Liu Weiwei, Jiang Chaoqiang, Lam Tai Hing, Zhang Weisen, Hedley Hosy A, Zhu Changqi, He Jianmin, Cao Min
Guangzhou Occupational Diseases Prevention & Treatment Center, Guangzhou 510620, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2002 Aug;20(4):289-92.
To study the main causes of death in workers from different industries in Guangzhou.
The industrial systems in Guangzhou were classified into six categories according to the Chinese Public Health Inspection Statistical Report. Baseline data on 79,547 workers, age > or = 35, were retrieved from individual health records under the Guangzhou Occupational Health Surveillance Record System established in 1989-1992. In this prospective cohort study, the workers' vital status and causes of death were followed up until 31 December 1998. Using SPSS 10.0, crude death rates were calculated and relative risks(RR) (95% CI) were estimated using Cox proportional-hazard models.
(1) Among 79,547 workers were 49,355 men and 30,192 women, with mean age of (43.8 +/- 6.5) years, and 64% were aged 35-44. The mean age difference of workers in different industries was +/- 1 year. At baseline, 41% had been exposed to occupational hazards. Exposure was most prevalent in petroleum chemical industry(53.9%), followed by metallurgical industry, and the lowest exposure was in mechanical industry (30.2%). (2) The mean follow-up period was (8.0 +/- 1.3) years with 633,510 person-years. 1,577 workers had died with a total death rate of 248.9 per 100,000 person-years. The death rate in rubber industry was the highest, followed by metallurgical and petroleum chemical industries. Malignant neoplasms, vascular and respiratory diseases were most common, constituting 80.3% of all causes of death. (3) For all causes of death and the three main categories, the top three crude death rates were observed in rubber and petroleum chemical industries, and in the metallurgical industry except for vascular causes. The rubber industry had the highest crude death rate for all and vascular causes, and the metallurgical industry for malignant neoplasms and respiratory causes. (4) With the light industry as a reference (RR = 1.0), the metallurgical industry had the highest adjusted relative risks (RR) (95% CI) of 1.62(1.20-2.18) and 7.42(3.38-16.31) for malignant neoplasms and respiratory causes, respectively. The rubber industry had the highest RR of 1.69(1.40-2.04) for all causes. A significant RR of 2.03(1.43-2.88) for vascular causes was observed only in the rubber industry.
The main causes of death varied from industry. Malignant neoplasms and respiratory diseases were the leading causes in metallurgical and petroleum chemical industries. In rubber industry, vascular and respiratory causes were most common. Preventive measures for disease control should be tailor-made for each industry.
研究广州不同行业工人的主要死亡原因。
根据《中国公共卫生监督统计报告》，将广州的工业系统分为六类。从1989 - 1992年建立的广州职业健康监测记录系统中的个人健康记录中检索出79547名年龄≥35岁工人的基线数据。在这项前瞻性队列研究中，对工人的生命状况和死亡原因进行随访至1998年12月31日。使用SPSS 10.0计算粗死亡率，并使用Cox比例风险模型估计相对风险（RR）（95%可信区间）。
（1）79547名工人中，男性49355名，女性30192名，平均年龄（43.8±6.5）岁，64%的工人年龄在35 - 44岁。不同行业工人的平均年龄差异为±1岁。在基线时，41%的工人曾接触职业危害。接触职业危害在石油化工行业最为普遍（53.9%），其次是冶金行业，机械行业接触率最低（30.2%）。（2）平均随访期为（8.0±1.3）年，随访人年数为633510人年。1577名工人死亡，总死亡率为每10万人年248.9例。橡胶行业的死亡率最高，其次是冶金和石油化工行业。恶性肿瘤、血管疾病和呼吸系统疾病最为常见，占所有死亡原因的80.3%。（3）对于所有死亡原因和三大主要类别，橡胶和石油化工行业以及冶金行业（血管疾病原因除外）的粗死亡率位列前三。橡胶行业所有原因和血管疾病原因的粗死亡率最高，冶金行业恶性肿瘤和呼吸系统疾病原因的粗死亡率最高。（4）以轻工业为参照（RR = 1.0），冶金行业恶性肿瘤和呼吸系统疾病原因的调整相对风险（RR）（95%可信区间）最高，分别为1.62（1.20 - 2.18）和7.42（3.38 - 16.31）。橡胶行业所有原因的RR最高，为1.69（1.40 - 2.04）。仅在橡胶行业观察到血管疾病原因有显著的RR值2.03（1.43 - 2.88）。
不同行业的主要死亡原因各不相同。恶性肿瘤和呼吸系统疾病是冶金和石油化工行业的主要死因。在橡胶行业，血管疾病和呼吸系统疾病最为常见。疾病控制的预防措施应针对每个行业量身定制。
