某钢铁厂男工肌肉骨骼疾患及其危险因素调查
모강철엄남공기육골격질환급기위험인소조사
Survey on the occupational musculoskeletal disorder and its risk factors among male steelworkers
  • 万方数据
    中华预防医学杂志 중화예방의학잡지
    CHINESE JOURNAL OF
    2013年 3期 249-254 ,共6页

    徐雷%王正伦%陈飙%吴磊%易桂林%李济超%何丽华%王生%杨磊

    서뢰%왕정륜%진표%오뢰%역계림%리제초%하려화%왕생%양뢰

    肌肉骨骼生理过程%患病率%危险因素%劳动负荷%工效学 肌肉骨骼生理過程%患病率%危險因素%勞動負荷%工效學
    기육골격생리과정%환병솔%위험인소%노동부하%공효학
    Musculoskeletal physiological processes%Prevalence%Risk factor%Work load%Ergonomics
    目的 了解某钢铁厂工人肌肉骨骼疾患(OMSD)患病率,探讨其职业和个体危险因素.方法 2010年采用整群随机抽样的方法选取某钢铁厂1620名男性工人为调查对象.采用经修改的北欧国家Nordic的OMSD标准调查表及荷兰国家职业卫生研究所的调查表询问.调查表由工人填写,统计不同年龄、工龄、文化程度的男T身体各部位OMSD年患病率,并采用logistic回归对其影响因素进行了分析.结果 该钢铁厂1620名工人中男工OMSD以腰部、颈部和肩部疾患为主,年患病率分别为51.0％ (825)、48.5％ (785)和37.7％ (610),背部、膝盖、手腕、踝足、肘部、髋臀部疾患的年患病率分别为28.0％(454)、23.6％(383)、21.0％ (341)、17.9％ (290)、14.1％ (229)、12.7％(205).身体各部位OMSD年患病率随着年龄增加有增加的趋势,其中以腰部颈部损伤为主,≤24、25 ～ 29、30 ～ 34、35 ～ 39、40 ～ 44、45 ～ 49、≥50岁组腰部OMSD的年患病率分别为26.4％ (43/163)、37.8％ (71/188)、52.8％(162/307)、55.6％(160/288)、53.8％ (99/184)、55.9％(80/143)、61.6％(204/331)(x2=72.5,P＜0.05)；颈部OMSD的年患病率分别为22.7％(37/163)、40.4％(76/188)、50.2％(154/307)、48.6％(140/288)、56.0％ (103/184)、53.1％ (76/143)、57.7％(191/331)(x2=65.3,P＜0.05).OMSD年患病率随工龄的增加有增长的趋势,工龄≤4、5～9、10～14、15 ～ 19、20 ～ 24、25 ～ 29、≥30年组腰部OMSD的年患病率分别为30.2％(85/281)、46.2％(66/143)、56.4％(162/287)、56.8％(137/241)、50.6％(78/154)、59.2％(90/152)、60.7％(173/285)(x2=71.3,P＜0.05)；颈部OMSD的年患病率分别为28.8％ (81/281)、49.0％(70/143)、52.6％ (151/287)、50.2％(121/241)、51.9％ (80/154)、53.9％ (82/152)、59.3％ (169/285)(x2=61.5,P＜0.05).同时,OMSD年患病率随着文化程度的升高而降低,其中初中及以下、高中及中专、大专及以上调查对象腰部OMSD年患病率分别为61.5％ (176/286)、61.9％ (359/692)、44.2％(272/615),差异有统计学意义(x2=26.0,P＜0.05)；颈部OMSD年患病率分别为56.3％(161/286)、50.0％(346/692)、42.3％(260/615),差异有统计学意义(x2=21.2,P＜0.05).单因素logistic回归分析提示,工龄≥30年(OR=3.562,95％CI:2.514～ 5.046)、长时间保持大幅度弯腰姿势(OR =2.003,95％ CI:1.612 ～2.488)、经常大幅度弯腰(OR=1.897,95％CI:1.557 ～ 2.312)、躯干每分钟多次做同一动作(OR=1.870,95％ CI:1.529～2.288)等劳动负荷因素可增加腰部OMSD患病风险.而工龄≥30年(OR=3.597,95％CI:2.535 ～5.105)、颈部前倾(OR=2.455,95％ CI:2.010 ～2.998)、颈部后仰(0R=1.999,95％ CI:1.569 ～2.546)、颈部扭转(OR =2.381,95％ CI:1.907 ～2.972)等会增加颈部OMSD的患病风险.结论 该钢铁厂男工OMSD以腰和颈部为主,年龄、工龄等个人因素、不良劳动姿势、手工搬举重物等职业因素以及加班作业等劳动组织因素是导致钢铁厂男工OMSD的主要危险因素.
