Article(id=1241771806550462518, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241771801366299468, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202405427, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1716825600000, receivedDateStr=2024-05-28, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773991069686, onlineDateStr=2026-03-20, pubDate=1729785600000, pubDateStr=2024-10-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773991069686, onlineIssueDateStr=2026-03-20, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773991069686, creator=13701087609, updateTime=1773991069686, updator=13701087609, issue=Issue{id=1241771801366299468, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='20', pageStart='3649', pageEnd='3840', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773991068450, creator=13701087609, updateTime=1773991676896, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241774353457681403, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241771801366299468, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241774353457681404, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241771801366299468, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3682, endPage=3686, ext={EN=ArticleExt(id=1241771807003447366, articleId=1241771806550462518, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Epidemiological characteristics of non-occupational carbon monoxide poisoning in Beijing, 2018-2022, columnId=null, journalTitle=Modern Preventive Medicine, columnName=null, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the epidemiological characteristics of non-occupational carbon monoxide poisoning incidents in Beijing from 2018 to 2022, and to explore targeted prevention and control measures.

Methods

The data were from the National Public Health Emergency Reporting Management Information System. Descriptive epidemiological methods were used to analyze non-occupational carbon monoxide poisoning incidents in Beijing from 2018 to 2022. Relative risk (RR) was used to assess the risk of morbidity and mortality.

Results

From 2018 to 2022, a total of 1841 non-occupational carbon monoxide poisoning incidents were reported in Beijing, with 2729 cases of poisoning and 31 deaths. The annual morbidity and mortality were 25.14 and 0.29 cases per million, respectively. There were two peaks of poisoning cases in spring and winter, accounting for 49.98% and 24.00% of the total cases, respectively. The highest incidence occurred between 8 and 11 o ’clock, accounting for 22.83%. In the inner suburbs, outer suburbs and urban areas, the incidence of non-occupational carbon monoxide was 0.96 cases/100 000, 1.27 cases/100 000 and 18.79 cases/100 000, and the mortality was 0.02 cases/100 000, 0.02 cases/100 000 and 0.11 cases/100 000, respectively. The poisoning incidents mainly occurred in residential families in 1633 cases, accounting for 88.70%; This was followed by 118 restaurants, accounting for 6.41 percent. The proportion of household poisoning incidents decreased from 92.10% in 2018 to 84.13% in 2022. The proportion of poisoning incidents in restaurants increased year by year from 4.23% in 2018 to 10.05% in 2022. The proportion of poisoning cases occurring at home decreased from 86.39% in 2018 to 71.84% in 2022. The proportion of poisoning cases in restaurants increased from 9.88% in 2018 to 20.57% in 2022.

Conclusion

The incidence and death risk of non-occupational carbon monoxide poisoning in Beijing is not balanced among regions, and the proportion of poisoning incidents in restaurants is increasing year by year. Targeted measures should be taken to strengthen the prevention and control work in the outer suburbs and key restaurants.

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目的

了解北京市非职业性一氧化碳中毒事件的流行病学特征,探讨针对性防控措施。

方法

数据来源于国家突发公共卫生事件报告管理信息系统,采用描述性流行病学方法对北京市2018—2022年非职业一氧化碳中毒事件进行统计分析。

结果

2018—2022年,北京市共报告非职业一氧化碳中毒事件1 841起,中毒2 729例,死亡31例。年均发病率和死亡率分别为25.14例/百万和0.29例/百万。存在春季和冬季两个发病高峰,分别占病例总数的49.98%和24.00%。发病最高峰出现在8~11时之间,占22.83%。近郊、远郊和市区的非职业一氧化碳发病率分别为0.96例/10万、1.27例/10万和18.79例/10万,死亡率分别是0.02例/10万、0.02例/10万和0.11例/10万。中毒事件主要发生在居民家庭1 633起,占88.70%;其次是餐馆118起,占6.41%。发生在家庭的中毒事件占比从2018年的92.10%逐年下降到2022年的84.13%;餐馆的中毒事件占比从2018年的4.23%逐年上升到2022年的10.05%。发生在家庭的中毒病例占比从2018年的86.39%整体逐年下降到2022年的71.84%;餐馆的中毒病例占比从2018年的9.88%整体逐年上升到2022年的20.57%。

