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[男性钢铁工人职业性肌肉骨骼疾病及其危险因素调查]

[Survey on the occupational musculoskeletal disorder and its risk factors among male steelworkers].

作者信息

Xu Lei, Wang Zheng-lun, Chen Biao, Wu Lei, Yi Gui-lin, Li Ji-chao, He Li-hua, Wang Sheng, Yang Lei

机构信息

Department of Occupational and Environmental Health and MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2013 Mar;47(3):249-54.

Abstract

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 (χ(2) = 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 (χ(2) = 65.3, P < 0.05). 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 (χ(2) = 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 (χ(2) = 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 (χ(2) = 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 (χ(2) = 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 organizational factors such as work overtime were the main risk factors of musculoskeletal disorders to the male steelworkers.

摘要

目的

研究男性钢铁工人职业性肌肉骨骼疾病(OMSD)的患病率,并探讨其职业和个体危险因素。

方法

2010年通过随机整群抽样选取某钢铁厂1620名男性工人作为研究对象。采用修订后的北欧肌肉骨骼疾病标准问卷和荷兰国家职业健康研究所的问卷,询问并记录OMSD及其危险因素。问卷由工人自行填写。按不同年龄、工龄和文化程度统计身体各部位OMSD的年患病率,采用logistic回归分析其影响因素。

结果

这些工人的OMSD主要集中在腰部、颈部和肩部,年患病率分别为51.0%(825例)、48.5%(785例)和37.7%(610例)。其他身体部位的年患病率分别为:背部28.0%(454例)、膝盖23.6%(383例)、手腕21.0%(341例)、脚踝/足部17.9%(290例)、肘部14.1%(229例)、髋部12.7%(205例)。各部位OMSD的年患病率随年龄增长呈上升趋势,主要集中在腰部和颈部。在年龄≤24岁、25 - 29岁、30 - 34岁、35 - 39岁、40 - 44岁、45 - 49岁、≥50岁的不同年龄组中,腰部的年患病率分别为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)(χ(2)=72.5,P<0.05);相应地,颈部的年患病率分别为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)(χ(2)=65.3,P<0.05)。OMSD的年患病率随工龄增加而升高。在工龄≤4年、5 - 9年、10 - 14年、15 - 19年、20 - 24年、25 - 29年、≥30年的不同工龄组中,腰部的年患病率分别为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)(χ(2)=71.3,P<0.05);相应地,颈部的年患病率分别为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)(χ(2)=61.5,P<0.05)。OMSD的年患病率随文化程度升高而降低。在文化程度(初中及以下、高中、大学及以上)不同组中,腰部OMSD患病率分别为61.5%(176/286)、61.9%(359/692)、44.2%(272/615)(χ(2)=26.0,P<0.05);相应地,颈部的年患病率分别为56.3%(161/286)、50.0%(346/692)、42.3%(260/615)(χ(2)=21.2,P<0.05)。单因素logistic回归显示,工龄≥30年(OR = 3.562,95%CI:2.514 - 5.046)、长时间保持大幅度弯腰(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)、躯干每分钟重复相同动作多次(OR = 1.870,95%CI:1.529 - 2.288)等工作负荷因素最有可能增加腰部OMSD的年患病率(P<0.05)。工龄≥30年(OR = 3.597,95%CI:2.535 - 5.105)、颈部前倾(OR = 2.455,95%CI:2.010 - 2.99)、颈部后仰(OR = 1.999,95%CI:1.569 - 2.546)、颈部旋转(OR = 2.381,95%CI:1.907 - 2.972)是导致颈部OMSD的主要危险因素(P<0.05)。

结论

男性钢铁工人最严重的肌肉骨骼疾病是腰背痛和颈痛。年龄、工龄等个人因素,有害工作姿势、手工重体力劳动等工作负荷因素,以及加班等劳动组织因素是男性钢铁工人肌肉骨骼疾病发生的主要危险因素。

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