1990―2019年中国煤工尘肺疾病负担研究

黄雪赞; 王冬明; 梁如意; 董超前; 张影蝶; 陈卫红

doi:10.16462/j.cnki.zhjbkz.2022.08.002

1990―2019年中国煤工尘肺疾病负担研究

doi: 10.16462/j.cnki.zhjbkz.2022.08.002

430030 武汉，华中科技大学同济医学院公共卫生学院劳动卫生与环境卫生学系，教育部环境与健康重点实验室，国家环境保护部环境与健康重点实验室

基金项目:

国工程院咨询研究项目 2019-ZCQ-8

武汉科技大学职业危害识别与控制湖北省重点实验室开放基金 OHIC2021G05

详细信息

通讯作者:
王冬明，E-mail: wangdm@hust.edu.cn

中图分类号: R181
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出版历程
- 收稿日期: 2022-04-07
- 修回日期: 2022-06-26
- 网络出版日期: 2022-08-23
- 刊出日期: 2022-08-10

Study on the burden of coal workers' pneumoconiosis in China from 1990 to 2019

Department of Occupational Environmental Health and Key Laboratory of Environment and Health, Ministry of Education Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

Funds:

Consulting and Research Project of Chinese Academy of Engineering 2019-ZCQ-8

The Open Fund of Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology OHIC2021G05

More Information

Corresponding author: WANG Dong-ming, E-mail: wangdm@hust.edu.cn

摘要

摘要: 目的分析1990―2019年中国煤工尘肺(coal workers’ pneumoconiosis, CWP)的疾病负担水平及其变化趋势。方法利用2019年全球疾病负担研究(Global Burden of Disease Study, GBD 2019)数据库，提取中国CWP的患病、发病与死亡者例数和特征信息，以及伤残调整寿命年(disability adjusted life year, DALYs)等疾病负担指标，分析CWP的疾病负担状况、年龄性别分布及时间变化趋势，并与全球人群进行对比。结果 1990―2019年中国CWP的患病人数从87 555例降至86 296例，降幅为1.44%；发病人数从5 450例降至4 974例，降幅为8.73%；死亡人数从1 661例降至1 302例，降幅为21.61%；DALYs从57 206.70人年降至41 359.25人年，降幅为27.70%。中国CWP的年龄标化患病率、发病率、死亡率和DALYs率均呈下降趋势，平均年度变化百分比(average annual percentage change, AAPC)分别为-2.75%、-2.53%、-3.67%和-3.73%。中国CWP造成的疾病负担主要集中在男性。相较于1990年，2019年中国有更多高龄工人现患、新发或死于CWP。1990―2019年中国CWP的各项年龄标化率指标均高于全球同期水平，差异均有统计学意义(均有P < 0.001)。结论中国CWP引起的疾病负担整体呈下降趋势，表明中国CWP的防治取得了一定成效，但发病例数仍维持在较高水平，且各项年龄标化率指标始终高于全球同期水平，提示需要大力加强CWP的防控。
- 煤工尘肺 /
- 疾病负担 /
- 变化趋势
Abstract: Objective To analyze the level of disease burden and temporal trend of coal workers' pneumoconiosis (CWP) in China from 1990 to 2019. Methods The detailed data on CWP extracted from the database of the Global Burden of Disease Study 2019 (GBD 2019) was used to evaluate the disease burden and temporal trend of CWP in the Chinese population. The data included prevalent cases, incident cases, death cases, and indicators concerning disease burden such as disability-adjusted life years (DALYs). Results In China, prevalent cases of CWP decreased by 1.44% from 87 555 in 1990 to 86 296 in 2019; incident cases of CWP decreased by 8.73% from 5 450 in 1990 to 4 974 in 2019; deaths of CWP decreased by 21.61% from 1 661 in 1990 to 1 302 in 2019; DALYs of CWP decreased by 27.70% from 57 206.70 person-years in 1990 to 41 359.25 person-years in 2019. The age-standardized prevalence, incidence, mortality, and DALY rates of CWP in China decreased since 1990, with AAPCs of -2.75%, -2.53%, -3.67%, and -3.73%, respectively. And the disease burden of CWP was mainly caused by male groups. Compared with 1990, more elderly workers in China in 2019 suffered from or died of CWP. The age-standardized indicators of CWP in China were all higher than those globally from 1990 to 2019, and the differences were statistically significant (all P < 0.001). Conclusions The disease burden caused by CWP in China showed a downward trend in general, indicating that the prevention and control of CWP in China had obtained certain achievements. However, the incident cases of CWP in China remained at a high level, and the age-standardized indicators were still higher than those globally. Therefore, more efforts are needed to pay attention to the prevention and control of CWP in China.
- Coal workers' pneumoconiosis /
- Disease burden /
- Temporal trend

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图 1 1990年和2019年中国CWP患病、发病、死亡及DALYs水平的年龄分布

