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建筑工人下背部工作相关肌肉骨骼疾患影响因素分析

彭志恒,  杨燕,  李刚,  邵华,  王如刚,  贾宁,  王忠旭,  刘移民

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文章导航 > 中华疾病控制杂志  > 2022 >  26(8): 907-913
彭志恒, 杨燕, 李刚, 邵华, 王如刚, 贾宁, 王忠旭, 刘移民. 建筑工人下背部工作相关肌肉骨骼疾患影响因素分析[J]. 中华疾病控制杂志, 2022, 26(8): 907-913. doi: 10.16462/j.cnki.zhjbkz.2022.08.007
引用本文: 彭志恒, 杨燕, 李刚, 邵华, 王如刚, 贾宁, 王忠旭, 刘移民. 建筑工人下背部工作相关肌肉骨骼疾患影响因素分析[J]. 中华疾病控制杂志, 2022, 26(8): 907-913. doi: 10.16462/j.cnki.zhjbkz.2022.08.007
shu
PENG Zhi-heng, YANG Yan, LI Gang, SHAO Hua, WANG Ru-gang, JIA Ning, WANG Zhong-xu, LIU Yi-min. Influencing factors of lower back work-related musculoskeletal disorders among construction workers[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(8): 907-913. doi: 10.16462/j.cnki.zhjbkz.2022.08.007
Citation: PENG Zhi-heng, YANG Yan, LI Gang, SHAO Hua, WANG Ru-gang, JIA Ning, WANG Zhong-xu, LIU Yi-min. Influencing factors of lower back work-related musculoskeletal disorders among construction workers[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(8): 907-913. doi: 10.16462/j.cnki.zhjbkz.2022.08.007
shu

建筑工人下背部工作相关肌肉骨骼疾患影响因素分析

doi: 10.16462/j.cnki.zhjbkz.2022.08.007
  • 1.

    510620 广州，广州市职业病防治院职业卫生评价检测中心

  • 2.

    110059 沈阳，辽宁省卫生健康监督中心办公室

  • 3.

    255030 淄博，山东省职业病防治院办公室

  • 4.

    100013 北京，北京市疾病预防控制中心职业健康体检中心

  • 5.

    100050 北京，中国疾病预防控制中心职业卫生与中毒控制所职业防护与工效学研究室

基金项目: 

中国疾病预防控制中心职业卫生所职业健康风险评估与国家职业卫生标准制定 131031109000160004

广州市高水平临床重点专科建设项目 SuiWeihan 〔2019〕 No.1555

广州市“121人才梯队工程”后备人才项目 Guangzhou Human Resources and Social Security Bureau 〔2011〕 No.167

详细信息
    通讯作者:

    刘移民，E-mail：ymliu61@163.com

    王忠旭，E-mail：wangzhongxu2003@163.com

  • 中图分类号: R135

Influencing factors of lower back work-related musculoskeletal disorders among construction workers

  • 1.

    Occupational Health Evaluation and Testing Center, Guangzhou Occupational Diseases Prevention and Treatment Hospital, Guangzhou 510620, China

  • 2.

    Office of Liaoning Provincial Health Supervision Center, Shenyang 110059, China

  • 3.

    Office of Shandong Occupational Disease Prevention and Control Institute, Zibo 255030, China

  • 4.

    Occupational Health Examination Center, Beijing Center for Disease Prevention and Control, Beijing 100013, China

  • 5.

    Department of Occupational Protection and Ergonomics, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China

Funds: 

Occupational Health Risk Assessment and National Occupational Health Standard Formulation, Institute of Occupational Health, China CDC 131031109000160004

Guangzhou High-level Key Clinical Specialty Construction Project SuiWeihan 〔2019〕 No.1555

Reserve Talents Project of "121 Talent Echelon Project" of Guangzhou (Guangzhou Human Resources and Social Security Bureau Guangzhou Human Resources and Social Security Bureau 〔2011〕 No.167

