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。

Characteristics and influencing factors of work-related musculoskeletal disorders of construction workers

  Objective  To investigate the current situation and influencing factors of work-related musculoskeletal disorders(WMSDs)among construction workers.  Methods  Using convenience sampling method, 471 construction workers from 8 construction companies located in Guangdong, Liaoning, Shandong, Beijing were selected as research objects. The prevalence of WMSDs was collected by using the online version of the Musculoskeletal Disorders Questionnaire under on-site guidance, and multivariate logistic regression was used to analyze the influencing factors of WMSDs of construction workers.  Results  A total of 453 valid questionnaires were collected, and the effective response rate was 91.2%. The total prevalence of WMSDs of these construction workers was 43.7%, and the higher prevalence were 24.1%(109/453)in the lower back, 18.3%(83/453)in the shoulder, and 14.6%(66/453)in the neck, respectively. Among 198 construction workers with WMSDs, the proportion of WMSDs in 1 to 3 body parts was 81.3%(161/198). Compared with age < 38 years old, the risk of WMSDs of construction workers aged 38 - 48 years old and ≥ 48 years old was 2.213 times and 2.573 times, respectively (P < 0.05); the risk of WMSDs of construction workers carrying heavy objects > 5 kg each time, or squatting and kneeling for a long time, or working in uncomfortable posture, or working overtime or holding the same waist position for long period was increased by 1.711, 1.010, 11.247, 1.214 and 1.002 times respectively, compared with the other construction workers(P < 0.05). The risk of WMSDs of construction workers with sufficient rest time was only 0.552 of these with insufficient rest(P < 0.05), while the risk of WMSDs of workers with higher school education or more was only 0.425 of these with middle school education or below(P < 0.05).  Conclusions  Construction workers were at higher risk for WMSDs, with the lower back, shoulders and neck at higher risk. The influencing factors of WMSDs of construction workers were elder, lower school education, carrying heavy loads, squatting or kneeling for a long time, working in uncomfortable posture, insufficient rest time, overtime working, and staying in one position for a long time. Therefore, the construction companies should strengthen staff training, publicize correct ergonomic knowledge, identify and reduce bad working posture, increase the frequency and time of breaks and other measures to reduce the risk of construction workers suffering from WMSDs.