民航手工搬举作业人员下背痛现状与预防

<正>随着现代工业技术的迅速发展,很多行业生产工艺已基本实现机械化、自动化。而在许多服务领域和制造业中手工提举却仍然普遍存在,与手工搬运提举有关的肌肉骨骼疾患(MSDs),特别是下背痛(LBP)发病逐渐增多[1,2],已引起企业及国内职业卫生领域的关注。民航手工搬举作业包括沉重货物或行李的提举、移动、分拣、运载和装卸等操作,广泛存在重负荷、推拉、搬举、频繁重复性弯腰、屈膝、扭转等不良姿势和负荷作业中,是导致作业人员工作相关肌肉骨骼疾患(WMSDs)的重要因     

BRIEF和PLIBEL方法在评价航空搬运工人肌肉骨骼疾患中的应用

目的探讨民航搬运作业工人工作相关肌肉骨骼疾患(WMSDs)的危险部位及工效学因素。方法应用BRIEF和PLIBEL方法,对北方某大型国际机场货运公司249名健康男性搬运工人的作业姿势、力量、持续时间和动作频率以及17个相关工效学问题进行现场调查与观测。结果机场搬运作业以手腕部WMSDs发生风险为最高,其次为背、肩和手肘部。不同作业发生风险的部位略有差异,行李分拣作业依次为手腕、背和肩部,工效学因素主要来自用力使用不便抓握的工具、无支撑站姿伴背部前屈与扭转、重复或持续性负荷提举和搬运等作业;舱外搬运作业依次为手腕、背、肩和右手肘,工效学因素主要来自用力使用不便抓握的工具、无支撑站姿伴背部前屈、重复或持续性负荷提举和搬运、受限空间等作业;舱口和舱内搬运作业依次为手腕和背部,工效学因素同舱外搬运作业类似。结论手腕、背、肩和手肘部为民航搬运作业WMSDs的主要危险部位,不同作业类别危险部位略有不同,工效学危险因素主要来自不良作业姿势、作业空间受限、工具重负荷以及劳动组织不合理等,机场搬运作业工人应加强对上述工效学危险因素的管理与控制,以预防WMSDs。     

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。     

某供电企业运检人员工作相关肌肉骨骼疾患及其危险因素研究

目的探讨某供电企业运检人员工作相关肌肉骨骼疾患(WMSDs)患病情况及可能的危险因素。方法采用流行病学横断面调查方法,选用肌肉骨骼疾患调查问卷(中文版),对我国某供电企业运检人员近1年内肌肉骨骼疾患及其危险因素开展调查。采用卡方检验以及Logistic回归分析WMSDs发生的危险因素。结果共发放问卷403份,收集有效问卷385份(有效率95.5%)。工人各部位WMSDs患病率为7.5%～57.9%,排在前三位的部位依次是颈部(57.9%)、下背部(56.9%)和肩部(39.2%)。腿部和膝部WMSDs的患病率在不同工种之间的差异具有统计学意义(P0.05)。多因素Logistic回归分析结果显示,搬运重物可能是导致颈部、下背部和手腕部WMSDs的危险因素,由同事轮流完成工作可能是颈部WMSDs的保护因素(P0.05);人员缺乏和弯腰同时转身可能是下背部WMSDs的危险因素(P0.05),颈部长时间保持同一姿势是颈部和肩部WMSDs的危险因素(P0.05);工龄和吸烟分别是影响肩部和颈部WMSDs的危险因素(P0.05)。结论供电企业运检人员WMSDs的患病率较高,需根据WMSDs的危险因素制定相关措施,以降低对工人健康的不良影响。     

某汽车制造企业电焊工肘痛患病状况及其影响因素分析

目的探讨电焊工肘痛的患病情况及其影响因素。方法随机选取某汽车公司从事电焊作业工龄1年,无肘部外伤及手术史的电焊工754人。统计不同人群患病率,在控制年龄影响的情况下,利用Logistic回归分析计算危险因素调整OR值;将卡方检验中P0.10的变量作为候选变量建立多因素Logistic回归模型。结果该公司电焊工肘痛的年患病率为20.0%。肘痛发病的危险因素包括年龄(≥40岁的OR值2.38)、以不舒适姿势搬举重物(OR值1.59)、搬运重物的时间(4 h/d OR值2.09)、上臂或手重复动作(OR值1.78)、工作时手的位置超过肩部(OR值1.51);性别、工龄、常搬举重物、手持振动工具、工作时有工间休息对肘痛的影响无统计学意义(P0.05)。结论电焊作业中存在引起肘痛的多种职业危险因素,需要采取有针对性的措施进行积极干预。     

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;...     

