长工时、轮班和职业紧张对云南省重点职业人群工作相关肌肉骨骼疾患的影响

Effects of long working hours, shift rotation, and job stress on work-related musculoskeletal disorders among key occupational populations in Yunnan Province

  • 摘要:
    背景 长工时、轮班作业和职业紧张所致职业人群的身心健康危害亟须引起高度重视。
    目的 调查并比较不同产业工作相关肌肉骨骼疾患(WMSDs)的阳性率,分析重点职业人群中长工时、轮班作业和职业紧张的暴露现状,探讨这些因素对制造业和服务业WMSDs的影响。
    方法 研究对象来源于2022年全国重点人群职业健康素养监测项目云南省重点职业人群。此次调查为横断面调查。重点职业人群从第二产业(制造业、金属和非金属矿采选业)分层分组随机抽样和第三产业(医疗卫生业、教育业、环境卫生业、交通运输业和快递/外卖配送业)成比例的概率抽样,最终纳入12014名一线工人作为调查对象。通过网络自填式问卷获取职业人群一般信息、工作相关因素(轮班作业、每周工作时间、职业紧张等)以及WMSDs评估,采用χ2检验和logistic回归分析长工时、轮班和职业紧张与WMSDs的关联。
    结果 云南省重点职业人群WMSDs的阳性率高达77.2%,其中,第二产业为69.4%,第三产业为81.6%,两者有统计学差异(P<0.001)。所调查的8个行业中教育行业WMSDs的阳性率最高,为94.2%,所有行业单个部位WMSDs主要涉及颈部、肩部和下背部。第二产业各行业以1~2个部位疼痛为主,第三产业各行业以多个(≥5)部位疼痛为主。长工时(OR:1.119、1.165、1.163)、轮班(OR:1.094、1.199、1.230)和职业紧张(OR:1.795、1.854、2.006)均为颈部、肩部和下背部WMSDs的危险因素,三者还是多部位WMSDs的危险因素,且随着疼痛部位的增加,长工时、职业紧张的作用更明显,与没有出现疼痛相比,1~2个、3~4个、5个及以上疼痛部位长工时的OR值分别为0.971(95%CI:0.871~1.082)、1.133(95%CI:1.004~1.279)、1.285(95%CI:1.155~1.429);高职业紧张的OR值分别为1.009(95%CI:0.878~1.160)、1.360(95%CI:1.174~1.575)、2.797(95%CI:2.471~3.166)。
    结论 云南省重点职业人群中第三产业的WMSDs阳性率高于第二产业,长工时、轮班和职业紧张显著增加WMSDs症状发生的风险。

     

    Abstract:
    Background The adverse effects of long working hours, shift rotation, and job stress on the physical and mental health of occupational populations require urgent attention.
    Objective To investigate and compare the positive rates of WMSDs between different industries, analyze the exposure status of long working hours, shift rotation, and job stress among key occupational groups, and evaluate the impacts of these factors on WMSDs in the manufacturing and service industries.
    Methods The study subjects were derived from key occupational populations in Yunnan Province, recruited by the Chinese National Occupational Health Literacy Monitoring Survey in 2022. A cross-sectional design was used for this survey. The key occupational populations were recruited from the secondary industry (manufacturing industry, metal mining and beneficiation industry, and non-metal mining and beneficiation industry) by stratified random sampling and from the tertiary industry (medical and healthcare industry, education industry, environmental sanitation industry, transportation industry, and express/takeaway delivery industry) by proportional probability sampling, and 12014 front-line workers were finally included as survey participants. General information, work-related factors (shift rotation, weekly working hours, job stress, etc.) and WMSDs assessment results were obtained through a web-based self-reported questionnaire, and the associations of long working hours, shift rotation, and job stress with WMSDs were analyzed using χ2 test and logistic regression.
    Results The average positive rate of WMSDs among the key occupational groups in Yunnan Province was 77.2%. The positive rate of WMSDs in the secondary industry group was 69.4%, while it was 81.6% in the tertiary industry group, with a statistically significant difference (P<0.001). Among the eight surveyed sectors, the education sector had the highest positive rate of WMSDs (94.2%). The single-site WMSDs mainly involved the neck, shoulders, and low back. In the secondary industry, WMSDs was reported in 1−2 body parts, while in the tertiary industry, WMSDs was mainly reported in multiple (≥5) body parts. Long working hours (OR: 1.119, 1.165, 1.163, respectively), shift rotation (OR: 1.094, 1.199, 1.230, respectively), and job stress (OR: 1.795, 1.854, 2.006, respectively) were risk factors for WMSDs in the neck, shoulder, or low back, and all three were also risk factors for multi-site WMSDs. Moreover, as the number of involved body parts increased, the effects of long working hours and job stress became more pronounced. For 1-2, 3-4, and 5 or more body parts compared to no pain reported, their OR values were 0.971 (95%CI: 0.871, 1.082), 1.133 (95%CI: 1.004, 1.279), and 1.285 (95%CI: 1.155, 1.429) for long working hours, respectively, and the OR values were 1.009 (95%CI: 0.878, 1.160), 1.360 (95%CI: 1.174, 1.575), and 2.797 (95%CI: 2.471, 3.166) for job stress, respectively.
    Conclusion The positive rate of WMSDs is higher in the tertiary industry than that in the secondary industry among the key occupational groups in Yunnan Province. Long working hours, rotating shift work, and job stress could significantly increase the risk of WMSDs.

     

/

返回文章
返回