民营陶瓷业工人尘肺流行病学调查分析

目的 探讨温州市民营陶瓷业工人尘肺患病现状及流行病学特征。方法 采用普查方法对52家民营陶瓷厂进行劳动卫生学调查，对2659名接尘工人的尘肺患病情况调查分析。结果民营陶瓷业平均粉尘浓度9．1me／m^3，游离SiO2含量平均为52．2％；工人尘肺患病率为4．5％，其中球磨工患病率12．4％，患病率排前4位的工种依次为球磨、进料、压机和机修；平均患病年龄36．5岁，尘肺患者平均工龄4．4年。结论该市民营陶瓷业陶尘危害十分严重，粉尘浓度、游离SiO2含量高以及日工作时间长，使得接尘工人发病时间缩短；全面贯彻落实《职业病防治法》是解决职业危害相关问题的关键。     

某煤矿井下粉尘作业工人10年健康动态观察报告

目的通过对煤矿井下粉尘作业工人10年健康动态观察,探讨煤工尘肺的发病因素,X线表现及诊断、尘肺发病率预测。方法1990～2000年对煤矿井下粉尘作业工人进行了10年健康动态观察。结果煤工尘肺患病率4．6％。结论煤矿井下作业场所粉尘浓度分散度及游离SiO2含量,防尘措施是影响煤工尘肺的发病因素。     

重庆煤矿粉尘危害的卫生学评价

煤矿粉尘是煤炭生产过程中最主要的职业危害，长期吸入可以引起煤矿尘肺。流调资料表明，在重庆煤矿47038名接尘工人中，尘肺发病6107例，累积患病率为13．0％，与全国煤矿系统尘肺患病率5．96％相比，重庆煤矿粉尘危害是严重的。为此，我们对重庆统配煤矿1960～1986年的井下粉尘资料进行了整理分析，并于近期对各局矿进行了现场卫生学调查。l资料来源和方法调查了解各统配矿井的历史情况，收集和整理1960～1986年采用滤膜法测定的粉尘浓度和焦磷酸法测定的粉尘中游离SIO。含量的原始资料。现场粉尘卫生学调查中，粉尘浓度测定采用滤膜法…     

小煤矿456例煤工尘肺发病及预后分析

目的：了解小煤矿煤工尘肺的发病、预后特点。方法：用小煤矿456例煤工尘肺与条件较好的大型煤矿5479例煤工尘肺对照，结果：小煤矿I期煤工尘肺发病工龄较对照组短6．88年，晋期年限短1．27年，晋期率高2．39％，小煤矿患病率高，70年代后接尘工人诊断为煤工尘肺的仍占25．44％，死亡原因多为尘肺引起的呼吸衰竭，肺结核，恶性肿瘤及其他肺部疾患，结论：有关部门应加强管理，关闭小煤矿，禁卡开采；对确有开采价值或因其他原因不能关闭的，应加强法制管理搞好综合防尘，改善劳动和生活条件，控制尘肺病的发生；尘肺患者要及时脱离粉尘，预防呼吸道感染，减少并发症发生，提高生命质量，延长寿命。     

某市煤工尘肺流行病学调查

目的 通过煤工尘肺流行病学调查,了解煤工尘肺发病规律,为预防煤工尘肺提供科学依据.方法 搜集作业场所粉尘检测资料、煤工尘肺发病资料和作业工人健康监护资料,对1 292例煤工尘肺病例进行流行病学调查.结果 该市1974-2010年煤工尘肺年均发病率为3.07‰,平均发病年龄(41.2±4.3)岁,平均接尘工龄(22.9±7.4)年,2001年以来,尘肺发病有明显下降的趋势.结论 粉尘依然是煤矿作业工人的主要职业危害,三级预防是控制煤工尘肺发生发展的有效措施.     

镇江东风煤矿煤工尘肺发病情况30年动态观察

为分析薄煤层小型煤矿煤工尘肺动态发病情况、规律及影响因素，按前瞻性调查方法对各作业点粉尘浓度、接尘工人Ｘ线胸片进行了３０年动态观察。结果３０年间全矿共发现煤工尘肺患者７５０例，患病率２５．０７％，病死率１１．８７％，现患率２２．７７％。动态观察表明随着作业场所防尘措施的不断改善，尘肺发病率明显下降。不同诊断年代的发病工龄、年龄及平均生存年限，随时间推移明显延长，经等极相关检验有非常显著性意义（Ｐ＜０．０５）。提示薄煤层小型矿只要能采取以湿式作业为主的综合防尘措施，就能预防和控制煤工尘肺的发生和发展。     

