1990年至2017年中国人群石棉肺的疾病负担分析

Analysis on disease burden of asbestosis in Chinese population from 1990 to 2017

目的分析1990-2017年中国人群石棉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年中国人群石棉肺的疾病负担状况并与全球人群进行比较。按年份、年龄、性别分析中国人群石棉肺的发病数、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石棉肺的标化发病率、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年中国人群因石棉肺造成的DALY为9 984人年,占中国人群因尘肺病造成DALY(247 619人年)的4. 03%,占中国总DALY (371 485 307人年)的0. 0027%,在293种疾病中排名第262位,较1990年(269位)上升了7位;占全球人群因石棉肺造成DALY (69 074人年)的14. 45%,在195个国家和地区中排名第1位。2017年中国人群石棉肺的发病数、死亡数、DALY分别为1 942例、285例、9 984人年,较1990年分别增长85. 5%、46. 9%、26. 2%,增幅均低于全球水平;2017年的标化发病率、死亡率、DALY率分别为0. 100/10万、0. 016/10万、0. 524/10万,分别较1990年下降6. 8%、33. 5%、34. 3%,降幅均高于全球水平。中国人群石棉肺的发病数、死亡数、≥40岁DALY进入高发状态,分别为1 839例(占94. 7%)、269例(占94. 5%)、8 919人年(占89. 3%);2017年发病年龄和死亡年龄的中位数分别为63. 6岁、70. 1岁,较1990年分别延长9. 4岁、6. 4岁。结论石棉肺对中国人群引起的疾病负担相对较轻,但占全球人群石棉肺疾病负担较大比重,应综合考虑过去我国石棉生产和使用量大、石棉肺潜伏期长等特征,持续关注石棉肺等相关疾病的健康风险和疾病负担。

Objective To analyze the disease burden of asbestosis 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 asbestosis 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 asbestosis in both China and global population. The percentage of change for these indicators were compared between 2017 and 1990. Results In 2017,the DALY due to pneumoconiosis in Chinese population was 9 984 person years,accounting for 4. 03% of the DALY due to pneumoconiosis in Chinese population( 247 619 person years),accounting for 0. 0027% of the total DALY of China( 371 485 307 person years),it ranked 262 out of 293 diseases in China,it moved up by 7 places compared to 1990( 269),that accounted for 14. 45% of the DALY of global population due to asbestosis( 69 074 person years),ranking 1 st among 195 countries and regions. The incidence number,death number,DALY number of asbestosis in Chinese population of 2017 were 1 942 cases,285 cases and 9 984 person years,that increased by 85. 5%,46. 9% and 26. 2% respectively,compared with that of 1990,the decline rate is lower than the global level. The standardized morbidity,mortality and DALY rate of asbestosis in Chinese population were 0. 100/100 000,0. 016/100 000 and0. 524/100 000,which decreased by 6. 8%,33. 5%and 34. 3% respectively,compared with that of 1990,the reduction rate is higher than the global level. In 2017,the total incidence number,death number and DALY number of asbestosis in Chinese population entered a high incidence state when people over 40 years old, which were 1 839 cases( 94. 7%),269 cases( 94. 5%),8 919 person years( 89. 3%). The median age of incidence and death in 2017 were 63. 6 years and 70. 1 years respectively,it extended 9. 4 and 6. 4 years longer than 1990,respectively. Conclusion The results suggested that the disease burden due to asbestosis in the Chinese population was relatively small,but it still accounts for a large proportion of the burden of asbestosis in the global population. The characteristics of large production,use of asbestosis in the past in China and long latency of asbestosis should be comprehensively considered. Therefore,health risks and disease burden of asbestosis and other related diseases should be continuously concerned.