2019—2023年乌鲁木齐市职业性尘肺病流行病学调查分析

Epidemiological investigation and analysis of occupational pneumoconiosis in Urumuqi Municipality from 2019 to 2023

目的分析2019—2023年乌鲁木齐市职业性尘肺病(occupational pneumoconiosis,OP)流行病学特征,为因地制宜优化OP防控策略提供参考。方法从中国疾病预防控制信息系统中的职业病与职业卫生信息监测系统《尘肺病例报告卡》(卫统33-1表)导出的2019年1月1日至2023年12月31日累计新诊断的乌鲁木齐市OP病例资料,并展开随访。调查结果用Excel 2018表格汇总,采用描述性统计法分析病种、期别、年龄、接尘工龄、死亡OP的根本死因分布和存活OP的企业类别分布。利用SPSS 25.0进行统计学分,计数资料用频数(%)描述,用卡方检验比较病种、期别、年龄、接尘工龄等方面的差异。检验水准α=0.05。结果随访到的506例OP患者,涵盖7个病种,以煤工尘肺(425例,占83.99%)、矽肺(76例,占15.02%)为主;期别以壹期(422例,占83.40%)为主。506例OP患者死亡44例,病死率8.70%。矽肺的病死率(21.05%)高于煤工尘肺(χ^(2)=16.837,P<0.001)。叁期的死亡率高于壹期(χ^(2)=23.241,P<0.001)和贰期(χ^(2)=5.086,P=0.024)。不同年龄的病死率比较差异有统计学意义(χ^(2)=33.521,P<0.001),且年龄集中于“≥60岁且<70岁”。不同接尘工龄的病死率比较差异有统计学意义(χ^(2)=82.009,P<0.001),且接尘工龄集中于“≥10年且<20年”。在死亡OP中,10例(22.73%)死因不明,9例(20.45%)根本死因为尘肺,6例(13.64%)根本死因为其他疾病、意外。不同期别居于首位的根本死因:壹期为死因不明、贰期为尘肺、叁期为尘肺。462例存活OP集中于采矿业(404例,87.45%)、私营企业(355例,76.84%)、小微型企业(368例,79.65%)。结论2019—2023年乌鲁木齐市OP病例以煤工尘肺、矽肺为主要病种,壹期占比较大,不同期别、年龄、接尘工龄的病死率存在差异,不同期别死亡OP的根本死因不同。

Objective To analyze the epidemiological characteristics of occupational pneumoconiosis(OP)in Wulumuqi from 2019 to 2023,to provide reference for optimizing OP prevention and control strategies according to local conditions.Methods New diagnosed OP case data in Urumqi from January 1,2019 to December 31,2023 in the“Occupational Disease and Occupational Health Information Monitoring System”and“Pneumoconiosis Case Report Card”(Health Statistics Table 33-1)of the“China Disease Prevention and Control Information System”were accumulated and conduct follow-up.The survey results were summarized in an Excel 2018 spreadsheet,and descriptive statistical methods were used to analyze the distribution of disease types,stages,ages,dust exposure years,root causes of death in OP,and the distribution of surviving OP by enterprise category.Statistical analysis was conducted by using SPSS 25.0,counting data was described by using frequency(%),and chi square tests were used to compare differences in disease type,stage age,and dust exposure experience.Inspection level alphaα=0.05.Results The 506 OP patients were followed up,covering 7 disease types,with coal worker pneumoconiosis(425 cases,accounting for 83.99%)and silicosis(76 cases,accounting for 15.02%)as the main types;And mainly in phaseⅠ(422 cases,accounting for 83.40%).Among 506 OP patients,44 died,with a mortality rate of 8.70%.The mortality rate of silicosis(21.05%)was higher than that of coal worker pneumoconiosis(χ^(2)=16.837,P<0.001).The mortality rate in phaseⅢwas higher than that in phaseⅠ(χ^(2)=23.241,P<0.001),phaseⅡ(χ^(2)=5.086,P=0.024).The difference in mortality rate among different ages was statistically significant(χ^(2)=33.521,P<0.001),and the age was concentrated in“≥60years old and<70 years old”.There was a statistically significant difference in mortality rates among workers of different dust exposure years(χ^(2)=82.009,P<0.001),and the dust exposure experience was concentrated in“≥10 years and<20 years”.Among the mortality cases of OP,10 cases(22.73%)had unknown causes of mortality,9 cases(20.45%)had underlying causes of pneumoconiosis,and 6 cases(13.64%)had underlying causes of mortality from other diseases or accidents.The fundamental causes of mortality that ranked first in different stages were:unknown cause of mortality in phaseⅠ,pneumoconiosis in phaseⅡ,and pneumoconiosis in phaseⅢ.462 surviving OP cases were concentrated in the mining industry(404 cases,accounting for 87.45%),private enterprises(355 cases,accounting for 76.84%),and small and micro enterprises(368 cases,accounting for 79.65%).Conclusions The main types of OP cases in Urumqi from 2019 to 2023 are coal worker pneumoconiosis and silicosis,with a relatively large proportion in phaseⅠ,there are differences in mortality rates among different stages,ages,and years of dust exposure,the fundamental causes of mortality for OP in different stages are different.