Epidemiological Characteristics and Diagnostic Outcomes of Suspected Occupational Noise-Induced Deafness — Guangdong Province, China, 2014–2023

Shanyu Zhou¹; Yongshun Huang¹; Xianzhong Wen¹; Shu Wang¹; Bing Xia¹; Lang Huang¹; Xudong Li^1,#

1. Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou City, Guangdong Province, China.

^# Corresponding author: Xudong Li, lixd116@126.com.

Suspected occupational noise-induced deafness (ONID) represents the most prevalent suspected occupational disease in Guangdong Province and is among the most frequently reported nationwide. Given its public health significance, we conducted a systematic investigation of suspected ONID cases in Guangdong from 2014 to 2023, analyzing their epidemiological characteristics and diagnostic outcomes to inform evidence-based policies for ONID prevention and management. Data on suspected ONID cases reported in Guangdong Province from 2014 to 2023 were extracted from the "Occupational Diseases and Health Hazard Factors Monitoring Information System." Cases were analyzed using descriptive epidemiological methods, with joinpoint regression analysis employed to assess long-term trends. From 2014 to 2023, 16,987 suspected ONID cases were reported in Guangdong Province, comprising 65.22% of all suspected occupational disease cases (26,044). Cases exhibited a significant increasing trend (Average annual percentage change: 11.8%, 95% CI: 2.9%–22.3%, P=0.013). The Pearl River Delta region accounted for 87.9% of all cases, with manufacturing being the predominant industry (90.1%). Within manufacturing, metal products industry represented the highest proportion (15.2%). Males constituted 87.7% (14,905/16,987) of cases. Analysis of diagnostic outcomes from 2020 to 2023 revealed an overall diagnostic procedure initiation rate of 45.1%, with a subsequent confirmation rate of 48.9%. Guangdong Province demonstrates high occurrence patterns of suspected ONID cases, particularly concentrated in the Pearl River Delta region and manufacturing sectors. The low rates of diagnostic procedure initiation and confirmation highlight the urgent need for enhanced regulatory oversight of diagnostic procedures and development of expert consensus on suspected ONID identification criteria to improve diagnostic confirmation rates.

疑似职业性噪声聋的流行病学特征和诊断结局 — 广东省，中国，2014–2023年

周珊宇¹；黄永顺¹；温贤忠¹；王姝¹；夏冰¹；黄浪¹；李旭东^1，#

1. 广东省职业病防治院，广州市，广东省，中国

^# 通信作者: 李旭东，lixd116@126.com。

疑似职业性噪声聋（ONID）作为广东省首位疑似职业病和全国最常见的疑似职业病之一，其防控工作具有重要的公共卫生意义。本研究旨在通过分析2014—2023年广东省疑似ONID病例的流行病学特征和诊断结局，为ONID的预防和控制提供循证依据。本研究基于"职业病与健康危害因素监测信息系统"收集广东省2014—2023年间网络报告的疑似ONID病例基本信息，运用描述流行病学方法对病例的基本特征和诊断结局进行分析，并采用joinpoint回归评估其长期趋势变化。研究结果显示，2014—2023年间广东省共报告疑似ONID病例16,987例，占同期所有疑似职业病病例（26,044例）的65.22%。病例报告数呈显著上升趋势（平均年度变化百分比：11.8%，95% CI：2.9%—22.3%，P=0.013）。地区分布上，珠江三角洲地区报告病例占总数的87.9%；行业分布上，制造业占90.1%，其中以金属制品业占比最大（15.2%）。性别分布上，男性占87.7%（14,905/16,987）。2020—2023年疑似ONID病例进入诊断程序率为45.1%，职业性噪声聋确诊率为48.9%。综上所述，广东省疑似ONID病例呈高发态势，主要集中在珠江三角洲地区和制造业。鉴于疑似ONID病例进入诊断程序率和确诊率偏低的现状，建议监管部门加强对疑似职业病人进入诊断程序的监督执法，建议技术支撑部门针对疑似ONID的界定标准形成专家共识，从而提高疑似ONID界定准确性和确诊率。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.275

Prevalence and Risk Factors of Lower Extremity Musculoskeletal Disorders Among Occupational Groups in Key Industries — China, 2018–2023

