| Background The incidence of hypertension is raising and has become one of the serious public health problems over the world.Coal miners exposed to occupational hazards such as dust,noise,extremely physically exhausted,unpredictable risks which resulting job stress.Mental stress,more likely causes hypertension.Epidemiological studies of coal miners’hypertension usually conducted by cross-sectional study,there are little report about cohort study.The aim of present study is to explore the prevalence and influencing factors of hypertension in coal miners,and to predict its incidence,so as to provide a basis for prevention and treatment of hypertension in coal mine enterprises.Objective The historical cohort study was aimed to analyse the epidemiological characteristics and law of Pingmei Group hypertension in coal miners;Analysis the occupational influencing factors of hypertension in coal miners.Forecast the incidence of hypertension in the next five years in Pingmei GroupMethods The historical cohort study was conducted in coal miners who entered 10 mines in Pingmei Shenma Group from 2006 to 2016.Hypertension was followed up from January2006 to December 2017.The baseline information about occupational health surveillance of coal miners were collected including general data and physical examination data.The database was setup by EpiData 3.0.Two cohorts were established by the exposure of occupational hazards(exposure group,control group),two cohorts by length of service(<5years,5~year),five cohorts by occupational category(tunneling,mining,helping,combining and administrative logistics(control group))The cumulative incidence of hypertension was calculated in the same observation period for each cohort of coal miners by life table method.Peto Log Rank Test was adopted to analyze differences of the cumulative incidence of hypertension between each cohort.The relationship between occupational exposure and hypertension in coal miners was analyzed byχ~2 test and multivariable Cox proportion model.The predictive models were constructed by using BP artificial neural network;The accuracy of the models was judge by receiver operating characteristic(ROC).The incidence number of hypertension are predicted in the next five years by BP artificial neural network(ANNS).Results 1 There were a total of 13025 male coal miners in Pingmei Group who entered the mine from 2006 to 2016.Among them 12647 coal miners data meet the requirements,the coincidence rate was 97.1%.During the observation period,a total of 2549 persons suffered from hypertension.In the total of 89259.75 person-years in the study,and the average following-up time was 7.1 person-years.The age was 16 to 50 years old when these coal miners entered the cohort,and the average age was(25.8±5.7)years old.The average length of service was(7.1±2.7)years.The incidence density of hypertension was 28.55per 1000 person-years among the coal miners.2 In the same observation period of 11 years,the cumulative incidence of hypertension in exposure group was 37.1%,control group was 29.3%;Coal miners length of service of<5years of cumulative incidence of hypertension was 57.7%,<5 years 31.6%;The cumulative incidence for different occupational category was as below,tunneling 38.7%,mining38.7%,helping 36.4%,combining 44.0%and control group 30.0%.3 The incidence density of hypertension was 29.68 per 1000 person-years in exposure group.The risks of incident hypertension in exposure group was 1.692(95%CI:1.410-2.032)times that of control group.Attributable risk(AR)was 13.24‰,attributable risk percentage(AR%)was 40.86%,population attributable risk(PAR)was12.12‰and population attributable risk percentage(PAR%)was 42.44%.The risks of incident hypertension in dust group,joint group was 2.147(95%CI:1.742-2.645),1.616(95%CI:1.344-1.942)respectively when the control group was used as reference.Compared with the control group,the risks of incident hypertension in tunneling,mining,helping was1.629(1.345-1.973),1.677(1.374-2.046),1.782(1.475-2.151),respectively;the risks of incident hypertension in combining was 0.979(95%CI:0.653-1.468).4 BP ANN model by established for prediction of hypertension.The sensitivity of BP ANN model was 82.1%,specificity was 94.3%,the consistency rate of the test set was 91.8%.The areas under the ROC curves(area under the curve)were 0.895(95%CI:0.886-0.904)for BP ANN.There would be 626 new hypertension patients among the coal miners in the next five years who entered the mine from 2006 to 2017.The number of new hypertension in the next five years in tunneling,mining,helping,combining and control group was 243,149,220,2,12 respectively.Conclusion 1 As time of occupational exposure,the cumulative incidence of hypertension among coal miners was gradually increasing.Occupational hazard exposures can increase the risk of hypertension among coal miners.2 Dust exposure as well as tunneling,mining,and helping can increase the risk of hypertension in coal miners;Tunneling,mining and combining were the key population to prevention and treatment of hypertension.3 There would be 626 new hypertension patients from 2018 to 2023 among the coal miners without hypertension who entered the mine from 2006 to 2016,if current conditions be kept. |
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