摘 要: 目的 研究三级医院临床医生工作相关肌肉骨骼疾患(work-related musculoskeletal disorders,WMSDs)的流行病学特征,探讨影响WMSDs发生的危险因素。方法 采用流行病学横断面调查方法,使用中国疾病预防控制中心职业卫生与中毒控制所提供的中文版《肌肉骨骼疾患调查表》电子问卷系统,对我国15家三级医院1121名在职临床医生(内科医生412人、外科医生709人)的肌肉骨骼疾患发生情况及其相关因素进行调查分析。结果 临床医生WMSDs发生率为55.9%,其中内科医生为59.0%、外科医生为54.2%,主要累及颈部、肩部和背部。长时间坐姿工作、搬运重物>20 kg/次、以不舒服的姿势工作及多次重复性操作是内科医生WMSDs发生的危险因素;长时间跪姿作业、搬运重物(>5 kg/次和>20 kg/次)、需要上肢或手部用力、使用振动工具是外科医生WMSDs发生的危险因素,以不舒服姿势工作时间越长、重复操作频率越高,WMSDs发生危险越高(OR有时=1.57,95%CI 1.17~2.11;OR很频繁=2.46,95%CI 1.83~3.32),而偶尔长时间站立是外科医生WMSDs发生的保护因素。与同事轮流完成工作是内科医生(OR=0.82,95%CI 0.67~0.97)和外科医生(OR=0.78,95%CI 0.67~0.90)发生WMSDs的共同保护因素,每月至少2~3次体育锻炼(OR=0.78,95%CI 0.63~0.98)可降低内科医生WMSDs的发生危险。结论 不良工效学因素与临床医生WMSDs的发生密切相关,应通过优化手术器械、改善个人生活方式及制定相关组织制度加以改进。 |
关键词: 临床医生 工作相关肌肉骨骼疾患(WMSDs) 不良工效学因素 工作组织因素 |
中图分类号: R68
文献标识码: A
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基金项目: 中国疾病预防控制中心职业卫生健康评估与国家职业卫生标准制定(编号:131031109000160004) |
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Study on characteristics and influencing factors of work-related musculoskeletal disorders in clinicians of tertiary hospitals |
LIU Fei,LING Ruijie,WANG Zhongxu,SUN Jingzhi,LI Gang,LIU Yimin,ZHANG Huadong,WANG Rugang,LI Dongxia,JIA Ning,YIN Hong
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Hubei Provincial Hospital of Integrated Chinese and Western Medicine/Hubei Provincial Hospital for Occupational Disease Prevention and Treatment,Wuhan,Hubei 430030,China
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Abstract: Objective To investigate the epidemiological characteristics of work-related musculoskeletal disorders(WMSDs)in clinical doctors of tertiary hospitals,and explore the risk factors affecting the occurrence of WMSDs. Methods A total of 1 121 clinicians(412 physicians and 709 surgeons)from 15 tertiary domestic hospitals were investigated using an electronic version of Chinese Musculoskeletal Disorders Questionnaire provided by the Occupational Health and Poisoning Control Institute of Chinese National Center for Disease Control and Prevention,and the information about the incidence and the related factor of WMSDs in these population were collected and analyzed. Results The results showed that the mean incidence of WMSDs in clinicians was 55.9% with 59.0% in physicians and 54.2% in surgeons,mainly affecting the neck,shoulders and back. Working in a sitting position for a long time,carrying heavy objects(>20 kg per time),working in uncomfortable postures,and multiple repetitive operations were the risk factors for WMSDs of physicians;meanwhile,long time kneeling operation,carrying heavy objects(>5 kg per time and >20 kg per time),operation requiring upper limb or hands force,and using vibrating tools were the risk factors for WMSDs of surgeons,the longer the working time in an uncomfortable postures and the higher the frequency of repetitive operations,the higher the risk of WMSDs(with OR sometimes=1.57,95%CI 1.17~2.11;OR very frequently=2.46,95%CI 1.83~3.32;whereas occasional prolonged standing was the protective factor for WMSDs of surgeons. In addition,alternately complete work with colleagues was a common protective factor of WMSDs for physicians(OR=0.82,95%CI 0.67~0.97)and surgeons(OR=0.78,95%CI 0.67~0.90),and taking physical exercise at least 2~3 times of physical exercise per month(OR=0.78,95%CI 0.63~0.98)could also reduce the risk of WMSDs among physicians. Conclusion The results suggested that the adverse ergonomic factors were closely related to the occurrence of WMSDs among clinicians,which should be improved by optimizing surgical instruments,improving personal lifestyles,and developing relevant organizational systems. |
Keywords: clinicians work-related musculoskeletal organization disorders(WMSDs) adverse ergonomic factors work factors |