制造业工人肌肉骨骼疾患和劳动负荷及工作姿势分析

目的 分析制造业工人肌肉骨骼疾患和劳动负荷及工作姿势在不同企业、性别、文化程度、年龄和工龄组间的分布.方法 采用横断面研究设计和问卷调查方法对12家制造业企业5134名工人进行近1年内肌肉骨骼疾患发生情况调查.结果 调查对象在近12个月内身体腰、颈、肩、腕、踝足、膝、髋臀、肘部肌肉骨骼疾患发生率分别为59.7%、47.9%、38.1%、33.7%、26.9%、25.4%、15.2%、14.9%.不同企业工人身体各部位肌肉骨骼疾患发生率的差异有统计学意义(P＜0.05或P＜0.01).耐火材料厂和化纤厂工人肘、腰、腕、足(踝)等部位肌肉骨骼疾患发生率高于其他企业,而服装厂和金刚石厂工人肌肉骨骼疾患发生率低于其他企业.女性工人颈、肩、腕部肌肉骨骼疾患发生率高于男性,差异有统计学意义(P＜0.01).不同文化程度工人身体各部位肌肉骨骼疾患发生率差异有统计学意义(P＜0.05或P＜0.01).颈、肩、肘、腰、髋臀和膝部肌肉骨骼疾患发生率的年龄和工龄组间差异有统计学意义(P＜0.01),肌肉骨骼疾患发生率随年龄和工龄增长而增加.耐火材料厂和化纤厂工人劳动负荷大者和不良姿势者比例较高,金刚石和服装厂工人较低.结论 制造业工人腰、颈、肩、腕部肌肉骨骼疾患发生率较高,性别、文化程度、年龄和工龄对肌肉骨骼疾患的发生存在影响.

Abstract：

Objective To analyze the distribution of the musculoskeletal disorders, work load and working postures in different factories, gender, education levels, age and working years among manufacturing workers. Methods In a cross-sectional study of 5134 manufacturing workers in 12 factories, the morbidities for musculoskeletal disorders in one year period were measured with questionnaires. Results The morbidities for musculoskeletal disorders in body sites: waist, neck, shoulder, wrist, ankle/feet, knee, hip/buttocks and elbows were 59.7%, 47.9%, 38.1%, 33.7%, 26.9%, 25.4%, 15.2%, and 14.9%, respectively in one year period.There were significant differences of morbidities for musculoskeletal symptoms in body sites of workers among different factories (P＜0.05 or P＜0.01 ). The morbidities of musculoskeletal symptoms in elbows, waist, wrists and ankle/feet of the workers in refractory material and chemical fiber factories were higher than those in other factories, the morbidities for musculoskeletal symptoms of workers in garments and diamond factories were lower than those in other factories. The morbidities for musculoskeletal symptoms in neck, shoulders and wrists of female workers were significantly higher than those of male workers (P＜0.01). There were significant differences of the morbidities for musculoskeletal symptoms in body sites among workers with different educational levels(P＜0.05 or P＜0.01 ). There were significant differences of the morbidities for musculoskeletal symptoms in neck, shoulders, wrists, hip/buttocks and knee among groups with different age or different working years (P＜0.01), and the morbidities for musculoskeletal symptoms increased with age and working years. The proportions of unhealthy working postures and high working load among workers in refractory material and chemical fiber factories were higher;, but those in garments and diamond factories were lower.Conclusion The morbidities for musculoskeletal symptoms in waist, neck, shoulder and wrists of workers in manufacturing workers were higher; the gender, education level, age and working years could influenced the morbidities for musculoskeletal disorders.     

某造船厂工人肌肉骨骼疾患调查

目的 调查某造船厂工人肌肉骨骼疾患的现况,探讨工种、年龄和工龄与职业性肌肉骨骼疾患(OMSD)的关系.方法 选取某造船厂1570人为调查对象,以其中的技术人员作为参比,采用经修改的北欧国家标准调查表进行肌肉骨骼疾患横断面流行病学调查.结果 造船厂工人肌肉骨骼疾患以腰部、颈部和肩部疾患为主,年患病率分别为58.0%、54.6%和44.3%.不同工种工人腰痛患病率由高到低依次为起重工(69.6%)、行车工(65.2%)、管工(63.6%)、装配工(62.7%)和电焊工(61.0%),而钳工最低(40.3%);参比组颈、肩痛患病率较高.女性颈和肩痛年患病率明显高于男性,差异有统计学意义(P＜0.05).随年龄增长,各部位OMSD患病率呈现递增趋势.工龄≤5年工人各部位OMSD年患病率最低,颈、肩、腰OMSD年患病率随工龄增长呈递增的趋势.结论 造船厂工人OMSD患病率较高,工种、工龄、年龄和性别是其危险因素,应积极采取工效学手段进行干预.

