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将全球疾病负担知识转化为预防行动。

Moving knowledge of global burden into preventive action.

作者信息

Eijkemans Gerry J M, Takala Jukka

出版信息

Am J Ind Med. 2005 Dec;48(6):395-9. doi: 10.1002/ajim.20227.

Abstract

BACKGROUND

Estimation of the global burden of disease and injury due to selected occupational factors is a topic of interest to policy makers, governments, and international bodies. The World Health Organization (WHO) has implemented a Comparative Risk Assessment (CRA) to estimate risk to exposed populations.

METHODS

Estimates of the risk factor-burden relationships by age, sex, and WHO subregion were generated. Risk measurements (relative risks and mortality rates) for the health outcomes were determined primarily from studies published in peer review journals. The resulting burden was described as the attributable fraction of disease or injury, using both mortality and disability-adjusted life years (DALYs).

RESULTS

The papers in this issue include discussions of worldwide mortality and morbidity from lung cancer, leukemia, and malignant mesothelioma arising from occupational exposures; mortality and morbidity from asthma, COPD, and pneumoconiosis; the global burden of low back pain; exposure to contaminated sharps injuries among health care workers; noise-induced hearing loss; and occupational injuries. Three papers focus on economic issues: estimation of net-costs for prevention of occupational low back pain; cost effectiveness of occupational health interventions; and the cost effectiveness of interventions in the prevention of silicosis.

CONCLUSIONS

The magnitude of the occupational health burden in the world is overwhelming, and the causes and mechanisms are multiple and complex. Commitment from all stakeholders is imperative to translate economic progress into sustainable human development and well-being.

摘要

背景

评估特定职业因素导致的全球疾病和伤害负担是政策制定者、政府及国际机构关注的话题。世界卫生组织(WHO)已实施比较风险评估(CRA)来估计暴露人群面临的风险。

方法

生成了按年龄、性别和WHO次区域划分的风险因素与负担关系的估计值。健康结局的风险测量指标(相对风险和死亡率)主要依据同行评审期刊上发表的研究确定。使用死亡率和伤残调整生命年(DALYs)将由此产生的负担描述为疾病或伤害的归因分数。

结果

本期论文包括对职业暴露导致的肺癌、白血病和恶性间皮瘤的全球死亡率和发病率的讨论;哮喘、慢性阻塞性肺疾病(COPD)和尘肺病的死亡率和发病率;下背痛的全球负担;医护人员接触受污染锐器伤害的情况;噪声性听力损失;以及职业伤害。三篇论文聚焦经济问题:预防职业性下背痛的净成本估计;职业健康干预措施的成本效益;以及预防矽肺病干预措施的成本效益。

结论

全球职业健康负担的规模巨大,其成因和机制复杂多样。所有利益相关者必须做出承诺,将经济进步转化为可持续的人类发展和福祉。

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