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1 065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。     

汽车装配作业工人肌肉骨骼损伤与工效学负荷水平的相关性

[目的]评估汽车装配作业工人工效学负荷,探讨其与肌肉骨骼损伤之间的相关性. [方法]采用横断面与回顾性调查相结合的方法,选择工作相关肌肉骨骼损伤快速暴露检查表(QEC)和北欧Nordic肌肉骨骼问卷,对某汽车制造企业1 502名男性装配作业工人的工效学负荷与肌肉骨骼损伤发生情况进行调查与分析,应用多因素logistic回归分析方法探讨二者间的相关性. [结果]回收有效问卷1 465份,研究对象颈部、肩膀、手腕部和下背/腰部肌肉骨骼损伤阳性发生率依次为6.28％(92人)、4.98％(73人)、6.48％(95人)、9.69％(142人),肌肉骨骼损伤阳性者4个部位的QEC分值均高于阴性者(P＜0.05).肌肉骨骼损伤的现患率与工效学负荷水平存在量效关系(OR＞1),且随着工效学负荷水平的增大而增高(P趋势＜0.01).多因素logistic回归分析发现身高和吸烟为颈、肩部肌肉骨骼损伤的影响因素.[结论]工效学负荷与肌肉骨骼损伤存在相关性,身高和吸烟是颈、肩部肌肉骨骼损伤的相关危险因素.     

工作场所工效学负荷对肌肉骨骼功能的影响

目的 探讨工作场所工效学负荷对肌肉骨骼功能的影响.方法 采用现场观察和自评的方法评估人造板制造工人现场工效学负荷,结合实验室测量研究对象的肌肉骨骼功能,包括背肌耐力、手部握力、腹肌力、躯干柔韧性以及肌肉骨骼功能指数(MSFI),运用多元回归分析工效学负荷对肌肉骨骼功能的影响.结果 不同工效学负荷水平肌肉骨骼功能存在明显差异,其中低负荷水平Ⅰ肌肉骨骼功能各指标均高于高负荷水平Ⅳ,在背肌力和MSFI指标上表现得尤为明显,即随着负荷水平的增高,肌肉骨骼功能呈现下降的趋势.分析身体各部位工效学负荷高低对肌肉骨骼功能的影响,显示高负荷组背部的背肌耐力低于低负荷组,高负荷组肩(臂)部位的背肌耐力和手部握力低于低负荷组,高负荷组下肢的各指标均低于低负荷组,差异均有统计学意义(P＜0.05).控制其他混杂因素后,工作场所工效学负荷与肌肉骨骼功能(除腹肌力外)存在明显的负相关(P＜0.05).结论 工作场所工效学负荷的增高在一定程度上使肌肉骨骼功能降低.     

肌肉骨骼紧张因素识别法联合快速暴露检查法识别制鞋工人工作相关肌肉骨骼疾患

目的探讨联合应用肌肉骨骼紧张因素识别法和快速暴露检查(QEC)法识别制鞋工人工作相关肌肉骨骼疾患(WMSDs)情况。方法采用简单随机抽样法,以福州市某制鞋厂129名制鞋工人为研究对象,采用肌肉骨骼紧张因素识别法和QEC法识别43个工种研究对象的WMSDs工效学危险因素。结果制鞋厂可能发生于颈、肩和上背部WMSDs风险的工种数量最多(36个),其次为肘、前臂和手(31个),足、膝和臀部最少(3个)。存在"重复或持续性工作时颈部轻微前曲"不良因素的工种最多(31个),其次为"重复性作业"(24个)。小车、检工等工种存在多部位和多危险因素。同时存在3个部位高度及以上工效学负荷的工种有10个,同时存在2个部位高度及以上工效学负荷的工种有21个。结论肌肉骨骼紧张因素识别法和QEC法可用于制鞋工人WMSDs风险的识别和评估。制鞋工人WMSDs发生风险以颈部最为明显,可同时伴有肩、前臂和手多部位发生风险。     

