某船舶制造厂工人工作相关肌肉骨骼疾患的发生情况及危险因素

贾宁; 陈西峰; 郑成彬; 曲颖; 张雪艳; 王忠旭

doi:10.13213/j.cnki.jeom.2018.17672

某船舶制造厂工人工作相关肌肉骨骼疾患的发生情况及危险因素

Incidence and risk factors of work-related musculoskeletal disorders among workers in a shipyard

摘要

摘要:
目的调查某船舶制造厂工人工作相关肌肉骨骼疾患（WMSDs）的发生情况，探讨可能的危险因素。

方法采用流行病学横断面调查方法，选用经修订的肌肉骨骼损伤情况调查问卷，对我国某船舶制造厂工人近1年内肌肉骨骼疾患与工效学负荷以及心理社会因素开展调查。采用卡方检验以及logistic回归分析导致WMSDs发生的危险因素。

结果共发放问卷830份，收回有效问卷809份（有效率97.5%）。工人各部位WMSDs年发生率为12.2%~39.4%，发生率排在前四位的部位依次是下背部（39.4%）、颈部（31.3%）、手腕部（26.8%）和肩部（26.3%）。下背部、颈部、手腕部、膝部和踝/足部WMSDs的发生率在不同工种之间的差异具有统计学意义（P < 0.05）。多因素logistic回归分析结果显示：弯腰同时转身是导致下背部和肩部（OR=1.53，1.68）、手腕部长时间弯曲是导致手腕部（OR=1.62）WMSDs的危险因素；身高是导致下背部（OR=1.03）WMSDs的危险因素；经常加班是导致下背部和手腕部（OR=1.62，1.55）WMSDs的危险因素；主观工作姿势舒适是下背部、颈部、手腕部和肩部（OR=0.68，0.52，0.62，0.54）的保护因素；自主控制工作进度是手腕部（OR=0.67）WMSDs的保护因素；工作节奏快是导致颈部、手腕部和肩部（OR=1.60，1.66，1.60）WMSDs的危险因素；上司关心下属是颈部和肩部（OR=0.67，0.69）WMSDs的保护因素。

结论造船业工人WMSDs的发生率较高，亟须根据WMSDs的职业、个体、心理社会因素制定相关措施，以降低此类疾患对工人健康的不良影响。

Abstract:
Objective To investigate the incidence and risk factors of work-related musculoskeletal disorders (WMSDs) among workers in a shipyard.

Methods A cross-sectional epidemiological survey was conducted using a revised musculoskeletal disorders questionnaire to investigate the incidence, ergonomic load, and psychosocial factors of musculoskeletal disorders in the past year among workers in a shipyard in China. Chi-square test and logistic regression models were used to analyze the risk factors of WMSDs.

Results A total of 830 questionnaires were distributed, and 809 valid questionnaires were returned with a valid response rate of 97.5%. The incidence rates of WMSDs in different body parts were 12.2%-39.4%. The top four WMSDs incidence rates by body parts were low back (39.4%), neck (31.3%), wrist (26.8%), and shoulder (26.3%). The incidence rates of WMSDs in low back, neck, wrist, knee, and ankle/foot were different among different types of work (P < 0.05). Multivariate logistic regression analysis results showed that stooping and turning round simultaneously was a risk factor for WMSDs in low back and shoulder (OR=1.53, 1.68); wrist bent for a long time was a risk factor for WMSDs in wrist (OR=1.62); height was a risk factor for WMSDs in low back (OR=1.03); working overtime frequently was a risk factor for WMSDs in low back and wrist (OR=1.62, 1.55); subjective comfortable working posture was a protective factor for WMSDs in low back, neck, wrist, and shoulder (OR=0.68, 0.52, 0.62, 0.54); controlling work progress independently was a protective factor for WMSDs in wrist (OR=0.67); fast work pace was a risk factor for WMSDs in neck, wrist, and shoulder (OR=1.60, 1.66, 1.60); concerns from supervisors was a protective factor for WMSDs in neck and shoulder (OR=0.67, 0.69).

Conclusion The incidence rate of WMSDs in shipbuilding industry is at a high level. Therefore, it is urgent to formulate relevant policies and measures considering occupational, individual, and psychosocial factors of WMSDs to reduce the adverse health effects.

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