Abstract：

Objective To study the prevalence of occupational musculoskeletal disorders (OMSDs)in a shipyard and explore the relationship between type of work, age, length of service and OMSDs by cross sectional epidemiological survey. Methods 1570 workers from a shipyard were selected as survey objects,and a revised Northern Europe Standardized Questionnaire was used to investigate OMSDs. 253 technicians and clerks in the shipyard were selected as controls. Results OMSDs in these workers primarily located in waist, neck and shoulder, prevalence were 58.0%, 54.6% and 44.3% respectively; There were significant differences among workers of different types of work (P＜0.05) in prevalence and the cumulative parts number of OMSDs. The control group in this study also showed a higher prevalence of neck, shoulder and waist OMSDs. Female workers had higher prevalence of OMSDs in neck and shoulder compared with male workers (P＜0.05). As well there was significant correlation between age and OMSDs prevalence except the wrist and ankle disorders (P＜0.05), OMSDs prevalence increased with years. In addition, there was correlation between length of service and OMSDs prevalence, the group of ≤5 years had the lowest prevalence and the prevalence of low-back, neck and shoulder increased with service years. Conclusion The OMSDs in workers engaged in shipyard are serious, the length of service, age, gender and type of work seem to be the risk factors, and it seems reasonable that the ergonomics intervention in the above aspects should be necessary for the prevention of OMSDs.     

心理因素及物理负荷对职业性肌肉骨骼疾患的影响分析

目的 探讨心理因素与物理负荷的交互作用及其对职业性肌肉骨骼疾患(WMSDs)的影响.方法 选取653名来源于电子行业流水线作业、缝纫行业、制造行业的工人及行政管理人员作为调查对象.采用改良的北欧国家肌肉骨骼疾患标准调查表调查肌肉骨骼疾患情况,心理社会状况调查采用工作内容量表(JCQ),进行流行病学横断面调查,并应用快速暴露检查法(QEC)问卷对其进行工效学的物理负荷评价.结果 不同暴露等级下,肩部、上背、下背、手/腕的肌肉骨骼疾患的年患病率的差异有统计学意义(P＜0.05或P＜0.01),同时暴露在高的物理和心理负荷时,工作人员各部位的年患病率明显高于暴露在其他等级时的肌肉骨骼疾患的患病率.调整工龄、年龄、性别后,用logistics回归分析结果表明,在肩部、上背、下背和手/腕部的WMSDs影响中可能存在物理负荷和心理负荷的交互作用(P＜0.05).结论 高物理负荷下,不良心理因素对工人WMSDs的发生造成的影响远大于工人处于低物理负荷工作时,实施工效学干预不仅要从过度负荷,不良姿势,静态负荷等物理因素方面进行干预来降低WMSD的发生,也要关注心理因素方面的干预.

Abstract：

Objective To investigate the interactive effect of job task and psychosocial factors on the outcomes of musculoskeletal disorders. Methods 653 workers from different type of manufacturing industries and administration office recruited in a cross-sectional epidemiological survey. The Quick Exposure Check (QEC) was applied to assess the ergonomic load of job task, Job Content Questionnaire (JCQ) for identifying psychological characteristics, and Nordic Standardized Questionnaire for investigating outcomes of WMSDs.Results The prevalence of WMSD in shoulder, upper back, lower back and hand/wrist were significantly different under a variety of combined job task and psychosocial characteristics (P＜0.05 or P＜0.01 ). The more physical and psychological loads, the higher prevalence of WMSDs were revealed. By using multivariate analyses, a potential interactive effect was found in terms of the WMSDs symptoms in hand/wrist shoulder,upper back and lower back after adjusted by work year, age, and gender. Conclusions Higher physical load and greater psychosocial risk are more frequent self-reported symptoms of WMSDs than those of lower exposures. Ergonomic intervention strategies aimed at reducing the incidence of WMSDs should not only be focused on control of physical work factors but also psychosocial risks of relevance.     

