制造业企业工人自报疾病患病情况与职业伤害分布特征分析

张林, 李志安, 谷一硕, 钱娟, 陆春花, 乔健健, 钱勇, 杨泽云, 朱晓俊

张林, 李志安, 谷一硕, 钱娟, 陆春花, 乔健健, 钱勇, 杨泽云, 朱晓俊. 制造业企业工人自报疾病患病情况与职业伤害分布特征分析[J]. 环境与职业医学, 2025, 42(2): 165-170, 195. DOI: 10.11836/JEOM24417
引用本文: 张林, 李志安, 谷一硕, 钱娟, 陆春花, 乔健健, 钱勇, 杨泽云, 朱晓俊. 制造业企业工人自报疾病患病情况与职业伤害分布特征分析[J]. 环境与职业医学, 2025, 42(2): 165-170, 195. DOI: 10.11836/JEOM24417
ZHANG Lin, LI Zhi’an, GU Yishuo, QIAN Juan, LU Chunhua, QIAO Jianjian, QIAN Yong, YANG Zeyun, ZHU Xiaojun. Distribution characteristics of self-reported diseases and occupational injuries among workers in manufacturing enterprises[J]. Journal of Environmental and Occupational Medicine, 2025, 42(2): 165-170, 195. DOI: 10.11836/JEOM24417
Citation: ZHANG Lin, LI Zhi’an, GU Yishuo, QIAN Juan, LU Chunhua, QIAO Jianjian, QIAN Yong, YANG Zeyun, ZHU Xiaojun. Distribution characteristics of self-reported diseases and occupational injuries among workers in manufacturing enterprises[J]. Journal of Environmental and Occupational Medicine, 2025, 42(2): 165-170, 195. DOI: 10.11836/JEOM24417

制造业企业工人自报疾病患病情况与职业伤害分布特征分析

详细信息
    作者简介:

    张林(1996—),女,硕士生;E-mail:2112341068@stu.gdpu.edu.cn

    通讯作者:

    朱晓俊,E-mail:zhuxj_bj@126.com

  • 中图分类号: R135

Distribution characteristics of self-reported diseases and occupational injuries among workers in manufacturing enterprises

More Information
  • 摘要:
    背景

    疾病严重影响工人的工作效能。共病是指同一个体中同时存在两种及两种以上慢性病或健康问题。既往研究多从职业场所角度研究职业伤害,对制造业工人自报疾病患病情况与职业伤害的流行特征分析尚不充分。

    目的

    分析制造业工人的自报疾病和职业伤害的分布情况,不同疾病之间的关联强度和常见的疾病组合,初步探讨自报疾病患病情况与职业伤害的关联性。

    方法

    采用横断面调查方法对江苏省2家制造业企业2382名工人过去1年发生的职业伤害情况进行调查,经过清洗后纳入分析的问卷共2355份。问卷内容主要包括基本情况、职业伤害发生情况和疾病患病情况三部分。患病情况为研究对象自我报告经医生确诊过的相关疾病,包括肌肉骨骼疾病、心血管疾病、呼吸系统疾病、心理健康问题、神经和感觉器官疾病、消化器官疾病、生殖泌尿器官疾病、皮肤病、肿瘤、内分泌和代谢系统疾病、血液病和出生缺陷共11类疾病。使用log-binomial模型计算患病率比值(PR)分析不同疾病之间的关联情况,使用UpSet图分析疾病组合模式。

    结果

    至少患一种疾病的工人占研究对象的40.2%(946/2355),2种、3种、4种疾病及以上共病人数分别占研究对象的8.6%(203/2355)、5.2%(122/2355)、5.9%(140/2355)。肌肉骨骼疾病、神经和感觉器官疾病、消化器官疾病、皮肤病患病人数居多,依次分别占研究对象的18.0%(423/2355)、13.8%(324/2355)、9.3%(218/2355)、9.1%(214/2355)。患有肌肉骨骼疾病、心血管疾病、神经和感觉器官疾病的工人其职业伤害发生率均较未患相应疾病的工人高(分别P<0.001,P=0.041,P=0.006)。肌肉骨骼疾病与神经和感觉器官疾病(PR值分别为1.86和1.98),肌肉骨骼疾病和消化器官疾病(PR和OR值分别为1.57和2.35),肌肉骨骼疾病和心血管疾病(PR和OR值分别为1.46和2.22)的关联性较强。二元共病组合分析显示:肌肉骨骼疾病及神经和感觉器官疾病共病人数最多,占全部共患病工人的5.4%(25/465)。

    结论

    制造业工人自报疾病中肌肉骨骼疾病、神经和感觉器官疾病、消化器官疾病、皮肤病患病人数居多。肌肉骨骼疾病及神经和感觉器官疾病在所有共病组合中人数最多。肌肉骨骼疾病、心血管疾病、神经和感觉器官疾病与职业伤害存在关联。在职业伤害防控中应加强与多种疾病的共防。

     

    Abstract:
    Background

    Diseases severely affect the efficiency of workers. Comorbidity refers to the coexistence of two or more chronic diseases or health problems in the same individual. Previous studies have primarily focused on occupational injuries caused by environmental exposures, while the analysis of the epidemiological characteristics of self-reported diseases and occupational injuries among manufacturing workers has been insufficient.

