RESUMEN
Background Tuberculosis is the most common complication of pneumoconiosis, which accelerates the progression of pneumoconiosis. Pneumoconiosis combined with tuberculosis is a major health risk. Objective To understand the outpatient health service utilization for patients of pneumoconiosis combined with tuberculosis and its main influencing factors. Methods A stratified random sampling combined with non-random sampling was used to select 11181 pneumoconiosis patients in 27 provincial administrative regions (excluding Shanghai, Tianjin, Hainan, Tibet Autonomous Region, Taiwan, Hongkong and Macao Special Administrative Regions) from December 2017 to June 2021. A self-constructed questionnaire, i.e. Health Seeking Behaviors of Pneumoconiosis Patients and Their Influencing Factors, was used, which included basic information, outpatient and inpatient service utilization, and influencing factors of medical treatment behaviors of pneumoconiosis patients. The effective recovery rate of the questionnaire was 90.7%. All patients of pneumoconiosis combined with tuberculosis (n=762) were included as the study subjects. The difference of outpatient utilization in the past two weeks, choosing medical institutions, and the reasons of not seeking medical treatment between urban and rural areas, and the influencing factors of outpatient service utilization were analyzed. Results The study subjects were mainly silicosis combined with tuberculosis (502 cases, 65.9%) and coal workers' pneumoconiosis combined with tuberculosis (232 cases, 30.5%), aged (58.6±12.5) years old. The main region was Western China (45.1%), followed by Eastern China (22.1%), Centeral China (20.2%), and Northeastern China (12.6%). The outpatient utilization rate in the past two weeks was 38.5% (293/762), and the main medical institutions consulted were municipal or provincial hospitals (32.0%), district or county hospitals (28.6%), and township hospitals or health service centers (17.5%). Short distance (20.7%), the availability of specialist outpatient services (16.7%), high level of medical care (14.8%), and low medical cost (12.3%) were the main reasons in choosing medical institutions. Higher proportion of patients seeking medical services due to acute exacerbation in rural areas was reported than in urban areas in the past two weeks (P<0.01). In addition to being hospitalized (113 cases, 41.4%) and self-purchasing medicine (46 cases, 16.8%), the reasons for not seeking medical treatment were self-perceived mild symptoms (15.0%) and high medical cost without reimbursement (9.5%). The multiple regression results showed that outpatient rate for patients of pneumoconiosis combined with tuberculosis in the western region was higher than that in the eastern region (OR=1.66, 95%CI: 1.03, 2.68); patients with an annual personal income of 10000-35500 yuan had a higher outpatient rate than the > 35500 yuan income group (OR=2.54, 95%CI: 1.49, 4.36); the outpatient rate of silicosis patients was higher than that of coal workers' pneumoconiosis (OR=1.83, 95%CI: 1.23, 2.72); the outpatient rate of patients with clinically diagnosed cases (no classified stage of pneumoconiosis) was higher than that of patients with stage I pneumoconiosis (OR=2.32, 95%CI: 1.24, 4.31). Exacerbation of pneumoconiosis-related symptoms in past two weeks (OR=4.26, 95%CI: 2.89, 6.28), occupational injury insurance (OR=0.49, 95%CI: 0.30, 0.80), and hospitalization in past one year (OR=2.37, 95%CI: 1.41, 3.97) were the main factors influencing the outpatient health service utilization among patients of pneumoconiosis combined with tuberculosis. Conclusion The outpatient rate of patients of pneumoconiosis combined with tuberculosis is higher than that of patients of pneumoconiosis without tuberculosis. The utilization of outpatient services is related with disease factors and socio-economic security factors.
