某煤矿21年工人死亡率的队列研究

对某煤矿男性职工２５８９人追踪２１年（１９７２．１．１～１９９２．１２，３１），发现肺心病占死因第一位，恶性肿瘤居第二位，恶性肿瘤的ＲＲ为４。７８，ＡＲ为７９．５６／１０万，工伤ＲＲ４．５，Ｍ６５．７３／１０万，同居民对照组比全死亡，恶性肿瘤均无显著差异（Ｐ＞０．０５）；工伤则显著高于居民组（ＳＭＲ９．０，Ｐ＜０．０１）．前１０年与后１１年相比，工伤死亡下降，恶性肿瘤死亡有上升趋势，肺心病无明显变化。故认为危及工人生命的主要疾病是慢性呼吸系统疾病、肺心病和恶性肿瘤等。因此应把防尘和防治慢性疾病作为预防工作的重点。     

Mortality study of gold miners exposed to silica and nonasbestiform amphibole minerals: An update with 14 more years of follow-up

We have updated a study of 3,328 gold miners who worked underground for at least 1 year between 1940-1965 in South Dakota, extending the follow-up from 1977 to 1990. The exposures of concern were silica and nonasbestiform amphibole minerals. The lung cancer standardized mortality ratio (SMR) was 1.13 (95% confidence interval [CI] 0.94-1.36, 115 observed) when the U.S. population was used as the referent group, increasing to 1.25 (95% CI 1.03-1.51) when the county was used as the referent, and to 1.27 (1.02-1.55) for person-time with more than 30 years potential latency. However, lung cancer mortality did not show a positive exposure-response trend with estimated cumulative dust exposure. Data on smoking habits suggested that the miners smoked slightly more than the U.S. population in a 1960 cross-sectional survey. In contrast to lung cancer, other diseases known to be associated with silica exposure (tuberculosis and silicosis) were significantly increased (SMR = 3.44 and 2.61) and exhibited clear exposure-response trends. Nonmalignant renal disease, also associated with silica exposure, was elevated for those hired in early years and showed a significant positive exposure-response trend. Multiple-cause analysis revealed significant excesses of arthritis, musculoskeletal diseases (including systemic lupus and sclerosis), and skin conditions (including scleroderma and lupus), diseases of autoimmune origin which have been associated with silica exposure in other studies. Multiple cause analysis also showed a significant excess of diseases of the blood and blood-forming organs.     

Health Survey in Gypsum Mines in India

Background:

Mining is a hazardous occupation in which workers are exposed to adverse conditions. In India, gypsum mining is mainly carried out in the state of Rajasthan, which contributes about 99% of the total production.

Objective:

The present study was carried out in 12 different gypsum mines in Rajasthan state to determine the health status of the miners.

Materials and Methods:

One hundred and fifty workers engaged in mining activities were included in the study and their health status was compared with that of 83 office staff of the same mines. The health status of the employees was evaluated using a standardized medical questionnaire and pulmonary function testing.

Statistical Analysis:

The unpaired ‘t’ test was used to determine whether there was any significant difference between the miners and the controls and the chi-square test to compare the prevalences of various respiratory impairments in workers with that in controls; we also examined the differences between smokers and nonsmokers.

Results:

Our findings show that the literacy rate is low (42%) among the miners. Pulmonary restrictive impairment was significantly higher amongst smokers as compared to nonsmokers in both miners and controls. Hypertension (22.6%), diabetes (8.8%), and musculoskeletal morbidity (8%) were the common diseases in miners.

Conclusion:

This study shows that there is high morbidity amongst miners, thus indicating the need for regular health checkups, health education, use of personal protective devices, and engineering measures for control of the workplace environment.     

煤矿井下工人心理健康水平研究

目的了解煤矿工人心理健康状况,为采取开展心理健康教育、咨询等综合性干预措施提供依据。方法运用整群抽样方法,对某煤矿800名工人统一填写症状自评量表(SCL-90)和一般情况调查表,进行问卷调查。结果煤矿工人的总体心理健康水平低下,井下作业工人尤其明显。煤矿井下作业工人各因子分、总分、总均分、阳性项目数、阳性症状均分均高于地面作业工人(P0.01)。结论煤矿工人尤其井下作业工人存在严重心理健康问题,令人堪忧。     

52例金矿农民工矽肺病调查

目的了解私营金矿农民工职业病危害原因和特点,为金矿农民工职业病危害的预防和控制提供科学依据。方法对52例私营金矿农民工患矽肺情况进行调查、统计与分析。结果78名体检农民工因资料不全等原因送诊66例,确诊52例,占送诊总数78.79%;无矽肺(0 )8例,二者合计为送诊总数的90.91%。合并肺结核5例,合并率9.62%。其中Ⅰ期矽肺13例、Ⅱ期矽肺27例、Ⅲ期矽肺12例,初诊期别明显高于我省尘肺对照资料。平均发病工龄2.08年,最短只有0.25年,比对照资料短16.23年。平均发病年龄39.83岁。结论私营金矿农民工是职业病危害重点人群。     

