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目的探讨与工作组织有关的因素对职业性肌肉骨骼损伤(WMSDs)患病的影响,为合理工作制度的制定以及WMSDs的干预提供依据。方法选取北京、河南、湖北、广东等地的14个行业共计41个企业(工厂)的工人进行病例对照研究,采用自主研制的肌肉骨骼损伤调查问卷对所选人群进行统一的问卷调查,其中,1 931名自诉患有WMSDs的工人作为观察组,1 991名对照组工人在性别、年龄、身高、体质量、教育程度等方面与之匹配,使用单因素分析和多因素非条件logistic回归进行分析。结果首先使用卡方检验对问卷中涉及到工作组织的18个可疑危险因素进行初步筛选(α=0.1),然后利用多因素非条件logistic回归,最终筛选出2个与WMSDs相关的因素,包括1个危险因素:人员短缺(OR=1.265,95%CI=1.190~1.346,P<0.01),1个保护因素:工间休息充足(OR=0.274,95%CI=1.073~1.433,P<0.01)。结论工作组织因素对WMSDs的影响是多样的,相关的队列研究可能为其机制提供更多的证据。
Objective To explore the impact of work-related factors on the prevalence of occupational musculoskeletal injuries (WMSDs) and to provide basis for the establishment of a reasonable working system and the intervention of WMSDs. Methods A total of 41 enterprises (factories) from 14 industries in Beijing, Henan, Hubei and Guangdong were selected for case-control study. A self-developed musculoskeletal injury questionnaire was used to conduct a questionnaire survey among selected groups. Among them, A total of 1 931 workers with private WMSDs as observation group and 1 991 control group workers were matched in terms of sex, age, height, body weight and educational level, and analyzed by univariate analysis and multivariate non-conditional logistic regression . Results A preliminary screening of 18 suspicious risk factors in the questionnaire (α = 0.1) was first conducted using the chi-square test. Two factors associated with WMSDs were finally screened using multivariate non-conditional logistic regression, including 1 Risk factors: a shortage of staff (OR = 1.265,95% CI = 1.190-1.346, P <0.01), one protective factor: adequate rest between workplaces (OR = 0.274, 95% CI = 1.073-1.433, P <0.01) . CONCLUSIONS The impact of work-organization factors on WMSDs is variable, and relevant cohort studies may provide more evidence for its mechanisms.