Ning Jia¹; Zhongxu Wang¹; Meibian Zhang¹; Huadong Zhang²; Ruijie Ling³; Zhi Wang⁴; Gang Li⁵; Yan Yin⁶; Hua Shao⁷; Jue Li⁸ ; Hengdong Zhang⁹; Bin Xiao¹⁰; Hua Zou¹¹; Dayu Wang¹²; Yan Ye¹³; Dongxia Li¹⁴; Jianchao Chen¹⁵; Enfei Jiang¹⁶; Bing Qiu¹⁷; Qiang Zeng¹⁸; Liangying Mei¹⁹; Yongquan Liu²⁰; Jixiang Liu²¹; Tianlai Li²²; Jun Qi²³; Qing Xu¹; Yang Mimi¹; Guo Xinwei¹; Xin Sun^1,#

1. National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China;

2. Chongqing Center for Disease Control and Prevention, Chongqing, China;

3. Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan City, Hubei Province, China;

4. Guangzhou Institute of Occupational Disease Control and Prevention, Guangzhou City, Guangdong Province, China;

5. Liaoning Center for Disease Control and Prevention, Shenyang City, Liaoning Province, China;

6. Shanghai Center for Disease Control and Prevention, Shanghai, China;

7. Shandong Academy of Occupational Health and Occupational Medicine, Jinan City, Shandong Province, China;

8. Beijing Institute of Chemical Industry Occupational Disease Prevention and Treatment, Beijing, China;

9. Jiangsu Provincial Center for Disease Control and Prevention, Nanjing City, Jiangsu Province, China;

10. Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou City, Guangdong Province, China;

11. Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou City, Zhejiang Province, China;

12. Tianjin Occupational Disease Prevention and Control Hospital, Tianjin, China;

13. Beijing Center for Disease Control and Prevention, Beijing, China;

14. Guizhou Province Occupational Disease Prevention and Control Hospital, Guiyang City, Guizhou Province, China;

15. Fujian Province Occupational Disease and Chemical Poisoning Prevention and Control Center, Fuzhou City, Fujian Province, China;

16. Sichuan Provincial Center for Disease Control and Prevention, Chengdu City, Sichuan Province, China;

17. Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing, China;

18. Tianjin Center for Disease Control and Prevention, Tianjin, China;

19. Hubei Provincial Center for Disease Control and Prevention, Wuhan City, Hubei Province, China;

20. Institute of Occupational Medicine of Jiangxi, Nanchang City, Jiangxi Province, China;

21. Ningxia Center for Disease Control and Prevention, Yinchuan City, Ningxia Province, China;

22. Shanxi Provincial Center for Disease Control and Prevention, Xian City, Shanxi Province, China;

23. Yunnan Provincial Center for Disease Control and Prevention, Kunming City, Yunnan Province, China.

^# Corresponding author: Xin Sun, sunxin@niohp.chinacdc.cn .

This study aimed to investigate the prevalence and risk factors of lower extremity musculoskeletal disorders (LE-MSDs) among key occupational groups in China, providing data support for the prevention and control of these occupational diseases. Using stratified random sampling, the study selected representative samples from nine major national economic industries across seven regions in China, including agriculture, manufacturing, and construction. A total of 88,609 valid questionnaires were collected and analyzed using the "Ergonomic Evaluation and Analysis System of WMSDs" and SPSS 26.0 software. The results indicated that the standardized prevalence rate of LE-MSDs among key industries or occupational groups in China was 17.7%, with the highest rates found in toy manufacturing, medical personnel, automobile manufacturing, nonferrous metal smelting and rolling processing, and coal mining and washing. Univariate and multivariate analyses identified various risk factors associated with LE-MSDs, including repetitive movements of the lower limbs and ankles, frequent standing, and job rotation. The study also found that physical exercise, investigation year, stretching or changing leg posture, frequent sitting at work, and sufficient rest time were protective factors against LE-MSDs. This research highlights the importance of personal and work organization factors in LE-MSDs, in addition to occupational factors, and recommends strengthening the dissemination and education of ergonomics knowledge, improving workstation design, implementing regular rest and activity breaks, and creating personalized exercise prescriptions tailored to the specific needs of the occupational population to reduce the impact of LE-MSDs in China.

