[某铁矿粉尘接触工人尘肺病特征及影响因素研究]

[The study of the characteristics and influencing factors of pneumoconiosis among workers exposed to dusts in an iron mine].

作者信息

Guan Hong-Yu, Zhang Hao, Su Liang-Ping, Liu Yue-Wei, Weng Shao-Fan, Chen Wei-Hong

机构信息

MOE Key Lab of Environmental and Health, School of Public Health, Tongli Medical College, Huazhong University of Science & Technology, Wuhan 430030, China

出版信息

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2012 Jan;30(1):36-40.

PMID:22730686

Abstract

OBJECTIVE

To analyze the prevalence characteristics and influence factors of pneumoconiosis of workers exposed to dusts in an iron mine, to provide the base of preventive measures for pneumoconiosis of iron mine.

METHODS

The subjects of cohort study were all workers exposed to dusts for at least one year registered in an iron mine during 1960 to 1974, and followed-up to the end in 2003. The cases with pneumoconiosis were diagnosed by the local diagnosis group of pneumoconiosis, according to the national diagnostic criteria of pneumoconiosis. The risk factors were analyzed with Cox risk model.

RESULTS

A total of 3647 miners were included in the cohort study and were followed up by 132 574.4 person years. There were 316 cases with pneumoconiosis, and the incidence of pneumoconiosis for a year was 0.24 per thousand. There were 274 cases (86.7%) with pneumoconiosis in workers exposed to dusts before 1960, the incidence of pneumoconiosis for a year was 0.40 per thousand, which was significantly higher than that (0.07 per thousand) of workers exposed to dusts after 1960. The average latency of pneumoconiosis was 26.0 +/- 7.3 years. The average durations of upgrade from stage 0(+) to I , I to II and II to III were 5.3 +/- 3.2, 6.6 +/- 5.2 and 11.3 +/- 5.0 years, respectively. However, 164 cases with pneumoconiosis were diagnosed after ceasing exposure to dusts for mean 8.3 years. The risk of pneumoconiosis in iron miners increased with exposure doses, and there was an obvious dose-effect relationship. The average cumulative exposure dose of cases with pneumoconiosis was 173.7 +/- 91.6 mg/m3 x y, which was significantly higher than that (112.1 +/- 64.8 mg/m3 x y) of workers without pneumoconiosis. Also the tuberculosis (HR = 5.9, P < 0.001) and smoking (HR = 1.7, P < 0.01) were the main risk factors.

CONCLUSION

There was an obvious dose-effect relationship between the cumulative exposure dose and pneumoconiosis incidence. Tuberculosis and smoking were the main risk factors influencing the pneumoconiosis incidence.

摘要

目的

分析某铁矿粉尘作业工人尘肺病的患病特征及影响因素，为铁矿尘肺病防治措施提供依据。

方法

队列研究对象为1960年至1974年期间在某铁矿登记的所有累计接尘工龄至少1年的工人，随访至2003年底。尘肺病病例由当地尘肺病诊断组依据国家尘肺病诊断标准进行诊断。采用Cox风险模型分析危险因素。

结果

队列研究共纳入3647名矿工，随访132574.4人年。共发现尘肺病病例316例，年发病率为0.24‰。1960年前接尘工人中有274例（86.7%）患尘肺病，年发病率为0.40‰，显著高于1960年后接尘工人（0.07‰）。尘肺病平均发病潜伏期为26.0±7.3年。从0（+）期进展到Ⅰ期、Ⅰ期进展到Ⅱ期、Ⅱ期进展到Ⅲ期的平均病程分别为5.3±3.2年、6.6±5.2年和11.3±5.0年。然而，有164例尘肺病病例是在停止接尘平均8.3年后被诊断出来的。铁矿工人尘肺病发病风险随接尘剂量增加而升高，存在明显的剂量 - 效应关系。尘肺病病例的平均累计接尘剂量为173.7±91.6mg/m³·y，显著高于未患尘肺病工人（112.1±64.8mg/m³·y）。此外，肺结核（HR = 5.9，P < 0.001）和吸烟（HR = 1.7，P < 0.01）是主要危险因素。