2008—2017年淮北矿业集团新发尘肺病流行病学特征
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摘要
目的为了解2008—2017年淮北市矿业集团煤矿企业新发尘肺病发病特征和流行趋势,为淮北市尘肺病防治提供科学依据。方法根据尘肺病报告系统中尘肺病例卡数据,导出2008—2017年新发尘肺病资料,从煤矿通风科和职业病防治院检测评价中心获得现场检测粉尘数据,录入Excel整理数据,SPSS 17.0统计分析。结果 2008—2017年间新发病例894例,以煤工尘肺壹期580例(64.9%)为主;死亡35例(3.9%),壹期结核19例,贰期结核1例,叁期结核2例,合并结核占新发病例构成比2.5%。总体发病呈先上升后下降趋势,2010、2012年发病出现高峰;不同煤矿工种尘肺病分布差异有统计学意义(P<0.01),采煤工、掘进工接尘工龄差异无统计学意义(P>0.05),其他各组间差异均有统计学意义(均P<0.01);发病潜伏期煤矿混合工>掘进工>采煤工;煤矿混合工发病296例(33.1%),比重有所上升;不同接尘年代接尘工龄、发病年龄、发病潜伏期差异均有统计学意义(均P<0.01)。随着年代推移、接尘工龄缩短,发病潜伏期提前,发病年龄趋向年轻化。死因首位为肺癌/气管癌(11例),其次是肺心病(8例)和消化道癌(4例),死于单纯尘肺病仅3例;现场调查数据显示不同采样点,总粉尘浓度和呼吸性粉尘浓度差异均有统计学意义(均P<0.01)。结论 2008—2017年淮北矿业集团尘肺发病率呈下降趋势,作业场所粉尘浓度得到有效控制,但粉尘污染依旧严重。
[Objective]To understand the characteristics situation and epidemic regularity of pneumoconiosis incidents in Mining Group from 2008 to 2017,and to provide evidence for prevention and control work.[Methods]Data of pneumoconiosis case card from 2008 to 2017 were retrieved from Pneumoconiosis reporting system of Mining Group. Dust data of field detection from the Coal Mine Ventilation Section and the Testing and Evaluation Center,and also used Excel to collate the data,SPSS17.0 to statistical analysis.[Results]894 cases of new cases occurred in 2008-2017,mainly 580 cases(64.9%)of coal workers' pneumoconiosis in stage Ⅰ,35 cases(3.9%)died,19 cases of tuberculosis in stage Ⅰ,1 case of tuberculosis in stage Ⅱ,2 cases of tuberculosis in stage Ⅲ. The combined tuberculosis rate was 2.46%. The overall incidence showed a downward trend,with a peak in 2010 and2012.There were significant differences in the distribution of pneumoconiosis among different types of work in coal mine(P<0.01).There was no significant difference in the working years of coal mining and tunneling(P>0.05),but significant differences among other groups(all P<0.01).The incidence latency of tunneling> mixture miners >coal mining. There were 296 cases(33.1%) of mixture miners,and the proportion had increased. The difference of dusting age,age of onset and incidence of incubation were statistically significant(all P<0.01). With the passage of the age,the dust length of service was shortened,latency was advanced,and age at diagnosis tended to be younger. The leading cause of death was lung cancer/tracheal cancer(11 cases),followed by pulmonary heart disease(8 cases) and digestive tract cancer(4 cases),and only 3 columns of simple pneumoconiosis. The field survey data showed that there were significant differences in total dust concentration and respiratory dust concentration at different sampling points(all P<0.01).[Conclusion]The pneumoconiosis mobidity in Mining Group of the Huaibei from 2008 to 2017 has been declining. The dust concentration in the workplace has been effectively controlled,but the dust pollution is still serious. Technological reform should still be strengthened.,Prevention and treatment of pneumoconiosis cannot be taken lightly.
