矽肺患者生存质量调查分析

目的评价并分析矽肺患者生存质量状况及其影响因素。方法采用WHOQOL-100量表调查150名矽肺患者及150名未患矽肺工人，将调查结果用SPSS11．0统计软件进行分析。结果矽肺患者对生存质量及其生理功能、心理状态、独立性领域的主观满意度均较对照组低，特别是在躯体疼痛、精力、睡眠、信心、负性情感、行动能力、日常生活能力、依赖性、获取信息、休闲活动、信仰等方面与对照组相比，差异有显著性。其影响因素主要为心理、生理、环境因素。结论关注矽肺患者的生存质量，在积极开展矽肺及合并症治疗的同时，做好健康教育及心理疏导工作。     

矽肺患者生存质量影响因素调查分析

[目的]评价并分析矽肺患者生存质量状况及其影响因素。[方法]采用WHOQOL-100量表调查150例矽肺患者及150名健康正常人。将调查结果用SPSS11．0统计软件进行分析。[结果]矽肺患者的生存质量较对照组明显降低，其在生理、心理、独立性、精神4个领域的得分与对照组相比差异有统计学意义（P〈0．05），影响其生存质量的因素主要为心理状态、生理功能、环境及社会关系（R^2=0．647）。[结论]在治疗矽肺及并发症的同时，重视患者健康教育，提供心理治疗，鼓励参加休闲活动和社会交往，有利于提高矽肺患者的生存质量。     

矽肺患者生存质量的调查分析

[目的]了解矽肺患者的生存质量及其影响因素,为提高矽肺患者的健康水平提供依据。[方法]随机抽取150名矽肺患者,采用生存质量量表和老年人微小营养评价表进行调查,并对其肺功能进行测定,数据用SPSS11.5统计软件进行分析。[结果]肺功能、营养状况和同病分等均对矽肺患者生存质量有显著的影响(P﹤0.05)。[结论]加强健康教育,使患者保持良好的营养状态,改善肺功能,减少合并其他疾病,可以显著提高矽肺患者的生存质量。     

窑街煤矿矽肺患者肺功能状况调查分析

目的了解矽肺患者的肺功能状况及其对生存质量的影响,为提高矽肺患者的健康水平提供依据。方法随机抽取300名矽肺患者,采用日本进VI的高级肺功能测量分析仪chest-8800和生存质量量表,对矽肺患者进行肺功能测定生存质量调查,数据用SPSS11．5统计软件进行分析。结果矽肺患者肺功能损伤以中度损伤为主,肺功能损伤与并发症或合并症程度有关联性（P〈0．05）,并对矽肺患者生存质量有显著的影响（P〈0．05）。结论应采取有效措施,改善矽肺患者肺功能,加强健康教育,减少合并其他疾病,堤进生存质量的提高。     

煤矿工人呼吸系统的健康状况调查

目的对煤矿工人呼吸系统的健康状况进行调查。方法选择中国西南两煤矿225例确诊的矽肺患者为病例组,294名接尘工人组成对照组,均为男性,进行详细地问卷调查并对肺功能进行检查分型。结果病例组和对照组比较,呼吸困难及肺功能障碍的严重程度均有所增加,且随着工种接触数值估测(JEM)及矽肺晋级增加而加重(P<0.05)。结论矽肺晋级、吸烟及其程度以及高剂量粉尘暴露等为影响矽肺患者呼吸系统健康的重要因素,需加强防尘控烟,从而提高矿工的健康质量。     

