芜湖市尘肺病回顾性调查

Retrospective investigation of pneumoconiosis in Wuhu City

目的对芜湖市历年诊断的尘肺病患者生存情况和存活患者的生存质量和保障情况进行调查,为制定尘肺病患者保障政策提供依据。方法收集芜湖市截止到2019年底所有诊断的尘肺病患者资料,调查患者的存活情况和保障情况,利用死因监测信息系统和现场调查等手段调查死亡患者的死亡原因。结果截止到2019年底,芜湖市共诊断尘肺病患者829例,以男性为主,目前存活545例,失访69例,死亡215例;Ⅰ期尘肺占全部病例的64.17%(532例);尘肺病患者诊断时平均年龄为(53.43±10.04)岁,平均接尘工龄为(10.38±8.17)年;矽肺和煤工尘肺诊断病例最多,分别为424和358例;无为市诊断的尘肺病病例占全市所有病例的55.01%(456例);煤炭开采和洗选业和公共管理、社会保障和社会组织2个行业诊断的病例最多,分别为329和322例;37例(6.79%)尘肺病患者享受工伤保险待遇,359例(65.87%)尘肺病患者享受基本医疗保险待遇,176例(32.29%)患者得到低保补助,372例(68.26%)尘肺病患者至少享受其中一项保障措施。门诊医保和住院医保报销比例中位数分别为53.4%和66.70%;215例死亡病例中有97例(45.12%)死于呼吸系统疾病,其中55例(25.58%)直接死于尘肺病,尘肺病患者的病死率为6.63%。结论芜湖市尘肺病危害严重,病死率高,患者经济负担重,尘肺病患者社会总体保障程度不高,需加强监管,加大社会保障措施,提高患者的生存质量。

Objective To investigate the survival status of patients with pneumoconiosis diagnosed over the years in Wuhu City and the quality of life and security of surviving patients,provide a basis for formulating protection policies for patients with pneumoconiosis.Methods The data of all pneumoconiosis patients diagnosed by the end of 2019 in Wuhu City were collected.The patient’s survival and security situation were investigated.The causes of death were investigated by using methods such as disease surveillance system and on-site investigation.Results By the end of 2019,a total of 829 patients with pneumoconiosis were diagnosed in Wuhu City,mainly men.There were currently 545 cases alive,69 cases lost to follow-up,and 215 deaths.StageⅠpneumoconiosis accounted for 64.17%(532 cases)of total cases.The average age of patients with pneumoconiosis at diagnosis was(53.43±10.04)years old.The average working age for dust exposure was(10.38±8.17)years.The most diagnosed cases of pneumoconiosis were silicosis and coal worker’s pneumoconiosis,with 424 and 358 cases respectively.Pneumoconiosis cases diagnosed in Wuwei City accounted for 55.01%(456 cases)of total cases in the city.Most of the cases were distributed in two industries:coal mining and washing industry,and public management,social security and social organization,with 329 cases and322 cases respectively.37 cases(6.79%)were entitled to work-related injury insurance.359 cases(65.87%)were treated with basic medical insurance.176 patients(32.29%)received subsistence allowance.372 cases(68.26%)of pneumoconiosis patients enjoyed at least one of the security measures.The median of outpatient medical insurance reimbursement ratio and inpatient medical insurance reimbursement ratio was 53.4%and 66.70%respectively.Among 215 deaths,97(45.12%)died of respiratory diseases,of which 55(25.58%)died of pneumoconiosis directly.The mortality of pneumoconiosis was 6.63%.Conclusion Pneumoconiosis is serious in Wuhu City,with a high mortality rate.The patient’s financial burden is heavy.The overall social security level of pneumoconiosis patients is low.Occupational health supervision needs to be strengthened and social security measure needs to be increased,to improve the quality of life of patients.