四家制造企业装配作业人员工作相关肌肉骨骼疾患的影响因素

Influencing factors for work-related musculoskeletal disorders among assembly workers in four manufacturing enterprises

  • 摘要:
    背景 制造业作业人员工作相关肌肉骨骼疾患(WMSDs)症状发生率较高,广受关注,但对于多部位WMSDs症状发生情况和危险因素的研究尚不充分。

    目的 探讨四家制造企业装配作业人员多部位WMSDs症状发生情况以及影响因素。

    方法 应用“中国肌肉骨骼疾患问卷”对四家制造业企业装配作业人员进行横断面调查,采用方便抽样获取研究对象1 401名,收集研究对象人口学特征,各部位WMSDs相关症状发生情况,生物力学、工作组织、工作环境以及社会心理因素暴露信息。统计描述WMSDs症状发生率以及多部位症状发生率,采用Pearson χ2检验进行多部位WMSDs影响因素的单因素分析,采用logistic回归进行多因素分析。

    结果 本研究中WMSDs症状发生率为54.9%(769/1401),症状发生比率居前三的部位分别是颈部41.4%,肩部30.7%,腕/手部25.1%。研究对象多部位WMSDs症状发生率为41.9%(587/1 401)。客车装配以及铆焊作业人员多部位WMSDs症状发生率高于电子配件及玻璃制造作业人员(P<0.001)。logistic回归分析结果显示:个体特征因素中女性(OR=2.09,95%CI: 1.48~2.97)、饮酒(OR=1.52,95%CI: 1.05~2.18),生物力学因素中长时间低头(OR=1.37,95%CI: 1.22~1.53)、频繁弯腰(OR=1.18,95%CI: 1.03~1.34)、手臂保持举起(OR=1.25,95%CI: 1.10~1.41)三种工作姿势频率高,工作组织因素中工种为电子配件、客车装配和铆焊(OR值分别为3.23、5.70和13.83),工作环境因素中温度有点儿冷(OR=4.84,95%CI: 1.90~12.37)、噪声严重影响工作(OR=2.25,95%CI: 1.23~4.11),以及社会心理因素中高工作需求(OR=1.47,95%CI: 1.04~2.08)、存在班后疲劳(OR=1.92~2.61)者多部位WMSDs的发生风险高。

    结论 装配作业人员多部位WMSDs症状发生率较高,主要影响因素包括个体因素、不良工作姿势、环境因素以及社会心理因素等方面。

     

    Abstract:
    Background The prevalence rate of work-related musculoskeletal disorders (WMSDs) among manufacturing workers is relatively high and has been widely concerned. However, research on the prevalence and risk factors of multi-site WMSDs is still insufficient.

    Objective To explore the prevalence and risk factors of multi-site WMSDs of assembly workers in four manufacturing enterprises.

    Methods The "Chinese Musculoskeletal Questionnaire" was used to conduct a cross-sectional survey among 1401 assembly workers selected by convenient sampling in four manufacturing enterprises, and their demographic characteristics, the prevalence of WMSDs in various body parts, and the information about biomechanical factors, work organizations, work environment, and psychosocial factor exposure were collected. The prevalence of WMSDs and multi-site WMSDs were estimated, Pearson χ2 test was used for univariate analysis of multi-site WMSDs risk factors, and logistic regression was used for multi-factor analysis.

    Results The total prevalence rate of WMSDs was 54.9% (769/1 401). The top three affected sites were neck (41.4%), shoulders (30.7%), and wrist/hand (25.1%). The prevalence rate of multi-site WMSDs was 41.9% (587/1 401). The prevalence rates of multi-site WMSDs in railway vehicle assembly and riveting workers were higher than those in electronic parts processing and glass manufacturing workers (P<0.001). The results of logistic regression analysis showed that individual factors such as female (OR=2.09, 95%CI: 1.48−2.97) and drinking (OR=1.52, 95%CI: 1.05−2.18), biomechanics factors such as keeping head down for a long time (OR=1.37, 95%CI: 1.22–1.53), keeping bending frequently (OR=1.18, 95%CI: 1.03–1.34), and keeping arms up for a long time (OR=1.25, 95%CI: 1.10–1.41), work organizational factors such as electronic parts processing, railway vehicle assembly, and riveting (OR values were 3.23, 5.70, and 13.83, respectively), environmental factors such as temperature a little cold (OR=4.84, 95%CI: 1.90–12.37), noise seriously affecting work (OR=2.25, 95%CI: 1.23–4.11), and psychosocial factors such as high job demands (OR=1.47, 95%CI: 1.04–2.08), fatigue after work (OR=1.92−2.61) were risk factors of multi-site WMSDs.

    Conclusion The prevalence rate of multi-site WMSDs in assembly workers is high, and the main influencing factors include individual factors, awkward work postures, environmental factors, and psychosocial factors.

     

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