口腔医生工作相关肌肉骨骼疾患影响因素及发生模式分析

[背景]工作相关肌肉骨骼疾患(WMSDs)是造成我国伤残调整寿命年的重要原因.口腔医生由于其工作特点,易发生WMSDs,应得到积极的关注.[目的]调查口腔医生的WMSDs患病情况,分析其发生与不良工效学因素之间的关系,并探讨WMSDs可能的发生模式.[方法]采用肌肉骨骼疾患调查表,于2020年4月15—22日以口腔医生...     

某公立口腔医院医生工作相关肌肉骨骼疾患影响因素分析

采用整群抽样方法,选择《北欧肌肉骨骼疾患问卷(修改版)》对某公立口腔医院157名医生工作相关肌肉骨骼疾患(work-related musculoskeletal disorders,WMSDs)进行流行病学调查。结果显示,口腔医生任一部位WMSDs发生率70.7%(111/157),各部位发生率从高到低依次为颈部(65.6%)、肩部(55.4%)、上背部(39.5%)、下背/腰部(30.6%)、手/腕部(16.6%)。Logistic回归分析显示,工作姿势不舒服是发生颈、肩、上背部WMSDs的危险因素;每分钟多次重复操作是颈、上背部 WMSDs的危险因素; 颈部大幅前倾是肩和背部WMSDs的危险因素;手腕长期处于弯曲状态是肩和腕部WMSDs的危险因素;经常加班是上背部WMSDs的危险因素。与同事轮流完成工作是背部WMSDs的保护因素;体育锻炼是颈部、下背/腰部、手/腕部的保护因素。建议采取针对性的措施,降低口腔医生罹患WMSDs的风险。     

海口市护理人员工作相关肌肉骨骼疾患现况及影响因素分析

目的 了解海口市护理人员工作相关肌肉骨骼疾患(work-related musculoskeletal disorders,WMSDs)症状发生情况并探讨其影响因素,为制订干预措施,提高护理人员健康水平提供依据.方法 以海口市2家三级甲等医院工龄满1年以上的护理人员为研究对象,用肌肉骨骼疾患自评问卷调查护理人员的一般情...     

三级医院临床医生工作相关肌肉骨骼疾患的特征及影响因素研究

目的 研究三级医院临床医生工作相关肌肉骨骼疾患(work-related musculoskeletal disorders, WMSDs)的流行病学特征，探讨影响WMSDs发生的危险因素。方法 采用流行病学横断面调查方法，使用中国疾病预防控制中心职业卫生与中毒控制所提供的中文版《肌肉骨骼疾患调查表》电子问卷系统，对我国15家三级医院1 121名在职临床医生(内科医生412人、外科医生709人)的肌肉骨骼疾患发生情况及其相关因素进行调查分析。结果 临床医生WMSDs发生率为55.9%,其中内科医生为59.0%、外科医生为54.2%,主要累及颈部、肩部和背部。长时间坐姿工作、搬运重物>20 kg/次、以不舒服的姿势工作及多次重复性操作是内科医生WMSDs发生的危险因素；长时间跪姿作业、搬运重物(>5 kg/次和>20 kg/次)、需要上肢或手部用力、使用振动工具是外科医生WMSDs发生的危险因素，以不舒服姿势工作时间越长、重复操作频率越高，WMSDs发生危险越高(OR_有时=1.57,95%CI 1.17～2.11;OR_很频繁=...     

汽车装配工人肌肉骨骼疾患的不良工效学因素

目的探讨汽车装配工人工作相关肌肉骨骼疾患(WMSDs)的发生情况及相关不良工效学因素。方法应用经适当修订的《美国危险区域检查表》和《北欧肌肉骨骼疾患调查问卷》形成综合调查问卷,对某汽车制造公司总装车间498名男性装配工人进行问卷调查。采用Logistic回归分析WMSDs发生的不良工效学因素。结果总人群中WMSDs的年发生率为84%,其中肩部(50.6%)最为严重,其次为颈部(49.7%)、下背部(43.4%)、手腕和小腿(均为38.4%)。Logistic回归分析显示,影响颈部的不良工效学因素有颈前曲45°和单手捏紧4.5 kg以上伴腕部不良姿势;影响肩部的因素有跪姿作业、每天搬举的物体超过34 kg和背前曲30°;影响下背部的因素有跪姿作业、搬举的物体超过4.5kg,且每分钟超过2次和背前曲45°;影响腕部的因素有单手捏紧4.5 kg以上伴腕部不良姿势。结论汽车装配工人WMSDs高发,可能与其接触的不良工效学因素有关。     

