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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 郭育良(Yue-liang Leon Guo) | |
dc.contributor.author | Shan-Wei Yang | en |
dc.contributor.author | 楊善圍 | zh_TW |
dc.date.accessioned | 2021-05-16T16:22:22Z | - |
dc.date.available | 2015-09-24 | |
dc.date.available | 2021-05-16T16:22:22Z | - |
dc.date.copyright | 2013-09-24 | |
dc.date.issued | 2013 | |
dc.date.submitted | 2013-07-23 | |
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Raffi, Case definition for upper limb disorders. Occupational ergonomics. Work related musculoskeletal disorders of the upper limb and back, 2000: p. 120-128. 44. Burton, A.K., et al., Management of upper limb disorders and the biopsychosocial model. 2008. 45. Gjesdal, S., et al., Sickness absence with musculoskeletal or mental diagnoses, transition into disability pension and all-cause mortality: a 9-year prospective cohort study. Scandinavian journal of public health, 2009. 37(4): p. 387-394. 46. Buckle, P.W. and J. Jason Devereux, The nature of Work-related neck and upper limb musculoskeletal disorders. Applied ergonomics, 2002. 33(3): p. 207-217. 47. Hanson, M.A., et al., The costs and benefits of active case management and rehabilitation for musculoskeletal disorders. Health and Safety Executive Research Report, 2006. 493. 48. Mackinnon, S.E. and C.B. Novak, Clinical commentary: pathogenesis of cumulative trauma disorder. The Journal of hand surgery, 1994. 19(5): p. 873. 49. Viikari-Juntura, E. and H. Riihimaki, New avenues in research on musculoskeletal disorders. Scandinavian Journal of Work, Environment & Health, 1999: p. 564-568. 50. Marx, R.G., C. Bombardier, and J.G. Wright, What do we know about the reliability and validity of physical examination tests used to examine the upper extremity? The Journal of hand surgery, 1999. 24(1): p. 185-193. 51. Jensen, A., et al., Locomotor diseases among male long-haul truck drivers and other professional drivers. International archives of occupational and environmental health, 2008. 81(7): p. 821-827. 52. MacGregor, A.J., et al., Structural, psychological, and genetic influences on low back and neck pain: a study of adult female twins. Arthritis Care & Research, 2004. 51(2): p. 160-167. 53. Battie, M.C. and T. Videman, Lumbar disc degeneration: epidemiology and genetics. The Journal of Bone & Joint Surgery, 2006. 88(suppl_2): p. 3-9. 54. Macfarlane, G.J., et al., Investigating the determinants of international differences in the prevalence of chronic widespread pain: evidence from the European Male Ageing Study. Annals of the rheumatic diseases, 2009. 68(5): p. 690-695. 55. Shiri, R., et al., The association between smoking and low back pain: a meta-analysis. The American journal of medicine, 2010. 123(1): p. 87. e7-87. e35. 56. NIOSH, National Occupational Research Agenda for Musculoskeletal Disorders: Research Topics for the Next Decade, A Report by the NORA Musculoskeletal Disorders Team., 2001, NIOSH: Cincinnati, Ohio. 57. Palmer, K.T., E.C. Harris, and D. Coggon, Carpal tunnel syndrome and its relation to occupation: a systematic literature review. Occupational Medicine, 2007. 57(1): p. 57-66. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/6172 | - |
dc.description.abstract | 職業性肌肉骨骼疾病 (Work-related musculoskeletal disorders, WMSDs) 在國際間已成為最常見的職業疾病,因職業性肌肉骨骼疾病連帶而來財務花費也高居所有職業性疾病之冠。在台灣,職業性肌肉骨骼疾病幾乎佔了所有職業性疾病的一半,而且也耗費了相當多的勞保補償。
