Health care use associated with work-related musculoskeletal disorders among hospital workers

Introduction: The purpose of this study was to investigate if work-related musculoskeletal disorders (WMSDs) are associated with increased health care use, over and above workers’ compensation health care benefits, in the period prior to and following a workers’ compensation claim indicating gradual progression and declining function associated with musculoskeletal morbidity. Methods: This study employed secondary analysis of employment data, workers’ compensation claim data and provincial (universal) medical services data for a cohort of health care workers; and investigated rates of medical care contacts among injured workers with a WMSD claim (n=549) compared to a matched group of non-claim workers. Predictors of health care contacts were estimated using general linear regression. Results: WMSD injured workers had significantly higher rates of health care contacts associated with a claim compared to non-injured workers, over and above workers compensation health care benefits. In the final multi-variable model, a WMSD claim among injured workers was associated with an estimated 69% (95% CI, 1.50, 1.91) increase in health care use for the 12-month period immediately after the injury date compared to non injured workers. Conclusion: The pattern of visits for WMSDs suggests that workers visit general practitioners as part of an ongoing pattern of symptoms, resulting in frequent utilization of health services prior to work disability that is also reflected in health care contacts after return-to-work.     

某电子制造企业工人职业性肌肉骨骼疾患现状与不良工效学因素的关联性探讨

  目的  探讨电子制造行业工人职业性肌肉骨骼疾患（work-related musculoskeletal disorders,WMSDs）的现状与不良工效学因素的关联性。
  方法  采用国内扩展版《肌肉骨骼疾患调查表》调查珠三角某市某电子制造企业生产工人的WMSDs患病情况,计算WMSDs的年患病率和各部位的检出率,并以VAS法评估研究对象患病期间最不能耐受的疼痛程度。
  结果  350名生产工人中,有203名工人（占58.0%）在过去12个月内曾发生WMSDs,各部位WMSDs检出率为:颈部75.37%、肩部56.16%、踝部36.94%、上背部35.96%,其他均低于35.00%。过去12个月内患WMSDs的工人VAS分值[M（P₂₅,P₇₅）]为4.0（3.0,6.0）分。二分类logistic回归分析显示:相对于未婚、不是一直坐位工作、工龄≤ 5年、不需要每分钟重复多次操作、工作时颈部直立（≤ 10°）,已婚（OR=2.39）、一直坐位工作（OR=1.83）、工龄 > 5年（OR=1.89）、每分钟重复多次操作（OR=1.87）、工作时颈部弯曲（> 10°）（OR=2.42）是罹患WMSDs的危险因素（P < 0.05）;“需要上肢或手用力” “以不舒服的姿势干活”的程度每增加一个等级,工人罹患WMSDs的危险性分别增加0.71、1.42倍（P < 0.05）。
  结论  珠三角某市电子制造行业WMSDs的患病率较高,但患病的持续时间和引起的疼痛感、不适感较轻。改善电子制造行业生产流程的工效学设计,加强对工人科学作业姿势和标准生产技能的培训,可能有助于预防电子制造行业WMSDs的发生。
     

职业性肌肉骨骼疾患与社会心理因素相关性调查分析

目的调查深圳市职业性肌肉骨骼疾患(WMSD)发病情况及社会心理因素的影响。方法采用横断面调查法,对深圳市机械加工、珠宝加工、钢结构、设备制造企业2 044名员工进行WMSD及相关社会心理因素的问卷调查。对调查对象工作情况进行聚类分析,可能的危险因素进行多因素logistic回归分析。结果调查对象曾患WMSD患病率56.4%,曾因患WMSD请假率7.5%;近1年患WMSD患病率48.1%,近1年因患WMSD请假率5.6%;近1周患WMSD患病率38.0%,近1周因患WMSD请假率3.7%。工作满意感评分与曾患WMSD率、年患WMSD率、周患WMSD率的比值比(OR)值分别为:0.766、0.865、0.779,消极心理情绪评分与曾患WMSD率、年患WMSD率、周患WMSD率的OR值分别为:1.406、1.458、1.455,积极心理情绪评分与曾经因患WMSD请假率的OR值为0.813,工作有危险性评分与周患WMSD率、周因患WMSD请假率的OR值分别为:1.123、1.226,支持与人际关系评分与周因患WMSD请假率的OR值为1.437。本次调查尚未发现工作任务、工作控制自评分与WMSD发生相关的统计学证据。结论调查企业的员工WMSD患病率较高,因患WMSD的工时损失不容忽视。职业相关心理社会因素对WMSD发生有一定影响,可从提高工作满意感,疏导化解悲观、焦虑、抑郁情绪,改善支持与人际关系,营造安全舒适的工作氛围等进行干预。     

