中华劳动卫生职业病杂志
中華勞動衛生職業病雜誌
중화노동위생직업병잡지
CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES
2013年
5期
356-360
,共5页
吴家兵%凌瑞杰%王正伦%祁成%吴琨%姚道华%刘富英%赵同强%曾玉宇
吳傢兵%凌瑞傑%王正倫%祁成%吳琨%姚道華%劉富英%趙同彊%曾玉宇
오가병%릉서걸%왕정륜%기성%오곤%요도화%류부영%조동강%증옥우
身体部位%肌肉骨骼疾患%危险因素
身體部位%肌肉骨骼疾患%危險因素
신체부위%기육골격질환%위험인소
Body regions%Musculoskeletal disorders%Risk factors
目的 分析汽车工人多部位肌肉骨骼疾患(MSDs)患病的分布规律、影响因素,及不同部位MSDs的相互联系.方法 采用整群随机抽样的方法,在某汽车公司采用经修改的北欧国家MSDs标准调查表对3998名汽车生产工人进行横断面调查,得到有效问卷3800份.多部位MSDs的影响因素采用multinomial logistic进行分析；不同部位之间的关联程度利用log-binomial模型,以某一部位是否患MSDs为因变量,其他部位为自变量,计算现患比(prevalenceratio,PR值)来评估.结果 汽车工人MSDs的患病以多部位为主,其中2个或2个以上部位的占64.5％(2452/3800),1个部位的仅占12.3％(469/3800)各部位MSDs相互关联的PR值在1.5～6.7之间,PR值的差异均有统计学意义(P＜0.01).汽车生产工人颈和肩、背与肩和腰、肘与腕/手、腰与颈、腕/手与腰、髋/臀与腰、膝与腰、踝/足与肘MSDs的联系比其他部位更为密切.多因素multinomial logistic回归分析发现,对汽车工人多部位MSDs影响最为突出的职业因素是不良姿势,包括经常以不舒服的姿势工工作、颈前倾、颈扭转(OR值分别为3.39、1.93、1.38)；其次是劳动组织:工间休息使3个以上部位MSDs的患病风险降到31％,而人员短缺则使患病风险上升到1.75倍；重体力劳动中推拉重物(超过20 kg)OR值为1.76.结论 汽车生产工人MSDs的患病以多部位为主；各部位MSDs具有较高的关联度；汽车工人患多部位MSDs的主要职业危险因素是不良姿势、劳动组织和重体力劳动.
目的 分析汽車工人多部位肌肉骨骼疾患(MSDs)患病的分佈規律、影響因素,及不同部位MSDs的相互聯繫.方法 採用整群隨機抽樣的方法,在某汽車公司採用經脩改的北歐國傢MSDs標準調查錶對3998名汽車生產工人進行橫斷麵調查,得到有效問捲3800份.多部位MSDs的影響因素採用multinomial logistic進行分析；不同部位之間的關聯程度利用log-binomial模型,以某一部位是否患MSDs為因變量,其他部位為自變量,計算現患比(prevalenceratio,PR值)來評估.結果 汽車工人MSDs的患病以多部位為主,其中2箇或2箇以上部位的佔64.5％(2452/3800),1箇部位的僅佔12.3％(469/3800)各部位MSDs相互關聯的PR值在1.5～6.7之間,PR值的差異均有統計學意義(P＜0.01).汽車生產工人頸和肩、揹與肩和腰、肘與腕/手、腰與頸、腕/手與腰、髖/臀與腰、膝與腰、踝/足與肘MSDs的聯繫比其他部位更為密切.多因素multinomial logistic迴歸分析髮現,對汽車工人多部位MSDs影響最為突齣的職業因素是不良姿勢,包括經常以不舒服的姿勢工工作、頸前傾、頸扭轉(OR值分彆為3.39、1.93、1.38)；其次是勞動組織:工間休息使3箇以上部位MSDs的患病風險降到31％,而人員短缺則使患病風險上升到1.75倍；重體力勞動中推拉重物(超過20 kg)OR值為1.76.結論 汽車生產工人MSDs的患病以多部位為主；各部位MSDs具有較高的關聯度；汽車工人患多部位MSDs的主要職業危險因素是不良姿勢、勞動組織和重體力勞動.
목적 분석기차공인다부위기육골격질환(MSDs)환병적분포규률、영향인소,급불동부위MSDs적상호련계.방법 채용정군수궤추양적방법,재모기차공사채용경수개적북구국가MSDs표준조사표대3998명기차생산공인진행횡단면조사,득도유효문권3800빈.다부위MSDs적영향인소채용multinomial logistic진행분석；불동부위지간적관련정도이용log-binomial모형,이모일부위시부환MSDs위인변량,기타부위위자변량,계산현환비(prevalenceratio,PR치)래평고.결과 기차공인MSDs적환병이다부위위주,기중2개혹2개이상부위적점64.5％(2452/3800),1개부위적부점12.3％(469/3800)각부위MSDs상호관련적PR치재1.5～6.7지간,PR치적차이균유통계학의의(P＜0.01).기차생산공인경화견、배여견화요、주여완/수、요여경、완/수여요、관/둔여요、슬여요、과/족여주MSDs적련계비기타부위경위밀절.다인소multinomial logistic회귀분석발현,대기차공인다부위MSDs영향최위돌출적직업인소시불량자세,포괄경상이불서복적자세공공작、경전경、경뉴전(OR치분별위3.39、1.93、1.38)；기차시노동조직:공간휴식사3개이상부위MSDs적환병풍험강도31％,이인원단결칙사환병풍험상승도1.75배；중체력노동중추랍중물(초과20 kg)OR치위1.76.결론 기차생산공인MSDs적환병이다부위위주；각부위MSDs구유교고적관련도；기차공인환다부위MSDs적주요직업위험인소시불량자세、노동조직화중체력노동.
Objective To analyze the prevalence and risk factors of multiple musculoskeletal disorders (MSDs) in auto workers and the associations between MSDs at different sites.Methods A cross-sectional survey was conducted in 3998 workers,who were selected from a Chinese auto corporation by cluster random sampling,using the revised Nordic MSDs standard questionnaire; 3800 completed questionnaires were returned.Multinomial logistic regression analysis was performed to assess the risk factors for multiple MSDs.The logbinomial model was used to calculate the prevalence ratios (PRs) of MSDs at different sites and evaluate the associations between MSDs at different sites.Results Of the 3800 subjects,2452 (64.5％) had MSDs at two or more sites,and 469 (12.3％) had MSDs at one site.The PRs varied from 1.5 to 6.7,with significant differences among different sites (P＜0.01).Relatively close associations were found between the MSDs at neck and shoulders,back and shoulders/waist,elbows and wrists/hands,waist and neck,wrists/hands and waist,hip and waist,knees and waist,and ankles/feet and elbows.The multinomial logistic regression analysis indicated that the highest risk factor for MSDs was poor posture,including often working in an uncomfortable posture,neck bending forward,and neck twisting (ORs =3.39,1.93,and 1.38),followed by labor organization,in which break between tasks could decrease the risk of MSDs at three or more sites to 31％,staff shortage,which could increase the risk of MSDs by 75％,and pushing and pulling heavy objects (＞20 kg) (OR=1.76).Conclusion Most auto workers with MSDs have multiple sites affected,and there are high associations between the MSDs at different sites.The major risk factors for multiple MSDs in auto workers include poor posture,labor organization,and heavy physical labor.