职业因素对汽车制造业工人肌肉骨骼疾患影响的研究

目的了解作业场所职业病危害因素与工效学危险因素等对工人几个主要身体部位肌肉骨骼疾患（MSDs）的影响。方法选取南方3家汽车生产制造企业,采用分层、整群抽样的方法,随机从冲压、焊装、涂装、总装、树脂、质检等生产部门中抽取1个班组的生产工人作为调查对象,对其进行问卷调查,收集个人一般情况、职业病危害因素接触情况、典型不良劳动姿势与活动的暴露情况及肩臂部、手部、下背部的阳性症状。影响肌肉骨骼症状发生的单因素分析采用X^2检验,多因素分析采用logistic回归。结果共调查794名工人,其中男性765人,女性29人,平均年龄为（23．34±4．52）岁,工龄中位数2年,其文化程度以中专及以上为主（97．8％）。车企工人总体的MSDs年患率分别为下背部47．0％、肩臂部42．9％、手腕／手掌41．3％。不同工种间不同身体部位MSDs的年患率的差异均有统计学意义（均P〈0．01）,其中肩臂部、手彬手掌的年患率以焊装工的最高,下背部的年患率以总装工的最高。多因素分析结果显示,背前屈〉30°的工作（OR=1．691）等2项与下背部阳性症状年患率有关,手部高力量大角度屈伸的上肢重复活动（OR=1．685）等3项与肩臂阳性症状年患率有关,手部高力量高度重复活动（OR=1．956）等4项与手腕／手掌的阳性症状年患率有关。结论被调查的汽车制造企业工人下背部、肩臂部、手部3个身体部位MSDs的患病情况较突出,各部位的MSDs年患率主要与不良的工作姿势、活动及搬举负荷强度等工效学不良因素有关,需针对其采取有效的控制措施。     

风电场运行维护人员工效学负荷水平评估

目的评估风电场运行维护作业工效学负荷的大小及分布,探讨工效学负荷与肌肉骨骼疾患(musculoskeletal disorders,MSDs)之间的剂量—效应关系。方法采用整群抽样法抽取我国某公司风电事业部所属风电场运行维护人员151人为研究对象。采用北欧肌肉骨骼疾患调查问卷(Nordic Musculoskeletal Questionnaires,NMQ)和肌肉骨骼疾患危险因素快速接触检查法(Quick Exposure Check,QEC)分析MSDs的发生情况、工效学负荷暴露水平及二者之间的剂量—效应关系。结果风电场运行维护人员背部(动态)、肩(臂)部、背部(静态)和手腕部这4个部位的工效学暴露等级均处于极高或高水平;MSDs阳性组工效学得分均高于阴性组,且随着工效学暴露水平的增高,MSDs的发生率随之升高。结论风电场运行维护作业工效学负荷水平较高,且工效学负荷与MSDs之间存在剂量—效应关系。     

PLIBEL和REBA两种方法在木质衣柜生产工人WMSDs评估中的应用研究

目的 调查木质衣柜厂工人工作相关肌肉骨骼疾患（WMSDs）现状及其工效学因素,评估其接触水平与患病风险,为预防和控制该人群WMSDs发生提供依据。方法 应用工效学因素识别法（PLIBEL）识别出该木质衣柜厂工人作业活动中存在的不良工效学因素,确定其危害部位,并用全身快速评估法（REBA）法对木质衣柜厂各车间不同工种进行工效学评估和风险等级排序,确定重点危害车间及工种。结果木质衣柜厂工人的背部、肘部及手/腕部是工效学危害重点部位,背部轻微前屈、颈部轻微前屈,颈、肩和上背部及肘、上臂和手部重复性活动、站立工作是作业活动中最常见的不良工效学因素。REBA危险等级评估结果显示,该木质衣柜厂非常高危险等级工种有8个（占44.44%）,高危险等级工种有5个（占27.78%）,中危险等级工种有2个（占11.11%）,低危险等级工种有3个（占16.67%）。结论 木质衣柜厂工人WMSDs发生危险以背部、肘部、手/腕部最为突出,主要涉及的不良工效学因素为不良作业姿势和重复性作业。应根据负荷等级原则,加强对以上重点部位存在的工效学危害因素管理与控制,降低工效学负荷水平,减少WMSDs发生。     

