Article(id=1241035818731631346, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241035810628235909, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202408311, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1723910400000, receivedDateStr=2024-08-18, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773815596515, onlineDateStr=2026-03-18, pubDate=1733760000000, pubDateStr=2024-12-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773815596515, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773815596515, creator=13701087609, updateTime=1773815596515, updator=13701087609, issue=Issue{id=1241035810628235909, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='23', pageStart='4225', pageEnd='4416', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773815594584, creator=13701087609, updateTime=1773815743629, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241036435843764756, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241035810628235909, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241036435843764757, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241035810628235909, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=4291, endPage=4296, ext={EN=ArticleExt(id=1241035819650183950, articleId=1241035818731631346, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of the burden and trend of mushroom poisoning diseases in Guizhou Province from 2011 to 2023, columnId=1228016572783063333, journalTitle=Modern Preventive Medicine, columnName=Nutrition and Food Hygiene, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the current status and trends of the burden of mushroom poisoning diseases in Guizhou Province from 2011 to 2023, providing a basis for the formulation of rational prevention and control measures.

Methods

A descriptive analysis was conducted on mushroom poisoning incident data from the “Foodborne Disease Outbreak Monitoring System” in Guizhou Province from 2011 to 2023. The mushroom poisoning mortality data were organized by gender, age, and year. The World Health Organization’s Excel template was used to calculate Years of Life Lost (YLLs) due to premature death, and the human capital method was employed to estimate the indirect economic burden caused by mushroom poisoning in Guizhou Province. The Join point regression model was utilized to analyze the temporal trends in incidence rates, mortality rates, and YLLs rates of mushroom poisoning.

Results

From 2011 to 2023, Guizhou Province reported a total of 2 518 mushroom poisoning outbreaks, affecting 8 716 individuals and resulting in 97 deaths, with a mortality rate of 0.25 per 100 000 population. The total YLLs for the entire population was 2 139 person-years, with a YLLs rate of 5.55 person-years per 100 000; YLLs and YLLs rates for males were higher than those for females. The highest YLLs were observed in the 45 to <60 age group, while the highest YLLs rate was found in the 60 to <70 age group. The overall indirect economic burden of the 97 mushroom poisoning deaths in Guizhou Province was 40.8 569 million yuan, averaging 421 200 yuan per case. From 2011 to 2023, the incidence rate of mushroom poisoning in Guizhou Province showed a continuous upward trend, while both the mortality rate and YLLs rate exhibited a continuous downward trend, with annual percentage changes (APC) of 26.79%, -17.76%, and -16.70%, respectively (P<0.05).

Conclusion

The incidence rate of mushroom poisoning in Guizhou Province is on a continuous rise, with higher YLLs in males compared to females and the highest YLLs observed in the 45 to <60 age group, corresponding to a significant indirect economic burden. It is essential to enhance effective public education and continue to strengthen medical treatment to reduce the occurrence of toxic mushroom poisoning.

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目的

了解2011—2023年贵州省蘑菇中毒疾病负担现状及变化趋势,为合理制定预防控制措施提供依据。

方法

对贵州省“食源性疾病暴发监测系统”中2011—2023年蘑菇中毒事件数据进行描述性分析;将蘑菇中毒死亡数据根据性别、年龄、年份进行整理,使用世界卫生组织疾病负担Excel计算模版计算早死所致生命损失年(YLLs),结合人力资本法估计贵州省蘑菇中毒间接造成的经济负担;采用joinpoint回归模型分析蘑菇中毒发病率、死亡率、YLLs率的时间变化趋势。

结果

2011—2023年贵州省共报告蘑菇中毒暴发事件2 518起,发病8 716人,死亡97人,死亡率为0.25/10万;全人群的YLLs为2 139人年,YLLs率为5.55人年/10万,男性的YLLs与YLLs率均高于女性;45~<60岁人群的YLLs最高,60~<70岁人群的YLLs率最高;贵州省97例蘑菇中毒死亡病例总体间接经济负担为4 085.69万元,人均42.12万元;2011—2023年贵州省蘑菇中毒发病率呈持续上升趋势,死亡率和YLLs率均呈持续下降趋势,即APC=AAPC,发病率、死亡率和YLLs率分别为26.79%、-17.76%、-16.70%(P<0.05)。

