烟草暴露对上海市35岁及以上居民呼吸系统疾病死亡的归因分析

Evaluating Respiratory System Diseases Mortality Attributable to Smoke Exposure in Residents Aged 35 Years Old and Above in Shanghai

[目的]通过人群归因健康效应评价方法,定量评估上海市居民烟草暴露所致呼吸系统疾病死亡,及寿命和劳动力损失情况,为公共卫生政策的制定提供科学依据。[方法]综合利用2013年上海市慢性病及其危险因素监测数据和全球疾病负担研究的烟草暴露导致呼吸系统疾病死亡的相对危险度,测算上海市居民烟草暴露的人群归因危险度百分比和归因死亡例数,以及潜在寿命损失年、劳动力损失年和早死指数。[结果]上海市35岁及以上居民归因于吸烟的呼吸系统疾病死亡有4 394人,男性4 076人,女性318人。潜在寿命损失为32 935人年,早死指数为7.50年,劳动力损失为1 636人年。在吸烟相关的呼吸系统疾病死亡中,人群吸烟归因危险度百分比最高的是COPD,男性为68.65%,女性为9.29%。归因于吸烟的COPD死亡人数最多,为4 299人,其中男性3 983人,女性316人;潜在寿命损失为31 457人年,男性28 582人年,女性2 875人年;劳动力损失为1 304人年,男性1 236人年,女性68人年。归因于吸烟的COPD早死指数低于其他疾病,仅为7.32年,女性(9.10年)高于男性(7.18年)。[结论]上海市居民归因于烟草暴露的呼吸系统疾病死亡人数众多,男性远高于女性,疾病以COPD为主,对寿命和劳动力损失均有较大影响。

[ Objective ] To quantitatively evaluate smoking attributable deaths, potential life lost, and labor loss of respiratory system diseases in Shanghai residents using population attributable health effect evaluation method, and to provide scientific evidence for making relevant public health policy. [ Methods ] Smoking rates from 2013 Shanghai Non-communicable Disease and Behavioral Risk Factor Surveillance System and relative risk of smoke exposure from the Global Burden of Disease Study were used to calculate population attributable risk percent and deaths of respiratory system diseases, years of potential life lost （YPLL）, labor loss, and index of life lost attributable to smoke exposure. [ Results ] The number of deaths of respiratory system diseases attributable to smoking among residents aged 35 years and above in Shanghai was 4394, 4076 males and 318 females. The YPLL was 32 935 person years, the life lost index was 7.5 years, and the labor loss was 1636 person years. Chronic obstructive pulmonary disease （COPD） had the highest population attributable risk percent associated with cigarette smoking, 68.65% for male and 9.29% for female. The deaths of COPD attributable to smoke exposure were 4 299, of which 3 983 were for male and 316 for female; the YPLL was 31457 person years, of which 28 582 person years were for male and 2 875 person years for female; the labor loss was 1304 person years, of which 1236 person years were for male and 68 person years for female. The life lost index of COP]） attributable to smoke exposure was lower than that of other diseases, being 7.32 years, and female （9.10 years） was higher than male （7.18 years）. [ Conclusion ] There axe a large number of deaths of respiratory system diseases attributable to smoke exposure in Shanghai, greatly affecting life lost and labor loss. The smoking attributable mortality of male is higher than female, and COPD is a dominant contributor.