牡蠣剝肉工作者肌肉骨骼不適之調查

A study of musculoskeletal disorders among oyster shuckers

楊雅萱(Ya-Hsuan Yang)

指導教授 ： 吳俊德

共同指導教授 ： 許德仁

長榮大學/健康科學學院/職業安全與衛生學系(所)/碩士(2010年)

https://doi.org/10.6833/CJCU.2010.00071

摘要

牡蠣剝肉為一耗時且需長時間久坐之工作，工作者常以不當的姿勢工作，故常會有肌肉骨骼不適情況發生；因此，為瞭解牡蠣剝肉者因工作而導致肌肉骨骼不適之盛行率與成因，本研究對台灣西部沿海地區(彰化、嘉義、台南) 牡蠣剝肉者進行北歐肌肉骨骼問卷(NMQ)調查並進行駝背嚴重程度量測，共獲得234份有效問卷，其中27位受訪者接受軟式電子量角器(electrogoniometer)及肌電訊號感測元件(electromyography)之量測。研究結果顯示，65.8%的牡蠣剝肉者為50歲以上，且半數受訪者不識字。平均工作年資為29.5年(SD=20.6)，每日平均工作時數為8.8小時(SD=2.6)，且有62.4%的受訪者一星期需工作6天，另外有62.6 %的受訪者有駝背情況；本研究234位受訪者在下背、手或手腕、肩部、手肘有較高之不適症狀，盛行率分別為75.2%、60.3%、44.0%、27.8%，且有76.6%的受訪者表示其肌肉骨骼不適全因工作所造成。由邏輯斯迴歸分析得知自覺駝背情況為下背不適之危害因子(OR=3.25, 95% C.I.= 1.54-6.84)、每週工作時間為手腕不適之危害因子(OR=1.02, 95% C.I.= 1.00- 1.03)、每日工作時間大於8小時為肩膀不適之危害因子(OR=2.05, 95% C.I.= 1.21-3.46)、於工作檯上進行工作為手肘不適的保護因子(OR=0.37, 95% C.I.= 0.18-0.76)。儀器量測結果顯示，受訪者左、右手手腕屈曲-伸展範圍分別為84.6°、72.2°，尺-橈偏範圍分別為119.4°、70.6°，上述範圍皆大於國內理髮業者之手腕屈曲-伸展及尺-橈偏活動範圍 (62.4°,37.8°)。本研究受訪者手腕屈曲-伸展及尺-橈偏運動頻率極高(224次/分)，此頻率與加拿大半自動鉛筆包裝業(216次/分)運動頻率相當，且高於瑞典女性牙(12次/分)。
參與本研究之受訪者於工作中食指伸肌群與手腕屈肌群有80%以上時間皆維持於用力狀態下，但肌肉最大自主收縮(%MVC)皆小於5%MVC。雖牡蠣剝肉者肌肉用力度較其他職業族群低，但因工時長、長時間久坐且以不當姿勢工作，肌肉持續處於用力狀態及手腕運動頻率極高，仍然極易導致肌肉骨骼傷害。然而由本研究可知，牡蠣剝肉者為一肌肉骨骼不適之高風險族群，而造成其不適之主要原因與長工時、久座、手腕運動頻率高及工作檯有無有關，若能夠降低其工作時間、採強制性輪班休息制度及架設工作檯，也許能減少其肌肉骨骼不適情況發生機率。

關鍵字

牡蠣剝肉 ； 肌肉骨骼不適 ； 北歐肌肉骨骼問卷 ； 軟式電子量角器 ； 肌電訊號感測元件 ； 駝背

並列摘要

Oyster shucking is a time-consuming work and needs long period of seated position. Oyster shuckers tend to work in an unnatural posture and, consequently, are a high risk group of developing musculoskeletal disorders (MSDs). In order to investigate the prevalence of work-related MSDs and the associated risk factors, the current study visited the oyster shuckers along the west coast of Taiwan. Total of 234 oyster shuckers agreed to participate in the study and were interviewed with Nordic Musculoskeletal Questionnaire (NMQ). Additionally, all the participants undertook the measurement of a kyphosis index, and 27 of them undertook the measurements of electrogoniometer and electromyography (EMG). The results showed that 65.8% of the participants were 50 years old and above, and half of them were illiterate. The average work year and daily work hour was 29.5 years (SD=20.6) and 8.8 hours (SD=2.6), respectively. 62.4% of them worked six days a week and were self-perceived with kyphosis. Among the nine body parts, lower back, hands/wrists, shoulders and elbows were the four most frequently reported areas with discomfort, with the prevalence rate of 75.2%, 60.3%, 44.0% and 27.8%, respectively. Moreover, 76.6% of those who had discomfort in, at least, one body part attributed their complaints to their work. The results of logistic regression indicated that the self-perceived kyphosis, weekly work hour and daily work hour was the significant risk factor for the discomfort in lower back (OR=3.25, 95% C.I.= 1.54-6.84), hands/wrists (OR=1.02, 95% C.I.= 1.00- 1.03) and shoulders (OR=2.05, 95% C.I.= 1.21-3.46), respectively, while working on benches was a protecting factor for discomfort in hands/wrists (OR=0.37, 95% C.I.= 0.18-0.76). The results of instrumental measurements showed that the flexion/extension ranges in the left and right wrist was 84.6 ° and 72.2°, respectively, while the radial/ulnar ranges was 119.4° and 70.6°in the left and right wrist, respectively. The above motion ranges were larger than those obtained from the hairdressers in Taiwan (62.4°, 37.8°). The repetitiveness of wrist motion obtained in the current study (224 times/ min) was comparable to that in the workers of Canadian semi-automated pencil packing (216 times/ min), but higher than the female dentists in Sweden (12 times/ min). Our results also indicated that the extensor indicis proprius and flexor carpi of the participants were observed in the state of force exertion for over 80% of the work time, yet the percentage of the maximal voluntary contraction (%MVC) are smaller than 5%MVC. Though oyster shuckers needed lower force exertion than the other occupations, long work hours, prolonged sitting, unnatural posture and high repetitiveness of wrists movement are likely to cause musculoskeletal disorders among oyster shuckers. The present study concluded that oyster shuckers are a high risk group of MSDs and the major risk factors are long work hours, prolonged sitting, higher repetitiveness of wrist movement and whether work on workbench or not. It is suggested that reducing work time, take more frequent break and the provision of workbenches can may the MSDs among oyster shuckers.

並列關鍵字

Oyster shucker ； Musculoskeletal disorders ； Nordic Musculoskeletal Questionnaire ； Electrogoniometer, Electromyography (EMG) ； Kyphosis

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