肌肉骨骼疾患危险因素的现场评价

目的 探讨职业接触快速检查表(Quick Exposure Check,QEC)在肌肉骨骼疾患危险因素现场研究中的可使用性.方法 在某造船厂和汽车制造厂,应用QEC观察不同工种工人的操作,评价其劳动负荷.根据调查结果 评价QEC的可信度,并分析劳动负荷QEC分值与工人肌肉骨骼疾患患病率间的关系.结果 观察者之间可信度组内相关系数(ICC)为0.737～1.000,不同观察者之间可信度Spearman系数为0.605～1.000.不同工种危险因素接触水平(QEC总分)在造船厂是管工＞装配工＞电焊工;在汽车厂为电焊工＞冲压工＞机加工＞铸造工＞装配工.身体某部位QEC分值与其年患病率相关分析表明,肩、手腕、背(静态活动)接触水平与其患病率有密切关系(r2值分别为0.670、0.740、0.958,P＜0.05).结论 QEC在造船和汽车制造厂可用于接触肌肉骨骼疾患危险因素的现场评价,方法 具有可信度,且接触水平与患病率密切相关.

Abstract：

Objective To investigate the usability of quick exposure check (Quick Exposure Check,QEC) for the field assessment of occupational musculoskeletal disorder risk factors. Method In the shipyard and automobile manufacturing plants, QEC was used to observe the operations among workers with different jobs and to assess the work loads of workers. On the basis of results, the reliability of QEC was evaluated, and the correlation between QEC scores and morbidities of musculoskeletal disorders in workers was analyzed. Results The inter-observer reliability (ICC) was in the range from 0.737 to 1.000, and intraobserver reliability (Spearman coefficient ) was from 0.605 to 1.000. The order of exposure levels to risk factors of workers engaged in different jobs (QEC scores) in the shipyard factory was plumbers ＞ assemblers ＞ welders; The order of exposure levels to risk factors of workers engaged in different jobs (QEC scores ) in the automobile factory was welders ＞ punching workers ＞ machinists ＞ casters＞ assemblers. In different body parts, the exposure level at back and neck parts was the highest and the exposure level at the shoulder and wrist parts was the second. The regression analysis between QEC scores of body parts and the morbidities of musculoskeletal disorders showed that there was a good correlation between exposure levels and morbidities,the coefficients (r2) at the shoulder, wrist, and back (static work) were 0.670, 0.740 and 0.958, respectively (P＜0.05). Conclusion The QEC method is suitable and reliable as demonstrated by the field assessment on the exposure to risk factors in shipyard and automobile workers, and its results is correlated closely to the disease prevalence.     

某煤矿工人肌肉骨骼损伤情况及其危险因素

目的 了解我国煤矿工人肌肉骨骼损伤的流行病学特征,探讨职业和个体相关影响因素,为制定针对性预防措施和策略提供科学依据.方法 对某煤炭集团一矿区的1900名工人进行肌肉骨骼损伤的横断面调查,应用北欧肌肉骨骼损伤标准问卷调查评估肌肉骨骼损伤情况;采用logistic 回归分析法了解职业因素与肌肉骨骼损伤的相关性.结果 在过去的1年中,1205名煤矿工人自诉患有肌肉骨骼损伤,患病率为78.4%.尤其是腰痛最为常见,患病率高达59.5%.身体各部位肌肉骨骼损伤患病率随年龄的增长而升高,差异有统计学意义(P＜0.05).井下工人肌肉骨骼损伤患病率明显高于井上工人,其中肩、腰、膝部患病率的差异有统计学意义(P＜0.05).经logistic回归分析,重复性操作和不舒适的姿势是颈、肩部和上肢肌肉骨骼损伤的危险因素;重复性操作、搬举重物和大幅度弯腰皆与腰背痛有很强相关性.下肢疼痛与长期的站立和不舒适姿势有关.结论 煤矿工人的职业因素与肌肉骨骼损伤具有很强的相关性.

Abstract：

Objective To explore the prevalence characteristics and influence factors related to occupation and individuals for musculoskeletal disorders of workers in Chinese mines. Methods In a crosssectional study of 1900 coal miners from a coal mine, the Standardized Nordic Questionnaire was used to assess the musculoskeletal disorders, and logistic regression analysis was performed to analyze the correlation between the occupational factor and he musculoskeletal disorders. Results During the past year, 1205 miners of 1537 miners (78.4%) complained of the musculoskeletal disorders. The morbidity of lumbago was 59.5%. The morbidity of the musculoskeletal disorders in different body sites of the miners increased significantly with age (P＜0.05). The morbidity of the musculoskeletal disorders in the underground workers was significantly higher than that in the ground workers. According to logistic regression analysis, the repetitive operation and awkward posture were the risk factors for the musculoskeletal disorders in neck,shoulder and upper limbs; the repetitive operation, moving heavy substance and stooping posture were related significantly to lumbago; the musculoskeletal disorders in lower limbs were associated with the long standing and awkward posture. Conclusion There is significant correlation between the occupational factors and the musculoskeletal disorders for coal miners.     

