河南省2006—2020年新发职业性尘肺病流行病学特征分析

Analysis of epidemiological characteristics of newly diagnosed occupational pneumoconiosis in Henan Province from 2006 to 2020

目的分析河南省2006—2020年新发职业性尘肺病(以下简称“尘肺病”)流行病学分布情况。方法收集河南省2006—2020年新发尘肺病病例资料进行回顾性分析。结果河南省15年间共报告新发尘肺病9624例,男性占98.6%;病例数量分别在2009—2011和2014—2017年出现两个高峰;除云母尘肺外,其余12种尘肺病均有报告,煤工尘肺和矽肺共占96.0%;尘肺病壹期、贰期、叁期分别占64.7%、21.0%和14.3%,矽肺贰期与叁期病例占比高于煤工尘肺(56.3%vs 22.7%,P<0.01);地区主要分布于郑州市、三门峡市、洛阳市、平顶山市和鹤壁市,共占85.0%;企业主要分布在采矿业、大中型企业和国有企业、集体企业;病例数居前5位的工种为主采煤工、凿岩工、主掘进工、煤矿混合工和纯采煤工,诊断共占72.0%。病例数≥10人/家的企业共196家,涉及17.2%的发生病例企业和80.3%的病例。新发病例的诊断年龄中位数(M)为49岁,接尘工龄M为16年。与煤工尘肺比较,矽肺病例诊断年龄偏小(M:49 vs 48岁,P<0.05),接尘工龄偏长(M:10 vs 20年,P<0.05)。结论河南省尘肺病的发病在病种分布,地区分布,企业的行业、规模、性质分布和工种分布等方面呈现聚集性,并呈群体发病的特征。应加强重点地区、重点企业和重点病种、工种的尘肺病的防治工作。

Objective To analyze the epidemiological distribution of new occupational pneumoconiosis(hereinafter referred as pneumoconiosis) in Henan Province from 2006 to 2020.Methods Clinical data of newly recruited pneumoconiosis cases from 2006 to 2020 in Henan Province were retrospectively analyzed.Results A total of 9 624 cases of newly diagnosed pneumoconiosis were reported in Henan Province in the past 15 years,of which 98.6% were males.The number of cases had two peaks,one in 2009-2011 and the other in 2014-2017.There were 12 types of pneumoconiosis of all reported cases except for mica pneumoconiosis,in which coal workers′ pneumoconiosis and silicosis accounted for 96.0%.The incidence of phase Ⅰ,Ⅱand Ⅲ pneumoconiosis was 64.7%,21.0% and 14.3%,respectively.The incidence of phase Ⅱ and Ⅲ silicosis was higher than that of coal miners′ pneumoconiosis(56.3% vs 22.7%,P<0.01).Patients with pneumoconiosis were mainly distributed in Zhengzhou City,Sanmenxia City,Luoyang City,Pingdingshan City and Hebi City,accounting for 85.0%.The enterprises involved were mainly mining industry,large-and medium-sized enterprises,state-owned enterprises and collective enterprises.The top five position of patients were coal miners,rock drillers,excavators,coal mixed workers and pure coal miners,total accounting for 72.0%.There were 196 enterprises reported ≥10 cases,accounting for 17.2% of all enterprises and 80.3% of the total of newly diagnosed pneumoconiosis cases.The median(M) of onset age of new cases was 49 years old,and the M of onset of working age was 16 years.The onset age of silicosis was younger(M:49 vs 48 years old,P<0.05),while the onset of working age was longer(M:10 vs 20 years,P<0.05),compared with that of coal workers′ pneumoconiosis.Conclusion The incidence of pneumoconiosis in Henan Province were disease clustering distribution,regional distribution,industry of enterprise,enterprise scale,enterprise type,nature and working position distribution of enterprises.And it showed the characteristics of group incidence.The prevention and control treatment of pneumoconiosis should be strengthened in key areas,key enterprises and key diseases and jobs.