大型机械维修男性工人WMSDs与甲状腺指标的关联  

The correlation between WMSDs and thyroid indicators in male large-scale mechanical maintenance workers

作　　者：毕明丽 崔西勇 王学峰 彭萧潇 李珏 王会宁 王晓舜 丁晓文 Bi Mingli;Cui Xiyong;Wang Xuefeng;Peng Xiaoxiao;Li Jue;Wang Huining;Wang Xiaoshun;Ding Xiaowen(Institute of Occupational Health,Beijing Institute of Occupational Disease Prevention and Treatment,Beijing 100093,China;School of Public Health,Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]北京市职业病防治研究院职业健康研究所,北京100093 [2]山西医科大学公共卫生学院,太原030001

出　　处：《中华劳动卫生职业病杂志》2025年第2期129-134,共6页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：首都卫生发展科研专项项目(首发2024-2-3103)。

摘　　要：目的调查大型机械维修男性工人工作相关肌肉骨骼疾患(work-related musculoskeletal disorders,WMSDs)情况,探索其与甲状腺指标的关联。方法于2022年4至7月,以在职并参加职业健康检查的某大型机械维修企业男性一线维修工人为研究对象(n=2036)。采用问卷进行WMSDs发生状况调查,并对其血清三碘甲状腺原氨酸(triiodothyronine,T3)、甲状腺素(thyroxine,T4)、促甲状腺激素(thyroid stimulating hormone,TSH)水平进行检测。采用χ^(2)检验、t检验和Mann-Whitney检验比较WMSDs组与非WMSDs组工人甲状腺疾病、T3、T4和TSH激素水平,并采用二元logistic回归模型分析甲状腺疾病、与WMSDs的关系。结果大型机械维修男性工人WMSDs发生率为73.18%(1490/2036)。WMSDs组的甲状腺疾病率高于非WMSDs组[8.26%(123/1490)比4.95%(27/546),χ^(2)=6.42,P=0.011],TSH值低于非WMSDs组[1.66(1.23,2.26)μIU/ml比1.75(1.30,2.42)μIU/ml,Z=-2.40,P=0.019]。两组间T3、T4水平和3种激素异常水平的分布差异均无统计学意义(P>0.05)。在考虑个体和职业因素后,患有甲状腺疾病工人WMSDs发生风险增加(OR=1.656,95%CI:1.072~2.559,P=0.023),而TSH值增加的工人WMSDs发生率降低(OR=0.897,95%CI:0.823~0.977,P=0.013)。结论大型机械维修男性工人WMSDs发生率高,可能与甲状腺指标有关,甲状腺疾病是WMSDs的危险因素,而TSH增加是WMSDs的保护因素。ObjectiveTo investigate the status of work-related musculoskeletal disorders(WMSDs)in male large-scale mechanical maintenance workers,and to explore the relationship between WMSDs and thyroid indexes.MethodsFrom April to July 2022,male front-line maintenance workers in a large-scale mechanical maintenance enterprise who participated in occupational health examination were selected as the study subjects(n=2036).The occurrence of WMSDs was investigated by questionnaire.The levels of triiodothyronine(T3),thyroxine(T4)and thyroid stimulating hormone(TSH)in serum were detected.χ^(2) test,t-test and Mann-Whitney U test were used to detect thyroid diseases and hormone levels of workers in WMSDs group and non-WMSDs group,and binary logistic regression model was used to analyze the relationship between thyroid disease,T3,T4,TSH and WMSDs.ResultsThe incidence of WMSDs among the male large-scale mechanical maintenance workers was 73.18%(1490/2036).The rate of thyroid disease in WMSDs group was higher than that in non-WMSDs group[8.26%(123/1490)vs.4.95%(27/546),χ^(2)=6.42,P=0.011],and the TSH value was lower than that in non-WMSDs group[1.66(1.23,2.26)μIU/ml vs.1.75(1.30,2.42)μIU/ml,Z=-2.40,P=0.019].There were no significant differences in the levels of T3,T4 and abnormal levels of 3 hormones between the two groups(P>0.05).After accounting for individual and occupational factors,workers with thyroid disease had an increased risk of WMSDs(OR=1.656,95%CI:1.072-2.559,P=0.023),while workers with increased TSH had a decreased risk of WMSDs(OR=0.897,95%CI:0.823-0.977,P=0.013).ConclusionThe incidence of WMSDs in male workers of large-scale mechanical maintenance is high,and its incidence may be related to thyroid index.Thyroid disease may be a risk factor for WMSDs,and increased TSH may be a protective factor for WMSDs.

关 键 词：肌肉骨骼系统 工作相关肌肉骨骼疾患 甲状腺疾病 促甲状腺激素 大型机械维修 

分 类 号：R58[医药卫生—内分泌]