结论

贵州省蘑菇中毒发病率呈持续上升趋势,且男性YLLs大于女性、45~<60岁人群YLLs最高,与之对应的间接经济负担重,应及时加强有效的宣传教育、继续强化医疗救治,降低毒蘑菇中毒的发生。

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郭华,E-mail:
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吴牡丽(2001—),女,硕士在读,研究方向:食源性疾病监测

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吴牡丽(2001—),女,硕士在读,研究方向:食源性疾病监测

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Chinese Hospitals,2023, 27(6): 11-14.(In Chinese)。, articleTitle=Study on the path of promoting the construction of a compact county medical consumption linkage with a county medical sub-center in Guizhou Province, refAbstract=null)], funds=[Fund(id=1241069120339366027, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, awardId=2017YFC1601805, language=CN, fundingSource=国家重点研发计划项目(2017YFC1601805), fundOrder=null, country=null), Fund(id=1241069120456806547, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, awardId=[2017]2972, language=CN, fundingSource=黔科合支撑项目([2017]2972), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241069112357606082, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, xref=1., ext=[AuthorCompanyExt(id=1241069112365994691, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, companyId=1241069112357606082, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health and Health, Guizhou Medical University, Key Laboratory of Environmental Pollution and Disease Monitoring, Ministry of Education, Guiyang, Guizhou 561113, China), AuthorCompanyExt(id=1241069112374383300, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, companyId=1241069112357606082, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州 贵阳 561113)]), AuthorCompany(id=1241069112458269384, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, xref=2., ext=[AuthorCompanyExt(id=1241069112466657993, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, companyId=1241069112458269384, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.贵州省疾病预防控制中心公共卫生监测评价研究所,贵州 贵阳 550004)]), AuthorCompany(id=1241069112638624466, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, xref=3., ext=[AuthorCompanyExt(id=1241069112647013075, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, companyId=1241069112638624466, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.贵州省疾病预防控制中心实验中心)])], figs=[ArticleFig(id=1241069118896525327, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, language=EN, label=Figure 1, caption=Distribution of mushroom poisoning outbreaks in Guizhou Province from 2011 to 2023 by month (A) and by year (B), figureFileSmall=8H4Yu1Ughfgfnb3E+Tz6kA==, figureFileBig=mOG40qvPi89I2Qj1XuwS8A==, tableContent=null), ArticleFig(id=1241069119018160160, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, language=CN, label=图1, caption=2011—2023年贵州省蘑菇中毒暴发事件的月份、年份分布情况

注:图A为月份;图B为年份。

, figureFileSmall=8H4Yu1Ughfgfnb3E+Tz6kA==, figureFileBig=mOG40qvPi89I2Qj1XuwS8A==, tableContent=null), ArticleFig(id=1241069119131406380, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, language=EN, label=Figure 2, caption=Trends in mushroom poisoning mortality rate and YLLs rate in Guizhou Province from 2011 to 2023, figureFileSmall=EPn7k0bcz8hE3h5a4iEOMA==, figureFileBig=CrxxB6Ze1GeYEXR+STtD3w==, tableContent=null), ArticleFig(id=1241069119244652596, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, language=CN, label=图2, caption=2011—2023年贵州省蘑菇中毒死亡率、YLLs率变化趋势

注:A为死亡率;B为YLLs率;*P<0.05。

, figureFileSmall=EPn7k0bcz8hE3h5a4iEOMA==, figureFileBig=CrxxB6Ze1GeYEXR+STtD3w==, tableContent=null), ArticleFig(id=1241069119345315900, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, language=EN, label=Table 1, caption=

