安徽省职业性煤工尘肺患者疾病负担分析

Analysis on disease burden of occupational coal workers′pneumoconiosis in Anhui Province

目的分析安徽省职业性煤工尘肺所造成的疾病负担。方法采用回顾性研究的方法,选择安徽省1950—2019年诊断的1649例职业性煤工尘肺患者为研究对象,调查其年龄、性别、存活情况、所在地区、发病工龄或死亡年龄、煤工尘肺期别与诊断日期、调查时的合并症情况、近1年住院与门诊费用、患者误工费用、陪护人员误工费用与营养交通费用等,计算其过早死亡损失寿命年、伤残损失寿命年(YLDs)、伤残调整寿命年(DALYs)和经济损失。结果研究对象中,存活病例1405例,死亡病例244例。在年龄为20.0~70.0岁时,存活患者YLDs为2.12~22.20(8.19±3.59)人年;有合并症患者YLDs高于无合并症患者[(8.55±3.95)vs(7.87±3.21)人年,P<0.01]。1649例煤工尘肺患者DALYs损失合计为14031.59人年,人均DALYs为8.51人年;其YLDs占合计DALYs的82.0%。1405例存活患者因煤工尘肺所造成的经济损失总量为35490.30万元,人均经济损失为25.26万元。结论安徽省由职业性煤工尘肺所造成的疾病负担较为沉重。在对职业性煤工尘肺实行早期发现、早期诊断、早期治疗的基础上,需重点预防和治疗合并症,以减轻疾病负担。

Objective To analyze the disease burden caused by occupational coal workers'pneumoconiosis(CWP)in Anhui Province.Methods A total of 1649 patients with occupational CWP diagnosed in Anhui Province from 1950 to 2019 were selected as the study subjects using a retrospective study method.Age,gender,survival time,location,working age of disease onset,age of death,stage and date of diagnosis of CWP,comorbidities at the time of investigation,hospitalization and outpatient expenses in the past year,cost of absence from work,cost of absence from work of caregivers,and cost of nutrition and transportation were investigated.The years of life lost,years lived with disability(YLDs),disability adjusted life years(DALYs)and economic losses were calculated.Results Among these patients,1405 cases survived and 244 cases died.In the age range of 20.0-70.0 years,the YLDs of surviving patients were 2.12-22.20(8.19±3.59)person-years.The YLDs of patients with disease complications was higher than that of patients without complications[(8.55±3.95)vs(7.87±3.21)person-years,P<0.01].The total DALYs of the patients was 14031.59 person-years,and the average per capita DALYs was 8.51 person-years.Its YLDs accounted for 82.0%of the total DALYs.The total economic loss caused by CWP in the 1405 surviving patients was 354.9030 million yuan,and the average per capita economic loss was 252600 yuan.Conclusion The disease burden caused by CWP is relatively high in Anhui Province.In addition to early detection,diagnosis and treatment,it is necessary to focus on prevention and treatment of CWP complications to reduce the disease burden.