2013年淮河流域14个县（区）肝癌对期望寿命的影响及其与水环境的关系

摘要

Objective To investigate the relationship between liver cancer and the water environment, we analyzed the life expectancy in 14 counties (districts), which form the Huai River Basin with respect to liver cancer deaths in 2013 and changes in the surface water quality from 2004 to 2010. Methods The study area included the 14 counties (districts) of the Huai River Basin in China. We obtained surveillance data for all causes of death in the study area during 2013, as well as data for International Classification of Diseases,Tenth Edition(ICD-10) code C22 or liver cancer. Life expectancy and life expectancy after elimination of liver cancer were then calculated. Based on water quality monitoring data from the China Environment Yearbook 2005-2011, we analyzed the water environment of the Huai River Basin, and changes in the water quality. According to the“Encyclopedia of Rivers and Lakes in China”(Huai River Basin section), we divided the river basin into five categories: upstream basin (upstream);midstream, north shore of the basin (midstream-north);midstream, south shore of the basin (midstream-south);downstream basin (downstream); and the Yishusi River Basin. To calculate the life expectancy and life expectancy after elimination of liver cancer in the study area, we used the Nemerow Pollution Index (NPI), to investigate the relationship between liver cancer and the water environment. Results Life expectancy in the 14 study districts varied from 68.99 years (Shenqiu County) to 78.85 years (Jinhu County). Gains in life expectancy after elimination of liver cancer varied from 0.86 to 0.31 years. Midstream-north showed the greatest improvement, with overall gain in life expectancy of 0.77 years;this gain was 1.04 years for males and 0.40 years for females. Yishusi River Basin showed the least improvement, with overall gain in life expectancy of 0.41 years;this gain was 0.54 years for males and 0.24 years for females. For the 7 years from 2004 to 2010, midstream-north had the highest annual NPI values, at 2.08, 1.74, 1.64, 1.81, 1.41, 1.26, and 1.06, respectively. There was a positive correlation between NPI and life expectancy gain for both males and females (r=0.64, P=0.014). There was positive correlation between NPI and life expectancy gain among males alone (r=0.64, P=0.014); there was no significant correlation between NPI and life expectancy gain among females (r=0.44, P=0.115). Conclusion Liver cancer had a significant impact on life expectancy in the Huai River Basin. The gain in life expectancy was higher for males than for females. There is a possible relationship between liver cancer deaths and the water environment in the research area, but this study did not infer a causal association.%目的：分析淮河流域14个县（区）2013年期望寿命、去肝癌死因期望寿命和2004—2010年地表水质变化情况，探讨肝癌与水环境的关系。方法选择淮河流域14个县（区）为调查地区，提取中国CDC淮河流域死因监测数据库中2013年死因监测数据，其中《国际疾病分类第十版（ICD-10）》中编码22的为肝癌死亡数据；收集并整理2004—2010年《中国环境年鉴》中淮河流域主要水质监测指标年均值数据。依据《中国河湖大典》将淮河流域地理特征及调查地区分为5类：淮河上游地区（上游）、淮河中游北部支流地区（中游北部）、淮河中游干流及南部支流地区（中游南部）、淮河下游地区（下游）和沂沭泗河流域（沂流）。计算调查地区期望寿命及去肝癌死因期望寿命和内梅罗水质污染指数，分析肝癌与水环境的关系。结果位于下游的江苏省金湖县期望寿命最高，为78.85岁，位于中游北部的河南省沈丘县期望寿命最低，为68.99岁；去肝癌死因后的期望寿命增加值最高的县（区）为0.86岁，最低的县（区）为0.31岁；中游北部期望寿命增加值较高，为0.77岁，其中男性、女性期望寿命增加值分别为1.04、0.40岁；沂流期望寿命增加值较低，为0.41岁，其中男性、女性期望寿命增加值分别为0.54、0.24岁。2004—2010年，中游北部内梅罗水质污染指数较高，分别为2.08、1.74、1.64、1.81、1.41、1.26、和1.06；内梅罗水质污染指数与人群期望寿命增加值呈正相关（r=0.64，P=0.014），其中，与男性期望寿命增加值呈正相关（r=0.64，P=0.014），与女性期望寿命增加值相关性无统计学意义（r=0.44，P=0.115）。结论肝癌对期望寿命的影响较大，男性去肝癌死因期望寿命增加值高于女性；肝癌死亡与调查地区水环境污染可能存在一定关联，但并不能判定其因果关系。