本研究希望能找到罹患職業性肌肉骨骼疾病的高風險行業,以及釐清人因相關因子與勞工自覺肌肉骨骼症狀與罹患職業性肌肉骨骼疾病之關係;另外,亦期望能以工作場所人因暴露以及勞工自覺痠痛症狀調查,發展偵測罹患職業性肌肉骨骼疾病風險之方法。職業性肌肉骨骼疾病種類繁多,本研究選取腕道症候群 (Carpal tunnel syndrome, CTS)為上肢部位代表、腰部椎間盤疾患 (Herniation of intervertebral disc, HIVD)為頸椎、腰椎部位代表,進行深入的探討。 利用生態研究架構,將兩個互相獨立的資料庫依89個行業別作為連結:(1)臺灣職業傷病通報系統,取得2008-2011四年間腕道症候群及腰部椎間盤疾患的通報資料,並分性別算出調整年齡之標準化發生率為依變項;(2) 勞研所2010年之工作環境安全衛生狀況認知調查,取得勞工自填之工作環境人因暴露因子及勞工自覺痠痛且影響工作表現在各行業之暴露比例為自變項。 以各行業總就業人口數為比重,線性迴歸分析結果顯示:「重複性手部動作」(β: 0.027, 95% CI: 0.008, 0.046) 是男性罹患腕道症候群主要的危險因子、「使用震動的手部工具」 (β: 0.124, 95% CI: 0.063, 0.185)則是女性罹患腕道症候群主要的危險因子;在腰部椎間盤疾患部分,男性以「全身震動」 (β: 0.106, 95% CI: 0.082, 0.133)及「搬運重物」 (β: 0.008, 95% CI: 0.001, 0.015)、女性以「全身震動」 (β: 0.086, 95% CI: 0.016, 0.157)及「不自然的姿勢」 (β: 0.030, 95% CI: 0.008, 0.052)為主要危險因子,此外,更發現男性與女性與各別的二種因子都有顯著的加成作用,同時暴露於二種因子而罹患腰部椎間盤疾患的危險性,高於僅暴露於單一種危險因子。 本研究亦針對一光電廠進行上肢肌肉骨骼問題的調查,結果顯示:在填答問卷之359位員工之中,76位有自覺肌肉骨骼不適症狀,而其中有19位被超音波診斷出確實有肌肉骨骼的問題。最常見的上肢肌肉骨骼問題為旋轉肌袖症候群 (N=17) 以及肩峰鎖骨關節腫脹 (N=7)。 工作場所人因暴露因子以及勞工自覺痠痛症狀,與職業性肌肉骨骼疾病確實有其相關性,更深入探討相關貢獻量以及機轉有其必要性。且此方法可以使用相當簡單的問卷取得相關資料,未來應可以用來發展篩檢各種工作場所,以評估或預測各職業場所引起職業性肌肉骨骼疾病之相關風險。 | zh_TW |
dc.description.abstract | Work-related musculoskeletal disorders (WMSDs) have become the most common occupational diseases internationally. Expenses due to WMSDs are most important among all occupational diseases. In Taiwan, WMSDs accounted for almost 50% of the total occupational diseases, and caused a significant portion of labor insurance payments.
The aim of this study is to find the high risk industries which have higher WMSDs incidence. Therefore, we wish to develop a method which use workplace factors to detect the risk of workers suffering from WMSDs. Because carpal tunnel syndrome (CTS) and herniation of intervertebral disc (HIVD) was the most two common WMSDs, this study chose these two WMSDs as outcome variables. We designed an ecological study using two separate databases: (1) Taiwan's occupational disease and injury notification system (ODIS). (2) Survey of Perceptions of Safety and Health in the Work Environment in 2010. We used the CTS and HIVD as cases reported on ODIS from 2008 to 2011 to calculate the age-adjusted standardized incidence rates (SIR) as dependent variable. The independent variables included the self-reported ergonomic factors and self-reported musculoskeletal discomforts. The two databases were connecting by 89 job divisions. In this study, linear regression was used to find the relationship between workplace factors and CTS and HIVD, and we used the number of employed workers in each job category as weighting. From this study, we found out that “repetitive hand movements” (β: 0.027, 95% CI: 0.008, 0.046) was a major risk factor for male with CTS and “vibration from hand tools” (β: 0.124, 95% CI: 0.063, 0.185) for female with CTS. As for HIVD, the risk factors were “whole body vibration” (β: 0.106, 95% CI: 0.082, 0.133) and “heavy lifting” (β: 0.008, 95% CI: 0.001, 0.015) for male, and “whole body vibration” (β: 0.086, 95% CI: 0.016, 0.157) and “awkward posture” (β: 0.030, 95% CI: 0.008, 0.052) for female respectively. Moreover, “whole body vibration” and “heavy lifting” showed significant additive effect for the male and “whole body vibration”; “awkward posture” showed significant additive effect for the female. A field study was conducted in a factory, in order to understand the gap between self-reported symptoms and diagnosed musculoskeletal disorders in upper extremities. A total of 359 questionnaires were completed. There were 76 workers having self-reported musculoskeletal symptoms and a total of 19 workers were diagnosed as having musculoskeletal disorders by ultrasound. The most frequently diagnosed conditions were rotator cuff syndrome (N=17) and acromioclavicular joint distention (N=7). In conclusion, the workplace factors had relationship with the incidence of WMSDs. Such factors can be identified by sample screening tools as questionnaire. By using this approach, it is possible to screen various kinds of workplaces and assess or predict the risk of WMSDs. Also, this will promote future efforts to improve the effectiveness in ergonomic intervention in workplaces and also establish the model for prevention against WMSDs. | en |
dc.description.provenance | Made available in DSpace on 2021-05-16T16:22:22Z (GMT). No. of bitstreams: 1 ntu-102-R00841014-1.pdf: 4012032 bytes, checksum: fbaf29999af45e51c93567a87424489d (MD5) Previous issue date: 2013 | en |
