深圳市公交司机每周工作时长与颈部和腰部工作相关肌肉骨骼疾患的关联性研究

Associations of weekly working hours with neck and lower back work-related musculoskeletal disorders among bus drivers in Shenzhen

  • 摘要:
    背景 工作相关肌肉骨骼疾患(WMSDs)作为公交司机面临的主要职业卫生问题之一,应受到充分关注。
    目的 探讨公交司机中每周工作时长、睡眠质量与颈部和腰部WMSDs的关联性以及睡眠质量在每周工作时长与颈部和腰部WMSDs关联中的中介作用。
    方法 2022年6—12月,本研究采用方便抽样法,选择深圳市巴士集团下属5个分公司的公交司机为研究对象,通过问卷调查收集了公交司机的人口学特征、生活方式及工作相关特征等信息。使用《匹兹堡睡眠质量指数》量表和《肌肉骨骼疾患调查问卷》对研究对象的睡眠质量和WMSDs的患病情况进行评估。采用logistic回归模型分析每周工作时长、睡眠质量与颈部和腰部WMSDs之间的关联性,并采用中介分析来探究睡眠质量在上述关联中的中介作用。
    结果 共回收有效问卷1792份,回收有效率95.07%。其中,89.3%的公交司机每周工作时长超过40 h,低睡眠质量的阳性率为28.2%。研究对象在调查前1年内的WMSDs总体阳性率为69.12%。在各部位中,颈部和腰部的阳性率最高,分别为55.92%和53.68%。Logistic回归模型分析结果显示:与每周工作时长≤40 h的人群相比,每周工作时长(40~48 h(OR=1.43,95%CI:1.02~2.01;OR=1.65,95%CI:1.17~2.34)、(48~56 h(OR=2.69,95%CI:1.89~3.83;OR=2.30,95%CI:1.62~3.29)和>56 h(OR=2.63,95%CI:1.86~3.74;OR=3.23,95%CI:2.27~4.62)的公交司机患颈部和腰部WMSDs风险提高。此外,与高睡眠质量者相比,低睡眠质量(OR=4.08,95%CI:3.20~5.23;OR=4.15,95%CI:3.26~5.30)的公交司机患颈部和腰部WMSDs风险提高。进一步的中介分析表明,睡眠质量在每周工作时长与颈部和腰部WMSDs的关联中起到了中介作用,中介效应百分比分别为36.15%和33.68%。
    结论 公交司机WMSDs阳性率较高,以颈部和腰部高发。长工时和低睡眠质量与颈部、腰部WMSDs患病风险升高存在关联,且睡眠质量在每周工作时长与颈部和腰部WMSDs关联间发挥中介作用。

     

    Abstract:
    Background Work-related musculoskeletal disorders (WMSDs) are one of the major occupational health problems faced by bus drivers and should receive special attention.
    Objective To explore the associations of weekly working hours and sleep quality with neck and lower back WMSDs among bus drivers, as well as assess the potential mediating role of sleep quality.
    Methods From June to December 2022, we recruited bus drivers from 5 subsidiaries of the Shenzhen Bus Group by convenient sampling method. Demographic characteristics, lifestyles, and work-related features of the bus drivers were collected through a questionnaire survey. The Pittsburgh Sleep Quality Index (PSQI) scale and the Musculoskeletal Disorders Survey Questionnaire were used to assess sleep quality and WMSDs respectively. Logistic regression models were applied to analyze the associations of weekly working hours and sleep quality with WMSDs in neck and lower back. Furthermore, mediation analysis was performed to investigate the role of sleep quality in the associations between weekly work hours and neck and lower back WMSDs.
    Results A total of 1792 valid questionnaires were collected, with a response rate of 95.07%. Among these, 89.3% of the bus drivers worked more than 40 h per week, and the positive rate of poor sleep quality was 28.2%. The overall positive rate of WMSDs within one year before the survey was 69.12%. Among different body regions, the leading positive rates were identified in neck and lower back regions, at 55.92% and 53.68%, respectively. The logistic regression model showed that compared to the bus drivers with weekly work hours ≤40 h, those weekly worked (40~48 h (OR=1.43, 95%CI: 1.02, 2.01; OR=1.65, 95%CI: 1.17, 2.34), (48~56 h (OR=2.69, 95%CI: 1.89, 3.83; OR=2.30, 95%CI: 1.62, 3.29) and >56 h (OR=2.63, 95%CI: 1.86, 3.74; OR=3.23, 95%CI: 2.27, 4.62) had significantly increased risk of WMSDs in neck and lower back. Additionally, when compared to those with good sleep quality, bus drivers with poor sleep quality had higher risks of both neck and lower back WMSDs (OR=4.08, 95%CI: 3.20, 5.23; OR=4.15, 95%CI: 3.26, 5.30, respectively). Further mediation analysis indicated that sleep quality partially mediated the associations between weekly working hours and both neck and lower back WMSDs, with 36.15% and 33.68% as the respective proportion of mediation.
    Conclusion The positive rate of WMSDs is high among bus drivers, and the most common WMSDs occur in neck and lower back. Long working hours and poor sleep quality are significantly associated with increased risks of neck and lower back WMSDs. Sleep quality may mediate the associations of weekly working hours with neck and lower back WMSDs.

     

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