饮水砷暴露居民死因的调查与分析

【作者】 李军；

【导师】 王素萍；

【作者基本信息】 山西医科大学 ， 公共卫生， 2006， 硕士

【摘要】 目的:调查饮水砷暴露地区居民的死亡情况,为揭示砷的慢性毒作用和致病机理提供研究途径,为砷中毒病区居民的预防和治疗提供科学依据。方法:运用横断面调查方法,对20个砷中毒病区常住居民1999~2001年3年的死亡情况进行调查,调查结果按照国际疾病分类(ICD-10)编码分类登记,标化死亡率采用2000年全国标准人口构成进行标化,并运用Excel和SPSS11.5 for windows软件对数据进行统计分析处理。结果:本次共调查20个砷中毒病区村,调查人口33473人,死亡人口256人,粗死亡率7.64‰,标化死亡率8.12‰,饮水砷暴露地区居民死亡率水平明显高于一般人群(u=3.82,P<0.01)。其中,男性死亡率水平明显高于女性(u=2.14,P<0.05);各年龄别死亡率水平分布近似“U”型分布,0~4岁组死亡率较高为13.25‰,最低的为5~15岁年龄组为0.94‰,15岁以后随年龄的增长死亡率水平在递增,通过与全国的分布趋势相比显示二者总的趋势是相接近的,儿童、中老年死亡率要明显高于一般人群(P <0.05);在各年龄的SM(R标化死亡比)上以0～4岁组的SMR最高为2.20(95%CL: 1.41～3.16,P <0.05),总体上看,砷中毒病区居民的全死因SMR为1.43(95%CL: 1.26～1.61,P <0.05),死亡率水平明显高于一般人群。砷中毒病区居民的前五位死因是呼吸系统、恶性肿瘤、脑血管病、心血管病、内分泌系统,并且各死因的标化死亡率均显著高于一般人群(P <0.05或P <0.01);在死因顺位上,高砷暴露区居民前四位死因顺位与一般人群一致,但砷中毒病区居民中第五位死因为内分泌系统疾病,与一般人群相比死因顺位明显前移。饮水砷暴露地区居民的平均期望寿命为68.08岁,低于一般人群。结论:饮水砷暴露地区居民的死亡率水平明显高于一般人群,尤以儿童和中老年明显,男性死亡率水平明显高于女性,死因主要是呼吸系统、恶性肿瘤、心脑血管疾病等慢性疾病为主,内分泌系统疾病死因与一般人群相比死因顺位明显前移,居民的平均期望寿命低于一般人群。更多还原

【Abstract】 Objective To investigate the death situation of resident in the arsenic exposure areas by drinking water, so that providing the evidence for prevention and treatment of resident in the arsenic exposure areas. Methods The death situation of resident in 1999～2001 was surveyed in 20 endemic arsenism diseased areas by cross sectional study. The results were classified according to ICD-10. Standardized death rate was adjusted according to the national standard population in 2000 year. The dates were analyzed by Excel and SPSS10.0 for windows. Results There were altogether 33473 people surveyed in 20 arsenic exposure areas. The death people were 256. Crude death rate was 7.64×10^-3. Standardized death rate in arsenic exposure areas was 8.12×10^-3 and was higher than that of standard population（u=3.82,P<0.01）. The death rate of man was higher than that of woman（u=2.14,P<0.05）;The distribute trend of different-age death rate was“U”style. The death rate of 0～4 years group was higher and was 13.25‰, The death rate of 5～15 years group was lower and was 0.94‰and then the trend of different-age death rate became higher with the increasing of age. The distribute trend of different-age death rate was the same with that of the common people.It was higher the death rate of children and middle-aged and older people than that of the others aged people. In endemic arsenism disease areas Standardized Mortality Ratio （SMR） of 0～4 years group was the highest and was 2.20（95%CL: 1.41～3.16,P<0.05）. Standardized Mortality Ratio （SMR） of all death cause was 1.43（95%CL: 1.26～1.41, P<0.05） and the death level of arsenic exposure areas was significantly higher than that of the standard population. The first five leading cause were respiratory system, malignant tumor, cerebrovascular disease, heart disease and endocrine system respectively, and the death rate of every death cause were significantly higher than that of the standard population. The first four death cause orders in arsenic exposure areas were the same with that of the standard population. However, the fifth death cause was endocrine system and it was obviously onward. The average length in arsenic exposure areas was 68.08 and lower than that in the standard population. Conclusions The death rate of resident in the arsenic exposure areas by drinking water is significant higher than that of the common people and it is clearer in children and middle-aged and older people. The death rate of man was higher than that of woman .The chief cause of death is respiratory system, malignant tumor, cerebrovascular and heart disease and other chronic diseases. the death cause of endocrine system was obviously onward than the standard population. The average length in arsenic exposure areas is lower than that of the common people.更多还原