Tüchsen F, Hannerz H, Roepstorff C, Krause N
Department of Surveillance and Epidemiology, National Institute of Occupational Health, Copenhagen Ø, Denmarkk.
Occup Environ Med. 2006 Jul;63(7):456-60. doi: 10.1136/oem.2005.025718. Epub 2006 May 30.
(1) To estimate the relative risk of stroke among various groups of professional drivers; (2) to determine if any excess risk should be attributed to infarction or haemorrhage; (3) to estimate the relative risk ratio for stroke among professional drivers living in Greater Copenhagen compared to those living outside the metropolis.
A cohort of 6285 bus drivers, 4204 car, taxi, and van drivers, and 25,879 heavy truck and lorry drivers were followed up for hospital admission due to stroke and sub-diagnoses in the period 1994-2003. Using hospital admission for all economically active men as the standard, the standardised hospitalisation ratios (SHR) were calculated, taking age and county into consideration.
There was a high SHR for stroke among all groups of professional drivers (SHR = 132; 95% CI 121-141). Among car, taxi, and van drivers the SHR was 157 (95% CI 132-189), among bus drivers it was 139 (95% CI 119-163), and among heavy truck and lorry drivers it was 124 (95% CI 113-136). The excess risk for all groups of professional drivers was highest for cerebrovascular infarction (SHR = 139; 95% CI 124-155) and lowest for non-traumatic intracranial haemorrhage (SHR = 113; 95% CI 96-133). The excess risks for all groups were significantly higher for cerebrovascular infarction than for non-traumatic intracranial haemorrhage (relative risk ratio (RRR) 1.23; 95% CI 1.01-1.51). The RRR of stroke among drivers in the metropolitan area compared to rural areas was 1.13 (95% CI 0.94-1.36). The RRR for stroke among car, taxi, and van drivers compared to drivers of heavy trucks and of lorries was 1.28 (95% CI 1.03-1.57).
All groups of professional drivers are at increased risk of stroke. The excess risk is more due to cerebral infarctions than to non-traumatic intracranial haemorrhage. The risk of stroke is higher among drivers carrying passengers than among drivers carrying goods.
(1)估计各类职业司机中风的相对风险;(2)确定是否有任何额外风险应归因于梗死或出血;(3)估计居住在大哥本哈根地区的职业司机与居住在该大都市以外地区的职业司机相比中风的相对风险比。
对6285名公交车司机、4204名汽车、出租车和货车司机以及25879名重型卡车和货车司机组成的队列进行随访,观察他们在1994年至2003年期间因中风及相关亚诊断而住院的情况。以所有经济活跃男性的住院情况作为标准,计算标准化住院率(SHR),同时考虑年龄和所在县。
所有职业司机组中风的标准化住院率都很高(SHR = 132;95%可信区间121 - 141)。在汽车、出租车和货车司机中,标准化住院率为157(95%可信区间132 - 189),公交车司机中为139(95%可信区间119 - 163),重型卡车和货车司机中为124(95%可信区间113 - 136)。所有职业司机组的额外风险中,脑血管梗死最高(SHR = 139;95%可信区间124 - 155),非创伤性颅内出血最低(SHR = 113;95%可信区间96 - 133)。所有组脑血管梗死的额外风险显著高于非创伤性颅内出血(相对风险比(RRR)1.23;95%可信区间1.01 - 1.51)。与农村地区相比,大都市地区司机中风的RRR为1.13(95%可信区间0.94 - 1.36)。与重型卡车和货车司机相比,汽车、出租车和货车司机中风的RRR为1.28(95%可信区间1.03 - 1.57)。
所有职业司机组中风风险均增加。额外风险更多是由于脑梗死而非非创伤性颅内出血。搭载乘客的司机中风风险高于运送货物的司机。