中国人群职业伤害的死亡趋势分析及预测探讨
Trend and prediction of fatality due to occupational injuries in China
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摘要:
背景 职业伤害是导致劳动人群死亡的重要原因之一，是世界范围内广泛关注的焦点问题，但目前我国职业伤害死亡的变化趋势及预测的相关研究较少。
目的 分析2000—2019年中国人群职业伤害死亡的变化趋势，构建灰色GM（1,1）模型，预测2020—2024年中国人群职业伤害的死亡情况，为开展职业伤害监测评估提供参考依据。
方法 应用全球疾病负担（GBD）2019年的研究结果，按年份、性别、年龄组分析中国人群职业伤害的死亡数、粗死亡率以及标化死亡率；采用Join-point模型分析，对2000—2019年标化死亡率的变化趋势进行分析，计算年度变化百分比（APC）和平均年度变化百分比（AAPC）；建立灰色GM（1,1）模型，以后验差比值（
C ）和小误差概率（P ）检验模型效果，当C ≤ 0.35且P ≥ 0.95时模型预测精度评定为1级（好），当 0.35 <C ≤ 0.50 且 0.80 ≤P < 0.95 提示模型预测精度为2级（合格），进一步运用灰色模型预测2020—2024年中国人群职业伤害的死亡数和标化死亡率。结果 2000—2019年，我国职业伤害死亡情况呈下降趋势，死亡数从111557人下降到61780人，粗死亡率从8.58/10万下降到4.34/10万，标化死亡率从7.67/10万下降到3.65/10万，标化死亡率的AAPC为−4.0%（
P ＜0.05）；其中男性死亡数从87760人下降到49192人，标化死亡率从11.78/10万下降到5.68/10万，女性死亡数从23797人下降到12588人，标化死亡率从3.34/10万下降到1.55/10万，男性和女性标化死亡率AAPC分别为−3.9%和−4.1%。建立的死亡人数灰色预测模型（C =0.09，P =1）精度等级为1级，标化死亡率灰色预测模型（C =0.41，P =0.9）精度等级为2级，可以进行预测外推。预测模型显示，2020—2024年职业伤害死亡数人数依次为76039人、 73849人、71721人、69655人、67649人，标化死亡率依次为4.23/10万、4.07/万、3.92/10万、3.77/10万、3.62/10万。结论 2000—2019年我国职业伤害标化死亡率呈下降趋势，预测2020—2024年中国人群职业伤害标化死亡率仍呈下降趋势，但死亡人数仍相对较高，需继续加强防控。
Abstract:Background Occupational injury is one of the important causes of death among the working population and a worldwide hot topic, but there are few relevant studies on the trend and prediction of occupational injury attributable deaths in China.
Objective To analyze the trend of occupational injury attributable deaths in China from 2000 to 2019, predict the deaths of occupational injuries in China from 2020 to 2024 by contructing a gray GM(1,1) model, and provid a reference for surveillance and assessment of occupational injuries.
Methods Mortality, crude mortality rates, and standardized mortality rates of occupational injuries in China by year, sex, and age groups were calculated using data of the Global Burden of Disease (GBD) 2019 study. Join-point model was used to analyze possible trend of standardized mortality rate from 2000 to 2019, and calculate annual percentage change (APC) and average annual percentage change (AAPC). After a gray model GM(1,1) was established, the accuracy of the model was evaluated by posterior error ratio (
C ) and small error probability (P ) and rated as Level 1 (good,C ≤0.35 andP ≥0.95) or Level 2 (qualified, 0.35<C ≤0.50 and 0.80≤P <0.95). Then the gray model was further used to predict the number of deaths and standardized mortality rates of occupational injuries in China from 2020 to 2024.Results From 2000 to 2019, the deaths due to occupational injuries in China showed a downward trend, the number of deaths decreased from 111557 to 61780, the crude mortality rate decreased from 8.58/100000 to 4.34/100000, the standardized mortality rate decreased from 7.67/100000 to 3.65/100000, and the AAPC of standardized mortality rate was −4.0% (
P <0.05); the number of male deaths decreased from 87760 to 49192, and the male standardized mortality rate decreased from 11.78/100000 to 5.68/100000; the number of female deaths decreased from 23797 to 12588, and the female standardized mortality rate decreased from 3.34/100000 to 1.55/100000; the AAPCs of male and female standardized mortality rate were −3.9% and −4.1% respectively. The accuracy of the established gray model for deaths (C =0.09,P =1) was rated as Level 1, and that for standardized mortality rate (C =0.41,P =0.9) was rated as level 2, which allowed for prediction extrapolation. The model showed that from 2020 to 2024, the number of occupational injury attributable deaths would be 76039, 73849, 71721, 69655, and 67649, and the standardized mortality rate would be 4.23/100000, 4.07/100000, 3.92/100000, 3.77/100000, and 3.62/100000, respectively.Conclusion From 2000 to 2019, the standardized mortality rate of occupational injuries in China showed a downward trend, and it is predicted that the standardized mortality rate from 2020 to 2024 will still show a downward trend, but the number of deaths will remain high, so it is necessary to continue to strengthen prevention and control of occupational injuries.
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