某家具制造企业工人职业性肌肉骨骼疾患调查分析

目的 调查某家具制造企业工人肌肉骨骼疾患(work-related musculoskeletal disorders, WMSDs)的患病情况和特征。
方法 选取某家具制造企业437名工人为研究对象, 采用横断面调查方法调查工人肌肉骨骼疾患患病情况。
结果 WMSDs年患病率为32.27%, 以下背(腰)部、颈部和肩部为主, 年患病率分别为11.21%、9.84%和7.78%。男性以下背(腰)部疾患年患病率最高(10.27%), 女性以颈部和下背(腰)部疾患年患病率最高(均为16.42%)。女性颈部和手腕/手疾患年患病率均高于男性, 差异有统计学意义(P < 0.05)。颈部疾患的年患病率在各段工龄之间比较, 差异有统计学意义(P < 0.05), 且患病率有随工龄增加而升高的趋势(P < 0.05)。手工搬举重物者颈部WMSDs年患病率(17.95%)高于不搬举重物者(8.08%)(P < 0.01), 工作台座椅与个人尺寸不相符者颈部WMSDs年患病率高于工作台座椅与个人尺寸相符者(P < 0.01)。
结论 该家具制造企业工人肌肉骨骼疾患较为严重, 以下背(腰)部、颈部和肩部发生较多, 可能与性别、年龄、工龄以及工效学等因素有关。
     

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。     

汽车制造工人职业性肌肉骨骼疾患与工作组织因素的相关性研究

目的调查汽车制造工人职业性肌肉骨骼疾患(WMSDs)发生情况及其工作组织影响因素。方法采用流行病学横断面调查方法,选用经修订的《肌肉骨骼疾患调查问卷》和中文版《工作付出-回报失衡(ERI)量表问卷》,对某汽车制造厂554名工人近1年内肌肉骨骼疾患患病与工作组织以及社会心理情况进行调查。结果该厂工人WMSDs发生率为661%;不同部位的发生率为114%～395%,其中前四位的依次为颈部(395%)、下背部(348%)、肩部(347%)和踝/足部(339%)。控制潜在混杂因素后发现,休息时间充足(OR=043)、自主选择工作间休息(OR=047)和与同事轮流完成工作(OR=058)是下背部WMSDs的保护因素;每天工作时长(加班)(OR=265)和工作涉及寒冷/凉风或气温变化(OR=177)是下背部WMSDs的危险因素;工间休息时间充足(OR=039)和休息次数(OR=05)是踝/足部WMSDs的保护因素;人员短缺(OR=159)和工作每天重复(OR=287)是肩部WMSDs的危险因素。结论汽车制造工人WMSDs的发生率较高,工作组织因素可能对工人WMSDs产生一定的影响。     

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.     