[Objective]To understand the characteristics situation and epidemic regularity of pneumoconiosis incidents in Mining Group from 2008 to 2017,and to provide evidence for prevention and control work.[Methods]Data of pneumoconiosis case card from 2008 to 2017 were retrieved from Pneumoconiosis reporting system of Mining Group. Dust data of field detection from the Coal Mine Ventilation Section and the Testing and Evaluation Center,and also used Excel to collate the data,SPSS17.0 to statistical analysis.[Results]894 cases of new cases occurred in 2008-2017,mainly 580 cases(64.9%)of coal workers' pneumoconiosis in stage Ⅰ,35 cases(3.9%)died,19 cases of tuberculosis in stage Ⅰ,1 case of tuberculosis in stage Ⅱ,2 cases of tuberculosis in stage Ⅲ. The combined tuberculosis rate was 2.46%. The overall incidence showed a downward trend,with a peak in 2010 and2012.There were significant differences in the distribution of pneumoconiosis among different types of work in coal mine(P<0.01).There was no significant difference in the working years of coal mining and tunneling(P>0.05),but significant differences among other groups(all P<0.01).The incidence latency of tunneling> mixture miners >coal mining. There were 296 cases(33.1%) of mixture miners,and the proportion had increased. The difference of dusting age,age of onset and incidence of incubation were statistically significant(all P<0.01). With the passage of the age,the dust length of service was shortened,latency was advanced,and age at diagnosis tended to be younger. The leading cause of death was lung cancer/tracheal cancer(11 cases),followed by pulmonary heart disease(8 cases) and digestive tract cancer(4 cases),and only 3 columns of simple pneumoconiosis. The field survey data showed that there were significant differences in total dust concentration and respiratory dust concentration at different sampling points(all P<0.01).[Conclusion]The pneumoconiosis mobidity in Mining Group of the Huaibei from 2008 to 2017 has been declining. The dust concentration in the workplace has been effectively controlled,but the dust pollution is still serious. Technological reform should still be strengthened.,Prevention and treatment of pneumoconiosis cannot be taken lightly.
引文
[1]孙贵范.职业卫生与职业医学[M].7版.北京:人民卫生出版社,2012:173-179.
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[13]查晚生,陈葆春,胡琼,等.安徽省2012—2016年职业病发病情况分析[J].安徽预防医学杂志,2018,24(1):63-66.
[14]王一丹,唐浩,陈卉,等.尘肺病合并肺结核发生情况的meta分析[J].职业与健康,2015,31(1):16-19.
[15]王黎,祝江伟,赵宁,等.某大型煤炭企业2007-2015年新发尘肺病特点分析[J].中国职业医学,2016,43(5):630-632.
[16]崔风涛,许洁,丁新平,等.1963—2012年淮北矿业集团尘肺病发病情况分析[J].职业与健康,2014,30(24):3519-3521.
[17]肖淑玉,齐慧生,张群,等.山西某煤矿集团不同工种尘肺患者发病特征[J].环境与职业医学,2016,33(7):661-664.
[18]王玉辉,李宝平,孙治平,等.职业性煤工尘肺并发症的相关研究[J].职业与健康,2018,34(19):2622-2627,2631.
[19]中华人民共和国国家卫生健康委员会.职业健康监护技术规范:GBZ 188-2014[S].北京:人民卫生出版社,2014:1-101.
[20]黄占有,唐学平,刘月红.泉州某煤矿2009—2014年尘肺发病分析[J].海峡预防医学杂志,2016,22(2):48-50.
[21]李朋起,韩志伟,吴辉,等.“十二五”期间河南省新发尘肺病流行病学调查[J].河南预防医学杂志,2018,29(8):590-593.
[22]孙伟,耿敬东,谢峰,等.2006—2014年宁夏地区尘肺病流行病学特征[J].职业与健康,2016,32(9):1184-1186.
[23]王焕强,李涛.尘肺病的定义与历史[J].中国职业医学,2017,44(4):485-493.
[24]JING FM,LU W,AU W,et al. Prevalence of coal workers'pneumoconiosis in China:A systematic analysis of 2001-2011 studies[J]. Int J Hyg Envir Heal,2014,217(1):46-51.
[25]华正兵,孙志谦,秦天榜,等.河北某煤矿工人累积接尘量与尘肺发病危险性的剂量-反应关系[J].环境与职业医学,2015,32(1):1-6.
[26]林燕,项橘香.2006—2015年杭州市余杭区新发尘肺病例的流行病学特征[J].环境与职业医学,2017,34(7):627-629.
[27]崔风涛,许洁,沈福海,等.某矿业集团1977例尘肺病患者死因分析[J].职业与健康,2014,30(22):3196-3198.
[28]李建国,郝世宾,赵俊琴,等.1996—2015年河北省尘肺病发病特点分析[J].中国工业医学杂志,2018,31(1):32-34.
[29]刘颖,李文鹏,胡定海.2007—2017年昆明市东川区尘肺病的发病特征[J].职业与健康,2018,34(18):2556-2558.
[2]Go LH,Krefft SD,Cohen RA,et al. Lung disease and coal mining[J].Current Opinion in Pulmonary Medicine,2016,22(2):170-178.
[3]李增敏,何洁,赵春香,等. 2016年河北省矽尘作业工人职业健康检查[J].职业与健康,2018,34(3):302-304.
