公务员健康风险评估研究

Health Risk Assessment: A Study in Civil Servants

目的评估沈阳市某区公务员健康风险并讨论相应对策。方法 2011年采用问卷调查法对沈阳市609例参加健康体检的公务员进行问卷调查,内容包括：一般情况、个人疾病史、家族疾病史、吸烟、饮酒、膳食、运动、睡眠、心理状况、居住环境、健康体检信息。采用北京中新惠尔健康科技有限公司授权的健康风险评估软件评估健康风险。结果调查对象中男405例,女204例。未来10年缺血性心血管疾病和肺癌、未来5年糖尿病发病极高风险的例数分别为258例（42.4%）、170例（27.9%）和40例（6.6%）;未来10年缺血性心血管疾病和肺癌、未来5年糖尿病、未来4年高血压发病高风险的例数分别为128例（21.0%）、99例（16.3%）、73例（12.0%）和148例（24.3%）。男性健康生活方式较差发生率（56.0%）高于女性（23.0%）,差异有统计学意义（χ2=59.73,P〈0.001）。谷类摄入过多220例（36.1%）,蔬菜水果摄入不足513例（84.2%）,肉类摄入过多246例（40.4%）。男性谷类摄入过多率（42.7%）高于女性（23.0%）,差异有统计学意义（χ2=22.76,P〈0.001）;男性蔬菜水果摄入不足率（85.4%）高于女性（81.9%）,差异无统计学意义（χ2=1.30,P=0.254）;男性肉类摄入过多率（44.0%）高于女性（33.3%）,差异有统计学意义（χ2=6.35,P=0.012）。运动不足211例（34.6%）,其中男性运动不足发生率（31.1%）低于女性（41.7%）,差异有统计学意义（χ2=6.68,P=0.01）。运动最充分的年龄组是60岁以上,最不充分的年龄组是30~40岁。吸烟者171例（28.1%）,不吸烟者364例（59.8%）,戒烟者74例（12.1%）。男性吸烟率（41.5%）高于女性（1.5%）,差异有统计学意义（χ2=10.80,P〈0.001）。不饮酒者296例（占48.6%）,适量饮酒者236例（占38.8%）,过量饮酒者77例（占12.6%）。男性过量饮酒率（17.0%）高于女性（3.9%）,差异有统计学意义（χ2=21.13,P〈0.001）。结论该公务员群体存在吸烟（含被动吸烟）、饮酒、运动不足、蔬菜水果摄入不足、谷类摄入过多等多种健康风险因素,且男性的健康风险因素普遍高于女性（运动除外）,故应开展健康管理以降低健康风险因素。

Objective To assess the health risks of civil servants in a certain district of Shenyang and to discuss its corresponding countermeasures. Methods In 2011,questionnaire was investigated on the general state of health,personal histories of disease,smoking,alcohol consumption,diet,exercises,sleeping,mental status,living environment,health medical information of 609 civil servants of Shenyang,used a health risk evaluation software to assess their health risks. Results The subjects included 405 males,204 females. The cases with high risks of ischemic cardiovascular disease,lung cancer in the future 10 years and risks of diabetes in the future 5 years were 258（ 42. 4%）,40（ 6. 6%）,170（ 27. 9%）,respectively.The cases with high risks of ischemic cardiovascular disease,lung cancer in the future 10 years,with high risks of diabetes in the future 5 years,with risks of hypertension were 128（ 21. 0%）,99（ 16. 3%）,73（ 12. 0%）,148（ 24. 3%）,respectively.The incidence of poor health lifestyle male（ 56. 0%） than female（ 23. 0%）,the difference was significant（ χ2= 59. 73,P 0. 001）; 220 cases had excessive intake of cereal（ 36. 1%）,513 had inadequate intake of fruits and vegetables（ 84. 2%）,246 had too much meat（ 40. 4%）; 173 males,47 females had luxus cereal（ accounting for 42. 7% of sum total of males,23. 0% of totality of females,respectively）,the difference was significant（ χ2= 22. 76,P 0. 001）; 346 males,167 females had inadequate fruits and vegetables（ accounting for 85. 4% of male totality,81. 9% of female totality,respectively）,the difference was not significant（ χ2= 1. 30,P = 0. 254）; 178 males,68 females had overmuch intake of meat（ accounting for44. 0% of male totality,33. 3% of female totality）,the difference was significant（ χ2= 6. 35,P = 0. 012）; 211 cases had inadequate exercises（ 34. 6%）,including 126 males（ 31. 1%）,85 females（ 41. 7%）,the difference was significant（ χ2=6. 68,P = 0. 01）; those who had the most adequate exercises were over- 60- year- old agegroup,those who had the least exercises were group aged 30- 40 years. Totally 171 cases smoked（ 28. 1%）,364 did not smoke（ 59. 8%）,74 had quitted smoking（ 12. 1%）; 168 males,3 females smoked（ accounting for 41. 5% of male totality,1. 5% of female totality,respectively）,the difference was significant（ χ2= 10. 80,P 0. 001）; 296 did not drink alcohol（ 48. 6%）,236 drank responsibly（ 38,8%）,77 over-drank（ 12.6%）; 69 males,8 females over-drank（ accounting for 17.0% of male totality,3. 9% of female totality）,the difference was significant（ χ2= 21. 13,P 0. 001）. Conclusion The civil servant group have smoking（ including passive smoking）,drinking alcohol,inadequate exercises,poor intake of vegetables and fruits,over-intake of cereal and other health risk factors. The health risk factors of males are generally higher than those of females（ except for sports）.Health management should be carried out to reduce health risk factors.