某汽车公司铸造厂工人腰背痛的危险因素分析

目的 通过横断面流行病学记查,寻找汽车铸造厂作业工人腰背痛的主要危险因素,为此类疾患的预防提供科学依据.方法 在某汽车公司铸造厂对1340名工人进行腰背痛和劳动负荷问卷调查,利用logistic回归进行危险因素分析.结果 铸造厂工人的腰背痛年患病率为58.9%,其中铸造、物流和造型工种工人腰背痛年患病率较高,分别为64.6%、64.6%和62.5%.以不适体位搬举、大幅度弯腰、弯腰与转身并存及搬运重物这些负荷因素导致患腰背痛危险性最高,其OR值分别为2.085、1.961、1.967和1.956.各个危险因素在不同工种中的分布不同.多元logistic同归分析表明,搬运重物、不适体位搬举、大幅度弯腰、弯腰与转身并存及工龄和性别均被选人模型.结论 手工搬运重物、不良劳动姿势或二者同时存在是导致腰背痛的首要危险因素,应从这方面入手,加强工效学干预研究,减少此类疾患.

Abstract：

Objective To study the main risk factors of low back pain of workers in a foundry factory of the automobile company using cross sectional epidemiological investigation, and to provide scientific base for preventing the disorder. Methods The low back pain and work loads of 1340 workers in a foundry factory of the automobile company were investigated using questionnaire, and logistic regression analysis was used to analyze the risk factors. Results The one-year morbidity of low back pain in workers was 58.9%the morbidities of low back pain in workers engaged in foundry, transportation and modeling were 64.6 %, 64.6 % and 62.5 %, respectively. The lifting with squat postures, bending trunk heavily, bending trunk with twisting and moving the heave objects were found to be the most dominant risk factors for low-back pain, the OR values were 2.085, 1.961, 1.967 and 1.956, respectively. The distributions of risk factors were different among the different jobs. The logistic regression analysis showed that moving the heave objects, lifting with squat postures, bending trunk heavily, bending trunk with twisting existed simultaneously, also the work years and gender were the risk factors. Conclusion The manual moving heave objects, awkward working posture or both were the most important risk factors for low-back pain. The intervene ergonomic study should be performed in future to reduce the morbidity of low-back pain.     

乙苯对职业人群神经行为的影响

目的 评价乙苯对职业人群神经行为的影响.方法 选择某石化公司苯乙烯合成原料车间246名乙苯上料工为接触组,相应的公司办公人员122名作为对照组,通过问卷调查,收集乙苯职业接触的基本信息.通过WHO神经行为核心测试组合(NCTB)法,测试对象的个体神经行为功能.结果 接触组和对照组的4项消极情绪状态(紧张、抑郁、愤怒、困惑)得分之间差异无统计学意义(P＞0.05),接触组的积极情绪状态(有力)得分(16.29±8.61)明显低于对照组(18.46±9.52),疲劳得分(9.23±1.27)明显高于对照组(7.16±1.15),(P＜0.05).接触组的平均反应时、数字广度得分明显高于对照组,手提转敏捷度、视觉记忆、目标追踪-Ⅱ正确打点数得分明显低于对照组,差异有统计学意义(P＜0.05).按不同的工龄分段,接触组各工龄段间视觉记忆、目标追踪-Ⅱ正确打点数得分的差异无统计学意义(P＞0.05),3～、4～和5～年工龄段的5项消极情绪状态(紧张、抑郁、愤怒、疲劳、困惑)得分及平均反应时得分均明显高于0～和2～年工龄段.3～、4～年工龄段的数字广度和3～、4～和5～年工龄段的手提转敏捷度、数字译码得分皆明显低于0～和2～年工龄段,差异均有统计学意义(P＜0.05).结论 乙苯可降低接触工人神经行为功能,工人神经行为功能在工龄为3年时发生了明显变化,工龄3年左右工人为乙苯神经行为损害的易感人群.

