1990―2019年中国煤工尘肺疾病负担研究

  目的  分析1990―2019年中国煤工尘肺(coal workers’ pneumoconiosis, CWP)的疾病负担水平及其变化趋势。  方法  利用2019年全球疾病负担研究(Global Burden of Disease Study, GBD 2019)数据库，提取中国CWP的患病、发病与死亡者例数和特征信息，以及伤残调整寿命年(disability adjusted life year, DALYs)等疾病负担指标，分析CWP的疾病负担状况、年龄性别分布及时间变化趋势，并与全球人群进行对比。  结果  1990―2019年中国CWP的患病人数从87 555例降至86 296例，降幅为1.44%；发病人数从5 450例降至4 974例，降幅为8.73%；死亡人数从1 661例降至1 302例，降幅为21.61%；DALYs从57 206.70人年降至41 359.25人年，降幅为27.70%。中国CWP的年龄标化患病率、发病率、死亡率和DALYs率均呈下降趋势，平均年度变化百分比(average annual percentage change, AAPC)分别为-2.75%、-2.53%、-3.67%和-3.73%。中国CWP造成的疾病负担主要集中在男性。相较于1990年，2019年中国有更多高龄工人现患、新发或死于CWP。1990―2019年中国CWP的各项年龄标化率指标均高于全球同期水平，差异均有统计学意义(均有P < 0.001)。  结论  中国CWP引起的疾病负担整体呈下降趋势，表明中国CWP的防治取得了一定成效，但发病例数仍维持在较高水平，且各项年龄标化率指标始终高于全球同期水平，提示需要大力加强CWP的防控。

Study on the burden of coal workers' pneumoconiosis in China from 1990 to 2019

  Objective  To analyze the level of disease burden and temporal trend of coal workers' pneumoconiosis (CWP) in China from 1990 to 2019.  Methods  The detailed data on CWP extracted from the database of the Global Burden of Disease Study 2019 (GBD 2019) was used to evaluate the disease burden and temporal trend of CWP in the Chinese population. The data included prevalent cases, incident cases, death cases, and indicators concerning disease burden such as disability-adjusted life years (DALYs).  Results  In China, prevalent cases of CWP decreased by 1.44% from 87 555 in 1990 to 86 296 in 2019; incident cases of CWP decreased by 8.73% from 5 450 in 1990 to 4 974 in 2019; deaths of CWP decreased by 21.61% from 1 661 in 1990 to 1 302 in 2019; DALYs of CWP decreased by 27.70% from 57 206.70 person-years in 1990 to 41 359.25 person-years in 2019. The age-standardized prevalence, incidence, mortality, and DALY rates of CWP in China decreased since 1990, with AAPCs of -2.75%, -2.53%, -3.67%, and -3.73%, respectively. And the disease burden of CWP was mainly caused by male groups. Compared with 1990, more elderly workers in China in 2019 suffered from or died of CWP. The age-standardized indicators of CWP in China were all higher than those globally from 1990 to 2019, and the differences were statistically significant (all P < 0.001).  Conclusions  The disease burden caused by CWP in China showed a downward trend in general, indicating that the prevention and control of CWP in China had obtained certain achievements. However, the incident cases of CWP in China remained at a high level, and the age-standardized indicators were still higher than those globally. Therefore, more efforts are needed to pay attention to the prevention and control of CWP in China.