【摘要】 目的了解作业场所职业病危害因素与工效学危险因素等对工人几个主要身体部位肌肉骨骼疾患(MSDs)的影响。方法选取南方3家汽车生产制造企业,采用分层、整群抽样的方法,随机从冲压、焊装、涂装、总装、树脂、质检等生产部门中抽取1个班组的生产工人作为调查对象,对其进行问卷调查,收集个人一般情况、职业病危害因素接触情况、典型不良劳动姿势与活动的暴露情况及肩臂部、手部、下背部的阳性症状。影响肌肉骨骼症状发生的单因素分析采用2检验,多因素分析采用logistic回归。结果共调查794名工人,其中男性765人,女性29人,平均年龄为(23.34±4.52)岁,工龄中位数2年,其文化程度以中专及以上为主(97.8%)。车企工人总体的MSDs年患率分别为下背部47.0%、肩臂部42.9%、手腕/手掌41.3%。不同工种间不同身体部位MSDs的年患率的差异均有统计学意义(均P<0.01),其中肩臂部、手腕/手掌的年患率以焊装工的最高,下背部的年患率以总装工的最高。多因素分析结果显示,背前屈>30°的工作(OR=1.691)等2项与下背部阳性症状年患率有关,手部高力量大角度屈伸的上肢重复活动(OR=1.685)等3项与肩臂阳性症状年患率有关,手部高力量高度重复活动(OR=1.956)等4项与手腕/手掌的阳性症状年患率有关。结论被调查的汽车制造企业工人下背部、肩臂部、手部3个身体部位MSDs的患病情况较突出,各部位的MSDs年患率主要与不良的工作姿势、活动及搬举负荷强度等工效学不良因素有关,需针对其采取有效的控制措施。更多还原

【Abstract】 Objective To study factors of occupational hazard,and ergonomic risk factors of manufacturing workers suffering from musculoskeletal disorders(MSDs) in automotive industry.Methods Samples were randomly selected from workers engaging in stamping,welding,painting and assembling production lines of three automobile manufacturing enterprises with a method of stratified cluster sampling,to investigate general personal information,exposure to occupational hazards,work activities including the specific physical risk factors in workplace and musculoskeletal pain by means of questionnaire.Univariate analysis was performed for risk factors using the chi-square test.Logistic regression was used for multivariate analysis of risk factors.Results A total of 794 workers(765 male,29 female,average age 23.34 ± 4.52 years) were investigated.,The median working age was 2 years.The level of education was secondary technical school education and above(97.8%).The overall annual prevalence rates of MSDs were low back(47.0%),shoulder and arm(42.9%),hand and wrist(41.3%).The annual prevalence of MSDs was different between different work groups and body parts(both P<0.01).Welding workers had the highest prevalence rate in shoulders,wrist/palm,assembling works had higher rate in low back.Multivariate analysis results showed that back anteflexion(>30°)(OR=1.691) was related to the low back positive symptoms.Upper extremity repetitive activities which need strong and large angle flexion of the hand(OR=1.685) was related to the shoulder and arm positive symptoms.High strength and high repetitive activities of the hand(OR=1.956) was related to the wrist/hand positive symptoms.Conclusion The prevalence of MSDs was more prominent among automobile manufacturing workers in the region and related to the adverse movement and posture.Measures should be taken to improve and control adverse ergonomic risk factors of the workplace to improve the quality of work and health of the workers.更多还原