新疆煤矿工人职业倦怠与肌肉骨骼疾患的流行病学调查及相关因素分析

发布时间：2018-09-14 07:44

【摘要】：目的:为了解一线作业煤矿工人职业倦怠与肌肉骨骼疾患对健康的影响,通过对其进行问卷调查,分析煤矿工人职业倦怠、肌肉骨骼疾患现状以及影响因素,探讨职业倦怠与肌肉骨骼疾患之间的关系,为保护其身心健康提供科学依据。方法:采用职业倦怠量表和简明职业紧张问卷以及肌肉骨骼疾患量表,以新疆范围内分层整群随机抽样的1500名新疆煤矿一线作业工人进行调查。结果:1)本次调查发放问卷1500分,回收有效问卷1325份,有效率88.33%。2)职业倦怠结果:本次调查一线作业煤矿工人职业倦怠检出率为90%,其中轻度倦怠占39.8%、中度倦怠占43.8%、重度倦怠占6.4%,职业倦怠均分50.77±11.93。不同性别、工龄、学历、倒班制度的煤矿工人职业倦怠得分、职业倦怠等级差异有统计学意义(P0.05),职业倦怠得分男性高于女性,工龄20年以上的倦怠得分最高,学历高的煤矿工人的倦怠得分低,两班倒的煤矿工人倦怠得分最高;JDC模式下工作要求、工作自主与职业倦怠有正向影响(P0.05);同事支持与职业倦怠有负向影响(P0.05);男性比女性更易发生职业倦怠;两班倒的工人发生中、重度职业倦怠的风险是固定白班的工人的2.271倍;ERI模式下回报与职业倦怠成负向影响(P0.05);两班倒比与固定白班更容易发生职业倦怠(P0.05)。3)肌肉骨骼疾患结果:煤矿工人MSDs年患病率为65.6%,年患病率最高的部位为腰(50.7%),其次是颈部、肩部、膝部,最低的为肘(18.8%);因病请假所占比例最大的部位为腰(25.7%),所占比例最小的为手腕(13.4%);随着工龄增长,MSDs的发病率也在上升,OR值也在上升,当工龄20年以上时OR值为1.613;倒班制度中,三班两倒的MSDs发病率最低;利用logistic回归分析,控制混杂因素后,大幅弯腰的OR值达到2.723,经常长时间轻微弯腰的调整OR值为2.048,颈前倾的调整OR值为2.967,做短时间最大力操作的调整OR值达到2.655,上肢用很大的力调整OR值为2.443,用手捏住物体、大力操纵工具的调整OR值分别为2.068、2.116,姿势不适使不上劲、没有倚靠、有时脚底打滑或跌倒、是否涉及寒冷或气温变化的调整OR值均超过2,人员短缺、经常加班为MSDs的危险因素,调整OR值分别达到2.817、2.392,职业倦怠是MSDs的危险因素之一,重度职业倦怠为煤矿工人MSDs的危险因素,其患病风险是零倦怠工人的2.53倍。工作要求与工作自主性的比值、付出与回报的比值,皆为MSDs的危险因素。4)MSDs的多元logistic回归方程提示幅度弯腰、颈前倾、做短时间最大力操作、上臂或手指重复动作、有时脚底打滑或跌倒、涉及寒冷或气温变化的工作是煤矿工人MSDs的危险因素,职业倦怠对煤矿工人MSDs也存在一定影响,上级支持是MSDs的保护因素,同事支持是MSDs的危险因素,倒班制度中三班两倒相对于固定白班对MSDs有保护作用。结论:1)一线作业煤矿工人职业倦怠检出率较高。职业倦怠得分男性高于女性,工龄20年以上的倦怠得分最高,学历高的倦怠得分低,两班倒的煤矿工人倦怠得分最高。2)倒班制度、工作要求、决定自主、同事支持、回报是煤矿工人职业倦怠主要影响因素,可加以干预。3)一线作业煤矿工人MSDs年患病率高,应得到重视。女性在颈部、腰部MSDs患病率高于男性,各部位MSDs患病率随工龄的增长而升高,不同学历组工人颈部MSDs患病率不同,不同倒班制度下煤矿工人在手腕和膝部MSDs患病率不同。4)倒班制度、工龄、大幅弯腰、颈前倾、做短时间最大力操作、上臂或手指重复性动作、有时脚底打滑或跌倒、涉及寒冷或气温变化、职业倦怠、上级支持、同事支持是煤矿工人MSDs的主要影响因素。5)职业倦怠是煤矿工人MSDs的危险因素,干预对身心均有益。
[Abstract]:Objective: To understand the effects of job burnout and musculoskeletal disorders on the health of coal miners in frontline operation, and to analyze the status and influencing factors of job burnout, musculoskeletal disorders, and to explore the relationship between job burnout and musculoskeletal disorders so as to provide scientific basis for protecting their physical and mental health. Methods: 1500 frontline coal miners in Xinjiang were investigated by using the Job Burnout Scale, Brief Occupational Stress Questionnaire and Musculoskeletal Disease Scale. The detection rate of job burnout among coal miners in front-line operation was 90%, among which mild burnout accounted for 39.8%, moderate burnout accounted for 43.8%, severe burnout accounted for 6.4%, and the average score of job burnout was 50.77 [11.93]. The burnout scores of coal miners with 20 years of service or more were higher than those of women, the burnout scores of coal miners with higher educational background were lower, the burnout scores of coal miners with two shifts were the highest; job demands, job autonomy and job burnout had positive effects under JDC mode (P 0.05); colleague support and job burnout had negative effects (P 0.05); men were more likely to have job burnout than women. The risk of severe burnout was 2.271 times as high as that of the fixed day shift workers; the return and burnout were negatively affected by ERI (P 0.05); the incidence