Objective: To investigate the detection of suspected occupational diseases in the occupational health examination population in Hangzhou, and to establish a two-level logistic model of influencing factors. Methods: In October 2018, the information of physical examinees was collected through the 2015-2017 occupational health examination and reexamination database of Hangzhou Hospital for the Prevention and Treatment of Occupational Disease. MlwiN 2.02 software was used to establish a 2-level logistic model of suspected occupational diseases, with the occupational hazard factors as the level 2 unit and the employees as the level 1 unit. χ(2) test was used to compare the detection rates of suspected occupational diseases with different characteristics. The trend of detection rates of suspected occupational diseases with age and working age were tested by Cochran-Armitage trend test. Results: The morbidity rate of suspected occupational diseases in 2965 workers was 59.6% (1767/2965) , and the rates caused by different occupational hazardous factors were significantly difference (χ(2)=1615.27, P<0.01) , that caused by noises was the highest (98.0%, 1206/1231) , and the next was the dust (87.5%, 70/80) . The rate in male was 61.5% (1532/2492) , and that in female was 49.7% (235/473) , they were significantly difference (χ(2)=22.96, P<0.01) . The rates of suspected occupational diseases increased with the ages (Z=8.77, P<0.01) and working years (Z=3.62, P<0.01) . The multivariate analysis by 2-level logistic model indicated that gender, age and working year were all no significant, instead the level 2 unit random effect was significant (χ(2)=4.77, P<0.05) . Conclusion: Suspected occupational diseases will occur in clusters in occupational hazardous factors. The influence of occupational hazardous factors on suspected occupational diseases was more than that of personal characteristics.
目的： 了解杭州市职业健康体检人群疑似职业病检出情况，探讨建立职业病患病影响因素两水平logistic模型。 方法： 于2018年10月，通过杭州市职业病防治院2015至2017年职业健康检查复查数据库收集体检者信息。利用MLwiN2.02软件，以职业病危害因素为水平2单位，职工为水平1单位，建立疑似职业病两水平Logistic模型，不同特征疑似职业病检出率比较采用χ(2)检验。疑似职业病检出率随年龄、工龄的变化趋势采用Cochran-Armitage趋势检验。 结果： 2 965名职业体检职工疑似职业病检出率为59.6%（1 767/2 965），不同职业病危害因素暴露所致疑似职业病检出率不同（χ(2)=1 615.27，P<0.01），噪声暴露所致疑似职业病检出率最高（98.0%，1 206/1 231），其次为粉尘暴露（87.5%，70/80）；男性检出率为61.5%（1 532/2 492），女性检出率为49.7%（235/473），检出率差异有统计学意义（χ(2)=22.96，P<0.01）。疑似职业病检出率随年龄和工龄增高呈增高趋势（Z=8.77、3.62，P<0.01）。水平2单位随机效应有统计学意义（χ(2)=4.77，P<0.05）。 结论： 疑似职业病检出水平在不同职业病危害因素暴露中存在聚集性，职业病危害因素暴露对疑似职业病的发生作用较个体特征的影响更大。.
Keywords: 2-level logistic model; Influencing factor; Occupational disease; Trend analysis.