结论

北京市非职业性一氧化碳中毒发病和死亡风险的地区间不均衡现象较为严重,餐馆中毒事件占比逐年升高,应采取针对性措施加强远郊区和重点餐馆的防控工作。

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孙鑫贵,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=kgaqhnMO2NQ0yUF6HHwgBQ==, magXml=Z7VE0EVKgHJCvYy0ShvHlg==, pdfUrl=null, pdf=cDlIMjDwcuuVBQz8hoPw+g==, pdfFileSize=469439, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=9IAQqMPJOFes4SBifTWAEA==, mapNumber=null, authorCompany=null, fund=null, authors=

张永强(1977—),男,硕士,副主任医师,研究方向:疾病预防与控制

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张永强(1977—),男,硕士,副主任医师,研究方向:疾病预防与控制

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张永强(1977—),男,硕士,副主任医师,研究方向:疾病预防与控制

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Occurrence, incidence and death of non-occupational carbon monoxide poisoning incidents in Beijing from 2018 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
年份事件数
(起)
发病数
(例)
死亡数
(例)
发病率
(/百万)
死亡率
(/百万)
20187099921145.700.51
2019439632829.340.37
2020258408418.950.19
2021246381417.400.18
2022189316414.440.18
总计1 8412 7293125.140.29
), ArticleFig(id=1241771815064899951, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806550462518, language=CN, label=表1, caption=

北京市2018—2022年非职业一氧化碳中毒事件发生起数、发病数及死亡数情况

, figureFileSmall=null, figureFileBig=null, tableContent=
年份事件数
(起)
发病数
(例)
死亡数
(例)
发病率
(/百万)
死亡率
(/百万)
20187099921145.700.51
2019439632829.340.37
2020258408418.950.19
2021246381417.400.18
2022189316414.440.18
总计1 8412 7293125.140.29
), ArticleFig(id=1241771815173951864, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806550462518, language=EN, label=Table 2, caption=

Non-occupational carbon monoxide poisoning incidents in different months in Beijing from 2018 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
月份发生情况发病情况死亡情况
事件数构成比(%)事件数构成比(%)事件数构成比(%)
149626.9464623.671135.48
232217.4940414.8039.68
322812.3831411.51619.35
4723.911013.7026.45
5331.79722.6413.23
6311.68692.5300.00
7542.931294.7313.23
8522.821575.7500.00
9191.03722.6413.23
10663.591104.0326.45
111839.942679.7813.23
1228515.4838814.2239.68
总计1 841100.002 729100.0031100.00
), ArticleFig(id=1241771815257837955, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806550462518, language=CN, label=表2, caption=

2018—2022年北京市不同月份非职业一氧化碳中毒事件情况

, figureFileSmall=null, figureFileBig=null, tableContent=
月份发生情况发病情况死亡情况
事件数构成比(%)事件数构成比(%)事件数构成比(%)
149626.9464623.671135.48
232217.4940414.8039.68
322812.3831411.51619.35
4723.911013.7026.45
5331.79722.6413.23
6311.68692.5300.00
7542.931294.7313.23
8522.821575.7500.00
9191.03722.6413.23
10663.591104.0326.45
111839.942679.7813.23
1228515.4838814.2239.68
总计1 841100.002 729100.0031100.00
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Non-occupational carbon monoxide poisoning incidents in different time periods in Beijing from 2018 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
时间段发生情况发病情况死亡情况
事件数构成比(%)事件数构成比(%)事件数构成比(%)
00:00~00:59462.50652.5000.00
01:00~01:59281.52531.5213.23
02:00~02:59301.63451.6300.00
03:00~03:59442.39742.3900.00
04:00~04:59281.52411.5200.00
05:00~05:59331.79571.7900.00
06:00~06:59573.10813.1039.68
07:00~07:59723.91993.9100.00
08:00~08:5923812.9332112.9326.45
09:00~09:591246.741586.7439.68
10:00~10:591548.372068.3739.68
11:00~11:59683.69853.6900.00
12:00~12:59563.04963.0413.23
13:00~13:591146.191496.19619.35
14:00~14:59975.271205.2700.00
15:00~15:591085.871475.8713.23
16:00~16:59925.001155.0000.00
17:00~17:59754.071024.0726.45
18:00~18:59693.75993.75412.90
19:00~19:59673.641293.6426.45
20:00~20:59824.451854.4526.45
21:00~21:59623.371333.3700.00
22:00~22:59522.82912.8200.00
23:00~23:59452.44782.4413.23
), ArticleFig(id=1241771815522079125, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806550462518, language=CN, label=表3, caption=

