烟草暴露对上海市35岁及以上居民循环系统疾病死亡的归因分析

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

[目的]运用人群归因健康效应的评价方法,定量评估上海市居民因烟草暴露所致循环系统疾病死亡、潜在寿命和劳动力损失的情况。[方法]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烟草暴露导致循环系统疾病死亡的相对危险度,测算上海市居民烟草暴露所致循环系统疾病死亡发生例数,及潜在寿命和劳动力损失情况。[结果]2013年,上海市35岁及以上居民中,归因于吸烟的循环系统疾病死亡有3 503人,男性3 329人,女性174人。潜在寿命损失为50 493人年,早死指数为14.41年,劳动力损失为10 264人年,其中早死指数最高的是出血性脑卒中(20.17年),其次为缺血性心脏病(12.83年)。归因于二手烟的循环系统疾病死亡有1 127人,男性479人,女性648人。潜在寿命损失为12 395人年,早死指数为11.00年,劳动力损失为1 390人年,其中出血性脑卒中早死指数最高(17.22年),其次为缺血性脑卒中(9.87年)。人群归因危险度百分比最高的是男性出血性脑卒中(26.48%),其次为男性缺血性心脏病(16.60%)。[结论]上海市居民归因于烟草暴露的循环系统疾病死亡人数众多,潜在寿命损失很大,出血性脑卒中最为严重。

[ Objective ] To quantitatively evaluate smoking attributable deaths, potential life lost, and labor loss of circulation system diseases in Shanghai residents based on population attributable health effect evaluation method. [ Methods ] Data retrieved 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 deaths of circulation system diseases, years of potential life lost （YPLL）, and labor loss attributable to smoke exposure. [ Results ] In 2013, there were 3 503 deaths of circulation system diseases attributable to smoking among population aged 35 years and above in Shanghai （3 329 males and 174 females）. The YPLL was 50493 person years, the index of life lost was 14.41 years, and the labor loss was 10264 person years. The leading index of life lost was 20.17 years for hemorrhagic stroke, followed by ischemic heart disease （12.83 years）. There were 1 127 deaths of circulation system diseases attributable to secondhand smoke exposure （479 males and 648 females）, the YPLL was 12 395 person years, the index of life lost was 11.00 years, and the labor loss was 1 390 person years. Hemorrhagic stroke had the highest index of life lost of 17.22 years, followed by ischemie stroke of 9.87 years. The population attributable risk percent of hemorrhagic stroke was the highest （26.48%）, followed by isehemic heart disease （16.60%）. [ Conclusion ] There are a large number of deaths of circulation system diseases ascribing to smoke exposure in Shanghai, with critical YPLL, especially contributed by hemorrhagic stroke.