淄博矿区煤矿尘肺死亡回顾性队列研究

A Retrospective Cohort Study on patients with Coal Mine Pneumoconiosisin Zibo Coal Mining District

应用回顾性队列研究方法对淄博矿区１２个煤矿１９７７年１月１日在册的２０３７例煤矿尘肺的死因进行了调查。队列成员追访至１９８６年，共死亡４４３人，煤矿尘肺全死因死亡率为２４０８．８／１０万，与用山东省居民死亡率计算的期望值比较显著超高，ＳＭＲ＝２３５，９５％ＣＩ＝２１４～２５８。４非恶性呼吸道疾病（主要是尘肺病）死亡为全死因之首，占２５．１％，其次是恶性肿瘤、心血管疾病和肺结核。恶性肿瘤死亡明显超高，ＳＭＲ＝１９０，且主要集中于肺癌（占５９．２％，ＳＭＲ＝５５６），与呼吸道疾病相关的肺心病ＳＭＲ＝１９０，以及肺结核ＳＭＲ＝１００６的死亡率也明显超高。在掘进工和采煤工尘肺中，全死因、呼吸系疾病、恶性肿瘤、肺结核的死亡率显著增高，Ｐ＜０．０１。此外，在掘进工尘肺中心血管疾病，尤其是肺心病的死亡人数高于预期值（ＳＭＲ＝２７１，Ｐ＜０．０１）。

retrospective cohort study of cause ofdeath was carried out in 2037 cases coalmine pneumoconicosis in Zibo coal miningarea, All subjects were follwed up to 1986.443 cases were known hving died at theend of the study period.Mortality of allcause of death was 2408.8/100, 000 with SMR235, 95%CI=214～258, whieh was significan-tly higher than the expected value based on the gneral mortortolity in Shandong Province.The nonmalignant respiratouy diseases,thepatients with pneumoconiess were the ma-jority of these patients , were the leadingcause of deaths (25.1% of total deaths ),the follows were cancer,cardio-vaseular diseasesand pulmonary tuberculcsis.the risk ofcancer was significantly elevated SMR 1190,primary due to lung cancer ,which accounts for 59.2% with SMR 556.Mortality forom cor pulmonale and pulmonary tuberculosis were also distinetly increased.In tunnelers’ andcoal worrkers’ pneumnoconicsis significantly eleveated SMR were found at P<0.01 levelfor all causes, respiratory diseases, cancerand pulmonary tuberculesis.In tunnelers’pneumoconiosis an increased rumber of de-ath was also seen for cardiovsscuiar diseases,especially for cor rulmonale (SMR217,P<0.01).