職場社會心理特質、人因暴露與肌肉骨骼不適的相關與性別差異

Abstract

工作相關肌肉骨骼不適為常見的健康問題，且呈現日益增加的趨勢。肌肉骨骼不適問題不僅影響工作者個人的生活品質，也可能造成整體社會龐大的經濟損失。產生肌肉骨骼不適的因素，除了傳統人因工程危害如重複性動作、長時間維持固定姿勢或姿勢不自然、搬運重物、振動等，還包含職場社會心理特質。國外已累積許多研究，證實工作相關肌肉骨骼不適與職場社會心理特質的關係，但是台灣在研究工作者肌肉骨骼情況，仍著重傳統人因工程，少有研究進一步探討職場社會心理特質與肌肉骨骼不適的相關。 女性肌肉骨骼不適盛行率一直較男性高，但過去研究較少從性別角度考慮工作相關肌肉骨骼不適，並且以工作特性、職業等級等社會決定因子來分析，另一方面職場社會心理特質、人因工程危害以及兩者暴露風險之加乘作用也尚未作清楚的釐清。若能結合職場社會心理特質、人因工程危害兩者危險因子來探討，將能有效降低肌肉骨骼不適並提升工作者的健康狀況與生活品質。 研究材料以勞研所2007年工作環境安全衛生狀況認知調查。本研究以兩主軸進行：第一部份探討男女工作者肌肉骨骼不適之分布情況；第二部份聚焦在職場社會心理特質、人因工程危害與肌肉骨骼不適之相關，以及合併職場社會心理特質、人因工程危害對肌肉骨骼不適是否有加乘作用。 結果發現，工作者有肌肉骨骼不適盛行於教育程度為國小(及以下)、職業等級為藍領技術、工作年資二十年以上、不安定僱用(臨時/約聘)、工作心理負荷高、職場正義低、工作無保障之工作族群。職場社會心理特質與人因工程危害呈顯著相關。男性工作者其工作心理負荷高合併有人因工程危害呈現加乘作用，證實職場社會心理特質合併人因工程危害對於肌肉骨骼不適具有加乘作用。 上述危險因子能解釋部份的肌肉骨骼不適發生率。職場健康促進策略應提高工作者勞動條件，並著重於預防層面，以保護工作者免於在工作場所損傷，更重要的是應制訂兼具人因工程與職場社會心理特質危害預防之策略，才能有效降低工作者肌肉骨骼不適的發生。

Work-related musculoskeletal discomfort is a common health problem, and has showed an increasing trend. Musculoskeletal discomfort not only results in reduced quality of life of individual worker, but may also cause substantial economic losses of the whole socieity. Factors that contribute to the risk of musculoskeletal discomfort include traditional ergonomics hazards such as repetitive motion, prolonged static posture or unnatural posture, carrying heavy loads, vibration, etc.. In addition, psychosocial hazards at work also play an important role. Accumulating studies from other countries confirmed that musculoskeletal discomfort was associated with adverse psychosocial work characteristics. However, research conducted in Taiwan mainly focused on traditional ergonomic factors; few studies have been conducted to explore the association between psychosocial work characteristics and the risk of musculoskeletal discomfort. Previous studies showed that female workers have a higher risk for musculoskeletal discomfort than male workers. However, few studies explore the impacts of work conditions on health from a gender perspective. Furthermore, the interaction of psychosocial characteristics at work and ergonomics hazards and their synergistic effects on musculoskeletal discomfort has not been well clarified. We anticipate that prevention strategies that take into account of both psychosocial risk factors and ergonomics hazards may be more effective in reducing the risk of musculoskeletal discomfort and improving workers' health status and quality of life. Study participants were from a survey conducted in 2007 by the Institute of Occupational Safety and Health of the Council of Labor Affairs. There were two research themes in this study: the first part was explored if there was difference in the prevalence of musculoskeletal discomfort between male and female workers; the second part focused on the synergistic effects of psychosocial factors and ergonomics hazards at work on the risk of musculoskeletal discomfort. It was found that musculoskeletal disorders were more prevalent in workers with lower education level, workers with lower occupational grades, workers with longer work tenure, workers on insure employment and workers with higher psychological work demands, lower workplace justice and higher level of job insecurity. The combination of adverse psychosocial work conditions and higher levels of ergonomic hazards contributed to higher risk of musculoskeletal discomfort, confirming the hypothesis of synergistic effect. The risk factors mentioned above explain partially the risk of musculoskeletal discomfort. Good occupational health and safety strategies should aim to improve the working conditions of workers, focusing on the aspect of prevention to protect workers from injuries in the workplace. More importantly, to both ergonomic and psychosocial work characteristics should be targeted in order to effectively reduce the occurrence of musculoskeletal discomforts in the workplace.