我国29个行业或作业人群职业接触特征与肌肉骨骼疾患关系的研究  

Study on the relationship between occupational exposure characteristics and musculoskeletal disorders in 29 industries or workforce 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896-910,共15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:探索我国重点职业人群工作相关肌肉骨骼疾患(WMSDs)的职业接触特征,评估职业因素对WMSDs发生的影响,并提出相应的预防策略。方法:于2018年1月1日至2023年12月31日,采用横断面流行病学调查方法,回顾性调查WMSDs的发生情况及相关职业因素。收集了来自我国七个地区29个行业或作业类型441家企业的88609名在岗工人的有效问卷数据,运用多因素logistic回归分析探讨WMSDs与各种职业因素之间的关系,计算了优势比(odds ratio,OR)及其95%置信区间(confidence interval,CI),以评估不同因素对WMSDs发生风险的影响。结果:调查对象中男性59989人,占67.7%(59989/88609);女性28620人,占32.3%(28620/88609)。在不考虑具体部位的情况下,全身9个部位的工作相关肌肉骨骼疾患(WMSDs)的标化发生率在不同工龄组间差异有统计学意义(P<0.05)。WMSDs(不分部位)的平均发病工龄为(4.52±2.67)年,不同部位WMSDs发病工龄的差异有统计学意义(P<0.05)。随着搬运重物频率的增加,各部位WMSDs的标化率和OR值均呈现明显增加的趋势。长时间保持不良工作姿势频繁重复操作、重物搬运与WMSDs的标准发生率明显相关(OR=1.52、1.45、1.63,P<0.01)。结论:本研究揭示了我国职业人群中WMSDs风险随工龄增长呈非线性变化,尤其在10至25年工龄时明显增加,且不良工作姿势、频繁重复操作和重物搬运与WMSDs明显相关,为制定更为精确和有效的WMSDs预防策略提供了科学依据。Objective:To explore the occupational contact characteristics of work-related musculoskeletal disorders(WMSDs)among key occupational groups in China,assess the impact of occupational factors on the occurrence of WMSDs,and propose corresponding preventive strategies.Methods:Between January 1,2018,and December 31,2023,a cross-sectional epidemiological survey method was employed to retrospectively investigate the occurrence of WMSDs and related occupational factors.Valid questionnaire data from 88609 on-the-job workers in 441 enterprises across 29 industries or job types in seven regions of China were collected,and the relationship between WMSDs and various occupational factors was discussed using multifactorial logistic regression analysis.Odds ratios(OR)and their 95%confidence intervals(CI)were calculated to assess the impact of different factors on the risk of WMSDs occurrence,with all statistical tests performed as two-tailed tests,using P<0.05 as the criterion for statistical significance.Results:Among the surveyed subjects,59989 were male,accounting for 67.7%(59989/88609);28620 women,accounting for 32.3%(28620/88609).The standardized incidence rate of work related musculoskeletal disorders(WMSDs)in 9 parts of the body was statistically significant(P<0.05)among different working age groups without considering specific parts.The average length of service for onset of WMSDs(regardless of location)is(4.52±2.67)years,and there is a statistically significant difference in the length of service for onset of WMSDs in different locations(P<0.05).As the frequency of heavy object handling increases,the standardization rate and OR value of WMSDs in various parts show a significant increase trend.The incidence of WMSDs is significantly correlated with maintaining poor work posture for a long time,frequent repetitive operations,and heavy object handling(OR=1.52,1.45,1.63,P<0.01).Conclusion:This study reveals that the risk of WMSDs in China's occupational population shows a non-linear change with increasing length of servic

关 键 词：工作相关肌肉骨骼疾患 发生率 职业人群 流行病学调查 职业接触特征 预防策略 

分 类 号：R135[医药卫生—劳动卫生]