Figure 1. Age distribution of prevalence, incidence, mortality, and DALYs of CWP in China in 1990 and 2019

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图 2 1990至2019年全球和中国CWP患病、发病、死亡及疾病负担水平的变化情况

Figure 2. Changes in prevalence, incidence, mortality, and disease burden of CWP worldwide and in China from 1990 to 2019

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表 1 1990年和2019年中国CWP患病、发病、死亡及疾病负担情况

Table 1. Prevalence, incidence, mortality, and disease burden of CWP in China in 1990 and 2019

指标	1990年(95% UI值)	2019年(95% UI值)	变化幅度(%)
患病人数(例)	87 555(68 429~108 803)	86 296(67 454~106 862)	-1.44
发病人数(例)	5 450(4 419~6 665)	4 974(3 976~6 263)	-8.73
死亡人数(例)	1 661(542~2 518)	1 302(708~2 209)	-21.61
DALYs(人年)	57 206.70(26 316.43~81 535.81)	41 359.25(28 064.25~62 580.63)	-27.70
YLDs(人年)	13 041.01(8 074.15~19 301.47)	13 305.85(8 284.65~19 818.05)	2.03
YLLs(人年)	44 165.69(13 773.30~68 448.66)	28 053.40(15 692.66~49 125.46)	-36.48
标化患病率(/10万)	9.15(7.19~11.34)	4.15(3.27~5.11)	-54.64
标化发病率(/10万)	0.52(0.42~0.64)	0.25(0.21~0.31)	-51.92
标化死亡率(/10万)	0.21(0.08~0.32)	0.07(0.04~0.12)	-66.67
标化DALYs率(/10万)	6.26(2.92~8.74)	2.06(1.39~3.09)	-67.09
标化YLDs率(/10万)	1.36(0.85~2.00)	0.64(0.40~0.95)	-52.94
标化YLLs率(/10万)	4.90(1.53~7.45)	1.42(0.79~2.43)	-71.02
注：DALYs：伤残调整寿命年；YLDs：伤残损失寿命年；YLLs：过早死亡损失寿命年。

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表 2 1990―2019年全球和中国CWP各项年龄标化率指标的Joinpoint分析

Table 2. Joinpoint analysis of the age-standardized indicators of CWP worldwide and in China from 1990 to 2019

指标	年份分段1		年份分段2		年份分段3		1990―2019年
指标	年份(年)	APC(%)	年份(年)	APC(%)	年份(年)	APC(%)	AAPC(%)	95% CI值
中国
年龄标化患病率	1990―2000	1.00 ^a	2000―2005	-8.24 ^a	2005―2019	-3.36 ^a	-2.75 ^a	-3.16~-2.34
年龄标化发病率	1990―2000	-0.01	2000―2005	-6.67 ^a	2005―2019	-2.78 ^a	-2.53 ^a	-2.82~-2.23
年龄标化死亡率	1990―2005	-2.56 ^a	2005―2008	-10.0 ^a	2008―2019	-3.39 ^a	-3.67 ^a	-4.23~-3.11
年龄标化DALYs率	1990―2003	-2.50 ^a	2003―2008	-7.47 ^a	2008―2019	-3.45 ^a	-3.73 ^a	-3.88~-3.58
年龄标化YLDs率	1990―2000	1.03 ^a	2000―2005	-7.94 ^a	2005―2019	-3.22 ^a	-2.62 ^a	-3.01~-2.22
年龄标化YLLs率	1990―2005	-3.27 ^a	2005―2009	-9.10 ^a	2009―2019	-3.08 ^a	-4.03 ^a	-4.43~-3.63
全球
年龄标化患病率	1990―2000	1.20 ^a	2000―2004	-8.30 ^a	2004―2019	-3.05 ^a	-2.36 ^a	-2.83~-1.88
年龄标化发病率	1990―2000	0.13	2000―2004	-6.57 ^a	2004―2019	-2.82 ^a	-2.34 ^a	-2.67~-2.01
年龄标化死亡率	1990―2003	-3.82 ^a	2003―2009	-6.37 ^a	2009―2019	-2.79 ^a	-4.00 ^a	-4.16~-3.84
年龄标化DALYs率	1990―2001	-3.34 ^a	2001―2009	-5.79 ^a	2009―2019	-3.05 ^a	-3.93 ^a	-4.03~-3.83
年龄标化YLDs率	1990―2000	1.24 ^a	2000―2004	-7.97 ^a	2004―2019	-2.94 ^a	-2.24 ^a	-2.69~-1.79
年龄标化YLLs率	1990―2004	-4.25 ^a	2004―2009	-6.91 ^a	2009―2019	-2.98 ^a	-4.28 ^a	-4.43~-4.12
注：^a表示P < 0.05；APC：年度变化百分比；AAPC：平均年度变化百分比；DALYs：伤残调整寿命年；YLLs：过早死亡损失寿命年；YLDs：伤残损失寿命年。

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