煤矿工人肺通气功能的分析

作者对415名煤矿接触粉尘工人的肺通气功能几项指标,按不同工龄、不同煤矽肺期别进行了对比分析。接触粉尘超过15年者,肺通气功能明显下降,并随接尘工龄的增长而加剧。工龄超过15年者肺通气功能的表现接近于Ⅰ期煤矽肺患者的肺功能水平。对这部分工人作经常性肺功能测定和X线动态观察,对煤矽肺的防治有积极意义。     

煤矿工人肺结核患病情况的调查分析

[目的]了解某矿区接尘工人肺结核患病情况。[方法]采用横断面调查方法,利用某矿职业性健康检查普查资料,选择该矿井下接尘工龄≥1年的在职、离退休人员2396人作为观察对象,年龄18～73岁,平均38.23岁;并以该矿无接尘接毒的地面工作人员948人作为对照人群。依据胸片征象,结合临床表现及既往病史,诊断结核病(包括稳定性和活动性肺结核),分析比较两组人群(不同工种工人、不同工龄工人)结核累计感染率等。[结果]井下接尘工人累计感染率比对照人群高(年龄标化后肺结核累计感染率分别为12.11‰、7.87‰),但两者差异未见统计学意义(x~2=1.01,P>0.05);采煤工人标化结核累计感染率高于其他工种工人,但差异未见统计学意义(x~2=0.43,P>0.05);不同工龄结核累计感染率虽稍有差异,但未见规律性的变化趋势(x~2=1.32,P>0.05)。[结论]井下接尘工人肺结核患病情况未高于地面对照人群。     

Lung function prediction equations derived from healthy South African gold miners

OBJECTIVES—To estimate lung function prediction equations and to identify appropriate normal reference values for the population of about 250 000 of South African gold miners.
METHODS—Data from a lung function screening programme conducted at a large South African gold mine from 1994 to 1998 were used to estimate the lung function prediction equations. The most reliable period of lung function testing was identified in a previous study of a temporal pattern in reliability, and lung function tests from this period were used. Miners with a history of pulmonary tuberculosis or with radiological abnormalities were excluded from the study. The prediction equations were estimated cross sectionally on 15 772 black and 2752 white miners, and published reference equations that fitted most closely the observed data were identified.
RESULTS—The estimated prediction equations for forced vital capacity (FVC) are as follows: for black men, FVC (l)=− 2.901−0.025×age+4.655×height; and for white men, FVC(l)=−4.407−0.036×age+ 5.940×height. For forced expiratory volume in one second (FEV₁) these equations are: for black men, FEV₁(l)=−1.654− 0.30×age+3.665×height; and for white men, FEV₁(l)= −2.341− 0.038×age+4.314×height. Units are years for age and metres for height. Knudson's and the European Community of Coal and Steel (ECCS) reference values provided the closest fit to the data on lung function of white miners, but the lower limits of normal from the ECCS equations were the closest to the observed one sided lower 95% confidence intervals (95% CIs). For black miners, reference equations that fitted best were derived by Louw et al on asymptomatic black South African men unexposed to occupational dust. There were significant differences between the two groups of miners in the estimated height adjusted mean lung function values for a 40 year old 1.7 m tall man (220 ml (5.2%) for FVC and 110 ml (3.2%) for FEV₁); white men had higher FVC and FEV₁, but lower FEV₁/FVC ratio. The ECCS reference values scaled by a conversion factor of 0.93 for the FVC and 0.95 for the FEV₁ provided close fits to the data for black miners, but the rate of decline with age was higher than that in the observed data. None of the linear equations provided a good fit for the 20-29 and more than 55 years old age categories.
CONCLUSION—The ECCS and Knudson equations provided the best fit to the data for white miners, whereas the equations by Louw et al estimated on asymptomatic black South African bank workers provided the best fit to the data for black miners. The ECCS reference values scaled by a factor of 0.93 for FVC and by 0.95 for FEV₁ provided close fits, but the rate of decline with age was higher than that in the data for black miners.


Keywords: silica dust; miners; pulmonary function reference equations     

Relative Leucopenia in the Peripheral Blood of Asbestos Miners: An Epidemiologic Analysis

The study examines differential leucocyte counts in blood of asbestos miners and quarriers identified during the course of a community health survey comprising 693 men over 25 years of age of all occupations. Subjects in the asbestos mining and quarrying occupational groups were present in the lowest total leucocyte quintile in significantly greater numbers than expected on the basis of an age-specific uniform leucocyte distribution based upon the total population of male workers. This relative leucopenia was not seen in their wives nor in any of the 22 other major occupational groups examined after their leucocyte counts were adjusted for age and sex variations.