口腔医生工效学负荷和工作相关肌肉骨骼疾患的研究

目的 评估口腔医生工效学负荷水平，探讨其与工作相关肌肉骨骼疾患（WMSDs）的相关性。方法 采用《中国肌肉骨骼疾患问卷》调查口腔医生WMSDs的患病情况，采用快速上肢评估（RULA）法进行现场工效学评估，并分析其相关性。结果 口腔医生WMSDs患病率为56.1%，各部位患病率差异有统计学意义（X2=62.400，P<0.01），颈部最高；女性患病率高于男性（X2=16.020，P<0.01）。RULA法评估口腔医生工效学负荷平均得分为5.6±1.1，82.4%的口腔医生工效学负荷等级Ⅲ～Ⅳ级。多因素Logistic回归分析显示，工效学负荷Ⅲ级和Ⅳ级（OR=2.413、14.700）、女性（OR=3.670）、中级职称（OR=2.479）、身高<160 cm或≥175 cm（OR=3.708）均为WMSDs的危险因素。WMSDs患病率与工效学负荷之间存在相关性（P<0.05），患病率随工效学负荷的增加而递增。结论 工效学负荷是WMSDs的危险因素；口腔医生WMSDs患病率高，工效学负荷水平高，需予以关注并尽快加以改善。     

玩具制造工人职业性肌肉骨骼疾患及其危险因素研究

目的调查玩具制造工人职业性肌肉骨骼疾患(WMSDs)的发生情况,探讨相关影响因素。方法采用流行病学横断面调查方法,选择电子版《北欧肌肉骨骼疾患问卷(修改版)》,对某玩具厂205名在岗作业工人近1年内肌肉骨骼疾患进行调查,并对其相关危险与影响因素进行单因素和多因素分析。结果获得的184份有效问卷中,工人不同部位WMSDs年发生率179%～391%,前四位依次为肩部(391%)、颈部(375%)、手腕部(326%)和下背部(288%)。各部位不同工种之间WMSDs发生率,除下背部外差异均具有统计学意义(P001)。与办公室人员比较,搪胶工肩部和手腕部WMSDs发生率差异具有统计学意义(P005)。多因素Logistic回归分析结果显示,不同部位WMSDs可能的危险因素不同:肩部和颈部为颈部长时间保持同一姿势(OR=590,527)以及过度或不合理的体育锻炼(OR=291, 351);手腕部为长时间弯曲(OR=371)、班组人员短缺(OR72)。下背部防止WMSDs可能的保护因素为工作姿势舒适(OR=0率较高,亟须根据WMSDs的职业、个体、社会心理、组织管理因素制定相关措施,降低WMSDs对工人健康的不良影响。     

Anxiety and depression predict musculoskeletal disorders in health care workers

Incidence of musculoskeletal disorders (MSDs) is high among health care workers (HCWs). To determine whether MSDs are associated with preexisting anxiety and/or depression, a case-control study was carried out in female HCWs (56 cases/55 controls). Cases were HCWs with a first-time clinical diagnosis of MSD within the previous 2 years. Occupation, workplace, work shift, direct patient assistance, and anxiety/depression scores (Goldberg scale) were assessed. Increased risk of incident MSDs (multivariate logistic regression) was found in workers with preexisting anxiety/depression compared to those without (OR 5.01; 95% CI 2.20–12.05; p < .01). Other significant risk factors were direct patient assistance (OR 2.59; 95% CI 1.03–6.92; p = .04) and morning work shift (OR 2.47; 95% CI 0.99–6.48; p = .05). Preexisting anxiety/depression was associated with incident MSDs in HCWs, adjusting for occupational exposure risk factors.     

Relationships between work-related factors and musculoskeletal health with current and future work ability among male workers

Purpose

The purpose was to increase job-specific knowledge about individual and work-related factors and their relationship with current and future work ability (WA). We studied cross-sectional relationships between mental demands, physical exertion during work, grip strength, musculoskeletal pain in the upper extremities and WA and the relationships between these variables and WA 11 years later.

Methods

We used a dataset of a prospective cohort study (1997–2008) among employees of an engineering plant (n?=?157). The cohort was surveyed by means of tests and written questions on work demands, musculoskeletal health, WA score (WAS; 0–10), and mental and physical WA. Spearman correlation coefficients and logistic regression analysis were used.

Results

Among manual workers, we found weak correlations between grip strength and current and future physical WA. We did not find predictors for future poor WA among the manual workers. Among the office workers, we found that musculoskeletal pain was moderately and negatively related to current WAS and physical WA. More handgrip strength related to better future WAS and physical WA. Musculoskeletal pain (OR 1.67 p?<?0.01) and lower handgrip strength (OR 0.91 p?<?0.05) predicted future poor WA among office workers.