兰州市医护人员工作相关肌肉骨骼疾患及其影响因素分析

采用整群随机抽样方法，对兰州市18家公立医院2 989名医护人员进行职业紧张因素及其工作相关肌肉骨骼疾患(WMSDs)发生情况调查，采用χ²检验、Mantel-Haenszel趋势检验、Pearson相关及Logistic回归进行统计分析。结果显示，医护人员WMSDs发生率为37.04%,患有≥2种WMSDs疾病的569人(19.04%),发生率最高的是颈椎病(22.68%),其次是腰肌劳损(13.35%)和颈肩肌肉酸痛(12.71%)。WMSDs患病情况与年龄、文化程度、工龄、职称、岗位、月收入、每周工作时间、过度承诺及付出-回报失衡情况成正相关；与户籍和所在科室成负相关。工龄<15年、每周工作时间>40 h、付出-回报失衡及高水平过度承诺状态是发生WMSDs的危险因素(P<0.01)。     

工作相关肌肉骨骼疾患与人体工效学负荷研究进展

工作相关肌肉骨骼疾患(WMSDs)是常见的慢性非传染性疾病。WMSDs已成为影响工人健康、降低工人生命质量和造成经济损失的重要因素,可见于多个行业、工种。本文对WMSDs流行现状及人体工效学负荷相关研究进行综述,以期找到职业人群保护的可行方法。     

木制家具作业人员工作相关肌肉骨骼疾患及其影响因素

目的 了解工作相关肌肉骨骼疾患(WMSDs)在重庆地区木制家具作业人员中的分布特征和影响因素。方法 2021-2023年在重庆市长寿区高新区内抽取8家共579名木制家具作业人员,运用《中文版肌肉骨骼疾患问卷》和《快速暴露检查表(QEC)》进行问卷调查。分别采用χ²检验和多因素logistic回归分析比较不同属性木制家具作业人员WMSDs发生情况和影响因素。结果 WMSDs发生率为42.6%;不同部位的发生率为2.8%～14.6%,其中身体各部位的发生率自高到低依次为：肩部和下背部(各占14.6%)、手部(占11.0%)、颈部(占8.9%)、踝部(占6.8%),肩部和手部WMSDs发生率不同工种比较,差异有统计学意义(P<0.05)。经χ²检验有17个因素与WMSDs的发生有关。多因素logistic回归分析发现总工龄>10年(OR=1.54)、身体健康状况相对差(OR=1.753)、每周工作天数>5 d(OR=2.971)、经常/频繁搬运重物(每次>5 kg)(OR=1.821)为木制家具作业人员WMSDs的危险因素;...     

某造船厂工人多部位工作相关肌肉骨骼疾患现况及其影响因素分析

目的 分析某造船厂工人多部位工作相关肌肉骨骼疾患（WMSDs）患病情况及其影响因素。方法 采用横断面调查设计，以整群抽样法选择某造船厂496名工人作为研究对象；采用电子版《北欧肌肉骨骼疾患调查问卷（修改版）》（NMQ）调查其WMSDs发生情况，采用多因素Logistic回归分析多部位WMSDs影响因素。结果 496名研究对象WMSDs总发生率为59.3%，其中多部位WMSDs发生率为37.3%，单一部位WMSDs发生率为22.0%。多因素Logistic回归分析结果显示，30～<50岁组罹患多部位WMSDs风险高于<30岁组（P<0.05）。经常以不舒服姿势工作、每天重复同样工作、手腕经常向上/下弯曲、长时间保持屈膝姿势或下肢及足踝反复做同一动作的工人罹患多部位WMSDs风险较高（P<0.05）；休息时间充足者WMSDs风险降低（P<0.05）。结论 造船厂工人多部位WMSDs较单一部位更为常见，且发病率较高，多部位WMSDs与不良工效学因素密切相关，应加强工效学干预，降低WMSDs患病风险。     