某汽车厂工人下背痛患病率及其影响因素

目的 研究汽车生产工人下背痛（LBP）的患病情况及其影响因素。方法 于2013年6月采用二阶段整群随机抽样方法在湖北省十堰市某汽车公司抽取3 800名工人进行问卷调查。结果 该公司工人LBP年患病率为60.3%;单因素分析,对LBP发生的危险因素有：年龄＞30岁、几乎一直长时间站立（指持续时间＞1 h,下同）、工作时需做弯腰动作、工龄11~15年、工作时需做转身动作、工作时需保持弯腰姿势、高频率的重复性作业、人员短缺,它们对患病率影响依次递降,OR值范围在2.14~1.54,影响最大的是年龄30~39岁（OR=2.14,95%CI=1.70~2.68）和“几乎一直长时间站立”（OR=1.93,95%CI=1.56~2.40）;保护因素有：有充足的休息时间 （OR=0.56,95%CI=0.49~0.64）、可以自己决定何时开始和结束工作（OR=0.65,95%CI=0.55~0.77）、长时间坐着工作（OR=0.91,95%CI=0.78~1.07）;体质指数、长时间跪着工作、长时间坐着工作对LBP的影响无统计学意义（P>0.05）。多因素非条件logistic回归分析结果显示,女性、年龄≥30岁、工龄≥11年、工作时需做弯腰动作、几乎一直站立工作、几乎一直坐位工作、多次重复性操作、人员短缺为危险因素,休息时间充足、可以自己决定何时开始和结束工作为保护因素。结论 在汽车制造业工人中,LBP具有较高的患病率,需要采取改进工作体位、减少高频重复动作、改善劳动组织管理等措施予以干预。     

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。     

基于BRIEF、PLIBEL和RULA方法的制鞋工人工作相关肌肉骨骼疾患工效学危险评估

目的 对制鞋生产中存在的工作相关肌肉骨骼疾患(WMSDs)工效学危害因素进行识别和危险评估。方法 选择18家制鞋企业53个重点岗位884名工人作为研究对象,采用美国工效学基本因素检查表(BRIEF)和瑞典工效学因素识别表(PLIBEL)两种方法识别作业人员作业过程中WMSDs罹患部位及不良工效学危害因素,并采用快速上肢评估(RULA)法进行WMSDs危险等级评估。结果 BRIEF识别结果显示,作业工种/岗位普遍存在手/腕部、肘部、颈部、肩部和背部的WMSDs危害因素,52个工种/岗位(98.11%)存在颈部和右腕部WMSDs危害因素;PLIBEL识别发现,存在≥6个WMSDs危害因素的工种/岗位有18个(33.96%)、有5个危害因素的14个(26.42%)、4个危害因素的有16个(30.19%)、3个危害因素的有5个(9.43%);RULA评估制鞋业生产工人WMSDs危险等级为Ⅱ～Ⅳ级,其中,Ⅱ级工种/岗位14个(26.42%)、Ⅲ级37个(69.81%)、Ⅳ级2个(3.78%),其主要得分源为不良姿势。结论 制鞋作业普遍存在中高风险的不良工效学危害因素,集中在颈部、手/腕部、肩部和...     

