconiosis in Gansu Province from 2010 to 2020

目的对比分析2010至2020年间甘肃省职业性尘肺病的疾病负担情况,筛选主要影响因素,为合理配置有限卫生资源、精准管理和施策提供科学依据。方法于2021年8月,调查收集甘肃省2010至2020年诊断的存活和死亡的职业性尘肺病患者信息,分析计算发病率、死亡率及伤残调整生命年(DALY)等指标。用多元线性回归分析疾病负担的影响因素。结果 2010至2020年甘肃省职业性尘肺病的年均发病率为0.999 2/10万,年均死亡率为0.897 3/10万,累计病死率为25.75%,累计DALY为28 932.96人年。DALY损失中壹期职业性尘肺病最高(19 920.14人年),且DALY损失随职业性尘肺病期别的增加而逐渐增加。甘肃省职业性尘肺病中以矽肺(13 753.66人年)和煤工尘肺(13 414.73人年)造成的疾病负担最高。期别、工龄、病种、地区均为DALY损失的影响因素(P<0.05)。结论 2010至2020年甘肃省因职业性尘肺病造成的DALY损失呈波动下降,DALY的构成由以因过早死亡而丧失的寿命年损失为主变化为以伤残损失年为主。

Objective Through comparative analysis of the disease burden of occupational pneumoconiosis in Gansu Province from 2010 to 2020,the main influencing factors are screened,and scientific basis is provided for rational allocation of limited health resources,precise management and policy implementation.Methods In August 2021,survey and collect information on surviving occupational pneumoconiosis patients and dead occupational pneumoconiosis patients diagnosed in Gansu Province from 2010 to 2020,and analyze and calculate indicators such as morbidity,mortality,and disability adjusted of life years(DALY).Analyzing the influencing factors of disease burden usirrg multiple linear regression.Results From 2010 to 2020,the average annual incidence of occupational pneumoconiosis in Gansu Province was 0.9992/100000,the average annual mortality was 0.897/100000,the cumulative case fatality rate was 25.75%,and the cumulative DALY was 28932.96 person-years.The first stage of occupational pneumoconiosis was the highest among DALY loss(19920.14 person-years),and the DALY loss was positively correlated with the stage of occupational pneumoconiosis.Among occupational pneumoconiosis in Gansu Province,silicosis(13753.66 person-years)and coal worker's pneumoconiosis(13414.73 person-years)caused the highest disease burden,followed by cement pneumoconiosis and asbestos lung.Period,length of service,type of disease,and region are all influencing factors of DALY loss(P<0.05).Conclusion From 2010 to 2020,the DALY losses caused by occupational pneumoconiosis in Gansu Province showed a fluctuating decrease,with the composition of DALY mainly changing from the loss of life years due to premature death to the loss of years due to injury and disability.