RESUMEN
Background At present, the practice of pulmonary rehabilitation for pneumoconiosis in China is in a primary stage. The basis for formulating an individualized comprehensive pulmonary rehabilitation plan is still insufficient, which is one of the factors limiting the development of community-level rehabilitation work. Objective To formulate an exercise prescription based on maximum heart rate measured by cardiopulmonary exercise test (CPET), conduct an individualized comprehensive pulmonary rehabilitation program with the exercise prescription for patients with stable pneumoconiosis, and evaluate its role in improving exercise endurance and quality of life, thus provide a basis for the application and promotion of pulmonary rehabilitation. Methods A total of 68 patients were recruited from the Occupational Disease Prevention Hospital of Jinneng Holding Coal Industry Group Co., Ltd. from April to August 2022 , and were divided into an intervention group and a control group by random number table method, with 34 cases in each group. All the pneumoconiosis patients participated in a baseline test. The control group was given routine drug treatment, while the intervention group received multidisciplinary comprehensive pulmonary rehabilitation treatment on the basis of routine drug treatment, including health education, breathing training, exercise training, nutrition guidance, psychological intervention, and sleep management, whose exercise intensity was determined according to the maximum heart rate provided by CPET. The rehabilitation training lasted for 24 weeks. Patients were evaluated at registration and the end of study respectively. CPET was used to measure peak oxygen uptake per kilogram (pVO2/kg), anaerobic threshold (AT), carbon dioxide equivalent of ventilation (EqCO2), maximum metabolic equivalent (METs), and maximum work (Wmax). The modified British Medical Research Council Dyspnea Questionnaire (mMRC), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Chronic Obstructive Pulmonary Disease Assessment Test (CAT), and Short Form of Health Survey (SF-36) were used to evaluate the potential effect of the comprehensive pulmonary rehabilitation program. Results Among the included 68 patients, 63 patients were having complete data, then 31 cases were assigned in the control group and 32 cases in the interventional group. Before the intervention, there was no significant difference in pVO2/kg, AT, EqCO2, METs, or Wmax between the two groups (P>0.05). At the end of the trail, the indicators like pVO2/kg [(19.81±2.38) mL·(min·kg)−1], AT [(14.48±2.33) mL·(min·kg)−1], METs (5.64±0.69), and Wmax [(85.25±14) W] of patients in the intervention group were all higher than those [(13.90±2.37) mL·(min·kg)−1, (11.70±1.94) mL·(min kg)−1, (3.97±0.70), and (61.77±14.72) W, respectively] in the control group (P<0.001); there was no significant difference in EqCO2 between the two groups (P=0.083). Before the trial, there was no significant difference in mMRC, SAS, SDS, PSQI, or CAT scores between the two groups (P>0.05). At the end of the trail, the mMRC score (1.16±0.57), SAS score (27.93±2.12), SDS score (26.48±1.44), PSQI score (1.08±0.88), and CAT score (4.34±3.28) of patients in the intervention group were lower than those [(2.03±0.83), (35.87±6.91), (34.23±6.65), (5.37±3.03), and (13.87±7.53), respectively] in the control group (P<0.001). The SF-36 scores of bodily pain (94.13±10.72), general health (87.50±5.68), vitality (95.31±5.53), mental health (99.88±0.71), and health changes (74.22±4.42) in the intervention group were higher than those [(71.87±32.72), (65.81±15.55), (74.52±16.45), (86.97±16.56), and (29.84±13.50), respectively] in the control group (P<0.001), and no significant difference was found in social functioning and role emotional scores (P>0.05). Conclusion Comprehensive pulmonary rehabilitation can increase the oxygen intake and exercise endurance of pneumoconiosis patients, ameliorate dyspnea symptoms, elevate psychological state and sleep quality, and improve the quality of life.
RESUMEN
The most important revision of the Consensus of Chinese experts on pneumoconiosis treatment (2024) is to attach importance to antifibrotic treatment, and recommend tetrandrine and nintedanib for the treatment of silicosis and coal worker's pneumoconiosis, especially in patients with rapidly progressing silicosis. The second most important revision is a positive attitude towards lung transplantation which is recommended for patients with end-stage pneumoconiosis who do not respond to medically optimized conservative treatment as early as possible. In addition, new updates also include the addition of the application of metagenomic next-generation sequencing (mNGS) in pneumoconiosis with pulmonary infection, the diagnosis and treatment of pneumoconiosis with nontuberculous mycobacteriosis (NTM), and high-flow nasal cannula oxygen therapy (HFNC) in pneumoconiosis with respiratory failure therapies. The evidence and recommendations of the current version are assessed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system.
RESUMEN
@#Pneumoconiosis is the most serious occupational disease in China, and the prevention and treatment of pneumoconiosis attracts extensive social concerns. As a pulmonary interstitial fibrotic disease, pneumoconiosis is featured by disrupted lung tissue structure and impaired lung function. With available evidence on tetrandrine and nintedanib demonstrably retarding the progression of pneumoconiosis fibrosis, antifibrotic treatment of pneumoconiosis, especially rapidly progressive silicosis, should be emphasized. Pneumoconiosis patients could maintain an average level of quality of life and capabilities in social activities through comprehensive health management, early initiation of antifibrotic treatment, active prevention and treatment of pulmonary tuberculosis and other complications and comorbidities, as well as regular rehabilitation treatment and training.
