职业应激与下肢肌肉骨骼系统疾患的关系

目的 探讨职业应激与下肢肌肉骨骼系统疾患的关系.方法 采用横断面研究设计和自报式问卷调查方法对13家企业5338名工人进行整群调查,采用修订的工作内容问卷和付出-回报失衡模式问卷调查职业应激状况.采用肌肉骨骼系统疾患调查表调查过去1年内下肢肌肉骨骼系统疾患和不良姿势情况.使用logistic回归分析职业应激因素与下肢肌肉骨骼系统疾患检出率之间的关系.结果 2个职业应激模式主要因子中,躯体需求和付出是臀部疾患的危险因素,而工作控制是臀部疾患的保护因素.当2个模式的主要因素一起分析时,仅有躯体需求是臀部疾患的危险因素.以4种工作类型的分类变量进行分析时,工作紧张是臀部疾患的危险因素,而付出-回报失衡是臀和膝部疾患的危险因素.随着患病部位的增多,工作紧张和付出-回报失衡的危险增加.工作控制的保护作用随患病部位的增加而增大.以连续变量进行分析时,以躯体需求计算的工作紧张是臀部疾患的危险因素,而付出-回报失衡是臀和膝部疾患的危险因素.结论 职业应激与下肢肌肉骨骼系统疾患存在统计学意义的相关,下肢肌肉骨骼系统疾患的预防应考虑控制职业应激因素和增加工作控制.

Association between occupational stress and musculoskeletal disorders in lower extremity

Objective To explore the relationshio between occupational stress and musculoskeletal disorders in lower extremity.Methods The cross-sectional study was used to investigate 5338 workers in 13 factories and companies for prevalence of musculoskeletal disorders in lower extremity,working postures and occupational stress were investigated with questionnaires for past year.Perceived occupational stress was evaluated by the Chinese version of the Job Content Questionnaire (JCQ) and Effort-Reward Imbalance (ERI) Model Questionnaire.Logistic regression analyses were conducted to estimate the associations between occupational stress and prevalence of musculoskeletal disorders in lower extremity.Results In the main demensions of job strain and ERI model,physical demands and effort were risk factors of hip disorders,but job control was a protective factor of hip disorders.When job strain and ERI model scales were analyzed simultaneously,only physical demands were risk factor of hip disorders.When job strain and the effort- reward imbalance were computed by creating four independent categories,job strain was a risk factor of hip disorders,ERI was a risk factor of hip and knee disorders.The risk of imbalance between job strain and effort-reward the protective effect of job control increased with the disorder regions.According to continuous variable analysis,job strain by calculated with physical demands was risk factor of hip disorders,continuous ERI variable was risk factor of hip and knee disorders.Conclusion Occupational stress is associated significantly with musculoskeletal disorders in lower extremity.The control of occupational stress and increase of job control should be considered for preventing the musculoskeletal disorders in lower extremity.