中国职业人群作业疲劳与工作相关肌肉骨骼疼痛及损伤关联性分析  

Correlation between work fatigue and work-related musculoskeletal pain or injury in the occupational population in China

作　　者：徐擎 张华东[2] 凌瑞杰[3] 刘移民[4] 李刚 任早亮 尹艳[7] 邵华[8] 张恒东[9] 邱兵[10] 张美辨 王大宇[11] 曾强[12] 王如刚[13] 陈建超[14] 张丹英[15] 梅梁英 刘永泉 刘吉祥[18] 张成云[19] 李天来[20] 贾宁[1] 王忠旭[1] XU Qing;ZHANG Huadong;LING Ruijie;LIU Yimin;LI Gang;REN Zaoliang;YIN Yan;SHAO Hua;ZHANG Hengdong;QIU Bing;ZHANG Meibian;WANG Dayu;ZENG Qiang;WANG Rugang;CHEN Jianchao;ZHANG Danying;MEI Liangying;LIU Yongquan;LIU Jixiang;ZHANG Chengyun;LI Tianlai;JIA Ning;WANG Zhongxu(不详;National Institute of Occupational Health and Poison Control,Chinese Center for Disease Control and Prevention,Beijing 100050,China)

机构地区：[1]中国疾病预防控制中心职业卫生与中毒控制所,北京100050 [2]重庆市疾病预防控制中心,重庆400042 [3]湖北省新华医院,湖北武汉430024 [4]广州市职业病防治院,广东广州510620 [5]辽宁省卫生健康服务中心,辽宁沈阳110399 [6]贵州省职业病防治院,贵州贵阳610599 [7]上海市疾病预防控制中心,上海200051 [8]山东省职业卫生与职业病防治研究院,山东济南255030 [9]江苏省疾病预防控制中心,江苏南京210009 [10]中国民用航空局民用航空医学中心,北京100010 [11]天津市职业病防治院,天津300011 [12]天津市疾病预防控制中心,天津300011 [13]北京市疾病预防控制中心,北京100013 [14]福建省职业病与化学中毒预防控制中心,福建福州350025 [15]广东省职业病防治院,广东广州510300 [16]湖北省疾病预防控制中心,湖北武汉430070 [17]江西省职业病防治研究院,江西南昌330006 [18]宁夏疾病预防控制中心,宁夏银川750003 [19]四川省疾病预防控制中心,四川成都610044 [20]陕西省疾病预防控制中心,陕西西安710054

出　　处：《中国职业医学》2023年第2期133-139,共7页China Occupational Medicine

基　　金：国家重点研发计划(2022YFC2503205);中国疾病预防控制中心职业卫生与中毒控制所职业健康风险评估与国家职业卫生标准制定项目(131031109000160004)。

摘　　要：目的分析我国职业人群工作相关肌肉骨骼疾患(WMSDs)、作业疲劳和肌肉骨骼疼痛现状,探讨作业疲劳与肌肉骨骼疼痛、WMSDs的关系。方法采用分层整群抽样方法,以我国15个重点行业323家企业66961名在职员工为研究对象,采用《中文版肌肉骨骼疾患调查表》调查其过去1年WMSDs发病情况,并采用《Borg 6-20主观疲劳等级量表》、视觉模拟疼痛评分法调查其作业疲劳和肌肉骨骼疼痛情况。以第七次全国人口普查中18~60岁年龄构成数据对数据进行标准化。结果研究对象中,一线作业人员WMSDs标准化发病率高于行政管理与其他辅助人员(38.82%vs 36.30%);作业疲劳、肌肉骨骼疼痛检出率分别为44.54%和63.08%。S型曲线拟合结果显示,研究对象WMSDs发病风险随着其作业疲劳程度的升高而升高(P<0.01)。一线作业人员中,WMSDs组人群颈部、肩部、下背部、上背部、腕/手部、足踝部、膝部、腿部和肘部9个部位每月平均疲劳次数均高于非WMSDs组(P值均<0.01)。疲劳组人群9个部位的肌肉骨骼疼痛程度均高于非疲劳组(P值均<0.01)。疲劳组人群肌肉骨骼疼痛标准化检出率高于非疲劳组(80.38%vs 25.71%)。除下背部和肘部外,研究对象其余7个部位的作业疲劳与肌肉骨骼疼痛程度均呈中度正相关,Kendall Tau-b相关系数为0.423~0.546(P值均<0.01)。结论我国职业人群作业疲劳与其局部肌肉骨骼疼痛、WMSDs均具有良好的关联性。通过工效学干预控制作业疲劳的发生发展是预防WMSDs的有效手段。Objective To analyze the current status of work-related musculoskeletal disorders(WMSDs),work fatigue and musculoskeletal pain in Chinese occupational population,and to study the relationship between work fatigue and musculoskeletal pain and WMSDs.Methods A total of 66961 employees from 323 enterprises in 15 key industries in China were selected as the study subjects using stratified cluster sampling method.The incidence of WMSDs in the past year was investigated using the Chinese version of the Musculoskeletal Disorders Questionnaire,and the work fatigue and musculoskeletal pain were investigated using Borg 6-20 Rating of Perceived Exertion Scale and visual analogue scale.The data were standardized using the age composition data of 18 to 60 years from the seventh national population census.Results The standardized annual incidence of WMSDs was higher in the front-line workers than that in the administrative and other supportive staff(38.82%vs 36.30%).The detection rates of work fatigue and musculoskeletal pain in the study subjects were 44.54%and 63.08%,respectively.The result of S-curve fitting showed that the risk of WMSDs increased with the level of work fatigue(P<0.01).Among the front-line workers,the average of monthly fatigue frequency in the neck,shoulder,lower back,upper back,wrist/hand,foot and ankle,knee,leg,and elbow were higher in the group with WMSDs compared to those without WMSDs(all P<0.01).The pain degree of musculoskeletal pain was higher in all nine sites in the fatigued group than in the nofatigue group(all P<0.01).The standardized detection rate of musculoskeletal pain was higher in the fatigued group than in the non-fatigued group(80.38%us 25.71%).The work fatigue was moderate and positively correlated with musculoskeletal pain in all seven sites except the lower back and elbow,with Kendall Tau-b correlation coefficients ranging from 0.423 to 0.546(all P<0.01).Conclusion There is a good correlation between work fatigue and local musculoskeletal pain,work fatigue and WMSDs in Chinese occupat

关 键 词：职业人群 作业疲劳 疼痛 工作相关肌肉骨骼疾患 发病率 相关性 

分 类 号：R135.99[医药卫生—劳动卫生]