某鞋厂工人职业性肌肉骨骼疾患发病状况及危险因素分析

采用流行病学横断面调查方法,选用经过信效度检验的《北欧肌肉骨骼疾患调查问卷（修改版）》,对泉州某鞋厂886名作业工人进行了肌肉骨骼疾患与工效学负荷因素的调查。结果显示,886名作业工人各部位WMSDs发生率为6.8%~17.0%,主要发生部位依次为颈部（17.0%）、肩部（15.3%）、手/腕部（13.0%）、下背部（12.4%）。多因素分析结果显示,以不舒服的姿势工作、长时间坐位工作和本工种工龄是导致颈部WMSDs的危险因素（OR=1.77,1.34,1.05）;以不舒服的姿势工作是肩部、下背部、手/腕部WMSDs的危险因素（OR=1.91,3.10,1.63）;与同事轮流完成工作是肩部WMSDs的保护因素（OR=0.56）。     

汽车制造工人肌肉骨骼疾患及不良工效学因素的调查与分析

目的了解汽车制造企业工人职业性肌肉骨骼疾患(WMSDs)的患病情况及相关不良工效学因素。方法采用流行病学横断面调查方法,选择重庆市某汽车制造厂523名男性作业人员为研究对象;选用电子版《北欧肌肉骨骼疾患调查问卷(修改版)》(NMQ)调查其WMSDs患病情况;采用多因素Logistic回归分析其不良工效学因素。结果 523名研究对象的WMSDs总发生率为54.1%,各部位WMSDs发生率由高到低依次为颈部(29.6%)、足部(27.7%)、肩部(25.8%)、手部(25.8%)、上背部(20.1%)、膝部(16.8%)、下背部(15.5%)、腿部(14.3%)和肘部(10.9%);多部位WMSDs总发生率为38.4%,≥2个部位WMSDs发生率最高的工种依次为钳工(50.0%)、技术人员(50.0%)、装配工(42.7%)、焊工(25.8%)和操作工(25.6%)。多因素Logistic回归分析显示,颈部大幅前倾或头后仰、长时间保持同一姿势和长时间转头是颈部WMSDs的主要风险因素(P0.05);肩部长时间保持同一姿势、手在肩部以上作业是肩部WMSDs的主要风险因素(P0.05);反复做同一动作和长时间站立是足部WMSDs的主要风险因素(P0.05)。结论汽车制造企业工人WMSDs高发,各部位WMSDs与其存在的不良工效学因素密切相关,应加强工效学干预,降低作业工人WMSDs的发生。     

某电厂工人职业性肌肉骨骼疾患研究

目的 探讨某电厂工人肌肉骨骼疾患(MSD)情况,研究性别、年龄、工龄与MSD的关系.方法 采用北欧Nordic MSD调查表对某电厂788名工人进行MSD的问卷调查,取其中从事人事及财务管理等轻体力劳动人员234名为对照组,其余554人为观察组.根据各因素的不同进行分析.结果 观察组MSD依次以腰部、颈部、肩部和背部为主,年患病率分别为61.0％、54.0％、46.0％和37.0％,均高于对照组(P＜0.05);观察组女性颈部、肩部和背部年患病率要高于男性,腰部年患病率低于男性(P＜0.05);MSD年患病率存在部分工龄和性别差异.结论 工龄和性别是MSD患病率影响因素之一,应采取积极合理的工效学手段进行干预和预防.     

