新疆某煤矿作业人员职业紧张及心理健康状况对工作相关肌肉骨骼疾患的影响  

Effects of occupational stress and mental health on work-related musculoskeletal disorders in coal mine workers in Xinjiang

作　　者：李雪[1] 易孝婷 刘继文[1] LI Xue;YI Xiaoting;LIU Jiwen(School of Public Health,Xinjiang Medical University,Urumqi,Xinjiang 830017,China)

机构地区：[1]新疆医科大学公共卫生学院,新疆乌鲁木齐830017

出　　处：《环境与职业医学》2022年第8期863-870,共8页Journal of Environmental and Occupational Medicine

基　　金：国家自然科学基金(81760581)。

摘　　要：[背景]煤矿作业人员肌肉骨骼疾患发生率居高不下,心理因素是影响工人肌肉骨骼疾患的重要因素之一。[目的]探究新疆煤矿工人职业紧张水平、心理健康状况及工作相关肌肉骨骼疾患(WMSDs)现状,并分析职业紧张、心理健康对WMSDs的影响。[方法]于2018年8月—2019年8月,采用整群随机抽样的方法对4家煤矿1300名工人进行问卷调查,采用肌肉骨骼疾患调查问卷、付出-回报失衡(ERI)量表、症状自评量表(SCL-90)调查分析工人WMSDs、职业紧张及心理健康状况。[结果]本次调查回收有效问卷1177份,有效率为90.5%。WMSDs总症状发生率为66.4%,职业紧张者占50.2%,心理症状阳性者占53.4%。煤矿工人ERI得分M(P_(25),P_(75))为1.0(0.9,1.2)分,SCL-90得分M(P_(25),P_(75))为138.0(117.0,184.0)分。职业紧张组中,≥3个部位WMSDs的症状发生率为45.0%;心理症状阳性组中,≥3个部位WMSDs的症状发生率为46.0%。二分类logistic回归分析结果提示,调整了性别、年龄、工龄、倒班、工种、婚姻状况、文化程度、月收入后,职业紧张(OR=1.835,95%CI:1.380~2.440)、心理症状阳性(OR=1.461,95%CI:1.083~1.969)与发生WMSDs呈正相关;女性(OR=2.393,95%CI:1.544~3.709)、年龄≥30岁(OR_(30~<40)=2.344,95%CI:1.507~3.645;OR_(40~<50)=2.395,95%CI:1.541~3.723;OR_(50~60)=5.115,95%CI:2.872~9.111)、工龄>15年(OR=2.283,95%CI:1.537~3.392)、采煤工(OR=1.591,95%CI:1.070~2.365)的WMSDs症状发生风险更高;文化程度为高中及以上(OR_(高中)=0.399,95%CI:0.279~0.571;OR_(大专及以上)=0.220,95%CI:0.157~0.310)、月收入>8000元(OR=0.364,95%CI:0.227~0.582)的煤矿工人WMSDs症状发生风险更低。结构方程模型结果显示:在以心理健康为中介变量的模型一中,职业紧张和心理健康可直接影响WMSDs,标准化路径系数(β)分别为0.10和0.25;ERI也可直接影响心理健康,β为0.20。在以WMSDs为中介变量的模型二中,ERI和WMSDs可直接影响心理健康,β分别为0.16和0.25;ER[Background]The occurrence of musculoskeletal disorders in coal mine workers remains high,and psychological factors are one of the important factors.[Objective]To explore the occupational stress level,mental health status,and prevalence of work-related musculoskeletal disorders(WMSDs)of coal miners in Xinjiang,and to analyze the effects of occupational stress and mental health on WMSDs.[Methods]From August 2018 to August 2019,1300 workers of 4 coal mines were selected by cluster sampling method.Musculoskeletal Disorders Questionnaire,Effort-Reward Imbalance(ERI)Scale,Self Reporting Inventory(SCL-90)were used to investigate the prevalence of WMSDs,occupational stress,and mental health.[Results]A total of 1177 valid questionnaires were collected,with a valid rate of 90.5%.The prevalence rate of WMSDs was 66.4%,the positive rate of occupational stress was 50.2%,and the positive rate of psychological symptoms was 53.4%.The M(P25,P75)ERI score was 1.0(0.9,1.2),and the M(P25,P75)SCL-90 score was 138.0(117.0,184.0).The prevalence rate of WMSDs in≥3 sites was 45.0%in the occupational stress group and 46.0%in the positive psychological symptoms group.The results of binary logistic regression analysis showed that reporting occupational stress(OR=1.835,95%CI:1.380-2.440)and positive psychological symptoms(OR=1.461,95%CI:1.083-1.969)were positively associated with the prevalence of WMSDs;those being female(OR=2.393,95%CI:1.544-3.709),aged≥30 years(OR_(30-<40)=2.344,95%CI:1.507-3.645;OR_(40-<50)=2.395,95%CI:1.541-3.723;OR_(50-60)=5.115,95%CI:2.872-9.111),with length of service>15 years(OR=2.283,95%CI:1.537-3.392),and being coal diggers(OR=1.591,95%CI:1.070-2.365)showed higher risks of reporting WMSDs;those with education level at high school and above(ORhigh school=0.399,95%CI:0.279-0.571;ORcollege and above=0.220,95%CI:0.157-0.310),and monthly income>8000 yuan(OR=0.364,95%CI:0.227-0.582)showed lower risks of reporting WMSDs.The results of structural equation model showed that in model 1 with mental health as the intermed

关 键 词：工作相关肌肉骨骼疾患 付出-回报失衡 心理健康 煤矿作业人员 

分 类 号：R135[医药卫生—劳动卫生]