Conclusions

Our results showed cross-sectional and longitudinal relationships between musculoskeletal health and work ability depending on occupation. However, the present implies that predicting work ability in the far future based on health surveillance data is rather difficult. Testing the musculoskeletal system (grip strength) and asking workers’ about their musculoskeletal health seems relevant when monitoring work ability.

     

Examination of postures and frequency of musculoskeletal disorders among manual workers in Calcutta,India

Background: Manual material handling (MMH) activities require workers to adopt various awkward postures leading to the development of musculoskeletal disorders (MSD).

Objectives: To investigate the postures adopted during heavy load handling and the frequency of MSDs among MMH workers in Calcutta, India.

Methods: We conducted a cross-sectional study with 100 MMH workers. MSD frequency was assessed via the Standardized Nordic Questionnaire. The Ovako Working Posture Assessment System (OWAS) was used to analyze working posture. We used logistic regression to predict MSD risk factors.

Results: Ninety five percent of workers reported a MSD in at least one body part in the past 12 months. According to OWAS results, 83% of the analysed work postures require immediate corrective measures for worker safety. The most harmful posture was carrying a heavy load overhead. Carrying more than 120 kg increased the odds of low back and neck pain by 4.527 and 4.555, respectively.

Conclusions: This sample had a high frequency of reported MSDs, likely attributed to physiologically strenuous occupational activities repeated on average of 30–40 times daily. Ergonomic interventions, such as the use of handcarts, and occupational training are urgently needed.     

汽车制造工人颈部职业性肌肉骨骼疾患及危险因素探讨

目的调查汽车制造工人职业性肌肉骨骼疾患(WMSDs)发病情况,探讨其颈部WMSDs的危险因素。方法采用整群抽样方法,选择广州市1家汽车整车及1家零部件生产企业共8 356名作业人员为研究对象,采用《北欧肌肉骨骼疾患问卷(修改版)》(NMQ)调查WMSDs患病情况,多因素Logistic回归分析颈部WMSDs影响因素,并对危险因素接触情况进行调查分析。结果研究对象WMSDs年患病率为44.6%,其中颈部WMSDs患病率为25.4%(2 126/8 356),以发动机生产及总装岗位作业工人的颈部WMSDs较高,年患病率分别为30.6%、26.3%。多因素Logistic回归分析结果显示,颈部WMSDs的主要危险因素包括年龄、工龄、以不舒服的姿势工作、每天从事同样的工作、涉及到寒冷凉风或气温变化、经常加班、腰背部经常重复同一动作、颈部前倾或后仰、颈部长时间保持同一姿势。调查发现,84.9%的研究对象每天从事同样的工作,总装岗位最高(89.0%);83.5%的作业工人经常加班;81.6%的作业工人工作中颈部前倾或后仰,以发动机生产岗位最为突出(87.5%)。结论汽车制造作业人员WMSDs患病率...     

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。     

汽车装配作业工人肌肉骨骼损伤的流行病学调查研究

目的 调查汽车装配作业工人肌肉骨骼疾患的发生情况,探讨可能的相关影响因素.方法 选择北方某汽车制造公司1508名装配作业工人作为调查对象,采用区域工种检查表、北欧标准化肌肉骨骼症状调查表(NMQ)与疼痛问卷,对调查对象的一般情况、不良工效学因素接触情况和肌肉骨骼疾患发生情况等进行流行病学横断面和回顾性调查.结果 汽车装配作业工人肌肉骨骼疾患发生部位以下背部为最高,其次为手腕部、颈部和肩部,发生较为严重的工段有发动机舱段、内饰段、门盖段、底盘段和调试段.发动机舱段和底盘段作业工人以下背部,内饰段以下背部和手腕部,门盖段以手腕部,调试段以颈部和下背部为肌肉骨骼损伤的主要部位.颈部肌肉骨骼疾患有随身高的增高而加重的趋势;吸烟可能会增加肌肉骨骼疾患的发生.结论 汽车装配作业工人肌肉骨骼疾患发病较为严重,各工段发生部位各有不同,表现特征比较明显,可能与其存在的不良作业姿势或活动有关.作业工人身高和吸烟习惯可能是影响肌肉骨骼疾患发生的重要因素.     

