口腔医生工作相关肌肉骨骼疾患影响因素分析

Influencing factors of work-related musculoskeletal disorders among dentists

目的分析口腔医生工作相关肌肉骨骼疾患(WMSDs)现状,并探讨其影响因素。方法采用典型抽样方法,以北京市和福州市9家医疗机构的455名口腔医务人员为研究对象,采用《中国肌肉骨骼疾患问卷》《主观负荷评价技术量表》调查其WMSDs的患病情况和心理负荷,采用多因素Logistic回归分析其罹患WMSDs的影响因素。结果口腔医生WMSDs总患病率为58.9%(268/455),各部位WMSDs患病率居前3位的依次为颈部(41.5%)、肩部(33.6%)、下背部(28.1%);心理负荷得分中位数为58分。多因素Logistic回归分析结果显示,排除混杂因素的影响后,女性口腔医生罹患WMSDs的风险高于男性口腔医生(P<0.01);口腔医生罹患WMSDs风险随着工龄的延长而增加(P<0.01);长时间保持侧头、频繁弯腰、使用振动工具的口腔医生罹患WMSDs的风险相对较高(P<0.01);使用扶手椅的口腔医生罹患WMSDs的风险相对较低(P<0.01)。口腔医生心理负荷与罹患WMSDs无关联(P>0.05)。结论口腔医生WMSDs的患病率较高;个体因素、不良操作姿势、使用振动工具均是罹患WMSDs的危险因素,使用扶手椅有利于降低口腔医生罹患WMSDs的风险。

Objective To analyze the prevalence of work-related musculoskeletal disorders(WMSDs) among dentists and explore its influencing factors. Methods A total of 455 dentists from 9 medical organizations of Beijing and Fuzhou cities were selected as study subjects. The disease occurrence and mental workload were investigated using China Musculoskeletal Disorders Questionnaire and Subjective Workload Assessment Technique. The influencing factors of WMSDs were analyzed by multivariate logistic regression. Results The total prevalence of WMSDs was 58.9%(268/455) among dentists. The top three body parts of WMSDs were neck(41.5%), shoulder(33.6%) and lower back(28.1%). The median of mental workload score was 58. Multivariate logistic regression analysis results indicated that female dentists showed a higher risk than male dentists(P<0.01) after excluding the influence of confounding factors. The higher the length of service, the higher their risk for WMSDs(P<0.01). Dentists who hold their heads sideways for long time, bent frequently, and use vibrating tools had relatively high risks of developing WMSDs(P<0.01). Dentists who use armchairs had a relatively low risk of WMSDs(P<0.01). There was no correlation between the mental workload and the prevalence of WMSDs in dentists(P>0.05). Conclusion The prevalence of WMSDs among dentists is high. Individual factors, awkward posture and using vibrating tools are risk factors of WMSDs among dentists.Armchair use can help reduce the risk of WMSDs.