Deaths due to mushroom poisoning across different age groups in Guizhou Province from 2011 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄段(岁)死亡人数死亡率(/10万)
合计合计
0~<54040.250.000.13
5~<1537100.090.240.16
15~<3074110.180.110.14
30~<45125170.310.140.23
45~<601717340.410.420.41
60~<70108180.650.510.58
70~<800220.000.190.10
≥801010.290.000.12
合计5443970.270.230.25
), ArticleFig(id=1241069119454367816, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, language=CN, label=表1, caption=

2011—2023年贵州省蘑菇中毒不同年龄段死亡水平

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄段(岁)死亡人数死亡率(/10万)
合计合计
0~<54040.250.000.13
5~<1537100.090.240.16
15~<3074110.180.110.14
30~<45125170.310.140.23
45~<601717340.410.420.41
60~<70108180.650.510.58
70~<800220.000.190.10
≥801010.290.000.12
合计5443970.270.230.25
), ArticleFig(id=1241069119555031119, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, language=EN, label=Table 2, caption=

Disease burden of fatal mushroom poisoning by gender and age group in Guizhou Province, 2011—2023

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄段(岁)男性女性全人群
YLLs(人年)YLLs率(/10万)YLLs(人年)YLLs率(/10万)YLLs(人年)YLLs率(/10万)
0~<51207.53001203.99
5~<15892.662097.222984.78
15~<301945.011143.043084.05
30~<452837.271263.444095.42
45~<603448.223588.867028.53
60~<701429.301298.162718.72
70~<8000252.33251.25
≥8061.600000
合计1 1785.989615.102 1395.55
), ArticleFig(id=1241069119647305815, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, language=CN, label=表2, caption=

2011—2023年贵州省蘑菇中毒不同性别、年龄段死亡疾病负担

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄段(岁)男性女性全人群
YLLs(人年)YLLs率(/10万)YLLs(人年)YLLs率(/10万)YLLs(人年)YLLs率(/10万)
0~<51207.53001203.99
5~<15892.662097.222984.78
15~<301945.011143.043084.05
30~<452837.271263.444095.42
45~<603448.223588.867028.53
60~<701429.301298.162718.72
70~<8000252.33251.25
≥8061.600000
合计1 1785.989615.102 1395.55
), ArticleFig(id=1241069119810883683, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, language=EN, label=Table 3, caption=

Disease burden of mushroom poisoning deaths in different years in Guizhou Province from 2011 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
年份(年)男性女性全人群
死亡人数YLLs(人年)YLLs率(/10万)死亡人数YLLs(人年)YLLs率(/10万)死亡人数YLLs(人年)YLLs率(/10万)
20111290.151250.132540.14
2012173881.97132871.52306751.75
201351230.6381911.01133140.82
20144850.433620.3371470.38
20151140.071300.162440.11
2016112241.1361440.76173680.94
20174780.401210.15990.26
20183650.333490.2661140.30
20191170.092410.223580.15
20204870.444910.4881780.46
20211210.101200.102410.13
2022000000000
20232470.240002470.12
合计541 1785.98439615.10972 1395.55
), ArticleFig(id=1241069119911546988, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, language=CN, label=表3, caption=

2011—2023年贵州省不同年份蘑菇中毒死亡疾病负担

, figureFileSmall=null, figureFileBig=null, tableContent=
年份(年)男性女性全人群
死亡人数YLLs(人年)YLLs率(/10万)死亡人数YLLs(人年)YLLs率(/10万)死亡人数YLLs(人年)YLLs率(/10万)
20111290.151250.132540.14
2012173881.97132871.52306751.75
201351230.6381911.01133140.82
20144850.433620.3371470.38
20151140.071300.162440.11
2016112241.1361440.76173680.94
20174780.401210.15990.26
20183650.333490.2661140.30
20191170.092410.223580.15
20204870.444910.4881780.46
20211210.101200.102410.13
2022000000000
20232470.240002470.12
合计541 1785.98439615.10972 1395.55
), ArticleFig(id=1241069120003821682, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, language=EN, label=Table 4, caption=

