某超大城市男性公交司机工作相关肌肉骨骼疾患发生情况及其影响因素
Prevalence and risk factors of work-related musculoskeletal disorders among male bus drivers in a mega-city
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摘要:
背景 公交司机是工作相关肌肉骨骼疾患（WMSDs）的高发人群。超大城市公交司机人数众多，面临着庞大的客运量和复杂的路况，罹患WMSDs风险较大，但目前对于这一群体相关研究较为缺乏。
目的 调查某超大城市公交司机WMSDs的发生情况，并分析其影响因素。
方法 采用横断面研究设计和自填式问卷调查方法，对某超大城市公交司机进行整群分层抽样调查，统计该群体过去12个月的WMSDs发生情况，采用Pearson
χ 2和二元logistic回归方法分析高发部位WMSDs的影响因素。结果 某超大城市公交司机过去12个月的WMSDs总症状发生率为49.5%（551/1113），不同部位的症状发生率为4.0%~38.5%，症状发生率位于前三位的部位分别是颈部（38.5%）、下背/腰部（25.5%）和肩部（20.8%）。多因素logistic回归分析结果显示：年龄（＞50岁）、吸烟、下班后疲惫（中等、严重）、长时间坐位作业（很频繁）、以不舒服姿势工作（有时、经常、很频繁）、加班（偶尔、经常）、工作场所温度（不舒适）、工作环境噪声（严重影响）是颈部WMSDs的危险因素（OR=2.014、1.577、2.793、3.025、2.708、2.032、3.406、2.746、1.442、2.998、1.456、3.506；
P <0.05）；本岗位工龄（6~10年、11~15年、16~20年）、吸烟、下班后疲惫（中等、严重）、以不舒服姿势工作（有时、经常、很频繁）是下背/腰部WMSDs的危险因素（OR=1.777、2.130、2.400、1.503、2.951、3.364、1.836、4.569、2.786，P <0.05）；年龄（46~50岁、＞50岁）、吸烟、下班后疲惫（中等、严重）、主要驾驶车辆类型（混合动力、柴油）、以不舒服姿势工作（经常、很频繁）、加班（经常）、工作场所温度（不舒适）是肩部WMSDs的危险因素（OR=1.737、2.357、1.553、2.259、2.489、1.659、3.295、2.777、3.320、2.266、1.426，P <0.05）。下班后体育锻炼（1~2次·周-1、≥3次·周-1）是颈部和下背/腰部WMSDs的保护因素（OR=0.553、0.470、0.586、0.485，P <0.05）。结论 近一半的某超大城市公交司机出现WMSDs症状，高发部位以颈部、下背/腰部和肩部为主，其发生状况与个人和职业因素有关，应积极采取预防和干预措施。
Abstract:Background Bus drivers are a high-risk group for work-related musculoskeletal disorders (WMSDs). There are a large number of bus drivers in mega-cities. High volumes of passenger traffic and complexity of road conditions may elevate their risk of WMSDs, but there are few studies related to this group.
Objective To investigate the prevalence of WMSDs among bus drivers in a mega-city and to analyze potential influencing factors.
Methods Based on cross-sectional study design and self-administered questionnaire, the prevalence of WMSDs in past 12 months were estimated by stratified cluster sampling among bus drivers in a mega-city. Pearson
χ 2 and logistic regression models were used to analyze the influencing factors for the body regions with a high prevalence.Results The overall prevalence of WMSDs in past 12 months among bus drivers in a mega-city was 49.5% (551/1113). The prevalence of WMSDs by body regions ranged from 4.0% to 38.5%, and led by neck pain (38.5%), lower back pain (25.5%), and shoulder pain (20.8%). The results of logistic regression showed that the risk factors for neck pain were age (>50 years), smoking, tiredness after work (moderate, severe), long sitting (frequently), awkward postures (sometimes, often, frequently), overtime(occasionally, often), workplace temperature (uncomfortable), and noise (severe) (OR=2.014、1.577、2.793、3.025、2.708、2.032、3.406、2.746、1.442、2.998、1.456、3.506;
P <0.05); the lower back pain risk factors were current work experience (6-10 years, 11-15 years, and 16-20 years), smoking, tiredness after work (moderate, severe), and awkward postures(sometimes, often, frequently)(OR=1.777、2.130、2.400、1.503、2.951、3.364、1.836、4.569、2.786,P <0.05); and the shoulder pain risk factors were age (46-50 years, and >50 years), smoking, tiredness after work (moderate, severe), vehicle type (hybrid power, diesel oil), awkward postures (often, frequently), overtime (often), and workplace temperature (uncomfortable) (OR=1.737、2.357、1.553、2.259、2.489、1.659、3.295、2.777、3.320、2.266、1.426,P <0.05). Identified protective factors for neck and lower back pain were off-duty physical activity (1-2 times per week, and ≥3 times per week) (OR=0.553、0.470、0.586、0.485,P <0.05).Conclusion Nearly half of the bus drivers in the mega-city report symptoms of WMSDs, mainly in the neck, lower back, and shoulders. The prevalence is related to individual and occupational factors, and prevention and intervention measures should be actively taken.
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