2019-2020年中国40岁及以上人群职业粉尘或有害气体暴露与防护情况分析

目的 分析中国≥40岁人群粉尘或有害气体的暴露和防护情况，为开展职业粉尘或有害气体暴露防控工作提供基础数据。方法 数据来源于2014-2015年和2019-2020年中国居民慢性阻塞性肺疾病监测。两次监测均采用多阶段分层整群抽样方法，在全国31个省（自治区、直辖市）中125个监测点抽取调查对象，并采用面对面询问调查的方式收集职业粉尘或有害气体暴露及其防护状况等相关信息。采用复杂抽样加权方法估计职业粉尘或有害气体暴露率及防护率，并比较两次监测的结果。结果 2014-2015年和2019-2020年分别有71 061人和71 023人纳入分析。2019-2020年我国≥40岁人群职业粉尘或有害气体的暴露率为33.8%（95%CI：29.9%~37.7%），男性高于女性，乡村高于城镇。随着文化程度的升高，职业粉尘或有害气体的暴露率呈下降趋势。2019-2020年我国≥40岁人群职业粉尘或有害气体防护率为47.9%（95%CI：43.2%~52.6%）。与2014-2015年相比，2019-2020年我国≥40岁人群职业粉尘或有害气体暴露率在不同性别、地区和职业人群中均有所下降，总体下降了10.7个百分点，职业粉尘或有害气体防护率均有所上升，总体上升了21.9个百分点。西部地区职业暴露率下降幅度高于东、中部地区，职业防护率上升幅度高于东、中部地区。结论 2019-2020年我国粉尘或有害气体职业暴露率有所下降，职业粉尘或有害气体防护率有所上升，但仍有约三分之一的人群存在职业粉尘或有害气体暴露，且其中采取防护的比例尚不足一半，应更加关注文化程度较低的职业人群、农民工群体等重点人群的职业防护。

Analysis on occupational dust or harmful gas exposure and protection in people aged 40 and above in China， 2019-2020

Objective To understand the current status of occupational exposure to dust or harmful gases and occupational protection in people aged ≥40 years in China, and provide data support for the prevention and control of occupational dust or harmful gas exposure. Methods The data were obtained from the surveillance for chronic obstructive pulmonary disease (COPD) in adults aged ≥40 years selected by multi-stage stratified cluster sampling from 125 surveillance points in 31 provinces (autonomous regions and municipalities) during 2014-2015 and 2019-2020, and relevant information about occupational dust or harmful gas exposure and protection measures were collected through face-to-face interviews. Occupational dust or harmful gas exposure rate and occupational protection rate were estimated by using weighting complex sampling methods, and then the results were compared. Results From 2014 to 2015 and from 2019 to 2020, a total of 71 061 and 71 023 individuals aged ≥40 years were surveyed, respectively. The rate of occupational exposure to dust or hazardous gas was 33.8% (95%CI: 29.9%-37.7%) during 2019-2020. The occupational exposure rate was higher in men than in women and in rural residents than in urban residents. With the increase of education level, the rate of occupational exposure to dust or harmful gas showed a downward trend. The protection rate against occupational dust or hazardous gas exposure was 47.9% (95%CI: 43.2%-52.6%) during 2019-2020. Compared with 2014-2015, the rate of occupational exposure to dust or hazardous gas decreased by 10.7 percentage points in different gender, area and occupational groups and the occupational protection rate increased by 21.9 percentage points during 2019-2020. The decrease in occupational exposure rate was higher in western China than in eastern and central China, and the increase in occupational protection rate was higher in western China than in eastern and central China. Conclusions The rate of occupational exposure to dust or harmful gas decreased and the rate of occupational protection against dust or harmful gas exposure increased in China during 2019-2020. However, about one-third of the population still suffer from the occupational exposure, and less than half of them take protection measures. It is necessary to pay more attention to the key populations, such as workers with lower cultural level and rural migrant workers, in occupational health practice.