尘肺疾病过程与接尘工人健康监护的关系

目的 分析尘肺流行病学特征，为完善粉尘作业工人健康监护技术规范提供依据。方法 运用回顾性队列研究方法对某地区20个厂矿的尘肺资料进行分析。结果 该地区尘肺的流行病学特征是：（1）尘肺发病平均潜伏期为22．9a。（2）52．2％的尘肺是在脱离接尘后发生的；平均时间为9．1a。（3）尘肺Ⅰ→Ⅱ、Ⅱ→Ⅲ晋期率分别为48．2％和18．5％，晋期平均时间为4．1a和6．8a。（4）尘肺并发结核率为51．3％。（5）尘肺患者平均生存时间为Ⅰ期21．5a，Ⅱ期15．8a，Ⅲ期6．8a，25％的Ⅰ期尘肺患者生存时间超过33a。（6）尘肺患者平均死亡年龄为56．0岁，20世纪90年代中期为66．0岁，已接近同期正常人群寿命。（7）疑似尘肺（0^＋）的潜伏期为20．8a。发展为尘肺的发生率为48．7％。晋为Ⅰ期的平均时间为5．1a。结论 尘肺是一种由于吸人不同生产性粉尘而引起的职业性肺病，呈慢性进展。脱离接尘作业后仍会发病，易并发肺结核，最终影响接尘工人寿命。完善并实施接尘工人健康监护体系是目前我国尘肺防治工作的重点之一。     

江西主要钨矿防尘效果的卫生学评价

自1958年综合防尘后，对江西钨矿的防尘效果进行卫生学评价。多数矿山矽肺患病率低于1％；个别矿山至1983年矽肺患病率为1．95％。以该矿资料，预测接尘30年的工人累积发病概率可达7．5％。据此，建议粉尘二氧化矽含量高于70％的矿山，粉尘最高允许浓度以1．0mg/m^3为宜。     

水泥生产性粉尘作业危害调查

目的 了解水泥生产性粉尘作业危害情况，探讨防治职业病危害对策和依据。方法 对水泥生产现场劳动卫生学调查并做生产性粉尘作业危害程度分级，以接尘工人为调查组，非接尘工作的管理人员为对照组进行健康检查。结果 水泥生产场所的粉尘浓度高(108．5mg／m^2)，工人接尘作业时间长(360min占8h劳动日的75％)，接尘作业时间肺总通气量大[5904L／(d．人)]，粉尘作业危害程度级别高(Ⅲ级)；接尘作业工人慢性上呼吸道炎患病率高，较对照组有显著性意义，尘肺患病率高达3.29％，尘肺种类既有矽肺也有水泥尘肺。结论 水泥生产作业的粉尘危害严重，呈现粉尘浓度高，粉尘作业危害程度级别高，尘肺患病率高的“三高”趋势。提示降低生产场所粉尘浓度，减少工人的接尘作业时间，降低劳动强度，是预防水泥生产性粉尘危害的有效措施。     

某煤炭集团公司尘肺病发病情况分析

目的了解某煤炭集团公司近7年尘肺病发病特征,为今后做好尘肺病防控工作提供可靠依据。方法对2006～2012年确诊并上报至中国疾病预防控制信息系统的某煤炭集团公司的685例尘肺病例进行描述性分析。结果685例尘肺病例中,煤工尘肺占87．59％,矽肺占12．41％。煤矿内主要工种（采煤和掘进）占发病人数的83．65％。685例尘肺患者中,平均接尘工龄为16．34年,其中接尘工龄〈10年的147例尘肺患者中,掘进与采煤工占85．03％,特别是纯掘进与纯采煤工患病工龄较短。矽肺患者的平均接尘工龄比煤工尘肺患者短,矽肺患者中纯掘进工人的接尘工龄比主掘进工人短。壹期尘肺患者所占比例偏低,贰期、叁期偏高。尘肺患者肺功能损伤者约占91％。肺结核并发率为2．34％。结论该煤炭集团公司职业病的发病情况不容乐观,应引起相关部门的重视,采取有效的预防措施,才能防止和减少职业病的发生。     

不同煤种呼吸性粉尘与尘肺病患病风险的剂量-反应关系分析

目的 探讨无烟煤、烟煤、褐煤呼吸性粉尘与尘肺病累计患病率的剂量-反应关系,为科学制定职业卫生标准提供依据。方法 对9处国有煤矿采煤工人的接尘和尘肺病患病情况进行调查研究,以寿命表法分别计算出无烟煤、烟煤、褐煤呼尘累计接尘量对应的累计患病率,利用线性回归方程进行单侧区间统计控制,得到呼尘接触浓度限值。结果 9处煤矿共21 000名采煤工人纳入研究,其中无烟煤、烟煤、褐煤煤矿采煤工人尘肺病检出率分别为11.27%、21.32%、6.00%,平均接尘工龄为20.12、22.88、25.21年。无烟煤、烟煤、褐煤煤矿采煤工人呼尘累计接尘量与尘肺病累计患病率的剂量-反应关系分别为线性回归方程y=5.788x-16.043（R²=0.949）、y=5.679x-16.837（R²=0.904）、y=6.465x-19.573（R²=0.944）。当接尘30年尘肺累计患病率≤1%时,以安全系数为1.2计算,三者呼尘接触浓度限值分别为1.7、2.3、3.9 mg/m³。结论 不同煤种的尘肺病检出率、平均接尘工龄、呼尘接触浓度限值均不同,在煤尘累计接尘量相似情况下,煤的挥发分越低（含碳量越高）,累计患病率越高（无烟煤 > 烟煤 > 褐煤）。建议按照不同煤种分别制定国家职业卫生煤尘标准。     

