工作者睡眠不足對下背部肌肉骨骼不適之影響

Abstract

研究目的：下背肌肉骨骼不適是工作者之常見健康問題，工作之暴露已知對於下背肌肉骨骼不適有相當的貢獻。本研究目的在評估工作者之下背肌肉骨骼不適是否與睡眠不足有相關性，以及睡眠不足對於下背肌肉骨骼不適之貢獻度。 方法：本研究根據勞研所在2007年進行之『台灣地區受僱者工作環境安全衛生狀況認知調查』，其研究對象乃具代表性抽樣之台灣地區受僱者。以問卷評估受僱工作者下背痛情形，並以邏輯式迴歸評估這些不適與睡眠習慣（含工作日和假日的平均睡眠時數）的相關性，同時調整年齡、身體質量指數、運動習慣、與自覺工作環境中人因工程危害因子。並推算所有相關因子之影響和貢獻度。 結果：以28,716位受雇者為研究對象，填寫問卷進行分析，總共回收有效問卷24,509份。約11%的受僱者有會影響工作程度的下背痛。在調整年齡、身體質量指數、運動習慣、與自覺工作環境中人因工程危害因子的影響後，發現男性下背痛的危險因子包括體重過重、重體力勞動、震動暴露、工作日平均睡眠時數少於6小時 (aRR=1.1, 95% CI:1.1~1.2)、假日平均睡眠時數少於7小時 (aRR=1.1, 95% CI:1.0~1.2)。睡眠缺乏對下背痛的族群可歸因危險性為6.2%。女性下背痛的危險因子包括體重過重、重體力勞動、震動暴露、工作站作業、工作日平均睡眠時數6~7小時 (aRR=1.2, 95% CI:1.1~1.3)、工作日平均睡眠時數少於6小時 (aRR=1.3, 95% CI:1.2~1.4)。睡眠缺乏對下背痛的族群可歸因危險性為11.9%。 結論：下背痛在男女性工作者間有高盛行律。在調整各項風險因子之後，睡眠時數不足與下背痛仍有相關性。

Objectives: Low back pain (LBP) is a common health problem in the working population worldwide. Insufficient sleep could be a potentially modifiable risk factor for LBP. The study aimed to evaluate whether insufficient sleep hours was associated with LBP among employed workers and to estimate the contribution of short sleep to LBP in the working population. Methods: A nationwide survey of representative employed workers in Taiwan was conducted to estimate the prevalence of musculoskeletal discomforts in lower back, as well as duration of sleep on workdays and on holidays. Relationship between LBP and short sleep were determined by estimating relative risk using generalized linear modeling when adjusting for age, body mass index (BMI), exercise habit, and perceived exposure to ergonomic factors in the work environment. Population-attributable risk (PAR) was calculated by the prevalence of each predictive factor and the relative risk of that predictive factor. Results: Among the candidates of 28,716 workers, 24,509 (85%) completed the questionnaire satisfactorily, including 14,772 men and 9,737 women. Approximately 11% complained of low back pain. For men, risk factors for LBP were overweight and obesity, heavy work, exposure to vibration, sleeping for less than 6 hr on workdays (aRR=1.1, 95% CI:1.1~1.2), and sleeping for less than 7 hr on weekends (aRR=1.1, 95% CI:1.0~1.2). The PAR for short sleeping time was 6.2%. For women, risk factors for LBP were overweight and obesity, heavy work, exposure to vibration, workstation exposure, sleeping for 6 to 7 hr on workdays (aRR=1.2, 95% CI:1.1~1.3), and less than 6 hr on workdays (aRR=1.3, 95% CI:1.2~1.4). The PAR for short sleeping time was 11.9%. Conclusions: Based on a large representative sample of employed workers, we found rather high prevalence of LBP in both male and female workers. Short sleeping time contributed to LBP in addition to ergonomic factors, more among female than male workers.