矽肺患者血清白细胞介素-12和γ-干扰素水平变化

目的探讨矽肺患者血清白细胞介素-12(IL-12)和γ-干扰素(IFN-γ)水平变化。方法用酶联免疫吸附双抗体夹心法检测45例矽肺患者、34例具有相同接尘史但未患矽肺的井下工人及32例井上健康人血清IL-12和IFN-γ含量。结果与对照组比较,矽肺组患者血清IL-12水平明显增高(P<0.01),IFN-γ明显降低(P<0.01)。与接尘工龄低于20年的矽肺患者比较,20~30年和高于30年2组矽肺患者IL-12和IFN-γ水平均明显降低,差异具有统计学意义(P<0.01和P<0.05)。随矽肺患者年龄增加,IL-12和IFN-γ水平明显降低(P<0.01)。Ⅱ和Ⅲ期矽肺患者血清IL-12和IFN-γ水平均高于Ⅰ期,两组比较其差异均具有统计学意义(P<0.01和P<0.05)。井下接尘工人IL-12和IFN-γ水平与矽尘接触工龄、年龄均无关(P>0.05)。结论IL-12和IFN-γ协同参与矽肺发生和发展过程,且与其严重程度有关。血清IL-12和IFN-γ检测可能对矽肺早期诊断、疗效观察及病情监测有一定价值。     

铜矿老工人生存质量研究

目的了解铜矿老工人生存质量现状。方法单纯随机抽取某铜矿60岁以上老工人208名,采用WHOQOL-100量表对其生存质量进行调查。结果73.6%的老工人生存质量在中等及以上水平;81.7%的老工人患有各种慢性病,居于前5位的是矽肺、慢性支气管炎、高血压、肺气肿、肺结核;影响铜矿老工人生存质量的因素有食欲、是否患慢性病、家庭摩擦、年龄、文化程度、婚姻及是否患矽肺。结论铜矿老工人生存质量低于城区老年人;其影响因素以健康状况、家庭关系方面为主。     

初诊矽肺患者心理分析及健康教育方法

目的了解初诊矽肺患者的心理特征,针对性地进行心理健康教育,提高患者生活质量。方法对患者进行口头问卷调查,了解患者矽肺防治知识和心理及生活情况,并针对性进行教育疏导,比较健康教育前后患者对矽肺知识的掌握情况和健康行为的改变。结果 72例矽肺患者通过健康教育对矽肺相关知识和健康行为认知均有不同程度的提高。结论应在初诊早期进行健康教育,有针对性对问题进行疏导,养成良好生活习惯,延缓病情进展,预防并发症的产生,提高患者生活质量。     

护理干预提升矽肺患者生存质量的研究

目的 探讨护理干预措施对矽肺患者生存质量(QOL)的影响.方法 采用世界卫生组织QOL测量表(WHOQOL-100)调查矽肺患者护理干预前后的QOL并进行测评.结果 矽肺患者接受护理干预后QOL较对照组明显提高,表现在生理、心理、独立性、精神领域及日常生活能力、总体健康等方面干预组与对照组比较,差异有显著性(P＜0.01).结论 以护理程序为工具的综合护理干预对提升矽肺患者QOL具有重要意义,值得推广.     

某钨矿矽肺患者生存状况调查分析

目的寻找防治矽肺的最佳策略,降低矽肺的发生率和死亡率。方法回顾性调查某钨矿1956—2008年间967例矽肺患者的死亡原因、死亡年龄和死亡季节,并与该矿同期未患矽肺的职工进行比较。结果各年代合计矽肺合并肺结核为全死因的第1位,占28.2%;其次为矽肺病本身占24.5%。与该矿同期未患矽肺死亡职工比较,不论是呼吸系统全部疾病(χ2=661.01,P0.01),还是单一的肺结核(χ2=228.98,P0.01),其病死率差异均有统计学意义。结论综合防尘、加强健康教育和个人防护,可有效降低矽肺发病率,积极治疗肺结核等并发症,可明显延长矽肺患者的寿命。     

上海耐火材料厂矽肺患者死亡情况分析

本文对上海耐火材料厂历年（１９５８－１９９０）确诊的矽肺患者进行不同入厂年代矽肺发病，死亡情况分析；计算矽肺患者各类疾病死亡率，与当地居民的年龄别死亡率进行比较，计算标化死亡比；并对不同年代的矽肺病人的平均死亡年龄，确诊至死亡的平均年限进行分析。结果表明，该厂矽肺患者死因中，以非特异死亡的恶性肿瘤和循环系统疾病占第一，第二位；与矽肺直接有关的特异死亡占第三位。矽肺患者寿命与当地居民相比，无统计学…     

Retrospective mortality cohort study of Italian workers compensated for silicosis

Objectives

To estimate cause specific mortality in a large cohort of Italian workers compensated for silicosis.

