Park R M, Krebs J M, Mirer F E
Health and Safety Department, International Union, United Auto Workers, Detroit, Mich. 48214, USA.
J Occup Environ Med. 1996 Nov;38(11):1111-23. doi: 10.1097/00043764-199611000-00011.
Sickness and accident-insurance (sick leave) claims at an automotive stamping and assembly complex were analyzed using Poisson regression over a 4-year period to identify occupational health problems. The incidence of lower-respiratory disability (excluding asthma) was higher in painting operations (rate ratio [RR] = 2.9, 95% confidence interval [CI] = 1.2 to 6.8), and final assembly and processing areas (RR = 2.7, 95% CI = 1.0 to 7.4) at the assembly plant, and in metal assembly (welding) areas (RR = 2.8, 95% CI = 1.4 to 5.7) at the stamping plant. Disability rates for upper-extremity musculoskeletal disorders were statistically significantly higher (RR = 3.1 to 3.8) in major assembly plant production areas, as were back disability rates (RR = 1.5). During the first 6 months of new work assignments in painting or final assembly, respiratory problem rates were four times higher than in other areas. Upper-extremity musculoskeletal rate ratios ranged from 4.4 to 5.7 for new assignments in body, hard trim, and chassis areas. Higher rates in new assignments appeared to result from assignment changes precipitated by developing health problems, or from routine assignments to new tasks, some of which conferred high risk and were tolerated for less than 6 months. Musculoskeletal disability was consistent with known ergonomic hazards and paralleled that reported on the Occupational Safety and Health Administration log. Work-related musculoskeletal and other problems can be readily identified from disability insurance claims without dependence on plant medical visits or workers' compensation records. Disability insurance appears to absorb considerable work-related medical and absence costs.
在四年时间里，运用泊松回归分析了一家汽车冲压和装配厂的疾病与事故保险（病假）索赔情况，以确定职业健康问题。在装配厂的喷漆作业区（率比[RR]=2.9，95%置信区间[CI]=1.2至6.8）、总装和加工区（RR=2.7，95%CI=1.0至7.4），以及冲压厂的金属装配（焊接）区（RR=2.8，95%CI=1.4至5.7），下呼吸道残疾（不包括哮喘）的发病率较高。主要装配厂生产区域上肢肌肉骨骼疾病的残疾率在统计学上显著更高（RR=3.1至3.8），背部残疾率也是如此（RR=1.5）。在喷漆或总装新工作任务的前6个月，呼吸系统问题发生率比其他区域高4倍。车身、硬内饰和底盘区域新任务的上肢肌肉骨骼率比在4.4至5.7之间。新任务中较高的发生率似乎是由健康问题引发的工作任务变更导致的，或者是由于新任务的常规分配，其中一些任务风险较高且持续时间不到6个月。肌肉骨骼残疾与已知的人体工程学危害相符，与职业安全与健康管理局日志中报告的情况相似。与工作相关的肌肉骨骼和其他问题可以从残疾保险索赔中轻松识别出来，而无需依赖工厂医疗就诊或工伤赔偿记录。残疾保险似乎承担了相当多与工作相关的医疗和缺勤成本。
