新疆某地铁路职工慢性病危险因素流行病学调查

Epidemiological study on the risk factors of chronic diseases among Xinjiang railway workers

目的明确新疆某铁路局职工不同人群慢性病主要危险因素分布、危险因素与慢性病之间关系、高危人群干预优先次序，为制订铁路局慢性病防控策略提供科学依据。方法采用多阶段分层随机抽样方法，抽取新疆某铁路局直属地区及西站2个地区18岁以上职工1171名，应用现场问卷调查和体格测量方式进行调查。结果慢性病检出率位居首位的是血脂异常（380／1171，32．45％），其次是高血压（197／1171，16．82％）、冠状动脉粥样硬化性心脏病（75／1171，6．40％）。年龄、家族史、吸烟、饮酒、超重肥胖、缺乏体育锻炼、不良饮食是慢性病发生的主要危险因素。可改变危险因素中，吸烟率为43．55％（510／1171），饮酒率为23．57％（276／1171），超重率为37．66％（441／1171），体育锻炼率为38．60％（452／1171），不良饮食率为32．11％（376／1171）。不同年龄人群中，吸烟、饮酒、肥胖、体育锻炼、不良饮食情况差异均有统计学意义（P〈0．05）。不同文化程度人群中，高中／中专以下吸烟率显著高于大专及以上，高中／中专体育锻炼率最低，为36．87％（212／575），大专及以上不良饮食率最低，为26．62％（127／477）。内燃机车司机、连接员的吸烟率高于其他工种，线路工、客车检车员的饮酒率高于其他工种，内燃机车司机、客车检车员、车站值班员肥胖率高于其他工种，内燃机车司机、列车员、货车检车员体育锻炼率低于其他工种。结论优先选择干预的慢性病是高血压和血脂异常，一线工人群体为高危人群，应针对在危险因素分布和慢性病检出率居前五位的5个特殊工种（内燃机车司机、货车检车员、车站值班员、客车检车员和列车员）进行重点干预。

Objective To determine the distribution of risk factors, the relationship between risk factors and chronic diseases and the order of intervention priorities of high-risk population, and to provide scientific evidence for the prevention and control of chronic diseases in different population within Xinjiang railway bureau. Methods A multi-stage stratified random sampling method was used to enroll 1 171 employees aged 18 and above from one region administered directly by the railway bureau and two other regions administered by the West Railway Station, on-site questionnaire interview and physical examination were conducted. Results The prevalence of dyslipidemia was the highest （380/1 171, 32.45%）, followed by hypertension （197/1 171, 16.82%） and coronary atheroselerotic heart disease （75/1 171, 6.40%）. Age, family history, smoking, drinking, overweight and obesity, lack of physical exercise, unhealthy diet are major risk factors for chronic disease. Among the modifiable risk factors, percentage of subjects with smoking, drinking, overweight and unhealthy eating were 43.55%（510/1 171）, 23.57% （276/1 171）, 37.66% （441/1 171） and 32.11%（376/1 171） respectively, the percentage of subjects with physical exercise was 38.60%（452/1 171）. There were significant differences in smoking, drinking, obesity, physical exercise and unhealthy diets among different age groups （P〈0.05）. In different education level, smoking rate of subjects at high school/ technical secondary school was significantly higher than those of college and above, High school/technical secondary school physical exercise rate is the lowest, 36.87% （212/575）, junior college and above the lowest rate of poor diet, 26.62% （127/477）. The smoking rate of diesel locomotive drivers, eonnecting workers arehigher than other types of workers, the drinking rate of line workers, train inspection staff are higher than other types of workers, the obesity rate of diesel locomotive drivers, train inspection staff, station attendant are higher than other types of workers, the physical exercise rate of diesel locomotives drivers, conductor, truck inspection staff are lower than other types of workers. Conclusion intervention Priorities for chronic disease should be given to hypertension and dyslipidemia; production and frontline workers are a higher risk. Intervention should focus on the top-five occupational groups ranked by the distribution of risk factors and prevalence of chronic diseases （diesel locomotive drivers, truck inspection staff, station attendants, train inspection staff and conductor）.