Smith Derek R, Mihashi Mutsuko, Adachi Yasuko, Koga Hatsuyo, Ishitake Tatsuya
Department of Hazard Assessment, National Institute of Industrial Health, 6-21-1 Nagao, Kawasaki 214-8585 Japan.
J Safety Res. 2006;37(2):195-200. doi: 10.1016/j.jsr.2006.01.004. Epub 2006 May 5.
Although Musculoskeletal Disorders (MSD) represent a common occupational problem, few epidemiological studies have investigated MSD risk factors among Asian nurses, particularly those in Japan.
We administered a modified Japanese-language version of the Standardized Nordic Questionnaire to 1,162 nurses from a large teaching hospital. MSD categories focused on the neck, shoulder, upper back, and lower back regions.
A total of 844 completed questionnaires were analyzed (response rate: 72.6%). The 12-month period-prevalence of MSD at any body site was 85.5%. MSD was most commonly reported at the shoulder (71.9%), followed by the lower back (71.3%), neck (54.7%), and upper back (33.9%). Alcohol consumption, tobacco smoking, and having children were shown to be significant risk factors, with adjusted Odds Ratios of 1.87 (95%CI: 1.17-2.96), 2.45 (95%CI: 1.43-4.35), and 2.53 (95%CI: 1.32-4.91), respectively. Workplace risk factors included manually handling patients (OR: 2.07 to 11.97) and undertaking physically laborious work (OR: 2.09 to 2.76). Nurses reporting pre-menstrual tension were 1.66 and 1.94 times more likely to suffer from lower back and upper back MSD, respectively. High mental pressure was also identified as a significant risk factor for MSD of the neck (OR: 1.53) and shoulder (OR: 2.07).
The complex nature of MSD risk factors identified during this study suggests that remediation strategies which focus only on manual handling tasks would probably be suboptimal in reducing MSD among nurses. Therefore, to help alleviate their considerable MSD burden, a greater emphasis will need to be placed on job satisfaction, work organization, and occupational stress, as well as the more traditional hazard reduction strategies such as manual handling, work tasks, and other occupational factors.
尽管肌肉骨骼疾病(MSD)是常见的职业问题,但很少有流行病学研究调查亚洲护士,尤其是日本护士的MSD风险因素。
我们对一家大型教学医院的1162名护士进行了一份经过修改的日语版标准化北欧问卷的调查。MSD类别集中在颈部、肩部、上背部和下背部区域。
共分析了844份完整问卷(回复率:72.6%)。任何身体部位MSD的12个月期间患病率为85.5%。MSD最常报告于肩部(71.9%),其次是下背部(71.3%)、颈部(54.7%)和上背部(33.9%)。饮酒、吸烟和育有子女被证明是显著的风险因素,调整后的优势比分别为1.87(95%CI:1.17 - 2.96)、2.45(95%CI:1.43 - 4.35)和2.53(95%CI:1.32 - 4.91)。工作场所风险因素包括人工搬运患者(OR:2.07至11.97)和从事体力劳动强度大的工作(OR:2.09至2.76)。报告经前紧张的护士患下背部和上背部MSD的可能性分别高出1.66倍和1.94倍。高精神压力也被确定为颈部(OR:1.53)和肩部(OR:2.07)MSD的显著风险因素。
本研究中确定的MSD风险因素的复杂性表明,仅专注于人工搬运任务的补救策略在降低护士的MSD方面可能效果不佳。因此,为帮助减轻他们相当大的MSD负担,需要更加重视工作满意度、工作组织和职业压力,以及更传统的减少危害策略,如人工搬运、工作任务和其他职业因素。