二次预防对建筑行业死亡率的影响 国家医学查计划:职业高风险管理的有效性
Knut Ringen1, John M Dement2, Marianne Cloeren3
1CPWR-The Center for Construction Research and Training, Silver Spring, Maryland, USA.
American journal of industrial medicine
|January 7, 2026
概括
医疗检查显著降低了核武器设施建筑工人的死亡风险. 定期查,即使在退休后,对于预防过早死亡和延长寿命至关重要.
科学领域:
- 职业健康 职业健康 职业健康
- 预防医学 预防医学
- 公共卫生 公共卫生
背景情况:
- 自1997年以来,建筑行业国家医疗检查计划 (BTMed) 已为美国核武器设施工人提供医疗检查.
- 查过程包括工作史面试和医疗检查.
- 这项研究比较了那些只接受过工作史面试的工人与那些还完成了医疗检查的工人之间的死亡率.
研究的目的:
- 评估医疗检查在降低高风险职业群体死亡率方面的有效性.
- 确定BTMed查对所有原因和特定原因死亡率的影响.
- 评估查计划的成本效益,以节省的生命年数来衡量.
主要方法:
- 一项比较死亡率研究,涉及3470名仅有工作史的参与者和23452名完成了工作史和医疗检查的参与者.
- 利用考克斯的比例危险和波桑回归模型来分析死亡率数据.
- 在统计分析中控制潜在的混因素.
主要成果:
- 医学检查参与者显示死亡风险显著降低:所有原因的28%,呼吸系统疾病的27%,COPD的37%,心血管疾病的30%,所有癌症的32%,肺癌的36%,结直肠癌的53%.
- 观察到剂量与反应的关系,增加医疗检查导致死亡风险降低 (25%,29%,43%为一个,两个或三个检查).
- 据估计,到2021年,BTMed已经预防了大约2911例过早死亡,并增加了35,178年的生命,每年的生命成本为2757美元.
结论:
- 包括定期医疗查在内的二次预防策略在高风险职业人群中非常有效.
- 为了持续降低死亡率,必须对工人进行持续的健康监测,延长到他们退休年龄之后.
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