南充市多行业工人长工时和业余体育活动与工作相关肌肉骨骼疾患的关联

Associations between long working hours, leisure-time physical activity, and work-related musculoskeletal disorders among multi-industry workers in Nanchong

  • 摘要:
    背景 工作相关肌肉骨骼疾患(WMSDs)被认为是工作场所的最大的健康问题之一,严重影响职业人群工作效率和生活质量。长工时可能导致WMSDs,业余体育活动(LTPA)有益于WMSDs,但二者独立或联合作用与WMSDs的关系尚不明确。
    目的 探讨长工时和/或LTPA与WMSDs的关系,为预防和干预WMSDs提供依据。
    方法 采用整群随机抽样方法于2023年开展横断面调查,以南充市多个第二产业企业1227名一线工人为研究对象,通过问卷收集人口学信息、周工作时间、LTPA、个人健康行为方式和职业因素等资料。使用《中文版肌肉骨骼疾患问卷》评估WMSDs。采用χ2检验和logistic回归分析长工时和/或LTPA与WMSDs的关系。
    结果  本次共调查工人1227人,男性855例(69.7%),女性372例(30.3%),年龄(41.3±9.3)岁。855人(69.7%)周工作时间>40 h,254人(20.7%)周工作时间≥55 h;无LTPA者561人,占45.7%,高LTPA者192人,占15.6%。1227人中WMSDs阳性率为57.4%。周工作时间≥55 h的工人WMSDs阳性率为71.3%,高于其他工作时间组(51.3%~58.2%,P<0.05);周工作时间41~48 h组(54.4%)、49~54 h组(58.2%)与≤40 h(51.3%)组的WMSDs阳性率比较,差异无统计学意义(P>0.05)。无LTPA(59.0%)或低LTPA(58.9%)较高LTPA(49.0%)的工人WMSDs阳性率高(P<0.05)。logistic回归分析发现,调整了性别、年龄、工龄、月收入、夜班轮班、行业、长时间同一姿势、长时间重复操作、吸烟、饮酒后,与周工作时间≤40 h者相比,超长工时(≥55 h·周−1)者的WMSDs阳性风险更高(OR=2.155,95%CI:1.504~3.088),而高LTPA者的WMSDs阳性风险较低(OR=0.614,95%CI:0.432~0.874)。分析显示无LTPA-超长工时(≥55 h·周−1)组合、低LTPA-超长工时(≥55 h·周−1)组合与WMSDs有关联,发生WMSDs的风险分别是无LTPA-标准工时(≤40 h·周−1)组合的2.360倍和2.049倍(P<0.05);未观察到高LTPA-长工时组合与WMSDs发生风险增加有关联(P>0.05)。
    结论 超长工时和/或LTPA与WMSDs阳性风险关联呈现不同特征。超长工时与WMSDs的阳性风险呈正相关,而高LTPA与WMSDs阳性风险呈负相关。超长工时与无LTPA或低LTPA的组合发生WMSDs的风险较高,而高LTPA-长工时组合未观察到WMSDs的风险升高。

     

    Abstract:
    Background Work-related musculoskeletal disorders (WMSDs) are considered to be one of the biggest health problems in the workplace, seriously affecting the productivity and quality of life of the working population. Long working hours may associate with WMSDs, and leisure-time physical activity (LTPA) is beneficial for WMSDs. However, the independent and combined effects of these two factors on WMSDs remain poorly understood.
    Objective To explore the independent and joint relationships between long working hours, leisure time physical activity (LTPA), and WMSDs, and to provide a basis for prevention and intervention of WMSDs.
    Methods A cross-sectional survey was conducted among 1227 frontline workers from multiple secondary industry companies in Nanchong City in 2023 using cluster random sampling. Demographic characteristics information, weekly working hours, LTPA, personal health behaviors, and occupational factors were collected through questionnaires. The Chinese version of Musculoskeletal Disorders Questionnaire was used to assess WMSDs. χ2 test and logistic regression were used to analyze the relationships between long working hours and/or LTPA and WMSDs.
    Results A total of 1227 workers were surveyed with a mean age of (41.3±9.3) years and 855 (69.7%) were male and 372 (30.3%) were female. Among then, 855 (69.7%) workers reported working >40 h per week, and 254 (20.7%) reported working ≥ 55 h per week; 561 (45.7%) reported no LTPA and 192 (15.6%) reported high LTPA. The overall positive rate of WMSDs was 57.4%. The positive rate of WMSDs was 71.3% in those working ≥55 h per week, which was significantly higher than those in the other groups (51.3%-58.2%, P<0.05). Comparison among the positive rate of WMSDs in the weekly working 41-48 h group (54.4%), the 49-54 h group (58.2%), and the ≤40 h group (51.3%) showed no statistically significant difference (P>0.05). The positive rate of WMSDs was higher in workers with no LTPA (59.0%)/low LTPA (58.9%) than in those with high LTPA (49.0%) (P<0.05). The logistic regression models showed that after adjusting gender, age, work experience, income per month, night shift, industry, prolonged fixed posture, prolonged repetition, smoking and alcohol drinking, compared with weekly working ≤40 h, the risk of WMSDs was higher in those with extra-long working hours (≥55 h·week−1 ) (OR=2.155, 95%CI: 1.504, 3.088), whereas those with high LTPA had a lower risk of WMSDs (OR=0.614, 95% CI: 0.432, 0.874 ). The combination of no LTPA and extra-long working hours (≥55 h·week−1) and low LTPA and extra-long working hours (≥55 h·week−1) showed associations with WMSDs, with 2.360 and 2.049 times higher risk of WMSDs than that of the combination of no LTPA and standard working hours (≤40 h ·week−1) respectively (P<0.05), whereas the combination of high LTPA and long working hours was not observed statistical significance (P>0.05).
    Conclusion Extra-long working hours and/or LTPA show different associations with the risk of WMSDs. Extra-long working hours are significantly positively associated with the risk of WMSDs, whereas high LTPA is significantly negatively associated with the risk of WMSDs. The combination of extra-long working hours with no or low LTPA is associated with elevated risk of reporting WMSDs, whereas no statistical significance is observed for the high LTPA-long work hours combination.

     

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