社区医务人员职业性肌肉骨骼疾患发生情况及危险因素分析

目的了解社区卫生服务中心医务人员职业性肌肉骨骼疾患(WMSDs)发生及其危险因素。方法采用流行病学横断面调查方法,选择《北欧肌肉骨骼疾患问卷(改良版)》对广州市3家社区卫生服务中心145名医务人员的肌肉骨骼疾患及其影响因素进行调查。结果 WMSDs发生率最高的部位依次是颈部(393%)、肩部(324%)、下背部(200%)和上背部(172%);下背和手部WMSDs发生率医生最高,肘和下肢(腿、膝和踝部) WMSDs发生率以护士最高。颈部WMSDs危险因素是经常加班(OR=307),下背部WMSDs危险因素是背部弯曲(OR=1215)和颈部长时间保持同一姿势(OR=1437)。工作姿势舒适(OR=037)为肩部保护因素。结论社区卫生服务中心医务人员WMSDs不容忽视,不同岗位医务人员WMSDs发生部位略有差异。可通过合理安排加班、保持工作姿势舒适、减少长时间弯腰和避免颈部长时间保持同一姿势等措施预防和控制医务人员WMSDs的发生。

Analysis on prevalence and risks factors of work-related musculoskeletal disorders in community medical staff

Objective The aim of the survey was to understand the prevalence and risk factors of work-related musculoskeletal diseases in community medical staff. Methods The musculoskeletal disease and its risk factors of 145 medical staff from three community health service centers in Guangzhou city were investigated cross-sectional epidemiological survey using Nordic Musculoskeletal Disease Questionnaire (modified version), were investigated and analyzed.Results The results showed that the general high incidences of WMSDs in turn were neck (39.3%), shoulder (32.4%), lower back (20.0%) and upper back (17.2%) , the high incidence of WMSDs in the lower back and hand were doctors, the high incidence of of WMSDs in elbow and lower extremity (leg, knee and ankle) were nurses. The risk factors of WMSDs in neck was frequent work overtime (OR=3.07); the risk factors of lower back WMSDs was back bending (OR=12.15) and keeping the same posture with neck for long time (OR=14.37). Additionally, comfortable working posture was the protective factor (OR=0.37). Conclusion The results suggested that the WMSDs in community medical staff should not be ignored, despite there was some slightly difference in the WMSDs occurrence according to the difference of work positions. The WMSDs in community medical staff might be prevented or relieved by lessening work-overtime, maintaining comfortable working posture, reducing long-time bending and avoiding the same posture of neck for long time.