    Objective

    To analyze the distribution of self-reported diseases and occupational injuries among manufacturing workers, the strength of correlation between different diseases, and common disease combinations, and to preliminarily explore the relationship between self-reported diseases and occupational injuries.

    Methods

    A cross-sectional survey was conducted to investigate the occupational injuries of 2382 workers in 2 manufacturing enterprises over the past year, and 2355 questionnaires were valid after cleaning. The questionnaire included three parts: basic information, occupational injury occurrence, and disease prevalence. The self-reported diseases diagnosed by physicians included musculoskeletal diseases, cardiovascular diseases, respiratory diseases, mental health problems, neurological and sensory organ diseases, digestive organ diseases, reproductive and urinary organ diseases, skin diseases, tumors, endocrine and metabolic system diseases, blood diseases and birth defects, a total of 11 types. Log-binomial model was used to calculate the prevalence ratio (PR) value of the association between different diseases, and UpSet diagram was used to present the disease combination pattern.

    Results

    In total, 40.2% (946/2355) of the study participants reported at least one disease, while 8.6% (203/2355), 5.2% (122/2355), and 5.9% (140/2355) reported having two, three, and four or more diseases, respectively. A higher prevalence was observed for musculoskeletal diseases, neurological and sensory organ diseases, digestive organ diseases, and skin diseases, which accounted for 18.0% (423/2355), 13.8% (324/2355), 9.3% (218/2355), and 9.1% (214/2355), respectively. Workers with musculoskeletal disorders, cardiovascular diseases, or neurological and sensory organ diseases reported significantly higher incidence of occupational injuries compared with workers without the corresponding diseases (P<0.001, P=0.041, and P=0.006, respectively). Musculoskeletal diseases were strongly associated with comorbidities of neurological and sensory organ diseases (PR values were 1.86 and 1.98, respectively), and the other patters were musculoskeletal diseases and digestive organ diseases (PR and OR values were 1.57 and 2.35, respectively), and musculoskeletal diseases and cardiovascular diseases (PR and OR values were 1.46 and 2.22, respectively). The largest binomial comorbidity group involved musculoskeletal diseases and neurological and sensory organ diseases, accounting for 5.4% (25/465) of the comorbid workers.

    Conclusion

    Among the self-reported diseases of manufacturing workers, musculoskeletal diseases, neurological and sensory organ diseases, digestive organ diseases, and skin diseases are more common. Musculoskeletal diseases and neurological and sensory organ diseases are the most common in all comorbidities. Musculoskeletal diseases, cardiovascular diseases, and neurological and sensory organ diseases are associated with occupational injuries. In the prevention and control of occupational injuries, joint prevention strategies targeting multiple diseases should be strengthened.

     

  • 图  1   研究对象患病数量分布(n=2355)[人数(占比/%)]

    Figure  1.   Distribution of the number of diseases among the study population (n=2355)[case (ratio/%)]

    图  2   研究对象疾病组合UpSet图

    Figure  2.   UpSet diagram of disease combination of the study population

    表  1   研究对象的人口学特征(n=2355

    Table  1   Demographic characteristics of the study population(n=2355)

    变量(Variable) 分类(Sort) 人数(Number) 构成比(Percent)/%
    性别(Gender) 男(Male) 1830 77.7
    女(Female) 525 22.3
    年龄/岁(Age/years) <25 115 4.9
    25~ 1147 48.7
    45~ 778 33.0
    55~ 315 13.4
    教育程度
    (Education level)
    小学及以下
    (Primary school and below)
    199 8.5
    初中(Middle school) 1293 54.9
    高中及以上(High school and above) 863 36.6
    月收入/元(Monthly income/yuan) 4999 512 21.7
    5000~ 1068 45.4
    7000~ 775 32.9
    周工作天数/d(Weekly working days/d) ≤5 113 4.8
    6 493 20.9
    7 1749 74.3
    吸烟(Smoking) 不吸烟(No) 1269 53.9
    曾经吸烟(Former) 162 6.9
    吸烟(Yes) 924 39.2
    饮酒(Drinking) 不饮酒(No) 1434 60.9
    曾经饮酒(Former) 258 11.0
    饮酒(Yes) 663 28.1
    睡眠时间/h
    (Sleep duration/h)
    ≤7 1423 60.4
    >7 932 39.6
    合计(Total) 2355 100.0
    下载: 导出CSV

