2017—2021年我国急性化学品中毒病例特征分析

Epidemiological characteristics of acute chemical poisoning cases in China from 2017 to 2021

目的分析我国急性化学品中毒发生状况,为制定化学品急性中毒预防控制策略提供依据。方法对收集到的全国26个省、市、自治区的87家监测医院的急性化学品中毒病例进行回顾性分析,按照中毒发生时间、地区、人群、毒物种类、中毒原因、接触途径与转归等进行分组,采用Excel、R 4.0.3等软件对数据进行整理分析。结果2017—2021年化学品急性中毒病例为11724例,包括住院病例5602例,门急诊病例6122例。一氧化碳急性中毒占总病例数的70.46%(8261例),日用化学品占7.89%(925例),其他化学品占21.65%(2538例)。中毒病例数男性多于女性,72.69%的中毒病例为具有劳动能力的中青年人,随文化程度增加中毒病例数下降(P<0.01)。急性化学品中毒职业排在首位的是农民(占26.34%),其次是工人(占13.37%)和自由职业者(占8.53%)。急性一氧化碳中毒冬春季高发,日用化学品和其他化学品无明显季节趋势。病例数居前3位的是黑龙江(占24.58%)、四川(占16.13%)、贵州(占14.96%)。意外中毒占总病例数的81.21%,职业接触为第2位的中毒原因,占总病例的8.38%,各毒物的中毒原因分布差异有统计学意义(P<0.01),意外中毒多见于一氧化碳中毒,职业接触中毒和有意中毒(自杀、投毒等)多见于其他化学品中毒。83.34%的急性化学品中毒患者离院时已痊愈或好转,死亡者占急性化学品中毒病例数的0.48%。随着年龄增长,病死率增加;日用化学品病死率最高(1.19%)。结论急性化学品中毒问题仍然存在,并且在特定毒物、特定地区、特定人群中较为明显,因此需要建立更健全的中毒监测机制,制定更科学精准的中毒防控策略。

Objective To analysis the epidemiological characteristics of acute chemical poisoning cases in China,and a provide evidence for establishment of prevention and control strategy against chemical poisoning.Methods A retrospective analysis of acute chemical poisoning cases in 87 hospitals from 26 provinces was carried out,including the time distribution,regional distribution,population distribution,varieties of toxicants,reason,exposure route and outcome,etc.The data were sorted out and analyzed by Excel and R 4.0.3.Results From 2017 to 2021,there were 11724 cases of acute chemical poisoning,including 5602 inpatient cases and 6122 outpatient and emergency cases.Acute carbon monoxide poisoning accounted for 70.46%(8261 cases),daily chemicals accounted for 7.89%(925 cases),and other chemicals accounted for21.65%(2538 cases).The number of poisoning cases was higher in men than in women.72.69%poisoning cases were young and middle-aged people with labor ability.The number of poisoning cases decreased with the increase of education level(P<0.01).Farmers(26.34%)ranked first,followed by workers(13.37%)and freelancers(8.53%).Acute carbon monoxide poisoning occurred frequently in winter and spring,and daily chemicals and other chemicals had no obvious seasonal trend.The top three cases were reported in Heilongjiang(24.58%),Sichuan(16.13%)and Guizhou(14.96%).Accidental poisoning cases accounted for 81.21%of the total cases.Occupational exposure was the second cause of poisoning,accounting for8.38%.The distribution of poisoning causes of different poisons was statistically significant(P<0.01).Accidental poisoning was more common in carbon monoxide poisoning cases,while occupational exposure and intentional poisoning were more common in other chemical poisoning cases.83.34%of the patients with acute chemical poisoning had recovered or improved when they left the hospital,and the death cases accounted for 0.48%.The fatality rate of daily chemicals was the highest(1.19%),which increased with age.Conclusions The problem of acute chemical poisoning still exists and is more obvious in specific poisons,regions and populations.Therefore,it is necessary to establish a more sound poisoning monitoring system and formulate more scientific and accurate poison prevention and control strategies.