陈双平, 胡艳敏, 王斌, 张峰, 胡丹标. 1974—2019年宁波市某县尘肺病例随访与回顾性调查[J]. 环境与职业医学, 2023, 40(10): 1190-1195. DOI: 10.11836/JEOM23004
引用本文: 陈双平, 胡艳敏, 王斌, 张峰, 胡丹标. 1974—2019年宁波市某县尘肺病例随访与回顾性调查[J]. 环境与职业医学, 2023, 40(10): 1190-1195. DOI: 10.11836/JEOM23004
CHEN Shuangping, HU Yanmin, WANG Bin, ZHANG Feng, HU Danbiao. Follow-up and retrospective investigation of pneumoconiosis cases in a county of Ningbo City from 1974 to 2019[J]. Journal of Environmental and Occupational Medicine, 2023, 40(10): 1190-1195. DOI: 10.11836/JEOM23004
Citation: CHEN Shuangping, HU Yanmin, WANG Bin, ZHANG Feng, HU Danbiao. Follow-up and retrospective investigation of pneumoconiosis cases in a county of Ningbo City from 1974 to 2019[J]. Journal of Environmental and Occupational Medicine, 2023, 40(10): 1190-1195. DOI: 10.11836/JEOM23004

1974—2019年宁波市某县尘肺病例随访与回顾性调查

Follow-up and retrospective investigation of pneumoconiosis cases in a county of Ningbo City from 1974 to 2019

  • 摘要: 背景

    尘肺病是我国最常见、影响最广泛的一种法定职业病,该病目前还没有根治方法。《“健康中国2030”规划纲要》提到要强化职业健康,防治尘肺病是促进职业健康的关键点。

    目的

    掌握宁海县尘肺病例的基本特点、社会保障及死因状况,为科学防治尘肺提供依据。

    方法

    通过查阅职业病与职业卫生信息监测系统、职业病诊断机构、用人单位等留存的历年职业性尘肺病诊断原始资料和尘肺病专题流行病学调查资料,获取1974—2019年宁海县用工单位接尘工人中诊断的尘肺病例信息,根据相关信息进行电话随访或入户面对面随访,调查或核实病例接尘工龄、尘肺病类型、期别、诊断日期等相关内容。采用方差分析、χ2检验与秩和检验分析病例的诊断年龄与死亡年龄、享受保障情况与病死率及接尘工龄。

    结果

    截至2019年底,宁海县用工单位接尘工人中累计诊断尘肺病例420例,完成随访409例(97.38%),失访11例(2.62%)。自1974年发现第1例尘肺病例起,宁海县在2000年以前、2000—2009年、2010—2019年各诊断尘肺病例39例、278例、101例。另有2 例尘肺病例诊断年份不详,1 例为死亡病例,1 例为失访病例。存活尘肺病例294例,主要分布于桑洲镇。诊断年龄为(58.68±15.37)岁,接尘工龄为8.0(4.0,15.7)年,叁期病例诊断年龄小于壹期和贰期,与贰期差异有统计学意义(P<0.05);年龄≥60岁者231例(78.57%),而≥80岁者74人(25.17%);工龄<10年者160例(54.42%);享受工伤保险补偿和用人单位民事赔偿者分别占12.59%与7.82%。从诊断年限看,2010—2019年组享受工伤保险补偿者、得到用人单位赔偿者占比较<2000年组、2000—2009年组高,差异均有统计学意义(P<0.01)。死亡尘肺病例115例,尘肺壹期、贰期和叁期病死率分别为23.86%、18.18%和50.75%,叁期病死率高于壹期和贰期,差异均具有统计学意义(P<0.05);叁期病例的诊断年龄、死亡年龄均小于壹期和贰期,差异均具有统计学意义(P<0.05);65例尘肺病例死因明确,其中呼吸系统疾病(肺癌除外)25例(38.46%)、肿瘤28例(43.07%),在因肿瘤死亡的尘肺病例中,肺癌占50.00%。

    结论

    宁海存活尘肺病例以≥60岁的中老年为主,且主要分布在桑洲镇,应以当地康复站的建设为契机,积极防治尘肺病并发症,进一步提高尘肺病例生活质量。

     

    Abstract: Background

    Pneumoconiosis is one of the most common and widespread prescribed occupational diseases in China, and there is no cure for it at present. The Healthy China 2030 underlines that the prevention and treatment of pneumoconiosis are the critical element of promoting occupational health.

    Objective

    To understand the basic characteristics, social security, and death causes of pneumoconiosis cases in Ninghai County, and to provide a basis for scientific prevention and treatment of pneumoconiosis.

    Methods

    Information on pneumoconiosis cases in Ninghai County from 1974 to 2019 was obtained by consulting occupational disease and occupational health information monitoring systems, occupational disease diagnosis institutions, and employers, which may retain original data on occupational pneumoconiosis diagnosis, as well as specialized epidemiological survey projects on pneumoconiosis. Telephone or face-to-face follow-up visits were conducted based on relevant information to complete or verify relevant information such as length of service with dust exposure, type, stage, and diagnosis date of pneumoconiosis. ANOVA, chi-square test, and rank-sum test were used to analyze age of diagnosis and age of death, entitlement to social security and mortality rate of cases/length of service.

    Results

    As of the end of 2019, a total of 420 cases of pneumoconiosis were diagnosed among workers exposed to dust in Ninghai County, with 409 cases (97.38%) followed up and 11 cases (2.62%) lost to follow-up. Since the first case of pneumoconiosis was reported in 1974, 39 cases, 278 cases, and 101 cases of pneumoconiosis were reported before 2000, from 2000 to 2009, and from 2010 to 2019, respectively. Two other cases of pneumoconiosis were diagnosed with an unknown year, one as a dead case and one as a lost case. There were 294 surviving pneumoconiosis cases, who mainly lived in Sangzhou Town. The mean age of diagnosis was (58.68±15.37) years old, and the median length of service with exposure to dust was 8.0 (4.0, 15.7) years. The age of diagnosing stage III pneumoconiosis was less than that of stage I and stage II, and the difference between the age of diagnosing stage III and stage II pneumoconiosis was significant (P <0.05). There were 231 cases (78.57%) aged ≥ 60 years, while there were 74 cases aged ≥ 80 years (25.17%). There were 160 cases (54.42%) whose length of service was < 10 years. There were 12.59% and 7.82% of the total cases compensated by work injury insurance and civil compensation by employers, respectively. From the perspective of diagnosis period, the proportion of patients who collected work-related injury insurance and civil compensation from employers in the 2010—2019 year group was higher than that in the <2000 year group or the 2000—2009 year group (P<0.01). There were 115 fatal pneumoconiosis cases, and the fatality rates of stage I, II , and III pneumoconiosis were 23.86%, 18.18%, and 50.75%, respectively. The fatality rate of stage III pneumoconiosis was higher than that of stage I or II (P <0.05). The age of diagnosis and age of death of stage III pneumoconiosis cases were lower than those of stage I and II (P <0.05). The cause of death was definite in 65 patients, including 25 cases (38.46%) of respiratory diseases (except lung cancer) and 28 cases (43.07%) of tumors, and lung cancer accounted for 1/2 of the pneumoconiosis cases that died due to tumors.

    Conclusion

    The surviving pneumoconiosis cases in Ninghai are mainly older than 60 years old and largely live in Sangzhou Town. Constructing local rehabilitation stations should be taken as an opportunity to actively prevent and treat pneumoconiosis complications, further improving the quality of life of pneumoconiosis patients.

     

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