NIOSH提举指数在下背痛流行病学研究中的应用

Study on the Prevalence of Low Back Pain Based on the Revised NIOSH Lifting Equation

[目的 ]探讨美国国家职业安全卫生研究所提出的手工作业提举指数 (LI)与下背痛患病率的关系。[方法 ]在 3个具有典型提举作业的工厂中采用流行病学横断面调查方法 ,利用NIOSH提出的提举指数进行接触负荷评价 ,按照Nordic肌肉骨骼症状分析调查表对 491名从事手工提举作业的工人和 3 4名无明显提举任务的行政人员进行问卷调查 ,并对静态肌力进行测试。根据提举指数分为 0 ,～ 1,～ 2 ,～ 3 ,>3共 5组。观察各组工人不同部位肌肉骨骼疾患的患病情况 ,并分析提举指数与下背痛患病的关系。 [结果 ]在肌肉骨骼症状中 ,下背痛的发生率最高。当LI增高时 ,下背痛的OR值也随之增加 ,但其峰值出现在～ 3组 (OR =1.3 5 ) ,而LI >3 ,其OR值并非最高 ,仅为 1.3 0。平均腰拉力最大的为～ 1组 ( 95 .5 9± 2 1.76)kg ,而对照组和LI >3组则分别为 ( 80 .3 6± 14 .49)kg、( 86.85± 2 0 .3 3 )kg。 [结论 ]提举指数对手工提举所引起的下背痛是一个有意义的危险度评价指标。过度手工提举活动可能降低腰拉力。

To investigate the correlation between the prevalence of low back pain and manual lifting stressors, measured with the lifting index(LI) of the revised lifting equation from the National Institute for Occupational Safety and Health (NIOSH). A cross-sectional study of the 1-year prevalence of low back pain was conducted in workers employed in manual lifting jobs in three industrial sites. The manual lifting tasks were evaluated with the NIOSH lifting equation, and categorized by LI. A symptom and occupational history questionnaire,modified from Standardized Nordic questionnaire,was administered to 491 workers employed in lifting jobs and 34 controls with nonlifting jobs. Regression analysis was used to determine whether there was a correlation between the lifting index and reported low back pain. Low back pain appeared to be the highest prevalence in musculoskeletal disorders. The odds ratio elevated as the lifting index increasing. However,the peak odds of low back pain occurred in the ～3 category (odds ratio=1.35),and the odds ratio dropped to 1.30 when LI increased to 3.0. It was found,the mean torso pull strength reached 86.85 kg for LI>3 group,95.59 kg for ～1 group,and 80.36 for control. [Conclusion] The lifting index appears to be an useful indicator for determining the risk of low back pain caused by manual lifting. Over exertion for lifting could decrease the torso strength.