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目的了解静脉药物配置中心(PIVAS)配药人员工作相关肌肉骨骼损伤(WMSDs)状况及其影响因素,尤其是工效学负荷水平的影响,为今后预防WMSDs的发生提供资料。方法选择3家三级甲等医院126名PIVAS配药人员进行肌肉骨骼疾患的流行病学调查,并对相关资料进行多因素logistic回归分析。结果 PIVAS配药人员过去一年内WMSDs总患病率为40.5%,居前四位的部位为颈部、腕/手部、肩部和上背部,WMSDs的患病率分别为36.51%、28.57%、23.81%和17.46%,4个部位WMSDs的患病率均有随工效学负荷水平的增加而增加的趋势(P<0.05)。多因素logistic回归分析显示,相比低的工效学负荷,高、极高的工效学负荷水平是颈部WMSDs患病的危险因素(OR=4.943、4.820,P<0.05);相比<30岁,40~岁是颈部WMSDs患病的危险因素(OR=3.032,P<0.05);相比PIVAS工龄<1年,工龄3~年是颈部WMSDs患病的危险因素(OR=2.481,P<0.05)。结论 PIVAS配药人员WMSDs有一定的职业特征,且与工效学负荷水平有明显的关系。应改善工效学负荷水平来降低WMSDs发生,同时做好对年龄较大、工龄较长员工的保护。
Objective To investigate the prevalence and influencing factors of job-related musculoskeletal injuries (WMSDs) in PIVAS dispensing workers, especially the impact of ergonomic load levels, and to provide information for the prevention of WMSDs in the future. Methods 126 PIVAS pharmacy staffs from 3 tertiary level hospitals were selected for epidemiological investigation of musculoskeletal disorders. Multivariate logistic regression analysis was performed on the related data. Results The total prevalence of WMSDs in PIVAS pharmacies was 40.5% in the past year. The top four sites were neck, wrist / hand, shoulder and upper back. The prevalence of WMSDs was 36.51% and 28.57% respectively, 23.81% and 17.46% respectively. The prevalence of WMSDs at 4 sites all increased with the increase of ergometry load (P <0.05). Multivariate logistic regression analysis showed that the high and the highest ergonomic load level were the risk factors of neck WMSDs (OR = 4.943, 4.820, P <0.05) compared with low ergonomic load, compared with <30 (OR = 3.032, P <0.05). Compared with PIVAS <1 year, length of service 3 to 3 years was the risk factor of neck WMSDs (OR = 2.481, P <0.05). Conclusion WMSDs of PIVAS dispensing staff have certain occupational characteristics, and have obvious relationship with ergonomic load level. The ergonomic load level should be improved to reduce the occurrence of WMSDs while protecting the older and longer-serving employees.