某汽车制造厂电焊工上背部工作相关肌肉骨骼疾患发生情况及影响因素

Prevalence and risk factors of work-related musculoskeletal disorders in upper back of welders in an automobile factory

  • 摘要:
    背景 我国汽车制造行业属于劳动密集型产业,电焊工作业大部分以手工作业为主,作业时经常需要观察焊点情况,在工作过程中涉及的不良工效学因素较多。对于电焊工上背部工作相关肌肉骨骼疾患(WMSDs)症状发生情况和危险因素的研究尚不充分。
    目的 调查汽车制造厂电焊工上背部WMSDs发生情况及影响因素。
    方法 采用横断面调查方法,整群随机选择汽车制造厂972名电焊工为研究对象,采用肌肉骨骼疾患调查表,调查近一年内上背部WMSDs的症状发生情况。
    结果 电焊工上背部WMSDs症状发生率为42.2%(410/972)。在工作中暴露比例较高的不良工效学因素是长时间同一姿势工作(72.5%,705/972)、长时间大幅度弯腰转身(71.8%,698/972)和躯干重复性动作(64.7%,629/972)。单因素分析结果显示:不同性别、不同工龄、是否长时间大幅度转身、是否长时间大幅度弯腰、是否长时间大幅度弯腰转身、是否长时间同一姿势工作、是否以不舒服体位搬举重物、是否躯干重复动作、是否姿势不适使不上劲、是否工作中涉及寒冷或气温变化、是否人员短缺以及工间休息时间是否充足、不同每周工作时间、是否以不舒服姿势工作,人群间WMSDs症状发生率差异有统计学意义(P<0.05)。多因素logistic回归分析显示:女性、长时间同一姿势工作、以不舒服姿势工作(很频繁)、以不舒服体位搬举重物、姿势不适使不上劲者上背部WMSDs症状发生风险升高(OR值分别为2.37、1.46、1.76、1.44、1.50,P<0.05),每周工作时间每增加10 h(41~50 h,51~60 h,61 h及以上与40 h及以下工作时间比较),症状发生风险分别增加95%、157%和196%;有充足的休息时间的电焊工上背部WMSDs症状发生风险降低(OR=0.70,95%CI:0.49~0.98)。
    结论 汽车制造厂电焊工上背部WMSDs症状发生率较高,接触的职业危害因素较多,应采取相应的措施进行干预和预防。

     

    Abstract:
    Background China's automobile manufacture is a labor-intensive industry, and most of the welding tasks are manual operations. It is often necessary to observe the solder joints during operation, and there are many adverse health outcome-related factors involved in the work process. However, the research on the prevalence and risk factors of work-related musculoskeletal disorders (WMSDs) in the upper back of welders is still insufficient.
    Objective To explore the prevalence and risk factors of WMSDs in the upper back of welders from an automobile factory.
    Methods This was a cross-sectional study. A cluster random sampling method was used to select 972 electric welders from an automobile factory as the study subjects. The Musculoskeletal Disorders Questionnaire was used to estimate the prevalence of WMSDs in the upper back in the past year.
    Results The prevalence rate of WMSDs in the upper back in the welders was 42.2% (410/972). The positive rates of studied occupational risk factors were 72.5% (705/972) for maintaining same posture for a long time, 71.8% (698/972) for bending and twisting for a long time, and 64.7% (629/972) for repetitive trunk movements. The univariate analysis showed that the prevalence rates of WMSDs were significantly different among workers categorized by gender, working age, twisting and/or bending for a long time, working in the same position for a long time, lifting heavy objects in an uncomfortable position, repetitive trunk movements, being unable to exert energy due to discomfort, work involving cold or temperature changes, personnel shortage, no rest between work, working hours per week, and working in an uncomfortable position (P<0.05). The results of multiple logistic regression indicated that female, working in the same position for a long time, working in an uncomfortable position (frequently), lifting heavy objects in an uncomfortable position, and being unable to exert energy due to discomfort were associated with higher risks of reporting WMSDs in the upper back (OR=2.37, 1.46, 1.76, 1.44, and 1.50, respectively, P<0.05); the risk of reporting WMSDs in the upper back increased by 95%, 157%, and 196% for every 10 h increase in weekly working hours (41-50 h, 51-60 h, ≥61 h vs ≤40 h); adequate rest time was associated with a lower risk for WMSDs in the upper back (OR=0.70, 95%CI: 0.49-0.98).
    Conclusion The prevalence rate of WMSDs in the upper back of welders in the automobile factory is high, and many occupational risk factors are involved. Measures should be taken for intervention and prevention.

     

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