RESUMEN
Objective To understand the epidemiological characteristics of new occupational pneumoconiosis in Zigong City from 2018 to 2022, and to provide the basis for further prevention and treatment of local pneumoconiosis. Methods The information of newly diagnosed and reported cases of pneumoconiosis in Zigong City from 2018 to 2022 was collected through the occupational disease and occupational health information monitoring system, and the characteristics of the distribution of pneumoconiosis in three regions, the composition of diseases and the length of service of exposure to dust were analyzed. Results From 2018 to 2022, the top 3 newly diagnosed pneumoconiosis diseases in Zigong City were silicosis, coal workers' pneumoconiosis and asbestosis. Silicosis cases were mainly distributed in small and medium-sized employers, accounting for 81.41%. Coal workers' pneumoconiosis was mainly distributed in large and medium-sized employers, accounting for 97.24%. Asbestosis mainly distributed in large scale employers, accounting for 96.36%. There was significant difference in dust handling age of different scale employers (H=11.453, P<0.05). The median ages of silicosis, coal workers' pneumoconiosis and other pneumoconiosis were 47.0 years, 52.0 years and 48.2 years, respectively. The median age of dust handling was 3.3 years, 22.0 years and 23.2 years, respectively. The age of onset of coal workers' pneumoconiosis was higher than that of silicosis and other pneumoconiosis (H=72.547, P<0.05), and the age of dust exposure of silicosis was shorter than that of coal workers' pneumoconiosis and other pneumoconiosis (H=10.453, P<0.05). Conclusion The current situation of pneumoconiosis in Zigong City is still severe, with obvious clustering in disease types and industries. Prevention and treatment of pneumoconiosis in key industries should be further strengthened to protect the health rights and interests of workers.
RESUMEN
Background and objective: Silicosis is one of the oldest occupational lung diseases. However, there are very few studies identifying the anthropometric variables associated with silicosis. The present study aimed at studying the association between body surface area (BSA), pulmonary function indices, and 6-minute walk distance (6MWD) in patients with silicosis. Materials and methods: The study was conducted on 102 male patients of silicosis. Height and weight were measured to calculate BSA. Spirometry and 6 minute-walk tests were performed. Data were analyzed using EPI info V 7 software. Student's t-test of significance (ANOVA) was applied to test the difference between means. Results: There are no significant changes found in the 6-minute walk distance with years of exposure and BSA. Statistically significant lower values of pulmonary function indices were observed in patients with BSA <1.6 sq m. Statistically significant higher values of forced expiratory volume in the first second and forced vital capacity were observed in patients with BSA >1.9 sq m in all categories of exposure. Conclusion: In conclusion, patients of silicosis with >1.9 sq m BSA had higher values of pulmonary function indices. Large body size may be of value in protection from developing occupational lung disease.
RESUMEN
Objective: To analyze the distribution feature of occupational pneumoconiosis in Sichuan Province. Methods: The cases of newly diagnosed occupational pneumoconiosis from 2012 to 2021 in Sichuan Province were collected from the Occupational Diseases and Hazards Monitoring Information System under China Disease Prevention and Control Information System, and were analyzed retrospectively. Results: From 2012 to 2021, there were 30 136 newly diagnosed occupational pneumoconiosis cases in Sichuan Province. The average age of patients was 55.2 years and the median work age was 12.1 years. There were 6 471 cases (accounting for 21.5%) exposed to dust for less than 5.0 years. The number of the cases declined in newly diagnosed occupational pneumoconiosis and occupational pneumoconiosis with less than 5.0 years of dust exposure. The numbers of coal workers' pneumoconiosis and silicosis were 16 210 and 13 577, respectively (accounting for 98.9% of the total cases). The majority of pneumoconiosis cases were classified as stage Ⅰ(accounting for 67.1%). The cases from Leshan City, Bazhong City, Dazhou City, Yibin City, Guangyuan City and Luzhou City accounted for 68.8% of the total cases. The main types of work were coal miner and excavation worker, which accounted for 31.7% and 18.8%, respectively. The scale of enterprises was mostly small and micro, accounting for 35.1% of the cases, and the industry distribution was mostly coal mining and washing, accounting for 53.4% of the cases. Conclusion: In Sichuan Province, the number of cases shows an overall decline in both newly diagnosed occupational pneumoconiosis and occupational pneumoconiosis with less than 5.0 years of dust exposure, with a relatively short duration of occupational exposure. The key cities for pneumoconiosis prevention and control are Leshan City, Bazhong City, and Dazhou City, while the key industry is coal mining and washing.
