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[上肢工作相关肌肉骨骼疾病(UL-WMSDs):在三家大型软体家具行业工厂进行的一项回顾性队列研究]

[Upper limb work-related musculoskeletal disorders (UL-WMSDs): a retrospective cohort study in three large factories of the upholstered furniture industry].

作者信息

Nicoletti S, Consonni D, Carino M, Di Leone G, Trani G, Battevi N, Colombini Daniela, Ambrosi L

机构信息

Scuola di Specializzazione in Medicina del Lavoro, Università di Foggia.

出版信息

Med Lav. 2008 Jul-Aug;99(4):281-96.

Abstract

BACKGROUND

The epidemiological evidence of work-related musculoskeletal disorders (UL-WMSDs) due to repetitive strain and movements in the various industries has been collected in the literature mainly through cross-sectional surveys. In particular there are no contributions so far regarding the upholstered furniture industry with a longitudinal design.

OBJECTIVES

The aim of the study was to evaluate the incidence rate of WMSDs such as hand-wrist and shoulder tendonitis, carpal tunnel syndrome, and epicondylitis in exposed workers of three large companies of the upholstered furniture industry in a large geographic area of southern Italy.

METHODS

The OCRA method, recommended by international standard ISO 11228-3 and EN 1005-5, was used for risk assessment. The following work tasks were considered:.filling preparation workers, leather-cutting operators, sewing and upholstery-assembly workers. A total population of 5,278 subjects (exposed n=2927, controls n=2351) was investigated. The person/year at risk parameters were calculated from 1 January 2000, or from the date of engagement if later, until the first diagnosis of WMSD or, in absence of disorders, until the end of the study, i.e. 31 December 2004. Disorders occurring after the first were not considered. A multiple regression analysis was used to evaluate relationships between rates.

RESULTS AND CONCLUSIONS

Incidence rates correlated with risk classes of the OCRA index. An incidence rate of WMSDs higher than 1.2 cases per 100 person/year may be considered as a threshold value to suspect an occupational exposure to repetitive strain and movements warranting further investigation. The analysis of single factors did not show a greater predisposition of the female gender, with the single exception of the carpal tunnel syndrome (RR 2.92; 95% CI 1.57-5.43). Shoulder disorders affected mainly male leather-cutting operators (RR 4.97; 95% CI 2.03-12.16) and among all the factors influencing risk (frequency, force, posture, additional risk factors, pauses) posture seems to play a significant role.

摘要

背景

文献中主要通过横断面调查收集了各行业因重复用力和动作导致的与工作相关的肌肉骨骼疾病(上肢 - 工作相关肌肉骨骼疾病,UL - WMSDs)的流行病学证据。特别是,迄今为止尚无关于软垫家具行业采用纵向设计的研究报道。

目的

本研究旨在评估意大利南部一个大地理区域内三家大型软垫家具公司的暴露工人中,诸如手腕和肩部肌腱炎、腕管综合征和肱骨外上髁炎等肌肉骨骼疾病的发病率。

方法

采用国际标准ISO 11228 - 3和EN 1005 - 5推荐的OCRA方法进行风险评估。考虑了以下工作任务:填充准备工人、皮革切割操作员、缝纫和软垫组装工人。共调查了5278名受试者(暴露组n = 2927,对照组n = 2351)。从2000年1月1日起,或从入职日期(若晚于此日期)开始计算人年风险参数,直至首次诊断出肌肉骨骼疾病,或在无疾病的情况下,直至研究结束,即2004年12月31日。首次发病后出现的疾病不予考虑。采用多元回归分析评估发病率之间的关系。

结果与结论

发病率与OCRA指数的风险等级相关。肌肉骨骼疾病发病率高于每100人年1.2例可被视为一个阈值,怀疑存在职业性暴露于重复用力和动作,需要进一步调查。单因素分析未显示女性有更大的易感性,唯一例外是腕管综合征(相对危险度RR = 2.92;95%可信区间CI为1.57 - 5.43)。肩部疾病主要影响男性皮革切割操作员(RR = 4.97;95% CI为2.03 - 12.16),在所有影响风险的因素(频率、力量、姿势、额外风险因素、休息)中,姿势似乎起着重要作用。

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