论文部分内容阅读
目的 探讨职业接触粉尘对死亡的影响 ,为现代职业卫生政策法规的制定以及相关工作提供科学依据。方法 以 1989～ 1992年广州市实施并建立的职工职业健康监护档案为基础资料 ,选年龄≥ 3 0岁的 80 987名接尘和无接尘职工为研究对象 ,进行前瞻性队列研究。结果 ( 1)队列平均 43 5岁 ,主要为工人 ,中学文化 ,已婚 ,接尘率16 3 % ,吸烟率 43 7% ,饮酒率 3 3 5 %。 ( 2 )队列平均随访 8年 ,失访 3 5例 ,死亡 15 3 9人 ,以恶性肿瘤死亡为主。接尘、无接尘全死因粗死亡率分别为男 3 80 14 /10万和 3 14 5 6/10万 ,女 95 72 /10万和 98 3 3 /10万。 ( 3 )调整相关混杂因素后 ,接尘者全死因、恶性肿瘤、呼吸系统疾病死亡相对危险度 (RR)分别为 1 2 4、 1 3 4和 2 41,其中男性矽尘接触者分别为 1 5 7、 1 61和 5 72 ,男接尘者肺癌和鼻咽癌死亡相对危险度分别为 1 67和 1 81,与无接尘者比 ,RR的增加均有显著性意义。 ( 4 )调整相关混杂因素后 ,接尘者全死因、恶性肿瘤死亡归因危险度百分比 (AR % )和人群归因危险度百分比 (PAR % )分别为 19 5 %、 3 8%、 2 5 4%和 5 3 %。结论 职业接触粉尘可致全死因死亡尤其是恶性肿瘤和呼吸系统疾病死亡危险性增加。
Objective To explore the impact of occupational exposure to dust on death and to provide a scientific basis for the formulation and related work of modern occupational health policies and regulations. Methods Based on the data of occupational health monitoring files implemented and set up in Guangzhou City from 1989 to 1992, 80 987 workers who were exposed to dust and no dust who were ≥ 30 years old were selected as the study subjects and prospective cohort study was conducted. Results (1) The average cohort was 43.5 years old. The main cohorts were workers, secondary school students, married women with dust-contact rate of 16.3%, smoking rate of 43.7% and drinking rate of 33.5%. (2) The average follow-up of the cohort was 8 years, 35 cases were lost to follow-up, and 15 3 9 died. Malignant tumor was the main cause of death. The total fatality rate of all causes of death without dusting were 3 80 14/10 million and 3 14 5 6/10 million respectively, 95 72/10 million and 98 3 3/10 million respectively. (3) After adjusting the related confounding factors, the relative risk (RR) of death from all causes of death, malignant tumor and respiratory system diseases were 122, 134 and 241 respectively, of which the men’s contact with silica dust was 1 The relative risk of death from lung cancer and nasopharyngeal cancer among men exposed to dust was 1 67 and 1 81 respectively, which was significantly higher than those without dust exposure. (4) After adjusting for the related confounding factors, the percentages of all at-risk, at-risk of at-risk of malignant tumor (AR%) and the percentage of at-risk attributable to population (19.5%, 38%, 25% 4% and 53%. Conclusion Occupational exposure to dust can increase the risk of all-cause mortality, especially death from malignant and respiratory diseases.