1990至2019年全球和中国尘肺病的疾病负担分析

Analysis of the disease burden of pneumoconiosis globally and in China from 1990 to 2019

目的利用2019年全球疾病负担数据库(GBD)数据,分析1990至2019年全球和中国尘肺病的疾病负担,为尘肺病防控提供理论依据。方法于2022年9月,收集整理GBD 2019中1990至2019年全球和中国尘肺病及不同类型尘肺病的发病、患病、死亡病例数与伤残调整寿命年(DALY)绝对值,并获取相应的年龄标准化率(ASR)。运用Joinpoint线性回归模型计算尘肺病及各类型尘肺病发病、患病、死亡和DALY ASR的平均年度变化百分比(AAPC)值,分析变化趋势。结果1990至2019年,全球和中国尘肺病的发病、患病例数与DALY绝对值均呈上升趋势,死亡病例数呈下降趋势,年龄标准化发病率(ASIR)、年龄标准化患病率(ASPR)、年龄标准化死亡率(ASMR)和年龄标准化DALY率(ASDR)均呈下降趋势。中国尘肺病在全球尘肺病疾病负担中占比较大,每年度新发病例数占全球67%以上,患病例数占80%以上,死亡例数占43%以上,DALY绝对值占60%以上。男性是全球及中国尘肺病疾病负担的主要人群,较女性发病年龄早。1990至2019年全球及中国尘肺病发病、患病、死亡及DALY高峰年龄段存在增大趋势。矽肺仍是全球及中国尘肺病疾病负担最重的尘肺病类型,煤工尘肺疾病负担总体存在改善趋势,但石棉肺在全球范围内存在疾病负担加重趋势。结论全球和中国尘肺病的疾病负担沉重,需根据性别、年龄及病因类型进一步针对性强化监管及防治对策。

Objective To analyze the disease burden of pneumoconiosis globally and in China from 1990 to 2019 using Global Burden of Disease(GBD)2019 data,and to provide a theoretical basis for prevention and control of pneumoconiosis.Methods In September 2022,the data of incidence,prevalence,morality and disability-adjusted life years(DALY)of pneumoconiosis and its subtypes globally and in China from 1990 to 2019 were collected from GBD 2019,including absolute number and age-standardized rate(ASR).Joinpoint linear regression model was used to calculate average annual percent change(AAPC)and analyze the change trends of incidence,prevalence,mortality and DALY of pneumoconiosis and its subtypes.Results From 1990 to 2019,the incident cases,prevalent cases and DALY value of pneumoconiosis showed upward trends,while the number of death cases showed downward trends.And the ASR of incidence(ASIR),the ASR of prevalence(ASPR),the ASR of mortality(ASMR)and the ASR of DALY(ASDR)showed downward trends globally and in China.China accounted for a large proportion of the global disease burden of penumoconiosis,accounting for more than 67%of the incident cases,more than 80%of the prevalent cases,more than 43%of the deaths cases and more than 60%of the absolute number of DALY in the world every year.Male were the main population of pneumoconiosis disease burden globally and in China,and the age of onset was earlier than that of female.The peak age periods of incidence,prevalence,mortality and DALY of pneumoconiosis globally and in China from 1990 to 2019 have increased.Silicosis was still the type with the highest disease burden of pneumoconiosis globally and in China.The disease burden of coal workers'pneumoconiosis had an overall improvement trend,but asbestosis had an increasing disease burden worldwide.Conclusion The disease burden of pneumoconiosis is heavy globally and in China,which is necessary to strengthen the supervision and prevention measures according to gender,age and etiological types.