工作相关肌肉骨骼疾患研究现状及进展

<正>工作相关肌肉骨骼疾患(work-related musculoskeletal disorders,WMSDs)是一类由接触工作场所中的危险因素(如重复操作、不良姿势、负荷、振动等)所引起的肌肉、骨骼、神经及局部血液循环系统的损伤~([1])。国际劳工组织(ILO)早在1960年就已将WMSDs列为职业病~([2])。WMSDs患病率高,涉及行业和人群广泛,不仅影响劳动者的工作效率和健康,也给国家造成了巨大的经济损失,因而关于WMSDs易发职业     

煤矿工人肌肉骨骼损伤与社会心理因素关系的研究

目的 探讨社会心理因素与肌肉骨骼损伤的关系,为制定预防肌肉骨骼损伤的措施和策略提供科学依据.方法 对某煤矿集团一矿区的500名工人进行肌肉骨骼损伤的现况调查,应用北欧肌肉骨骼损伤标准问卷调查评估煤矿工人肌肉骨骼损伤;采用Logistic回归分析法分析社会心理因素对肌肉骨骼损伤的影响.结果 在过去的1年中,有227名煤矿工人自诉患有肌肉骨骼损伤,占总人数的60.9％,下背痛最为严重.高工工作要求(OR=1.3,95％CI:1.3～3.5)、低工作控制(OR=1.6,95％CI:1.0～2.4)、低人际关系( OR=1.9,95％CI:1.2～3.0)和低工作满意度(OR=1.6,95％CI:1.0～2.4)是肌肉骨骼损伤发生的危险因素.结论 社会心理因素对肌肉骨骼损伤的发生有影响,提示在制定预防肌肉骨骼损伤措施时需考虑社会心理因素.     

建筑工人下背部工作相关肌肉骨骼疾患影响因素分析

目的  分析建筑工人下背部工作相关肌肉骨骼疾患(work-related musculoskeletal disorders, WMSDs)的患病现状和影响因素。方法  选择北京市、辽宁省、山东省和广东省等地共8家建筑公司的453名建筑工人为研究对象,采用《肌肉骨骼疾患调查问卷》收集研究对象各部位WMSDs的患病情况,应用多因素logistic回归分析模型分析建筑工人下背部WMSDs的影响因素。结果  研究对象WMSDs总患病率为43.7%,其中患病率从高到低排序为下背部24.1%、肩部18.3%、颈部14.6%、上背部12.4%、手腕部12.1%、足踝部6.0%、腿部5.5%、膝部5.1%及肘部5.1%。研究对象的多部位WMSDs患病率为28.9%。多因素logistic回归分析模型分析结果显示,以初中及以下组为参考组,高中及中专文化程度是建筑工人罹患WMSDs的保护因素(OR=0.390, 95% CI: 0.179~0.849, P=0.018);长时间蹲或跪姿(OR=1.818, 95% CI: 1.053~3.138, P=0.032)、搬运重物(每次>20 kg)(OR=2.876, 95% CI: 1.629~5.077, P＜0.001)、以不舒服姿势工作(OR=2.619, 95% CI: 1.455~4.714, P=0.001)、下背部长时间保持同一姿势(OR=2.913, 95% CI: 1.640~5.177, P＜0.001)和长时间屈膝(OR=2.958, 95% CI: 1.659~5.274, P＜0.001)是研究对象罹患WMSDs的独立危险因素。结论  建筑工人WMSDs患病风险较高,其中最常见的是下背部WMSDs。其影响因素主要包括个体特征、劳动类型和不良工效学因素。     

Work-organisational and personal factors associated with upper body musculoskeletal disorders among sewing machine operators

Objective

To assess the contribution of work-organisational and personal factors to the prevalence of work-related musculoskeletal disorders (WMSDs) among garment workers in Los Angeles.

