山东省莱州市金矿从业者尘肺病发病影响因素分析

Analysis on influencing factors of silicosis among gold miners in Laizhou city,Shandong province

目的分析山东省莱州市金矿从业者尘肺病发病的影响因素,为尘肺病的防治提供一定的参考价值。方法回顾性分析2017年9月-2020年12月山东省莱州市某职业病防治医院收治入院的632例尘肺病患者的临床资料。收集尘肺病患者首次住院时的资料,包括患者性别、文化水平、体质量指数(BMI)、家庭情况、吸烟情况、个人防护用品佩戴情况、发病年龄、接尘工龄、期别、合并症、工种等资料,采用有序logistic回归分析尘肺病的影响因素。结果金矿从业尘肺病患者632例,男性占95.09%(601/632);文化水平以初中学历为主,占64.08%(405/632);家庭情况以与家人共同居住为主,占92.72%(586/632);吸烟比例达54.91%(347/632);个人防护用品佩戴情况以经常佩戴为主,占52.85%(334/632);发病年龄以41~50岁为主,占39.72%(251/632);接尘工龄以≤20年为主,占55.70%(352/632);期别以一期为主,占57.28%(362/632);合并症发病率较低,为8.07%(51/632)。不同文化水平(χ^(2)=13.739,P=0.033)、家庭情况(χ^(2)=13.299,P=0.010)、个人防护用品佩戴情况(χ^(2)=18.942,P=0.004)、接尘工龄(χ^(2)=13.591,P=0.009)和工种情况(χ^(2)=37.173,P=0.023)的尘肺病发病期别比较差异有统计学意义。个人防护用品佩戴情况(OR=2.423,95%CI:0.297~1.473,P=0.003)、发病年龄(OR=1.761,95%CI:0.019~1.114,P=0.043)、接尘工龄(不同接尘工龄OR值分别为0.035、0.043,95%CI分别为-5.756~0.941、-5.554~0.740,P值分别为0.006、0.010)、合并症(OR=3.083,95%CI:0.316~1.936,P=0.006)和工种情况(不同工作OR值分别为2.724、2.275、2.442、2.732,95%CI分别为0.400~1.604、0.204~1.440、0.192~1.593、0.293~1.718,P值分别为0.001、0.009、0.013、0.006)均为尘肺病发病的独立影响因素。结论个人防护用品佩戴情况、发病年龄、接尘工龄、合并症和工种是金矿从业者尘肺病发病的独立影响因素。

Objective To analyze the factors influencing silicosis among gold miners in Laizhou city,Shandong province,so as to provide some reference value for the prevention and treatment of silicosis.Methods The clinical data of 632 patients with silicosis who were admitted to a hospital for occupational disease prevention and treatment in Laizhou city,Shandong province from September 2017 to December 2020 were retrospectively analyzed.Data on patients'gender,education level,body mass index(BMI),family situation,smoking status,use of personal protective equipment,age at onset,years of exposure to dust at work,duration of exposure period,complications and type of work were collected during their first hospitalization.Ordinal logistic regression was used to analyze the factors that influenced the development of silicosis.Results There were 632 patients with silicosis in gold miners,of which males accounted for 95.09%(601/632).The education level was mainly junior high school,accounting for 64.08%(405/632).The main family situation was living with family members,accounting for 92.72%(586/632).The proportion of smokers was 54.91%(347/632).Most of the patients frequently wore personal protective equipment,accounting for 52.85%(334/632).The age of onset was mainly between 41 to 50 years old,accounting for 39.72%(251/632).The dust exposure duration was mainly less than 20 years,accounting for 55.70%(352/632).The first stage was the most common stage,accounting for 57.28%(362/632).The incidence of complications was relatively low,accounting for 8.07%(51/632).There were significant differences in the onset period of silicosis among patients with different education levels(χ^(2)=13.739,P=0.033),family conditions(χ^(2)=13.299,P=0.010),use of personal protective equipment(χ^(2)=18.942,P=0.004),duration of dust exposure at work(χ^(2)=13.591,P=0.009)and types of work(χ^(2)=37.173,P=0.023).The use of personal protective equipment(OR=2.423,95%CI:0.297-1.473,P=0.003),age at onset(OR=1.761,95%CI:0.019-1.114,P=0.043),duration of dust exposure at work(OR=0.035,95%CI:-5.756-0.941,P=0.006;OR=0.043,95%CI:-5.554-0.740,P=0.010),presence or absence of complications(OR_(COPD)=3.083,95%CI_(COPD):0.316-1.936,P_(COPD)=0.006)and type of work(OR was 2.724,2.275,2.442,2.732;95%CI was 0.400-1.604,0.204-1.440,0.192-1.593,0.293-1.718.P was 0.001,0.009,0.013,0.006)were independent influencing factors on the incidence rate.Conclusion The wearing of personal protective equipment,age at onset,years of exposure to dust in the workplace,complications,and type of work are independent factors that influence the incidence of silicosis in gold miners.