Analysis of the indirect economic burden of fatal mushroom poisoning in Guizhou Province from 2011 to 2023 (10 000 yuan)

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄段(岁)生产力权重例数总YLLs(人年)间接经济负担(万元)
总数构成比(%)平均
0~<150.1514418214.975.315.36
15~<450.75287171 843.7345.165.85
45~<600.8347021 925.5047.156.63
≥600.121296101.492.54.83
合计979614 085.6910042.12
), ArticleFig(id=1241069120108679290, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035818731631346, language=CN, label=表4, caption=

2011—2023年贵州省蘑菇中毒死亡间接经济负担分析(万元)

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄段(岁)生产力权重例数总YLLs(人年)间接经济负担(万元)
总数构成比(%)平均
0~<150.1514418214.975.315.36
15~<450.75287171 843.7345.165.85
45~<600.8347021 925.5047.156.63
≥600.121296101.492.54.83
合计979614 085.6910042.12
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2011—2023年贵州省蘑菇中毒疾病负担现状及变化趋势分析
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吴牡丽 1 , 熊涑钫 1 , 陈庆园 3 , 吴安忠 2 , 左佩佩 2 , 王青 1 , 李军 1 , 郭华 1, 2
现代预防医学 | 营养与食品卫生 2024,51(23): 4291-4296
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现代预防医学 | 营养与食品卫生 2024, 51(23): 4291-4296
2011—2023年贵州省蘑菇中毒疾病负担现状及变化趋势分析
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吴牡丽1, 熊涑钫1, 陈庆园3, 吴安忠2, 左佩佩2, 王青1, 李军1, 郭华1, 2
作者信息
  • 1.贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州 贵阳 561113
  • 2.贵州省疾病预防控制中心公共卫生监测评价研究所,贵州 贵阳 550004
  • 3.贵州省疾病预防控制中心实验中心
  • 吴牡丽(2001—),女,硕士在读,研究方向:食源性疾病监测

通讯作者:

郭华,E-mail:
Analysis of the burden and trend of mushroom poisoning diseases in Guizhou Province from 2011 to 2023
Mu-li WU1, Su-fang XIONG1, Qing-yuan CHEN3, An-zhong WU2, Pei-pei ZUO2, Qing WANG1, Jun LI1, Hua GUO1, 2
Affiliations
  • School of Public Health and Health, Guizhou Medical University, Key Laboratory of Environmental Pollution and Disease Monitoring, Ministry of Education, Guiyang, Guizhou 561113, China
出版时间: 2024-12-10 doi: 10.20043/j.cnki.MPM.202408311
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目的

了解2011—2023年贵州省蘑菇中毒疾病负担现状及变化趋势,为合理制定预防控制措施提供依据。

方法

对贵州省“食源性疾病暴发监测系统”中2011—2023年蘑菇中毒事件数据进行描述性分析;将蘑菇中毒死亡数据根据性别、年龄、年份进行整理,使用世界卫生组织疾病负担Excel计算模版计算早死所致生命损失年(YLLs),结合人力资本法估计贵州省蘑菇中毒间接造成的经济负担;采用joinpoint回归模型分析蘑菇中毒发病率、死亡率、YLLs率的时间变化趋势。

结果

2011—2023年贵州省共报告蘑菇中毒暴发事件2 518起,发病8 716人,死亡97人,死亡率为0.25/10万;全人群的YLLs为2 139人年,YLLs率为5.55人年/10万,男性的YLLs与YLLs率均高于女性;45~<60岁人群的YLLs最高,60~<70岁人群的YLLs率最高;贵州省97例蘑菇中毒死亡病例总体间接经济负担为4 085.69万元,人均42.12万元;2011—2023年贵州省蘑菇中毒发病率呈持续上升趋势,死亡率和YLLs率均呈持续下降趋势,即APC=AAPC,发病率、死亡率和YLLs率分别为26.79%、-17.76%、-16.70%(P<0.05)。

结论

贵州省蘑菇中毒发病率呈持续上升趋势,且男性YLLs大于女性、45~<60岁人群YLLs最高,与之对应的间接经济负担重,应及时加强有效的宣传教育、继续强化医疗救治,降低毒蘑菇中毒的发生。

蘑菇中毒  /  食源性疾病  /  疾病负担  /  Joinpoint趋势分析
Objective

To understand the current status and trends of the burden of mushroom poisoning diseases in Guizhou Province from 2011 to 2023, providing a basis for the formulation of rational prevention and control measures.