More Information

    摘要
  • 摘要:   目的  分析建筑工人下背部工作相关肌肉骨骼疾患(work-related musculoskeletal disorders, WMSDs)的患病现状和影响因素。  方法  选择北京市、辽宁省、山东省和广东省等地共8家建筑公司的453名建筑工人为研究对象，采用《肌肉骨骼疾患调查问卷》收集研究对象各部位WMSDs的患病情况，应用多因素logistic回归分析模型分析建筑工人下背部WMSDs的影响因素。  结果  研究对象WMSDs总患病率为43.7%，其中患病率从高到低排序为下背部24.1%、肩部18.3%、颈部14.6%、上背部12.4%、手腕部12.1%、足踝部6.0%、腿部5.5%、膝部5.1%及肘部5.1%。研究对象的多部位WMSDs患病率为28.9%。多因素logistic回归分析模型分析结果显示，以初中及以下组为参考组，高中及中专文化程度是建筑工人罹患WMSDs的保护因素(OR=0.390, 95% CI: 0.179~0.849, P=0.018)；长时间蹲或跪姿(OR=1.818, 95% CI: 1.053~3.138, P=0.032)、搬运重物(每次>20 kg)(OR=2.876, 95% CI: 1.629~5.077, P＜0.001)、以不舒服姿势工作(OR=2.619, 95% CI: 1.455~4.714, P=0.001)、下背部长时间保持同一姿势(OR=2.913, 95% CI: 1.640~5.177, P＜0.001)和长时间屈膝(OR=2.958, 95% CI: 1.659~5.274, P＜0.001)是研究对象罹患WMSDs的独立危险因素。  结论  建筑工人WMSDs患病风险较高，其中最常见的是下背部WMSDs。其影响因素主要包括个体特征、劳动类型和不良工效学因素。
    Abstract:   Objective  To investigate the current situation of lower back work-related musculoskeletal disorders (WMSDs) among construction workers and to explore the influencing factors.  Methods  A total of 453 construction workers from 8 construction companies in Beijing, Liaoning, Shandong and Guangdong provinces were selected as the subjects. The prevalence of WMSDs in different parts of the subjects was collected by the Musculoskeletal Disorders Questionnaire, and multivariate logistic regression was used to analyze the influencing factors of WMSDs in the lower back of construction workers.  Results  The total prevalence of WMSDs was 43.7%. The prevalence rate was 24.1% in the lower back, 18.3% in the shoulder, 14.6% in the neck, 12.4% in the upper back, 12.1% in the wrist, 6.0% in the foot and ankle, and 5.5% in the leg, 5.1% in the knee and 5.1% in the elbow. The prevalence of multisite WMSDs was 28.9%. Multivariate logistic regression analysis showed that high school and secondary school education (refer to junior high school and below) (OR=0.390, 95% CI: 0.179-0.849, P=0.018) was a protective factor for WMSDs in construction workers. However, squatting or kneeling for a long time (OR=1.818, 95% CI: 1.053-3.138, P=0.032), carrying heavy objects (each time >20 kg) (OR=2.876, 95% CI: 1.629-5.077, P < 0.001), working in an uncomfortable posture (OR=2.619, 95% CI: 1.455-4.714, P=0.001), holding the same posture for a long time on the lower back (OR=2.913, 95% CI: 1.640-5.177, P < 0.001) and bending the knee for a long time (OR=2.958, 95% CI: 1.659-5.274, P < 0.001) were independent risk factors for WMSDs.  Conclusions  Construction workers are at higher risk of WMSDs, the most common of which is lower back WMSDs. The influencing factors mainly include individual characteristics, labor type and poor ergonomic factors.
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  • 表  1  不同个体特征人群下背部WMSDs患病情况比较[n(%)]

    Table  1.   Comparison of WMSDs in lower back among different individuals [n(%)]