    목적 료해모강철엄공인기육골격질환(OMSD)환병솔,탐토기직업화개체위험인소.방법 2010년채용정군수궤추양적방법선취모강철엄1620명남성공인위조사대상.채용경수개적북구국가Nordic적OMSD표준조사표급하란국가직업위생연구소적조사표순문.조사표유공인전사,통계불동년령、공령、문화정도적남T신체각부위OMSD년환병솔,병채용logistic회귀대기영향인소진행료분석.결과 해강철엄1620명공인중남공OMSD이요부、경부화견부질환위주,년환병솔분별위51.0％ (825)、48.5％ (785)화37.7％ (610),배부、슬개、수완、과족、주부、관둔부질환적년환병솔분별위28.0％(454)、23.6％(383)、21.0％ (341)、17.9％ (290)、14.1％ (229)、12.7％(205).신체각부위OMSD년환병솔수착년령증가유증가적추세,기중이요부경부손상위주,≤24、25 ～ 29、30 ～ 34、35 ～ 39、40 ～ 44、45 ～ 49、≥50세조요부OMSD적년환병솔분별위26.4％ (43/163)、37.8％ (71/188)、52.8％(162/307)、55.6％(160/288)、53.8％ (99/184)、55.9％(80/143)、61.6％(204/331)(x2=72.5,P＜0.05)；경부OMSD적년환병솔분별위22.7％(37/163)、40.4％(76/188)、50.2％(154/307)、48.6％(140/288)、56.0％ (103/184)、53.1％ (76/143)、57.7％(191/331)(x2=65.3,P＜0.05).OMSD년환병솔수공령적증가유증장적추세,공령≤4、5～9、10～14、15 ～ 19、20 ～ 24、25 ～ 29、≥30년조요부OMSD적년환병솔분별위30.2％(85/281)、46.2％(66/143)、56.4％(162/287)、56.8％(137/241)、50.6％(78/154)、59.2％(90/152)、60.7％(173/285)(x2=71.3,P＜0.05)；경부OMSD적년환병솔분별위28.8％ (81/281)、49.0％(70/143)、52.6％ (151/287)、50.2％(121/241)、51.9％ (80/154)、53.9％ (82/152)、59.3％ (169/285)(x2=61.5,P＜0.05).동시,OMSD년환병솔수착문화정도적승고이강저,기중초중급이하、고중급중전、대전급이상조사대상요부OMSD년환병솔분별위61.5％ (176/286)、61.9％ (359/692)、44.2％(272/615),차이유통계학의의(x2=26.0,P＜0.05)；경부OMSD년환병솔분별위56.3％(161/286)、50.0％(346/692)、42.3％(260/615),차이유통계학의의(x2=21.2,P＜0.05).단인소logistic회귀분석제시,공령≥30년(OR=3.562,95％CI:2.514～ 5.046)、장시간보지대폭도만요자세(OR =2.003,95％ CI:1.612 ～2.488)、경상대폭도만요(OR=1.897,95％CI:1.557 ～ 2.312)、구간매분종다차주동일동작(OR=1.870,95％ CI:1.529～2.288)등노동부하인소가증가요부OMSD환병풍험.이공령≥30년(OR=3.597,95％CI:2.535 ～5.105)、경부전경(OR=2.455,95％ CI:2.010 ～2.998)、경부후앙(0R=1.999,95％ CI:1.569 ～2.546)、경부뉴전(OR =2.381,95％ CI:1.907 ～2.972)등회증가경부OMSD적환병풍험.결론 해강철엄남공OMSD이요화경부위주,년령、공령등개인인소、불량노동자세、수공반거중물등직업인소이급가반작업등노동조직인소시도치강철엄남공OMSD적주요위험인소.