Abstract：

Objective To evaluate the influence of ethylbenzene on the neurobehavior of occupationally exposed workers. Methods The exposure group consisted of 246 workers occupationally exposed to ethylbenzene and 172 staffs from the offices served as controls. The basic information on ethylbenzene exposure was collected by the questionnaire. The nervous behavior and function of workers were evaluated by Neurobehavioral Core Test Battery (NCTB). Results There were no differences of the scores for four emotional states (tension, depression, angry and bewilderment) between exposure group and control group (P＞0.05). The score of emotion (vigor) in exposure group was significantly lower than that in control group (P＜0.05), but the fatigue score in exposure group was significantly higher than that in control group (P＜0.05).The score of mean reaction time in exposure group was significantly higher than that in control group (P＜0.05), the scores of digital span, manual dexterity, visual retention and target tracking in exposure group were significantly lower than those in control group (P＜0.05). The exposure group was divided into 5 sub-groups,according to working duration. There were no differences for the scores of visual retention and target tracking among 5 sub-groups (P＞0.05). The scores of five emotional states (tension, depression, angry, fatigue and bewilderment) in 3 sub-groups exposed to ethylbenzene for 3～, 4～ and 5～ years were significantly higher than those in 2 sub-groups exposed to ethylbenzene for 0～ and 2 ～ years (P＜0.05). The scores of digital span in 2 sub-groups exposed to ethylbenzene for 3～ or 4～ years and the scores of manual dexterity and digital symbol in 3 sub-groups exposed to ethylbenzene for 3 ～, 4～ and 5～ years were significantly lower than those in 2 subgroups exposed to ethylbenzene for 0～ and 2 ～ years (P＜0.05). Conclusion Ethylbenzene can depress the neurobehavioral functions of exposed workers. The neurobehavioral functions of workers exposed to ethylbenzene for 3 years changed significantly. The workers exposed to ethylbenzene for 3 years may be the susceptible population of neurobehavioral function impairment.     

机械制造和陶瓷及钢铁行业接尘工人防护行为调查

目的 了解接尘工人的防护行为,为接尘工人的健康教育提供参考依据.方法 采用现场询问,调查员填写问卷的方法对唐山市机械制造、陶瓷、钢铁行业有代表性的3家企业的746名接尘工人进行调查.将所有数据录入计算机,整理数据后,用Excel建立数据库,应用SPSS11.5统计分析软件分析学历、工龄、培训与否等因素对防护行为的影响.结果 唐山市接尘工人定期体检率和要求发放防护用品率分别为94.4%和75.3%,选择有效方式防护率较低(15.4%).不同学历接尘工人定期体检率比较,差异有统计学意义(P＜0.01).参加过粉尘防护知识培训的接尘工人选择有效方式防护率(20.3%),定期体检率(98.3%),要求发放防护用品率(86.4%)均高于未参加过培训的接尘工人(13.9%、93.1%、71.9%),差异有统计学意义(P＜0.05,P＜0.01).不同企业接尘工人的有效防护率、定期体检率及要求发放防护用品率比较,差异有统计学意义(P＜0.05).结论 唐山市机械制造、冶金和陶瓷行业接尘工人选择有效方式防护率普遍较低.未参加过培训的接尘工作人员选择有效方式防护率、定期体检率和要求上级发放防护用品率较低.

Abstract：

Objective The purposes of this thesis were to study the behavior about workers exposed to dust and provide scientific basis for health promotion. Methods We designed a questionnaire and carry it on the 746 dust workers in the 3 representative corporations of Machinery,Ceramic,and Metallurgy Industry.All data were input into computer. And a database was established with Excel. SPSS11.5 statistical analysis software was used to analyze the influence on protecting behavioral between the application of qualifications,different jobs, training or protection, and other aspects etc. Results The rates were 94.4% and 75.3% about the regular physical examination and requirements for protective equipment. The rate of choosing an effective way of protection was generally low (15.4%). There was significant difference for among different educational background workers (P＜0.01). The rates of choosing an effective way of protection (20.3%), the regular physical examination (98.3%) and requirements for protective equipment (86.4%) in the dust workers who participated in the training of dust protection were superior than those who did not participated in the training. There was the significant difference (P＜0.05 ,P＜0.01 ). There was the significant difference for the rate of effective way of protection, regular physical examination, and requirements for protective equipment among the different corporations (P＜0.05). Conclusions Dust workers' using rate about the choosing an effective way of protection was generally Iow in Machinery,Ceramic,and Metallurgy Industry. Those who were not educated had a lower using rate about the protection behavior, regular physical examination, and requirements for protective equipment than those educated.     