dc.description.tableofcontents | 口試委員會審定書 I
致謝 II 摘要 IV Abstract VI Contents IX List of Tables XI List of Figures XIII Chapter 1 Introduction 1 Chapter 2 Literature review 3 2.1 The significance of WMSDs 3 2.2 The risk factors of WMSDs, CTS and HIVD 5 2.2.1 Risk factors of CTS 6 2.2.2 Risk factors of HIVD 7 2.3 WMSDs in different industries and occupations 7 Chapter 3 Material and Method 10 3.1 Research Design 10 3.2 Subjects/Materials 10 3.2.1 Standard Industrial Classification System 11 3.2.2 Collected and classified the WMSDs cases nearly four years (2008-2011) 12 3.2.3 Selected and recognized the disease types of WMSDs 14 3.2.4 Survey of Perceptions of Safety and Health in the Work Environment 15 3.3 Data analysis 15 3.3.1 Standardized incidence rates (SIR) 16 3.3.2 Linear regression 16 3.3.3 Geometric mean of SIR 17 Chapter 4 Results 19 4.1 The collected and classified WMSDs cases for nearly four years (2008-2011) 19 4.2 Selected and recognized the disease types of WMSDs 20 4.3 Standardized incidence rates in different job categories of WMSDs 21 4.3.1 Different job categories with CTS: case numbers and SIR 21 4.3.2 Different job categories with HIVD: case numbers and SIR 22 4.4 Survey of Perceptions of Safety and Health in the Work Environment 23 4.4.1 Workplace exposure factors - ergonomic factors 23 4.4.2 Workplace exposure factors - self-reported musculoskeletal discomforts 25 4.5 The relationship between Work-related musculoskeletal disorders and workplace ergonomic factors 26 4.5.1 Log-transformed SIR (case/year/million workers) and workplace ergonomic factors (% reported +) - CTS 27 4.5.2 Log-transformed SIR (case/year/million workers) and workplace ergonomic factors (% reported +) -HIVD 27 4.6 The relationship between the geometric mean of SIR and different levels of workplace exposure factors 28 4.6.1 Geometric Mean SIR of CTS and ergonomic factors 29 4.6.2 Geometric Mean SIR of HIVD and ergonomic factors 30 4.6.3 Combination of risk factors - HIVD 33 4.7 The relationship between the geometric mean of SIR and different levels of self-reported musculoskeletal discomforts 35 4.7.1 Geometric Mean SIR of CTS and hands or wrists musculoskeletal discomfort 35 4.7.2 Geometric Mean SIR of HIVD and low back or waist musculoskeletal discomfort 36 Chapter 5 Field study 37 5.1 The objective of the field study 37 5.2 Material and method of the field study 37 5.3 Results of the field study 38 5.4 Conclusion and future works 39 Chapter 6 Discussion 40 6.1 WMSDs accounted for the largest part of occupational diseases 40 6.2 The high risk industrial categories suffering from WMSDs 41 6.3 The risk factors of WMSDs 42 6.4 Secondary self-reported questionnaire 44 6.5 Limitation 45 Chapter 7 Conclusion 47 Reference 48 Appendix 147 1. Questionnaire of field study 147 2. Scandinavian criteria of physical examination 151 | |
dc.language.iso | en | |
dc.title | 職業性肌肉骨骼疾病與就業場所相關暴露因子之探討:腕道症候群及腰部椎間盤疾患 | zh_TW |
dc.title | The Relationship Between Work-related Musculoskeletal Disorders and Workplace Exposure Factors - CTS And HIVD | en |
dc.type | Thesis | |
dc.date.schoolyear | 101-2 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 黃耀輝(Yaw-Huei Hwang) | |
dc.contributor.oralexamcommittee | 許昺奇(Ping-Chi Hsu),游志雲(Chi-Yuang Yu) | |
dc.subject.keyword | 職業性肌肉骨骼疾病,腕道症候群,腰部椎間盤疾患,人因工程,自覺症狀,通報系統,共同作用, | zh_TW |
dc.subject.keyword | WMSDs,Carpal tunnel syndrome (CTS),Herniation of intervertebral disc (HIVD),Ergonomic,Self-reported discomforts,Surveillance,combination of risk factors, | en |
dc.relation.page | 154 | |
dc.rights.note | 同意授權(全球公開) | |
dc.date.accepted | 2013-07-23 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 職業醫學與工業衛生研究所 | zh_TW |
顯示於系所單位: | 職業醫學與工業衛生研究所 |
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