北京市2019年职业性尘肺病主动监测结果分析

Analysis on active surveillance results of occupational pneumoconiosis in Beijing in 2019

目的 分析2019年北京市职业性尘肺病(以下简称“尘肺病”)主动监测结果的分布特征。方法 采用判断抽样方法,选择北京市2 634名接尘工人为研究对象,分析其2019年X射线高千伏或数字化摄影后前位胸片(以下简称“胸片”)和肺功能异常情况及其影响因素。结果 研究对象胸片异常率为14.0%(368/2 634),肺功能异常率为6.6%(175/2 634)。多因素Logistic回归分析结果显示,年龄越大的接尘工人检出胸片异常的风险越高(P<0.01),采矿业和建筑业接尘工人检出胸片异常的风险均高于制造业接尘工人(P值均<0.05),国有和外商企业接尘工人检出胸片异常的风险均高于私有企业接尘工人(P值均<0.05);年龄越大、工龄越长的接尘工人检出肺功能异常的风险均越高(P值均<0.05),矽尘和铝尘接触工人检出肺功能异常的风险均高于电焊烟尘接触工人(P值均<0.01);小、微型企业接尘工人检出肺功能异常的风险均高于大型企业接尘工人(P值均<0.01);采矿业接尘工人检出肺功能异常的风险高于制造业接尘工人(P<0.05)。结论 年龄、接尘工龄、接尘类型、企业和行业的规模、经济类型均为粉尘作业工人肺部损伤的影响因素;应加强对重点人群和重点行业的监督管理,以减少尘肺病的发生。

Objective To analyze the active surveillance results of occupational pneumoconiosis(hereinafter referred to as “pneumoconiosis”) in Beijing in 2019. Methods A total of 2 634 dust exposed workers were recruited as the active surveillance subjects by judgment sampling method. The abnormalities and influencing factors of High kV or digital photography of posterior-anterior chest radiography(hereinafter referred to as “chest radiography”) and lung function were analyzed. Results The detection rate of abnormal chest radiograph and pulmonary dysfunction were 14.0%(368/2 634) and 6.6%(175/2 634), respectively. The multivariate logistic regression analysis showed that the risk of abnormal chest radiograph in dust-exposed workers increased with age(P<0.01). Mining and construction workers had higher risk of abnormal chest radiograph than manufacturers(all P<0.05). The risk of abnormal chest radiograph of dusk-exposed workers in state-owned and foreign enterprises was higher than that of workers in private enterprises(P<0.05). The risk of pulmonary dysfunction was increased with age and length of dust exposure(all P<0.05). Workers exposed to silica dust and aluminum dust had higher risks than those exposed to welding dust(all P<0.01). The risk of pulmonary dysfunction of workers in small and micro enterprises was higher than that of workers in large enterprises(all P<0.01). Mining workers had higher risks of pulmonary dysfunction than manufacturing workers(P<0.05). Conclusion Age, length of dust exposure, dust type, industry type, enterprise scale and economic type were the influencing factors of lung injury of dust exposed workers. Therefore, the supervision of key population and industries should be strengthened to reduce the occurrence of pneumoconiosis.