中国人群矽肺的疾病负担分析及预测探讨

Discussion on analysis and prediction of disease burden of silicosis in Chinese population

关键词: 矽肺  疾病负担  贝叶斯年龄-时期-队列(BAPC)模型

Keywords: silicosis  burden of disease  Bayesian age-period-cohort (BAPC) model

摘 要: 目的 对 1990—2021 年中国人群矽肺的疾病负担进行系统分析,并预测 2022—2030 年的疾病负担水平,为矽肺防治的政策制定和措施实行提供数据支持。方法 应用发病、死亡和伤残调整生命年(disability-adjusted lifeyears,DALYs)的绝对数、率及其年龄标准化率衡量 1990—2021 年我国矽肺的疾病负担;采用年均变化率(estimated annual percentage change,EAPC)反映疾病负担指标的标准化率随时间变化情况;应用贝叶斯年龄-时期-队列(Bayesian age-period-cohort, BAPC)模型预测 2022—2030 年中国人群矽肺疾病负担。结果 与 1990 年相比,2021 年中国人群矽肺发病数由 1.33 万例(95%UI 1.10~1.58)增至 2.34 万例(95%UI 1.99~2.70),死亡数由 0.48 万例(95%UI 0.35~0.63)增至 0.63 万例(95%UI 0.47~0.82),DALYs 由 15.07 万人年(95%UI 11.39~19.36)增至 17.31 万人年(95%UI 13.44~22.47)。2021 年中国矽肺发病数、死亡数和 DALYs 占全球总水平的比例分别为 65.92%、61.76%、66.25%,其中在 55~<60 岁组发病比例最高(75.94%),40~<45 岁组死亡比例最高(79.52%), DALYs 在 40~<45 岁组比例最高(75.95%)。1990—2021 年,我国全人群年龄标化发病率的 EAPC-0.98% (95%CI-1.11%~-0.86%);年龄标化死亡率的 EAPC -2.06%(95%CI-2.16%~-1.97%);年龄标化 DALY 率的 EAPC-2.15%(95%CI-2.22%~-2.09%)。预测结果显示,2022—2030 年中国矽肺的标化发病率预计在 1.80/10 万上下浮动,标化死亡率从 0.61/10 万降至0.48/10 万。结论 虽然中国矽肺疾病负担呈下降趋势,但由于其现存病例数庞大,在未来职业病防治领域仍占据重要地位。

Abstract: Objective Analyze the disease burden of silicosis in Chinese population from 1990 to 2021,and predict the disease burden level of 2022 to 2030,thereby provide some data support for the policy formulation and measure implementation of silicosis prevention and control in future.Methods The disease burden of silicosis in China from 1990 to 2021 was measured using the absolute number,rate,and age standardized rate of incidence,death and disability adjusted life-years (DALYs),the estimated annual percentage change (EAPC) was used to reflect the standardized rate of disease burden indicators over time,and Bayesian age-period-cohort (BAPC) model was used to predict the disease burden of silicosis in the Chinese population from 2022 to 2030. Results Compared with 1990,the number of silicosis cases in the Chinese population increased from 13300 (95%UI 11000~15800) to 23 400 (95%UI 19900~27000) in 2021, the deaths number from 4800 (95%UI 3500~6300) increased to 6300 (95%UI 4700~8200),and DALYs from 150700 person-years (95%UI 113900~193600) also increased to 173 100 person-years (95% UI 134400~224700).In 2021,the incidence,mortality and DALYs of sicosis in Chinaaccounted for 65.92%,61.76% and 66.25% of the global total,respectively,the highest proportion of incidence was in the 55 to<60 age group (75.94%),the highest proportion of death was in the 40 to<45 age group (79.52%),and the highest proportion of DALYs was in the 40 to <45 age group (75.95%).From 1990 to 2021,the EAPC of age-standardized incidence rate (ASIR) in whole population in China was-0.98%(95%CI-1.11%~-0.86%),the EAPC of age-standardized mortality rate (ASMR) was-2.06% (95%CI -2.16%~-1.97%),the EAPC of age-standardized DALY rate (ASDR) was-2.15% (95%CI -2.22%~-2.09%).The prediction results show that the ASIR of silicosis in China is expected to fluctuate around 1.80/100000 from 2022 to 2030,and the ASMR will decrease from 0.61/100000 to 0.48/100000.Conclusion The results suggested that although the burden of silicosis in China is decreasing, due to its large number of existing cases,it still holds an important position in the field of future prevention and control of occupational disease.