铁矿工人队列死因研究

目的 探索危害铁矿作业工人健康的主要疾患及职业有害因素对工人寿命的影响.方法 用流行病学队列研究方法,对武钢大冶铁矿7 469名职工从1972年开始随访30余年,以全国城市居民年龄别死亡率为参照,用标化死亡比（SMR）作为统计指标,并计算95%可信区间.结果 自1972年至2003年底,共计199 108.0人年,死亡1 752人,累积死亡率为23.5%.影响铁矿工人寿命的主要疾病按累积死亡率从高到低排序分别是：肿瘤（7.8%）、脑血管疾病（3.9%）、心血管系疾病（3.4%）和呼吸系疾病（2.9%）,恶性肿瘤以肺癌和肝癌最多,分别占总死亡数的10%和7.4%.全死因SMR为1.06,高于全国平均水平.死亡率明显升高的疾病有鼻咽癌、肝癌、肺癌、尘肺和意外事故,SMR分别为1.84、1.51、1.83、14.94和1.25.队列中接尘工人与非接尘工人比较,接尘工人全死因、胃癌、肺癌、呼吸系统疾病、心血管疾病和意外事故的累积死亡率明显升高（相对危险度分别为1.35、1.83、1.61、2.27、1.34和1.69）.结论 以粉尘为主的职业有害因素明显影响铁矿工人健康和寿命.

Cohort mortality study of dust exposed miners in iron mine

Objective To investigate the main diseases jeopardizing the health of the iron miners and to explore the relationship between dust exposure and malignancies as well as other diseases.Methods A retrospec- tive study with a cohort of 7,469 workers employed between January 1,1972 and December 31,1974 in Daye Iron Ore Mine Co.in Hubei Province was conducted.Standardized mortality ratio(SMR) was calculated for the main causes of death using Chinese national mortality rates for reference.Results All subjects were followed up through December 31,2003 with an accumulation of 199,108.0 person years.A total of 1 752 workers died.The cumulative mortality was 23.5%.The cancers,cerebrovascular diseases,non-malignant respiratory diseases and cardiovascular diseases were main diseases that threatened workers' life span.The SMR for all subjects was a little higher than ex- pected based on the Chinese national mortality rates.The diseases causing the significantly higher death rate were the nasopharynx cancer,liver cancer,lung cancer,pneumoconiosis and accidence with SMR 1.84,1.51,1.83, 14.94 and 1.25 respectively.Increased mortality was observed among dust-exposed workers in the cohort.The cu- mulative mortality from all causes such as stomach cancer,lung cancer,nonmalignant respiratory diseases,cardio- vascular diseases and accidence in dust exposed workers were significantly increased compared with those in non- exposure workers with RR 1.35,1.83,1.61,2.27,1.34 and 1.69 respectively.Conclusion The risk factors es- pecially dust exposure affect the health and lifespan of the iron mine workers.