Methods

The cohort included 14 929 subjects (14 098 men and 831 women) compensated for silicosis between 1946 and 1979, alive on 1 January 1980, and resident in Tuscany (a region of central Italy with 3 547 000 inhabitants). Mortality follow up ranged from 1980 to 1999. Vital status and the causes of death were determined by linkage with the regional mortality registry and with the national mortality database. The cohort mortality rates were compared to the rates of the local reference population. SMRs and their 95% confidence intervals were computed assuming a Poisson distribution of the observed deaths. Specific SMR analyses were performed according to the level of disability, the year of compensation assignment, and the job type.

Results

A significant excess mortality was observed in male silicotics for cancer of the lung, trachea, and bronchus and cancer of the liver, respiratory diseases (silicosis, asbestosis, antracosilicosis, and other pneumoconiosis), and for tubercolosis. Statistically significant mortality excess was observed in female silicotics for respiratory diseases (specifically silicosis and other pneumoconiosis) and tuberculosis. Analyses for period of compensation assignment showed a twofold increased SMR for biliary tract cancer among female workers and for liver cancer among male workers compensated before 1970.

Conclusions

The excess mortality from respiratory tract cancers and respiratory tract diseases detected in Italian compensated silicotics are in agreement with previous epidemiological studies. Although the twofold increased risk for liver cancer among males is suggestive of a possible association with silica dust exposure, the finding needs to be confirmed.     

尘肺管理工作的回顾与控制策略的探讨

本文回顾了我国矽肺预防和控制的历史，重点阐述了有关矽肺预防的管理方法诸如１９４９年以来的有关法律和法规的建立方面。虽然几十年来取得了很大成绩，但矽肺仍是危害工人健康的最大威胁。主要问题是执法力度不够，各部门之间缺乏必要的协作，防治矽肺的策略有待改进。由此作者提出对矽肺的预防和控制应是②贯彻预防矽肺的综合措施，坚持“八字”方针；②向矽肺病人提供综合治疗，而不仅仅是特殊疗法；③加大执法力度；④把预防矽     

Long-term effect of occupational dust exposure

In 1950-1960, a cohort of dust-exposed workers and a cohort of multiple matched unexposed subjects was set up from the files of preventive medical checkups performed in 1,089 Viennese plants. Male workers with a history of long-term exposure to nonfibrous particulates in different industries (metal, ceramics, brick, glass, stone etc.) aged greater than or equal to 40, and male workers without dust exposure (matched for residency, start of observation, age, and smoking) were followed up to 1980 or death (48,960 person yr). By life table methods, dust-exposed workers compared to unexposed workers showed a reduced survival of age 60 (p less than 0.0001), due to lung cancer (123 exposed, 87 controls, p = 0.001), stomach cancer (48/27, p = 0.003), silicosis (40/0), emphysema, bronchitis and asthma (41/23, p = 0.007). No difference in mortality from cardiovascular diseases was observed (p greater than 0.50). We concluded that heavy and long term exposure to respirable particulates is related to increased lung cancer mortality after age 60. A comparison of 2,212 deaths among Austrian silicotics, with deaths in the corresponding population showed a relation between lung cancer and silicosis (p less than 0.001), fairly independent of age and time-period. The estimated relative lung cancer risk of Austrian silicotics in the period 1955-79 averaged 1.41 (95% confidence 1.21-1.64).     

