孟诗迪, 徐婷, 莫有桦, 朱晓俊. 1990—2019年中国人群归因于职业伤害的死亡疾病负担分析[J]. 环境与职业医学, 2023, 40(10): 1121-1127. DOI: 10.11836/JEOM23212
引用本文: 孟诗迪, 徐婷, 莫有桦, 朱晓俊. 1990—2019年中国人群归因于职业伤害的死亡疾病负担分析[J]. 环境与职业医学, 2023, 40(10): 1121-1127. DOI: 10.11836/JEOM23212
MENG Shidi, XU Ting, MO Youhua, ZHU Xiaojun. Disease burden of deaths attributable to occupational injuries in China from 1990 to 2019[J]. Journal of Environmental and Occupational Medicine, 2023, 40(10): 1121-1127. DOI: 10.11836/JEOM23212
Citation: MENG Shidi, XU Ting, MO Youhua, ZHU Xiaojun. Disease burden of deaths attributable to occupational injuries in China from 1990 to 2019[J]. Journal of Environmental and Occupational Medicine, 2023, 40(10): 1121-1127. DOI: 10.11836/JEOM23212

1990—2019年中国人群归因于职业伤害的死亡疾病负担分析

Disease burden of deaths attributable to occupational injuries in China from 1990 to 2019

  • 摘要:
    背景 职业伤害是导致职业人群死亡或伤残的重要原因之一。世界卫生组织和国际劳工组织的研究结果显示,职业伤害是导致全球2016年伤残调整寿命损失年最多的职业危险因素。
    目的 分析1990—2019年中国人群归因于职业伤害的死亡疾病负担水平及其变化趋势,为进一步构建职业伤害监测体系提供参考依据。
    方法 应用全球疾病负担2019年(GBD 2019)研究结果和数据,本研究衡量职业伤害在不同年份、性别、年龄组的归因疾病负担,指标包括死亡数、寿命损失年数(YLL)、死亡率和YLL率,采用GBD 2019世界标准人口年龄结构计算标化死亡率和标化YLL率,以年均变化率(ARC)反映指标随时间的变化,结果以点估计值及其95%不确定区间(95%UI)表示。
    结果 2019年,中国女性归因于职业伤害的死亡数占全球女性的比例占33.16%,YLL占31.88%,男性分别为17.98%、17.09%。与1990年相比,2019年中国人群归因于职业伤害的标化死亡率和标化YLL率降低,其中全人群标化死亡率的ARC为−0.68(95%UI:−0.78~−0.51),男性为−0.68(95%UI:−0.80~−0.47),女性为−0.68(95%UI:−0.82~−0.46);全人群标化YLL率的ARC为−0.68(95%UI:−0.78~−0.51),男性为−0.67(95%UI:−0.80~−0.48),女性为−0.68(95%UI:−0.81~−0.44)。1990—2010年职业伤害各死因的标化死亡率和标化YLL率的ARC绝对值大于2010—2019年的ARC。1990—2010年道路伤害、坠落和淹溺标化YLL率的ARC分别是−0.55(95%UI:−0.67~−0.36)、−0.57(95%UI:−0.73~−0.38)、−0.77(95%UI:−0.84~−0.63),2010—2019年的ARC分别是−0.27(95%UI:−0.46~−0.02)、−0.07(95%UI:−0.34~0.26)、−0.06(95%UI:−0.32~0.29)。2019年,中国男性归因于职业伤害的标化死亡率为5.68/10万(95%UI:3.89/10万~8.23/10万),标化YLL率为286.27/10万(95%UI:197.58/10万~411.38/10万);中国女性职业伤害的标化死亡率为1.55/10万(95%UI:0.99/10万~2.36/10万),标化YLL率为80.85/10万(95%UI:51.61/10万~122.07/10万)。
    结论 1990—2019年中国归因于职业伤害的死亡疾病负担下降,但近十年下降速度减慢。中国女性占全球女性归因于职业伤害的死亡疾病负担的比例仍较高,中国男性归因于职业伤害的死亡疾病负担高于女性。

     

    Abstract:
    Background Occupational injuries are one of the leading causes of death or disability in occupational populations. According to the World Health Organization and the International Labour Organization, occupational injuries were the occupational contributor responsible for the largest loss of disability-adjusted life years (DALY) globally in 2016.
    Objective To analyze the burden of deaths attributed to occupational injuries in Chinese population from 1990 to 2019, and provide a reference for further construction of occupational injury surveillance system.
    Methods Using the results and data of the Global Burden of Disease 2019 (GBD 2019), this study estimated the burden of deaths attributable to occupational injuries by year, sex, and age groups, and the indicators included deaths, years of life lost (YLL), mortality, and YLL rates. Age-standardized rates of deaths and YLL rates were calculated using a world standard population presented by GBD 2019. Annualized rate of change (ARC) was use to evaluate changes in the indicators over time. All results were presented as point estimates with 95% uncertainty intervals (95%UI).
    Results In 2019, the deaths attributable to occupational injuries among women in China accounted for 33.16% of that among world's women, their YLL accounted for 31.88%, and the two indicators among Chinese men accounted for 17.98% and 17.09%, respectively. Compared with 1990, the standardized mortality rate and the standardized YLL rate attributable to occupational injuries in China in 2019 decreased, among which the ARCs of the standardized mortality rate in the whole population, men, and women were −0.68 (95%UI: −0.78, −0.51), −0.68 (95%UI: −0.80, −0.47), and −0.68 (95%UI: −0.82, −0.46), respectively. The ARCs of the standardized YLL rate in the whole population, men, and women were −0.68 (95%UI: −0.78, −0.51), −0.67 (95%UI: −0.80, −0.48), and −0.68 (95%UI: −0.81, −0.44), respectively. Absolute values of the ARCs of the standardized mortality rate and the standardized YLL rate attributable to occupational injuries from 1990 to 2010 were higher than those from 2010 to 2019. The ARCs of the standardized YLL rate for road injuries, falls, and drowning from 1990 to 2010 were −0.55 (95%UI: −0.67, −0.36), −0.57 (95%UI: −0.73, −0.38), −0.77 (95%UI: −0.84, −0.63), and the ARCs from 2010 to 2019 were −0.27 (95%UI: −0.46, −0.02), −0.07 (95%UI: −0.34, −0.26), −0.06 (95%UI: −0.32, −0.29), respectively. In 2019, the standardized mortality rate attributable to occupational injuries among Chinese men was 5.68/100000 (95%UI: 3.89/100000, 8.23/100000), and the standardized YLL rate was 286.27/100000 (95%UI: 197.58/100000, 411.38/100000); the standardized mortality rate attributable to occupational injuries among Chinese women was 1.55/100000 (95%UI: 0.99/100000, 2.36/100000), and the standardized YLL rate was 80.85/100000 (95%UI: 51.61/100000, 122.07/100000).
    Conclusion From 1990 to 2019, the burden of deaths attributable to occupational injuries in China is declined, but the rate of decline is slowed down in the last decade. The burden of deaths attributable to occupational injuries among women in China still accounts for a high proportion of the global burden among women. The burden of deaths attributable to occupational injuries among Chinese men is higher than that among Chinese women.

     

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