Study On Prevalence Of The Pneumoconiosis Tuberculosis Of Coal Mine Workers In Shandong Province And Put Forward The Countermeasures

[Objective] To investigate the prevalence of the pneumoconiosis tuberculosis of the workers exposed to dust in Shandong Province, and investigation on the situation of pneumoconiosis complicated with tuberculosis, and to analyze its influencing factors, providing the basis for the prevention and treatment of the pneumoconiosis tuberculosis. According to the prevalence of pneumoconiosis tuberculosis of Shandong province coal workers’, put forward the technical ways and measures.[Methods] Retrospective investigation: To Collect the chest X-ray of the pneumoconiosis tuberculosis cases of coal mine workers of Shandong Province in A, B and C coal mine on 2008-2012. According to "mine workers exposed to dust retrospective survey of basic information on the registration form", to register the information of the case of previous medical diagnosis of tuberculosis or suspected tuberculosis and pneumoconiosis tuberculosis case. The details of the survey includes general information, occupational situations(such as type of work, exposure time, etc.), medical diagnosis time, the medical diagnosis, etc. And according to the "dust workers retrospective survey chest X-ray film reading record form" to re-read the piece, recorded cases and diagnosis. The data about the pneumoconiosis tuberculosis of the workers exposed to dust in Shandong Province was collected by Epidata3.1 and analyzed by SPSS17.0, which include analyzing the prevalence of the pneumoconiosis tuberculosis of the workers exposed to dust, the situation of pneumoconiosis complicated with tuberculosis and its influencing factors, and from the X-ray imaging analysis of coal dust workers tuberculosis, etc. Cross-sectional investigation: To survey of six coal mines in Shandong Province and obtain information through the occupation health examination, 4438 working underground coal mine workers as the research object whose age more than 18 years and less than 60 years, exposure time more than half. Using face-to-face questionnaire, and the details of the survey includes general information, smoking history, disease history, occupational situations(such as type of work, exposure time, etc.), etc. And asked in detail about their subjects disease history and history of occupation, On the basis of X-ray, combined with clinical manifestations and past medical history, diagnosis of tuberculosis and fill out the "coal dust workers on-site survey chest X-ray film reading record form". The data about the pneumoconiosis tuberculosis of the workers exposed to dust in Shandong Province was collected by Epidata3.1 and analyzed by SPSS17.0, which include analyzing the prevalence of the pneumoconiosis tuberculosis of the workers exposed to dust, the situation of pneumoconiosis complicated with tuberculosis. And carries on the factors analysis of coal dust workers pneumoconiosis tuberculosis risk factors.[Results] 1. Retrospective investigation: This review surveys were obtained 323 cases of suspected tuberculosis, coal mine pneumoconiosis tuberculosis and old tuberculosis and other abnormal imaging cases in 2008 to 2012. There were 111 cases of active pulmonary tuberculosis(including tuberculosis and pneumoconiosis combined with tuberculosis), the rate of active tuberculosis detection was 628.61/10 million, and the rate of pneumoconiosis with tuberculosis is 27.63%. The incidence of pneumoconiosis tuberculosis increased with age and exposure years, and the rate of pneumoconiosis increased gradually, and the difference was statistically significant(P<0.05); The average age and average seniority of pneumoconiosis tuberculosis patients are higher than the pulmonary tuberculosis patients; 111 patients with active pulmonary tuberculosis were diagnosed as secondary pulmonary tuberculosis, chest X-ray in patients with secondary pulmonary tuberculosis lesions are mainly proliferative lesions in 74 cases(66.67%). 2.Cross-sectional investigation: In the survey, 4438 dust exposed workers are male, whose average age is(37.93±8.796) years old and the age group distribution uniformity. Their exposure time is 0.5~38 years and average exposure time is(12.02±8.865) years, the workers’ exposure time which less 10 years accounted for 60.8%; 99.6% of the workers had no history of tuberculosis; The rate of pneumoconiosis with tuberculosis is 4.88%; The rate of active pulmonary tuberculosis prevalence is 7.21 per thousand(721.05/10 million), and in addition to the I coal mine, the TB prevalence rate of other coal dust workers were higher than the general population prevalence rate of TB(459/10 million). According to the chi-square tests and analysis of variance, the worker’s age, exposure history(exposure time), occupation, history of smoking, daily smoking these factors that affect the prevalence of coal workers, there were significant differences(P<0.05); TB contact history is one of the important risk factors of coal mine workers suffering from tuberculosis, and the difference was statistically significant(P<0.05); Multivariate analysis showed that the mining area, age, previous history of tuberculosis, and tuberculosis patients have close contact history and family income is coal worker’s pneumoconiosis tuberculosis prevalence of influencing factors(P<0.05), including age, previous history of tuberculosis, and tuberculosis patients have close contact history were risk factors, family income is the protective factor. Workers active pulmonary tuberculosis were diagnosed as pulmonary tuberculosis and the lesions are mainly proliferative lesions in 18 cases(56.25%).[Conclusions] 1.Through the retrospective investigation and analysis for current situation of the research, the conclusion is that the TB prevalence rate of coal dust workers in Shandong province was significantly higher than the average resident TB prevalence rate(459/10 million). 2.The retrospective investigation diagnosis out pneumoconiosis complicated with pulmonary tuberculosis in 63 cases, and the combined rate was 27.63%. The stage of pneumoconiosis formed in stage I cases mainly; The phase III of pneumoconiosis combined with tuberculosis rates is higher than the phase I, phase II of pneumoconiosis, and with the pneumoconiosis period increased, the increased rates of tuberculosis. 3.By retrospective investigation analysis that the combined rate of the pneumoconiosis tuberculosis was influenced by age and dust history, the older of the age and the longer of the service, the higher about the rate of the merger, the difference was statistically significant(P < 0.05). 4.In the tatus survey, there are 41 cases of pneumoconiosis and 2 cases of pneumoconiosis complicated with active pulmonary tuberculosis,so the combined rate was 4.88%. 5.The survey found that Mine area, age, past tuberculosis, and close contact history and family income were the influencing factors of pneumoconiosis tuberculosis(P < 0.05). 6.In Shandong Province, coal dust workers’ active pulmonary tuberculosis is mainly for secondary pulmonary tuberculosis, and the lesions is mainly proliferative lesion.