重点行业职业人群下肢肌肉骨骼疾患发生率及危险因素研究 — 中国，2018–2023年

贾宁¹；王忠旭¹；张美辨¹；张华东²；凌瑞杰³；刘移民⁴；王致⁴；李刚⁵；尹艳⁶；邵华7；李珏⁸；张恒东⁹；肖斌¹⁰；邹华¹¹；王大宇¹²；王如刚¹³；叶研¹³；黎东霞¹⁴；陈建超¹⁵；蒋恩霏¹⁶；邱兵¹⁷；曾强¹⁸；梅良英¹⁹；刘永泉²⁰；刘吉祥²¹；赵显锋²²；漆骏²³；徐擎¹；杨咪咪¹；郭新苇¹；孙新^1,#

1. 中国疾病预防控制中心职业卫生与中毒控制研究所，北京，中国；

2. 重庆市疾病预防控制中心，重庆，中国；

3. 湖北省中西医结合医院，武汉市，湖北省，中国；

4. 广州市职业病防治院，广州市，广东省，中国；

5. 辽宁省疾病预防控制中心，沈阳市，辽宁省，中国；

6. 上海市疾病预防控制中心，上海，中国；

7. 山东省职业卫生与职业医学研究院，济南市，山东省，中国；

8. 北京市化工职业病防治院，北京，中国；

9. 江苏省疾病预防控制中心，南京市，江苏省，中国；

10. 广东省职业病防治院，广州市，广东省，中国；

11. 浙江省疾病预防控制中心，杭州市，浙江省，中国；

12. 天津市职业病防治院，天津，中国；

13. 北京市疾病预防控制中心，北京，中国；

14. 贵州省职业病防治医院，贵阳市，贵州省，中国；

15. 福建省职业病与化学中毒预防控制中心，福州市，福建省，中国；

16. 四川省疾病预防控制中心，成都市，四川省，中国；

17. 中国民用航空局民用航空医学中心，北京，中国；

18. 天津市疾病预防控制中心，天津，中国；

19. 湖北省疾病预防控制中心，武汉市，湖北省，中国；

20. 江西省职业病防治研究院，南昌市，江西省，中国；

21. 宁夏疾病预防控制中心，银川市，宁夏回族自治区，中国；

22. 陕西省疾病预防控制中心，太原市，山西省，中国；

23. 云南省疾病预防控制中心，昆明市，云南省，中国。

^# 通信作者: 孙新，sunxin@niohp.chinacdc.cn。

本研究旨在探究中国重点行业职业人群下肢肌肉骨骼疾患（LE-MSDs）的流行率及风险因素，为预防和控制此类疾患提供大数据支持。研究采用分层随机抽样方法，从中国七个地区的九大国民经济行业中选取代表性样本，包括农业、制造业、建筑业等。共收集有效问卷88,609份，通过“工效学评估与分析系统”进行调查，使用SPSS 26.0软件进行数据分析。结果显示，中国重点行业或职业群体中LE-MSDs的标化发生率为17.7%，其中玩具制造业、医疗人员、汽车制造业、有色金属冶炼及压延加工和煤炭开采洗选行业的发生率最高。单因素和多因素分析识别了与LE-MSDs相关的多种危险因素，包括重复下肢和踝关节动作、频繁站立、工作轮换等。研究还发现，体育锻炼、调查年份、伸展或改变腿部姿势、频繁坐着工作和充足休息时间是预防LE-MSDs的保护因素。本研究强调除了职业因素外，个人和工作组织因素在LE-MSDs中的重要性，并建议加强人因工效学知识的传播和教育，改善工作台设计，实施定期休息和工作间休，以及为职业人群制定个性化的运动处方，减轻LE-MSDs在中国的影响。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.276

Recommended Occupational Exposure Limits for GMA Using Benchmark Dose and Bayesian Model Averaging

Zhihao Chen¹; Meng Wang¹; Nankun Liu¹; Shiyu Wang¹; Feng Tan^1,#

1. Chinese Center for Disease Control and Prevention, Beijing, China.

^# Corresponding author: Feng Tan, tanfeng@chinacdc.cn.