Methods

A descriptive analysis was conducted on mushroom poisoning incident data from the “Foodborne Disease Outbreak Monitoring System” in Guizhou Province from 2011 to 2023. The mushroom poisoning mortality data were organized by gender, age, and year. The World Health Organization’s Excel template was used to calculate Years of Life Lost (YLLs) due to premature death, and the human capital method was employed to estimate the indirect economic burden caused by mushroom poisoning in Guizhou Province. The Join point regression model was utilized to analyze the temporal trends in incidence rates, mortality rates, and YLLs rates of mushroom poisoning.

Results

From 2011 to 2023, Guizhou Province reported a total of 2 518 mushroom poisoning outbreaks, affecting 8 716 individuals and resulting in 97 deaths, with a mortality rate of 0.25 per 100 000 population. The total YLLs for the entire population was 2 139 person-years, with a YLLs rate of 5.55 person-years per 100 000; YLLs and YLLs rates for males were higher than those for females. The highest YLLs were observed in the 45 to <60 age group, while the highest YLLs rate was found in the 60 to <70 age group. The overall indirect economic burden of the 97 mushroom poisoning deaths in Guizhou Province was 40.8 569 million yuan, averaging 421 200 yuan per case. From 2011 to 2023, the incidence rate of mushroom poisoning in Guizhou Province showed a continuous upward trend, while both the mortality rate and YLLs rate exhibited a continuous downward trend, with annual percentage changes (APC) of 26.79%, -17.76%, and -16.70%, respectively (P<0.05).

Conclusion

The incidence rate of mushroom poisoning in Guizhou Province is on a continuous rise, with higher YLLs in males compared to females and the highest YLLs observed in the 45 to <60 age group, corresponding to a significant indirect economic burden. It is essential to enhance effective public education and continue to strengthen medical treatment to reduce the occurrence of toxic mushroom poisoning.

