National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa.
Environ Health Perspect. 2010 Mar;118(3):421-6. doi: 10.1289/ehp.0900918.
Eliminating silicosis is a priority of the International Labour Organization and the World Health Organization. Prevalence is particularly high in developing countries.
We describe trends in silicosis among South African gold miners who had had an autopsy between 1975 and 2007 and quantify the contributions of age at autopsy and employment duration to these trends.
South African miners and ex-miners are eligible for autopsy examination for occupational lung disease, regardless of the clinical cause of death, and the families of deceased mine workers may receive compensation from the government of South Africa. Miners who died from external causes and who had been employed in the gold mines for > 1 year were stratified by population group because of differences in exposure, patterns of employment, and autopsy referral patterns. We extracted data from PATHAUT (Pathology Automation System) and used Stata 10 to estimate trends in relative proportions of silicosis that were standardized for age and employment duration.
The crude proportion of silicosis for white miners was six times that of black miners in 1975. By 2007, it was 1.5 times higher for black miners. The proportion of miners with silicosis increased from 0.03 to 0.32 for black miners and from 0.18 to 0.22 for white miners. The increase can be explained by increasing age and employment duration for white miners. For black miners, it can be only partly explained by these two factors.
As miners continue to age and work for longer periods, the burden of silicosis will continue to rise. South Africa is committed to global efforts to eliminate silicosis by 2030. The autopsy database allows for disease surveillance, which is necessary to monitor the success of this initiative.
消除矽肺是国际劳工组织和世界卫生组织的重点工作。在发展中国家，矽肺的发病率尤其高。
我们描述了南非金矿矿工尸检中矽肺的流行趋势，并量化了尸检年龄和工龄对这些趋势的影响。
南非矿工和前矿工有资格接受职业性肺部疾病的尸检检查，无论其临床死因如何，且已故矿工的家属可能会从南非政府获得赔偿。由于接触情况、就业模式和尸检转诊模式的不同，死于外部原因且在金矿工作超过 1 年的矿工按人群进行分层。我们从 PATHAUT（病理学自动化系统）中提取数据，并使用 Stata 10 估计矽肺相对比例的趋势，该趋势已根据年龄和工龄进行标准化。
1975 年，白人矿工的矽肺粗发病率是黑人矿工的 6 倍。到 2007 年，黑人矿工的发病率高出 1.5 倍。矽肺矿工的比例从黑人矿工的 0.03 增加到 0.32，从白人矿工的 0.18 增加到 0.22。白人矿工发病率的增加可以用年龄和工龄的增加来解释。对于黑人矿工来说，这两个因素只能部分解释。
随着矿工年龄的增长和工作时间的延长，矽肺的负担将继续增加。南非致力于到 2030 年消除矽肺的全球努力。尸检数据库允许进行疾病监测，这对于监测这一倡议的成功至关重要。