孕期暴露苯并[a]芘对子代大鼠神经发育毒性的影响

Objective To study the effects of prenatal exposure to benzo[a]pyrene (B[a]P) on the physical development, early behavioral development, the adaptability to new environment and the learning and memory ability of rat offspring. Methods Pregnant rats were randomly divided into five groups: control group,olive oil group, 3 exposure groups (25, 50 and 100 mg/kg B [a]P). The rats were exposed to B [a]P) by intraperitoneal injection on the 17th-19th days during gestation. The offspring were weighed on postnatal days (PND)1, PND 4, PND 7 and PND 28, the indices of physical development, reflective ability and sensory function were detected for offspring, the Morris water maze and Open-field tests were used to measure the ability of learning and memory and the adaptability to new environment of offspring. Results The time of ear opening in middle and high-dose groups[(4. 1 ±0.4),(5.0±0.4) d] was posterior to that in untreated and solvent groups[(3.3±0.5),(3.4±0.6) d](P＜0.01).The attainment rate (6.5%) of the surface righting reflex test in highdose group on the 4th day was significantly lower than that (36.1%) in untreated group, the attainment rate(50.0%) in high-dose group on PND7 was significantly lower than those (81.3% and 79.3%) in untreated group and solvent group (P＜0.05). Compared to the untreated group, the time of forelimb hanging test in all exposure groups on PND12 and PND14 significantly decreased; compared to the solvent group the time of forelimb hanging test decreased in high-dose group on the 14th day significantly decreased (P＜0.01). The attainment rate (61.9%) of olfactory discrimination in high-dose group on PND 12 was significantly lower than that (94.3%) in untreated group (P＜0.05). The results of morris water maze test showed that the escape latency of different dose groups significantly increased, and the time of spatial probe and the times of traversing flat in high-dose group decreased significantly, as compared to the untreated and solvent groups(P＜0.01). The results of open-field test indicated that the center retention time in middle and high-dose groups significantly prolonged, the times of crossing lattice obviously reduced, and the rearing times decreased in high-dose group,as compared to untreated(P＜0.05).Compared to the solvent group, the times of crossing lattice in all exposure groups reduced significantly(P＜0.01 or P＜0.05). Conclusion The prenatal exposure to B[a]P could inhibit the physical development and early behavioral development, and influence the adaptability to new environment and learning and memory ability for offspring.     

慢性阻塞性肺疾病急性加重期合并深静脉血栓形成危险因素及抗凝因子检测

Objective To investigate the risk factors and anticoagulation parameters in patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with deep venous thrombosis (DVT). Methods All of 110 AECOPD patients were divided into two groups according to Doppler examination of lower extremities: DVT group and non-DVT group. The risk factors and anticoagulation parameters were compared. Results Twelve cases (10.9%) were in DVT group,of whom 2 cases (1.8%)had pulmonary embolism. The rate of lying in bed > 3 d, smoke, mechanical ventilation, hospital stays and the levels of PaCO2 were significantly higher in DVT group than those in non-DVT group (P < 0.01 or <0.05 ). In DVT group, the activity of antithrombin Ⅲ and the level of protein S decreased (P < 0.05 ), and the level of D-Dimer increased (P < 0.05). Conclusions Long-term bed, smoke and mechanical ventilation requirement are the main risk factors of DVT in patients with AECOPD. Respiratory failure (type Ⅱ ) is easier to combine with DVT. Abnormality of coagulation and fibrinolytic system exists in AECOPD with DVT.     

某汽车零部件生产企业工人工作相关肌肉骨骼损伤影响因素分析

目的 分析某汽车零部件生产企业工人工作相关肌肉骨骼损伤(work-related musculoskeletal disorders,WMSDs)的患病情况及其影响因素.方法 选择某汽车零部件生产企业831名作业人员为研究对象,采用《北欧肌肉骨骼疾患问卷(改良版)》调查其WMSDs患病情况,采用logistic回归分析...     

广州市某啤酒制造厂工人颈肩背多部位肌肉骨骼疾患危险因素研究

目的 调查啤酒制造厂工人多部位工作相关肌肉骨骼疾患（work-related musculoskeletal disorders,WMSDs）的现状,并分析其影响因素。方法 采用横断面调查方法,于2021年9月以广州市某啤酒制造厂的501名员工为研究对象,使用中文版《肌肉骨骼疾患调查问卷》调查WMSDs患病现状,应用多因素logistic回归方法分析颈、肩、背多部位WMSDs的危险因素。结果 啤酒制造厂员工WMSDs总患病率达39.7%,其中各部位患病率较高的是颈部27.1%、肩部25.0%、下背部24.0%和上背部23.2%。工人单一部位WMSDs患病率为10.8%,多部位WMSDs患病率为28.9%,2个部位同时患病的比例是3.8%,3个部位同时患病的比例是4.4%,4个部位同时患病的比例是16.4%,5个及以上部位同时患病的比例为4.6%,其中颈、肩、上背、下背4个部位同时患病的比例为17.8%(89/501),上肢部位（肘部、手腕部）同时患病的比例为3.2%(16/501),下肢部位（腿部、膝部、踝部）同时患病的比例为2.2%(11/501)。多因素logistic回归分析结果...     