Glycidyl methacrylate (GMA) is a widely used industrial polymerization material. Current occupational exposure limits (OELs) for GMA in China show significant disparities compared to those established by international regulatory bodies, including the United States, European Union, and Japan. A comprehensive revision of GMA exposure limits is crucial for ensuring optimal worker protection. This investigation analyzed data from a 104-week inhalation carcinogenicity study of GMA in mice conducted in Japan. This study identified statistically significant pathological endpoints and employed benchmark dose (BMD) analysis to evaluate meaningful endpoints, focusing on those with the lowest benchmark dose lower bound (BMDL₁₀) values. The final recommendations were optimized using Bayesian model averaging (BMA) methodology to establish appropriate OELs. Our analysis recommends a time-weighted average allowable concentration (PC-TWA) of 0.01 ppm for GMA, which aligns with international standards established by the European Chemicals Agency (ECHA) (0.016 ppm), Japan Society for Occupational Health (0.012 ppm), and American Conference of Governmental Industrial Hygienists (ACGIH) (0.01 ppm). The combined application of BMD and BMA methodologies represents a scientifically robust approach for deriving points of departure (PoD) in risk assessment. These evidence-based OELs are essential for effective occupational hazard management and worker health protection.

使用基准计量和贝叶斯模型平均的方法推荐甲基丙烯酸缩水甘油酯的职业接触限值

陈智豪¹；王萌¹；刘楠堃¹；王诗语¹；谭枫^1,#

1. 中国疾病预防控制中心，北京，中国

^# 通信作者：谭枫，tanfeng@chinacdc.cn。

甲基丙烯酸缩水甘油酯（glycidyl methacrylate, GMA）是一种广泛使用的工业聚合材料，当前我国GMA的职业接触限值与其他制定GMA职业接触限值的国家或组织如美国，欧盟，日本等存在较大差距。修订新的GMA的职业接触限值对于保护劳动者健康具有重要意义。本研究使用了日本进行的为期104周的小鼠吸入GMA致癌性试验报告为分析对象，筛选有统计学意义的病理学结局，使用基准剂量法分析有意义的终点或结局，选取基准剂量下限值（benchmark dose lower bound, BMDL₁₀）最小的终点为分析对象，最后，研究使用贝叶斯模型平均的方法优化分析结果，最终的结果作为GMA推荐的职业接触限值（occupational exposure limit, OEL）值。模型推荐0.01ppm作为GMA的时间加权平均容许浓度（permissible concentration-time weighted average, PC-TWA），与欧盟（0.016ppm）、日本（0.012ppm）、美国（0.01ppm）的职业接触限值基本一致。基准计量和贝叶斯模型平均方法的综合应用代表了在风险评估中推导出发点(points of departure, PoD)的一种科学可靠的方法。这些以证据为基础的OEL对于有效的职业危害管理和工人健康保护至关重要。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.277

Targeted Analysis of VOCS in Exhaled Breath of Coal Workers’Pneumoconiosis Patients, An Exploratory Study

Rui Gao^1,2,3; Lijia Yu¹; Qingyu Meng¹; Yazhen He^1,2,3; Fangda Peng^1,2; Xiangfu Cao¹; Qingjun Qian¹; Qicai Liu¹; Gaisheng Liu⁴; Fan Yang⁴; Yiwei Shi⁵; Qingsong Chen³; Chunguang Ding^1,2,3,5,#

1. National Center for Occupational Safety and Health, NHC, Beijing, China;

2. NHC Key Laboratory for Engineering Control of Dust Hazard, Beijing, China;

3. Guangdong Pharmaceutical University, Guangzhou City, Guangdong Province, China;

4. Xishan Coal and Electricity (Group) Co., Ltd. Occupational Disease Prevention and Control Center, Taiyuan City, Shanxi Province, China;

5. NHC Key Laboratory of Pneumoconiosis, MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Key Laboratory of Respiratory Diseases, The First Hospital of Shanxi Medical University, Taiyuan City, Shanxi Province, China.

^# Corresponding authors: Chunguang Ding, ding_chg@163.com.