RESUMEN
Objective: To analyze the existing problems in the construction of pneumoconiosis rehabilitation station in Beijing under the framework of ecosystem theory, and put forward countermeasures. Methods: A total of four managers directly involved in the construction of three pneumoconiosis rehabilitation stations in Beijing and 12 rehabilitation doctors working in rehabilitation stations were selected as the interviewees using the judgment sampling method. Based on the perspective of ecosystem theory, an interview outline was designed to conduct a semi-structured interview with the interview subjects. In combination with literature data, the current situation, existing problems and solutions of pneumoconiosis rehabilitation station construction were analyzed. Results: There were still deficiencies in the construction of pneumoconiosis rehabilitation stations in Beijing. At the microscale level, pneumoconiosis patients could not make full use of family resources for active and effective pulmonary rehabilitation treatment, and family members lack of effective rehabilitation guidance and assistance for patients. At the medium-scale level, the resources of primary rehabilitation institutions were insufficient, the medical support for pneumoconiosis rehabilitation was insufficient, and the pneumoconiosis rehabilitation stations lacked a unified information management and technology platform. At the macroscale level, it has not established clear and specific requirements for the construction management and evaluation of pneumoconiosis rehabilitation stations, and there was social discrimination and prejudice against pneumoconiosis patients. Conclusion: It is necessary to improve the recognition of rehabilitation in primary medical and health institutions, strengthen education on the awareness of the disease and rehabilitation skills guidance for patients and their families, strengthen the responsibilities of technical support institutions in rehabilitation stations, promote the construction of primary rehabilitation stations and personnel training, make full use of information technology, promote information exchange and knowledge sharing, and ensure the quality of rehabilitation of pneumoconiosis.
RESUMEN
Objective: To verify the accuracy of the autoregressive integrated moving average (ARIMA) in predicting the incidence of occupational pneumoconiosis (hereinafter referred as pneumoconiosis) and to predict the incidence of pneumoconiosis in Guangdong Province in the next five years. Methods: A follow-up survey was performed to collect data on pneumoconiosis patients reported in Guangdong Province from 1956 to 2021. Collected data from 1956 to 2016 were used as the training set to build an ARIMA model. Collected data from 2017 to 2021 were used as the prediction set to evaluate the predicting result of the ARIMA model. The ARIMA model was used to predict the incidence of pneumoconiosis in Guangdong Province in next five years. Results: The ARIMA (1,1,2) model was set up after model identification and order estimation. The model was used to predict the prediction set, and its result was good. The ARIMA result and actual values in 2021 were 213 and 210 cases, respectively, with a difference of only three cases. The number of pneumoconiosis cases predicted using the ARIMA model in Guangdong Province from 2022 to 2026 was 214, 204, 202, 194, and 191 cases, respectively, showing a trend of low-level prevalence. Conclusion: The ARIMA model demonstrates high accuracy in predicting pneumoconiosis incidence over a long period of time and with large sample sizes. The forecast results of the ARIMA(1,1,2) model indicate that the incidence of pneumoconiosis in Guangdong Province will be around 200 cases in the next five years, indicating a low-level prevalence.
RESUMEN
Objective: To study the survival time and its risk factors of patients with occupational pneumoconiosis. Methods: A total of 11 011 newly diagnosed occupational pneumoconiosis patients in Guangdong Province from 1980 to 2019 were selected as study subjects. The life table method was used for survival analysis. The influencing factors of survival time of occupational pneumoconiosis patients were analyzed using the WilCoxon (Gehan) test and Cox proportional hazards regression model. Results: The median survival time of pneumoconiosis patients was 26.0 years. The median survival period of stage Ⅰpatients was 3.5 years longer than that of stage Ⅱ patients and 10.1 years longer than that of stage Ⅲ patients. The median survival time of patients with an initial diagnosis age under 40.0 years old was 34.8 years longer than that of patients with an initial diagnosis age over 60.0 years old. The median survival time of patients with dust exposure duration under 25.0 years old was 13.6 years longer than patients with dust exposure duration age over 45.0 years old. The results of the Cox proportional hazards regression model showed that the initial diagnosis stage, initial diagnosis age, dust exposure duration, and medical insurance were risk factors of the survival time of occupational pneumoconiosis patients (all P<0.01). The risk of reduced survival time for patients with stage Ⅱ and stage Ⅲ as the initial diagnosis stage was 1.15 and 2.04 times higher, respectively, compared with stage Ⅰ patients (both P<0.01). The risk of reduced survival time for patients without medical insurance was 60.22 times higher than those with medical insurance (P<0.01). Conclusion: The risk factors of the survival time of occupational pneumoconiosis patients in Guangdong Province are initial diagnosis stage, initial diagnosis age, the dust exposure age, and medical insurance. Earlier detection, earlier diagnosis, and improvement of medical insurance coverage for patients can effectively improve the survival time of occupational pneumoconiosis patients.