建筑工人工作相关骨骼肌肉疾患现状及影响因素研究

  目的  调查建筑行业工人工作相关骨骼肌肉疾患（work-related musculoskeletal disorders,WMSDs）的现状,探讨建筑工人WMSDs的影响因素。
  方法  采用方便抽样方法,选择广东省、辽宁省、山东省、北京市等多个省市8家建筑业公司的471名建筑工人为研究对象,应用电子版的《骨骼肌肉疾患调查问卷》收集WMSDs的患病情况,采用多因素logistic回归方法分析建筑工人WMSDs的影响因素。
  结果  回收有效问卷453份,有效回收率为91.2%。建筑工人WMSDs总患病率为43.7%,其中患病率较高的部位是下背部24.1%（109/453）、肩部18.3%（83/453）、颈部14.6%（66/453）。罹患WMSDs的198名建筑工人中有1 ~ 3个部位患WMSDs的比例为81.3%（161/198）。相比年龄 < 38岁,年龄38 ~ 48岁、≥ 49岁的建筑工人WMSDs患病风险分别是2.213倍和2.573倍（P < 0.05）;分别相比其他工人,搬运重物每次 > 5 kg的建筑工人WMSDs患病风险提高1.711倍,长时间蹲或跪姿的建筑工人WMSDs患病风险提高1.010倍,以不舒服姿势工作的建筑工人罹患WMSDs的风险提高11.247倍,经常加班的建筑工人罹患WMSDs的风险提高1.214倍,腰部长时间保持同一姿势的建筑工人罹患WMSDs的风险提高1.002倍（P < 0.05）;休息时间充足的建筑工人罹患WMSDs的风险仅是休息不足的0.552倍（P < 0.05）;高中及中专文化程度工人罹患WMSDs的风险仅是是初中及以下文化程度工人的0.425倍（P < 0.05）。
  结论  建筑工人WMSDs患病风险高,患病率较高的部位分别是下背部、肩部和颈部。建筑工人WMSDs的影响因素有年龄、学历、搬运重物每次＞5 kg、长时间蹲或跪姿工作、以不舒服姿势工作、休息时间充足、经常加班、腰部长时间保持同一姿势。建筑公司应加强员工培训,宣传正确的工效学知识,识别和减少不良工作姿势,通过增加工间休息频率和时长等措施降低建筑工人罹患WMSDs的风险。
     

中国医疗行业工作相关肌肉骨骼疾患发生模式及其影响因素分析

  目的  调查中国医疗行业工作相关肌肉骨骼疾患(work-related musculoskeletal disorders, WMSDs)发生情况,探究不同岗位不良工效学职业危害因素及WMSDs发生模式。  方法  通过《北欧肌肉骨骼疾患问卷(修改版)》电子问卷系统对中国6 854名医疗行业从业人员进行横断面调查。根据美国国家职业安全卫生研究所(National Institute for Occupational Safety and Health, NIOSH)判定WMSDs方法进行发生结果统计分析。应用潜类别分析(latent class analysis, LCA)对主要工种WMSDs多部位发生模式进行分析,利用logistic回归分析法确定不良工效学因素。  结果  调查样本中,不计部位的总体WMSDs发生率为56.1%。其中,医生为54.15%、护士为58.66%、护工为51.04%、技师为54.05%、药师为48.48%。根据LCA分类结果,医生与护士WMSDs发生模式主要有颈肩型和躯干型;技师主要为颈肩型;药师为颈肩型;护工主要为颈肩型和轻微疼痛型。多因素logistic回归分析结果显示,颈肩型医生发生危险主要来自手腕长期弯曲(OR=1.383, P=0.036),频繁坐位工作(OR=2.110, P=0.020),工作姿势经常不舒服(OR=2.023, P=0.001);躯干型医生发生危险主要有腿部姿势受限(OR=1.413, P=0.044),频繁不舒适工作姿势(OR=4.402, P＜0.001);颈肩型护士发生危险主要来自颈部大幅度前倾(OR=2.218, P=0.024),长时间频繁坐位工作(OR=1.533, P=0.006);躯干型护士发生危险有长时间频繁坐位工作(OR=1.883, P < 0.001),频繁不舒适工作姿势(OR=2.137, P < 0.001)。  结论  中国医疗行业WMSDs发生率同世界主流国家地区相比处于中等水平。但行业总体不良工效学危害水平较高,不良作业姿势普遍存在。其中颈部、肩部、上背部、下背部的工效学负荷水平较高,主要与颈部工作中长时间保持不变、长时间低头、颈部大幅度前倾、手腕长期弯曲、长时间保持转身、腿部空间受限、长时间坐姿、作业姿势不舒服等职业因素有关。应通过加强宣教培训、增加辅助助力设施、改善工作组织模式等方式,降低肌肉骨骼损伤危险。     

