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  • 學位論文

醫院員工上肢職業性肌肉骨骼傷害與危險因子之調查

A survey of work-related upper extremity musculoskeletal disorders among hospital employees

指導教授 : 李素幸

摘要


職業性肌肉骨骼傷害(Work-Related Musculoskeletal Disorders, WMSDs)是一種因工作不當造成的肌肉骨骼傷害,過去研究顯示醫療服務業是職業性肌肉骨骼傷害的高危險群,因此本研究以醫院員工為對象探討上肢職業性肌肉骨骼傷害盛行率及相關危險因子,以做為傷害預防之參考。本研究以問卷為調查工具,使用北歐肌肉骨骼系統調查問卷表(NMQ)來評估上肢骨骼傷害問題,同時收集工作因子、個人因子、社會心理因子及勞動條件等潛在危害因素,共發出700份問卷,回收了675份,回收率為96.4%。 研究結果顯示,醫院員工上肢肌肉骨骼不適之盛行率為82.8%;各部位盛行率為肩膀71%、脖子62.7%、手腕32.4%、手部29.2%及手肘22.5%;以不適的程度分級,達到嚴重或極嚴重者,手腕為26.1%、手部25.2%、手肘18.8%、肩膀3.1%及脖子2.6%。逐步廻歸分析結果顯示性別、年齡、BMI、教育程度、睡眠、自覺生活品質、總年資、工作負荷量、員工類別、使用很重的手工具、提舉上臂、推拉重物、工作桌/椅高度不合適、工作心理負荷等因素與上肢肌肉骨骼不適有重要相關;其中,工作桌/椅高度不合適之因素同時與脖子、手腕、手部及手肘等部位均有相關。 雖然本研究中醫院員工較多數有肩頸不適的問題,然而嚴重程度上,手腕與手部則遠遠高過肩頸部位,建議醫院應優先找到這些手腕與手部不適的員工,給予積極協助。此外,工作桌/椅高度不合適之因素同時與脖子、手腕、手部及手肘等部位均有重要相關,顯示本工作職場的人因設計考量不足,醫院管理者及職安部門應正視此問題,並依據職業安全衛生法令,重新檢視其人因性危害預防計畫。

並列摘要


Work-related musculoskeletal disorders (WMSDs) is a musculoskeletal injury caused by improper working activities. Previous studies have shown that health care industry is a high risk group of work-related musculoskeletal disorders, therefore this study aimed at hospital staff to explore the prevalence of WMSDs in upper limbs and related risk factors as a reference for injury prevention. In this study, we used the Nordic Musculoskeletal Questionnaire (NMQ) to assess the problem of upper limb musculoskeletal injuries and collect potential risk factors such as job factors, personal factors, psychosocial factors and working conditions. A total of 700 questionnaires were distributed to the hospital workers and 675 (96.4%) returned. The results showed that the prevalence of upper limb musculoskeletal discomforts was 82.8% among these hospital staff. The prevalence was 72% in the shoulder, 62.7% in the necks, 32.4% in the wrists, 29.2% in the hands and 22.5% in the elbows. The extent of discomforts, to the degree of severe or extremely serious, was as the followings: wrists (26.1%), hands (25.2%), elbows (18.8%), shoulders (3.1%) and necks (2.6%). Stepwise analysis showed gender, age, BMI, education, sleep, self-conscious quality of life, work experience, workload, job types, the use of heavy manual tools, upper arm lifting, weight pushing, inappropriate height of working desk/chair and the psychological workload were important risk predictors for upper limb musculoskeletal discomforts, especially height of working desk/chair were at the same time associated with the discomforts of necks, wrists, hands and elbows. Although the hospital staff in this study reported higher prevalence of discomforts over necks and shoulders areas, yet from the perspectives of severity, prevalence over wrists and hands was even higher than that of necks and shoulders. We suggest the hospital should set priorities to find these staff with wrist and hand discomforts and assist them aggressively. In addition, we found that improper height of working desk/chair was at the same time related to necks, wrists, hands and elbows. It indicated that these workplaces are somewhat lack of concept in ergonomic design. Hospital management or the occupational safety and health departments should face this problem and re-examine current ergonomic prevention programs in accordance with the Occupational Safety and Health Act.

參考文獻


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