工作有关的肌肉骨骼疾患评价的现况研究

Study on current status of work-related musculoskeletal disorders evaluation

目的 描述职业人群工作有关的肌肉骨骼疾患（work-related musculoskeletal disorders,WRMD）的分布特征.方法 采用整群随机抽样方法抽取行政管理、教育等不同职业的在职职工1 686人作为研究样本.采用标准化北欧国家肌肉骨骼系统症状分析量表,对研究对象最近1年颈部、肩部、下背部是否存在肌肉骨骼系统症状进行调查.采用年患病率指标描述WRMD的患病水平,应用t检验、方差分析、x2检验等方法进行资料差异性检验;应用非条件Logistic回归分析研究个体特征与WRMD的关系.结果 （1）劳动者颈部WRMD患病率最高,其次是下背部,肩部最低（P＜0.05）;脑力劳动者WRMD患病率高于脑体混合劳动者、体力劳动者（P＜0.01）;女性WRMD患病率均高于男性（P＜0.05）.（2）随年龄段（＜30岁、30岁～、40岁～和≥50岁）和工龄段（＜10年、10年～和≥20年）由低到高,职工WRMD患病率基本呈现逐步增高趋势（P＜0.05）.（3）体力劳动者和脑力劳动者因病（伤）缺勤率较高,但因病（伤）就诊率较低（13.05％）.（4）脑力劳动类型、性别、工龄是劳动者WRMD的重要影响因素.结论 不同劳动类型、性别、年龄和工龄的劳动者颈部、肩部和下背部WRMD的患病危险性不同.

Objective To characterize the distribution of work-related musculoskeletal disorders （WRMD） among the occupational population.Methods A total of 1686 people of various occupations were recruited with random cluster sampling.Standardized Nordic questionnaires for the analysis of musculoskeletal systems were used to evaluate WRMD at the neck,shoulder,or lower back in the past one year.The annual prevalence of WRMD was determined.Difference analysis was performed with t-test,ANOVA,or chi-square test.The relationship between personal characteristics and WRMD was analyzed by unconditional logistic regression.Results （1） WRMD were most frequently observed at the neck,followed by the lower back,and was least observed at the shoulder （P〈0.05）.The prevalence of WRMD among mental workers was significantly higher than those among physical workers and mental-physical workers （P〈0.01）.The prevalence of WRMD among female workers was significantly higher than that among male workers （P〈0.05）.（2） In general,the prevalence of WRMD significantly rose with the increases in age （〈30,30～,40～,and ≥50 years） or working years （〈10,10～,and ≥20 years） （P〈0.05）.（3） In the face of sickness or injury,physical workers and mental workers showed a relatively high absence rate but a relatively low medical visiting rate （13.05%）.（4） Unconditional logistic regression analysis showed that mental work,gender,and working year were the main influential factors for WRMD among workers.Conclusion Workers of different types of occupation,genders,ages,and working years have different risks of WRMD at the neck,shoulder,and lower back.