2018—2022年北京市不同时间段非职业一氧化碳中毒事件情况

, figureFileSmall=null, figureFileBig=null, tableContent=
时间段发生情况发病情况死亡情况
事件数构成比(%)事件数构成比(%)事件数构成比(%)
00:00~00:59462.50652.5000.00
01:00~01:59281.52531.5213.23
02:00~02:59301.63451.6300.00
03:00~03:59442.39742.3900.00
04:00~04:59281.52411.5200.00
05:00~05:59331.79571.7900.00
06:00~06:59573.10813.1039.68
07:00~07:59723.91993.9100.00
08:00~08:5923812.9332112.9326.45
09:00~09:591246.741586.7439.68
10:00~10:591548.372068.3739.68
11:00~11:59683.69853.6900.00
12:00~12:59563.04963.0413.23
13:00~13:591146.191496.19619.35
14:00~14:59975.271205.2700.00
15:00~15:591085.871475.8713.23
16:00~16:59925.001155.0000.00
17:00~17:59754.071024.0726.45
18:00~18:59693.75993.75412.90
19:00~19:59673.641293.6426.45
20:00~20:59824.451854.4526.45
21:00~21:59623.371333.3700.00
22:00~22:59522.82912.8200.00
23:00~23:59452.44782.4413.23
), ArticleFig(id=1241771815647908252, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806550462518, language=EN, label=Table 4, caption=

Number of non-occupational carbon monoxide poisoning incidents in different places in Beijing from 2018 to 2022

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年份餐馆家庭其他场所总计
发病起数构成比(%)发病起数构成比(%)发病起数构成比(%)
2018304.2365392.1020.28709
2019306.8338888.3820.46439
2020186.9822386.4341.55258
2021218.5421085.3793.66246
20221910.0515984.1331.59189
总计1186.411 63388.70201.091 841
), ArticleFig(id=1241771815903760812, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806550462518, language=CN, label=表4, caption=

2018—2022年北京市不同场所非职业一氧化碳中毒事件发生起数

, figureFileSmall=null, figureFileBig=null, tableContent=
年份餐馆家庭其他场所总计
发病起数构成比(%)发病起数构成比(%)发病起数构成比(%)
2018304.2365392.1020.28709
2019306.8338888.3820.46439
2020186.9822386.4341.55258
2021218.5421085.3793.66246
20221910.0515984.1331.59189
总计1186.411 63388.70201.091 841
), ArticleFig(id=1241771816067338681, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806550462518, language=EN, label=Table 5, caption=

Number of non-occupational carbon monoxide poisoning cases in different places in Beijing from 2018 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
年份餐馆家庭其他场所总计
发病数(例)构成比(%)发病数(例)构成比(%)发病数(例)构成比(%)
2018989.8885786.3920.20992
20198212.9750780.2220.32632
20205012.2529672.55389.31408
20216015.7528775.33164.20381
20226520.5722771.8461.90316
总计35513.012 17479.66642.352 729
), ArticleFig(id=1241771816180584899, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806550462518, language=CN, label=表5, caption=

2018—2022年北京市不同场所非职业一氧化碳中毒病例数

, figureFileSmall=null, figureFileBig=null, tableContent=
年份餐馆家庭其他场所总计
发病数(例)构成比(%)发病数(例)构成比(%)发病数(例)构成比(%)
2018989.8885786.3920.20992
20198212.9750780.2220.32632
20205012.2529672.55389.31408
20216015.7528775.33164.20381
20226520.5722771.8461.90316
总计35513.012 17479.66642.352 729
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2018—2022年北京市非职业性一氧化碳中毒事件的流行病学特征分析
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张永强 , 杜世昌 , 卜凡 , 韩宛彤 , 王薇 , 孙秀梅 , 孙鑫贵
现代预防医学 | 环境与职业卫生 2024,51(20): 3682-3686
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现代预防医学 | 环境与职业卫生 2024, 51(20): 3682-3686
2018—2022年北京市非职业性一氧化碳中毒事件的流行病学特征分析
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张永强, 杜世昌, 卜凡, 韩宛彤, 王薇, 孙秀梅, 孙鑫贵
作者信息
  • 北京市疾病预防控制中心,北京 100013
  • 张永强(1977—),男,硕士,副主任医师,研究方向:疾病预防与控制

通讯作者:

孙鑫贵,E-mail:
Epidemiological characteristics of non-occupational carbon monoxide poisoning in Beijing, 2018-2022
Yong-qiang ZHANG, Shi-chang DU, Fan BU, Wan-tong HAN, Wei WANG, Xiu-mei SUN, Xin-gui SUN
Affiliations
  • Beijing Center for Disease Control and Prevention, Beijing 100013, China
出版时间: 2024-10-25 doi: 10.20043/j.cnki.MPM.202405427
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目的

了解北京市非职业性一氧化碳中毒事件的流行病学特征,探讨针对性防控措施。

方法

数据来源于国家突发公共卫生事件报告管理信息系统,采用描述性流行病学方法对北京市2018—2022年非职业一氧化碳中毒事件进行统计分析。

结果

2018—2022年,北京市共报告非职业一氧化碳中毒事件1 841起,中毒2 729例,死亡31例。年均发病率和死亡率分别为25.14例/百万和0.29例/百万。存在春季和冬季两个发病高峰,分别占病例总数的49.98%和24.00%。发病最高峰出现在8~11时之间,占22.83%。近郊、远郊和市区的非职业一氧化碳发病率分别为0.96例/10万、1.27例/10万和18.79例/10万,死亡率分别是0.02例/10万、0.02例/10万和0.11例/10万。中毒事件主要发生在居民家庭1 633起,占88.70%;其次是餐馆118起,占6.41%。发生在家庭的中毒事件占比从2018年的92.10%逐年下降到2022年的84.13%;餐馆的中毒事件占比从2018年的4.23%逐年上升到2022年的10.05%。发生在家庭的中毒病例占比从2018年的86.39%整体逐年下降到2022年的71.84%;餐馆的中毒病例占比从2018年的9.88%整体逐年上升到2022年的20.57%。

结论

北京市非职业性一氧化碳中毒发病和死亡风险的地区间不均衡现象较为严重,餐馆中毒事件占比逐年升高,应采取针对性措施加强远郊区和重点餐馆的防控工作。

一氧化碳中毒  /  非职业性  /  流行病学特征
Objective

To understand the epidemiological characteristics of non-occupational carbon monoxide poisoning incidents in Beijing from 2018 to 2022, and to explore targeted prevention and control measures.

Methods

The data were from the National Public Health Emergency Reporting Management Information System. Descriptive epidemiological methods were used to analyze non-occupational carbon monoxide poisoning incidents in Beijing from 2018 to 2022. Relative risk (RR) was used to assess the risk of morbidity and mortality.

Results

From 2018 to 2022, a total of 1841 non-occupational carbon monoxide poisoning incidents were reported in Beijing, with 2729 cases of poisoning and 31 deaths. The annual morbidity and mortality were 25.14 and 0.29 cases per million, respectively. There were two peaks of poisoning cases in spring and winter, accounting for 49.98% and 24.00% of the total cases, respectively. The highest incidence occurred between 8 and 11 o ’clock, accounting for 22.83%. In the inner suburbs, outer suburbs and urban areas, the incidence of non-occupational carbon monoxide was 0.96 cases/100 000, 1.27 cases/100 000 and 18.79 cases/100 000, and the mortality was 0.02 cases/100 000, 0.02 cases/100 000 and 0.11 cases/100 000, respectively. The poisoning incidents mainly occurred in residential families in 1633 cases, accounting for 88.70%; This was followed by 118 restaurants, accounting for 6.41 percent. The proportion of household poisoning incidents decreased from 92.10% in 2018 to 84.13% in 2022. The proportion of poisoning incidents in restaurants increased year by year from 4.23% in 2018 to 10.05% in 2022. The proportion of poisoning cases occurring at home decreased from 86.39% in 2018 to 71.84% in 2022. The proportion of poisoning cases in restaurants increased from 9.88% in 2018 to 20.57% in 2022.

Conclusion

The incidence and death risk of non-occupational carbon monoxide poisoning in Beijing is not balanced among regions, and the proportion of poisoning incidents in restaurants is increasing year by year. Targeted measures should be taken to strengthen the prevention and control work in the outer suburbs and key restaurants.

