發(fā)布時(shí)間：2018-09-14 07:44

【摘要】：目的:為了解一線(xiàn)作業(yè)煤礦工人職業(yè)倦怠與肌肉骨骼疾患對(duì)健康的影響,通過(guò)對(duì)其進(jìn)行問(wèn)卷調(diào)查,分析煤礦工人職業(yè)倦怠、肌肉骨骼疾患現(xiàn)狀以及影響因素,探討職業(yè)倦怠與肌肉骨骼疾患之間的關(guān)系,為保護(hù)其身心健康提供科學(xué)依據(jù)。方法:采用職業(yè)倦怠量表和簡(jiǎn)明職業(yè)緊張問(wèn)卷以及肌肉骨骼疾患量表,以新疆范圍內(nèi)分層整群隨機(jī)抽樣的1500名新疆煤礦一線(xiàn)作業(yè)工人進(jìn)行調(diào)查。結(jié)果:1)本次調(diào)查發(fā)放問(wèn)卷1500分,回收有效問(wèn)卷1325份,有效率88.33%。2)職業(yè)倦怠結(jié)果:本次調(diào)查一線(xiàn)作業(yè)煤礦工人職業(yè)倦怠檢出率為90%,其中輕度倦怠占39.8%、中度倦怠占43.8%、重度倦怠占6.4%,職業(yè)倦怠均分50.77±11.93。不同性別、工齡、學(xué)歷、倒班制度的煤礦工人職業(yè)倦怠得分、職業(yè)倦怠等級(jí)差異有統(tǒng)計(jì)學(xué)意義(P0.05),職業(yè)倦怠得分男性高于女性,工齡20年以上的倦怠得分最高,學(xué)歷高的煤礦工人的倦怠得分低,兩班倒的煤礦工人倦怠得分最高;JDC模式下工作要求、工作自主與職業(yè)倦怠有正向影響(P0.05);同事支持與職業(yè)倦怠有負(fù)向影響(P0.05);男性比女性更易發(fā)生職業(yè)倦怠;兩班倒的工人發(fā)生中、重度職業(yè)倦怠的風(fēng)險(xiǎn)是固定白班的工人的2.271倍;ERI模式下回報(bào)與職業(yè)倦怠成負(fù)向影響(P0.05);兩班倒比與固定白班更容易發(fā)生職業(yè)倦怠(P0.05)。3)肌肉骨骼疾患結(jié)果:煤礦工人MSDs年患病率為65.6%,年患病率最高的部位為腰(50.7%),其次是頸部、肩部、膝部,最低的為肘(18.8%);因病請(qǐng)假所占比例最大的部位為腰(25.7%),所占比例最小的為手腕(13.4%);隨著工齡增長(zhǎng),MSDs的發(fā)病率也在上升,OR值也在上升,當(dāng)工齡20年以上時(shí)OR值為1.613;倒班制度中,三班兩倒的MSDs發(fā)病率最低;利用logistic回歸分析,控制混雜因素后,大幅彎腰的OR值達(dá)到2.723,經(jīng)常長(zhǎng)時(shí)間輕微彎腰的調(diào)整OR值為2.048,頸前傾的調(diào)整OR值為2.967,做短時(shí)間最大力操作的調(diào)整OR值達(dá)到2.655,上肢用很大的力調(diào)整OR值為2.443,用手捏住物體、大力操縱工具的調(diào)整OR值分別為2.068、2.116,姿勢(shì)不適使不上勁、沒(méi)有倚靠、有時(shí)腳底打滑或跌倒、是否涉及寒冷或氣溫變化的調(diào)整OR值均超過(guò)2,人員短缺、經(jīng)常加班為MSDs的危險(xiǎn)因素,調(diào)整OR值分別達(dá)到2.817、2.392,職業(yè)倦怠是MSDs的危險(xiǎn)因素之一,重度職業(yè)倦怠為煤礦工人MSDs的危險(xiǎn)因素,其患病風(fēng)險(xiǎn)是零倦怠工人的2.53倍。工作要求與工作自主性的比值、付出與回報(bào)的比值,皆為MSDs的危險(xiǎn)因素。4)MSDs的多元logistic回歸方程提示幅度彎腰、頸前傾、做短時(shí)間最大力操作、上臂或手指重復(fù)動(dòng)作、有時(shí)腳底打滑或跌倒、涉及寒冷或氣溫變化的工作是煤礦工人MSDs的危險(xiǎn)因素,職業(yè)倦怠對(duì)煤礦工人MSDs也存在一定影響,上級(jí)支持是MSDs的保護(hù)因素,同事支持是MSDs的危險(xiǎn)因素,倒班制度中三班兩倒相對(duì)于固定白班對(duì)MSDs有保護(hù)作用。結(jié)論:1)一線(xiàn)作業(yè)煤礦工人職業(yè)倦怠檢出率較高。職業(yè)倦怠得分男性高于女性,工齡20年以上的倦怠得分最高,學(xué)歷高的倦怠得分低,兩班倒的煤礦工人倦怠得分最高。2)倒班制度、工作要求、決定自主、同事支持、回報(bào)是煤礦工人職業(yè)倦怠主要影響因素,可加以干預(yù)。3)一線(xiàn)作業(yè)煤礦工人MSDs年患病率高,應(yīng)得到重視。女性在頸部、腰部MSDs患病率高于男性,各部位MSDs患病率隨工齡的增長(zhǎng)而升高,不同學(xué)歷組工人頸部MSDs患病率不同,不同倒班制度下煤礦工人在手腕和膝部MSDs患病率不同。4)倒班制度、工齡、大幅彎腰、頸前傾、做短時(shí)間最大力操作、上臂或手指重復(fù)性動(dòng)作、有時(shí)腳底打滑或跌倒、涉及寒冷或氣溫變化、職業(yè)倦怠、上級(jí)支持、同事支持是煤礦工人MSDs的主要影響因素。5)職業(yè)倦怠是煤礦工人MSDs的危險(xiǎn)因素,干預(yù)對(duì)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.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R135

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