Gan W Q, Demers P A, McLeod C B, Koehoorn M
School of Environmental Health, The University of British Columbia, Vancouver, BC, V6T 1Z3, Canada.
Occup Environ Med. 2009 Nov;66(11):766-71. doi: 10.1136/oem.2008.045211. Epub 2009 Jun 14.
To investigate the use of multiple health data sources for population-based asbestosis surveillance in British Columbia, Canada.
Provincial health insurance registration records, workers' compensation records, hospitalisation records, and outpatient medical service records were linked using individual-specific study identifiers. The study population was restricted to individuals > or = 15 years of age living in the province during 1992-2004.
1170 new asbestosis cases were identified from 1992 to 2004 for an overall incidence rate of 2.82 (men: 5.48, women: 0.23) per 100,000 population; 96% of cases were male and average (SD) age was 69 (10) years. Although the annual number of new cases increased by 30% during the surveillance period (beta = 2.36, p = 0.019), the observed increase in annual incidence rates was not significant (beta = 0.02, p = 0.398). Workers' compensation, hospitalisation and outpatient databases identified 23%, 48% and 50% of the total new cases, respectively. Of the new cases, 82% were identified through single data sources, 10% were only recorded in the workers' compensation records, and 36% only in each of the hospitalisation and outpatient records. 84% of hospitalisation cases and 83% of outpatient cases were not included in the workers' compensation records. The three data sources showed different temporal trends in the annual number of new cases and annual incidence rates.
Single data sources were not sufficient to identify all new cases, thus leading to serious underestimations of the true burden of asbestosis. Integrating multiple health data sources could provide a more complete picture in population-based surveillance of asbestosis and other occupational diseases.
调查在加拿大不列颠哥伦比亚省基于人群的石棉沉着病监测中多种健康数据来源的使用情况。
使用个体特定的研究标识符将省级医疗保险登记记录、工人赔偿记录、住院记录和门诊医疗服务记录相链接。研究人群仅限于1992 - 2004年期间居住在该省且年龄≥15岁的个体。
1992年至2004年共识别出1170例新的石棉沉着病病例，总体发病率为每10万人2.82例（男性：5.48例，女性：0.23例）；96%的病例为男性，平均（标准差）年龄为69（10）岁。尽管在监测期间新病例的年度数量增加了30%（β = 2.36，p = 0.019），但观察到的年度发病率增加并不显著（β = 0.02，p = 0.398）。工人赔偿、住院和门诊数据库分别识别出23%、48%和50%的新病例总数。在新病例中，82%通过单一数据源识别，10%仅记录在工人赔偿记录中，36%仅记录在住院和门诊记录中。84%的住院病例和83%的门诊病例未包含在工人赔偿记录中。这三个数据源在新病例年度数量和年度发病率方面呈现出不同的时间趋势。
单一数据源不足以识别所有新病例，从而导致石棉沉着病真实负担的严重低估。整合多种健康数据来源可为基于人群的石棉沉着病及其他职业病监测提供更全面的情况。
