长沙市尘肺病分布现状及发病规律流行病学研究

Epidemiological Study on Distribution Regularity and Incidence of Pneumoconiosis in Changsha

目的探讨长沙市尘肺分布现状和发病规律,预测尘肺病流行趋势,为制定尘肺防治对策提供科学依据。方法按照全国尘肺病流行病学调查方案,对长沙市1956-2010年尘肺诊断病例输入计算机建立尘肺病数据库,经Excel导出,用SPSS17.0统计分析。结果全市尘肺累计病例3 689例,主要分布在开福区(17.5%)、浏阳市(15.9%)、望城县(14.3%)。行业以轻工945例(25.62%)、煤炭631例(17.1%)、机械374例(10.14%)居前3位。种类以矽肺、陶工尘肺和煤工尘肺为主;尘肺Ⅰ期和Ⅱ期3 408例(92.38%),Ⅲ期尘肺不足8%。肺结核并发率26.29%,累积报告尘肺死亡病例690例,病死率18.7%,平均死亡年龄为59.86岁;主要死因依次为肺结核、慢性呼吸衰竭、慢性肺心病。结论全市尘肺病新发病例1960-1980年代呈逐渐增长趋势,90年代后病例明显减少。需加大高危行业粉尘危害监测与风险控制,建立粉尘暴露人群健康监护与预警机制。

Objective To investigate the distribution regularity and incidence of pneumoconiosis,to predict the epidemic trend of pneumoconiosis,and to provide the scientific evidence for making preventive countermeasures. Methods According to the national pneumoconiosis disease epidemiology investigation plan,an epidemiological investigation on total cases of pneumoconiosis in Changsha from 1956 to 2010 was carried out.We built the municipal database of pneumoconiosis and derived by Excel.And the data were statistically analyzed using SPSS 17.0. Results There were 3,689 cases of pneumoconiosis in the city and mainly distributed in Kaifu District（17.5%）,Liuyang City（15.9%） and Wangcheng County（14.3%）.Industry distribution showed that the top three industries were the light industry（n=945,25.62%）,the coal-mining industry（n=631,17.1%）,and machinery industry（n=374,10.14%）.The silicosis,potter and the coal workers＇ pneumoconiosis constituted the largest portion（n=3,206,86.90%）.The cases of pneumoconiosis stage I and II added up to 3,408（92.38%）,and the stage Ⅲ was less than 8%.The rate of complication with tuberculosis was 26.29%.690 death cases were reported,the fatality rate was 18.7%.The average death age of pneumoconiosis was 59.86 years.The main death causes of pneumoconiosis were in sequence of pulmonary tuberculosis,chronic respiratory failure and chronic corpulmonale. Conclusions The new cases of pneumoconiosis in Changsha during the period of 1960～1980 showed an increasing tendency,but the new cases significantly reduced since 1990s.The results suggest that it is necessary to enhance the monitoring and risk control of dust hazard in high-risk industries,and establish health care and early warning mechanism for the dust exposure population.