Mushroom poisoning  /  Foodborne diseases  /  Disease burden  /  Joinpoint trend analysis
吴牡丽, 熊涑钫, 陈庆园, 吴安忠, 左佩佩, 王青, 李军, 郭华. 2011—2023年贵州省蘑菇中毒疾病负担现状及变化趋势分析. 现代预防医学, 2024 , 51 (23) : 4291 -4296 . DOI: 10.20043/j.cnki.MPM.202408311
Mu-li WU, Su-fang XIONG, Qing-yuan CHEN, An-zhong WU, Pei-pei ZUO, Qing WANG, Jun LI, Hua GUO. Analysis of the burden and trend of mushroom poisoning diseases in Guizhou Province from 2011 to 2023[J]. Modern Preventive Medicine, 2024 , 51 (23) : 4291 -4296 . DOI: 10.20043/j.cnki.MPM.202408311
毒蘑菇(俗称毒菌)指有毒大型真菌,人体可通过食入等接触方式发生中毒[1]。蘑菇中毒是中国最严重的食品安全问题之一,是食源性疾病中导致死亡的最主要原因[2],截至2023年年底,中国涉及中毒事件的蘑菇种类总数已达到约220种[3]。食源性疾病的频发给全球食品安全和公共卫生方面带来了重大挑战,每年均造成了严重的社会和经济损失[4]。目前国内外关于对蘑菇中毒导致的疾病负担研究尚少,而蘑菇中毒在贵州省食源性疾病中占比最高,严重危害着人民群众的身体健康和生命安全[5],因此,对贵州省蘑菇中毒引起的疾病负担进行评估是十分必要的。本文通过收集贵州省2011—2023年蘑菇中毒监测数据,结合贵州省统计年鉴人口学数据,计算蘑菇中毒的早死所致生命损失年(years of life lost,YLLs),采用人力资本法(human capital approach)计算蘑菇中毒导致的间接经济损失,并分析蘑菇中毒发病率、死亡率,YLLs率的变化趋势,以期评价该地区蘑菇中毒对人群健康的影响,为制定合理的防控对策提供科学依据。
蘑菇中毒资料来源于贵州省“食源性疾病暴发监测系统”中2011—2023年上报的监测数据;《国家食源性疾病监测工作册(2024年)》规定,食源性疾病暴发监测系统中收集的是所有发病人数在2人及以上或死亡至少1人及以上的食源性疾病暴发事件[6]。人口数据来源于2011—2023年“贵州省统计年鉴”;分性别、年龄人口数据来源于“2020年贵州省人口普查年鉴”。本研究经贵州省疾病预防控制中心伦理委员会(Q2024-07)批准。
对贵州省2011—2023年蘑菇中毒发病死亡基本情况进行描述性分析。
计算YLLs,并使用该指标对贵州省蘑菇中毒导致的流行病学疾病负担进行分析。YLLs的计算公式[7-10]:
将该被积函数在区间α到α+L上积分,得下式:
式中:D为失能权重(死亡时取值为1),α为死亡发生年龄,L为早逝导致的寿命年损失,e为每一年龄的期望寿命,依据西方标准期望寿命表(26级)来计算(男80岁、女82.5岁),γ为贴现率,全球疾病负担(global burden of disease,GBD)分析中取值0.03,C为连续调整系数,GBD分析中取值0.165 8,β为年龄权重系数,GBD分析中取值0.04。
人力资本法是根据患者损失时间而引起收入减少来测算的间接经济负担,常用的折算方法是用工作或市场劳动力价值、人均国民收入或人均净产值、人均国民生产总值测算[11]。本文选用人均国民生产总值来进行测算。计算公式:间接经济损失=YLLs×当年人均国民生产总值×年龄加权系数[12],该方法考虑到不同年龄段的生产率存在差异,因而加权系数也不同,0~14岁年龄组没有参与创造社会财富,其加权系数是0.15;15~44岁组、45~59岁组最能创造财富,其加权系数最大为0.75、0.80;60岁及以上的加权系数又降到0.1[13]。2011—2023年贵州省人均国民生产总值来自贵州省统计年鉴,本文应用2011—2023人均国民生产总值的平均值(34 286万元)来计算间接经济负担。
Joinpoint回归模型通过在时间序列中引入多个连接点,将其划分为若干个区间,并在每个区间内进行趋势拟合与优化,从而更深入地评估整体时间范围内各区间的疾病变化特征[14]。文采用网格搜索法(grid search method,GSM)分析趋势变化连接点的数量、位置及模型参数,Monte carlo置换检验(peemutation test)筛选最优模型。最终通过Joinpoint软件分析得出年度变化百分比(APC)和平均年度变化百分比(AAPC),对蘑菇中毒的发病率,死亡率和YLLs率进行趋势分析,APC>0或 AAPC>0表明呈上升趋势,反之则为下降趋势;当APC =AAPC时,表明趋势变化连接点数为0,即总体趋势未发生变化。
