采掘作业工人矽肺发病调查

Incidence of silicosis among excavation workers

目的了解苏州市采掘作业工人矽肺发病情况。方法于2011至2016年,调查苏州市1971至1974年3190名采掘作业工人的矽肺发病情况,比较不同期别矽肺患者的一般情况、并发症、血液指标及肺功能情况。结果共调查采掘作业工人3190名,确诊矽肺患者144例,矽肺发病率为4.51%,其中矽肺壹期138例(95.83%),贰期4例(2.78%),叄期2例(1.39%)。贰、叁期矽肺患者的收缩压(154.17±14.74 mmHg)和舒张压(96.67±10.25 mmHg)均高于壹期患者(134.64±15.41 mmHg,82.20±10.62 mmHg),差异均有统计学意义(P<0.05)。矽肺患者合并高血压54例(37.50%)、心电图异常38例(26.39%)、糖尿病22例(15.28%)、恶性肿瘤10例(6.94%)、乙型肝炎8例(5.56%)、肺结核8例(5.56%)。壹期矽肺患者红细胞计数(RBC)、血红蛋白(Hb)、白蛋白(ALB)、镁(Mg)、钠(Na)水平高于贰、叄期患者,C反应蛋白(CRP)和糖类抗原199(CA199)水平低于贰、叄期患者,差异均具有统计学意义(P<0.05)。矽肺患者肺功能正常、轻度损害、中度损害和重度损害的比例分别为44.03%(59/134)、18.66%(25/134)、29.85%(40/134)和7.46%(10/134)。结论采掘作业工人的矽肺发病率较高,应加强对此类人员的职业健康监护,减少并发症,提高其生活质量。

Objective To assess the incidence of silicosis among excavation workers in Suzhou city.Methods In 2011-2016,we investigated the incidence of silicosis among 3190 excavation workers who participated in the mining operations from 1971 to 1974 in Suzhou city.To compare the general condition,complications,blood indexes and pulmonary function between different stages of silicosis patients.Results Among all the participants,144 cases were diagnosed as silicosis,and the incidence of silicosis was 4.51%,including 138 stage Ⅰ cases(95.83%),4 stage Ⅱ cases(2.78%),and 2 stage Ⅲ cases(1.39%).Both systolic blood pressure(154.17±14.74 mmHg)and diastolic blood pressure(96.67±10.25 mmHg)of silicosis patients in stage Ⅱ-Ⅲ were significantly higher than that of patients in stage I(134.64±15.41 mmHg,82.20±10.62 mmHg)(P<0.05).Hypertension(54 cases,37.50%)were the most commonly complication of silicosis patients,followed by abnormal electrocardiogram(38 cases,26.39%),diabetes(22 cases,15.28%),malignant tumor(10 cases,6.94%),hepatitis B(8 cases,5.56%)and tuberculosis(8 cases,5.56%).The serum levels of red blood cell count(RBC),hemoglobin(Hb),albumin(ALB),magnesium(Mg)and sodium(Na)in stage I silicosis patients were significantly higher than stage Ⅱ-Ⅲ patients(P<0.05).While the serum levels of C-reactive protein(CRP)and carbohydrate antigen 199(CA199)in stage I silicosis patients were significantly lower than stage Ⅱ-Ⅲ patients(P<0.05).The proportions of normal pulmonary function,mild airflow limitation,moderate airflow limitation and severe airflow limitation in silicosis patients were 44.03%(59/134),18.66%(25/134),29.85%(40/134)and 7.46%(10/134),respectively.Conclusion Our data obviously show that the excavation workers has a high incidence of silicosis.It is necessary to strengthen the occupational health surveillance of silicosis patients,reduce complications and improve their quality of life.