2014年中国40岁及以上人群粉尘和/或有害气体暴露及其防护情况分析

摘要

Objective To understand the current status of dust and/or harmful gas exposure in adults aged ≥40 years and corresponding protection in China,and provide evidence for strengthening the occupational protection against dust and harmful gas exposure.Methods The data were obtained from 2014-2015 COPD surveillance in China.A total of 75 107 adults aged ≥40 years selected through multi-stage stratified cluster sampling from 125 surveillance points in 31 provinces (autonomous regions and municipalities) were surveyed in face to face interviews.Occupational exposure was defined as occupational exposure to dust and/or harmful gas for more than 1 year.The weighted percentages of exposure were estimated by using complex sampling design.Results Among eligible 71 061 participants,the exposure rate of dust and/or harmful gas was 46.3％.The exposure rate in rural area (51.7％) was significantly higher than that in urban area (40.3％),and the exposure rate in the western area was higher than those in the eastern and central areas (P＜0.001).Among the groups with different education level,the exposure rate in those with education level of primary school and below was highest (49.7％,P＜0.001).The exposure protection rate was 26.7％,and the exposure protection rate was highest in the eastern area (29.9％),followed by that in the central area (27.0％) and that in the western area (22.9％) The exposure protection rate in urban area was significantly higher than that in rural area,and the exposure protection rate was lowest in those with education level of primary school and below.The regular exposure protection was taken by only 50.7％ of the adults surveyed.Conclusion The exposure rate of dust and/or harmful gas is high in China,while the exposure protection rate is very low.Health education,occupational protection and supervision should be strengthened among those with low education level,and those living in rural area and in the western area.%目的 分析我国≥40岁人群粉尘和/或有害气体暴露的流行及其防护状况,为加强我国粉尘和有害气体暴露的职业防护提供依据.方法 资料来源于2014-2015年中国居民COPD监测,在31个省(自治区、直辖市)采用多阶段分层整群抽样,横断面调查125个监测点的≥40岁研究对象共75 107名,采用面对面询问调查方式收集相关信息,职业暴露定义为职业接触粉尘和/或有害气体累积超过1年.对样本进行复杂抽样加权估计暴露比例.结果 在纳入分析的71 061人中,粉尘和/或有害气体暴露率为46.3％,乡村(51.7％)高于城镇(40.3％);西部地区人群的暴露率高于东、中部地区(P＜0.001);在不同文化程度人群中,小学及以下人群的暴露率最高(49.7％,P＜0.001).暴露人群采取防护措施比例总体为26.7％,东、中、西部地区暴露人群防护比例依次降低;城镇高于乡村;小学及以下文化程度的采取防护措施比例最低(20.7％).在采取防护措施的人群中,经常防护者仅占50.7％.结论 我国人群粉尘和有害气体职业暴露率较高,采取防护措施比例较低,应当加强西部、乡村及文化程度较低人群的健康教育、职业防护和监管.