[中国汽车工人肌肉骨骼疾病的共现情况及影响因素]
[Co-occurrence of musculoskeletal disorders and influence factors among Chinese auto workers].
作者信息
Wu Jia-bing, Ling Rui-jie, Wang Zheng-lun, Qi Cheng, Wu Kun, Yao Dao-hua, Liu Fu-ying, Zhao Tong-qiang, Zheng Yu-yu, Wang Sheng, Yang Lei
机构信息
Department of Occupational and Environmental Health, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
出版信息
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2013 May;31(5):356-60.
OBJECTIVE
To analyze the prevalence and risk factors of multiple musculoskeletal disorders (MSDs) in auto workers and the associations between MSDs at different sites.
METHODS
A cross-sectional survey was conducted in 3998 workers, who were selected from a Chinese auto corporation by cluster random sampling, using the revised Nordic MSDs standard questionnaire; 3800 completed questionnaires were returned. Multinomial logistic regression analysis was performed to assess the risk factors for multiple MSDs. The logbinomial model was used to calculate the prevalence ratios (PRs) of MSDs at different sites and evaluate the associations between MSDs at different sites.
RESULTS
Of the 3800 subjects, 2452 (64.5%) had MSDs at two or more sites, and 469 (12.3%) had MSDs at one site. The PRs varied from 1.5 to 6.7, with significant differences among different sites (P < 0.01). Relatively close associations were found between the MSDs at neck and shoulders, back and shoulders/waist, elbows and wrists/hands, waist and neck, wrists/hands and waist, hip and waist, knees and waist, and ankles/feet and elbows. The multinomial logistic regression analysis indicated that the highest risk factor for MSDs was poor posture, including often working in an uncomfortable posture, neck bending forward, and neck twisting (ORs = 3.39, 1.93, and 1.38), followed by labor organization, in which break between tasks could decrease the risk of MSDs at three or more sites to 31%, staff shortage, which could increase the risk of MSDs by 75%, and pushing and pulling heavy objects (> 20 kg) (OR = 1.76).
CONCLUSION
Most auto workers with MSDs have multiple sites affected, and there are high associations between the MSDs at different sites. The major risk factors for multiple MSDs in auto workers include poor posture, labor organization, and heavy physical labor.
目的
分析汽车制造工人中多种肌肉骨骼疾病(MSDs)的患病率及危险因素,以及不同部位MSDs之间的关联。
方法
采用整群随机抽样方法,从一家中国汽车制造企业选取3998名工人进行横断面调查,使用修订后的北欧MSDs标准问卷;共回收3800份有效问卷。采用多项逻辑回归分析评估多种MSDs的危险因素。运用对数二项模型计算不同部位MSDs的患病率比(PRs),并评估不同部位MSDs之间的关联。
结果
在3800名受试者中,2452人(64.5%)在两个或以上部位患有MSDs,469人(12.3%)在一个部位患有MSDs。PRs在1.5至6.7之间,不同部位之间存在显著差异(P < 0.01)。颈部与肩部、背部与肩部/腰部、肘部与手腕/手部、腰部与颈部、手腕/手部与腰部、臀部与腰部、膝盖与腰部、脚踝/足部与肘部的MSDs之间存在相对密切的关联。多项逻辑回归分析表明,MSDs的最高风险因素是不良姿势,包括经常以不舒服的姿势工作、颈部向前弯曲和颈部扭转(OR分别为3.39、1.93和1.38),其次是劳动组织,其中任务间隙可将三个或以上部位MSDs的风险降低至31%,人员短缺可使MSDs风险增加75%,以及推/拉重物(> 20 kg)(OR = 1.76)。
结论
大多数患有MSDs的汽车制造工人有多个部位受累,不同部位的MSDs之间存在高度关联。汽车制造工人多种MSDs的主要危险因素包括不良姿势、劳动组织和重体力劳动。