烟草暴露对上海市35岁及以上居民肺癌死亡的归因分析

Evaluating Lung Cancer Mortality Attributable to Smoke Exposure in Residents Aged 35 Years Old and Above in Shanghai

  • 摘要:
    目的 采用人群归因健康效应评价方法,分析上海市居民因烟草暴露所致肺癌死亡,潜在寿命和劳动力损失情况,为公共卫生政策的制定提供科学依据。
    方法 利用2013年上海市慢性病及其危险因素监测数据和全球疾病负担研究关于烟草暴露导致肺癌死亡的相对危险度,计算上海市居民因烟草暴露所致肺癌死亡发生例数及其潜在寿命和劳动力损失情况。
    结果 2013年,在上海35岁及以上户籍人群中,归因于吸烟的肺癌死亡有5998人,占该人群肺癌死亡总数的64.46%(男性86.25%,女性12.94%)。因吸烟导致肺癌死亡后引起的潜在寿命损失为85979人年,早死指数为14.33年,男性(14.22年)低于女性(16.19年);劳动力损失为13428人年,男性平均损失低于女性(7.08年vs.10.48年)。归因于二手烟暴露的肺癌死亡数为395人,占人群肺癌死亡总数的13.10%(男性13.50%,女性12.99%)。因二手烟暴露导致肺癌死亡后引起的潜在寿命损失为6481人年,早死指数为16.41年(男性11.45年,女性17.79年);劳动力损失为988人年,其平均损失为男性6.5年,女性7.8年。
    结论 上海市居民归因于烟草暴露的肺癌死亡人数众多,烟草暴露对女性的寿命损失和平均劳动力损失均高于男性,建议相关部门在加强对公共场所控烟力度的同时,还应关注家中二手烟暴露所致危害的防控和宣传。

     

    Abstract:
    Objective To quantitatively evaluate lung cancer deaths, potential life lost, and labor loss attributable to smoke exposure in Shanghai residents aged 35 years and above using population attributable health effect evaluation method, and to provide scientific evidence for making public health policy.
    Methods Based on the data of 2013 Shanghai Non-communicable Disease and Behavioral Risk Factor Surveillance System and the relative risk of tobacco exposure from the Global Burden of Disease Study, we calculated the number of lung cancer deaths attributable to smoke exposure and its years of potential life lost (YPLL) and labor loss.
    Results In 2013, there were 5 998 lung cancer deaths attributable to smoking among the residents aged 35 years and above in Shanghai, accounting for 64.46% of the total lung cancer deaths (86.25% for male, 12.94% for female). YPLL attributable to smoking was 85979 person years, and the index of life lost was 14.33 years, higher in female (16.19 years) than in male (14.22 years); the labor loss was 13 428 person years, and its average loss in male was lower than in female (7.08 vs. 10.48 years). Meanwhile, there were 395 lung cancer deaths attributable to secondhand smoke exposure, accounting for 13.10% of the total lung cancer deaths (13.50% for male, 12.99% for female). YPLL attributable to secondhand smoke exposure was 6481 person years, and the index of life lost was 16.41 years (11.45 years for male, 17.79 years for female); the labor loss was 988 person years, and its average loss was 6.5 and 7.8 years in men and women respectively.
    Conclusion The number of lung cancer deaths attributable to smoke exposure is large in Shanghai and its potential life lost and average labor loss are more serious in female than in male. It is suggested that more efforts should be made to strengthen the tobacco control in public places, as well as the prevention of exposure to secondhand smoke at home.

     

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