目的 了解我国工业企业接尘劳动者的职业健康状况,为制定尘肺病预防控制策略提供科学依据.方法 从中国疾病预防控制中心"职业病与健康危害因素监测"信息系统中提取2021年采矿业、制造业和电力、热力、燃气及水生产和供应业三大门类行业接触煤尘和接触矽尘劳动者的职业健康档案975 029人,从地区、行业、性别、年龄、工龄和企业规模等维度对接尘劳动者胸片结果和肺功能用力肺活量(forced vital capacity,FVC)、第 1 秒用力呼气容积(forced expiratory volume in one second,FEV1)和FEV1/FVC结果进行分析.结果 接尘劳动者中出现尘肺样改变6 486人,改变率为0.67％;FVC异常119 787人,FEV1异常28 966人,FEV1/FVC异常10 196人,肺功能各项指标异常率分别为12.29％、2.97％和1.05％.西南地区尘肺样改变率最高,为2.20％,东北地区肺功能FVC、FEV1和FEV1/FVC异常率最高,分别为21.40％、4.40％和1.80％.采矿业尘肺样改变率为1.06％,高于其他行业工业企业(x2=2 736.665,P＜0.01).男性接尘劳动者尘肺样改变率和肺功能FVC、FEV1/FVC异常率高于女性(x2=638.365、105.472、23.799,P＜0.01),且随年龄和工龄的增加呈现上升趋势.小微型企业尘肺样改变率和肺功能FEV1、FEV1/FVC异常率均显著高于大、中型企业(x2=14.136、11.366、9.493,P＜0.01),接尘劳动者肺功能异常率随肺部纤维化程度加重而升高.结论 我国粉尘作业劳动者尘肺样改变率较高,应加强重点地区、重点行业的粉尘治理工作,以保护劳动者健康.
Analysis of chest radiography and pulmonary function results of dust-exposed workers from Chinese industrial enterprises in 2021
Objective To understand the occupational health status of dust-exposed workers in Chinese industrial enterprises,and to provide scientific basis for prevention and control strategy of pneumoconiosis.Methods A total of 975 029 occupational health files of workers exposed to coal dust or silica dust from three major industries including mining,manufacturing and electricity,heat,gas and water production and supply industries in 2021 were collected from the"Occupational Disease and Health Hazardous Factors Surveillance System".Chest radiography and pulmonary function including FVC,FEV1 and FEV1/FVC of dust-exposed workers were analyzed by region,industry,gender,age,duration of dust exposures and enterprise scale.Results There were 6 486 cases indicated pneumoconiosis-like change among the dust-exposed workers,with a detection rate of 0.67％.There were 119 787 cases with abnormal FVC,28 966 cases with abnormal FEV1 and 10 196 cases with abnormal FEV1/FVC,with detection rates of 12.29％,2.97％and 1.05％,respectively.The rate of pneumoconiosis-like change in southwest region was the highest(2.20％),while the abnormal rates of FVC,FEV1 and FEV1/FVC were the highest in Northeast region(21.40％,4.40％and 1.80％,respectively).The rate of pneumoconiosis-like change in mining industry was 1.06％,which was significantly higher than other industries(x2=2 736.665,P＜0.01).The rate of pneumoconiosis-like change and the abnormal rates of FVC and FEV1/FVC of dust-exposed workers were significantly higher in males than in females(x2=638.365,105.472,23.799,P＜0.01),and showed an uptrend with the increase of age and duration of dust exposures.The rate of pneumoconiosis-like change and the abnormal rates of FEV1 and FEV1/FVC in small and micro enterprises were significantly higher than those of large and medium-sized enterprises(x2=14.136,11.366,9.493,P＜0.01).The rate of pulmonary dysfunction increases with the aggravation of pulmonary fibrosis.Conclusion The rate of pneumoconiosis-like change of dust-exposed workers in Chinese industrial enterprises is still high,and the dust control in key areas and key industries should be strengthened to protect their health.
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