RESUMEN
Early diagnosis of pulmonary diseases is of great significance for their prevention and treatment. Serum Krebs von den Lungen-6 (KL-6) assay can reflect the damage degree of alveolar epithelium and stromal tissue, and is simple, non-invasive and low-cost. Pervious study showed that the serum KL-6 level was higher in patients with various interstitial lung diseases (e.g. idiopathic pulmonary fibrosis and connective tissue disease, primary Sjögren's syndrome, rheumatoid arthritis, idiopathic inflammatory myopathy and systemic sclerosis combined with interstitial lung disease), non-small cell lung cancer, various pneumonias and chronic obstructive pulmonary disease compared to healthy controls. Therefore, serum KL-6 has good sensitivity and specificity for the early diagnosis of these diseases. Occupational pneumoconiosis is an interstitial lung disease with a well-established etiology. Pervious study has shown that serum KL-6 level was higher in patients with occupational silicosis, occupational asbestosis, and dust-exposed workers compared to healthy controls. However, due to the limited sample size and the inconsistent findings on different studies, further research is needed to study the role of serum KL-6 in the early diagnosis of pneumoconiosis. Future studies should increase the sample size, improve the detection methods for serum KL-6, explore its feasibility as an early diagnostic biomarker for occupational pulmonary diseases, and investigate the efficacy andvalue of its combined application with other biomarkers in the early diagnosis of various pulmonary diseases, including occupational lung diseases, to fully exploit its predictive role in pulmonary diseases.
RESUMEN
Objective: To analyze the base incidence, distribution characteristics, survival status and social security of occupational pneumoconiosis (hereinafter referred to as "pneumoconiosis") in Zibo City. Methods: The new pneumoconiosis patients in Zibo City from 1949 to 2021 were selected as the research subjects using a cross-sectional survey. Household survey or telephone follow-up were carried out, and the distribution characteristics, living conditions and social security situation were retrospectively analyzed. Results: A total of 8 910 patients with pneumoconiosis were investigated, and 96.0% of them were male. The stage Ⅰ pneumoconiosis patients accounted for 91.3%. From 1949 to 2021, the number of pneumoconiosis patients showed a stepwise upward trend with time. Most of the patients suffered from coal worker pneumoconiosis and silicosis, which accounted for 48.7% and 38.9%, respectively. The average age of onset was (52.7±11.4) years, and the average length of service exposed to dust was (21.1±9.4) years. The patients were concentrated in Zichuan District, Boshan District and Zhangdian District, that accounted for 87.8%. The industry distribution was mostly mining industry and manufacturing industry, accounting for 61.1% and 31.6% respectively. Among the 8 910 cases of pneumoconiosis, 543 cases were lost in follow-up. A total of 8 367 patients were followed-up, with a follow-up rate of 93.9%. The mortality rate of patients who completed follow-up was 50.5%, and the mortality rate decreased with the increase of the stage of pneumoconiosis (P<0.01). The rate of adoring social security in the 4 138 surviving patients was 98.4%. Conclusion: The situation of prevention and treatment of pneumoconiosis in Zibo City is challenging. It is necessary to strengthen the special control of dust hazards in mining and manufacturing industries in key areas such as Zichuan District, Boshan District and Zhangdian District.
RESUMEN
Objective: To analyze the epidemiological distribution of new occupational pneumoconiosis (hereinafter referred as pneumoconiosis) in Henan Province from 2006 to 2020. Methods: Clinical data of newly recruited pneumoconiosis cases from 2006 to 2020 in Henan Province were retrospectively analyzed. Results: A total of 9 624 cases of newly diagnosed pneumoconiosis were reported in Henan Province in the past 15 years, of which 98.6% were males. The number of cases had two peaks, one in 2009-2011 and the other in 2014-2017. There were 12 types of pneumoconiosis of all reported cases except for mica pneumoconiosis, in which coal workers' pneumoconiosis and silicosis accounted for 96.0%. The incidence of phase Ⅰ, Ⅱ and Ⅲ pneumoconiosis was 64.7%, 21.0% and 14.3%, respectively. The incidence of phase Ⅱ and Ⅲ silicosis was higher than that of coal miners' pneumoconiosis (56.3% vs 22.7%, P<0.01). Patients with pneumoconiosis were mainly distributed in Zhengzhou City, Sanmenxia City, Luoyang City, Pingdingshan City and Hebi City, accounting for 85.0%. The enterprises involved were mainly mining industry, large- and medium-sized enterprises, state-owned enterprises and collective enterprises. The top five position of patients were coal miners, rock drillers, excavators, coal mixed workers and pure coal miners, total accounting for 72.0%. There were 196 enterprises reported ≥10 cases, accounting for 17.2% of all enterprises and 80.3% of the total of newly diagnosed pneumoconiosis cases. The median (M) of onset age of new cases was 49 years old, and the M of onset of working age was 16 years. The onset age of silicosis was younger (M: 49 vs 48 years old, P<0.05), while the onset of working age was longer (M: 10 vs 20 years, P<0.05), compared with that of coal workers' pneumoconiosis. Conclusion: The incidence of pneumoconiosis in Henan Province were disease clustering distribution, regional distribution, industry of enterprise, enterprise scale, enterprise type, nature and working position distribution of enterprises. And it showed the characteristics of group incidence. The prevention and control treatment of pneumoconiosis should be strengthened in key areas, key enterprises and key diseases and jobs.
