Huang Wenchu, Jin Xu, Yang Longao, Dong Yidan, Wang Yun, He Lihua, Yang Liyun, Forsman Mikael
Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, 100191, China.
Section of Epidemiology and Population Health, Department of Gynecology and Obstetrics, Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
BMC Public Health. 2025 Jun 10;25(1):2143. doi: 10.1186/s12889-025-22903-0.
Musculoskeletal pain is waste collectors' most common non-fatal and disabling health problem. However, research on how psychosocial factors affect musculoskeletal pain via physical and psychosocial pathways is limited. This study aimed to examine the effects of leadership quality, social support, and job demands on musculoskeletal pain among Swedish waste collectors. In addition, the mediating roles of physical demands and occupational fatigue and their chain mediation were also examined.
A 2015 cross-sectional survey of all Swedish waste collectors utilized validated scales (COPSOQ II, SOFI-20, Nordic Questionnaire) to assess exposures (psychosocial factors), mediators (occupational fatigue, physical demands), and outcomes (musculoskeletal pain). Of 1005 eligible workers (≥ 1 year experience), 662 analyzed (65.9% response rate). Participants (median age = 47 years, IQR = 34-54; mean BMI = 27.1 ± 4.0 kg/m) were primarily male (96.4%), operated rear-loader trucks (77.8%), and had 1-10 years of work experience (54.8%). Structural equation modeling and bias-corrected bootstrapping were used to assess direct/indirect pathways, with p ≤ 0.05 or 95% bootstrapped CIs excluded zero taken as significant.
Occupational fatigue explains the majority of the intermediate processes. Specifically, occupational fatigue mediated the effects of job demands (β = 0.185, 95% CI: 0.134-0.246), leadership quality (β = -0.074, 95% CI: -0.123 - -0.031), and social support (β = -0.051, 95% CI: -0.095 - -0.007) on musculoskeletal pain. Physical demands mediated job demands (β = 0.113, 95% CI: 0.075-0.155) and leadership quality (β = -0.038, 95% CI: -0.077 - -0.003) on musculoskeletal pain. Physical demands also amplified occupational fatigue (β = 0.369, p < 0.001), forming a chain mediation pathway.
Leadership quality and job demands significantly influenced musculoskeletal pain through the mediating roles of occupational fatigue and physical demands, respectively. Social support's impact was limited to occupational fatigue mediation. Physical demands may translate to occupational fatigue and be linked to musculoskeletal pain. Managers of waste collectors should prioritize leadership training and the construction of good psychosocial factors to manage physical demands, ensure mental health, and thereby mitigate musculoskeletal pain.
肌肉骨骼疼痛是垃圾收集工最常见的非致命性致残健康问题。然而，关于社会心理因素如何通过生理和社会心理途径影响肌肉骨骼疼痛的研究有限。本研究旨在探讨领导素质、社会支持和工作需求对瑞典垃圾收集工肌肉骨骼疼痛的影响。此外，还研究了身体需求和职业疲劳的中介作用及其链式中介作用。
2015年对所有瑞典垃圾收集工进行横断面调查，使用经过验证的量表（COPSOQ II、SOFI - 20、北欧问卷）来评估暴露因素（社会心理因素）、中介因素（职业疲劳、身体需求）和结果（肌肉骨骼疼痛）。在1005名符合条件的工人（≥1年工作经验）中，662人进行了分析（回复率65.9%）。参与者（中位年龄 = 47岁，四分位间距 = 34 - 54岁；平均体重指数 = 27.1 ± 4.0 kg/m²）主要为男性（96.4%），操作后装式卡车（77.8%），工作经验为1 - 10年（54.8%）。采用结构方程模型和偏差校正自助法来评估直接/间接途径，以p≤0.05或95%自助法置信区间不包含零为有统计学意义。
职业疲劳解释了大部分中间过程。具体而言，职业疲劳介导了工作需求（β = 0.185，95%置信区间：0.134 - 0.246）、领导素质（β = -0.074，95%置信区间：-0.123 - -0.031）和社会支持（β = -0.051，95%置信区间：-0.095 - -0.007）对肌肉骨骼疼痛的影响。身体需求介导了工作需求（β = 0.113，95%置信区间：0.075 - 0.155）和领导素质（β = -0.038，95%置信区间：-0.077 - -0.003）对肌肉骨骼疼痛的影响。身体需求还加剧了职业疲劳（β = 0.369，p < 0.001），形成了一条链式中介途径。
领导素质和工作需求分别通过职业疲劳和身体需求的中介作用显著影响肌肉骨骼疼痛。社会支持的影响仅限于职业疲劳中介。身体需求可能转化为职业疲劳并与肌肉骨骼疼痛相关。垃圾收集工的管理者应优先进行领导力培训并构建良好的社会心理因素，以管理身体需求、确保心理健康，从而减轻肌肉骨骼疼痛。