自贡市极薄煤层煤矿煤工尘肺X射线影像分析

目的了解极簿煤层煤矿工作场所职业卫生状况并探讨其与煤工尘肺X射线影像特征的关系。方法对15家煤矿井下、地面作业岗位开展职业病危害因素检测,对确诊的672例煤工尘肺病例的X射线胸片进行影像表现的统计分析。结果采煤、掘进、地面卸煤(岩石)岗位游离二氧化硅含量最低5.9%,最高58.4%,平均含量大于10%。极薄煤层煤矿工人工作场所接触的粉尘应为煤矽混合尘,工作场所粉尘浓度最低1.05 mg/m3,最高16.04 mg/m3。所测定的104份煤矿井下、地面工作场所粉尘样品浓度平均值均超过了国家职业卫生标准的限值。672份煤工尘肺X射线胸片表现形态为圆形小阴影的病例占90.18%。以圆形小阴影为主的X线胸片中q型占71.12%,p型25.41%r,型3.47%。Ш期煤工尘肺均表现为大阴影。Ⅰ期煤工尘肺小阴影主要分布于中下肺区的占67.33%;Ⅱ期煤工尘肺小阴影主要分布于上中下肺区的95.80%。Ш期煤工尘肺大阴影主要分布于上肺区和上中肺区。结论自贡市煤矿工人接触的粉尘为煤矽混合尘,煤工尘肺病患者X线影像形态大小以q型为主。     

Pneumoconiosis and advanced occupational lung disease among surface coal miners--16 states, 2010-2011

Coal workers' pneumoconiosis (CWP) is a chronic occupational lung disease caused by long-term inhalation of dust, which triggers inflammation of the alveoli, eventually resulting in irreversible lung damage. CWP ranges in severity from simple to advanced; the most severe form is progressive massive fibrosis (PMF). Advanced CWP is debilitating and often fatal. To prevent CWP, the Coal Mine Health and Safety Act of 1969 established the current federal exposure limit for respirable dust in underground and surface coal mines. The Act also established a surveillance system for assessing prevalence of pneumoconiosis among underground coal miners, but this surveillance does not extend to surface coal miners. With enforcement of the exposure limit, the prevalence of CWP among underground coal miners declined from 11.2% during 1970-1974 to 2.0% during 1995-1999, before increasing unexpectedly in the last decade, particularly in Central Appalachia. Exposure to respirable dust is thought to be less in surface than underground coal miners. Although they comprise 48% of the coal mining workforce, surface coal miners have not been studied since 2002. To assess the prevalence, severity, and geographic distribution of pneumoconiosis among current surface coal miners, CDC obtained chest radiographs of 2,328 miners during 2010-2011 through the Coal Workers' Health Surveillance Program of the National Institute for Occupational Safety and Health (NIOSH). Forty-six (2.0%) of 2,257 miners with >1 year of surface mining experience had CWP, including 37 who had never worked underground. Twelve (0.5%) had PMF, including nine who had never worked underground. A high proportion of the radiographs suggested silicosis, a disease caused by inhalation of crystalline silica. Surface coal mine operators should monitor worker exposures closely to ensure that both respirable dust and silica are below recommended levels to prevent CWP. Clinicians should be aware of the risk for advanced pneumoconiosis among surface coal miners, in addition to underground coal miners, to facilitate prompt disease identification and intervention.     

The incidence and progression of pneumoconiosis over nine years in U.S. coal miners: II. Relationship with dust exposure and other potential causative factors

Examination of the incidence and progression of pneumoconiosis over 9 years in 1,261 nationally distributed U.S. coal miners has been undertaken in relationship to potential causative factors. Use has been made of a large body of data on dust levels collected by the Mine Safety and Health Administration principally for compliance purposes. Reported dust levels were low and generally under the current 2 mg/m3 standard. No link between dust level and disease progression could be detected. Some evidence was seen that radiological change was related to dust exposures prior to the study in both coal and noncoal mines, and thus experienced before the current dust standards were mandated. Neither migration of miners nor mining method appeared to be associated with disease incidence or progression. None of these findings can be taken as final, as the period of study is short and the number of cases of pneumoconiosis few. Further study is under way to obtain more reliable information over a longer period of follow-up.     