    Objective To study the prevalence of occupational musculoskeletal disorders (OMSD) of male steelworkers and explore its occupational and individual risk factors.Methods 1620 male workers from a steel mill were selected as subjects through random cluster sampling in 2010.A revised Nordic Musculoskeletal disorder standard questionnaire and a questionnaire from National Institute for Occupational and Health of the Netherlands were used to ask and record the OMSD and its risk factors.The questionnaires were filled in by the workers.Annual prevalence of OMSD in different parts of the body were counted according to different age,working years and educational level,logistic regression was used to analyze its influence factors.Results OMSD in these workers primarily located in waist,neck and shoulders,annual prevalence were 51.0％ (825),48.5％ (785) and 37.7％ (610) respectively.Annual prevalence of other body parts were 28.0％ (454) for back,23.6％ (383) for knee,21.0％ (341) for wrist,17.9％ (290) for ankle/foot,14.1％ (229) for elbow and 12.7％ (205) for coxa.The annual prevalence of OMSD for each part tended to increase with age,mainly in waist and neck.Of the different age groups ≤ 24,25-29,30-34,35-39,40-44,45-49,≥ 50,the annual prevalence in waist was 26.4％ (43/163),37.8％ (71/188),52.8％ (162/307),55.6％ (160/288),53.8％ (99/184),55.9％ (80/143),61.6％ (204/331)respectively (x2 =72.5,P ＜ 0.05) ; correspondingly,the annual prevalence in neck was 22.7％ (37/163),40.4％ (76/188),50.2％ (154/307),48.6％ (140/288),56.0％ (103/184),53.1％ (76/143),57.7％(191/331) respectively (x2 =65.3,P ＜ O.05).The annual prevalence of OMSD increased with the working years.Of the different working years groups ≤4,5-9,10-14,15-19,20-24,25-29,≥ 30,the annual prevalence in waist was 30.2％ (85/281),46.2％ (66/143),56.4％ (162/287),56.8％ (137/241),50.6％ (78/154),59.2％ (90/152),60.7％ (173/285) respectively (x2 =71.3,P ＜ 0.05);correspondingly,the annual prevalence in neck was 28.8％ (81/281),49.0％ (70/143),52.6％ (151/287),50.2％ (121/241),51.9％ (80/154),53.9％ (82/152),59.3％ (169/285) respectively (x2 =61.5,P ＜ 0.05).The annual prevalence of OMSD decreased with education level.Of the different groups of education level (junior high school level and below,senior high school level,university level or above),the OMSD prevalence in waist was 61.5％ (176/286),61.9％ (359/692),44.2％ (272/615) respectively (x2 =26.0,P ＜ 0.05) ; correspondingly,the annual prevalence in neck was 56.3％ (161/286),50.0％ (346/692),42.3 ％ (260/615) respectively (x2 =21.2,P ＜ 0.05).Univariate logistic regression showed that the work load factors such as the working years ≥30 (OR =3.562,95％ CI:2.514-5.046),maintain substantial stoop for a long time (OR =2.003,95％ CI:1.612-2.488),often stooping with vast scale (OR =1.897,95％ CI:1.557-2.312),and torso repeating same action many times per minute (OR =1.870,95％ CI:1.529-2.288) could increase the annual prevalence of OMSD in waist most likely (P ＜0.05).The working years ≥ 30 (OR =3.597,95％ CI:2.535-5.105),neck leaning forward (OR =2.455,95％ CI:2.010-2.99),neck leaning back (OR =1.999,95％ CI:1.569-2.546),and neck rotation (OR =2.381,95 ％ CI:1.907-2.972) were main risk factors causing OMSD in neck (P ＜ 0.05).Conclusion The most serious musculoskeletal disorders of male steelworkers were waist and neck pain.Personal factors such as age,working years,work load factors such as harmful working postures,manual heavy lifting,and labour organizationsl factors such as work overtime were the main risk factors of musculoskeletal disorders to the male steelworkers.
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