【摘要】 目的 探讨社会心理学与工作负荷因素对体力劳动工人颈部工作相关肌肉骨骼疾患（WMSDs）的交互作用。方法 采用典型抽样方法，选择河南省和湖北省共20家制造业企业的工人为研究对象，采用《中国肌肉骨骼疾患问卷》调查研究对象罹患颈部WMSDs情况。以4 327例罹患颈部WMSDs的工人为病例组，以1∶1配对选择4 327名无罹患颈部WMSDs的工人为对照组。采用条件logistic回归分析比较2组人群的相关危险因素，建立相加交互作用模型分析危险因素之间的交互作用。结果 单因素条件logistic回归分析结果显示，动态负荷、静态负荷、力量负荷和社会心理学因素均增加体力劳动工人罹患颈部WMSDs的风险（P值均<0.05）。其中，社会心理学因素中，休息时间不充足的影响最大，比值比（OR）及其95%置信区间（CI）为1.799(1.647～1.965)；动态负荷、静态负荷和力量负荷中，头部每分钟内多次重复相同动作（弯曲、扭转）、颈部前倾或长时间保持这种姿势、搬举>20 kg物品的影响最大，OR及其95%CI为1.599(1.470～1.739)、1.984(1.805～2.181)和1.241(1.093～1.408)。休息时间不充足与颈部前倾或长时间保持该姿势存在协同交互作用，相对超危险度比与归因比及其95%CI分别为0.420(0.187～0.652)和0.171(0.066～0.276)。休息时间不充分与头部每分钟内多次重复相同动作（弯曲、扭转）、搬举>20 kg物品均不存在交互作用。结论 休息时间不充足与颈部前倾或长时间保持该姿势因素（静态负荷）的交互作用可增加体力劳动工人罹患颈部WMSDs的风险，为相加协同作用。更多还原

【Abstract】 Objective To explore the interaction between social psychology and workload factors on neck work-related musculoskeletal disorders(WMSDs) in manual workers. Methods Manual workers in Henan Province and Hubei Province were selected as the research subjects using typical sampling method. The Chinese Musculoskeletal Questionnaire was used to investigate the prevalence of neck WMSDs in the research subjects. A total of 4 327 workers with neck WMSDs were selected as the case group, and 4 327 workers without neck WMSDs were selected as the control group in a 1∶1 pairing. Conditional logistic regression analysis was used to compare the relevant risk factors in the two groups, and the additive interaction model was established to analyze the interactions between the risk factors. Results The univariate conditional logistic analysis results showed that dynamic load, static load, power load and psychosocial factors increased the risk of neck WMSDs in manual workers(all P<0.05). In terms of the social psychological factors, insufficient rest time had the greatest impact workers, with the odds ratio(OR) and 95% confidence interval(CI) of 1.799(1.647-1.965). In terms of dynamic load, static load and power load, repeated similar movements of the head per minute(bending, twisting), forward bending of the neck or maintaining this posture for a long time, and lifting heavy objects>20 kg had the greatest impact, with the OR and 95%CI of 1.599(1.470-1.739), 1.984(1.805-2.181) and 1.241(1.093-1.408), respectively. There was a synergistic interaction between insufficient rest time and forward bending of the neck or maintaining this posture for a long time, and the relative excess risk due to interaction(95%CI) and attributable proportion(95%CI) were 0.420(0.187-0.652) and 0.171(0.066-0.276), respectively. There is no interaction between insufficient rest time and repeated similar movements of the head per minute(bending, twisting), and lifting heavy objects >20 kg. Conclusion The interaction between insufficient rest time and forward bending of the neck or maintaining this posture for a long time(static load) can increase the risk of neck WMSDs in manual workers, which is an additive synergistic effect.更多还原