汽车制造业工人使用振动工具与下背痛的关联性——基于倾向性得分匹配法

Association between use of vibrating tools and low back pain in automobile manufacturing workers: A propensity score matching analysis

  • 摘要:
    背景 汽车制造业使用振动工具者下背痛患病率较高,相关风险因素研究仍显不足。
    目的 探讨汽车制造业工人使用振动工具与下背痛的关联性及人群归因危险度百分比(PAR%)。
    方法 采用横断面调查的方法,使用《中国肌肉骨骼疾患调查问卷》对某汽车制造企业工龄在1年以上工人进行问卷调查。根据工人在作业中是否使用振动工具分为“暴露组”(使用振动工具组)和“对照组”(不使用振动工具组),采用1∶2近邻匹配的倾向性评分匹配方法,选择两组间差异有统计学意义的变量作为协变量进行评分匹配。采用卡方检验对匹配后暴露组和对照组在下背痛患病率差异进行比较,采用多因素log-binomial回归模型计算现患比(PR)值,并进一步计算使用振动工具对下背痛贡献的PAR%。
    结果 本次参与调查回收有效问卷6973份,其中男性为5676人,女性1297人,下背痛总患病率为40.3%(2809/6973)。以使用振动工具的1255名作业工人作为暴露组(男性1134人,女性121人),平均年龄为(44.2±8.7)岁,现岗位工龄(23.5±9.9)年;匹配对照组2510人(男性2279人,女性231人),平均年龄(44.7±8.6)岁,现岗位工龄(24.0±10.0)年;暴露组下背痛患病率为76.7%(963/1255),高于对照组的29.9%(750/2510),差异具有统计学意义(P<0.001);多因素log-binomial回归分析结果显示,暴露组的PR值为2.57(95%CI:2.28~2.90);PAR%为22.03%。
    结论 汽车制造业工人使用振动工具与下背痛患病的发生具有正向关联性,采取有效措施控制振动危害,对降低汽车制造业工人下背痛的发生率具有重要意义 。

     

    Abstract:
    Background The prevalence of low back pain among workers using vibrating tools in the automobile manufacturing industry is high; however, research on associated risk factors remains limited.
    Objective To investigate the association between use of vibrating tools and low back pain among automobile manufacturing workers, and to estimate related population attributable risk percentage (PAR%).
    Methods A cross-sectional survey was conducted using the Chinese Musculoskeletal Disorders Questionnaire among workers with over one year of service in an automobile manufacturing enterprise. Workers were categorized into an exposed group (vibrating tool users) and a control group (non-users) based on their use of vibrating tools during work. The variables showing statistically significant differences between the two groups were selected as covariates for matching by 1∶2 nearest-neighbor propensity score. Chi-square test was used to compare the prevalence of low back pain between the matched exposed and control groups. Log-binomial regression model was employed to calculate the prevalence ratio (PR), and the PAR% of low back pain attributable to vibrating tool use was subsequently determined.
    Results A total of 6973 valid questionnaires were collected, comprising 5676 males and 1297 females, with an overall low back pain prevalence of 40.3% (2809/6973). The exposed group included 1255 workers (1134 males, 121 females), with a mean age of (44.2 ± 8.7) years and a mean tenure in the current position of (23.5 ± 9.9) years; the matching control group consisted of 2510 workers (2279 males, 231 females), with a mean age of (44.7 ± 8.6) years and a mean tenure in the current position of (24.0 ± 10.0) years. The prevalence of low back pain was 76.7% (963/1255) in the exposed group, significantly higher than the 29.9% (750/2510) in the control group (P<0.001). The log-binomial regression analysis showed a PR of 2.57 (95%CI: 2.28, 2.90) for the exposed group, with a PAR% of 22.03%.
    Conclusion The use of vibrating tools among automobile manufacturing workers is positively associated with reporting low back pain. Implementing effective measures to mitigate vibration hazards is crucial for reducing the burden of low back pain in this population.

     

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