万秋萍, 熊建菁, 褚晓婷, 尹晓烈, 张国慧, 任东升, 王云徽, 王春芳, 杨晓明. 2017年上海市静安区居民COPD的健康损失及其吸烟归因负担分析[J]. 环境与职业医学, 2021, 38(7): 725-732. DOI: 10.13213/j.cnki.jeom.2021.21023
引用本文: 万秋萍, 熊建菁, 褚晓婷, 尹晓烈, 张国慧, 任东升, 王云徽, 王春芳, 杨晓明. 2017年上海市静安区居民COPD的健康损失及其吸烟归因负担分析[J]. 环境与职业医学, 2021, 38(7): 725-732. DOI: 10.13213/j.cnki.jeom.2021.21023
WAN Quiping, XIONG Jianjing, CHU Xiaoting, YIN Xiaolie, ZHANG Guohui, REN Dongsheng, WANG Yunhui, WANG Chunfang, YANG Xiaoming. Analysis of health loss and attributable disease burden to smoking of chronic obstructive pulmonary disease among residents in Jing'an District of Shanghai in 2017[J]. Journal of Environmental and Occupational Medicine, 2021, 38(7): 725-732. DOI: 10.13213/j.cnki.jeom.2021.21023
Citation: WAN Quiping, XIONG Jianjing, CHU Xiaoting, YIN Xiaolie, ZHANG Guohui, REN Dongsheng, WANG Yunhui, WANG Chunfang, YANG Xiaoming. Analysis of health loss and attributable disease burden to smoking of chronic obstructive pulmonary disease among residents in Jing'an District of Shanghai in 2017[J]. Journal of Environmental and Occupational Medicine, 2021, 38(7): 725-732. DOI: 10.13213/j.cnki.jeom.2021.21023

2017年上海市静安区居民COPD的健康损失及其吸烟归因负担分析

Analysis of health loss and attributable disease burden to smoking of chronic obstructive pulmonary disease among residents in Jing'an District of Shanghai in 2017

  • 摘要: 背景

    近年来慢性阻塞性肺疾病(COPD)患病率和疾病负担逐年增加,成为全球重要的公共卫生问题之一。

    目的

    分析静安区居民COPD健康损失及其吸烟归因疾病负担,为制定相应公共卫生政策提供依据。

    方法

    利用2017年静安区死因数据,分析COPD在不同性别、年龄组、根本死因及伴发疾病之间的分布情况,并计算不同性别和年龄组的粗死亡率及标化死亡率。结合2017年上海市静安区慢性病及其危险因素监测和人口数据,基于2017年全球疾病负担研究资料和比较风险评估方法,计算静安区居民COPD及其归因于吸烟的早死所致的寿命损失年(YLL)、伤残所致的寿命损失年(YLD)和伤残调整寿命年(DALY)等归因健康损失及间接经济负担。

    结果

    COPD死亡患者中以80岁及以上者居多(占80.07%),且伴发高血压(占29.26%)、冠心病(28.90%)和脑血管病(24.60%)等疾病。COPD死亡占总死亡的6.21%(其中男性7.66%,女性4.57%),死亡率为58.97/10万(其中男性78.63/10万,女性39.97/10万)。因COPD损失的DALY为7 211人年(男性4 964人年,女性2 247人年),DALY率为7.63‰(男性10.69‰,女性4.68‰)。COPD死亡的吸烟归因分值为50.12%(其中男性67.97%,女性10.68%),归因于吸烟的死亡数为254人(其中男性239人,女性15人),归因于吸烟的死亡率为29.55/10万(其中男性53.44/10万,女性4.27人/10万)。归因于吸烟的DALY值为3 614人年(其中男性3 374人年,女性为240人年),归因于吸烟的COPD死亡数、死亡率和DALY值男性要高于女性,且随年龄增加而升高。COPD死亡患者的人均间接经济负担和归因于吸烟的人均间接经济负担分别为27.82万元和16.14万元,且两者均随年龄增高而降低。

    结论

    COPD造成的疾病负担巨大,且吸烟是最重要的危险因素。

     

    Abstract: Background

    In recent years, the prevalence and burden of chronic obstructive pulmonary disease (COPD) have increased year by year, becoming one of the most important public health problems in the world.

    Objective

    This study analyzes the health loss and disease burden to smoking of COPD of residents in Jing'an District, aiming to provide evidence for formulating related public health policies.

    Methods

    The monitoring data of cause of death in Jing'an District of Shanghai in 2017 were collected to analyze the distribution of COPD in different genders, age groups, underlying causes of death, and associated diseases, and calculate crude mortalities and standardized mortalities of different genders and age groups. Combining with the surveillance data of chronic diseases and their risk factors in the district in 2017, Global Disease Burden 2017 and a comparative risk assessment method were adopted to calculate health loss indexes such as years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life year (DALY) as well as indirect economic burden of COPD and its attribution to smoking.

    Results

    The majority of COPD deaths aged 80 years and above (80.07%), and were accompanied by hypertension (29.26%), coronary heart disease (28.90%), cerebrovascular disease (24.60%), and other diseases in the studied area. COPD deaths accounted for 6.21% of the total deaths (including 7.66% males and 4.57% females), and the mortality rate was 58.97/105 (78.63/105 for men and 39.97/105 for women). The DALY due to COPD was 7 211 person-years (4 964 person-years for men and 2 247 person-years for women), and the DALY rate was 7.63‰ (10.69‰ for men and 4.68‰ for women). The attributable risk of smoking on COPD deaths was 50.12% (67.97% for men and 10.68% for women), the number of smoking attributable deaths was 254 (239 males and 15 women), and the smoking attributable mortality rate was 29.55/105 (53.44/105 for men and 4.27/105 for women). The DALY attributable to smoking was 3 614 person-years (3 374 person-years for men and 240 person-years for women). The number of deaths, mortality rate, and DALY of COPD attributable to smoking were higher in males than those in females, and increased with age. The per capita indirect economic burden of COPD deaths and those attributable to smoking were 278200 yuan and 161400 yuan respectively, and both decreased with age.

    Conclusion

    The burden of disease caused by COPD is huge, and smoking is the most important risk factor.

     

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