Zhou S, Wang Z X, Ling R J, Xu Q, Zhang H D, Liu Y M, Li G, Yin Y, Shao H, Li J, Zhang H D, Qiu B, Wang D Y, Zeng Q, Ye Y, Xiao B, Zou H, Chen J C, Li D X, Liu Y Q, Liu J X, Jiang E F, Qi J, Mei L Y, Zhao X F, Yang M M, Jia N
Office of Comprehensive Management of Occupational Disease Prevention and Control, Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine (Hubei Provincial Occupational Disease Hospital), Wuhan 430015, China.
Laboratory of Occupational Protection and Ergonomics, 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. 2025 Feb 20;43(2):91-100. doi: 10.3760/cma.j.cn121094-20240701-00291.
To investigate the incidence of shoulder work-related musculoskeletal disorders (WMSDs) among occupational population in China, and to explore their intrinsic association with personal and work-related factors. In April 2024, 73497 valid questionnaires of the Chinese version of the Musculoskeletal Disorders Electronic Questionnaire were retrospectively analyzed from June 2018 to December 2023 in 22 provinces and 29 key industries in China, and the general information, occurrence of WMSDs and related risk factors of key occupational populations in different regions in China were collected. By using Chi-square test and confirmatory factor analysis, the relationship between shoulder fatigue and pain in key occupational groups and individual factors, work type, work posture and work organization was discussed, and the internal relationship was analyzed based on structural equation model. Higher incidence of shoulder fatigue and pain were associated with female, lack of physical exercise, uncomfortable working posture and neck leaning forward (<0.05). Structural equation model analysis showed that work type, work posture and work organization were strongly correlated (=0.58, 0.55). Work organization and work type were strongly correlated with shoulder fatigue (=0.65) and moderately correlated with shoulder fatigue (=0.21). Shoulder fatigue was moderately associated with shoulder pain (=0.40). Individual factors, work type, work posture and shoulder fatigue could directly affect shoulder pain (=0.07, -0.09, 0.17 and 0.40), and work type and work posture could also indirectly affect shoulder pain through shoulder fatigue (=0.08, 0.03). Work organization only indirectly affected shoulder pain through shoulder fatigue (=0.26) . The main influencing factor of shoulder pain is shoulder fatigue, followed by work posture and individual factors. Structural equation model can better reflect the complex relationship between work type, work posture and work organization and shoulder WMSDs. Improving work posture and work organization may be an effective way to control the influence of shoulder fatigue on shoulder pain.
为调查中国职业人群中肩部工作相关肌肉骨骼疾病(WMSDs)的发病率,并探讨其与个人及工作相关因素的内在关联。2024年4月,对2018年6月至2023年12月期间中国22个省份和29个重点行业的73497份中文版肌肉骨骼疾病电子问卷有效问卷进行回顾性分析,收集中国不同地区重点职业人群的一般信息、WMSDs发生情况及相关危险因素。采用卡方检验和验证性因子分析,探讨重点职业人群肩部疲劳与疼痛与个体因素、工作类型、工作姿势和工作组织之间的关系,并基于结构方程模型分析内在关系。肩部疲劳和疼痛的较高发病率与女性、缺乏体育锻炼、工作姿势不舒服和颈部前倾有关(<0.05)。结构方程模型分析表明,工作类型、工作姿势和工作组织之间存在强相关性(=0.58,0.55)。工作组织和工作类型与肩部疲劳强相关(=0.65),与肩部疼痛中度相关(=0.21)。肩部疲劳与肩部疼痛中度相关(=0.40)。个体因素、工作类型、工作姿势和肩部疲劳可直接影响肩部疼痛(=0.07,-0.09,0.17和0.40),工作类型和工作姿势也可通过肩部疲劳间接影响肩部疼痛(=0.08,0.03)。工作组织仅通过肩部疲劳间接影响肩部疼痛(=0.26)。肩部疼痛的主要影响因素是肩部疲劳,其次是工作姿势和个体因素。结构方程模型能够更好地反映工作类型、工作姿势和工作组织与肩部WMSDs之间的复杂关系。改善工作姿势和工作组织可能是控制肩部疲劳对肩部疼痛影响的有效途径。