十堰市某汽车制造企业工人肩部肌肉骨骼疾患影响因素及人群归因危险度分析

Analysis on influence factors of musculoskeletal disorders of the shoulder and the population attributable risk of workers in an automobile manufacturing company in Shiyan City

目的探讨汽车制造企业工人肩部肌肉骨骼疾患(musculoskeletal disorders,MSDs)影响因素及人群归因危险度百分比(population attributable risk proportion,PAR%),为筛选重点干预措施提供理论依据。方法2022年10—11月,采用横断面调查法选择十堰市某汽车制造企业工人为研究对象,使用《中国肌肉骨骼疾患调查问卷》调查工人近1年肩部肌肉骨骼疾患的患病情况及相关因素,采用χ^(2)检验比较不同类型人群患病率差异,采用多因素log-binomial回归模型计算现患比(prevalence ratio,PR)值,进一步计算有统计学意义的职业影响因素的PAR%。结果该汽车制造企业工人肩部MSDs患病率为37.3%,多因素log-binomial回归分析结果显示,女性(PR=1.43,95%CI:1.29~1.58)、30~<40岁(PR=1.73,95%CI:1.30~2.35)、40~<50岁(PR=1.92,95%CI:1.48~2.57)、≥50岁(PR=2.10,95%CI:1.62~2.82)、工作压力大(PR=1.17,95%CI:1.05~1.32)、每周工作>5 d(PR=1.11,95%CI:1.01~1.22)、每周工作时间>40 h(PR=1.10,95%CI:1.00~1.20)、工作环境不满意(PR=1.43,95%CI:1.31~1.57)、工作中涉及手腕弯曲的作业姿势(PR=1.26,95%CI:1.04~1.51)及伏案状态(PR=1.26,95%CI:1.15~1.37)均是汽车制造企业工人肩部MSDs患病的影响因素(均P<0.05)。主要职业危险因素的PAR%分别为工作压力大13.18%、工作中涉及手腕弯曲的作业姿势12.04%、伏案工作7.20%。结论该汽车制造企业工人肩部患病率较高,工作压力大、工作中涉及手腕弯曲的作业姿势、伏案工作均是企业预防和控制工人肩部MSDs的重点干预因素。

Objective To investigate the factors and percentage of population attributable risk ratios(PAR%)for shoulder musculoskeletal disorders(MSDS)among workers in automobile manufacturing companies and provide a rationale for screening focused interventions.Methods A cross-sectional survey was conducted from October to November 2022,and workers in an automobile manufacturing enterprise in Shiyan City were selected as the study subjects to investigate the prevalence of shoulder musculoskeletal disorders during the past year among workers using the Chinese Musculoskeletal Disorders Questionnaire(CMQ).The χ^(2)test was used to compare the differences in the prevalence among different types of population,and the multivariate log binomial regression model was used to calculate the PR value,and the PAR%of occupation influencing factors with statistical significance was further calculated.Results The prevalence of MSDs in shoulders among workers in this automobile manufacturing enterprise was37.3%.The results of multivariate log binomial regression analysis showed that female workers(PR=1.43,95%CI:1.29-1.58),aged30-<40 years(PR=1.73,95%CI:1.30-2.35),40-<50 years(PR=1.92,95%CI:1.48-2.57),and≥50 years(PR=2.10,95%CI:1.62-2.82),high work pressure(PR=1.17,95%CI:1.05-1.32),working>5 days per week(PR=1.11,95%CI:1.01-1.22),working hours per week>40 h(PR=1.10,95%CI:1.00-1.20),unsatisfactory work environment(PR=1.43,95%CI:1.31-1.57),working posture involving wrist flexion(PR=1.26,95%CI:1.04-1.51),and desk-bound status(PR=1.26,95%CI:1.15-1.37)were all the influencing factors for shoulder MSDs among workers in automobile manufacturing company.The PAR% of the main occupational risk factors were 13.18%of higher work stress,12.04% of working posture involving wrist flexion,and 7.20% for desk-bound working,respectively.Conclusion The prevalence rate of shoulder among workers in this automobile manufacturing company is relatively high.High work stress,working posture involving wrist flexion,and desk-bound working are the key intervention factors for the entriprise to prevent and control shoulder MSDs among workers.