中国男性不同类型尘肺病的疾病负担及变化趋势分析

Disease burden and trends of different types of pneumoconiosis among Chinese males

  • 摘要:
    背景 尘肺病是我国职业性疾病中影响面较广、危害较为严重的一类疾病。
    目的 本研究旨在分析1992—2021年中国男性群体不同类型尘肺病的疾病负担及变化趋势,为我国尘肺病的预防控制、公共卫生政策制定提供参考。
    方法 基于全球疾病负担研究(GBD)最新数据(2021),采用死亡率、伤残调整寿命年(DALYs)等指标评估中国男性尘肺病疾病负担情况。应用Joinpoint回归模型以及年龄−时期−队列模型来分析中国男性人群尘肺病死亡率的变化趋势。
    结果 1992—2021年,中国男性总体尘肺病标化DALYs率、标化生命年损失(YLLs)率、标化伤残损失寿命年(YLDs)率、标化死亡率均呈下降趋势,其平均年度变化百分比(AAPC)分别为−2.63%、−2.81%、−0.87%、−2.56%(P<0.05)。四种类型的尘肺病中,矽肺疾病负担最重。中国男性矽肺、石棉尘肺、煤工尘肺、其他尘肺病的标化死亡率AAPC分别为−2.18%、−1.24%、−3.81%、−3.21%(P<0.05)。年龄效应显示这四类尘肺病死亡率均随年龄增长而上升,矽肺和煤工尘肺受年龄效应影响最大。时期效应显示四类尘肺病死亡风险均呈下降趋势,但矽肺死亡风险明显高于其他三类。队列效应显示,中国男性人群出生越晚,死亡风险越小。
    结论 1992—2021年,我国男性四类尘肺病疾病负担有所减缓,但尘肺病仍是我国危害最严重的职业病。男性作为我国尘肺病发病、死亡的主要人群,我国各方应高度重视,针对不同尘肺病的特点,采取有效手段进行防控。

     

    Abstract:
    Background Pneumoconiosis is a prevalent and severely harmful occupational disease in China.
    Objective To estimate disease burden and trends of different types of pneumoconiosis among Chinese males from 1992 to 2021, and to provide insights for pneumoconiosis prevention and control as well as the development of public health policies in China.
    Methods Based on the latest data from the Global Burden of Disease (GBD) study (2021), this study evaluated the disease burden of pneumoconiosis among Chinese males using indicators such as mortality rate and disability-adjusted life years (DALYs). Joinpoint regression model and age-period-cohort model were applied to analyze trends in the mortality rates of pneumoconiosis among Chinese males.
    Results From 1992 to 2021, the age-standardized DALYs rate, age-standardized years of life lost (YLLs) rate, age-standardized years lived with disability (YLDs) rate, and age-standardized mortality rate of pneumoconiosis among Chinese men all showed a downward trend, with average annual percentage changes (AAPC) of −2.63%, −2.81%, −0.87%, and −2.56%, respectively (P<0.05). Among the four types of pneumoconiosis, the disease burden of silicosis was the highest. The age-standardized mortality rates for silicosis, asbestosis, coal worker’s pneumoconiosis, and other types of pneumoconiosis had AAPC of −2.18%, −1.24%, −3.81%, and −3.21% (P<0.05), respectively. The age effects showed mortality rates for all types increased with age, particularly in silicosis and coal worker’s pneumoconiosis. The period effects showed a general decline in mortality risk, though silicosis remained significantly higher than other types. The cohort effects indicated that later birth cohorts had progressively lower mortality risks.
    Conclusion From 1992 to 2021, the burden of pneumoconiosis among Chinese males has shownsome alleviation; however, pneumoconiosis remains China’s most severe occupational disease. Given that males are the primary affected group in both incidence and mortality, continued attention and targeted preventive measures are essential. Effective control strategies should be tailored to address the specific characteristics of each type of pneumoconiosis.

     

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