Bang Ki Moon, Weissman David N, Pinheiro Germania A, Antao Vinicius C S, Wood John M, Syamlal Girija
National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia 26505, USA.
Am J Ind Med. 2006 Dec;49(12):997-1004. doi: 10.1002/ajim.20405.
There are few population-based studies addressing hypersensitivity pneumonitis (HP) in the United States. The National Institute for Occupational Safety and Health (NIOSH) has nationally comprehensive longitudinal mortality data that can contribute to a better understanding of the epidemiology of HP.
The National Center for Health Statistics multiple cause-of-death data were analyzed for the period 1980-2002. Annual death rate was age-adjusted to the 2000 U.S. standard population. Death rate time-trends were calculated using a linear regression model and geographic distribution of death rates were mapped by state and county. Proportionate mortality ratios (PMRs) by usual industry and occupation adjusted for age, sex, and race, were based on data from 26 states reporting industry and occupation during 1985-1999.
Overall age-adjusted death rates increased significantly (P < 0.0001) between 1980 and 2002, from 0.09 to 0.29 per million. Wisconsin had the highest rate at 1.04 per million. Among industries, PMR for HP was significantly high for agricultural production, livestock (PMR, 19.3; 95% CI, 14.0-25.9) and agricultural production, crops (PMR, 4.3; 95% CI, 3.0-6.0). Among occupations, PMR for HP was significantly elevated for farmers, except horticulture (PMR, 8.1; 95% CI, 6.4-10.2).
These findings indicate that agricultural industries are closely associated with HP mortality and preventive strategies are needed to protect workers in these industries.
在美国，针对过敏性肺炎（HP）开展的基于人群的研究较少。美国国家职业安全与健康研究所（NIOSH）拥有全国范围的综合纵向死亡率数据，有助于更好地了解HP的流行病学情况。
分析了1980 - 2002年期间美国国家卫生统计中心的多死因数据。将年死亡率按照2000年美国标准人口进行年龄调整。使用线性回归模型计算死亡率的时间趋势，并按州和县绘制死亡率的地理分布图。根据1985 - 1999年期间26个报告行业和职业的州的数据，计算经年龄、性别和种族调整后的按通常行业和职业划分的比例死亡率（PMR）。
1980年至2002年期间，总体年龄调整后的死亡率显著上升（P < 0.0001），从每百万0.09上升至每百万0.29。威斯康星州的死亡率最高，为每百万1.04。在各行业中，农业生产、畜牧业（PMR，19.3；95%可信区间，14.0 - 25.9）和农业生产、农作物（PMR，4.3；95%可信区间，3.0 - 6.0）的HP比例死亡率显著较高。在各职业中，除园艺业外，农民的HP比例死亡率显著升高（PMR，8.1；95%可信区间，6.4 - 10.2）。
这些发现表明，农业行业与HP死亡率密切相关，需要采取预防策略来保护这些行业的工人。
