首页|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

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

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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88 609份有效问卷.计量资料用(x)±s表示,WMSDs的发生率等计数资料标准处理后用x2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(x2=44 757.82,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,呈现出显著的"S型"趋势性关系(主观疲劳等级量表得分=13、15、17、19、20分时,OR=2.19、3.16、4.71、5.49、3.97.x2趋势=17.23,P＜0.001).结论 我国重点行业职业人群WMSDs的分布特征在不同部位、地域、时间、企业规模、行业及人群属性上表现出明显差异.农业、医药制造业和包装装潢及其他印刷业在多部位同时发生和单一部位发生WMSDs的比例较高.需要针对特定地区、行业和企业规模,以及多部位WMSDs的特点,研究并实施精准的预防措施,以有效保障职业人群的健康和福祉.
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(x2=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 WMSDs decreased from 42.88％in 2018 to 29.94％in 2023.The micro-enterprise observation group had a higher concentration of WMSDs in the neck(20.66％),lower back(17.95％),and shoulders(17.79％),while the large enterprise observation group had a higher concentration in the neck(20.54％),shoulders(17.52％),and lower back(14.65％).Among the industries surveyed,the highest standardized prevalence rate of WMSDs was found in the healthcare industry(53.18％),followed by the toy manufacturing industry(50.54％),the automotive manufacturing industry(43.39％),general aviation services(42.71％),and the ship and related equipment manufacturing industry(40.56％).The standardized prevalence rate of WMSDs among women was significantly higher than that of men(OR value=1.44,P＜0.05).In addition,the standardized prevalence rate of WMSDs with multiple affected body parts(four or more body parts affected simultaneously)was higher,and the risk of WMSDs increased with subjective fatigue,showing a significant"S-shaped"trend(the OR value was 2.19,3.16,4.71,5.49,and 3.97 when the RPE was 13,15,17,19,and 20,respectively.x2trend=17.23,P＜0.001).Conclusion The distribution characteristics of WMSDs in key industries in China show obvious differences in different parts,regions,time,enterprise scale,industry and population attributes.Agriculture,pharmaceutical manufacturing,packaging and decoration and other printing industries have a high proportion of WMSDs in multiple parts at the same time and in a single site.It is necessary to study and implement precise preventive measures according to specific regions,industries and enterprise scales,as well as the characteristics of multi-site WMSDs,so as to effectively protect the health and well-being of the working population.

Musculoskeletal systemWork-related musculoskeletal disordersIncidenceOccupational populationEpidemic characteristicsInfluencing factorsPrevention strategies

贾宁、张美辨、徐擎、张华东、凌瑞杰、刘移民、王致、李刚、尹艳、邵华、李珏、张恒东、邱兵、王大宇、曾强、王如刚、叶研、肖斌、邹华、陈建超、黎东霞、刘永泉、时庆华、刘吉祥、蒋恩霏、漆骏、梅良英、赵显锋、杨咪咪、郭新苇、孙新、王忠旭

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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

中国疾病预防控制中心职业卫生与中毒控制所,北京 100050

重庆市疾病预防控制中心主任办公室,重庆 400042

湖北省职业病与中毒临床医学研究中心办公室,武汉 430024

广州市职业病防治院职业卫生管理科,广州 510620

广州市职业病防治院职业环境与健康重点实验室,广州 510620

辽宁省疾病预防控制中心职业病防治所,沈阳 110399

上海市疾病预防控制中心职业健康科,上海 200051

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

北京市化工职业病防治院院办公室,北京 100195

江苏省疾病预防控制中心职业病防治所,南京 210009

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

天津市职业病防治院体检科,天津 300011

天津市疾病预防控制中心职业健康所,天津 300011

北京市疾病预防控制中心职业卫生所,北京 100013

广东省职业病防治院物理因素监测所,广州 510300

浙江省疾病预防控制中心职业健康与辐射防护所,杭州 310051

福建省职业病与化学中毒预防控制中心医务科,福州 350025

贵州省职业病防治院院办公室,贵阳 610599

江西省职业病防治研究院职业病医院,南昌 330006

宁夏疾病预防控制中心办公室,银川 750003

四川省疾病预防控制中心职业与辐射卫生所,成都 610044

云南省疾病预防控制中心职业健康与放射卫生所,昆明 650118

湖北省疾病预防控制中心卫生监测所,武汉 430070

陕西省疾病预防控制中心职业与放射卫生所,西安 710054

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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

2024

10.3760/cma.j.cn121094-20240731-00358

中华劳动卫生职业病杂志
中华医学会

中华劳动卫生职业病杂志

CSTPCD北大核心
影响因子：0.787
ISSN：1001-9391
年,卷(期)：2024.42(12)