1990年至2017年中国人群煤工尘肺的疾病负担分析

Analysis on disease burden of coal workers pneumoconiosis in Chinese population from 1990 to 2017

目的分析1990-2017年中国人群煤工尘肺的疾病负担水平及其变化趋势。方法利用全球疾病负担2017年(GBD 2017)研究结果和数据,分析1990-2017年中国人群煤工尘肺的疾病负担状况并与全球人群进行比较。按年份、年龄、性别分析中国人群煤工尘肺的发病数、死亡数、伤残调整寿命年(DALY)、过早死亡损失寿命年(YLL)、伤残损失寿命年(YLD);同时采用2000-2025年世界人口的平均年龄结构作为标准人口计算中国和全球人群煤工尘肺的标化发病率、标化死亡率、标化DALY率、标化YLL率、标化YLD率。计算2017年与1990年的变化幅度,分析疾病负担指标的变化。结果 2017年中国人群因煤工尘肺造成的DALY为40 243人年,占中国人群因尘肺病造成DALY (247 619人年)的16. 2%,占中国总DALY (371 485 307人年)的0. 011%,在293种疾病中排名第232位,较1990年(244位)上升了12位;占全球人群因煤工尘肺造成DALY (80 825人年)的49. 8%,在195个国家和地区中排名第1位。2017年中国人群煤工尘肺的发病数为10 287例,较1990年增长60. 3%;2017年的死亡数、DALY、标化发病率、标化死亡率、标化DALY率分别为1 227例、40 243人年、0. 53/10万、0. 07/10万、2. 10/10万,较1990年分别下降24. 7%、18. 4%、27. 0%、67. 3%、61. 3%;但2011-2017年死亡数和DALY呈上升趋势。2017年中国人群煤工尘肺的发病数、死亡数、DALY在≥45岁进入高发状态,分别为9 778例(95. 1%)、1 175例(95. 8%)、37 160人年(92. 3%),且2017年煤工尘肺的发病和死亡年龄中位数分别为68. 3岁、73. 8岁,较1990年分别延长了3. 1岁和4. 8岁。结论中国人群煤工尘肺引起的疾病负担整体下降,但近年仍有上升趋势,是我国需要重点关注的尘肺病病种。

Objective To analyze the disease burden of coal workers pneumoconiosis in Chinese population and its trend from 1990 to 2017. Methods The data of Global Burden of Disease study 2017( GBD 2017) was used for analyzing the disease burden of coal workers pneumoconiosis in Chinese population from 1990 to 2017 and compared with the result from global analysis in the same period according to year,age and gender,the indicators including incidence number,death number,disability-adjusted life years( DALY),years of life lost( YLL),and years lived with disability( YLD). The average age structure of world population from 2000 to 2025 was used as the standard population to calculate the standardized morbidity,standardized mortality,standardized DALY rate,standardized YLL rate and standardized YLD rate of coal workers pneumoconiosis in both China and global population. The percentage change for these indicators were compared between 2017 and 1990. Results In2017,the DALY due to coal workers pneumoconiosis in Chinese population was 40 243 person years,accounting for 16. 2% of the DALY due to pneumoconiosis in Chinese population( 247 619 person years),accounting for 0. 011% of the total DALY of China( 371 485 307 person years),it ranked 232 out of 293 diseases in China,it moved up by 12 places compared to 1990( 244),that accounted for 49. 8% of the DALY of global population due to coal workers pneumoconiosis( 80 825 person years),ranking 1 st among 195 countries and regions. The incidence number of coal workers pneumoconiosis in Chinese population were10 287 cases,that increased by 60. 3%,compared with that of 1990. The death number,DALY number,standardized morbidity,mortality and DALY rate of coal workers pneumoconiosis in Chinese population were 1 227 cases,40 243 person years,0. 53/100 000,0. 07/100 000 and 2. 10/100 000,which decreased by 24. 7%,18. 4%,27. 0%,67. 3%and 61. 3% respectively,compared with that of 1990. But the death number and DALY number showed rising trend from 2011 to 2017. In 2017,the total incidence number,deaths number and DALY number of coal workers pneumoconiosis in Chinese population entered a high incidence state when people over 45 years old,which were 9 778 cases( 95. 1%),1 175 cases( 95. 8%),37 160 person years( 92. 3%). The median age of incidence and death in 2017 were 68. 3 years and 73. 8 years respectively,it extended 3. 1 and 4. 8 years longer than 1990,respectively. Conclusion The results suggested that the disease burden due to coal workers pneumoconiosis in the Chinese population had declined on the whole,but it still showed rising trend in recent years. Therefore,it is a type of pneumoconiosis that needs to be focused on in China.