供电企业攀爬作业人员工作相关肌肉骨骼疾患现况调查及影响因素分析

Prevalence of work-related musculoskeletal disorders and its influencing factors among workers involving climbing task in power supply enterprises

  • 摘要:
    背景 电网攀爬作业常存在攀爬、负重和不良体位,由此导致的工作相关肌肉骨骼疾患(WMSDs)较为严重,但其影响因素尚未十分明确,已受到行业的普遍关注。
    目的 了解供电企业攀爬作业人员WMSDs症状发生现状及其影响因素。
    方法 采用整群抽样方法在吉林省、天津市和山东省3省(直辖市)选择10家供电公司的全部702名攀爬作业人员作为研究对象,选择杨磊修订版《肌肉骨骼疾患问卷》,对其WMSDs症状的发生情况以及相关因素进行了调查,并运用χ2检验和多因素logistic回归模型对调查结果进行分析。
    结果 共调查702人,回收有效问卷649份,问卷有效率92.45%。研究对象WMSDs症状发生率为81.2%,颈部(65.0%)、腰部(59.0%)和肩部(54.4%)为WMSDs症状高发部位。多因素logistic回归分析结果显示,有时、经常/很频繁以不舒服姿势作业是颈部、肩部、腰部、膝部、背部、手/腕部、踝/足部、肘部和髋/臀部WMSDs症状发生的危险因素,其OR(95%CI)依次为:1.931(1.260~2.959)和3.145(1.810~15.465)、2.700(1.694~4.305)和3.888(2.224~6.798)、1.860(1.213~2.852)和3.150(1.833~5.414)、2.348(1.456~3.785)和3.689(2.130~6.388)、1.782(1.128~2.815)和3.274(1.935~5.538)、1.710(1.014~2.884)和2.595(1.455~4.630)、1.836(1.019~3.305)和2.860(1.526~5.358)、2.250(1.185~4.275)和3.032(1.505~6.108)、2.080(1.048~4.128)和3.127(1.501~6.516);部门人员紧缺是颈部、肩部、腰部、背部、手/腕部和踝/足部WMSDs症状发生的危险因素,其OR(95%CI)依次为:1.791(1.038~3.093)、2.000(1.119~3.573)、2.506(1.429~4.394)、2.063(1.113~3.822)、2.256(1.069~4.762)和2.699(1.103~6.601);膝盖频繁弯曲是膝部、背部和手/腕部WMSDs症状发生的危险因素,其OR(95%CI)依次为:1.895(1.327~2.704)、1.586(1.131~2.224)和2.026(1.390~2.951);经常推动/拉动重物是肩部、腰部和髋/臀部WMSDs症状发生的危险因素,其OR(95%CI)依次为:1.485(1.066~2.192)、1.547(1.064~2.749)和1.822(1.160~2.862);颈部长时间大幅度前倾是肘部和髋/臀部WMSDs症状发生的危险因素,其OR(95%CI)为:1.649(1.068~2.546)和2.005(1.285~3.129);踝足部长时间保持不自然弯曲是踝/足部和肘部WMSDs症状发生的危险因素,其OR(95%CI)为:2.481(1.685~3.655)和1.655(1.065~2.571);涉及寒风或气温变化是颈部和肩部WMSDs症状发生的危险因素,其OR(95%CI)为:2.182(1.072~4.443)和2.116(1.010~4.431);而体育锻炼是颈部、肩部、腰部、背部和踝/足部WMSDs症状发生的保护因素,其OR(95%CI)依次为:0.493(0.363~0.666)、0.625(0.438~0.888)、0.404(0.283~0.576)、0.570(0.408~0.797)和0.639(0.436~0.937)。
    结论 供电企业攀爬作业人员WMSDs症状发生率较高,多发生在颈部、腰部和肩部;其影响因素包括不舒服作业姿势、重复性动作、重复性工作内容、推拉重物、人员紧缺、不良作业环境和体育锻炼。

     