Carbon monoxide poisoning  /  Non-occupational  /  Epidemiological characteristics
张永强, 杜世昌, 卜凡, 韩宛彤, 王薇, 孙秀梅, 孙鑫贵. 2018—2022年北京市非职业性一氧化碳中毒事件的流行病学特征分析. 现代预防医学, 2024 , 51 (20) : 3682 -3686 . DOI: 10.20043/j.cnki.MPM.202405427
Yong-qiang ZHANG, Shi-chang DU, Fan BU, Wan-tong HAN, Wei WANG, Xiu-mei SUN, Xin-gui SUN. Epidemiological characteristics of non-occupational carbon monoxide poisoning in Beijing, 2018-2022[J]. Modern Preventive Medicine, 2024 , 51 (20) : 3682 -3686 . DOI: 10.20043/j.cnki.MPM.202405427
一氧化碳是碳氢化合物不完全燃烧产生的一种无色、无味、无刺激性的气体,对人体有很高毒性[1-2];人体吸入后能扩散进入红细胞与血红蛋白结合形成碳氧血红蛋白,其结合力比氧气高近200倍[3] ,使血红蛋白失去携带氧的能力从而导致组织缺氧。根据暴露量、暴露时间和人体血液中碳氧血红蛋白浓度的不同,一氧化碳中毒病例表现出不同程度的症状,轻者包括头痛、头晕、恶心、呕吐、疲劳和意识不清,重者发展为意识丧失、迟发性神经系统后遗症、心肺衰竭和死亡 [4-7]。无论是在发展中国家还是发达国家,一氧化碳中毒都是一个主要的健康问题[8]。在中国大陆尤其是北方地区,每年冬春季非职业一氧化碳中毒事件较为常见。前期研究显示,北京市非职业性一氧化碳中毒事件导致的发病和死亡负担较重,是突发公共卫生事件防控的重点。本研究对2018—2022年北京市非职业一氧化碳中毒事件的流行病学特征进行分析,探讨可能的影响因素,提出可行性防控措施。
北京市2018—2022年非职业一氧化碳中毒数据来源于中国疾病预防控制信息系统中突发公共卫生事件报告管理信息系统,收集的信息包括事件名称、级别、发生地区、发生时间、发生场所、中毒病例数、死亡病例数等。所有事件均经疾病预防控制部门核查、确认和结案。人口资料来源于中国疾病预防控制信息系统中疾病预防控制基本信息系统。
根据《非职业性一氧化碳中毒事件应急预案》中毒事件的危害程度和范围,将非职业性一氧化碳中毒事件分为一般、较大、重大和特别重大4个级别,达不到分级标准的均为未分级事件。分城区(包括东城、西城、朝阳、海淀、丰台、石景山、石景山)、近郊(包括大兴、通州、顺义、昌平、门头沟、房山、经济技术开发区)和远郊(包括怀柔、平谷、密云、延庆)进行统计分析。使用事件数、发病数、死亡数、发病率、死亡率等指标对资料进行描述性流行病学分析。
2018—2022年,北京市共报告非职业一氧化碳中毒事件1 841起,中毒2 729例,死亡31例,年均发病率为25.14例/百万,年均死亡率0.29例/百万,病死率为1.14%。发病数和发病率均呈逐年降低的趋势,每年均有死亡病例报告。见表1
1 841起事件中,未分级事件1 836起(累计中毒2 652例,死亡28例),占99.73%;IV级事件5起(累计中毒77例,死亡3例),占0.27%;无特别重大、重大和较大事件报告。
存在两个高发季节,春季(1—3月)共报告1 046起,占总起数的56.82%,累计发病1 364例,占发病总人数的49.98%;冬季(11—12月)为次高峰,共报告468起,占25.42%,累计发病655例,占24.00%。死亡病例高发于春季(1—3月),累计死亡20例,占总死亡人数的64.52%。从不同时间段看,发病最高峰出现在8~11时之间,共报告发病685例,占22.83%;次高峰在13~16时之间,累计报告发病416例,占17.33%。见表2表3
2018—2022年北京市城区、近郊和远郊分别报告非职业一氧化碳事件238起、311起和1 292起;病例分别为545例、545例和1 639例;死亡11例、10例和10例。近郊、远郊和市区的非职业一氧化碳发病率分别为0.96例/10万、1.27例/10万和18.79例/10万,近郊、远郊和市区的非职业一氧化碳死亡率分别是0.02例/10万、0.02例/10万和0.11例/10万。
1 841起中毒事件,主要发生在居民家庭1 633起,占88.70%;餐馆118起,占6.41%;交通工具、停车场、公共场所、工地、蔬菜大棚等其它场所共90起,占4.89%。家庭中毒事件占比从2018年的92.10%逐年下降到2022年的84.13%;餐馆中毒事件占比从2018年的4.23%逐年上升到2022年的10.05%。见表4表5