    表  2   研究对象的自报疾病患病和职业伤害发生情况

    Table  2   The number of self-reported disease and occupational injury of the study population

    疾病
    (Disease)
    人数
    (Number)
    构成比(Percent)/%职业伤害发生
    (Reported occupational injuries)
    人数(n)率(Rate)/%P
    肌肉骨骼疾病(Musculoskeletal diseases) <0.001
     是(Yes) 424 18.0 54 12.7
     否(No) 1931 82.0 120 6.2
    心血管疾病(Cardiovascular diseases) 0.041
     是(Yes) 178 7.6 20 11.2
     否(No) 2177 92.4 154 7.1
    呼吸系统疾病(Respiratory diseases) 0.480
     是(Yes) 159 6.8 14 8.8
     否(No) 2196 93.2 160 7.3
    心理健康问题(Mental health problems) 0.083
     是(Yes) 134 5.7 15 11.2
     否(No) 2221 94.3 159 7.2
    神经和感觉器官疾病(Neurological and sensory organ diseases) 0.006
     是(Yes) 324 13.8 36 11.1
     否(No) 2031 86.2 138 6.8
    消化器官疾病(Digestive organ diseases) 0.061
     是(Yes) 218 9.3 23 10.5
     否(No) 2137 90.7 151 7.1
    生殖泌尿器官疾病(Reproductive and urinary organ diseases) 0.795
     是(Yes) 53 2.3 3 5.7
     否(No) 2302 97.7 171 7.4
    皮肤病(Skin diseases) 0.251
     是(Yes) 214 9.1 20 9.4
     否(No) 2141 90.9 154 7.2
    肿瘤(Tumors) 0.161
     是(Yes) 19 0.8 3 15.8
     否(No) 2336 99.2 171 7.3
    内分泌和代谢系统疾病(Endocrine and metabolic system diseases) 0.731
     是(Yes) 178 7.6 12 6.7
     否(No) 2177 92.4 162 7.4
    血液病和出生缺陷(Blood diseases and birth defects) 0.433
     是(Yes) 56 2.4 2 3.6
     否(No) 2299 97.6 172 7.5
    下载: 导出CSV

