1963—2020年常州市职业性尘肺病流行病学特征分析

Analysis on epidemiological characteristics of occupational pneumoconiosis in Changzhou City from 1963-2020

目的了解1963—2020年常州市职业性尘肺病患者人数、存活数量和流行病学特征,为预防控制尘肺病提供依据。方法调查常州市诊断的职业性尘肺病患者,分析职业性尘肺病患者总数、存活情况以及期别、地区和病种分布。结果1963—2020年常州市累计诊断职业性尘肺病患者784例,男性708例,女性76例。存活370例,其中武进区存活214例(57.84%)、溧阳市存活86例(23.24%),死亡413例,失访1例。壹期446例(56.89%),贰期225例(28.70%),叁期113例(14.41%)。不同期别尘肺病患者的性别构成比较,差异无统计学意义(χ^(2)=0.003,P>0.05),不同期别尘肺病患者的存活、死亡构成比较,差异有统计学意义(χ^(2)=31.560,P<0.05),趋势χ^(2)检验,差异有统计学意义(χ^(2)趋势=31.519,P<0.05)。壹期尘肺存活比例显著高于贰期尘肺(χ^(2)=11.433,P<0.05)和叁期尘肺(χ^(2)=27.039,P<0.05),贰期尘肺存活比例显著高于叁期尘肺(χ^(2)=5.995,P<0.05)。行业分布以非金属矿采选业(214例,27.30%),公共管理、社会保障和社会组织(135例,17.22%)居多。武进区435例(55.48%),溧阳市173例(22.07%),钟楼区97例(12.37%);矽肺601例(76.66%),铸工尘肺76例(9.69%),电焊工尘肺42例(5.36%)。存活患者中,年龄≥70岁209例(56.49%),60~<70岁67例(18.11%),<60岁94例(25.41%),不同性别存活人群中年龄构成比较,差异无统计学意义(P>0.05);不同期别存活人群中年龄构成比较,差异无统计学意义(P>0.05)。结论1963—2020年常州市职业性尘肺病患者主要为壹期,病种主要为矽肺,主要分布于武进区和溧阳市。现存患者中武进区和溧阳市最多,应考虑设置尘肺病康复站(点)。尘肺病期别越高,存活比例越低,因此应重视尘肺病的早发现、早诊断和早治疗。近年来,常州市尘肺病发病人数有所上升,防治任务仍然繁重,用人单位应落实职业病防治主体责任,卫生部门应对产生矽尘的企业进行重点监管。

Objective To understand the case number,survival status and epidemiological characteristics of occupational pneumoconiosis cases in Changzhou City in order to provide evidence for the prevention and control of pneumoconiosis.Methods The total number of occupational pneumoconiosis patients diagnosed in Changzhou were investigated,and the survival,stage,region and disease distribution were analyzed.Results A total of 784 cases of occupational pneumoconiosis were diagnosed from 1963-2020 in Changzhou,including 708 males and 76 females.370 cases survived,including 214 cases in Wujin District(57.84%),86 in Liyang City(23.24%),413 died and 1 lost to follow-up.446 cases(56.89%)had stageⅠpneumoconiosis,225(28.7%)had stageⅡpneumoconiosis and 113(14.41%)had stageⅢpneumoconiosis.There was no significant difference in the gender composition with different stages of pneumoconiosis cases(χ^(2)=0.003,P>0.05),there was significant difference in the composition of survival and death of different stages of pneumoconiosis cases(χ^(2)=31.560,P<0.05),and there was significant difference in trend chi-square test(χ^(2)=31.519,P<0.05).The survival rate of stageⅠpneumoconiosis cases was significantly higher than that of stageⅡpneumoconiosiscases(χ^(2)=11.433,P<0.05)and stageⅢpneumoconiosis cases(χ^(2)=27.039,P<0.05),and the survival rate of stageⅡpneumoconiosis cases was significantly higher than that of stageⅢpneumoconiosis cases(χ^(2)=5.995,P<0.05).Non-metallic mining and beneficiation industry(214 cases,27.30%)and public management,social security and social organizations(135 cases,17.22%)were the main industries.435 cases(55.48%)were in Wujin District,173(22.07%)in Liyang City and 97(12.37%)in Zhonglou District.There were 601 cases of silicosis(76.66%),76 foundry pneumoconiosis(9.69%),and 42 welder pneumoconiosis(5.36%).Among the surviving patients,209(56.49%)were aged≥70 years,67(18.11%)were aged 60-<70 years,and 94(25.41%)were under 60 years old.There was no significant difference in age composition between the surviving populations of different sexes(P>0.05).There was no significant difference in age composition among survivors at different stages(P>0.05).Conclusions Occupational pneumoconiosis in Changzhou city is mainly in stage I,and the disease type is mainly silicosis,most of them in Wujin District and Liyang City.Wujin District and Liyang City have the bulk of surviving patients.Institutions such as Pneumoconiosis Rehabilitation Stations are highly recommended.The higher the stage of pneumoconiosis,the lower the survival rate.Therefore,we should pay attention to the early detection,early diagnosis and early treatment of pneumoconiosis.In recent years,the number of pneumoconiosis cases in Changzhou city has increased,and the task of prevention and control is still arduous.Employers should take the main responsibility for occupational disease prevention and control,and the health supervision departments should focus on the supervision of enterprises that produce silica dust.