使用Excel 2016软件对数据进行整理汇总,采用世界卫生组织(WHO)推荐的疾病负担Excel计算模版计算YLLs;采用GraphPad Prism 8.4.3软件进行绘图;采用Joinpoint Regression Pro‐gram 5.2.0软件进行趋势分析,APC和AAPC采用t检验;其他统计分析均在R4.4.1软件中进行。检验水准α=0.05。
贵州省2011—2023年“食源性疾病暴发监测系统”中共报告2 518起蘑菇中毒暴发事件,在同时期食源性疾病暴发事件中占比57.59%(2 518/4 372);8 716人发病,在总发病人数中占比44.36%(8 716/19 649);97人死亡,在总死亡人数中占比66.90%(97/145)。
2011—2023年全省蘑菇中毒暴发事件中发生58起死亡事件,227人暴露,217人发病,97人死亡,病死率为44.70%,死亡率为0.25/10万,男性(0.27/10万)与女性(0.23/10万)死亡率之间差异无统计学意义;各年龄段之间总体死亡率的差异具有统计学意义(P<0.001),60~<70岁年龄段死亡率高于5~<15岁年龄段与15~<30岁年龄段(P1=0.03、P2=0.006),且发生死亡事件中暴露场所均为家庭。见表1
从月份分布来看,2011—2023年间每个月都有蘑菇中毒暴发事件发生,6~9月是蘑菇中毒暴发事件发生的高发期;从年份分布来看,2023年报告的事件起数最多为826起,占总报告起数的32.76%(826/2 518);2012年死亡人数最多,在总死亡人数中的占比为30.93%(30/97)。见图1
2011—2023年贵州省蘑菇中毒总YLLs为2 139人年,YLLs率为5.55人年/10万。从性别分布来看,男性YLLs与YLLs率均高于女性,其中男性YLLs为1 178人年,YLLs率为5.98人年/10万;女性YLLs为961人年,YLLs率为5.10人年/10万。45~<60岁人群YLLs最高为702人年,其次是30~<45岁人群为409人年,YLLs率是60~<70岁人群最高为8.72人年/10万,其次是45~<60岁人群为8.53人年/10万。见表2
2011—2023年贵州省蘑菇中毒总YLLs为2 139人年,除2020外,每年都有因蘑菇中毒而死亡的患者,男、女性死亡人数分别为54和43人;其中在2012年,全人群、男性、女性蘑菇中毒YLLs均为最高,分别为675人年、388人年、287人年,YLLs率也是2012年最高,分别为1.75/10万、1.97/10万、1.52/10万。见表3
2011—2023年贵州省统计年鉴中的人均国民生产总值的平均值为34 286万元,根据各年龄组的生产力权重,按照间接经济负担计算公式,贵州省97例蘑菇中毒死亡病例的总体间接经济负担为4 085.69万元,人均为42.12万元。45~<60岁年龄组的间接经济负担最高,其次是15~<45岁年龄组。见表4
Joinpoint回归分析结果显示,2011—2023年贵州省蘑菇中毒发病率由2011年的0.26/10万上升至2023年的7.33/10万,呈持续上升趋势(APC=AAPC=26.79%,95%CI:18.40~45.56);2011—2023蘑菇中毒死亡率在全人群(APC=AAPC=-17.76%,95%CI:-30.30~-9.92)、男性(APC= AAPC=-16.52%,95%CI:-30.61~-7.63)、女性(APC= AAPC=-16.53%,95%CI:-37.92~-1.48)人群中均呈持续下降趋势;2011—2023蘑菇中毒YLLs率在全人群(APC=AAPC =-16.70%,95%CI:-28.83~-8.87)、男性(APC= AAPC=-15.37%,95%CI:-31.17~-4.54)、女性(APC = AAPC=-16.11%,95%CI:-33.60~-2.99)人群中均呈持续下降趋势。见图2