    表  3   研究对象不同疾病患病情况的关联度

    Table  3   Correlation of reported diseases among the study population

    疾病种类-应变量(Disease category dependent variable) 疾病种类-自变量(Disease category-independent variable)
    肌肉骨骼
    疾病(Musculoske-letal diseases)c
    心血管疾病(Cardiovascu-lar diseases)d 呼吸系统
    疾病(Respiratory diseases)d
    心理健康
    问题(Mental health problems)d
    神经和感觉器官疾病(Neurological and sensory organ diseases)c 消化器官
    疾病(Digestive organ diseases)d
    生殖泌尿器官疾病(Reproduc-tive and urinary organ diseases)d 皮肤病
    (Skin diseases)d
    肿瘤
    (Tumors)d
    内分泌和代谢系统疾病(Endocrine and meta-bolic system diseases)d 血液和出生缺陷(Blood diseases and birth defects)d
    肌肉骨骼疾病(Musculoskeletal diseases) 1.46*
    (1.16~1.83)
    1.88*
    (1.49~2.35)
    1.20
    (0.94~1.52)
    1.86*
    (1.48~2.34)
    1.57*
    (1.25~1.98)
    0.96
    (0.69~1.32)
    1.30*
    (1.05~1.61)
    1.49
    (0.95~2.32)
    1.37*
    (1.08~2.06)
    1.49*
    (1.08~2.06)
    心血管疾病(Cardiovascular diseases) 2.22*
    (1.53~3.23)
    1.35
    (0.81~2.24)
    0.88
    (0.49~1.57)
    3.43*
    (2.31~5.09)
    1.86*
    (1.19~2.90)
    0.99
    (0.45~2.18)
    0.84
    (0.50~1.41)
    0.49
    (0.11~2.26)
    4.11*
    (2.69~6.27)
    0.17*
    (0.04~0.78)
    呼吸系统疾病(Respiratory diseases) 3.83*
    (2.60~5.66)
    1.40
    (0.84~2.33)
    1.08
    (0.61~1.91)
    3.76*
    (2.49~5.68)
    1.74*
    (1.10~2.76)
    2.57*
    (1.24~5.35)
    1.78*
    (1.11~2.88)
    1.06
    (0.30~3.79)
    1.95*
    (1.18~3.22)
    1.97
    (0.88~4.42)
    心理健康问题(Mental health problems) 1.68*
    (1.08~2.61)
    0.85
    (0.47~1.53)
    1.13
    (0.65~1.97)
    3.27*
    (2.09~5.13)
    2.08*
    (1.28~3.37)
    1.22
    (0.55~2.71)
    3.20*
    (2.05~4.99)
    0.71
    (0.16~3.04)
    2.59*
    (1.57~4.27)
    2.04
    (0.89~4.71)
    神经和感觉器官
    疾病(Neurological and sensory organs diseases)
    1.98*
    (1.54~2.56)
    1.77*
    (1.35~2.32)
    1.85*
    (1.42~2.40)
    1.64*
    (1.27~2.13)
    1.94*
    (1.52~2.48)
    1.06
    (0.74~1.51)
    1.61*
    (1.27~2.05)
    1.21
    (0.76~1.94)
    0.99
    (0.74~1.32)
    1.59*
    (1.02~2.49)
    消化器官
    疾病(Digestive organ diseases)
    2.35*
    (1.66~3.34)
    1.90*
    (1.21~2.96)
    1.66*
    (1.04~2.63)
    1.96*
    (1.19~3.21)
    3.15*
    (2.18~4.53)
    3.95*
    (1.99~7.82)
    1.55*
    (1.00~2.40)
    2.65
    (0.82~8.56)
    1.37
    (0.85~2.19)
    0.63
    (0.25~1.57)
    生殖泌尿器官疾病(Reproductive and urinary organ diseases) 1.75
    (0.88~3.49)
    1.05
    (0.48~2.29)
    2.66*
    (1.30~5.44)
    1.45
    (0.66~3.21)
    2.86*
    (1.38~5.94)
    4.01*
    (2.05~7.84)
    1.60
    (0.77~3.30)
    0.43
    (0.04~4.07)
    1.67
    (0.79~3.56)
    0.61
    (0.12~3.08)
    皮肤病(Skin diseases) 1.66*
    (1.16~2.38)
    0.83
    (0.50~1.38)
    1.83*
    (1.15~2.90)
    3.21*
    (2.06~4.98)
    2.61*
    (1.79~3.80)
    1.60*
    (1.04~2.45)
    1.48
    (0.72~3.05)
    0.24
    (0.04~1.25)
    1.99*
    (1.27~3.10)
    1.16
    (0.52~2.60)
    肿瘤(Tumors) 4.03*
    (1.36~12.00)
    0.64
    (0.15~2.67)
    1.23
    (0.34~4.36)
    0.87
    (0.20~3.88)
    1.79
    (0.58~5.50)
    2.44
    (0.80~7.48)
    0.55
    (0.06~5.26)
    0.33
    (0.06~1.75)
    5.10*
    (1.75~14.88)
    6.30*
    (1.77~22.42)
    内分泌和代谢系统疾病(Endocrine and metabolic system diseases) 1.86*
    (1.26~2.75)
    4.04*
    (2.64~6.17)
    1.81*
    (1.10~2.99)
    2.45*
    (1.47~4.08)
    1.10
    (0.70~1.72)
    1.39
    (0.88~2.22)
    1.34
    (0.61~2.93)
    1.88*
    (1.19~2.97)
    5.53*
    (1.90~16.10)
    1.32
    (0.56~3.12)
    血液病和出生缺陷(Blood diseases and birth defects) 2.01*
    (1.06~3.82)
    0.17*
    (0.04~0.79)
    2.01
    (0.92~4.40)
    1.95
    (0.84~4.53)
    2.69*
    (1.36~5.34)
    0.70
    (0.29~1.67)
    0.68
    (0.15~3.20)
    1.00
    (0.43~2.31)
    5.79*
    (1.53~21.87)
    1.32
    (0.56~3.13)
    [注] c:患病率大于 10%,采用 log-binomial 模型回归估计 PR(95%CI);d:患病率小于 10%,采用 logistic 模型回归估计 OR(95%CI)。*:P < 0.05。[Note] c: Log-binomial regression analysis for prevalence rate > 10%, and PR (95%CI) was estimated.; d: Logistic regression analysis for prevalence rate < 10%, and OR (95%CI) was estimated. *: P < 0.05.
    下载: 导出CSV
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出版历程
  • 收稿日期:  2024-09-04
  • 录用日期:  2024-12-08
  • 刊出日期:  2025-02-24

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