摘 要: 目的 调查煤矿作业工人职业性肌肉骨骼疾患(WMSDs)的发生情况,对其影响因素进行研究,为促进煤矿作业工人健康提供科学依据。方法 采用整群抽样法抽取调查对象,选择《北欧肌肉骨骼疾患调查问卷(修改版)》(NMQ)对2个煤矿矿区1 049名作业工人进行问卷调查;运用单因素和多因素分析方法比较不同工种WMSDs的发生率及其个体因素影响,筛选影响不同部位WMSDs的职业因素。结果 1 035例有效问卷中,WMSDs发生率前四个部位依次为颈部(50.2%)、肩部(40.7%)、下背部(36.3%)和膝部(33.4%);不同工种间颈部、下背部、上背部、手/腕部和肘部WMSDs发生率差异有统计学意义(P<0.05),不同工种受累部位数量差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,以不舒服的姿势工作(OR=3.193)、休息后立即开始工作(OR=2.450)、轮班工作(OR=1.877)、工作涉及寒冷/凉风或者气温变化(OR=1.583)及长时间保持低头姿势(OR=1.446)是颈部WMSDs的危险因素;背部长期保持同一姿势(OR=2.295)、搬运很重的物体(OR=2.125)、需要上肢或手用力工作(OR=1.879)、休息后立即开始工作(OR=1.753)及工作在同一车间完成(OR=1.486)是肩部WMSDs的危险因素,休息时间充足(OR=0.663)为保护因素;每分钟多次重复性操作(OR=2.214)、工作中腰/背常重复同一动作(OR=2.149)、轮班工作(OR=1.156)、休息后立即开始工作(OR=1.753)及工作在同一车间完成(OR=1.156)是下背部WMSDs的危险因素;以不舒服的姿势工作(OR=2.827)、下肢及足/踝常反复做同一动作(OR=1.898)、工作涉及寒冷/凉风或者气温变化(OR=1.606)是膝部WMSDs的危险因素。结论 煤矿工人WMSDs发生率较高,主要集中在颈部、肩部、下背部和膝部,且与多种职业因素有关,OR值分布在2.0左右,不同部位相关危险因素略有差异。因此,需从职业因素入手积极预防和控制WMSDs发生。 |
关键词: 煤矿 职业性肌肉骨骼疾患(WMSDs) 职业因素 影响因素 |
中图分类号: R68
文献标识码: A
|
基金项目: 中国疾病预防控制中心职业卫生与中毒控制所职业健康风险评估与国家职业卫生标准制定项目(项目号:131031109000150003) |
|
Investigation and research on musculoskeletal disorders and related factors in coal mine workers |
WANG Xue-tao,BIE Feng-sai,LI Xiao-guang,WANG Zhong-xu
|
National Center for Occupational Safety and Health,NHC,Beijing 102308,China
|
Abstract: Objective To explore the prevalence of work-related musculoskeletal diseases(WMSDs)in coal mine workers and its interfering factor,thereby provide a scientific basis for promoting the health of coal mine workers.Methods Using the cluster sampling method to extract respondents,and conduct a survey on 1 049 coal mine workers with Nordic musculoskeletal questionnaire(NMQ),the univariate analysis was used to compare the differences of prevalences of WMSDs among the jobs and the individual interfering factors,while,multivariate Logistic regression analysis was used to screen those interfering factors of musculoskeletal disorders in different parts of body.Results The results showed that the top four parts with high prevalences of WMSDs are neck(50.2%),shoulder(40.7%),lower back(36.3%),and knee(33.4%),there were statistical difference in prevalences of WMSDs in neck,lower back,upper back,wrist and elbow among different types of work (P<0.05),and the number of parts of WMSDs involved as well (P<0.05).Multivariate Logistic regression analysis showed that working in an uncomfortable posture (OR 3.193),immediate work after rest(OR 2.450),shift work(OR 1.877),work involving cold/cool wind or temperature changes(OR 1.583),and keeping head down for a long time(OR 1.446)were the risk factor of WMSDs for neck;back keeping same posture for a long time(OR 2.295),carrying heavy objects(OR 2.125),needing upper limb or hand to work hard(OR 1.879),immediate work after rest(OR 1.753),the work comlished in same workshop(OR 1.486)were the risk factors of WMSDs for shoulder,while enough rest time(OR 0.663)was a protective factor;multiple repetitive operations per minute(OR 2.214),the same operation repeated at waist/back(OR 2.149),shift work(OR 1.156),immediate work after rest(OR 1.753),work is completed in same workshop(OR 1.156)were the risk factors of WMSDs for lower back;working in an uncomfortable posture(OR 2.827),often do the same action repeatedly(OR 1.898),the work involves cold/cool wind or temperature changes(OR 1.606)were the risk factors of WMSDs for knees.Conclusion The results suggested that the coal mine workers had high prevalence of WMSDs,which mainly located at necks,shoulders,lower backs and knees,which were related to a variety of occupational factors,the OR values were near 2.0,the related risk factors of different parts were slightly different.Therefore,the prevention and control measure was needed and it should start from the improvement of various occupational factors. |
Keywords: coal mine work-related musculoskeletal disorders(WMSDs) occupational factors interfering factors |