RESUMEN
Objective: To analyze the clinical characteristics and imaging features of occupational pulmonary thesaurosis induced by dust of iron and its compounds (OPTIDIC). Methods: A total of 230 cases of occupational welder's pneumoconiosis (OWP) patients or observation subjects were selected as the research subjects using the retrospective analysis method. They were diagnosed in four occupational disease diagnosis institutions in Shandong Province from 2010 to 2017. The high kV X-ray chest radiography or chest digital radiograph (hereinafter referred to as X-ray) were re-read to screen OPTIDIC patients. The clinical data of OPTIDIC patients were collected and analyzed. Results: Among the 230 cases, 56 cases were diagnosed as OPTIDIC, accounting for 24.3%. The clinical symptoms of the 56 patients with OPTIDIC were cough, sputum, chest tightness, shortness of breath, and difficulty breathing, while their physical signs were low or coarse breath sounds in lungs and others. Most of the X-ray results showed p shadows or q shadows, accounted for 98.2%, of which p/p shadow and q/q shadow accounted for 62.5%. The result of chest computed tomography (CT) showed diffuse point/round shadow and diffuse glass shadow in OPTIDIC patients. The result of fibro-bronchoscopy showed that a large amount of iron lutein particles was accumulated in macrophages and biopsy of lung showed idiopathic pulmonary hemosiderosis in OPTIDIC patients. Conclusion: The clinical characteristics of OPTIDIC patients showed no different from OWP. However, the result of X-ray of OPTIDIC patients mainly showed small circular shadows, and their CT images mainly showed diffuse point/round shadows or grinding glass shadow, which could be used to the differential diagnosis of OPTIDIC and OWP.
RESUMEN
Objective: To evaluate the utilization and influencing factors of whole lung lavage (WLL) for patients with pneumoconiosis. Methods: A total of 10 524 pneumoconiosis patients who sought medical treatment from 2018 to 2021 were selected as the research subjects using a combination of stratified random sampling and non-random sampling methods. The patients were from 27 provincial administrative regions of Chinese mainland (excluding Shanghai City, Tianjin City, Hainan Province and Tibet Autonomous Region). The effects of demographic and sociological characteristics, disease-related factors, and economic and social security status on WLL utilization were analyzed. Results: The WLL rate of pneumoconiosis patients was 17.8% (1 871/10 524). The main reason for promoting WLL in pneumoconiosis patients was “doctor's advice”, accounting for 65.4%； followed by “known-pneumoconiosis-patients had WLL” and “patient's recommendation”, accounting for 24.1% and 18.1%, respectively. Multivariate logistic regression analysis showed that age, body mass index, smoking index, education level, survey area, source of patients, current employment status, nature of dust-exposed unit, stage of pneumoconiosis, type of pneumoconiosis, pneumoconiosis symptoms (coughing up phlegm, chest pain, dyspnea, joint pain), contraindications to WLL (tuberculosis, pulmonary heart disease), family annual income, medical insurance for urban employees, proportion of medical insurance reimbursement, disability benefits, and social assistance were the influencing factors of WLL utilization in pneumoconiosis patients (all P<0.05). Conclusion: A large proportion of pneumoconiosis patients used WLL. The influencing factors of WLL utilization included demographic and sociological characteristics, disease-related factors, economic and social security status, and more. It is necessary to protect the interests of pneumoconiosis patients, strengthen occupational health education and health promotion for pneumoconiosis patients, standardize the use of WLL in medical institutions, and make rational use of WLL.