生物制药企业员工肌肉骨骼疾患及其危险因素研究

目的探讨生物药品制造企业员工职业性肌肉骨骼疾患(WMSDs)发生状况及可能的影响因素。方法采用流行病学横断面调查方法,选用《中文版肌肉骨骼疾患调查表》电子问卷系统对某生物制药厂部分车间286名员工近1年肌肉骨骼疾患的发生情况进行调查。结果该企业员工WMSDs的年发生率为664%,各部位肌肉骨骼疾患年发生率63%～458%,发病部位居前三位的依次是颈部(458%)、肩部(332%)和上背部(287%),下背部、手腕部、腿部、膝部和踝/足部WMSDs的发生率在不同工种之间的差异具有统计学意义(P005)。多因素Logistic回归分析显示,长时间保持低头姿势和背部弯曲分别是导致颈部和上背部WMSDs的危险因素(P005),休息时间充足和经常体育锻炼分别是预防颈部和上背部WMSDs的保护因素(P005)。结论生物制药企业员工WMSDs年发生率较高,亟需制定有针对性的干预措施,以降低WMSDs对员工健康的影响,如搬运过程中缩短手臂与身体的水平距离,调整不良作业姿势,减少重复性作业,合理安排工作时间等。     

Impact of ergonomic intervention on back pain among nurses

OBJECTIVES: This study assessed the impact of ergonomic intervention on rates of low-back pain among hospital nurses. METHODS: Altogether 1239 female nurses from two hospitals in southern England completed a baseline postal questionnaire about low-back pain and associated risk factors. Between 18 and 28 months after the baseline survey, major intervention was implemented at one hospital to minimize unassisted patient handling and high-risk nursing tasks. At the other, no intervention was initiated, and efforts to improve patient handling were more limited. Thirty-two months after the baseline survey, a second postal survey was carried out in both hospitals (1,167 respondents) to reassess the prevalence of symptoms and risk factors. RESULTS: After adjustment for nonoccupational risk factors, prevalent low-back pain at baseline was associated with low job satisfaction and the performance of patient-handling activities without mechanical aids. After the intervention, the prevalence of occupational risk factors was somewhat lower, but similar improvements occurred at the comparison hospital. At the intervention site the prevalence of symptoms increased slightly (from 27% to 30%), whereas at the comparison site there was no change, the prevalence remaining constant at 27%. Calculations based on the association of risk factors with symptoms at baseline and the observed changes in their prevalence indicated that the change in risk factors was insufficient to produce a substantial reduction in back pain. CONCLUSIONS: These findings cast doubt on the means by which many hospitals are attempting to improve the ergonomics of nursing activities. More effective methods of implementing changes in work systems are needed.     

Effect of telephone-supported ergonomic education on pregnancy-related low back pain

This study investigated the effect of telephone-supported ergonomic education on pregnancy-related low back pain. This study was performed at Trakya University Hospital in Edirne, Turkey between December 15, 2016 and April 4, 2017. One hundred ten pregnant women were included in the study and randomly assigned to one of two groups. Sixty pregnant women received one face-to-face session of ergonomic education followed by three weekly sessions of telephone-supported ergonomic education (intervention group). Fifty pregnant women received only one session of standard face-to-face ergonomic education. Before and after the intervention, low back pain was evaluated using the Visual Analog Scale. Pain-related disability was evaluated with the Oswestry Disability Index, and health-related quality of life was evaluated with the SF-36. Telephone-supported ergonomic education was more effective than standard ergonomic education and can be used as an effective solution for pregnancy-related low back pain.     

Risk factors for low back pain among taxi drivers in Japan]

We conducted a questionnaire study on low back pain (LBP) and working conditions among male taxi drivers employed in the company in Fukuoka city in order to investigate the occurrence of LBP and occupational factors related to LBP among taxi drivers. The study was undertaken through two questionnaires, the first conducted in 1999 (n = 280, first cross-sectional study), the second conducted in 2001 (n = 284, second cross-sectional study). The questionnaire results were used to conduct two analyses: 1) the one-year prevalence of LBP and the relationship between LBP and occupational factors in the second cross-sectional study, and 2) the incidence of LBP and the relationship between LBP and occupational factors from the first to the second cross-sectional study in the longitudinal study. The incidence cases were defined as subjects who met the following conditions: those who had never experienced LBP at the time of the first study but had experienced LBP during the previous year at the time of the 2nd study. The one-year prevalence (45.8%) of LBP among taxi drivers was comparable to rates reported for other occupational drivers in which LBP occurs frequently. This result indicates that LBP is an important health problem for taxi drivers, and an urgent occupational safety and health management issue. The two-year incidence of LBP among the taxi drivers was estimated at 25.9%. LBP was significantly related with the suitability of the driver's seat pan, total mileage on the taxi (total mileage), the level of uncomfortable vibrations on the road, job stress and time employed as a taxi driver. Importantly, the prevalence of LBP increased with increasing total mileage, a finding which had not previously been reported. The findings of this study also suggest that ergonomic problems with the driver's seat pan, whole-body vibration (WBV) and job stress may contribute to LBP among taxi drivers. Further study is needed to confirm how total mileage contributes to LBP. Furthermore, WBV during normal use of taxies should be measured in order to evaluate the association between WBV and LBP.     

