某汽车制造厂电焊工手/腕部肌肉骨骼疾患的影响因素及归因分析

Influencing factors and attribution analysis of hand/wrist musculoskeletal disorders among welders in an automobile factory

  • 摘要:
    背景 汽车制造业电焊工易发生手/腕部肌肉骨骼疾患(MSDs),严重影响工人的身心健康。
    目的 探讨某汽车制造厂电焊工手/腕部MSDs的影响因素及人群归因危险度百分比(PARP)。
    方法 采用方便抽样法选择某汽车制造厂5家分厂,以选取的分厂内所有符合条件的电焊工为研究对象,采用“肌肉骨骼疾患调查表”进行问卷调查。调查内容包括电焊工的一般情况、手腕部MSDs发生情况、不良工效学因素等内容。采用SAS log-binomial程序计算各影响因素的现患比(PR),并计算PARP。
    结果 该汽车制造厂电焊工手/腕部MSDs的症状发生率为44.1%(345/782)。多因素分析显示,女性(PR=1.25,95%CI:1.10~1.44)、下班后感觉很累(与不累相比,PR=2.22,95%CI:1.16~4.25)、腕扭转(PR=1.44,95%CI:1.19~1.74)、操作空间不足(PR=1.22,95%CI:1.07~1.40)、用手握捏物体(PR=1.58,95%CI:1.18~2.12)者手/腕部MSDs症状发生风险升高。主要职业相关影响因素的PARP依次为:用手握捏物体32.46%,腕扭转21.50%,下班后感觉很累15.28%,操作空间不足8.18%。
    结论 该汽车制造厂电焊工手/腕部MSDs症状发生率较高;性别、用手握捏物体、腕扭转、下班后感觉很累、操作空间不足是手/腕部MSDs的影响因素,其中手握捏物体、腕扭转是优先干预因素。

     

    Abstract:
    Background Welders in automobile manufacturers are prone to hand/wrist musculoskeletal disorders (MSDs), which seriously affect workers' physical and mental health.
    Objective To investigate the factors influencing hand/wrist MSDs of welders in an automobile factory and the population attributable risk percentage (PARP).
    Methods Five branches of an automobile factory were selected by convenient sampling method, and all qualified welders in the selected branches were enrolled as research participants. The Chinese Musculoskeletal Disorders Questionnaire was used to collect information such as general characteristics of welders, presentation of MSDs in the wrists and hands, and selected ergonomic factors. Log-binomial model in the SAS program was used to calculate the prevalence ratio (PR) of each influencing factor and PARP.
    Results The prevalence rate of MSDs in the hands/wrists of welders in the automobile factory was 44.1% (345/782). The results of multiple analysis showed that female (PR=1.25, 95%CI: 1.10-1.44), being very tired after work (versus not tired, PR=2.22, 95%CI: 1.16-4.25), twisting wrists (PR=1.44, 95%CI: 1.19-1.74), insufficient operating space (PR=1.22, 95%CI: 1.07-1.40), and holding or pinching objects by hands (PR=1.58, 95%CI: 1.18-2.12) increased the risk of reporting hand/wrist MSDs symptoms. The PARP of major occupational risk factors was: holding or pinching objects by hands, 32.46%; twisting wrists, 21.50%; being very tired after work, 15.28%; and insufficient operating space, 8.18%.
    Conclusion The prevalence of MSDs symptoms in hands/wrists of welders in this automobile factory is high. Gender, holding or pinching objects by hands, twisting wrists, being very tired after work, and insufficient operating space are the factors affecting hand/wrist MSDs, among which holding or pinching objects by hands and twisting wrists are the priority intervention factors.

     

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