■尘肺是全球分布最广的职业病。中国目前是最大的煤炭生产国和消费国,也是煤矿工人和煤工尘肺病例最多的国家。尽管经过70多年的努力,CWP和矽肺的问题仍然很严重。缺乏对来自全国各地的煤矿工人尘肺病的直接数据的分析。这项研究旨在描述煤矿工人尘肺的流行病学,并揭示有关其社会决定因素的一些重要线索。
■年发病率,20年患病率,从1949年到2021年,中国每百万吨煤矿工人尘肺的发病率是通过使用煤炭开采和选矿行业诊断和报告的年度煤矿工人尘肺数量的数据来计算的,煤矿工人的数量,和原煤生产,采用Pearson相关分析对煤矿工人尘肺事件与煤矿安全事故死亡人数的关系进行分析,目的是通过生态学研究探讨煤矿工人尘肺事件及其社会决定因素之间的关系。
■从1949年到2021年,中国有超过46.2万名煤矿工人尘肺病患者,呈双U形分布,呈增加趋势,约占中国所有尘肺诊断的50.5%(46.2万/91.5万),而煤矿工人尘肺的发生率呈W形分布,在50多年的时间跨度内有三个峰值。从1949年到1986年,煤矿工人尘肺事件与原煤生产之间存在很强的相关性,煤矿工人的数量,和煤矿事故死亡人数(分别为r=0.849,P<0.001;r=0.817,P<0.001;r=0.697,P<0.001),但是从1987年到2006年没有发现这种相关性。据估计,2016-2020年中国煤矿工人尘肺的年发病率为3.4‰(95%CI:2.6-4.3‰),最近20年观察期的患病率为4.8%(95%CI:4.6-4.9%),两者都是在70年的峰值或峰值附近测量的。特别是,1963年、1986年、2006年和2009年是四个重要的时间转折点。
■在中国,煤矿工人尘肺事件的发生率持续很高,呈双U形曲线,这可能会受到各种社会决定因素和风险因素的影响。
UNASSIGNED: Pneumoconiosis is the most widely distributed occupational disease worldwide. China is currently the largest coal producer and consumer and the country with the most coal
miners and cases of coal workers\' pneumoconiosis (CWP). Despite more than 70 years of effort, the problem of CWP and silicosis remains serious. There is a lack of analysis of direct data on coal
miners\' pneumoconiosis from all over the country. This study aimed to describe the epidemiology of coal
miners\' pneumoconiosis and reveal some important clues regarding its social determinants.
UNASSIGNED: The annual incidence rate, 20-year prevalence rate, and incidence rate of coal miners\' pneumoconiosis per million tons in China from 1949 to 2021 were calculated by using the data of annual number of coal miners\' pneumoconiosis diagnosed and reported from the coal mining and dressing industry, the number of coal miners, and the raw coal production, and the relationship between the incident cases of coal miners\' pneumoconiosis and the death toll from coal mine safety accidents was analyzed using Pearson correlation analysis, with the aim of exploring the relationship between the incident cases of coal miners\' pneumoconiosis and its social determinants with an ecological study.
UNASSIGNED: From 1949 to 2021, there have been more than 462,000 patients with coal
miners\' pneumoconiosis in China, showing double U-shaped distributions with an increasing trend, accounting for about 50.5% (462,000/915,000) of all diagnosed pneumoconiosis in China, while the incidencet rate of coal miners\' pneumoconiosis presents a large W shaped distribution with three peaks over a time span of more than 50 years. From 1949 to 1986, there was a strong correlation between the incident cases of coal miners\' pneumoconiosis and raw coal production, the number of coal miners, and the number of deaths from coal mine accidents (r = 0.849, P < 0.001; r = 0.817, P < 0.001; r = 0.697, P < 0.001, respectively), but there was no such correlation found from 1987 to 2006. It was estimated that the annual incidence rate of coal
miners\' pneumoconiosis in China from 2016 to 2020 was 3.4‰ (95% CI: 2.6-4.3‰), and the prevalence rate across the recent 20-year observation period was 4.8% (95% CI: 4.6-4.9%), both measured at the peak or around the peak over the 70 years. In particular, 1963, 1986, 2006, and 2009 were the four important turning points in time.
UNASSIGNED: There was a sustained high level of incident cases of coal miners\' pneumoconiosis with double U-shaped curve in China, which may be affected by a variety of social determinants and risk factors.