    组别 人数 患病人数 患病率(%) χ2值 P值 组别 人数 患病人数 患病率(%) χ2值 P值
    性别 体育锻炼(次/周) 18.845 < 0.001
      女性a 28(6.2)    < 1 282(62.3) 87 30.9
      男性 425(93.8) 105 24.7   ≥1 171(37.7) 22 12.9
    年龄(岁) 7.840 0.049 当前岗位工龄(年) 4.152 0.246
       < 30 52(11.5) 7 13.5    < 5 157(34.7) 29 18.5
      30~ < 40 119(26.3) 24 20.2   5~ < 10 112(24.7) 31 27.7
      40~ < 50 146(32.2) 45 30.8   10~ < 15 60(13.2) 16 26.7
      ≥50 136(30.0) 33 24.3   ≥15 124(27.4) 33 26.6
    文化程度 8.977 b 0.003 BMI(kg/m2) 0.306 0.858
      初中及以下 338(74.6) 94 27.8   正常 293(64.7) 71 24.2
      高中及中专 75(16.6) 10 13.3   超重 135(29.8) 31 23.0
      大专及以上 40(8.8) 5 12.5   肥胖和低体重 25(5.5) 7 28.0
    吸烟习惯(支/周) 2.955 0.086 婚姻状况 0.347 0.556
       < 20 190(41.9) 38 20.0   未婚或其他 59(13.0) 16 27.1
      ≥20 263(58.1) 71 27.0   已婚 394(87.0) 93 23.6
    工种 个人月收入(元) 4.444 b 0.035
      技术员 49(10.8) 7 14.3   ≤3 000 44(9.7) 12 27.3
      木工 178(39.3) 64 36.0   >3 000~5 000 267(58.9) 73 27.3
      钢筋工 104(23.0) 21 20.2   >5 000 142(31.3) 24 16.9
      架子工a 32(7.1)
      其他工种c 90(19.9) 14 15.6
    注：a表示患病人数 < 5人，不列入统计分析；b表示趋势性χ2检验；c表示包括电焊工、打孔工、混水泥工、砼工、力工、起重工、升降机工、水暖工、铝膜工、其他辅助工种等。
    下载: 导出CSV

    表  2  不同作业类型和劳动组织制度人群下背部WMSDs患病情况比较[n(%)]

    Table  2.   Comparison of WMSDs prevalence in the lower back among people with different job types and labor organization systems [n(%)]

    组别 人数 患病人数 患病率(%) χ2值 P值 组别 人数 患病人数 患病率(%) χ2值 P值
    长时间站立 7.916 0.005 每分钟多次重复性操作 0.445 0.505
      从不/有时 122(26.9) 18 14.8   否 315(69.5) 73 23.2
      经常/频繁 331(73.1) 91 27.5   是 138(30.5) 36 26.1
    长时间坐位 3.402 0.065 每天从事同样工作 2.363 0.124
      从不/有时 407(89.8) 103 25.3   否 71(15.7) 12 16.9
      经常/频繁 46(10.2) 6 5.5   是 382(84.3) 97 25.4
    长时间蹲或跪姿 25.347 < 0.001 休息时间充足 5.280 0.022
      从不/有时 323(71.3) 57 17.6   否 162(35.8) 49 30.2
      经常/频繁 130(28.7) 52 40.0   是 291(64.2) 60 20.6
    搬运重物(每次>20 kg) 47.739 < 0.001 部门人员紧缺 0.005 0.945
      从不/有时 262(57.8) 32 12.2   否 348(76.8) 84 24.1
      经常/频繁 191(42.2) 77 40.3   是 105(23.2) 25 23.8
    上肢或手用力工作 14.885 < 0.001 自主选择工间休息时间 1.244 0.265
      从不/有时 152(33.6) 20 13.2   否 266(58.7) 69 25.9
      经常/频繁 301(66.4) 89 29.6   是 187(41.3) 40 21.4
    使用振动工具 0.011 0.918 自主选择上下班时间 7.551 0.006
      从不/有时 359(79.2) 86 24.0   否 337(74.4) 92 27.3
      经常/频繁 94(20.8) 23 21.1   是 116(25.6 17 14.7
    以不舒服姿势工作 18.672 < 0.001 需要轮班 1.214 0.270
      从不/有时 166(36.6) 21 12.7   否 384(84.8) 96 25.0
      经常/频繁 287(63.4) 88 30.7   是 69(15.2) 13 18.8
    工作在户外完成 3.852 0.050 经常加班 1.620 0.203
      从不/有时 73(16.1) 11 15.1   否 329(72.6) 74 22.5
      经常/频繁 380(83.9) 98 25.8   是 124(27.4) 35 28.2
    经常替同事上班 0.122 0.727
      否 387(85.4) 92 23.8
      是 66(14.6) 17 25.8
    下载: 导出CSV

