徐州矿务集团尘肺患者死亡状况调查分析

Survey on death of pneumoconiosis patients in Xuzhou Coal Mining Groups

目的调查尘肺发病状况,探讨分析尘肺发生、发展及死亡规律。评价徐州矿务集团40余年来的尘肺病控制工作效果,为有效防治尘肺提供科学依据。方法回顾性分析徐州矿务集团2005年底前诊断的3291例尘肺病患者资料。结果死因构成居前4位的是:尘肺、肺结核、慢性肺心病、肺癌;1990年开始,死因构成顺序变化为尘肺、慢性肺心病、肺癌、脑血管意外,肺结核已不再是导致尘肺患者死亡的主要因素;死亡尘肺病例累计死亡百分比变化与接尘工龄长短有关,接尘工龄5～20年间累计死亡百分比呈快速直线上升;死亡尘肺病例中不同接尘工种之间平均死亡年龄、发病工龄有显著性差异(P<0.01),纯掘进工、纯采煤工尘肺患者的平均死亡年龄和发病工龄短于其他接尘工种;20世纪70年代以后,尘肺患者死亡年龄和病程呈延长趋势;尘肺的晋期率逐步下降,晋期时间明显延长。结论该集团尘肺控治措施取得了较明显的效果。

Objective To investigate the general rules concerning the onset, development and death of pneumoconiosis and evaluate the effect of dust control in Xuzhou Coal Mining Groups over the past 40 years. Methods 3 291 cases of pneumoconiosis （1964- 2005） from the employees of Xuzhou Coal Mining Groups were studied retrospectively. Results The top 4 causes of death were originally pneumoconiosis, pulmonary TB, chronic cor pulmonale and pulmonary carcinoma. The list changed gradually till 1990s when pneumoconiosis, chronic cor pulmonale, pulmonary carcinoma and cerebrovascular accident were the main four, but pulmonary TB was no longer one main cause of pneumoconiosis death. The cumulative death percentage due to pneumoconiosis was related to the length of dust exposure, and the cumulative death percentage soared in a straight line when the dust exposure had lasted for 5 to 20 years. The digging or mining workers who were facing direct exposure to dust had earlier onset of pneumoconiosis and shorter life span （ P 〈 0.01 ）. Since 1970s, the situation of pneumoconiosis got improved evidently, as seen in the prolonged mean life span and varied course and upgrade rate of the disease. Conclusion The dust control of Xuzhou Coal Mining Groups has yielded remarkable effects. The key to preventing and controlling pneumoconiosis is to minimize the concentration of dust in the workplace and limit the working hour in the dusty mining environment.