我国29个行业或作业人群工作相关肌肉骨骼疾患的流行特征研究  

Study on the epidemiological characteristics of work-related musculoskeletal disorders among 29 industries or occupational groups in China

作　　者：贾宁[1] 张美辨 徐擎 张华东[3] 凌瑞杰 刘移民[5] 王致[6] 李刚[7] 尹艳[8] 邵华[9] 李珏[10] 张恒东[11] 邱兵[12] 王大宇[13] 曾强[14] 王如刚[15] 叶研[15] 肖斌[16] 邹华[17] 陈建超[18] 黎东霞 刘永泉 时庆华 刘吉祥[21] 蒋恩霏[22] 漆骏[23] 梅良英 赵显锋 杨咪咪 郭新苇 孙新[2] 王忠旭[1] Jia Ning;Zhang Meibian;Xu Qing;Zhang Huadong;Ling Ruijie;Liu Yimin;Wang Zhi;Li Gang;Yin Yan;Shao Hua;Li Jue;Zhang Hengdong;Qiu Bing;Wang Dayu;Zeng Qiang;Wang Rugang;Ye Yan;Xiao Bin;Zou Hua;Chen Jianchao;Li Dongxia;Liu Yongquan;Shi Qinghua;Liu Jixiang;Jiang Enfei;Qi Jun;Mei Liangying;Zhao Xianfeng;Yang Mimi;Guo Xinwei;Sun Xin;Wang Zhongxu(Laboratory of Occupational Protection and Ergonomics,National Institute of Occupational Health and Poison Control,Chinese Center for Disease Control and Prevention,Beijing 100050,China;National Institute of Occupational Health and Poison Control,Chinese Center for Disease Control and Prevention,Beijing 100050,China;Office of the Director,Chongqing Center for Disease Control and Prevention,Chongqing 400042,China;Office of Hubei Clinical Medical Research Center for Occupational Diseases and Poisoning,Wuhan 430024,China;Department of Occupational Health Management,Guangzhou Institute of Occupational Disease Control and Prevention,Guangzhou 510620,China;Key Laboratory of Occupational Environment and Health,Guangzhou Institute of Occupational Disease Control and Prevention,Guangzhou 510620;Liaoning Provincial Health Service Center,Shenyang 110399,China;Department of Occupational Health,Shanghai Center for Disease Control and Prevention,Shanghai 200051,China;Testing and Evaluation Center,Shandong Academy of Occupational Health and Occupational Medicine,Jinan 255030,China;Office of Beijing Institute of Chemical Industry Occupational Disease Prevention and Treatment,Beijing 100195,China;Jiangsu Provincial Center for Disease Control and Prevention,Nanjing 210009,China;Office of Public Health Emergency Management,Civil Aviation Medical Center,Civil Aviation Administration of China,Beijing 100010,China;Department of Physical Examination,Tianjin Occupational Diseases Precaution and Therapeutic Hospital,Tianjin 30001l,China;Institute of Occupational Health,Tianjin Center for Disease Control and Prevention,Tianjin 30001l,China;Institute of Occupational Health,Beijing Centers for Disease Contro

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职业防护与工效学研究室,北京100050 [2]中国疾病预防控制中心职业卫生与中毒控制所,北京100050 [3]重庆市疾病预防控制中心主任办公室,重庆400042 [4]湖北省职业病与中毒临床医学研究中心办公室,武汉430024 [5]广州市职业病防治院职业卫生管理科,广州510620 [6]广州市职业病防治院职业环境与健康重点实验室,广州510620 [7]辽宁省疾病预防控制中心职业病防治所,沈阳110399 [8]上海市疾病预防控制中心职业健康科,上海200051 [9]山东省职业卫生与职业病防治研究院检测评价中心,济南255030 [10]北京市化工职业病防治院院办公室,北京100195 [11]江苏省疾病预防控制中心职业病防治所,南京210009 [12]中国民用航空局民用航空医学中心民航公共卫生应急管理办公室,北京100010 [13]天津市职业病防治院体检科,天津300011 [14]天津市疾病预防控制中心职业健康所,天津300011 [15]北京市疾病预防控制中心职业卫生所,北京100013 [16]广东省职业病防治院物理因素监测所,广州510300 [17]浙江省疾病预防控制中心职业健康与辐射防护所,杭州310051 [18]福建省职业病与化学中毒预防控制中心医务科,福州350025 [19]贵州省职业病防治院院办公室,贵阳610599 [20]江西省职业病防治研究院职业病医院,南昌330006 [21]宁夏疾病预防控制中心办公室,银川750003 [22]四川省疾病预防控制中心职业与辐射卫生所,成都610044 [23]云南省疾病预防控制中心职业健康与放射卫生所,昆明650118 [24]湖北省疾病预防控制中心卫生监测所,武汉430070 [25]陕西省疾病预防控制中心职业与放射卫生所,西安710054

