河南省结核病防治人员结核病发病队列研究

Cohort study on incidence of tuberculosis among health workers of anti-TB in Henan province

目的了解河南省结核病防治工作人员结核病发病情况,为建立健全结核病防治机构感染控制及职业卫生防护体系提供参考依据。方法以1995年1月1日～2004年12月31日在河南省结核病防治机构工作的人员为队列,回顾性调查近10年结核病防治工作经历、结核病发病情况等。以人年发病率、相对危险度为评价指标。采用Cox回归模型进行多因素分析。结果在所调查的4229名结核病防治工作人员中,结核病、肺结核病、涂阳肺结核病的发病率分别为449.4/10万人年、388.1/10万人年、136.2/10万人年。医务人员结核病发病率为579.1/10万人年;非医务员结核病发病率为205.8/10万人年。单因素Cox回归分析,医务人员发生结核病的RR值为2.89(95%CI=1.81～4.60),多因素分析校正后的RR值为2.66(95%CI=1.64～4.19)。结论河南省结核防治工作人员结核病发病水平显著高于一般人群,其中医务人员显著高于非医务人员,结核病防治机构结核病感染控制及职业卫生防护工作有待加强。

Objective To study the incidence and its risk factors of tuberculosis（TB）among the employess of the anti-TB instiutions in Henan province for the reference to establish and perfect the measures, strategies and system of the vocational biosafety of TB. Methods The cohort consisted of all employess in the anti-TB institutions of Henan from Jan 1, 1995 to Dec 31,2004. All employees were interviewed to survey retrospectively their work experience, TB incidence and others. Incidence density and relative risk （ RR ）was used to measure vocational biosafety of TB. Cox regression model was used to do multivariate analysis. Results The incidence rates of TB, pulmonary TB and smear-psotove TB among 4 429 employees with retrospective survey were 449.4/105 person-years （PY）（ healthcare worker. 579. 1/10^5 PY; non-healthcare worker： 205.8/ 10^5 PY）, 388.1/10^5 and 136.2/10^5 PY respectively. The OR value of healthcare worker regarding non-healthcare as reference was 2.89（95 % CI = 1.81- 4.60） with multivariate cox regression model. Conclusion The TB incidence rate among em- ployees working in the anti -TB was higher than that of non-healthcare worker in anti-TB institutions; the condition of TB vocational biology safety in anti-TB institutions, and its corresponding administrations and bio-sefety of the healthcare workers need to be improved.