本研究结果显示,贵州省2011—2023年蘑菇中毒暴发事件每年均有发生,且2023年报告的事件起数明显多于往年,发病率也呈现持续增加的趋势(AAPC=26.79%)。这可能是因为国家食品安全风险评价中心在2011年启动了食源性疾病监控网络系统的建设,并随后不断提出构建高效监测体系的策略,从而持续提升了对食源性疾病的监测能力有关[15-16],但同时也提示了贵州省蘑菇中毒防控形势依然严峻。蘑菇中毒发病率的增加导致因蘑菇中毒而住院的患者也随之增加,梁进军等[17]指出,2016年湖南省蘑菇中毒住院患者的疾病负担较重,医疗支出在居民可支配收入中所占的比重较大,已经对居民日常生活产生了直接的影响。疾病负担的科学评估对于国家优化医疗资源配置、监测人口健康水平、预防和控制疾病有着重大的现实意义[18]。目前贵州省对蘑菇中毒的分析主要为描述性流行病学分析[19-20],因此本次研究为蘑菇中毒疾病负担的测算提供了可参考的资料。
2011—2023年贵州省蘑菇中毒总YLLs为2 139人年,YLLs率为5.55人年/10万。通过对YLLs的性别构成进行分析,结果显示男性的YLLs与YLLs率分别为1 178人年和5.98人年/10万,均高于女性的961人年和5.10人年/10万,这一结果提示男性是蘑菇中毒的主要疾病负担人群,应对其采取有针对性的措施。这与云南省研究结果一致[21]。其原因可能是因为我省的男性饮酒率为52.8%,明显高于女性饮酒率的13.2%[22],而当酒精与煮熟的蘑菇一起食用后蘑菇和酒精会发生反应而加重蘑菇的毒性作用[23]。此外,男性的进食量通常大于女性,食用同种蘑菇,进食量的多少会直接影响患者的结局[24]。年龄构成分析显示,45~<60岁人群YLLs最高,60~<70岁人群YLLs率最高,这可能是由于蘑菇中毒场所主要发生在农村家庭[5],而年轻人大多外出务工,导致蘑菇中毒患者大多为45~<70岁年龄段的农村常住人群。本研究按照间接经济负担计算公式得出贵州省97例蘑菇中毒死亡病例总体间接经济负担为4 085.69万元,人均42.12万元,其中以45~<60年龄组间接经济负担最高,也进一步验证了45~<60岁年龄段人群是蘑菇中毒的重点人群,应重视该年龄段人群的防治工作。这与湖南省[17]、云南省[21]等的研究结果基本一致。间接经济负担仅包含因疾病、残疾(失能)和过早死亡对患者和社会所造成的的经济损失,不包括门诊医疗费用和住院医疗等费用[12],因此,贵州省因蘑菇中毒造成的经济负担会高于4 085.69万元,这也提示了贵州省因蘑菇中毒导致的经济负担重,且大多为农村家庭,这将给患者及其家庭带来不可估量的影响。
本研究采用joinpoint回归模型对贵州省2011—2023年蘑菇中毒的发病率、死亡率、YLLs率的变化趋势进行分析,结果显示发病率呈持续上升趋势,死亡率与YLLs率呈持续下降趋势(AAPC分别为26.79%、-17.76%、-16.70%),均没有出现拐点。这提示了贵州省因蘑菇中毒而导致死亡的人数有所减少,原因可能是因为近年来贵州省医疗卫生服务体系得到了完善,医疗水平有所提高[25],对蘑菇中毒患者的医疗救治方案逐步得到了优化;但蘑菇中毒的发病率只增不减,且高发场所主要是农村家庭,这提示应进一步加强农村地区的健康教育宣传,从而更有效地预防蘑菇中毒事件的发生。
本研究存在一定的局限性,目前GBD没有公布蘑菇中毒对应的残疾权重,因此无法计算伤残调整寿命年,本次仅计算了YLLs,可能会低估蘑菇中毒的流行病学疾病负担,且本次只计算了蘑菇中毒导致的间接经济负担,但基于此次的研究基础,在今后的研究中可以前瞻性的收集蘑菇中毒住院患者导致的直接经济负担,以期对贵州省蘑菇中毒的疾病负担做一个全面的了解。
  • 国家重点研发计划项目(2017YFC1601805)
  • 黔科合支撑项目([2017]2972)
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2024年第51卷第23期
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doi: 10.20043/j.cnki.MPM.202408311
  • 接收时间:2024-08-18
  • 首发时间:2026-03-18
  • 出版时间:2024-12-10
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  • 收稿日期:2024-08-18
基金
国家重点研发计划项目(2017YFC1601805)
黔科合支撑项目([2017]2972)
作者信息
    1.贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州 贵阳 561113
    2.贵州省疾病预防控制中心公共卫生监测评价研究所,贵州 贵阳 550004
    3.贵州省疾病预防控制中心实验中心

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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