Silicosis and lung cancer in North Carolina dusty trades workers

Since 1940, 760 cases of silicosis have been diagnosed as part of the State of North Carolina's (NC) pneumoconiosis surveillance program for dusty trades workers. Vital status was ascertained through 1983 for 714 cases that had been diagnosed since 1940 and death certificates were obtained for 546 of the 550 deceased. Mortality from tuberculosis, cancer of the intestine and lung, pneumonia, bronchitis, emphysema, asthma, pneumoconiosis, and kidney disease was significantly increased in whites. Mortality from tuberculosis, ischemic heart disease, and pneumoconiosis was significantly increased in non-whites. The standardized mortality ratio (95% CI) for lung cancer based on U.S. rates was 2.6 (1.8-3.6) in whites, 2.3 (1.5-3.4) in those who had no exposure to other known occupational carcinogens, and 2.4 (1.5-3.6) in those who had no other exposure and who had been diagnosed for silicosis while employed in the NC dusty trades. Age-adjusted lung cancer rates in silicotics who had no exposure to other known occupational carcinogens were 1.5 (.8-2.9) times higher than that in a referent group of coal miners with coalworkers' pneumoconiosis (CWP) and 2.4 (1.5-3.9) times higher than that in a referent group of non-silicotic metal miners. Age- and smoking-adjusted rates in silicotics were 3.9 (2.4-6.4) times higher than that in metal miners. This analysis effectively controls for confounding by age, cigarette smoking, and exposure to other known occupational carcinogens, and it is unlikely that other correlates of silica exposure could explain the excess lung cancer mortality in the silicotics.     

Silicosis in a grey iron foundry. The persistence of an ancient disease

An industrial hygiene and medical survey was conducted in an iron foundry to study the occurrence of silicosis. Breathing zone exposures to respirable crystalline silica had been very high in 1977 [1 045 micrograms/m3 (geometric mean) for coremakers and 198 micrograms/m3 for fettlers]; exposures in 1980 and 1982 were substantially lower. A radiographic evaluation of 188 workers revealed silicosis in 18 (9.6%). Eight had category 1 profusion of small rounded pulmonary lesions (by the 1980 classification of the International Labour Office); two had category 2; and eight had category 3. Two had progressive massive fibrosis. Four workers without silicosis in 1977 had developed lesions by 1980. The prevalence increased from 1.5% among workers employed less than 20 years to 53% among longer term workers. No association was found between the prevalence of silicosis and cigarette smoking. Chronic cough was more common in workers with heavy current dust exposure than in those with light exposure, more common in smokers than in nonsmokers, and more common in silicotics than in nonsilicotics. A multiplicative interaction existed between dust exposure and smoking in the etiology of cough. Silicosis continues to exist in American foundries. Cigarette smoking does not contribute to the causation of silicosis, but it aggravates the attendant respiratory symptoms.     

矽肺及矽肺结核患者血液黏度和体外血栓的研究

目的：探讨矽肺以及矽肺结核患者血液黏度和体外血栓的变化。方法：检测288例矽肺患者、178例矽肺结核患者以及150例健康对照者血液黏度和体外血栓的长度和干重。结果：矽肺组和矽肺结核组与正常对照组比较血液黏度（Ⅰ期矽肺除外）和体外血栓均显著增高,患者各组内Ⅰ、Ⅱ及Ⅲ期间血液黏度亦随期别增加而递增,且差异显著,体外血栓无显著差异;Ⅰ、Ⅱ期矽肺结核患者分别与同期矽肺患者比较,全血黏度在高、中剪切率下显著增加,在低剪切率下以及血浆黏度差异无显著性,体外血栓长度和干重亦增加显著;Ⅲ期矽肺结核患者与Ⅲ期矽肺患者比较,血液黏度和体外血栓均无显著差异。结论：矽肺患者血液呈高黏、高凝状态,且随期别增加血液黏度和体外血栓长度及干重均相应增加,合并结核者尤甚。     

Mortality of workers compensated for silicosis during the period 1959-1963 in the Veneto region of Italy

After reports appeared from other countries indicating an excess risk of lung cancer among silicotics, a cohort of workers compensated for silicosis during the period 1959-1963 in the Veneto region of Italy was constructed and followed for mortality through 1984. The results of the study showed a large mortality excess for infectious diseases (180 observed versus 9.5 expected), due to silicotuberculosis, and for diseases of the respiratory system (270 observed versus 33.5 expected) due to silicosis. An elevated standardized mortality ratio of 239 (70 observed versus 29.3 expected) from lung cancer was also detected. An increasing pattern was observed with time since first exposure, while the relationship with employment category and duration of exposure was less clear-cut. The lung cancer excess was also strongly associated with cigarette smoking, there being a dose-response relationship with daily cigarette consumption. The study confirms the results from other epidemiologic studies on silicotics which show this pathological condition to be associated with increased lung cancer mortality.