Musculoskeletal problems among workers of an Iranian rubber factory

Musculoskeletal disorders (MSDs) are a common health problem throughout the world and a major cause of disability among the work force. Assessment of exposure level to MSD risk factors can be an appropriate base for planning and implementing interventional ergonomic programs in the workplace. This study was conducted among workers of an Iranian rubber factory with the objectives of (a) determination of the prevalence of MSDs among production line workers, and (b) assessment of the level of exposure to MSD risks. In this study, all 16 production units of the factory were studied. In each unit, 50% of the workers were randomly selected and included in the study. A total of 454 workers participated. The Nordic Musculoskeletal Questionnaire was used to study the prevalence of MSDs and the Quick Exposure Check (QEC) technique was applied to assess physical exposure to the risks. The videotaping technique was used to collect the required data for each worker. The vast majority of the workers (73.6%) had suffered from some kind of musculoskeletal symptoms during the last 12 months. The highest prevalence was reported in the lower back (50.2%), knees (48.5%) and upper back (38.1%). In 85.5% of the workers studied, the QEC score was high or very high. Statistical analysis showed a significant association between the QEC level of risk and MSDs symptoms (p<0.001). The most common ergonomics problems were found to be awkward postures and manual material handling. MSDs had occurred with a high rate among workers of this rubber factory. Corrective measures for reducing risk level seemed essential. Elimination of awkward postures and manual material handling in the workplace were recommended.     

The health effects of automobile exhaust. VI. Relationship of respiratory symptoms and pulmonary function in tunnel and turnpike workers

To examine the effect of automobile exhaust on respiratory symptoms and pulmonary function, the authors studied 175 tunnel and turnpike workers employed by the Massachusetts Turnpike Authority on two occasions 3 yr apart beginning in 1972. A standard respiratory symptom and illness questionnaire was administered, spirometry was performed, and proximal hair lead and blood lead content were measured as biologic indices of automobile exhaust exposure. One hundred nine (63%) workers were current cigarette smokers, 41 (23%) were exsmokers, and 24 (14%) had never smoked. Smoking was strongly related to respiratory symptoms of cough (P less than .001) and phlegm production (P less than .001), but not to wheezing (P = .41), breathlessness (P = .14), bronchial asthma (P = .13), or frequent chest colds (P = .14). When workers were stratified by smoking status, no effect could be seen between high automobile exhaust exposure as measured by a variety of parameters and all of the above respiratory symptoms and illnesses. The level of pulmonary function [forced expiratory volume in 1 sec (FEV1.0) and forced vital capacity (FVC)] was not related to past or current exhaust exposure in a cross-sectional analysis when we controlled for age, height, and cigarette consumption. In a prospective analysis of 84 of these workers, the observed changes in FEV1.0 and FVC over 3 yr were unrelated to exhaust exposure after controlling for age, height, cigarette consumption, and initial level of pulmonary function.     

Musculoskeletal disorders in relation to age and occupation in Swedish construction workers

BACKGROUND: Physical exposure load varies between trades in the construction industry. Our hypothesis is that the prevalence of MSD in a trade, reflects the level of physical exposure; the aim of the study was to describe MSD in relation to age and occupation within the industry. METHODS: The study is based on data from self-administered questionnaires filled out by 85,191 males in the Swedish construction industry. RESULTS: Construction workers had higher age-adjusted prevalence of MSD than foremen and office workers. In general prevalence rates increased steadily with age. Scaffolders showed the highest prevalence of MSD in all body locations. Elevated prevalence of neck disorders was found in crane operators, insulators, and painters, and of lower back and lower extremity disorders in roofers and floorers. CONCLUSION: MSD increase with age. The variation between trades of MSD prevalence seems to correspond to the variation with respect to physical exposure.     