    表  3  不同作业姿势人群下背部WMSDs患病情况比较[n(%)]

    Table  3.   Comparison of WMSDs in lower back among people with different postures [n(%)]

    组别 人数 患病人数 患病率(%) χ2值 P值 组别 人数 患病人数 患病率(%) χ2值 P值
    背部弯曲 9.227 0.002 长时间保持转身 16.455 < 0.001
      否 102(22.5) 13 12.7   否 301(66.4) 55 18.3
      是 351(77.5) 96 27.4   是 152(33.6) 54 35.5
    经常转身 0.517 0.472 长时间保持弯腰 47.515 < 0.001
      否 125(27.6) 33 26.4   否 273(60.3) 35 12.8
      是 328(72.4) 76 23.2   是 180(39.7) 74 41.1
    经常弯腰同时转身 1.510 0.219 能伸展或改变腿部姿势 0.565 0.452
      否 206(45.5) 44 21.4   否 55(12.1) 11 20.0
      是 247(54.5) 65 26.5   是 398(87.9) 98 24.6
    下背部常重复相同动作 5.146 0.023 长时间保持屈膝 38.958 < 0.001
      否 192(42.4) 36 18.8   否 262(57.8) 35 13.4
      是 261(57.6) 73 28.0   是 191(42.2) 74 38.7
    下背部长时间同一姿势 30.715 < 0.001 足踝部经常重复相同动作 2.244 0.134
      否 204(45.0) 24 11.8   否 281(62.0) 61 21.7
      是 249(55.0) 85 34.1   是 172(38.0) 48 27.9
    下载: 导出CSV

    表  4  建筑工人下背部WMSDs患病影响因素的多因素logistic回归分析结果

    Table  4.   Multivariate logistic regression analysis results of influencing factors of WMSDs in the lower back of construction workers

    影响因素 偏回归系数 sx Wald χ2值 OR (95% CI)值 P值
    文化程度
      初中及以下 1.000
      高中及中专 -0.943 0.398 5.618 0.390 (0.179~0.849) 0.018
      大专及以上 -0.644 0.550 1.373 0.525 (0.179~1.543) 0.241
    长时间蹲或跪姿 0.598 0.279 4.597 1.818 (1.053~3.138) 0.032
    搬运重物(每次>20 kg) 1.056 0.290 13.274 2.876 (1.629~5.077) < 0.001
    以不舒服姿势工作 0.963 0.300 10.303 2.619 (1.455~4.714) 0.001
    下背部长时间保持同一姿势 1.069 0.293 13.289 2.913 (1.640~5.177) < 0.001
    长时间屈膝 1.084 0.295 13.503 2.958 (1.659~5.274) < 0.001
    足踝部经常重复相同动作 -0.592 0.302 3.854 0.553 (0.306~1.000) 0.050
    注：变量赋值：下背部WMSDs：否=0，是=1；性别：女性=0，男性=1；年龄：＜30岁=1，30~＜40岁=2，40~＜50岁=3，≥50岁=4；当前岗位工龄：＜5年=1，5~＜10年=2，10~＜15年=3，≥15年=4；文化程度(哑变量)：初中及以下=1(参照)，高中及中专=2，本科及以上=3；吸烟习惯：＜20支/周=1，≥20支/周=2；体育锻炼：＜1次/周=1，≥1次/周=2；BMI(哑变量)：正常=1(参照)，超重=2，肥胖和低体重=3；个人月收入(哑变量)：≤3 000元=1(参照)，＞3 000~5 000元=2，＞5 000元=3；长时间站立、长时间坐位、长时间蹲或跪姿、搬运重物(每次＞20 kg)、上肢或手用力工作、使用振动工具、以不舒服姿势工作、每天从事同样工作、自主选择上班时间、工作在户外完成、休息时间充足、部门人员紧缺、经常加班、需要轮班等：从不/有时=1，经常/频繁=2；其他自变量赋值，否=0，是=1。
    下载: 导出CSV
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  • 收稿日期:  2022-03-24
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