| Objective①To investigate the characteristics of gem processing worker silicosis (GWS), and to provide fundamental information for their life quality analysis.②To understand the quality of life and influencing factors of GWS patients and to provide scientific basis for formulating intervention measures to improve their life quality.Methods(DA retrospective study was carried out in268cases of GWS diagnosed between2002～2010, including103natural GWS and165synthetic GWS. The distribution, clinical manifestations, pathogenic characteristics of the GWS were analyzed.②The quality of life was measured by WHOQOL-BREF and possible factors were investigated by questionnaire.135cases of GWS were investigated.122valid questionnaires were statistically analyzed and the results were compared with the norm model and70cases of silicosis patients from non-gem processing enterprises (control group) diagnosed during the same period. Corresponding related factors were analyzed by multiple linear regression.Results①Characteristics of GWS in gem processing industry The average age of natural GWS (103cases) was (33.78±5.83) years old. The duration of dust exposure was (8.00±3.20) years. The types of work were mainly gem cutting (67.96%). Chest radiographic examination showed mainly small round opacities "q"(68.93%). The incidence rate of pulmonary tuberculosis was22.33%and the pulmonary ventilative capacity damage was observed to be31.87%.58.76%of natural GWS were totally lost their working abilities.The average age of synthetic GWS (165cases) was (31.09±4.26) years old. The duration of dust exposure was (8.40±2.63) years. The types of work were mainly gem grinding (81.82%). Chest radiographic examination showed mainly small round opacities "p"(87.88%). The incidence rate of pulmonary tuberculosis was1.82%and the pulmonary ventilative capacity damage was observed to be12.27%.6.06%of artificial GWS were totally lost their working abilities.②Results of dust detection in the workplace The average dust concentration in natural and synthetic gem processing enterprises were1.71mg/m3(0.03～18.50mg/m3) and3.75mg/m3(0.20～15.00mg/m3) respectively, the former with an exceeding mark rate of21.59%. The average free SiO2were (47.23±5.42)%and (44.85±7.3)%respectively.③Results of the life quality survey211questionnaires were issued in this research. Although all questionnaires were recalled,192including122GWS and70controls were effectively feedbacked with the valid response rate91.00%. The mean scores of physical, psychological, social and environmental domain in122GWS were respectively10.77±2.98,11.74±3.19,12.31±2.67and10.56±2.39, which were statistically lower than those of the normal ranges, so were the natural GWS and synthetic GWS (P<0.01). And the natural ones were lower than that of the synthetic in mean scores of physical, psychological and environmental domain (P <0.05). There were no significant differences between GWS and control group on the mean scores of four domains, their own quality of life, health state and the score of their own judgment of quality of life (P>0.05).76(62.30%) GWS had "average","good" or "pretty good" feelings of their own quality of life, while53(43.44%) had the same feelings of their own health state. The mean score of own judgment of quality of life was10～100(58.23±18.66).Single factor analysis found that totally25factors were correlated with most of physical, psychological, social and environmental domain, including age, educational level, marriage status, family relationship, career, drinking, interests, exercises, knowledge about silicosis, personal monthly income, family monthly income, medical expenses, economic compensation, silicosis stage, exposure time, level of disability, colds, complications, cough, chest pain, shortness of breath, sleep supine, self-care, family friction and appetite.Based on multiple linear regression analysis, the ranked factors from strong to weak correlated with physical domain were sleep supine, common cold, appetite, family friction, shortness of breath and interests, with psychological domain were sleep supine, family friction, shortness of breath, family relationship, interests, appetite, career and colds, with social domain were sleep supine, family relationship, family friction and appetite, with environmental domain were family friction, self-care, appetite, career and family monthly income.Conclusion①The hazards of gem silica produced during gem processing were so extraordinary serious that physical and mental health of GWS patients were impaired, mainly for the age of onset, short dust-exposed length and respiratory symptoms. Chest radiographic examination showed mainly small round opacities. Compared with artificial GWS, the incidence rate of pulmonary ventilative capacity damage and working ability lost were more serious in natural GWS.②The quality score of GWS group from high to low was social, psychological, physical and environmental domain, which were statistically lower than those of the normal ranges, so were natural GWS and synthetic GWS. The score of natural GWS were statistically lower than that of the synthetic in physical, psychological and environmental domain. ③There was no significant difference between GWS group and control group, but the former’s subjective feelings were positive.④Many factors were correlated with life quality of GWS, including common cold, shortness of breath, sleep supine, self-care, family friction, career, interests, family relationship, family monthly income and appetite. The negative factors were colds, shortness of breath, sleep supine, self-care and family friction, while career, interests, family relationship, family monthly income and appetite were the positive factors.⑤Important measures should be taken to improve the life quality of GWS, such as health surveillance and rehabilitation to mitigate the effects of negative factors, and health education, family and social support and rehabilitation of professional ability to enhance the positive factors. |
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