RESUMEN
Objective To analyze the distribution features of newly reported cases of occupational welder′s pneumoconiosis (OWP) in Guangdong Province from 2013 to 2022. Methods Data of newly reported cases of OWP from National Occupational Disease Network Direct Reporting System of Guangdong Province from 2013 to 2022 was analyzed using conventional data analyzing Methods. Results A total of 294 cases of OWP were reported in Guangdong Province from 2013 to 2022 with an overall downward trend. The average age at diagnosis for new OWP cases was 44±6 years old, and the median of dust exposure duration was 11 years. Males accounted for 99.3% of the cases, and 94.2% of the cases were phase Ⅰ OWP. Guangzhou City had the highest regional distribution with 74.8% of the cases. The industry distribution was mainly manufacturing, accounting for 86.7% of the cases. The scale of enterprises was most common in small enterprises, followed by large and medium-sized enterprises, accounting for 38.4%, 30.6% and 24.5% of the cases respectively. The economic types of enterprises were mostly private enterprises, followed by state-owned enterprises, accounting for 54.1% and 32.0% of the cases respectively. Conclusion In Guangdong Province, the newly reported OWP cases were clustered in terms of disease stage, regional distribution, industry, enterprise scale and enterprise economic type. There was a tendency of younger age at diagnosis and shorter dust exposure duration.
RESUMEN
Objective To analyze the epidemiological characteristics of newly diagnosed occupational pneumoconiosis (hereinafter referred to as "pneumoconiosis") in Guangdong Province from 2011 to 2020. Methods Clinical data of newly diagnosed pneumoconiosis in Guangdong Province from 2011 to 2020 was collected from the “Health Hazards Monitoring Information System” under “China Disease Prevention and Control Information System”. The distribution of the cases was analyzed retrospectively. Results A total of 2 731 cases of newly diagnosed pneumoconiosis were reported from 2011 to 2020 in Guangdong Province, with cases at stages Ⅰ,Ⅱ, and Ⅲ accounting for 61.6%, 23.8%, and 14.6%, respectively. Except for talc pneumoconiosis, 12 other types of pneumoconiosis were reported. The top three incidence of diseases were silicosis, other pneumoconiosis, and welder's pneumoconiosis, accounting for 58.8%, 22.0% and 11.0%, respectively. Males accounted for 97.5%, and females 2.5%. The median age of onset was 47 years old. The median dust exposure duration was 9.8 years, with 19.4% of cases having a dust exposure duration less than 5.0 years. And 80.7% of the cases were distributed in the Pearl River Delta region. The industries with the new cases were mainly the manufacturing (accounting for 69.4%), and 34.8% of cases were found in private limited liability companies. Cases in medium- and small-sized enterprises accounted for 35.7% and 34.3% respectively. Conclusion Silicosis, other pneumoconiosis, and welder's pneumoconiosis are predominant in Guangdong Province. The prevention and control of pneumoconiosis should focus on small- and medium-sized private enterprises in the concentrated manufacturing industry in the Pearl River Delta region.
RESUMEN
Objective To analyze the survival status, distribution characteristics and social security of newly diagnosed occupational pneumoconiosis patients in Guizhou Province from 2006 to 2021. Methods The newly diagnosed pneumoconiosis cases reported in Guizhou Province from 2006 to 2021 were collected from the “Occupational Diseases and Hazards Monitoring Information System” under “National Health Insurance Disease Prevention and Control Information System”. Telephone or face-to-face surveys were conducted to investigate these patients. Results A total of 12 413 newly diagnosed pneumoconiosis patients were reported in Guizhou Province from 2006 to 2021, with 11 192 cases included in the follow-up, and 10 631 cases were followed-up successfully. According to the follow-up study, 10 565 cases (accounting for 99.4%) were survived, and 66 cases (accounting for 0.6%) died. The number of pneumoconiosis showed an increasing trend followed by a sharp decline from 2006 to 2021, reaching its peak in 2016. The main industry of the newly pneumoconiosis cases was concentrated in the mining industry (accounting for 90.6%). The top three regions with surviving cases in the follow-up were Bijie City, Zunyi City, and Qiannan Prefecture, accounting for 34.0%, 25.4% and 12.0%, respectively. The main types of pneumoconiosis were coal workers' pneumoconiosis and silicosis, accounting for 67.1% and 30.8%, respectively. Most cases were in the age group of 50 to <60 years old, accounting for 59.1%, and the majority of the workers had worked in dusty environments for 5 to <25 years, accounting for 91.5%. In terms of social security, about 89.5% of cases were in the basic medical insurance for urban and rural residents which was the most popular social security. The employer's compensation rate was 67.7%, and the work-related injury insurance participation rate was 51.5%. Conclusion Pneumoconiosis cases in Guizhou Province exhibit significant regional disparities. It has a high concentration in the industry, a younger age profile, and limited social security coverage. It is necessary to strengthen the special management of dust and industry supervision in mining industry, intensify follow-up work for pneumoconiosis cases, reinforce the construction of pneumoconiosis rehabilitation station in key regions, and improve the quality of life of pneumoconiosis cases.