出　　处：《中华劳动卫生职业病杂志》2024年第12期884-895,共12页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：国家重点研发计划课题(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(102393220020090000020)。

摘　　要：目的:分析2018年至2023年中国重点行业职业人群中工作相关肌肉骨骼疾患(work-related musculoskeletal disorders,WMSDs)的分布特征,为制定针对性预防策略提供数据支持。方法:于2018年1月1日至2023年12月31日,采用流行病学横断面与回顾性调查相结合的方法,对华北、华东、华中、华南、西南、西北和东北七个地理区域,按照与WMSDs发生密切程度、职业人群规模和国民经济重要性对行业进行分层,再根据企业规模(大型、中型、小型)在每个层级中进行整群抽样,选择具有代表性的企业,并以这些企业工龄超过1年且符合纳入标准的在岗作业工人作为研究对象。调查对象通过扫描二维码在线完成《中文版肌肉骨骼疾患调查表》,共收集到88609份有效问卷。计量资料用±s表示,WMSDs的发生率等计数资料标准处理后用χ^(2)检验评估不同部位间WMSDs标化发生率的差异。结果:我国一线职业人群中WMSDs不分部位的标化发生率为36.7%,标化发生率位居前三位的为颈部(21.37%)、肩部(18.23%)和下背部(14.92%),不同部位间WMSDs标化发生率差异存在统计学意义(χ^(2)=44757.82,P<0.05)。WMSDs标化发生率以我国东南部沿海地区(32.54%)为最低,而西北(49.70%)和东北地区(46.16%)均较高。WMSDs的标化发生率由2018年的42.88%逐渐下降至2023年的29.94%。微型企业观察人群的WMSDs主要集中在颈部(20.66%)、下背部(17.95%)和肩部(17.79%),大型企业观察人群则集中在颈部(20.54%)、肩部(17.52%)和下背部(14.65%)。在所调查的行业中,卫生行业WMSDs标化发生率最高(53.18%),其次为玩具制造业(50.54%)、汽车制造业(43.39%)、通用航空服务(42.71%)以及船舶及相关装置制造业(40.56%)。女性患WMSDs不分部位的标准化发生率明显高于男性(OR值=1.44,P<0.05)。此外,多部位(四个或以上部位同时发生)WMSDs及单一部位发生率最高,且WMSDs风险随主观疲劳程度的增加而上升,�Objective:To analyze the distribution characteristics of work-related musculoskeletal disorders(WMSDs)among the occupational population in China's key industries during the period from 2018 to 2023,and to provide data support for the formulation of targeted prevention strategies.Methods:Between January 1,2018,and December 31,2023,a cross-sectional epidemiological survey and a retrospective investigation were conducted in seven geographical regions of North China,East China,Central China,South China,Southwest China,Northwest China,and Northeast China,using a combination of epidemiological cross-sectional and retrospective surveys.The industries were stratified according to the degree of closeness to WMSDs,the size of the occupational population,and the importance of the national economy,and then cluster sampling was conducted according to the size of the enterprises(large,medium,and small)within each stratum.Representative enterprises were selected,and workers who had been employed for more than one year and met the inclusion criteria were selected as the study subjects.The survey subjects completed the Chinese version of the Musculoskeletal Disorders Survey Questionnaire online by scanning a QR code.A total of 88,609 valid questionnaires were collected.Continuous data were described by means and standard deviations,and the standardized incidence rates of WMSDs were evaluated using chi-square tests to compare the standardized incidence rates of different body parts.Results:The standardized prevalence rate of WMSDs among the frontline working population in China was 36.7%,with the top three being the neck(21.37%),shoulders(18.23%),and lower back(14.92%).There was a statistically significant difference in the standardized prevalence rate of WMSDs between different body parts(χ^(2)=47577.82,P<0.05).The lowest standardized prevalence rate of WMSDs was found in the southeast coastal region of China(32.54%),while the highest was in the northwest(49.70%)and northeast regions(46.16%).The standardized prevalence rate of W

关 键 词：肌肉骨骼系统 工作相关肌肉骨骼疾患 发生率 职业人群 流行特征 影响因素 预防策略 

分 类 号：R135[医药卫生—劳动卫生]