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[目的]分析武钢大冶铁矿尘肺发病规律,探讨尘肺发病的主要影响因素。[方法]选择该铁矿1960～1974年间登记在册且工作过1年以上的所有工人建立研究队列,随访至2003年底。收集队列成员的基本资料、职业史、疾病史及各工种历年的粉尘浓度监测资料,分析铁矿尘肺的发病规律。随机选取1714名存活的队列成员,测定TNF-α-308位点及hOGG1Ser326Cys多态性。计算各影响因素对尘肺发病的相对危险度(RR)。[结果]队列共7666人,到2003年底共随访261410.72人年,失访275人。接尘工人3604人,共随访126863.13人年,诊断314例尘肺,尘肺发病率为0.25%,累计发病率8.71%。75.80%的尘肺病例1960年之前开始接尘,83.12%的病例累积接尘量大于50mg(/m3·a)。铁矿尘肺的平均潜伏期19.65年,77.71%的病例潜伏期在10～30年之间。发病率随着累积接尘量的增加而升高,高、中接尘组相对于低接尘组的RR分别为8.25和2.27;吸烟组尘肺发病率是不吸烟组的1.7倍;肺结核组发生尘肺危险较非肺结核组明显增高(RR=32.34);TNF-α-308位点及hOGG1Ser326Cys的突变型和野生纯合子组间发病情况差异无统计学意义(P>0.05)。[结论]累积接尘量高是影响铁矿尘肺发病的根本因素,吸烟和患肺结核可促进其发生。TNF-α-308位点及hOGG1Ser326Cys多态性在铁矿尘肺的发病中不起主要作用。
[Objective] To analyze the incidence of pneumoconiosis in Daye Iron Mine of WISCO and explore the main influencing factors of the incidence of pneumoconiosis. [Method] All the workers who were registered in the iron mine from 1960 to 1974 and had been working for more than one year were selected to establish a research cohort and followed up till the end of 2003. Collect the basic information of the members of the cohort, occupational history, disease history and various dust monitoring data of various types of workers over the years, analyze the incidence of iron pneumoconiosis. A total of 1714 surviving cohorts were selected randomly to determine TNF-α-308 locus and hOGG1Ser326Cys polymorphism. Calculate the relative risk of various factors on the incidence of pneumoconiosis (RR). [Results] A total of 7666 cohorts were enrolled. By the end of 2003, a total of 261410.72 person-years were followed-up and 275 lost. A total of 3604 workers were interviewed for a total of 126,863.13 person-years. A total of 314 cases of pneumoconiosis were diagnosed. The incidence of pneumoconiosis was 0.25% and the cumulative incidence was 8.71%. 75.80% of cases of pneumoconiosis began to catch dust before 1960, and 83.12% of cases accumulated more than 50mg of dust (/ m3 · a). The average incubation period for iron miners pneumoconiosis was 19.65 years, 77.71% of cases had an incubation period of 10-30 years. The incidence of pneumoconiosis increased with the increase of dust accumulation. The RRs of high and middle dust groups were 8.25 and 2.27 respectively, while the incidence of pneumoconiosis in smoking group was 1.7 times that of non-smoking group. The incidence of tuberculosis The risk of pneumoconiosis was significantly higher than that of non-pulmonary tuberculosis (RR = 32.34). There was no significant difference in the incidence of TNF-α-308 locus and hOGG1Ser326Cys between mutant and wild homozygotes (P> 0.05). [Conclusion] The high accumulated dust accumulation was the fundamental factor that affected the incidence of pneumoconiosis in iron miners. Smoking and suffering from tuberculosis could promote its occurrence. TNF-α-308 locus and hOGG1Ser326Cys polymorphism can not play a major role in the pathogenesis of iron pneumoconiosis.