[4]中华人民共和国国家卫生健康委员会.关于2016年职业病防治工作的通报[EB/OL].(2017-12-28)[2018-06-08].http://www.nhfpc.gov.cn/jkj/s5899t/201712/c46227a95f054f5fa75a40e4db05bb37.shtml.
[5]吴宾,汉锋,张思雨,等.职业危害风险指数法在煤矿煤尘职业健康风险评估中的应用[J].中国工业医学杂志,2016,29(4):311-312.
[6]中华人民共和国国家卫生部.工作场所空气中有害物质监测采样规范:GBZ 159-2004[EB/OL]. http://www.nhc.gov.cn/zhuz/pyl/201412/23d80783145a44b998bd0a0f122e9f87.shtml.
[7]中华人民共和国国家卫生部.工作场所空气中粉尘测定第1部分:总粉尘浓度:GBZ/T 192-2007[S].北京:人民卫生出版社,2008:1-6.
[8]中华人民共和国国家卫生部.工作场所空气中粉尘测定第2部分:呼吸性粉尘浓度:GBZ/T 192-2007[S].北京:人民卫生出版社,2008:1-2.
[9]中华人民共和国国家卫生部.尘肺病诊断标准:GBZ 70-2002[S].北京:法律出版社,2004:1-12.
[10]中华人民共和国国家卫生部.尘肺病诊断标准:GBZ 70-2009[S].北京:人民卫生出版社,2009:1-11.
[11]中华人民共和国国家卫生和计划生育委员会.职业性尘肺病的诊断:GBZ 70-2015[S].北京:中国标准出版社,2016:1-13.
[12]中华人民共和国国家卫生部.工作场所有害因素职业接触限值第一部分:化学有害因素:GBZ 2.1-2007[S].北京:人民卫生出版社,2008:1-19.
[13]查晚生,陈葆春,胡琼,等.安徽省2012—2016年职业病发病情况分析[J].安徽预防医学杂志,2018,24(1):63-66.
[14]王一丹,唐浩,陈卉,等.尘肺病合并肺结核发生情况的meta分析[J].职业与健康,2015,31(1):16-19.
[15]王黎,祝江伟,赵宁,等.某大型煤炭企业2007-2015年新发尘肺病特点分析[J].中国职业医学,2016,43(5):630-632.
[16]崔风涛,许洁,丁新平,等.1963—2012年淮北矿业集团尘肺病发病情况分析[J].职业与健康,2014,30(24):3519-3521.
[17]肖淑玉,齐慧生,张群,等.山西某煤矿集团不同工种尘肺患者发病特征[J].环境与职业医学,2016,33(7):661-664.
[18]王玉辉,李宝平,孙治平,等.职业性煤工尘肺并发症的相关研究[J].职业与健康,2018,34(19):2622-2627,2631.
[19]中华人民共和国国家卫生健康委员会.职业健康监护技术规范:GBZ 188-2014[S].北京:人民卫生出版社,2014:1-101.
[20]黄占有,唐学平,刘月红.泉州某煤矿2009—2014年尘肺发病分析[J].海峡预防医学杂志,2016,22(2):48-50.
[21]李朋起,韩志伟,吴辉,等.“十二五”期间河南省新发尘肺病流行病学调查[J].河南预防医学杂志,2018,29(8):590-593.
[22]孙伟,耿敬东,谢峰,等.2006—2014年宁夏地区尘肺病流行病学特征[J].职业与健康,2016,32(9):1184-1186.
[23]王焕强,李涛.尘肺病的定义与历史[J].中国职业医学,2017,44(4):485-493.
[24]JING FM,LU W,AU W,et al. Prevalence of coal workers'pneumoconiosis in China:A systematic analysis of 2001-2011 studies[J]. Int J Hyg Envir Heal,2014,217(1):46-51.
[25]华正兵,孙志谦,秦天榜,等.河北某煤矿工人累积接尘量与尘肺发病危险性的剂量-反应关系[J].环境与职业医学,2015,32(1):1-6.
[26]林燕,项橘香.2006—2015年杭州市余杭区新发尘肺病例的流行病学特征[J].环境与职业医学,2017,34(7):627-629.
[27]崔风涛,许洁,沈福海,等.某矿业集团1977例尘肺病患者死因分析[J].职业与健康,2014,30(22):3196-3198.
[28]李建国,郝世宾,赵俊琴,等.1996—2015年河北省尘肺病发病特点分析[J].中国工业医学杂志,2018,31(1):32-34.
[29]刘颖,李文鹏,胡定海.2007—2017年昆明市东川区尘肺病的发病特征[J].职业与健康,2018,34(18):2556-2558.