夜班作业与职业紧张对金属制品业工人手腕部工作相关肌肉骨骼疾患的影响

Effects of night-shift work and occupational stress on wrist work-related musculoskeletal disorders among workers in metal products industry

关键词: 金属制品业  手腕部  工作相关肌肉骨骼疾患(WMSDs)  夜班轮班作业  职业紧张  交互作用  协同作用

Keywords: metal products industry  wrist  work-related musculoskeletal disorders( WMSDs)  night-shift work  occupational stress  interaction  synergistic effect

摘 要: 目的 分析轮值夜班和职业紧张及其交互作用对金属制品业工人手腕部工作相关肌肉骨骼疾患(WMSDs)的影响。方法 采用分层整群随机抽样法,选择广东省 117 家金属制品企业 5193 名工人为研究对象,采用《基本情况调查量表》《肌肉骨骼疾患问卷》《职业紧张测量核心量表》调查其夜班轮班作业、职业紧张和手腕部 WMSDs 发生情况,采用二分类 logistic 回归模型分析夜班轮班作业、职业紧张及二者交互作用对手腕部 WMSDs 的影响。结果 研究对象夜班轮班作业者占 30.6%,职业紧张、手腕部 WMSDs 检出率分别为 14.4%、17.1%。二分类 logistic 回归分析显示,校正年龄、文化程度等混杂因素影响后,夜班轮班作业和职业紧张均为研究对象发生手腕部 WMSDs 的独立危险因素,OR(95%CI)分别为 1.420(1.211~1.664)、1.864(1.547~2.245),均 P<0.01;与非夜班轮班作业+无职业紧张人群比较,单独夜班轮班作业、单独职业紧张、夜班轮班作业+职业紧张人群发生手腕部 WMSDs 风险更高,OR(95%CI)分别为1.418(1.185~1.698)、1.916(1.482~2.478)、2.621(2.040~3.367),均 P<0.01。结论 夜班轮班作业和职业紧张均可增加金属制品业工人手腕部 WMSDs 发生风险,且二者存在协同作用。

Abstract: Objective To analyze the effects of night-shift work, occupational stress and their interaction on wrist work-related musculoskeletal disorders (WMSDs)in metal products industry employees. Methods A total of 5 193 employees from 117 metalproduct enterprises in Guangdong province were selected as the research subjects using the stratified cluster random sampling. The Basic Situation Survey Scale, Questionnaire of Musculoskeletal Disorders and Questionnaire of Occupational Stress Core were used to assess night-shift work, occupational stress and the prevalence of wrist WMSDs. The multivariate logistic regression model was used to analyze the effects of night-shift work, occupational stress and their interaction on wrist WMSDs. Results The proportion of night-shift work was 30.6%, the detection rates of occupational stress and wrist WMSDs were 14.4% and 17.1%, respectively. The results of multivariate logistic regression analysis showed that night-shift work and occupational stress were independent risk factors of wrist WMSDs after excluding the confounding effects of age and educational level, odds ratios (ORs) and 95% confidence intervals (CIs) were 1.420 (1.211—1.664) and 1.864 (1.547—2.245), respectively, all P<0.01. Compared with those neither night-shift work nor occupational stress, the risk of wrist WMSDs was higher among individuals with only night-shift work, only occupational stress, or both night-shift work and occupational stress [OR(95%CI) were 1.418 (1.185—1.698), 1.916 (1.482—2.478), 2.621 (2.040—3.367), respectively, all P<0.01]. Conclusion Both nightshift work and occupational stress can increase the risk of wrist WMSDs in metal products employees, and these two factors exhibit a synergistic effect on increasing the risk of wrist WMSDs.