To explore the metabolic characteristics of volatile organic compounds (VOCs) in exhaled breath of patients with coal workers' pneumoconiosis and screen potential biomarkers. Study data were collected through questionnaires and medical examinations. Thermal desorption-gas chromatography-mass spectrometry (TD-GC-MS) was employed for targeted VOC analysis. Differential VOCs were identified using OPLS-DA, Mann-Whitney U test, and fold change analysis. The discriminatory efficacy of differential VOCs was evaluated using receiver operating characteristic (ROC) curves. Spearman correlation analysis explored relationships between differential VOCs, lung function indices, and blood cell levels. The pneumoconiosis group showed elevated concentrations of 10 compounds, including isopentane, n-pentane, and isoprene, while four compounds, including 2,4-dimethylpentane, methylcyclohexane, 2,3,4-trimethylpentane, and methylheptane showed decreased concentrations. Combined univariate and multivariate statistical analyses identified six significant VOCs, including isopentane and pentane. Notably, isopentane and n-pentane demonstrated negative correlations with FVC and FEV1.0 levels, while 2-methylheptane showed positive correlations. There are evident disparities in the metabolism of VOCs between coal workers' pneumoconiosis and non-dust-connected healthy individuals. Isopentane, n-pentane, 3-methylpentane, n-hexane, cyclohexane, and 2-methylheptane in exhaled breath can be used as potential biomarkers of coal workers' pneumoconiosis.

煤工尘肺患者呼出气中VOCs靶向定量分析，探索性研究

高汭^1,2,3；于丽佳¹；孟庆玉¹；何雅珍^1,2,3；彭方达^1,2；曹香府¹；钱青俊¹；刘其才¹；刘改生⁴；杨帆⁴；施熠炜⁵；陈青松³；丁春光^1,2,3,5,#

1. 国家卫生健康委职业安全卫生研究中心，北京，中国

2. 国家卫生健康委粉尘危害工程防护重点实验室，北京，中国

3. 广东药科大学，广州市，广东省，中国

4. 西山煤电(集团)有限责任公司职业病防治所，太原市，山西省，中国

5. 国家卫生健康委员会尘肺病重点实验室、煤炭环境致病与防治教育部重点实验室、山西省呼吸疾病重点实验室、山西医科大学第一附属医院，太原市，山西省，中国。

^# 通信作者：丁春光，ding_chg@163.com。

对煤工尘肺病患者呼出气中VOCs的代谢特征进行探索研究，筛选潜在生物标志物。通过问卷调查和医学检查收集数据。用热解吸-气相色谱-质谱法（TD-GC-MS）对VOC进行靶向分析。通过OPLS-DA、Mann-Whitney U检验和差异倍数（Fold Change）筛选差异VOCs，用受试者工作特征曲线（ROC）评估差异 VOCs 的鉴别效能；采用 Spearman 相关性分析探索差异 VOCs 与肺功能指标和血细胞水平的关系。煤工尘肺组中异戊烷、正戊烷、异戊二烯等10种VOCs浓度升高，2,4-二甲基戊烷、甲基环己烷、2,3,4-三甲基戊烷和甲基庚烷4种VOCs浓度降低。结合单变量和多元统计分析，筛选出异戊烷、正戊烷等 6 种 VOCs。其中异戊烷和正戊烷与FVC和FEV1.0水平呈负相关，2-甲基庚烷与FVC、FEV1.0水平呈正相关。煤工尘肺病患者与健康对照人群呼出气VOCs存在代谢差异，异戊烷、正戊烷、3-甲基戊烷、正己烷、环己烷、2-甲基庚烷6种差异VOCs为可作为潜在生物标志物进一步研究。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.278

Coal Worker’s Pneumoconiosis-Targeted Lipidomics Reveals Aberrant Phospholipid Metabolism for Early-Stage Diagnosis

Yuzhen Feng^1,2,3; Jing Dai^2,3; Junyun Wang^2,3; Fangda Peng^2,3; Wenrong Wang^2,3,4; Xiao Yu⁵; Xiaomei Kong⁵; Qingjun Qian^2,3; Qicai Liu^2,3; Huanqiang Wang⁴; Chunguang Ding^1,2,3,#; Yiwei Shi^5,#

1. Guangdong Pharmaceutical University, Guangzhou City, Guangdong Province, China;

2. National Center for Occupational Safety and Health, NHC, Beijing, China;

3. NHC Key Laboratary for Engineering Control of Dust Hazard, Beijing, China;

4. National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China;

5.NHC Key Laboratory of Pneumoconiosis, MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Key Laboratory of Respiratory Diseases, The First Hospital of Shanxi Medical University, Taiyuan City, Shanxi Province, China.