    Abstract:
    Background Operation and maintenance work in the power grid industry often involving climbing, manual handling, and poor postures causing serious problems like work-related musculoskeletal disorders (WMSDs). The influencing factors of WMSDs are not very clear, but the problem has been widely concerned in this industry.
    Objective To understand the prevalence and influencing factors of WMSDs among climbing task-involved workers in power supply enterprises.
    Methods Using a cross-sectional design, a total of 702 workers involving climbing task from 10 power supply enterprises in Jilin Province, Tianjin Municipality, and Shandong province were selected as study subjects using cluster sampling. The Musculoskeletal Disorders Questionnaire which was revised by Lei Yang was used to estimate the prevalence and identify related factors of WMSDs. \chi ^2 test and multiple logistic regression were used to analyze the data.
    Results A total of 702 subjects were approached, 649 valid questionnaires were recovered, and the effective recovery rate was 92.45%. The prevalence of WMSDs was 81.2%, and neck (65.0%), low back (59.0%), and shoulders (54.4%) were areas of high prevalence of WMSDs. The multiple logistic regression analysis results showed that sometimes and often/very often holding awkward postures were the risk factors of neck, shoulders, low back, knees, upper back, hands/wrists, ankles/feet, elbows, and hips/thighs WMSDs; the OR (95%CI) values were 1.931 (1.260-2.959) and 3.145 (1.810-15.465), 2.700 (1.694-4.305) and 3.888 (2.224-6.798), 1.860 (1.213-2.852) and 3.150 (1.833-5.414), 2.348 (1.456-3.785) and 3.689 (2.130-6.388), 1.782 (1.128-2.815) and 3.274 (1.935-5.538), 1.710 (1.014-2.884) and 2.595 (1.455-4.630), 1.836 (1.019-3.305) and 2.860 (1.526-5.358), 2.250 (1.185-4.275) and 3.032 (1.505-6.108), 2.080 (1.048-4.128) and 3.127 (1.501-6.516), respectively. Department staff shortage was the risk factor of neck, shoulders, low back, upper back, hands/wrists, and ankles/feet WMSDs; the OR (95%CI) values were 1.791 (1.038-3.093), 2.000 (1.119-3.573), 2.506 (1.429-4.394), 2.063 (1.113-3.822), 2.256 (1.069-4.762), and 2.699 (1.103-6.601), respectively. Frequent knee bending was the risk factor of knees, upper back, and hands/wrists WMSDs; the OR (95%CI) values were 1.895 (1.327-2.704), 1.586 (1.131-2.224), and 2.026 (1.390-2.951), respectively. Often pushing/pulling heavy objects was the risk factor of shoulders, low back, and hips/thighs WMSDs; the OR (95%CI) values were 1.485 (1.066-2.192), 1.547 (1.064-2.749), and 1.822 (1.160-2.862), respectively. Long-time heavily neck tilting forward was the risk factor of elbows and hips/thighs WMSDs; the OR (95%CI) values were 1.649 (1.068-2.546) and 2.005 (1.285-3.129) respectively. Long-time ankle or foot bending was the risk factor of ankles/feet and elbows WMSDs; the OR (95%CI) values were 2.481 (1.685-3.655) and 1.655 (1.065-2.571) respectively. Cold or changes in temperature was the risk factor of neck and shoulders WMSDs; the OR (95%CI) values were 2.182 (1.072-4.443) and 2.116 (1.010-4.431) respectively. Exercise was the protective factor of neck, shoulders, low back, upper back, and ankles/feet WMSDs; the OR (95%CI) values were 0.493 (0.363-0.666), 0.625 (0.438-0.888), 0.404 (0.283-0.576), 0.570 (0.408-0.797), and 0.639 (0.436-0.937), respectively.
    Conclusion The prevalence of WMSDs is high among workers involving climbing task in power supply enterprises, and neck, low back, and shoulders are the most commonly affected body parts. The influencing factors involve awkward postures, repetitive movements, repetitive tasks, pushing/pulling heavy objects, staff shortage, poor working environment, and exercise.

     

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