中国外派与斯里兰卡当地建筑工作者职业工效学暴露模式和健康状况的比较

[背景]近年来中国外派建筑工作者数量已至相当规模,然而目前对这一特殊群体的职业工效学暴露特征、生存质量得分和肌肉骨骼疾患的患病情况了解都严重不足。[目的]本研究拟识别不同工种的中国外派和斯里兰卡当地建筑工作者职业工效学因素暴露模式,并探讨国家和工种与主要健康结局(生存质量和肌肉骨骼疾患)之间的关系。[方法]采用横断面调查,分别使用中文版和僧伽罗语版世界卫生组织生存质量测定简表和肌肉骨骼疾患调查表,于2018年10—12月分别对中国驻斯里兰卡某建筑工地和当地一个建筑工地的各300名工作者进行问卷调查。采用t检验、卡方检验、线性回归和logistic回归等方法识别不同国家和工种在健康结局的差异。[结果]共回收有效问卷581份(中国281份、斯里兰卡300份)。职业工效学暴露模式表现为:中国外派管理后勤人员主要暴露于久坐(59.6%)、颈部(50.6%)和手腕(78.7%)的不良姿势,而一线工人在不良姿势(44.8%~58.9%)、负重(58.3%~75.0%)、重复性操作(54.7%)等不良工效学因素均有较高比例;中国外派与当地一线工人负重> 5 kg(75.0%,81.9%)、手/臂取物(80.1%,87.5%)、长时间站位工作(78.1%,92.0%)的暴露比例较高,但前者出现稍微弯腰转身(58.9%)和操作空间不足(34.4%)的问题更突出,后者则更多地暴露于手腕不良姿势(64.6%)、负重(67.7%~81.9%)、重复性操作(69.1%)等。健康结局的比较结果显示:中国外派建筑工作者在生理(56.2±12.2 vs. 72.9±8.6,中国vs.斯里兰卡,下同)、心理(55.5±14.5 vs.75.9±6.4)、社会关系(61.7±17.2 vs. 70.0±8.7)和环境(51.2±16.9 vs. 67.2±6.9)领域的生存质量得分低于当地工作者。中国外派管理后勤人员过去一年内肌肉骨骼疾患的患病率达50.6%,高于中斯两国一线工人的28.1%和34.0%(P <0.001)。交互作用分析显示国家与不良姿势在社会关系、环境领域得分,工种与不良姿势在MSDs患病均存在交互作用(P <0.05)。[结论]不同国家和工种的职业工效学暴露模式存在一定差异,管理后勤人员主要暴露于久坐和上半身不良姿势,一线工人在多种不良工效学因素的暴露比例均较高,其中中国工人报告弯腰转身和操作空间不足的比例更高,而斯里兰卡工人则更多报告手腕不良姿势、负重、重复性操作等。外派建筑工作者生存质量得分远低于当地工作者,中国管理后勤人员肌肉骨骼疾患患病率远高于其他各组。

Health-related quality of life in Chinese workers:a systematic review and metaanalysis

Background:Studies of health-related quality of life among workers have generated varying results.The purpose of this study was to conduct a systematic review to synthesize the scores of health-related quality of life measured by the World Health Organization Quality of Life questionnaire among Chinese workers and compare the results across gender,age,occupation and region.Methods:Six databases including China National Knowledge Infrastructure,WanFang Data,China Science and Technology Journal Database,PubMed,Web of science and Scopus were searched for relevant publications in both English and Chinese from their inception to February 2021.Inclusion and exclusion criteria were established,and study and participant characters as well as health-related quality of life scores were extracted from included publications.Study quality was assessed by using the Crombie tool.The meta-analysis including individual publications used random-effects models.Subgroups analyses by gender,age,occupation and region were also conducted to explore the source of heterogeneity.Results:One hundred thirty-nine out of 1437 potential publications were included.The pooled mean scores of healthrelated quality of life were 14.1 for the physical domain(95%CI:13.9–14.3),13.7 for the psychological domain(95%CI:13.5–13.8),14.0 for the social relationship domain(95%CI:13.8–14.2),12.3 for the environment domain(95%CI:12.1–12.5).No significant statistical difference was found between the different subgroups.Publication bias was present in the independence domain and the pooled scores were corrected to 15.0(95%CI:14.6–15.5)using the trim and fill method.Sensitivity analysis suggested that the results of the meta-analysis were stable.Region might be a source of heterogeneity.Workers in northeast China reported higher scores in the social relationship domain,and those in the central region reported lower scores in the environmental domain.Conclusions:Chinese workers reported lower scores in four health-related quality of life domains than the general population.Region might be a potential influencing factor for workers’scores different,which needs further study.The pooled scores can served as benchmarks for workplace health promotion programes in Chinese workers and global occupational health studies.

Correction to: Health-related quality of life in Chinese workers: a systematic review and meta-analysis

Correction to:Global Health Research and Policy(2021)6:29 https://doi.org/10.1186/s41256-021-00209-z Following publication of the original article[1],it is reported that there were errors in the first author’s name and the third affiliation.