非职业性一氧化碳中毒与刮风、雨雪等气象条件密切相关[9],与气温呈密切负相关[10-11],温度越低,发生危险越大。在寒冷季节,在采暖炉使用不当以及未安装烟道等情况下,在通风不良的房间里烧炭或烧煤取暖是造成非职业性一氧化碳中毒的主要原因[8, 11-14]。北京地处中国北方,冬春季气温较低,持续时间较长,尤其是远郊地区,气温低于城区,尚未实现清洁能源取暖的家庭多分布在远郊且只能采取炭火取暖以及冬季通风不良等综合因素影响,导致北京远郊地区非职业性一氧化碳中毒的发病风险远高于城区,从而导致地区间发病的不均衡现象。2018年北京对平原地区村庄的清洁取暖工作开始收尾,对山区村庄开始试点清洁取暖工作,远郊地区尤其是偏远山村清洁取暖村庄数量大幅上升,非职业性一氧化碳中毒的高危人群逐年减少,可能导致2018年以来北京市非职业性一氧化碳中毒事件起数、发病数和发病率均呈逐年下降趋势。
从发生场所看,家庭非职业性一氧化碳中毒事件起数占比和病例数占比整体均呈逐年下降趋势,与此相反,餐馆中毒事件起数占比和病例数占比均逐年升高,分别上升到2022年的10.05%和20.57%,提示餐馆中毒事件的防控不容忽视。餐馆中毒事件主要发生在碳火锅型餐馆,夏天密闭空间采用能产生二氧化碳的碳火锅进餐、时间较久且通风不良情况下易引发中毒,应重点加强此类餐馆的卫生宣教、监督检查等防控工作。
死亡率是医疗能力的体现,农村地区由于医疗资源匮乏,中毒患者往往难以得到及时有效的治疗而出现死亡[15]。尽管北京通过大医院搬迁或者建分院的方式向郊区倾斜医疗卫生资源,但从整体来看,远郊区域面积大,人口较为分散,医疗卫生资源的可及性、均衡性仍相对不足,可能导致远郊非职业性一氧化碳中毒的死亡率远高于城区,可根据远郊非职业性一氧化碳中毒高危人群的分布情况在冬春季侧重性加强医疗急救转运力量的布局。发生在餐馆的非职业性一氧化碳中毒事件有118起,但没有出现死亡病例,可能是餐馆就餐的中毒患者能尽早发现或尽快就医而避免死亡,提示早发现早就医是防控一氧化碳中毒死亡的关键。
从不同时间段看,发病最高峰出现在8~11时之间,占所有病例数的22.83%;可能由于中毒发生在夜间[13, 16-17], 中毒患者在早晨醒来后察觉症状主动就医或被家人朋友发现而就医;由于不知道中毒的确切时间,医生可能会将就诊时间报告为发病时间,这可以从院前非职业性一氧化碳中毒急诊患者高峰出现在上午8点至10点之间得到侧面验证[16]。提示应加强医疗机构非职业性一氧化碳中毒诊断及报告的培训工作,提高中毒病例发病信息的准确性。
为进一步做好北京特别是远郊区非职业性一氧化碳中毒防控工作,结合既往研究结果,我们认为在尚未实现清洁能源取暖的偏远地区和城乡结合带,对居民进行持续的一氧化碳中毒风险教育[9, 11, 18], 推广安装一氧化碳中毒探测器 [15, 18],以及让居民学会正确安装和使用炭火炉[7],在防控中毒避免出现死亡病例方面更具可操作性和较佳现实效果;此外,应加强碳火锅型易发中毒餐馆的综合防控工作。一些研究阐述了年龄和性别对一氧化碳中毒发生和死亡的影响[3, 19-20],由于缺乏性别、年龄、职业等详细数据,本研究尚不足以全面解释北京市非职业性一氧化碳中毒发病和死亡的流行病学规律。需要进一步开展现场调查,以便为公众、公共卫生从业人员、医生和决策者提供更准确的预防和控制信息。
  • 首都卫生发展科研专项项目(2022-1G-4261)
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2024年第51卷第20期
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doi: 10.20043/j.cnki.MPM.202405427
  • 接收时间:2024-05-28
  • 首发时间:2026-03-20
  • 出版时间:2024-10-25
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  • 收稿日期:2024-05-28
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首都卫生发展科研专项项目(2022-1G-4261)
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    北京市疾病预防控制中心,北京 100013

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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
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