Methods

This is a cross-sectional study of self-reported musculoskeletal symptoms among 520 sewing machine operators from 13 garment industry sewing shops. Detailed information on work-organisational factors, personal factors, and musculoskeletal symptoms were obtained in face-to-face interviews. The outcome of interest, upper body WMSD, was defined as a worker experiencing moderate or severe musculoskeletal pain. Unconditional logistic regression models were adopted to assess the association between both work-organisational factors and personal factors and the prevalence of musculoskeletal pain.

Results

The prevalence of moderate or severe musculoskeletal pain in the neck/shoulder region was 24% and for distal upper extremity it was 16%. Elevated prevalence of upper body pain was associated with age less than 30 years, female gender, Hispanic ethnicity, being single, having a diagnosis of a MSD or a systemic illness, working more than 10 years as a sewing machine operator, using a single sewing machine, work in large shops, higher work–rest ratios, high physical exertion, high physical isometric loads, high job demand, and low job satisfaction.

Conclusion

Work-organisational and personal factors were associated with increased prevalence of moderate or severe upper body musculoskeletal pain among garment workers. Owners of sewing companies may be able to reduce or prevent WMSDs among employees by adopting rotations between different types of workstations thus increasing task variety; by either shortening work periods or increasing rest periods to reduce the work–rest ratio; and by improving the work-organisation to control psychosocial stressors. The findings may guide prevention efforts in the garment sector and have important public health implications for this workforce of largely immigrant labourers.     

汽车制造业工人肌肉骨骼疾患工效学因素分析

目的 研究汽车制造行业工人患肌肉骨骼疾患(MSDs)的工效学危险因素.方法 采取分层整群抽样的方式,从广东省3家汽车生产企业随机抽取冲压、焊装、涂装及总装工人共1065名,对其进行问卷调查,内容包括个人一般情况、工效学危险作业活动及肌肉骨骼疾患症状.结果 颈部(38.87%)与背部(31.83%)的大角度弯曲及高度重复性伴手部大角度高度用力活动(39.34%)是汽车企业作业过程最为突出的工效学危险姿势或动作,各工种的暴露与患病情况各有不同;在MSDs的多因素Logistic分析中,各部位的危险姿势或动作与相应部位的肌肉骨骼疾患有关,此外,颈部的不适症状还与工龄(OR=1.238)相关,膝盖的不适症状与体重(OR=1.644)相关.结论 汽车制造企业工人的职业性肌肉骨骼疾患与其作业中相应部位典型工效学危险活动或姿势有关,应采取措施改善和控制作业过程中的高危因素,预防肌肉骨骼疾患的发生.     

A strategy for evaluating occupational risk factors of musculoskeletal disorders

There is a large and increasing incidence of work-related muscoloskeletal disorders, both upper extremity cumulative trauma disorders and low back pain. Several occupational risk factors have been linked with the development of musculoskeletal disorders. In order to identify the known occupational risk factors associated with a specific job, an analysis procedure is described to help identify ergonomic risk factors in the workplace. Job analysis should be one part of an overall ergonomics control program. Once the ergonomic risk factors have been documented, the ergonomics committee can use that information to begin developing solutions that will decrease or eliminate the identified risk factors. When placing a worker who is returning to the workforce after recovering from an injury, health care professionals can also use the information from the job analysis to assist in matching up task demands with worker capabilities and limitations.     

红河州居民高血压患病率及其影响因素分析

目的 分析红河州居民高血压流行情况及其影响因素,为红河州制定高血压防控相关政策提供科学依据。 方法 采用多阶段分层随机整群抽样的方法,对红河州4 704名18岁及以上常住居民进行问卷调查、体格测量和实验室检测,并采用多因素logistic回归方法探讨高血压的影响因素。 结果 红河州居民高血压患病率为20.5%,男性20.9%,女性20.2%,城市24.9%,农村19.0%,高血压患病率随年龄增长而增加。农民(OR=1.5)、小学以下文化(OR=1.3)、不健康饮酒(OR=1.4)、居住城市(OR=1.5)、年龄≥35岁(OR=5.3)、超重肥胖(OR=2.1)、血脂异常(OR=1.7)、糖尿病(OR=1.8)是高血压的危险因素。体重知晓(OR=0.7)、已婚或同居(OR=0.7)与高血压呈负相关。 结论 红河州居民高血压患病率处于较高水平,不同特征人群存在差异,亟待加强红河州高血压防控工作     