A survey for rhinitis in an automotive ring manufacturing plant

We report findings regarding otolaryngologist-confirmed rhinitis, current exposure to MWF aerosols, fungi, and endotoxins for workers in a plant manufacturing automobile piston rings. Questionnaire data showed that 61.5% of 187 workers exhibited rhinitis-related symptoms. Rhinitis was confirmed in 99 of 115 workers whom were medically examined. Otolaryngologist-confirmed rhinitis was present in 10 of 19 grinding workers (52.6%), 67 of 142 production workers (47.2%), and 22 of 26 quality control (QC) workers (84.6%). These rates are much higher than the rates of rhinitis-related symptoms in automobile plants and other occupational settings and quite high even allowing for the common occurrence of rhinitis in the general population. We found that rhinitis could develop even in workers exposed to less than 0.5mg/m(3) MWF aerosol. The average exposure to fungi exceeded 10 x 10(3) CFU/m(3), a level higher than that reported for other automobile plants. Although we were unable to identify significant risk factors for rhinitis using only the physician-confirmed rhinitis cases, this study concludes that exposure to MWF aerosol, which would include microbes and metals, could contribute to a high occurrence of rhinitis in grinding and production workers. Forty-nine workers (63.6%) of 77 rhinitis patients in grinding and production operations were determined to handle synthetic MWF directly. For QC workers, for whom the prevalence of physician-confirmed rhinitis was highest, exposure to a low level of MWF aerosol, including specific microbe species we couldn't identify, bright light, dry air, and certain work characteristics during inspection are possible risk factors for development of rhinitis. Further studies including identification of fungi species should be conducted so a firm conclusion can be made regarding the development of rhinitis in QC manufacturing plant workers.     

Ache, pain, and discomfort: the reward for working with many cows and sows?

The main purpose of the study was to investigate the prevalence of perceived symptoms of musculoskeletal disorders (MSD) among workers on large-scale dairy and pig farms in Sweden (herd size more than 300 cows and 450 sows) and to identify potential risk factors in the development of MSD. A study based on questionnaires was carried out among 42 workers on 10 large dairy farms and among 37 workers on 10 large pig farms in Southern Sweden during the autumn of 2002. Most importantly, the study showed that 86% of the dairy workers and 78% of the pig workers reported some kind of MSD during a period of 12 months prior to the study. The most frequently reported MSD among both the dairy and the pig workers were in the "upper extremities" (52% and 62%, respectively) especially in the shoulders and in "the back" (60% and 57%, respectively) especially in the lower back. Furthermore, being of short stature, doing repetitive work, working in awkward positions and being exposed to dust were significant risk factors in having MSD among the workers in this study. Thus, working with many cows and sows on large-scale farms in Sweden can be considered as a high risk job with regard to MSD.     

Accuracy of a Disability Instrument to Identify Workers Likely to Develop Upper Extremity Musculoskeletal Disorders

Background Work related upper extremity musculoskeletal disorders (MSD) result in substantial disability, and expense. Identifying workers or jobs with high risk can trigger intervention before workers are injured or the condition worsens. Methods We investigated a disability instrument, the QuickDASH, as a workplace screening tool to identify workers at high risk of developing upper extremity MSDs. Subjects included workers reporting recurring upper extremity MSD symptoms in the past 7 days (n = 559). Results The QuickDASH was reasonably accurate at baseline with sensitivity of 73% for MSD diagnosis, and 96% for symptom severity. Specificity was 56% for diagnosis, and 53% for symptom severity. At 1-year follow-up sensitivity and specificity for MSD diagnosis was 72% and 54%, respectively, as predicted by the baseline QuickDASH score. For symptom severity, sensitivity and specificity were 86% and 52%. An a priori target sensitivity of 70% and specificity of 50% was met by symptom severity, work pace and quality, and MSD diagnosis. Conclusion The QuickDASH may be useful for identifying jobs or workers with increased risk for upper extremity MSDs. It may provide an efficient health surveillance screening tool useful for targeting early workplace intervention for prevention of upper extremity MSD problems.     

Prevalence of upper limb musculo skeletal disorders among brass metal workers in West Bengal, India

Brass metal work is one of the oldest cottage industries in West Bengal, India. Workers performing rigorous hand intensive jobs are likely to suffer from MSD affecting the upper limbs. The present investigation was intended to establish the prevalence of upper limb MSD among the brass metal workers and to identify the causative factors behind its development. In this study, 50 male brass metal workers (Experimental Group) and 50 male office workers (Comparison Group) were selected. For the symptom survey, a questionnaire on discomfort symptoms was performed. Repetitiveness of work and Hand Grip Strength of both the groups were measured. It was revealed that upper limb MSD was a major problem among brass metal workers, primarily involving the hand, wrist, fingers and shoulder. Among the workers reporting subjective discomfort, most of them felt pain, followed by tingling and numbness in their hands. Many complained of swelling, warmth and tenderness in their wrists. Their activities were highly repetitive and the handgrip strength of these workers was significantly less than that of the comparison group. Based on these findings, it appears that high repetitiveness, prolonged work activity (10.5 h of work per day with 8.4 h spent on hammering) and decreased handgrip strength may be causative factors in the occurrence of upper limb MSD among brass metal workers in West Bengal, India.     

