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西班牙汽车制造业中肩部慢性肌腱病变的职业风险因素:一项病例对照研究。

Occupational risk factors for shoulder chronic tendinous pathology in the Spanish automotive manufacturing sector: a case-control study.

作者信息

Rodriguez Diez-Caballero Beatriz, Alfonso-Beltrán Joaquín, Bautista Iker J, Barrios Carlos

机构信息

Doctorate School, Valencia Catholic University San Vicente Martir, Valencia, Spain.

Institute for Research on Musculoskeletal Disorders, School of Medicine and Health Sciences, Valencia Catholic University, Valencia, Spain.

出版信息

BMC Musculoskelet Disord. 2020 Dec 7;21(1):818. doi: 10.1186/s12891-020-03801-5.

Abstract

BACKGROUND

Musculoskeletal Diseases (MSDs) are among the most prevalent health problems encountered in the workforce in Europe. Multiple risk factors contribute to their onset. In the present study, different individual risk factors for chronic tendinous pathology affecting the shoulder were analysed in a sample of workers from the automotive manufacturing sector.

METHODS

An observational retrospective study was conducted with 73 cases of officially recognised and compensated occupational diseases and 94 aleatory cases of healthy workers from the same car assembly company. The experimental group comprised individuals with tendinous chronic pathology of the rotator cuff. Multiple variables that identified the risks present in the job were assessed along with participants clinical evaluation. Furthermore, two standardised guidelines for risk factors assessment were also used: the Spanish National Institute of Social Security (INSS) and the American Occupational Information Network (O*Net). Both descriptive statistical analysis and Odds ratios calculations considering the occupational disease as a dependent variable were performed.

RESULTS

The use of hand tools, exposure to mechanical pressure in the upper limbs and awkward postures were the most prevalent risk factors. Pressure on the palm of the hand and the hand tool impacting the hand were also important risk factors. Some psychosocial factors such as lack of autonomy and mental workload were also associated shoulder tendinous diseases. The association of age, load handling, and awkward postures were the core risk factors responsible for most of the tendinous chronic injuries of the shoulder in this sample of car assembly workers.

CONCLUSIONS

Both ergonomic and psychosocial factors were present and increased the risk of developing occupational chronic tendinopathies at the shoulder in this sample of workers. Aging, load handling, and awkward postures showed the strongest predictive values. Greater knowledge of how risk factors interact would facilitate the design of better preventive workplace strategies.

摘要

背景

肌肉骨骼疾病(MSDs)是欧洲劳动力中最普遍遇到的健康问题之一。多种风险因素导致其发病。在本研究中,对汽车制造业工人样本中影响肩部的慢性肌腱病变的不同个体风险因素进行了分析。

方法

进行了一项观察性回顾性研究,研究对象包括73例官方认可并获赔偿的职业病病例以及来自同一家汽车装配公司的94例随机抽取的健康工人病例。实验组由患有肩袖肌腱慢性病变的个体组成。评估了识别工作中存在风险的多个变量以及参与者的临床评估。此外,还使用了两种风险因素评估的标准化指南:西班牙国家社会保障研究所(INSS)和美国职业信息网络(O*Net)。进行了描述性统计分析以及将职业病作为因变量的优势比计算。

结果

使用手动工具、上肢受到机械压力以及姿势笨拙是最普遍的风险因素。手掌受到压力以及手动工具对手部的撞击也是重要的风险因素。一些社会心理因素,如缺乏自主性和精神负荷,也与肩部肌腱疾病有关。年龄、负荷搬运和姿势笨拙之间的关联是导致该汽车装配工人样本中大多数肩部肌腱慢性损伤的核心风险因素。

结论

在该工人样本中,人体工程学和社会心理因素都存在,并且增加了患肩部职业性慢性肌腱病的风险。衰老、负荷搬运和姿势笨拙显示出最强的预测价值。对风险因素如何相互作用有更深入的了解将有助于设计更好的工作场所预防策略。

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