肩部肌肉骨骼疾患及危险因素

肌肉骨骼疾患(MSDs)是一类常见的工作有关疾病,发病率较高,严重影响劳动者的身心健康和工作质量。引起MSDs的危险因素众多、复杂,查阅近年来国内外文献,本文针对肩部MSDs的危险因素进行综述,探讨职业因素、社会心理因素和个体因素在MSDs的发生发展中的作用。以期从加强个人体育锻炼、定期体检、改善工作环境、合理安排劳动组织等方面加以预防。     

Individual and work-related risk factors for musculoskeletal pain among computer workers in Nigeria

We investigated the prevalence of musculoskeletal pain (MSP) and the association of 1-month prevalence with individual and work-related factors among commercial typists in Enugu. Participants responded to a questionnaire about occurrences of MSP and a 75.6% (242/320) response rate was achieved. Prevalence was summarized in frequencies and percentages while associations between MSPs and risk factors were explored using chi-square. MSP was most common in the low back (58.3%), and low back pain limited 51.7% from activities between 1 and 30 days. Advancing age was significantly associated with MSP in the low back (x² = 19.885; p = .001), neck (x² = 28.309; p < .001), shoulder (x² = 13.122; p = .011), but not wrist/hand (p = .075). Working 1–5 years in this job was associated with increasing prevalence of MSP in all body regions studied. Lesser job control was associated with increased prevalence of wrist/hand pain. Prevalence of MSDs among computer operators in Enugu, Nigeria, is high and highlights the importance of workplace intervention.     

Ergonomic methods for assessing exposure to risk factors for work-related musculoskeletal disorders

BACKGROUND: This review provides an overview of the range of methods that have been developed for the assessment of exposure to risk factors for work-related musculoskeletal disorders. METHODS: Relevant publications and material on exposure assessment techniques have been gathered for inclusion in this review. RESULTS: The methods have been categorized under three main headings: (1) self-reports from workers can be used to collect data on workplace exposure to both physical and psychosocial factors by using methods that include worker diaries, interviews and questionnaires; (2) observational methods that may be further subdivided between (a) simpler techniques developed for systematically recording workplace exposure that enable an observer to assess and record data on a number of factors using specifically designed pro-forma sheets for establishing priorities for workplace intervention; and (b) advanced techniques developed for the assessment of postural variation for highly dynamic activities that record data either on videotape or are computer analysed using dedicated software; (3) direct measurements using monitoring instruments that rely on sensors attached directly to the subject for the measurement of exposure variables at work. CONCLUSIONS: The choice between the methods available will depend upon the application concerned and the objectives of the study. General, observation-based assessments appear to provide the levels of costs, capacity, versatility, generality and exactness best matched to the needs of occupational safety and health practitioners (or those from related professions) who have limited time and resources at their disposal and need a basis for establishing priorities for intervention.     

新生儿窒息发生率及危险因素分析

目的了解新生儿窒息的发生率及其危险因素。方法对2012年1至12月在义乌市妇幼保健院产科分娩的6592例活产儿病历资料进行回顾性分析。结果6592例新生儿中,发生窒息187例（窒息组）,发生率为2．84％,未发生窒息6405例（无窒息组）。母亲小学以下文化程度、胎龄〈37周、妊娠期糖尿病、胎盘早剥、羊水污染、胎儿宫内窘迫、新生儿出生体重〈2500g均为新生儿窒息的独立危险因素（OR值分别为2．567、3．132、7．359、6．418、1．838、5．814、5．146,均P〈0．05）。结论母亲小学以下文化程度、早产、妊娠期糖尿病、胎盘早剥、羊水污染、胎儿宫内窘迫、新生儿出生体重〈2500g均是新生儿窒息的主要危险因素,临床应重视并针对危险因素加以预防。