摘要目的 分析危害汽车铸造作业工人健康的主要疾病,探讨铸造作业有害因素对工人寿命的影响.方法 采用流行病学队列研究方法,以某汽车铸造厂1980年在册的3529名职工为研究对象,从1980年随访至2005年底,以全国城市居民年龄别死亡率均值为参照,用标化死亡比(SMR)作为统计指标,并计算95%可信区间.结果 随访至2005年底,共计84 999人年,共死亡265人,死亡率3.12‰,累积死亡率为7.51%.铸工队列全死因SMR为0.96(95%CI:0.85～1.08)与全国平均水平持平,随着年龄增长,全死因SMR呈现升高趋势,50岁以上组工人的SMR均大于1.影响铸造工人寿命的主要疾病按累积死亡率从高到低排序分别是:恶性肿瘤(3.43%)、意外伤害(1.16%)、脑血管疾病(1.08%)、心血管疾病(0.79%).恶性肿瘤占总死亡原因的45.7%.铸造工人中死亡率明显升高的疾病有恶性肿瘤(SMR=7.87)、意外伤害(SMR=2.70)、心血管疾病(SMR=2.68)、消化系统疾病(SMR=2.79).一线作业工人恶性肿瘤死亡是辅助丁人的1.95倍(RR=1.95,P<0.05).结论 铸造作业中粉尘等职业危害因素明显影响工人的健康,恶性肿瘤死亡明显增加,应加强防护.

abstractsObjective To understand the major causes of death in automobile foundry workers and investigate casting manipulations hazards to health. Methods A cohort study of 3529 foundry workers registered in one big automobile factory in Shiyan city of China was performed. Standardized mortality ratios (SMRs) were calculated for the main causes of death by using Chinese national mortality rates as reference.Results The cohort mortality was traced from 1980 to the end of 2005 with an accumulation of 84 999 personyears, revealed 265 deaths. The results of this study showed that the standardized mortality ratio for all subjects was 0.96( 95%CI: 0.85～1.08), which was very close to that expected on the basis of the China national mortality rates. The SMR increased with age ,the SMR became greater than 1 in all groups of age 50 and higher. The results showed that malignant neoplasm(3.43%), accidents(1.16%), cerebro-vascular diseases (1.08%),cardio-vascular diseases (0.79%) were the first four illnesses that threatened workers' life span. Statistically significant mortality of malignant neoplasm (SMR=7.87), accidents (SMR=2.70), cardio-vascular diseases(SMR=2.68) and digestive diseases (SMR=2.79)were found in the foundry workers. The relative risk of malignant neoplasm for first line workers to assistant workers was 1.99 (P<0.05). Conclusion The occupational hazards in foundry factory have harmful impact on the workers' health and life span.