Unge Jeannette, Ohlsson Kerstina, Nordander Catarina, Hansson Gert-Ake, Skerfving Staffan, Balogh Istvan
Department of Occupational and Environmental Medicine, University Hospital Lund, Lund, Sweden.
Int Arch Occup Environ Health. 2007 Nov;81(2):209-20. doi: 10.1007/s00420-007-0208-x. Epub 2007 Jun 13.
To clarify if differences in the physical workload, the psychosocial factors and in musculoskeletal disorders can be attributed to work organizational factors.
The physical workload (muscular activity of m. trapezius, positions and movements of the head, upper arms and wrists and heart rate) was assessed in 24 female hospital cleaners working in a traditional work organization (TO) and in 22 working in an extended one (i.e. with an enlarged work content and more responsibilities; EO). The psychosocial work environment was assessed as job demand, decision latitude and social support in 135 (TO) and 111 (EO) cleaners, and disorders of the neck and upper extremity by a physical examination.
The EO group was associated with lower physical workload, in terms of heart rate ratio (23 vs 32; P<0.001), head and upper arm positions and movements (right upper arm, 50th percentile, 35 degrees/s vs 71 degrees/s; P<0.001) and wrist movements (20 degrees/s vs 27 degrees/s; P=0.001), than the TO group. The EO group reported higher decision latitude and lower work demand than the TO one, while we found no difference in social support. The prevalence of complaints and diagnoses in neck/shoulders were lower in the EO group (diagnoses 35% vs 48%; P=0.04). Moreover, the prevalence of subjects with at least ten physical finding in elbows/hands was lower in the EO group (10 vs 29; P<0.001).
Hospital cleaners have a high prevalence of neck and upper limb disorders and a high physical workload. Comparing two groups of cleaners, with differences in the way of organizing the work, lower physical workload, more beneficial psychosocial factors and a better musculoskeletal health was found in the group with an extended organization. Hence, the differences found can be attributed to the organizational factors.
明确体力劳动负荷、社会心理因素及肌肉骨骼疾病的差异是否可归因于工作组织因素。
对24名在传统工作组织（TO）工作的女性医院清洁工和22名在扩展工作组织（即工作内容扩大且责任增加；EO）工作的女性医院清洁工进行了体力劳动负荷评估（斜方肌的肌肉活动、头部、上臂和手腕的姿势及运动以及心率）。对135名（TO）和111名（EO）清洁工的社会心理工作环境进行了评估，包括工作需求、决策自由度和社会支持，并通过体格检查评估颈部和上肢疾病。
与TO组相比，EO组在心率比（23对32；P<0.001）、头部和上臂姿势及运动（右上臂，第50百分位数，35度/秒对71度/秒；P<0.001）以及手腕运动（20度/秒对27度/秒；P=0.001）方面的体力劳动负荷较低。EO组报告的决策自由度较高，工作需求较低，而我们发现社会支持方面没有差异。EO组颈部/肩部的主诉和诊断患病率较低（诊断率35%对48%；P=0.04）。此外，EO组肘部/手部至少有10项体格检查发现的受试者患病率较低（10对29；P<0.001）。
医院清洁工颈部和上肢疾病的患病率较高，体力劳动负荷较大。比较两组工作组织方式不同的清洁工，发现扩展组织组的体力劳动负荷较低、社会心理因素更有利且肌肉骨骼健康状况更好。因此，发现的差异可归因于组织因素。