of burnout was more likely to occur in the two shifts than in the fixed day shift workers (P 0.05). The waist (50.7%), neck, shoulder, knee, elbow (18.8%) and wrist (13.4%) accounted for the largest proportion of sick leave. The morbidity of MSDs increased with the length of service, and the OR value was 1.613 when the length of service was over 20 years. In the shift system, the number of triple shifts with double inversion was 25.7%. The morbidity of SDs was the lowest; by logistic regression analysis, the OR value of large bend reached 2.723, the OR value of long-term slight bend was 2.048, the OR value of neck anteversion was 2.967, the OR value of short-term maximum force operation was 2.655, the OR value of upper limb was 2.443, and the object was held by hand. The adjusted OR values of force manipulation tools were 2.068 and 2.116, respectively. Posture was not strong, there was no dependence, sometimes the sole of the foot slipped or fell. Whether or not the adjusted OR values involving cold or temperature changes exceeded 2, personnel shortage, overtime was the risk factor of MSDs. The adjusted OR values were 2.817 and 2.392, respectively. Job burnout was one of the risk factors of MSDs. Severe burnout was a risk factor for MSDs in coal miners, and the risk was 2.53 times higher than that of zero burnout. The ratio of job demands to job autonomy and the ratio of pay to return were risk factors for MSDs. Multiple movements, sometimes foot slips or falls, involving cold or temperature changes in the work of coal miners MSDs risk factors, job burnout on coal miners MSDs also have a certain impact, superior support is the protective factor of MSDs, colleague support is the risk factor of MSDs, shift system in the three shifts two shifts compared with the fixed day shift has a protective effect on MSDs. Conclusion: 1) The detection rate of job burnout of coal miners working in the first-line is higher than that of women. The score of male is higher than that of female. The score of burnout of coal miners working for more than 20 years is the highest. The score of burnout of higher education is lower. The score of burnout of coal miners working in two shifts is the highest. The prevalence of MSDs in the neck and waist was higher in women than in men. The prevalence of MSDs in all parts of the neck increased with the increase of working age. The prevalence of MSDs in the neck was different among workers with different educational backgrounds. The prevalence of MSDs in the wrist and knee was different in coal miners under different shift systems. 4) Working shift system, length of service, large bow, neck forward tilt, doing short-term maximum operation, arm or finger repetitive movements, sometimes foot slip or fall, involving cold or temperature changes, job burnout, superior support, colleague support are the main influencing factors of coal miners MSDs. 5) Job burnout is the risk of coal miners MSDs. Intervention is beneficial to both body and mind.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R135

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