Jia N, Zhang M B, Xu Q, Zhang H D, Ling R J, Liu Y M, Wang Z, Li G, Yin Y, Shao H, Li J, Zhang H D, Qiu B, Wang D Y, Zeng Q, Wang R G, Ye Y, Xiao B, Zou H, Chen J C, Li D X, Liu Y Q, Shi Q H, Liu J X, Jiang E F, Qi J, Mei L Y, Zhao X F, Yang M M, Guo X W, Sun X, Wang Z X
Laboratory of Occupational Protection and Ergonomics, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2024 Dec 20;42(12):884-895. doi: 10.3760/cma.j.cn121094-20240731-00358.
To analyze the distribution characteristics of work-related musculoskeletal disorders (WMSDs) among the occupational population in China's key industries during the period from 2018 to 2023, and to provide data support for the formulation of targeted prevention strategies. Between January 1, 2018, and December 31, 2023, a cross-sectional epidemiological survey and a retrospective investigation were conducted in seven geographical regions of North China, East China, Central China, South China, Southwest China, Northwest China, and Northeast China, using a combination of epidemiological cross-sectional and retrospective surveys. The industries were stratified according to the degree of closeness to WMSDs, the size of the occupational population, and the importance of the national economy, and then cluster sampling was conducted according to the size of the enterprises (large, medium, and small) within each stratum. Representative enterprises were selected, and workers who had been employed for more than one year and met the inclusion criteria were selected as the study subjects. The survey subjects completed the Chinese version of the Musculoskeletal Disorders Survey Questionnaire online by scanning a QR code. A total of 88, 609 valid questionnaires were collected. Continuous data were described by means and standard deviations, and the standardized incidence rates of WMSDs were evaluated using chi-square tests to compare the standardized incidence rates of different body parts. The standardized prevalence rate of WMSDs among the frontline working population in China was 36.7%, with the top three being the neck (21.37%), shoulders (18.23%), and lower back (14.92%). There was a statistically significant difference in the standardized prevalence rate of WMSDs between different body parts (χ(2)=47577.82, <0.05). The lowest standardized prevalence rate of WMSDs was found in the southeast coastal region of China (32.54%), while the highest was in the northwest (49.70%) and northeast regions (46.16%). The standardized prevalence rate of WMSDs decreased from 42.88% in 2018 to 29.94% in 2023. The micro-enterprise observation group had a higher concentration of WMSDs in the neck (20.66%), lower back (17.95%), and shoulders (17.79%), while the large enterprise observation group had a higher concentration in the neck (20.54%), shoulders (17.52%), and lower back (14.65%). Among the industries surveyed, the highest standardized prevalence rate of WMSDs was found in the healthcare industry (53.18%), followed by the toy manufacturing industry (50.54%), the automotive manufacturing industry (43.39%), general aviation services (42.71%), and the ship and related equipment manufacturing industry (40.56%). The standardized prevalence rate of WMSDs among women was significantly higher than that of men ( value=1.44, <0.05). In addition, the standardized prevalence rate of WMSDs with multiple affected body parts (four or more body parts affected simultaneously) was higher, and the risk of WMSDs increased with subjective fatigue, showing a significant "S-shaped" trend (the OR value was 2.19, 3.16, 4.71, 5.49, and 3.97 when the RPE was 13, 15, 17, 19, and 20, respectively. χ(2)(trend)=17.23, <0.001) . The distribution characteristics of WMSDs in key industries in China show obvious differences in different parts, regions, time, enterprise scale, industry and population attributes. Agriculture, pharmaceutical manufacturing, packaging and decoration and other printing industries have a high proportion of WMSDs in multiple parts at the same time and in a single site. It is necessary to study and implement precise preventive measures according to specific regions, industries and enterprise scales, as well as the characteristics of multi-site WMSDs, so as to effectively protect the health and well-being of the working population.
分析2018年至2023年期间中国重点行业职业人群中与工作相关的肌肉骨骼疾病(WMSDs)的分布特征,为制定针对性预防策略提供数据支持。2018年1月1日至2023年12月31日,在中国华北、华东、华中、华南、西南、西北和东北七个地理区域进行了横断面流行病学调查和回顾性调查,采用流行病学横断面和回顾性调查相结合的方法。根据与WMSDs的接近程度、职业人群规模和国民经济重要性对行业进行分层,然后根据各层内企业规模(大、中、小)进行整群抽样。选择有代表性的企业,选取从业一年以上且符合纳入标准的工人作为研究对象。调查对象通过扫描二维码在线完成中文版肌肉骨骼疾病调查问卷。共收集到88609份有效问卷。连续数据用均值和标准差描述,采用卡方检验评估WMSDs的标准化发病率,比较不同身体部位的标准化发病率。中国一线工作人群中WMSDs的标准化患病率为36.7%,前三位分别是颈部(21.37%)、肩部(18.23%)和下背部(14.92%)。不同身体部位WMSDs的标准化患病率存在统计学差异(χ(2)=47577.82,P<0.05)。中国东南沿海地区WMSDs的标准化患病率最低(32.54%),而最高的是西北地区(49.70%)和东北地区(46.16%)。WMSDs的标准化患病率从2018年的42.88%降至2023年的29.94%。微型企业观察组WMSDs在颈部(20.66%)、下背部(17.95%)和肩部(17.79%)的集中程度较高,而大型企业观察组在颈部(20.54%)、肩部(17.52%)和下背部(14.65%)的集中程度较高。在所调查的行业中,WMSDs标准化患病率最高的是医疗行业(53.18%),其次是玩具制造业(50.54%)、汽车制造业(43.39%)、通用航空服务业(42.71%)和船舶及相关设备制造业(40.56%)。女性WMSDs的标准化患病率显著高于男性(Z值=1.44,P<0.05)。此外,多个身体部位同时受累(四个或更多身体部位同时受累)的WMSDs标准化患病率较高,且WMSDs的风险随主观疲劳程度增加,呈显著的“S形”趋势(当RPE分别为13、15、17、19和20时,OR值分别为2.19、3.16、4.71、5.49和3.97。χ(2)(趋势)=17.23,P<0.001)。中国重点行业WMSDs的分布特征在不同部位、地区、时间、企业规模、行业和人群属性方面存在明显差异。农业、制药制造、包装装潢及其他印刷行业等多个部位同时受累且单一部位WMSDs占比高。有必要根据特定地区、行业和企业规模以及多部位WMSDs的特点研究并实施精准预防措施,以有效保护工作人群的健康和福祉。