Stressful psychosocial work environment increases risk for back pain among retail material handlers

BACKGROUND: Back pain is a major source of lost work time. Occupational physical activity only accounts for a fraction of low back pain; therefore, there is growing interest in investigating other possible causes of back pain including the psychosocial work environment. METHODS: Material handlers (N = 6,311) in 160 newly opened stores were interviewed at study entry and approximately 6 months later. Factor analysis was used to reduce the 37 psychosocial questionnaire items to seven distinct factors. RESULTS: After adjusting for history of back problems and work-related lifting, risk of back pain was moderately increased among employees who reported high job intensity demands (odds ratio (OR) = 1.8), job dissatisfaction (OR = 1.7), and high job scheduling demands (OR = 1.6). CONCLUSIONS: Modification of the psychosocial work environment for material handlers in large retail stores may help reduce back pain among employees.     

Risk factors for first-ever low back pain among workers in their first employment

BACKGROUND: Low back pain has been estimated to be the most costly ailment of people of working age. Both work characteristics and individual factors have been identified as risk factors. The first interaction between work characteristics and individual factors occurs when workers start in their first job. AIMS: To investigate work-related risk factors for first-ever low back pain in young workers in their first employment. METHODS: A cross-sectional analysis was performed on 278 young workers in their first employment and without a history of low back pain prior to working. Work-related physical factors, psychosocial work characteristics, individual variables and first-ever low back pain were queried by means of a questionnaire. RESULTS: About half of the workers who developed low back pain after job start did so in the first year of employment. An increased risk was observed for (i) long periods of seated work [relative risk (RR) = 3.2, 95% confidence interval (CI) = 1.6-6.4]; (ii) more than 12 flexion or rotation movements of the trunk per hour (RR = 3.0, 95%CI = 1.4-6.4); and (iii) more than 3 years seniority in a job involving lifting more than 25 kg at least once an hour (RR = 3.7, 95%CI = 1.4-9.4). As to psychosocial work characteristics, first-ever low back pain was associated with a combination of low psychological job demands and low supervisor support. CONCLUSION: Work-related physical factors and psychosocial work characteristics should be considered as risk factors for first-ever low back pain. First-ever episodes of low back pain are common in the first year of employment. This may reflect a lack of work experience or training.     

Occupational risk factors for low back pain among drivers of three-wheelers in Sri Lanka

Abstract

Background:

Approximately 5% of all households in Sri Lanka operate a three-wheeler as their primary source of income. However, very little is known about the occupational health risks associated with driving these vehicles.

Objectives:

The aim of this study was to assess occupational risk factors, including the number of hours worked associated with the 4-week prevalence of low back pain (LBP) among drivers of three-wheelers.

Methods:

Questionnaires were administered to 200 full-time drivers of three-wheelers from the Galle District in Sri Lanka. Occupational, psychological, socio-demographic, lifestyle, and anthropometric variables were collected. Univariate and multivariate analysis were used to investigate the correlation between occupational risk factors of the prevalence of LBP.

Results:

15·5% of respondents reported experiencing LBP in the previous 4 months. Univariate analysis revealed that the number of hours worked per week, feeling pressure to compete with other drivers, and perceived stress scale scores were significantly associated with the 4-week prevalence of LBP. Multivariate analysis found that the number of hours worked per week and engine type were significantly associated with LBP.

Conclusions:

LBP is common among drivers of three-wheelers in Sri Lanka. Long work hours and two-stroke engines were significantly associated with LBP. Results from this study point towards a role for educational, behavioral health, and policy interventions to help prevent and reduce LBP among these drivers.