Analysis Of Epidemiologic Characteristics And Latent Variables Of Carotid Atherosclerosis In Occupational Population

Objectives Based on the survey of health status andhealth influence factors of Jinchuan company occupational population,to observe the prevalence and incidence of carotid atherosclerosis and ascertain the key groups for prevention and treatmentof disease;To analyze the effects of the living behavior,occupational exposure,combined disease as well as physiological and biochemical indexes;To explore the risk factors of CAS,the direct effect and indirect effect between various factors.The ultimate aim is to provide decis ion-making bas is for prevention interventions to reduce the incidence of CAS.Methods 18087 cases from Jinchuan nickel exposure occupational population with complete data of carotid color-coded ultrasonic were chosen as the subject population.Observational study methods were adopted in the study to observe the prevalence of CAS in this population by collecting their epidemiologic data and physical examination data.Use the two-year follow-up data to study the status of CAS in newly detected cases.Fisrtly extract the latent variables by exploratory factor analysis,then use structural equation model to analyze the risk factors of CAS and the direct effect and indirect effect between various factors.Results 1.The CAS prevalence of this occupational population was 15.09%,17.63%for male group,11.95%for female group.In the disease classification of CAS,the main type were 1950cases carotid plaque,accounted for 62.40%.The CAS cumulative morbilityin two years was5.30%,3.29%for male group,7.78%for female group.In the disease classification of CAS,the main type were 705 cases carotid plaque,accounted for 61.30%.2.The prevalence and incidence of CAS in this occupational population showed anascending tendency with the increasing of age and BMI,and an descending tendency with the increasing of literacy?P<0.05?.Except the group 0,the prevalence and incidence of CAS went up with the increasing of smoking index and alcohol consumption index?P<0.05?.The prevalence and incidence of CAS in people with occupational exposureand chronic diseases were higher than non-exposure group?P<0.05?.The hematological biochemical indexes were different between normal people and CAS patients.3.According to the literature experience and result of exploratory factor analysis,the dimension reduction of 22 original variable were finally extracted seven factors that were be analyzed as latent variables in CAS risk factors.The six factors are physiological factor,biochemical factor,behavior characteristics factor,diet custom factor,metal dust factor,poisonous gas factor and combined disease factor.4.The final model of the research is a recursive model.The model includes 50 variables and96 parameters.The path coefficient in the model reached a signif icant level?P<0.05?.The role of SBP and DBP in physiological factor is larger,their loading coefficient respectively are 0.866 and0.854.The role of smoking index in behavior characteristics factor is larger,its loading coefficient is 0.812.The role of SO₂ and CL in occupational exposure factor are larger,their loading coefficientrespectively are 0.816 and 0.740.The role of hypertension in combined disease factor is larger,its loading coefficient is 0.847.5.The risk factors for carotid atherosclerosis includedcombined diseases factor,age,physiological factor,biological factor,occupational exposure factor and health behavior factor.Among them,the age,combined disease factor have a direct effect on CAS,the standardized regression coefficients are 0.34 and 0.07 respectively.And the age,physiological factoralso had indirect effect on CAS.6.There were correlation in carotid atherosclerosis risk factors,especially health behavior and biochemical factors with the highest correlation cofficient of 0.711.There are synergies in all the risk factors on the CAS.5.The evaluation of the model indicated that the the part R² of observed variables reached more than 0.50.All the evaluation index to the model met the standard requirements including GFI?AGFI?PGFI?RMSEA?NFI?RFI?IFI?BIC?CAIC.Both the external quality and internal quality evaluationmet requirements.Conlusions 1.The prevalence and incidence of CAS in this occupational population are low,and carotid plaque dominates in the disease classification of CAS.People with characteristics of high age,obesity,low cultural level,smoking,drinking,occupational exposures,combined diseases and abnormal lipid metabolism have higer prevalence and incidence of CAS than normal people.2.The risk factors for carotid atherosclerosis includedcombined diseases factor,age,physiological factor,biological factor,occupational exposure factor and health behavior factor.Among them,the age had the most signif icant impact on carotid atherosclerosis,followed by physical factor and combined disease factor.The high loaf of SBP and DBP in physiological factor and hypertension of combined disease factor showed the higher blood pressure with the greater the risk on CAS.The control of blood pressure could reduce the risk of CAS effectively.3.The risk factors of CAS affected each other.The effect of age on CAS could be expressed not only by direct path,but also by indirect path of combined diseases factor.The effect of combined diseases factor on CAS just be expressed by direct path.The effect of physiological factor on CAS just be expressed by direct path of combined diseases factor.All of these indicated the the prevention and treatment of CAS needed take comprehensive measures in many aspects.