摘要目的 探讨职业人群感染布鲁菌病(简称布病)的影响因素.方法 2013-2015年,采用病例-对照研究方法,在甘肃省靖远县通过《疾病监测信息报告管理系统》检索病例,以实验室确诊的布病职业人员作为病例组,以同期非布病的职业人群为对照组.通过问卷调查,收集其一般社会学特征和职业暴露特征信息;运用非条件Logistic回归分析职业人员感染布病的影响因素.结果 共收集有效调查问卷1 012份,其中病例组203份,对照组809份.Logistic回归分析显示,圈养(OR=1.971,95％CI:1.193～ 3.256)、人畜水源类型(窖水,OR=1.610,95％CI:1.392 ～ 1.950)经常剥死羊羔(OR=2.027,95％CI:1.272～3.231)、处理流产物(丢弃、喂狗、剥食,OR=2.120、1.176、2.160,95％CI:1.274 ～ 3.731、1.148 ～ 2.134、1.548～4.671)、经常吃病死羊肉(OR=2.497,95％CI:1.438 ～ 4.339)、民族(回族,OR=1.202,95％CI:1.061～1.995)、家庭收入少于1万元(OR=3.857,95％CI:1.593～ 9.336)、工作年限≤4年(OR=2.892,95％CI:1.838 ～ 4.552)是职业人群患布病的主要危险因素;家畜类别为绵羊、绵羊+奶羊(OR=0.412、0.277,95％CI:0.217～0.782、0.107～ 0.720)、婚姻状况(已婚,OR=0.124,95％CI:0.016～0.979)、接触或接羔时戴手套口罩(OR=0.455,95％CI:0.230 ～ 0.899)、经常给家畜注射疫苗(OR=0.283,95％CI:0.107～ 0.747)是降低职业人群感染布病风险的因素.结论 靖远县职业人群不良的生活习惯和行为是布病发生的主要原因,其中圈养、经常剥死羊羔、处理流产物、吃病死羊肉等均为布鲁菌感染的危险因素.接触家畜或给家畜接羔时戴口罩和手套、给家畜注射疫苗是预防感染布病的重要手段.

abstractsObjective To investigate influencing factors of brucellosis infection in occupational population in Gansu Province.Methods In Jingyuan County of Gansu Province,using the case-control method,the cases were collected through "National Disease Surveillance Information Reporting Management System",the case group was confirmed as brucellosis professionals after laboratory tests were positive in 2013-2015 (203 cases),and the control group was confmmed as occupations without brucellosis (809 cases) in the same periods.Information on general sociological characteristics and occupational exposure characteristic was collected,non-conditional Logistic regression analysis was used for analyzing influence factors of brucellosis.Results A total of 1 012 questionnaires were collected,among them,203 were case group and 809 were control group.Logistic regression analysis showed that,captive (OR =1.971,95％CI:1.193-3.256),type of water source (lage,OR =1.610,95％CI:1.392-1.950),often stripping the dead lamb (OR =2.027,95 ％ CI:1.272-3.231),processing abortion material (throwing away,feeding the dog,stripping;OR =2.120,1.176,2.160;95％CI:1.274-3.731,1.148-2.134,1.548-4.671),often eating dead meat (OR =2.497,95％CI:1.438-4.339),Hui nationality (OR =1.202,95％CI:1.061-1.995),household income less than 10 000 yuan (OR =3.857,95％CI:1.593-9.336),work experience 1-4 years (OR =2.892,95％CI:1.838-4.552) were major risk factors for occupational persons suffering from brucellosis.Livestock was sheep or sheep and goats (OR =0.412,0.277,95％CI:0.217-0.782,0.107-0.720),married(OR =0.124,95％CI:0.016-0.979),wearing gloves and mask when exposed to livestock or livestock lambing (OR =0.455,95％CI:0.230-0.899),and livestock vaccination (OR =0.283,95％CI:0.107-0.747) were protective factors for occupational infection of brucellosis.Conclusions The poor living habits and behaviors of professional people in Jingyuan County of Gansu Province are the main causes of the disease.Among them,captive,often stripping the dead lamb,processing abortion material,eating dead meat are the risk factors for brucella infection.Wearing masks and gloves when livestock lambing,and livestock vaccination are important means in avoiding brucellosis infection.