RESUMEN
Objective To analyze the distribution, survival conditions, and medical support of newly diagnosed occupational pneumoconiosis (hereinafter referred to as pneumoconiosis) patients in Zhangdian District, Zibo City. Methods A total of 1 189 newly diagnosed pneumoconiosis patients in Zhangdian District from 1956 to 2019 were selected as the study subjects using retrospective method. Data of their age of onset, years of occupational exposure, category of working industry, type of pneumoconiosis, and status of medical support was collected and analyzed. Results The median and the 25th-75th percentiles ［M (P25, P75)］ of the age of onset were 51.8 (45.5, 56.1) years, and the mortality was 37.0%. The majority of pneumoconiosis cases were silicosis (45.2%) and coal workers' pneumoconiosis (39.8%). The highest prevalence of pneumoconiosis was in the coal mining and washing industry (42.4%), followed by manufacturing (33.4%). Pneumoconiosis patients in stage Ⅰ,Ⅱ, and Ⅲ accounted for 89.1%, 8.7%, and 2.2%, respectively. The M (P25, P75) of the length of work exposed to dust were 24.1 (16.5, 29.9) years.The higher stage of pneumoconiosis the shorter of the length of work exposed to dust among these pneumoconiosis patients(all P<0.05). The overall survival rate, the 5-year survival rate and the 10-year survival rate of these pneumoconiosis patients were 63.0%, 92.3% and 85.9%, respectively. Among the 749 surviving cases, 60.8% were aged 60.0 to <80.0 years. In terms of social security, 100.0% surviving cases enjoyed basic medical insurance, meanwhile, 96.1% and 81.8% patients were covered by major medical insurances and occupational injury insurances, respectively. The M (P25, P75) of age at death were 73.1 (64.0, 77.1) years. The main causes of death were respiratory diseases (59.3%) and malignant tumors (20.4%). Conclusion The prevalent types of pneumoconiosis in Zhangdian District, Zibo City, are coal workers' pneumoconiosis and silicosis. Medical support and assistance are relatively limited. The pneumoconiosis prevention and control focus should be on silicosis and coal workers' pneumoconiosis, particularly in the manufacturing industry.
RESUMEN
Objective To understand the health-related quality of life (HRQOL) of migrant workers with pneumoconiosis who received basic medical treatment in Hunan Province. Methods A total of 613 migrant workers with pneumoconiosis who received basic medical treatment and assistance in Hunan Province was selected as the study subjects using stratified random sampling method. The European Quality of Life-5 Dimensions (EQ-5D) questionnaire was used to assess their HRQOL. Results The abnormality of the five dimensions of the EQ-5D health description system, from high to low, were as follows： daily activities, mobility, pain/discomfort, anxiety/depression, and self-care, with the abnormal rates of 50.9%, 46.8%, 41.1%, 21.0%, and 14.5%, respectively. The visual analogue scale (VAS) score of EQ-5D was (63.5±18.6) points. Patients with stage Ⅲ pneumoconiosis had high abnormality in mobility, daily activities, and pain/discomfort compared with those with stage Ⅰ and Ⅱ disease (all P<0.02). Patients in stage Ⅱ and Ⅲ of pneumoconiosis had higher incidence of anxiety/depression compared with those with stage I disease (all P<0.02). Patients with complications in addition to pneumoconiosis had higher abnormality in mobility, self-care, and pain/discomfort compared to those with simple pneumoconiosis or those eligible for lung lavage treatment (all P<0.02). Patients with simple pneumoconiosis had a higher incidence of anxiety/depression compared with those eligible for lung lavage treatment (P<0.02). Patients with stage Ⅲ pneumoconiosis had lower average VAS scores compared with stage Ⅰ and Ⅱ patients (all P<0.02). Patients with simple pneumoconiosis or those with complications had lower average VAS scores compared with those eligible for lung lavage treatment (all P<0.05). Conclusion The HRQOL of pneumoconiosis patients among migrant workers needs improvement, especially for patients with stage Ⅲ disease and those with complications. This study indicates the need of optimizing policies, raising the hospitalization expense limit for critically ill patients with stage Ⅲ pneumoconiosis or with complications, and improving their HRQOL.