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累积煤尘暴露与尘肺病风险之间的剂量反应关系分析

[Dose-response relationship analysis between cumulative coal dust exposure and pneumoconiosis risk].

作者信息

Zhang G, Wang X T

机构信息

National Center for Occupational Safety and Health, National Health Commission of the People's Republic of China, Beijing 102308, China.

出版信息

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2020 Jun 20;38(6):433-437. doi: 10.3760/cma.j.cn121094-20190510-00194.

Abstract

To explore the dose-response relationship between the cumulative coal dust exposure and the cumulative prevalence rate of pneumoconiosis among the coal miners, and to provide a basis for the revision of exposure concentration limits standards of the respirable coal dust and the total dust. A retrospective cohort study was conducted to study the coal miners in 11 state-owned coal mines from January to August 2013. 21000 coal miners in the 9 coal mines were adopted in the furthre study after the bias treatment.The occupational health records of coal miners from the date of coal production to the end of 2012 in each coal mine were collected. Based on the cumulative dust exposure group of the respirable coal dust and that of the total dust, both the miner's cumulative prevalence rate of pneumoconiosis were calculated by the life table method respectively. The dose-response relationship between the cumulative coal dust exposure and pneumoconiosis risk was established (subject to logistic regression model) . Assuming the cumulative prevalence rate is not higher than 1% after 30 or 25 years of exposure to coal dust and the safety factor is 1.2, the exposure concentration limits of the respirable coal dust and the total dust were calculated by the logistic regression equations with one-sided interval statistical control. There were 3224 pneumoconiosis patients (15.35%) altogether. The dose-response relationship between the cumulative respirable coal dust exposure and the cumulative prevalence rate of pneumoconiosis is a logistic regression equation logistic(r)=5.649lgDr-16.573 ((2)=0.925) , and the legistic regression equation for the total dust, is logistic(t)=5.712lgDt-18.767 ((2)=0.897) . When the prevalence rate of pneumoconiosis after 30 years of exposure to coal dust is not higher than 1%, the exposure concentration limits of the respirable coal dust and that of total dust contact are 2.2 mg/m(3) and 4.8 mg/m(3), which are similar to those of national occupational health standards of China (2.5 mg/m(3) and 4 mg/m(3)) . When the prevalence rate of pneumoconiosis after 25 years of exposure to coal dust is not higher than 1%, the exposure concentration limits of the respirable coal dust is 2.7 mg/m(3). It is recommended to strictly implement the current national occupational health standard and abolish the relevant safety production industry standard.

摘要

为探讨煤矿工人累积煤尘接触量与尘肺病累积患病率之间的剂量-反应关系,为修订可吸入煤尘和总粉尘接触浓度限值标准提供依据。采用回顾性队列研究方法,对2013年1月至8月期间11家国有煤矿的煤矿工人进行研究。对9家煤矿的21000名煤矿工人进行偏倚处理后纳入进一步研究。收集各煤矿从煤炭生产之日至2012年底煤矿工人的职业健康记录。根据可吸入煤尘和总粉尘的累积接触组,分别采用寿命表法计算煤矿工人尘肺病的累积患病率。建立煤尘累积接触量与尘肺病发病风险的剂量-反应关系(以logistic回归模型为准)。假设煤尘接触30年或25年后累积患病率不高于1%,安全系数为1.2,采用单侧区间统计控制的logistic回归方程计算可吸入煤尘和总粉尘的接触浓度限值。共有3224例尘肺病患者(15.35%)。可吸入煤尘累积接触量与尘肺病累积患病率的剂量-反应关系为logistic回归方程logistic(r)=5.649lgDr - 16.573 ((2)=0.925),总粉尘的logistic回归方程为logistic(t)=5.712lgDt - 18.767 ((2)=0.897)。当煤尘接触30年后尘肺病患病率不高于1%时,可吸入煤尘和总粉尘接触的浓度限值分别为2.2mg/m(3)和4.8mg/m(3),与我国国家职业卫生标准(2.5mg/m(3)和4mg/m(3))相近。当煤尘接触25年后尘肺病患病率不高于1%时,可吸入煤尘的接触浓度限值为2.7mg/m(3)。建议严格执行现行国家职业卫生标准,废止相关安全生产行业标准。

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