新疆煤矿工人职业性肌肉骨骼疾患的危险因素分析

Work-related musculoskeletal disorders and risk factors of workers in coal mines

目的探讨新疆煤矿工人职业性肌肉骨骼疾患(WMSDs)的危险因素,为促进煤矿工人的身心健康提供科学依据。方法采用分层整群随机抽样的方法,对1 325名新疆煤矿一线作业工人进行职业性肌肉骨骼疾患(WMSDs)的横断面调查,采用Logistic回归分析法了解职业因素与职业性肌肉骨骼疾患(WMSDs)的相关性。结果不同性别、民族、年龄、学历的煤矿工人WMSDs患病率差异均无统计学意义(P>0.05)。身体各部位WMSDs患病率随工龄的增长而升高,差异有统计学意义(P<0.05)。动态负荷使WMSDs的患病风险上升1.300~2.723倍。静态负荷使WMSDs的患病风险上升1.759~2.967倍。体力负荷对WMSDs的患病OR值为2.068~2.655。每分钟多次重复动作使WMSDs的患病风险上升2.070倍。有时脚底打滑或跌倒、是否涉及寒冷或气温变化、没有足够空间、姿势不适使不上劲、无倚靠均会增加煤矿工人WMSDs的患病风险,其调整OR值分别达到2.744、2.688、2.203、2.122和2.099。很频繁的使用振动工具和驾驶车辆使WMSDs的患病风险分别上升1.681和1.433倍。人员短缺、经常加班使WMSDs患病风险分别上升2.817和2.392倍;休息时间充足、可以决定何时工间休息使WMSDs患病风险分别下降0.552和0.307倍。颈前倾、大幅度弯腰、涉及寒冷或气温变化、有时脚底打滑或跌倒、做短时间最大力操作、上臂或手指重复动作和人员短缺均是煤矿工人WMSDs的危险因素(P<0.05)。倒班制度中三班两倒相对于固定白班是煤矿工人WMSDs的保护因素(P<0.05)。结论煤矿工人的职业因素与职业性肌肉骨骼疾患(WMSDs)具有很强的相关性,应该采取相应的综合预防措施。

Objective To analyze the risk factors of work-related musculoskeletal disorders（WMSDs）among coal miners in Xinjiang,thereby providing scientific basis for promoting the physical and mental health of coal miners.Methods A cross-sectional survey was conducted in 1325 workers selected from stratified cluster random sampling method.Logistic regression analysis was performed to analyze the correlation between the occupational factor and WMSDs.Results No significant difference was observed in the prevalence of WMSDs among different sex,ethnic groups,age and educational backgrounds（P〈0.05）.The morbidity of WMSDs in different body sites of the miners increased significantly with length of service（P〈0.05）.Dynamic load was shown to increase the risk of WMSDs（OR：1.300-2.723）,Meanwhile static load was also shown to increase the risk of WMSDs（OR：1.759-2.967）.Physical load was presented to be significantly associated with the incidence of WMSDs（OR：2.068-2.655）;repetitive movement per minute was also displayed to be significantly associated with WMSDs（OR =2.07）.Slipping or falling during work,coldness,cramped working room,working in uncomfortable postures,and no leaning were exhibited to increase the risk of WMSDs（OR：2.744,2.688,2.203,2.122 and 2.099,respectively）.Vibrating and driving were found to increase the risk of WMSDs（OR：1.681 and 1.433,respectively）.Personnel shortage and working overtime frequently was observed to be positively associated with WMSDs（OR：2.817 and 2.392,respectively）,while breaks at work and having sufficient normal breaks were shown to decrease WMSDs（OR：0.552 and 0.307,respectively）.Multivariate logistic regression models showed that the main risk factors for WMSDs were neck in a bent posture for long periods,stoop sharply,coldness,slipping or falling during work,maximum force operation,and repetitive movement of the upper arm or finger and personnel shortage.Conclusion There was significant correlation observed between the occupational factors and the WMSDs for coal miners.Measures should be taken to improve and control the risk factors of the workplace to improve the quality of work and health of the workers.