三级医院护士下背和下肢工作相关肌肉骨骼疾患及其影响因素分析  

Analysis of work-related musculoskeletal disorders of lower back and lower limbs and influencing factors in nurses at tertiary hospitals

作　　者：刘飞 凌瑞杰 贾宁[2] 刘爽[3] 孙敬智 李刚 刘移民[5] 杨燕 张华东[6] 王如刚[7] 刘吉祥[8] 王忠旭[2] 殷红 LIU Fei;LING Ruijie;JIA Ning;LIU Shuang;SUN Jingzhi;LI Gang;LIU Yimin;YANG Yan;ZHANG Huadong;WAGN Rugang;LIU Jixiang;WAGN Zhongxu;YIN Hong(Hubei Provincial Hospital of Integrated Chinese and Western Medicine,Hubei Provincial Occupational Disease Hospital,Wuhan,Hubei 430030,China;Occupational Health and Poison Control Institute,Chinese Center for Disease Control and Prevention,Beijing 100050,China;School of Public Health,Wuhan University of Science and Technology,Wuhan,Hubei 430030,China;Liaoning Provincial Health and Wellness Service Center,Shenyang,Liaoning 110023,China;The Twelfth People's Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510620,China;Chongqing Center for Disease Control and Prevention,Chongqing 400042,China;Beijing Center for Disease Control and Prevention,Beijing 100050,China;Ningxia Hui Autonomous Region Center for Disease Control and Prevention,Yinchuan,Ningxia 750003,China)

机构地区：[1]湖北省中西医结合医院(湖北省职业病医院),湖北武汉430030 [2]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,北京100050 [3]武汉科技大学公共卫生学院,湖北武汉430030 [4]辽宁省卫生健康服务中心,辽宁沈阳110023 [5]广州市第十二人民医院,广东广州510620 [6]重庆市疾病预防控制中心,重庆400042 [7]北京市疾病预防控制中心,北京100050 [8]宁夏回族自治区疾病预防控制中心,宁夏银川750003

出　　处：《职业卫生与应急救援》2024年第2期165-170,共6页Occupational Health and Emergency Rescue

基　　金：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(131031109000160004);职业危害识别与控制湖北省重点实验室开放基金青年项目(OHIC2023Y06)。

摘　　要：目的调查三级医院护士下背部和下肢不同部位工作相关肌肉骨骼疾患(work-related musculoskeletal disorders,WMSDs)的患病情况,分析工效学危险因素与护士下背部和下肢各部位WMSDs患病风险之间的关联。方法2018—2020年,采用分层整群抽样,以15家三级医院3060名护士为研究对象,使用《中文版肌肉骨骼疾患调查表》电子问卷系统收集医院护士WMSDs患病及相关危险因素的信息,采用logistic回归模型分析工效学危险因素与护士下背部及下肢不同部位WMSDs患病风险之间的关系。结果护士下背部WMSDs患病率最高,为29.1%;腿部、足或踝部WMSDs患病率分别为21.6%和19.6%;膝部WMSDs患病率最低,为15.3%。多因素logistic回归分析结果显示,每周工作时长超过40 h、总工龄≥10年、长时间屈膝、搬运重物、以不舒服的姿势工作、多次的重复性操作工作、在同一场所完成工作、大学本科及以上学历会增加护士下背部WMSDs患病风险(OR=1.20~2.26,P<0.05),体育锻炼会降低护士下背部WMSDs患病风险(OR=0.64~0.75,P<0.05);周工作时长超过40 h、长时间屈膝工作、经常和患者进行沟通会增加护士下肢各部位WMSDs患病风险(OR=1.30~2.36,P<0.05);长时间站立、以不舒服的姿势工作、每天从事同样的工作会增加护士腿部WMSDs患病风险(OR=1.82~2.05,P<0.05);搬运重物、以不舒服的姿势工作、每天从事同样的工作会增加护士足或踝部WMSDs患病风险(OR=1.35~1.90,P<0.05);年龄≥30岁、搬运重物会增加护士膝部WMSDs患病风险(OR=1.36、1.36,P<0.05);长时间坐位工作可以降低护士腿部、膝部和足或踝部WMSDs的患病风险(OR=0.60~0.70,P<0.05)。结论三级医院护士下背部及下肢各部位均有不同程度的WMSDs患病风险,应通过加强教育培训、制定相关制度以及提供适宜的操作工具来改善。Objective To investigate the prevalence of work-related musculoskeletal disorders(WMSDs)in different parts of the lower back and lower limbs among nurses in tertiary hospitals and to analyze the association between ergonomics risk factors and the risk of WMSDs in these body parts.Methods Using stratified cluster sampling,3060 nurses from 15 tertiary hospitals were selected as the research subjects from 2018 to 2020.The electronic questionnaire system of the Chinese Version Musculoskeletal Disorders Questionnaire was used to collect information on the prevalence of WMSDs and related risk factors among these nurses.Logistic regression models were employed to analyze the association between ergonomic risk factors and the risk of WMSDs in different parts of the lower back and lower limbs.Results The prevalence of lower back WMSDs was the highest among nurses,at 29.1%;the prevalence of leg,foot,or ankle WMSDs was 21.6%and 19.6%,respectively;and the prevalence of knee WMSDs was the lowest,at 15.3%.Multifactorial logistic regression analysis revealed that working more than 40 hours per week,having a total working time of more than 10 years,working with long bent knees,manual handling of heavy loads,working in uncomfortable postures,repetitive operations,completing tasks in the same location,and having a bachelor's degree or higher increased the risk of lower back WMSDs(OR=1.20-2.26,P<0.05).Physical exercise reduced the risk(OR=0.64-0.75,P<0.05).Working more than 40 hours per week,working with long bent knees,and having frequent communication with patients increased the risk of WMSDs in various parts of the lower limbs(OR=1.30-2.36,P<0.05).Prolonged standing,working in uncomfortable postures,and performing the same tasks daily increased the risk of leg WMSDs(OR=1.82-2.05,P<0.05).Manual handling of heavy loads,working in uncomfortable postures,and performing the same tasks daily increased the risk of foot or ankle WMSDs(OR=1.35-1.90,P<0.05).Being aged≥30 years and manual handling of heavy loads increased the risk of kne

关 键 词：护士 工作相关肌肉骨骼疾患 下背部 下肢 影响因素 

分 类 号：R135[医药卫生—劳动卫生]