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[目的]通过对河北唐山某煤业集团唐山地区所属煤矿接尘工人的队列研究,分析煤工尘肺发病特征,研究接尘工人累积接尘量与尘肺发病危险性的剂量-反应关系。[方法]以该集团1970—2010年开始接尘工人为研究对象,按照研究内容收集资料,通过寿命表的方法对累积接尘量与累计发病率进行分析。煤工尘肺患者发病年龄、接尘工龄、潜伏期等采用单因素方差分析;发病率差异采用χ2检验,累计发病率之间差异采用Log-Rank检验。[结果]符合纳入标准接尘工人共17 023人,其中煤工尘肺患者838人,发病率为4.92%。掘进工尘肺发病率最高(17.91%),其次为混合工(11.35%),以下为采煤工(8.74%)和辅助工(0.81%),4个工种尘肺发病率差异有统计学意义(χ2=1168.08,P<0.001)。按累积接尘量分段,掘进工在1 700 mg/(m3·年)~组段的累计发病率为49.79%;采煤工在1 800 mg/(m3·年)及以上组段的累计发病率为35.92%;混合工在1 800 mg/(m3·年)及以上组段的累计发病率为38.01%;辅助工在16 mg/(m3·年)及以上组段的累计发病率为3.69%。[结论]不同工种的累计发病率均随着累积接尘量的增加逐渐增高。在一定累积接尘量区间内,累计发病率快速增长,此累积接尘量区间下的限值为:掘进工900 mg/(m3·年),采煤工1 200 mg/(m3·年),混合工1 000 mg/(m3·年),有参考意义。
[Objective] The purpose of this study was to investigate the characteristics of coal workers’ pneumoconiosis and to study the dose-response relationship between the cumulative amount of dust pick-up and the risk of pneumoconiosis in Tangshan coal mine in Tangshan, Hebei province. [Method] Taking the group of workers who started to collect dust as a research object from 1970 to 2010, the data were collected according to the research contents, and the accumulated dust accumulation and cumulative incidence were analyzed by life table method. The coal worker’s pneumoconiosis patient’s age of onset, the lead-age and the incubation period were analyzed by one-way ANOVA. The difference of incidence was analyzed byχ2 test. The Log-Rank test was used to analyze the difference of cumulative incidence. [Results] A total of 17 023 workers who met the inclusion criteria were involved, of whom 838 were pneumoconiosis workers with a prevalence of 4.92%. The incidence of pneumoconiosis was the highest (17.91%), followed by mixed workers (11.35%), coal workers (8.74%) and auxiliary workers (0.81%), the incidence of pneumoconiosis was significant = 1168.08, P <0.001). According to the cumulative dust exposure, the cumulative incidence of tunneling workers in the section of 1 700 mg / (m3 · year) ~ was 49.79%; the total number of coal mining workers in the section of 1 800 mg / (m3 · year) and above The incidence of hybrid workers was 38.01% at 1 800 mg / (m3 · year) and above. The cumulative incidence of auxiliary workers at 16 mg / (m3 · year) and above was 3.69%. [Conclusion] The cumulative incidence of different types of occupations increased with the increase of cumulative dust collection. In a certain range of cumulative dust exposure, the cumulative incidence rate increased rapidly. The limits under this cumulative dust exposure range are: excavator 900 mg / (m3 · year), coal mining worker 1200 mg / (m3 · year) , Mixing 1 000 mg / (m3 · year), a reference.