Respiratory Status of Surface Coal Miners in the United States

The United States Public Health Service examined 1,438 surface coal miners to determine the prevalence of coal worker’s pneumoconiosis (CWP), chronic bronchitis, and ventilatory impairment among them. Four percent (fifty-nine individuals) showed some roentgenographic evidence of pneumoconiosis, but only seven miners had films interpreted as CWP of category2 or greater (according to the UlCC/Cincinnati classification system). Moreover, most of the affected miners had worked in underground coal mines for prolonged periods. Significant decrements in pulmonary function to increasing exposure to surface mine dust were demonstrated only in the forced vital capacity of smokers. Increased prevalence of chronic bronchitis with increasing exposure was found in all smoking categories. However, significant airway obstruction was an uncommon finding (6.6%) in nonsmoking miners. Employment in surface mining was not likely to cause either the development of CWP or clinically significant respiratory impairment.     

An investigation into the relationship between coal workers' pneumoconiosis and dust exposure in U.S. coal miners.

The National Study of Coal Workers' Pneumoconiosis (NSCWP) is a large, continuing epidemiologic study of the respiratory health of U.S. coal miners. By using information from the study, prevalence of coal workers' pneumoconiosis (CWP) was related to indexes of dust exposure obtained from research and compliance sampling data. Clear relationships between prevalences of both simple CWP and progressive massive fibrosis (PMF) and estimated dust exposure were seen. Additional effects independently associated with coal rank (% carbon) and age were also seen. Logistic model fitting indicated that between 2% and 12% of miners exposed to a 2-mg/m3 dust environment in bituminous coal mines would be expected to have Category 2 or greater CWP after a 40-yr working life; PMF would be expected for between 1.3% and 6.7%. The risks for anthracite miners appeared to be greater. There was a suggestion of a background level of abnormality, not associated with dust exposure, but increasing with age. Although there are certain weaknesses in the data used to derive these exposure estimates, the results are in general agreement with, but somewhat greater than, some recent findings for British coal miners.     

煤矿呼吸性粉尘与尘肺的剂量-反应关系

本文采用呼吸性粉尘与总粉尘同步对照监测方法,计算出两种粉尘浓度比值:岩尘为1:4.6;煤尘为1:22.3。把历年总粉尘浓度值转换为呼吸性粉尘浓度值,用寿命表法分析呼吸性粉尘接尘量与尘肺发病的剂量-反应关系。剂量-反应关系回归方程;掘进工为Y=3.3757LgX-2.6666(r=0.9585);采煤工为Y=7.2383 LgX-8.7793(r=0.9751)。由此推算出:呼吸性岩尘(含游离SiO_238.2%)容许浓度为1.18mg/m~3;呼吸性煤尘(含游离SiO_2<5%)容许浓度为1.27mg/m~3。作者力图能为国家有关部门制定呼吸性粉尘浓度卫生标准提供参考依据。     

British data on coal miners'' pneumoconiosis and relevance to US conditions.

OBJECTIVES. The current primary federal dust standard for US underground coal miners of 2 mg/m3 respirable dust is based on British epidemiological information on exposure-response derived in 1969. Since then, much new information has become available. This paper reviews and compares the available information as it relates to the US mining situation. METHODS. Recent exposure-response information on pneumoconiosis and dust exposure derived by British researchers was employed to estimate working-life risks of pneumoconiosis for miners exposed to 2 mg/m3. RESULTS. It is estimated that close to 9% of underground coal miners who work for 40 years in a 2 mg/m3 environment would develop pneumoconiosis (category 1 or greater). Progressive massive fibrosis would develop in 0.7%. CONCLUSIONS. There are unresolved questions relating to the validity of extrapolating findings on British mines and miners to the US and also in predicting disease levels at the low end of the dust exposure spectrum. Given the data available, current information suggests miners who are employed for a working life-time at the current federal dust limit of 2 mg/m3 are still at risk of developing pneumoconiosis.     

煤工尘肺预期发病工龄寿命表法研究

目的 研究煤工尘肺预期发病工龄。方法 收集整理某局1960－1995年期间的8291份接尘工人健康检查资料,分别计算不同时间的尘肺累积发病数,队列寿命表法求得矿工预期发病工龄。结果 煤矿工人的接尘工龄与累积患病率的概率单位之间呈正相关（r=0.98,P=0.0001),煤工尘肺的发病率随工龄的增加而增高,预期发病工龄随工龄的增加而缩短。结论 煤矿工人的尘肺发病工龄约为15年左右,在目前煤矿粉尘浓度水平的条件下,若想把尘肺患病率控制在1％左右,各工种的工人接尘期限以不超过6年为宜。