# Corresponding author: Chunguang Ding, ding_chg@163.com; Yiwei Shi, shiyw@sxmu.edu.cn.

This study aims to investigate potential phospholipid biomarkers in the serum of coal workers' pneumoconiosis (CWP) patients. Utilizing ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), we conducted a targeted lipidomic analysis of serum samples from 62 CWP patients, 105 coal dust-exposed workers, and 50 healthy controls. Through comprehensive univariate and multivariate statistical approaches, we identified a panel of significantly altered phospholipid molecular species in CWP patients. Compared to healthy controls, CWP patients  exhibited significant alterations in phospholipid profiles: a notable decrease in lysophosphatidylserine (Lyso-PS 18:0) and a significant increase in phosphatidylcholines (PC 16:0, PC 18:0, PC 16:0/18:1), phosphatidylinositol (PI 16:0/18:1), phosphatidylserine (PS 18:1), and phosphatidylglycerol (PG 16:0).Receiver operating characteristic (ROC) curve analysis revealed that these differential lipids demonstrated robust diagnostic potential, with area under the curve (AUC) values exceeding 0.7. Compared with coal dust-exposed workers, CWP patients exhibited significant elevations in the levels of lysophosphatidylcholine (Lyso-PC 16:0), phosphatidylcholines (PC 16:0, PC 16:0/18:1), phosphatidylinositol (PI 16:0/18:1), and phosphatidylglycerol (PG 16:0). The areas under the receiver operating characteristic curves (AUCs) for these molecules indicated their high predictive value. Based on these differential lipids, we developed a diagnostic model incorporating PC 16:0, PC 16:0/18:1, PI 16:0/18:1, and PG 16:0, which exhibited exceptional discriminatory performance with an AUC of 0.956 in distinguishing CWP patients from coal dust-exposed workers. Our findings reveal the differences in phospholipid metabolism between coal dust exposure and CWP patients, and based on these differences, an efficient diagnostic model has been constructed. This provides a novel approach to early CWP diagnosis and may inform targeted intervention strategies for occupational lung diseases.

基于靶向脂质组学的煤工尘肺患者的差异磷脂代谢有助于早期诊断

冯钰贞^1,2,3；代静^2,3；王均云^2,3；彭方达^2,3；王文荣^2,3,4；尉骁⁵；孔晓梅⁵；

钱青俊^2,3；刘其才^2,3；王焕强⁴；丁春光^1,2,3,#；施熠炜^5,#

1. 广东药科大学，广州市，广东省，中国；

2. 国家卫生健康委职业安全卫生研究中心，北京，中国；

3. 国家卫生健康委粉尘危害工程防护重点实验室，北京，中国；

4. 职业卫生与中毒控制所，中国疾病预防控制中心，北京，中国；

5. 国家卫生健康委员会尘肺病重点实验室，教育部煤炭环境致病性与防治重点实验室、山西省呼吸疾病重点实验室，山西医科大学附属第一医院，太原市，山西省，中国。

^# 通信作者：丁春光，ding_chg@163.com；施熠炜，shiyw@sxmu.edu.cn。

本研究旨在探索煤工尘肺（CWP）的潜在血清磷脂生物标志物。我们采用超高效液相色谱-串联质谱（UPLC-MS/MS）技术，对62例尘肺病患者、105例煤尘暴露工人及50例健康对照者的血清样本进行了靶向脂质组学分析。经过单变量和多变量统计，我们筛选出了一系列在尘肺病患者中显著变化的磷脂分子。与健康对照者相比，尘肺病患者中溶血磷脂酰丝氨酸（Lyso-PS 18:0）水平显著下降，而磷脂酰胆碱PC(16:0)、PC(18:0)、PC(16:0/18:1）、磷脂酰肌醇PI(16:0/18:1)、磷脂酰丝氨酸PS(18:1)和磷脂酰甘油PG(16:0)水平显著升高，且这些差异磷脂的受试者工作特征曲线（ROC）下面积（AUC）均大于0.7。与煤尘暴露工人相比，CWP患者中的溶血磷脂酰胆碱Lyso-PC(16:0)及PC(16:0)、PC(16:0/18:1)、PI(16:0/18:1) 和PG(16:0)水平显著升高，AUC值表明其具有较高的预测价值。基于这些差异磷脂，我们构建了一个包含PC(16:0)、PC(16:0/18:1)、PI(16:0/18:1)和PG(16:0)的诊断模型，该模型在区分CWP患者方面的表现出色，AUC高达0.956。本研究结果揭示了煤尘暴露与CWP患者之间磷脂代谢的差异，并据此构建了一个高效的诊断模型，为CWP的早期诊断提供新的方向，为相关职业病的早期干预提供科学依据。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.279

