應用OCRA Index於職業性上肢肌肉骨骼不適之評估

職業性上肢肌肉骨骼疾病由於因果關係較難認定且潛伏期長，並常因個人主觀因素導致判斷標準不一，在評估診斷上有其困難性。且因職業病鑑定過程冗長，因此，為簡便評估流程可使用人因工程檢核工具加以輔助。本研究選擇職業重複性活動指標(OCRA Index)用以評估上肢罹患肌肉骨骼疾病之危害風險，評估項目包含動作次數、力量、姿勢、重複性、附加危害因子、肌肉缺乏休息時間及執行作業時間。本研究針對不同職業性肌肉骨骼疾病個案，挑選高風險工作單元並拍攝影片進行事後影像分析，以OCRA Index量化高風險危害因子，進行數據計算和統計分析。同時以OCRA Index評估結果與職業病專科醫師診斷結果相互對照，探討OCRA Index對不同肌肉骨骼疾病之敏感度，期望可用來輔助職業性上肢肌肉骨骼疾病之診斷。研究結果顯示任何作業類型及工作對於上肢職業肌肉骨骼疾病來說皆有其風險性，惟高低之不同。不同肌肉骨骼疾病對OCRA Index評估結果有顯著的影響，職業性上肢肌肉骨骼疾病個案OCRA Index分數明顯高於非職業性上肢肌肉骨骼疾病個案，OCRA Index分數對於上肢肌肉骨骼疾病確有其敏感度。不同的作業類型對於OCRA Index的分數有顯著的影響，其中服務工作人員及售貨員有較高上肢肌肉骨骼危害之風險，技術工及有關工作人員有較低上肢肌肉骨骼危害風險。另一方面，OCRA Index評估結果與醫師診斷結果相符，可輔助職業病專科醫師作為診斷上評估暴露的參考。由工作週期作事後影像分析可節省於職場直接測量所耗費的時間，為一值得推廣的人因工程分析工具。本研究為案例分析研究，樣本數較少，若由疾病及作業類型來分析雖有其趨勢變化及參考價值，但仍建議後續研究採大樣本研究，結果會較具代表性。

關鍵字

職業重複性活動指標； OCRA Index ；職業性上肢肌肉骨骼疾病；職業病診斷

並列摘要

It’s difficult to assess occupational upper extremity musculoskeletal disorders due to tough identified causation, long incubation period and different standards. The identification process is lengthy, thus it needs to use ergonomic checklists to simplify evaluating process. This study adopts Occupational Repetitive Activity Index (OCRA Index) to assess the risk of upper limb musculoskeletal disorders. The assessment items in this study contain the number of actions, force, posture, repetitive, additional elements, lack of recovery period and duration of repetitive task. This study assorts cases of occupational musculoskeletal disorders and select some high-risk tasks and make film for afterwards image analysis to quantify the high-risk factors, data calculations and statistical analysis via OCRA Index. Cross-referencing OCRA Index results of the assessment and diagnosis of occupational physicians to explore the sensitivity of OCRA Index of different musculoskeletal diseases, and this study can be used to aid in the diagnosis of occupational musculoskeletal diseases. The results showed that there’s risk for any type of operation and task on upper extremity occupational musculoskeletal disorders, but just the level of risk is different. Different musculoskeletal disorders cases have a significant impact on the OCRA Index assessment results. Occupational upper extremity musculoskeletal disorders cases of OCRA Index score was significantly higher than the case of non-occupational upper extremity musculoskeletal disorders and that shows the sensitivity of OCRA Index scores for upper limb musculoskeletal disorders. Different type of operation have an eventful impact on OCRA Index scores and service workers, shop and market sales workers have the higher risk of upper extremity musculoskeletal disorders, technical staff and related workers have lower musculoskeletal risks. Additionally, OCRA Index assessment results are consistent with physician diagnosis, and it could assist Occupational physicians as a diagnostic assessment of exposure reference. By the duty cycle for post image analysis can be saved in the workplace to directly measure the time it takes. It’s really a worthy promotion of the engineering analysis tools. There’s small sample size in this study to be analyzed, although the trends and the reference value by the disease and the type of operation, it is recommended that a follow-up study used a large sample size, the results are more representative.

並列關鍵字

Occupational Repetitive Activity Index ； OCRA Index ； Occupational upper extremity musculoskeletal disorders ； the diagnosis of occupational diseases

參考文獻

15.陳志勇、趙國竣、陳協慶、林彦輝。從職業性肌肉骨骼傷病案例比較OCRA Index 與 HALTLV。勞工安全衛生研究季刊，2010；18(3)：286-296。

22.Horng, Y.S., et al., Work-related Musculoskeletal Disorders of the Workers in a Child Care Institution. Taiwan journal of physical medicine & rehabilitation, 2008. 36(1): p. 15-21.

43.全中妤、嚴雯聖、李中一等。飯店房務清潔人員工作特性與肌肉骨骼不適之橫斷式研究。勞工安全衛生研究季刊，2007；15(3)：232-242。

59.黃百粲。職業性腰椎椎間盤突出之認定基準。2008，行政院勞工委員會。

2.戴基福、楊瑞鍾、葉文裕。受僱者工作環境安全衛生狀況認知調查—中華民國九十年九月台灣地區。2002，行政院勞工委員會勞工安全衛生研究所。

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應用OCRA Index於職業性上肢肌肉骨骼不適之評估

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