浙江省 ≥ 40岁居民慢性阻塞性肺疾病检出情况及与职业暴露关系

戴若骐; 陈向宇; 钟节鸣; 方乐; 陆凤

doi:10.11847/zgggws1139850

浙江省 ≥ 40岁居民慢性阻塞性肺疾病检出情况及与职业暴露关系

Association of occupational hazards exposure with chronic obstructive pulmonary disease among residents aged 40 years and above in Zhejiang province

摘要

摘要:
目的了解浙江省 ≥ 40岁居民慢性阻塞性肺疾病（慢阻肺）检出情况及与职业暴露之间的关系，为慢阻肺的防控提供科学依据。
方法于2019年4 — 12月采用多阶段随机抽样方法在浙江省杭州市桐庐县、温州市永嘉县、绍兴市嵊州市、衢州市衢江区和丽水市庆元县5个慢阻肺监测点抽取3000名 ≥ 40岁的常住居民进行问卷调查、身体测量和肺功能检查，并应用多因素非条件logistic回归模型分析慢阻肺检出情况及与职业暴露的关系。
结果浙江省最终纳入分析的2926名 ≥ 40岁居民中，1004人（34.3%）有职业粉尘接触史，755人（25.8%）有职业有害气体接触史，48人（1.6%）从事过煤炭、采矿、采石、采气作业，53人（1.8%）从事过冶金、铸造、机械加工制造作业，95人（3.2%）从事过水泥、石棉、陶瓷、玻璃、石墨制造作业，119人（4.1%）从事过土木、建筑工程、交通建设作业，108人（3.7%）从事过石油化工、化学产品制造、制药作业，157人（5.4%）从事过木材加工、家具加工、装饰房修作业，100人（3.4%）从事过纺织、造纸、棉絮、皮毛加工作业，63人（2.2%）从事过服装干洗、清洁打扫、厨师、搬运工作业，551人（18.8%）从事过农田生产作业；经肺功能检查共检出慢阻肺患者361例，慢阻肺检出率为12.34%；在调整了性别、年龄、文化程度、婚姻状况、体质指数（BMI）和吸烟史等混杂因素后，多因素非条件logistic回归分析结果显示，浙江省 ≥ 40岁从事过农田生产作业居民慢阻肺检出风险为未从事过农田生产作业居民的1.38倍（OR = 1.38，95%CI = 1.05～1.79）。
结论从事过农田生产作业是浙江省 ≥ 40岁居民慢阻肺检出的危险因素。

Abstract:
Objective To explore the association between the detection of chronic obstructive pulmonary disease (COPD) and occupational hazards exposure among permanent residents ≥ 40 years old in Zhejiang province for providing evidence to COPD prevention.
Methods Face-to-face questionnaire interview, anthropometry measurement and pulmonary function test were conducted among 3 004 permanent urban/rural residents aged 40 years and above recruited with stratified multistage random sampling in five counties/prefectures of Zhejiang province during April – December 2019. Unconditional multivariate logistic regression model was applied to analyze the correlation between occupational hazards exposure and the detection of COPD.
Results Among the 2 926 participants (51.3% males, 48.7% females) finally included in the analysis, 1 004 (34.3%) and 755 (25.8%) reported having been exposed to occupational dust and harmful gas; the percentages of the participants reporting specific occupational history were 1.6% (48 participants) for coal/mining/quarrying/gas industry, 1.8% (53) for metallurgy/casting/machine manufacturing industry, 3.2% (95) for cement/asbestos/ceramics/glass/graphite produc-tion, 4.1% (119) for engineering/construction engineering/traffic construction, 3.7% (108) for petrochemical/chemical/pharma-ceutical industry, 5.4% (157) for wood processing/furniture processing/house decoration industry, 3.4% (100) for textile/papermaking/cotton/fur processing, 2.2% (63) for dry cleaning/cleaning/cook/porter work, and 18.8% (551) for farm work, respectively. Totally 361 (12.34%) participants were detected as having COPD based on the results of pulmonary function test (forced expiratory volume in one second FEV1/forced vital capacity FVC < 70%). The results of logistic regression analysis revealed that the participants with farm work history were more likely to have COPD (odds ratio = 1.38, 95% confidence interval: 1.05 − 1.89) after adjusting for sex, age, education, marital status, body mass index and smoking status.
Conclusion Being engaged in farm work may be a risk factor for COPD among residents 40 years old and above in Zhejiang province.

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