汽车制造男性作业工人多部位肌肉骨骼损伤的横断面研究

Cross-sectional study of multisite musculoskeletal disorders among male auto manufacture workers

[目的]描述汽车制造男性作业工人多部位工作相关肌肉骨骼疾患(WMSDs)发生特征及其职业相关性。[方法]采用职业流行病学横断面与回顾性调查方法,选择北欧标准化肌肉骨骼症状调查表(NMQ)疼痛问卷对某汽车制造企业1 494名男性作业工人的WMSDs、发生部位及其发生风险进行了评估。[结果]WMSDs阳性率28.51%,主要发生在下背/腰、颈、肩、手腕和小腿。同时发生多部位WMSDs的阳性率为18.53%,各车间同时发生2部位和≥5部位WMSDs的阳性率的差异具有统计学意义(均P<0.05)。9项指标变量(年龄、身高、体重、体质指数、文化程度、运动、吸烟、饮酒和工龄)的分层分析中,年龄和工龄两项指标WMSDs的发生风险(OR值)具有统计学意义(P<0.05或P<0.01),且有随其增加而增加的趋势。高中比大学文化程度者更易同时发生3部位和≥5部位WMSDs(P<0.05)。各车间作业工人WMSDs发生部位各有不同,冲压车间以下背/腰、颈和肩部为主,焊装车间以颈、下背/腰、手腕和肩部为主,树脂车间以颈、小腿、踝、肩和下背/腰为主,涂装车间以下背/腰、颈部为主,总装车间以下背/腰、颈、肩和手腕为主。以同时发生2部位WMSDs为例,冲压车间主要为颈与下背/腰;总装车间主要为颈和其他、下背/腰和其他、手腕和其他;焊装车间主要为手腕和其他、肩和其他、大腿和小腿;树脂车间为肩和小腿。[结论]汽车制造工人WMSDs主要发生在下背/腰、颈、肩、手腕和小腿,不同车间作业工人WMSDs发生部位各有不同,汽车总装、冲压和涂装作业工人均以下背/腰部阳性率为最高,而焊装和树脂作业工人均以颈部阳性率为最高。同时发生多部位WMSDs可能与工人的作业活动类型相关,多部位WMSDs发生风险有随年龄和工龄增加而增加的趋势,高中比大学学历者更易同时发生多部位WMSDs。

[Objective] To describe the characteristics and occupational relationships of multisite work-related musculoskeletal disorders（WMSDs） among male workers in automobile manufacturing industry. [Methods] A combined cross-sectional and retrospective survey was conducted among 1 494 male workers in automobile manufacturing industry. Nordic Musculoskeletal Questionnaire（NMQ） was used to assess the prevalence, body sites, and risks of WMSDs. [Results] The positive rate of WMSDs was 28.51%, mainly in low back/waist, neck, shoulder, wrist, and leg. The positive rate of multisite WMSDs was 18.53%, and the positive rates of WMSDs in 2 and ≥ 5 body sites were statistically different among themale workers in different workshops（P〈0.05）. The WMSDs risks（OR values） were different for age and work length in the stratified analysis of nine variables（age, height, weight, body mass index, educational level, physical exercise, smoking, drinking, and work length）（P〈0.05 or P〈0.01）, showing a rising trend with the increase of either two indicators. Workers with high school education were more likely to have WMSDs in 3 and ≥5 body sites than those with university education（P〈0.05）. The dominant body sites with WMSDs were different for workers in different workshops： low back/waist, neck, and shoulder for those in stamping workshop; neck, low back/waist, wrist, and shoulder for those in welding workshop; neck, shank, ankle, shoulder, and low back/waist for those in resin workshop; low back/waist and neck for those in painting workshop; and low back/waist, neck, shoulder, and wrist for those in assembly workshop. As for WMSDs that occurred in two body sites at the same time, neck and low back/waist were the dominant body sites for those in stamping workshop; neck and others except low back/waist, low back/waist and others except neck, shoulder, and wrist, as well as wrist and others except low back/waist for those in assembly workshop; wrist and others except low back/waist, shoulder and others except low back/waist for those in welding workshop; shoulder and shank for those in resin workshop. [Conclusion] WMSDs among the auto manufacture workers mainly occur in low back/waist, neck, shoulder, wrist, and shank, and lesion body sites of workers with WMSDs vary by workshops. The highest positive rate of WMSDs among the assembly, stamping, and painting workers is for low back/waist, and the highest rate among the welding and resin workers is for neck. The prevalence of multisite WMSDs may be associated with the type of work activities. The risk of multisite WMSDs has a rising tendency with higher age and work length. The workers with high school education are more likely to have multisite WMSDs than those with university degree.