2001—2012年河北省新发矽肺病病例特征及趋势研究

Study on epidemiological characteristic and trend on silicosis of Hebei Province

目的了解河北省新发矽肺病例的特征和流行趋势,为建立矽肺病监测、预警数学模型,制定河北省矽肺防治对策提供依据。方法整合2001年1月1日—2012年12月31日全省职业病网络报告数据并建立数据库,采用SPSS 17.0对矽肺新发病例的时间、地区、行业、工种进行统计描述;对矽肺新发病例的企业、经济类型的期别的构成进行χ2检验,对矽肺新发病例发病年龄、发病工龄的中位数进行H检验,对矽肺时间、发病工龄的变化趋势进行分析。结果 2001年-2012年河北省累计报告新发矽肺病例2 679例,主要集中在承德、张家口和唐山,分别为870(32.5%)、662(24.7%)和656例(24.5%)。唐山、承德和张家口各年度矽肺病例数与总矽肺例数变化趋势基本一致。矽肺病例主要集中在冶金(1 041例,38.86%)、有色金属(655例,24.45%)和煤炭(323例,12.06%)行业。2006年后,煤炭、有色金属行业发病例数明显高于2005年之前。有色金属、煤炭和冶金行业贰、叁期矽肺病例数所占比例依次减少,分别为44.58%、31.06%和24.90%。矽肺病例主要集中在凿岩工(41.10%)、破碎工(8.17%)和采矿工(7.54%);凿岩工、主掘进工和破碎工的贰、叁期矽肺检出率较高。矽肺期别与大、中、小型企业之间构成比比较,差异有统计学意义(χ2=235.80,P<0.01),矽肺期别与企业规模之间呈正相关(r=0.29)。矽肺期别与国有经济、集体经济和私有经济3者构成比比较,差异有统计学意义(χ2=41.98,P<0.01),经济类型与矽肺期别之间呈正相关(r=0.15)。矽肺发病年龄中位数变化趋于平缓(M=48.89,43.38,55.38);发病年龄总体分布比较,差异有统计学意义(χ2=81.38,P<0.01)。发病工龄呈明显下降趋势,2010年矽肺发病工龄最短为9a;2001—2012年发病工龄总体分布比较,差异有统计学意义(χ2=239.38,P<0.01)。结论矽肺病发病形势依然严峻,主要表现为:新发矽肺病例数仍呈逐年增长趋势,矽肺发病工龄呈现明显缩短趋势,贰期及以上新发病例达30%以上;新发矽肺病呈现明显的地区、行业、工种和企业规模的集聚性或集中趋势。

Objective To describe the prevalence,development of silicosis from 2001 to 2012in Hebei and to investigate the epidemiological trends and characteristics of silicosis,in order to establish the time series model for monitoring and early warning of silicosis and to formulate the guidelines and policies for control of silicosis.Methods New cases of silicosis collected from 2001 to 2012in Hebei were systematically integrated in a database.The statistical indices included number of new silicosis cases in each year,regional,work types and industrial distributions of silicosis cases.Theχ2 test was used for period difference between company size and economy type.The H test was applied for the analysis of age and seniority of the incidence.The working years and the age of the incidence were used for trend analysis of silicosis.Results A total of2679 new cases of silicosis were reported from 2001 to 2012.Most cases were reported from Tangshan,Chengde,Zhangjiakou,respectively 870（32.5%）,662（24.7%）,656（24.5%）.There were most cases incoal industry（323,12.06%）, metallurgical industry（1041,38.86%）,nonferrous metals industry（655,24.45%）.The number of new cases after 2006 weremore than before.The proportion of the cases with the stage Ⅱ and stage Ⅲ of the silicosis in non-ferrous metals,coal,metallurgy industries reduced successively.The work types of these cases mainly included drilling（41.40%）,crushing（8.17%）,coal work（7.54%）.There was significant difference among small,medium and large companies（χ2=168.30,P0.01）,showing apositive correlation（r=0.29）.Significant difference was found among state-owned economy types,private economic types and collective economy types（χ2=41.98,P0.01）with positive correlation（r=0.15）.The change of incidence ages kept flat from 2001 to 2012（M =48.89;（43.38,55.38））.The distribution of the incidence ages was significantly different（χ2=81.38,P0.01）.The working years at silicosis incidence in new cases was shorted with calendar years.the shortest was 9years in 2010（）.There was significantly different（χ2=239.38,P0.01）in the distribution of the working years at silicosis incidence.Conclusions Higher prevanlence of silicosis was found in Hebei Province as following：The new cases of silicosis was still rising.The working years at the incidence in new cases was shorted by annually.The new cases with stageⅡ and over were accounted for more than 30%.The prevention and control of silicosis should be enhanced in,key regions,industries,types of work according to the epidemiological characteristics of silicosis.