Association between perceived inadequate staffing and musculoskeletal pain among hospital patient care workers

Objective

To examine association between perceived inadequate staffing and musculoskeletal pain and to evaluate the role of work-related psychosocial and physical work factors in the association among hospital patient care workers.

Methods

A cross-sectional study was conducted among 1,572 patient care workers in two academic hospitals. Perceived inadequate staffing was measured using the “staffing adequacy subscale” of Nursing Work Index, which is a continuous scale that averages estimates of staffing adequacy by workers in the same units. Musculoskeletal pain (i.e., neck/shoulder, arm, low back, lower extremity, any musculoskeletal pain, and the number of area in pain) in the past 3 months was assessed using a self-reported Nordic questionnaire. Multilevel logistic regression was applied to examine associations between perceived inadequate staffing and musculoskeletal pain, considering clustering among the workers in the same units.

Results

We found significant associations of perceived inadequate staffing with back pain (OR 1.50, 95 % CI 1.06, 2.14) and the number of body area in pain (OR 1.42, 95 % CI 1.01, 2.00) after adjusting for confounders including work characteristics (job title, having a second job or not, day shift or not, and worked hours per week). When we additionally adjusted for physical work factors (i.e., use of a lifting device, and the amount of the time for each of five physical activities on the job), only the association between perceived inadequate staffing and back pain remained significant (OR 1.50, 95 % CI 1.03, 2.19), whereas none of the associations was significant for all of musculoskeletal pains including back pain (OR 0.96, 95 % CI 0.66, 1.41) when we additionally adjusted for work-related psychosocial factors (i.e., job demands, job control, supervisor support, and co-worker support) instead of physical work factors.

Conclusions

Perceived inadequate staffing may be associated with higher prevalence of back pain, and work-related psychosocial factor may play an important role in the potential pathway linking staffing level to back pain among hospital workers.     

某院医务人员职业暴露监测

目的了解医务人员发生职业暴露人群的分布特征、危险因素与风险环节。方法对某院所有医务人员2011年1月—2014年6月发生的职业暴露进行风险监控,分别从发生职业暴露者的职业类别,暴露的地点、环节以及方式进行数据统计。结果 286例次职业暴露者中,男性63例(22.03%),女性223例(77.97%);2011年111例次(38.81%),2012年75例次(26.22%),2013年67例次(23.43%),2014年1—6月份33例次(11.54%);对不同人群发生职业暴露者统计数据显示,各年度不同人群发生职业暴露所占百分比相似,由高到低依次为护士(31.97)%、医师(19.90%)、护工(15.79%)、技师(7.64%)、护师(4.17%)和保洁员(2.84%);整理废物、拔针或更换针头、丢弃锐器入利器盒、手术缝合或器械传递、各种穿刺(含抽血)操作时的锐器伤是医务人员发生职业暴露损伤的主要风险环节,其构成比分别为22.38%、19.58%、14.34%、12.94%和11.19%;各年度职业暴露发生地点相似,主要是病房、手术室和注射(治疗)室,其构成比分别为51.40%、19.58%和11.54%。结论医院应建立完善的职业暴露监控与风险管理体系,强化标准预防,加强对职业暴露高危人群的培训,对风险环节及危险因素进行监控和干预,以有效降低医务人员职业暴露发生率。     

Self-reported musculoskeletal disorders among visiting and office home care workers

This paper examines the associations between self-reported musculoskeletal disorders (MSDs) and work factors and injuries among home care workers. Based on 99 focus group participants and 892 survey respondents, results show a high level of MSDs among both visiting and office home care workers. While visiting home care workers tend to feel pain in the back, office workers tend to report pain in the neck and shoulder. Hazards in clients' homes, injuries moving clients and stress are associated with self-reported MSDs for visiting home care workers. Repetitive tasks and stress are associated with self-reported MSDs for office home care workers. Age and months in the profession have no affect on self-reported MSDs.