制鞋业作业工人膝部工作相关肌肉骨骼疾患现况及影响因素
Prevalence and influencing factors of work-related knee pain among workers in shoemaking industry
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摘要:
背景 制鞋业工人在工作过程中长期处于不良工效学姿势，易发生工作相关肌肉骨骼疾患（WMSDs）。针对该行业膝部WMSDs发生率和影响因素的研究较少，应予以重视。
目的 调查制鞋业作业人员膝部WMSDs的发生情况并分析相关的影响因素。
方法 采用方便抽样方法，选取广东省、湖北省、福建省、重庆市、山东省、浙江省和江西省7个省（直辖市）26家制鞋企业，共纳入6982名符合标准的制鞋业工人作为研究对象。采用电子版《肌肉骨骼疾患调查问卷》，通过横断面调查收集其近一年内膝部WMSDs的发生情况、人口学特征、职业相关因素及作业姿势特征因素，采用logistic回归分析可能影响发病的因素。
结果 本次调查回收有效问卷6982份（有效率98.3%）。本研究中制鞋业工人过去一年膝部WMSDs发生率为13.0%（908/6982）。多因素logistic回归分析结果显示，从事本行业工龄5~10年（OR=1.21，95%CI：1.02~1.45）和大于10年（OR=1.53，95%CI：1.27~1.83）相较于工龄不足5年的工人发生膝部WMSDs的风险更高；有时、经常和很频繁（参照很少或从不）长时间站立工作（OR=1.33，95%CI：1.08~1.64；OR=2.67，95%CI：2.10~3.39；OR=2.75，95%CI：2.08~3.63）和有时、经常和很频繁（参照很少或从不）长时间蹲或跪姿工作（OR=1.80，95%CI：1.47~2.21；OR=2.43，95%CI：1.58~3.75；OR=3.22，95%CI：1.66~6.24）的制鞋业工人发生膝部WMSDs风险增加；工作中长时间保持屈膝姿势（OR=1.59，95%CI：1.34~1.89）和工作中下肢及足踝经常反复做同一动作（OR=1.48，95%CI：1.25~1.75）也是制鞋厂工人膝部WMSDs的危险因素（
P <0.05）。休息时间充足（OR=0.58，95%CI：0.49~0.68）、工作中能伸展或改变腿部姿势（OR=0.75，95%CI：0.64~0.88）的工人膝部WMSDs发生风险降低（P <0.05）。结论 工龄与不良工作姿势是制鞋业工人膝部WMSDs发生的危险因素。企业应保证作业工人有充足休息时间，并减少长时间站立作业、长时间蹲或跪姿作业、长时间屈膝姿势和下肢及足踝经常反复做同一动作的不良作业姿势，以降低作业工人膝部WMSDs发生的风险。
Abstract:Background Shoemaking industry workers are prone to work-related musculoskeletal disorders (WMSDs) due to long-term awkward postures during the work process. There is little research on the prevalence and influencing factors of WMSDs in the knee region of this industry, and it should be taken seriously.
Objective To estimate the prevalence of work-related knee pain among shoemaking workers and analyze the related influencing factors.
Methods A total of 6982 shoemaking workers were selected from 26 shoemaking factories in Guangdong, Hubei, Fujian, Chongqing, Shandong, Zhejiang, and Jingxi by convenience sampling. Prevalence of work-related knee pain in past year, demographic characteristics, occupational related factors, and work posture were collected by a cross-sectional survey using the electronic version of Musculoskeletal Disorder Questionnaire. Logistic regression analysis was used to analyze the influencing factors that may lead to work-related knee pain.
Results This survey collected 6982 valid questionnaires with a recovery rate of 98.3%. The prevalence of work-related knee pain of shoemaking workers in the past 12 months was 13.0% (908/6982). According to the results of logistic regression analysis, compared with workers with less than 5 years of service, workers with 5-10 years of service (OR=1.21, 95%CI: 1.02, 1.45) and more than 10 years (1.53, 95%CI: 1.27, 1.83) showed a higher risk of knee WMSDs; sometimes, often and very frequent (reference : rarely or never) long-term standing (OR=1.33, 95%CI: 1.08, 1.64; OR=2.67, 95%CI: 2.10, 3.39; OR=2.75, 95%CI: 2.08, 3.63) and sometimes, often and very frequent (reference: rarely or never) long-term squatting or kneeling (OR=1.80, 95%CI: 1.47, 2.21; OR=2.43, 95%CI: 1.58, 3.75; OR=3.22, 95%CI: 1.66, 6.24) increased the risk of knee pain: long-term bending (OR=1.59, 95%CI: 1.34, 1.89) and often repeated movement of lower limbs and ankles (OR=1.48, 95%CI: 1.25, 1.75) were also risk factors for knee WMSDs among shoemaking industry workers (
P <0.05). Adequate rest time (OR=0.58, 95%CI: 0.49, 0.68) and able to stretch or change leg posture (OR=0.75, 95%CI: 0.64, 0.88) reduced the risk of knee WMSDs (P <0.05).Conclusion In the shoemaking industry, length of service and awkward postures are risk factors for knee pain. The shoemaking enterprises should ensure that workers have sufficient rest time, reduce long-term standing, squatting, kneeling, and bending postures, as well as lower limbs repetition in order to reduce the occurrence of knee WMSDs of workers.
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