工作相關性肌肉骨骼系統疾病的復工及健康管理：文獻回顧

Return to work and Health Management in Patients with Work-Related Musculoskeletal Disorder: Literature Review

連一潔(Yi-Chieh Lien) ； 魏章婷(Jang-Ting Wei) ； 洪怡珣(Yi-Shiung Horng)

《台灣復健醫學雜誌》 46卷2期 (2018/12) Pp. 55-62

https://doi.org/10.6315/TJPMR.201812_46(2).0001

摘要

「工作相關性骨骼肌肉系統疾病」（work-related musculoskeletal disorders）為工作中重複暴露於危險因子如持續或重複施力、不協調姿勢、使用震動手工具或暴露於全身震動的工作環境而造成的累積性傷害：包含常見的肌腱炎、腱鞘炎、壓迫性神經病變、滑液囊炎、半月軟骨損傷、甚至腰椎椎間盤突出等。這些「工作相關性骨骼肌肉系統疾病」不僅會影響健康及生活品質，也會造成顯著的工作失能及工時損失。因此，如何早期診斷並且管理工作中的危險因子，以及藉由職能復健和職業重建過程減少工作失能，促進早日復工是個重要議題。因此，本文將回顧「工作相關性骨骼肌肉系統疾病」的流行病學及危險因子、健康促進管理以及職能復健、職業重建、復工等相關文獻，並且針對台灣現況加以討論。

關鍵字

工作相關性骨骼肌肉系統疾病（work-related musculoskeletal disorders） ； 人因工程危險因子（ergonomic risk factors） ； 復工（return to work） ； 健康促進（health promotion）

並列摘要

Work-related musculoskeletal disorders (WRMSDs) are cumulative traumatic disorders that result from work-related ergonomic factors, such as repetitive motion, forceful exertion, awkward posture, holding a vibrating tool, and working in an environment that causes whole-body vibration. These risk factors may induce tendinitis, tenosynovitis, entrapment neuropathy, bursitis, meniscus tear, and even herniation of the lumbar intervertebral disc. WRMSDs may not only affect a patient's health and quality of life but also entail substantial economic and labor costs. Methods for early diagnosis of WRMSDs and management of workplace risk factors must be determined. In addition, vocational rehabilitation should be offered to individuals with WRMSDs to minimize the prevalence of work disability and improve return-to-work outcomes. This study involved a review of the literature on WRMSD epidemiology and risk factors as well as associated health promotion management and vocational rehabilitation practices. We also discussed WRMSD diagnosis and management in Taiwan.

並列關鍵字

work-related musculoskeletal disorders ； ergonomic risk factors ； return to work ； health promotion

參考文獻

43. 林金定、羅慶徽、呂學琳等：職場健康促進：“健康促進醫院”組織發展之初探。中華職業醫學雜誌2005。12:125-34。

44. 范國棟，李蘭。職場健康促進：國際與台灣經驗之比較。台灣衛誌2008。p.271-81。

45. 陳芬苓。企業規模與實施職場健康促進之調查研究。台灣管理學刊2005。p.149-68。

1. da Costa BR, Vieira ER. Risk factors for work-related musculoskeletal disorders: A systematic review of recent longitudinal studies. Am J Ind Med. 2010;53:285-323.

2. Grieco A, Molteni G, De Vito G, et al. Epidemiology of musculoskeletal disorders due to biomechanical overload. 1998;41:1253-60.