煤矿工人腰颈肩肌肉骨骼疾患风险预测模型的研究  

Study on risk prediction model of waist,neck and shoulder musculoskeletal diseases among coal miners

作　　者：马翔宇 迪丽娜尔·艾克拜尔 李富业[1] MA Xiangyu;Dilinaer Aikebaier;LI Fuye(School of Public Health,Xinjiang Medical University,Urumqi Xinjiang,830011,China)

机构地区：[1]新疆医科大学公共卫生学院,新疆乌鲁木齐830011

出　　处：《职业与健康》2024年第3期289-295,共7页Occupation and Health

基　　金：国家自然科学基金项目(82060590)。

摘　　要：目的了解煤矿工人职业性肌肉骨骼疾患(work-related musculoskeletal disorders,WMSDs)的危险因素,构建煤矿工人WMSDs风险预测模型。方法2019—2020年,采用分层整群抽样的方法,选用经修订的《肌肉骨骼疾患调查问卷》对新疆6家煤矿共1588名一线煤矿工人WMSDs发生情况进行调查。对排名前3的部位采用logistic回归法筛选变量并构建预测模型,绘制Nomogram。通过ROC曲线下面积评价模型的区分度,运用Bootstrap重抽样的方法进行模型的内部验证,并绘制Calibration曲线。结果新疆6家煤矿工人WMSDs症状发生率高达80.4%,排名前3的为腰、颈和肩部。性别、工龄、工种在腰、颈、肩部WMSDs差异均有统计学意义(均P<0.05);工作情况中长时间保持1种姿势、以不舒服姿势工作、单次承重过大、多次重复1种动作且未及时得到休息等与WMSDs症状发生相关(均P<0.05)。工龄(OR=1.575,95%CI:1.351~1.837)、文化程度本科(OR=2.039,95%CI:1.258~3.306)、工作涉及到寒冷/凉风或者气温变化(OR=1.419,95%CI:1.109~1.817)、长时间保持颈部前倾(OR=2.035,95%CI:1.591~2.603)、脚底打滑或跌倒(OR=1.886,95%CI:1.458~2.440)、因为姿势不舒服很难用得上劲(OR=1.327,95%CI:1.004~1.755)、需上肢或手用力(OR=1.264,95%CI:1.004~1.755)与罹患WMSDs均呈正相关;工间休息时间充足(OR=0.709,95%CI:0.557~0.904)、掘进工(OR=0.560,95%CI:0.340~0.922)、电钳工(OR=0.536,95%CI:0.324~0.887)与罹患WMSDs呈负相关。煤矿工人WMSDs预测模型具有较好预测效能,ROC曲线下面积为0.729(95%CI:0.702~0.756)。结论多种职业因素是新疆6家煤矿工人WMSDs的危险因素,且发生率相对较高,多集中在腰部、颈部和肩部。本次构建的风险预测模型可以对煤矿工人WMSDs起到一定的辅助预测作用。Objective To understand the risk factors of coal miners’work-related musculoskeletal disordes(WMSDs)and construct the risk prediction model of coal miners’WMSDs.Methods From 2019 to 2020,1588 coal miners in 6 coal mines in Xinjiang were selected by the method of stratified cluster sampling,the revised musculoskeletal diseases questionnaire was used to investigated the incidence of WMSDs among them.For the top 3 parts,the logistic regression method was used to screen the variables and construct the prediction model to draw the Nomogram line diagram.The differentiation of the model was evaluated by the area under the receiver operating curve(ROC),the internal verification of the model was carried out by the method of Bootstrap resampling,and the Calibration curve was drawn.Results The incidence of WMSDs among coal miners was as high as 80.4%,and the top 3 were waist,neck and shoulder.Gender,length of service and type of work had significant differences in WMSDs of waist,neck and shoulder(all P<0.05).Maintaining a posture for a long time,working in an uncomfortable position,bearing too much weight at a single time,repeating a movement for many times and not getting a rest in time were related to the occurrence of WMSDs(all P<0.05).Length of service(OR=1.575,95%CI:1.351-1.837),bachelor degree of education(OR=2.039,95%CI:1.258-3.306),cold/cool breeze or temperature change(OR=1.419,95%CI:1.109-1.817),neck tilt for a long time(OR=2.035,95%CI:1.591-2.603),foot slippage or fall(OR=1.886,95%CI:1.458-2.440),difficulty in using strength(OR=1.327,95%CI:1.004-1.755)because of uncomfortable posture,and need for upper limb or hand strength(OR=1.264,95%CI:1.004-1.755)were positively correlated with WMSDs.Adequate rest time between work(OR=0.709,95%CI:0.557-0.904),tunneling workers(OR=0.560,95%CI:0.340-0.922)and electric fitters(OR=0.536,95%CI:0.324-0.887)were negatively correlated with WMSDs.The risk model of WMSDs of coal miners has good prediction efficiency,and the area under the ROC curve was 0.729(95%CI:0.702-0.756).Conc

关 键 词：职业性肌肉骨骼疾患 预测模型 煤矿工人 

分 类 号：R181.31[医药卫生—流行病学]