Analysis of Mortality and Life Expectancy Determinants Among 5,791 Deceased Pneumoconiosis Patients — Jiangsu Province, China, 2011–2023

Hangju Zhu^1,2,&;  Lang Zhou^3,&;  Jinyi Zhou⁴ ;  Lei Han^3,#;  Ming Wu^1,4,#

1. Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing City, Jiangsu Province, China;

2. The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing City, Jiangsu Province, China;

3. Department of Occupation Disease Prevention and Cure, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing City, Jiangsu Province, China;

4. Department of Noncommunicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing City, Jiangsu Province, China.

^& Joint first authors

^# Corresponding author: Ming Wu, wuming@jscdc.cn; Lei Han, hanlei@jscdc.cn.

Pneumoconiosis is the occupational disease with the highest proportion in China. This study conducted a retrospective analysis of 5,791 deceased pneumoconiosis patients using SPSS 23.0 and R 4.4.1 software. In this study, males comprised 93.02% of cases, with primary affected industries being mining (58.47%), manufacturing (20.55%), and public management (16.42%). Silicosis (69.42%) and coal worker’s pneumoconiosis (20.57%) were the predominant diagnoses. Most patients (66.47%) were diagnosed at stage one. Significant differences were observed in both diagnosis age and post-diagnosis survival time across disease stages (P<0.05). The proportion of patients who died directly from lung infections was the highest (37.32%). The primary underlying causes of death in pneumoconiosis patients include pulmonary infections, cardiovascular and cerebrovascular diseases, and digestive tract and lung tumors. Life expectancy for patients aged 30–35 years was 15.83 years. After excluding the effects of pulmonary infections, cardiovascular diseases, digestive tract tumors, and lung tumors, life expectancy increased by 3.75, 1.11, 1.31, and 0.63 years, respectively. Pneumoconiosis patients with concurrent lung tumors showed a 7.797-fold increased mortality risk, while pulmonary infections elevated mortality risk by 3.030-fold. Management strategies for pneumoconiosis should emphasize both primary disease treatment and comprehensive care for complications, particularly pulmonary infections, cardiovascular diseases, and malignancies. This integrated approach could extend survival time and enhance quality of life for affected patients.

共5,791例尘肺死亡患者死亡率和预期寿命决定因素分析 — 江苏省，中国，2011–2023年

朱航榉^1,2,&；周琅^3,&；周金意⁴ ；韩磊^3,#；武鸣^1,4,#

1. 南京医科大学公共卫生学院流行病学教研室，南京市，江苏省，中国；

2. 南京医科大学附属肿瘤医院，南京市，江苏省，中国；

3. 江苏省疾病预防控制中心职业病防治所，南京市，江苏省，中国；

4. 江苏省疾病预防控制中心慢性非传染性疾病防治所，南京市，江苏省，中国。

^& 共同第一作者。

^# 通信作者：武鸣，wuming@jscdc.cn；韩磊，hanlei@jscdc.cn。

尘肺病是中国发病率最高的职业病。本研究采用SPSS 23.0和r4.4.1软件对5791例尘肺病故患者进行回顾性分析。在本研究中，男性占93.02%，所属行业以采矿业（58.47%）、制造业（20.55%）和公共管理（16.42%）为主。患者的尘肺病种类以矽肺（69.42%）和煤矿工人尘肺（20.57%）为主。患者的诊断期别以尘肺壹期（66.47%）为主。不同分期患者的诊断年龄和诊断后生存时间差异均有统计学意义（P<0.05）。直接死于肺部感染的比例最高（37.32%）。尘肺患者的主要潜在死亡原因包括肺部感染、心脑血管疾病、消化道和肺部肿瘤。30-35岁患者的预期寿命为15.83岁。在排除肺部感染、心血管疾病、消化道肿瘤和肺部肿瘤的影响后，预期寿命分别增加了3.75岁、1.11岁、1.31岁和0.63岁。合并肺部肿瘤的尘肺患者死亡风险增加7.797倍，肺部感染患者死亡风险增加3.030倍。尘肺病的管理策略应强调原发疾病治疗和并发症的综合护理，特别是肺部感染、心血管疾病和恶性肿瘤。这种综合方法可以延长患者的生存时间，提高患者的生活质量。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.280