Prevalence of musculoskeletal disorder among workers in Taiwan: a nationwide study

Musculoskeletal disorder (MSD) is a common problem among workers. In spite of the numerous reports on MSD in various specific groups of workers, few data on the prevalence in the general working population are available except for back pain. We analyzed the information collected through a nationwide survey in Taiwan in 1994 to estimate the prevalence of MSD by age, gender, and education level and identify high-risk industries. In the survey, a standard questionnaire was distributed to a representative sample of 22,475 non-self-employed workers in Taiwan. National estimates were obtained by applying a weight to each participant. Among the sampled workers, 18,942 (84.3%) participated, and 37.0% (standard error=0.4%) had MSD. Female workers had a significantly higher overall prevalence than male workers (39.5% vs. 35.2%, p<0.05). Education and age also had significant associations with MSD (p<0.001 in both genders). "Lower back and waist" were the most frequently affected body parts (18.3% among males and 19.7% among females), but the prevalence of MSDs of the neck, shoulders, hands and wrists were also above 10%. The top ten high-risk major industries for MSD of various body parts for each gender were identified, and some industries, including "Basic Metal Industries" and "Buildings Construction," were among the top ten for multiple body parts. Our study showed that MSDs of body parts other than the back are also prevalent, especially in the neck, shoulders, hands and wrists. We also identified high-risk industries for further research and intervention.     

汽车制造业铸造作业工人职业健康状况分析

目的了解汽车制造业铸造粉尘对作业工人健康的影响。方法选择汽车制造业230名铸造工人为接尘组和200名非接触尘毒职工为对照组,通过职业健康体检,比较两组的健康状况。同时测定生产环境中粉尘浓度及二氧化硅含量。结果生产环境粉尘中游离SiO2含量为12.2%￣85.3%,粉尘浓度0.5￣1.75mg/m3,合格率为80%;接尘组工人自觉症状中咳嗽、咯痰、气短阳性率及体检项目中慢性咽炎、慢性鼻炎检出率均明显高于对照组(P<0.05或P<0.01);接尘组肺功能指标(FEF25%￣75%、FEF75%)均低于对照组(P<0.05);小气道功能异常率接尘组为8.3%,对照组为2.5%,两组比较,差异有显著性(P<0.01)。结论汽车制造业铸造粉尘可影响作业工人的健康,尤其对呼吸系统损害更明显,应加强防护措施。     

汽车装配工人工作相关肌肉骨骼损伤危险暴露水平及发病调查研究

[目的]评估汽车装配作业工人工作相关肌肉骨骼损伤（work-related musculoskeletal disorders,WMSDs）危险暴露水平,探讨WMSDs暴露危险与损伤之间的关系。[方法]采用英国快速暴露检查表（QEC）和北欧标准化肌肉骨骼症状调查问卷（NMQ）对1465名北方某汽车制造厂装配作业工人一般情况、暴露水平、WMSDs发生等情况进行流行病学调查。[结果]多数工人颈、背和肩（臂）3个部位的WMSDs处于高或极高暴露水平,不同工段作业工人风险暴露水平有差异。颈、背、肩（臂）和手（腕）4个部位WMSDs的发生率范围为4．98％～9．69％,WMSDs的发生率有随暴露水平的增加而增加的趋势。[结论]汽车装配作业工人存在WMSDs发生的暴露风险,不同身体部位和不同工段其暴露风险各有不同,颈、背、肩（臂）和手（腕）4个部位存在暴露水平-反应关系。