广州市不同工业行业职工主要死因分析

An analysis of the main causes of death in different industrial systems in Guangzhou

目的 比较广州市不同工业行业职工的主要死因。方法 将广州市工业系统参照中国卫生监督统计报告表行业分类分为 6个行业 ,以 1989～ 1992年实施职业健康监护系统中建立的 795 4 7名年龄≥ 35岁的工厂职工个体健康档案为基础资料 ,按前瞻性队列研究方法 ,随访至 1998年 12月 31日 ,登记队列中职工的生存状态和死亡原因 ,计算粗死亡率 ,用Cox比例风险模型计算RR及 95 %CI。结果 (1) 795 4 7名职工中 ,男 4 935 5人、女 30 192人 ,平均年龄 (43.8± 6 .5 )岁 ,6 4 %的职工年龄在 35～4 4岁 ,各行业职工年龄相近 ,相差± 1岁 ;4 1%的职工接触职业有害因素 ,石化行业职业有害因素接触率最高 (5 3.9% ) ,冶金行业次之 ,机械行业最低 (30 .2 % )。 (2 )截至 1998年 12月 31日 ,平均追踪 (8.0±1.3)年 ,共 6 335 10人年 ;共有 15 77名职工死亡 ,总死亡率为 2 4 8.9/ 10万人年 ,其中橡胶行业总死亡率最高 ,其次为冶金和石化行业 ,主要死因为恶性肿瘤、血管疾病和呼吸系统疾病 ,占总死亡人数的 80 .3%。(3)全死因和血管疾病的粗死亡率橡胶行业排第一位 ,恶性肿瘤和呼吸系统疾病粗死亡率则为冶金行业排第一位。 (4)调整各相关因素后 ,以轻工行业为对照 (RR为 1.0 ) ,发现冶金行业的恶性肿瘤和呼吸系统疾病的RR(

Objective To study the main causes of death in workers from different industries in Guangzhou. Methods The industrial systems in Guangzhou were classified into six categories according to the Chinese Public Health Inspection Statistical Report.Baseline data on 79,547 workers,age≥35,were retrieved from individual health records under the Guangzhou Occupational Health Surveillance Record System established in 1989 1992.In this prospective cohort study,the workers' vital status and causes of death were followed up until 31 December 1998.Using SPSS 10.0,crude death rates were calculated and relative risksRR)(95%CI) were estimated using Cox proportional hazard models. Results (1)Among 79 547 workers were 49 355 men and 30 192 women,with mean age of (43.8±6.5) years,and 64% were aged 35～44.The mean age difference of workers in different industries was ±1 year.At baseline,41% had been exposed to occupational hazards.Exposure was most prevalent in petroleum chemical industry(53.9%),followed by metallurgical industry,and the lowest exposure was in mechanical industry (30.2%).(2)The mean follow up period was (8.0±1.3)years with 633 510 person years. 1 577 workers had died with a total death rate of 248.9 per 100 000 person years.The death rate in rubber industry was the highest ,followed by metallurgical and petroleum chemical industries.Malignant neoplasms,vascular and respiratory diseases were most common,constituting 80.3% of all causes of death.(3)For all causes of death and the three main categories,the top three crude death rates were observed in rubber and petroleum chemical industries,and in the metallurgical industry except for vascular causes.The rubber industry had the highest crude death rate for all and vascular causes,and the metallurgical industry for malignant neoplasms and respiratory causes.(4)With the light industry as a reference (RR=1.0),the metallurgical industry had the highest adjusted relative risks (RR)(95%CI) of 1.62(1.20～2.18) and 7.42(3.38～16.31) for malignant neoplasms and respiratory causes,respectively.The rubber industry had the highest RR of 1.69(1.40～2.04) for all causes.A significant RR of 2.03(1.43～2.88) for vascular causes was observed only in the rubber industry. Conclusions The main causes of death varied from industry.Malignant neoplasms and respiratory diseases were the leading causes in metallurgical and petroleum chemical industries.In rubber industry,vascular and respiratory causes were most common.Preventive measures for disease control should be tailor_made for each industry.