社区医务人员职业性肌肉骨骼疾患发生情况及危险因素分析

目的了解社区卫生服务中心医务人员职业性肌肉骨骼疾患(WMSDs)发生及其危险因素。方法采用流行病学横断面调查方法,选择《北欧肌肉骨骼疾患问卷(改良版)》对广州市3家社区卫生服务中心145名医务人员的肌肉骨骼疾患及其影响因素进行调查。结果 WMSDs发生率最高的部位依次是颈部(393%)、肩部(324%)、下背部(200%)和上背部(172%);下背和手部WMSDs发生率医生最高,肘和下肢(腿、膝和踝部) WMSDs发生率以护士最高。颈部WMSDs危险因素是经常加班(OR=307),下背部WMSDs危险因素是背部弯曲(OR=1215)和颈部长时间保持同一姿势(OR=1437)。工作姿势舒适(OR=037)为肩部保护因素。结论社区卫生服务中心医务人员WMSDs不容忽视,不同岗位医务人员WMSDs发生部位略有差异。可通过合理安排加班、保持工作姿势舒适、减少长时间弯腰和避免颈部长时间保持同一姿势等措施预防和控制医务人员WMSDs的发生。     

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...     

大学生电子产品使用习惯现状调查及颈肩痛相关性分析

目的 调查大学生颈肩痛现状以及电子产品的使用情况对颈肩痛患病率的影响。方法 以上海交通大学为中心向全国各地多所大学随机抽取学生发放6000份问卷,内容包括人口统计学信息、颈肩痛患病情况、电子产品的使用时间和使用姿势等。使用logistic回归分析法来分析颈肩痛的可能危险因素。结果 结果显示,中国大学生人群中颈肩痛的患病率为39.1％,女性患病率高于男性。多因素logistic回归分析结果显示,女性（OR=1.722）、每天使用手持电子设备大于4小时（OR=1.219）、每天使用电脑总时长大于3小时（OR=1.305）、使用电脑单次最长时间大于2小时,（OR=1.210）是大学生患颈肩痛的危险因素,P<0.05。采用低头不弯腰的姿势在桌前使用电子设备（A姿势OR=1.302;C姿势OR=1.445;D姿势OR=1.137）、在床上不使用电子设备（仰卧OR=1.575;俯卧OR=1.720,;侧卧OR=1.769;半卧OR=1.385;坐立OR=1.351）是大学生患颈肩痛的保护因素,P<0.05。结论 大学生颈肩痛的患病率较高,同电子产品的使用时间和使用姿势关系密切,应倡导大学生正确科学地使用电子产品。     

上海市闵行区电子行业作业工人肌肉骨骼疾患发生情况及影响因素研究

目的 调查上海市闵行区电子行业作业工人工作有关肌肉骨骼疾患（work-related muscular skeletal disorders,WMSDs）的发生情况,并探讨其影响因素。方法 选取闵行区8家电子行业企业1 426名生产工人作为研究对象,采用横断面调查方法,发放调查问卷,调查工人近1年内肌肉骨骼疾患的发生情况,并采用logistic模型对工人肌肉骨骼疾患的影响因素进行分析。结果 回收有效问卷1 319份,有效率92.5%。工人不同身体部位WMSDs的年发生率在3.6%～23.0%之间,发生率最高的依次为颈部（23.0%）、肩部（20.0%）和下背部（10.4%）。焊锡工手腕部WMSDs的年发生率（10.7%）最高,车间管理员踝/足部WMSDs的年发生率（15.4%）最高（P <0.05）。多因素logistic回归分析结果显示：背部长时间保持同一姿势是颈部、肩部和下背部WMSDs发生的危险因素（OR=1.56、1.45、1.86,P <0.05）;长时间坐位工作（OR=1.60、2.44）、颈部长时间保持同一姿势（OR=2.30、1.79）、背部稍弯曲（OR=1...