製造業勞工職場社會心理危害與肩頸部及上肢肌肉骨骼症狀之相關性研究

The Contribution of Psychosocial Factors at Work on Neck/Shoulder and Upper Limb Complaints among Manufacturing Workers in Taiwan

林冠芬(Kuan-Fen Lin)

指導教授 ： 郭育良

共同指導教授 ： 黃耀輝

國立臺灣大學/公共衛生學院/職業醫學與工業衛生研究所/碩士(2017年)

https://doi.org/10.6342/NTU201701628

摘要

前言: 根據台灣勞工保險局調查，上肢肌肉骨骼疾病為一常見之職業疾病，而製造業族群為此疾病之重要族群之一，而肌肉骨骼疾病發生前會有肌肉骨骼症狀的發生，因此，預防肌肉骨骼症狀為重要之議題。過去已有許多文獻探討社會心理因子和肌肉骨骼的關係，然而鮮少有研究探討社會心理因子中職場正義、社會支持以及就業不安定性對於肌肉骨骼的影響，因此，本研究目的為探討職場正義、職場社會支持以及就業不安定性與上肢及肩頸肌肉骨骼症狀之影響。

方法: 本研究為橫斷性研究，以台灣5家製造業工廠員工為對象，利用自填式問卷進行調查。以台灣人因工程危害預防指引來評估肌肉骨骼不適症狀。使用職場正義問卷(7項)、職場社會支持問卷(8項)以及就業不安定性問卷(6項)評估員工職場社會心理狀況，並以人因工程因子(11項)評估工作中所暴露的人因因子。以多變項回歸進行分析，並且使用族群可歸因風險性(PAR)計算職場社會心理因子對於肩頸及上肢肌肉骨骼症狀之貢獻。

結果: 總共有710位員工參與此問卷調查，可使用之資料有658位。其中有會影響工作之肩頸肌肉骨骼症狀有7.60%，上肢肌肉骨骼症狀有4.41%。21.73%低職場正義、36.93%缺乏社會支持，54.10%自覺就業不安定。經過多變項調整個人因子、職場人因工程暴露因子後，低職場正義與肩頸肌肉骨骼症狀有顯著相關性，其可歸因風險比率(PAR)為16.29%。而就業不安性與上肢肌肉骨骼症狀有顯著相關性。其可歸因風險比率(PAR)為31.25%。

結論: 在製造業受僱者中，職場正義與肩頸肌肉骨骼症狀有顯著相關，以及就業不安定性與上肢肌肉骨骼症狀有顯著相關。建議未來可以針對低職場正義及自覺就業不安定性危險因子進行探討，並設計預防策略，以降低勞工肌肉骨骼症狀之盛行率。

關鍵字

肩頸 ； 上肢 ； 肌肉骨骼症狀 ； 社會支持 ； 職場正義 ； 就業不安定性

並列摘要

Objective: According to the Bureau of Labor Insurance in Taiwan, musculoskeletal disorders are the commonest occupational diseases. Among workers who received the labor insurance benefits for upper limb musculoskeletal disorders, manufacturing workers are an important population. Thus, preventions of diseases of neck/shoulder and upper limb are an important issue. The contribution of workplace psychosocial factors has not been studied thoroughly. Research is lacking on the workplace social support, justice, and job insecurity among workers with neck/shoulder and upper limb complaints. This investigation aimed to determine the contribution of workplace social support, justice, and job insecurity to neck/shoulder and upper limb complaints among manufacturing workers in Taiwan.

Method: This is a cross-sessional study. The employees of five manufacturing companies were invited to participate in a self-administered questionnaire survey. Musculoskeletal Symptom Checklist from Ergonomic Prevention Guidelines in Taiwan was used to assess musculoskeletal discomforts. Self-reported neck/shoulder and upper limb (hand/arm) pains that affected work performance were considered positive outcomes. Workplace justice (7 items), social support (8 items), job insecurity (6 items) and self-reported ergonomic factors (11 items) were also assessed by using previously validated instruments.

Result: A total of 710 workers participated in Taiwan, among them, 658 were included for the final analysis. After adjusting for personal demographic and ergonomic factors, low workplace justice showed significant associations with symptoms of neck/shoulder. The population attributable risk (PAR) for low workplace justice was 16.29%. After adjusting for personal demographic and ergonomic factors, job insecurity was associated with symptoms of upper limb. The PAR of and job insecurity for upper limb symptoms were 31.25% respectively.

Conclusion: Among the manufacturing workers, workplace justice showed significant association with neck/shoulder musculoskeletal symptoms, and job insecurity was associated with symptoms of upper limb. We suggest that to prevent musculoskeletal symptoms in manufacturing workers, the strategy should be developed to increase workplace justice and reduce job insecurity.

並列關鍵字

Neck/shoulder ； upper limb ； musculoskeletal symptoms ； workplace social support ； workplace justice ； job insecurity

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