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研究生:殷歆宜
研究生(外文):Shin-Yi Yin
論文名稱:檳榔包填作業勞工肌肉骨骼傷害之調查
論文名稱(外文):Investigation of musculoskeletal disorders in betel nut stuffing workers
指導教授:許德仁許德仁引用關係
學位類別:碩士
校院名稱:長榮大學
系所名稱:職業安全與衛生研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:中文
論文頁數:106
中文關鍵詞:檳榔包填肌肉骨骼傷害北歐肌肉骨骼問卷調查表軟式電子量角器人因工程檢核表
外文關鍵詞:betel nut stuffingmusculoskeletal disordersNordic Musculoskeletal QuestionnairebiometricsMSDs checklists
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近年國內職業病通報中肌肉骨骼案例逐漸增加,顯見為數不少的勞工深受肌肉骨骼傷害之困擾,其中,檳榔包填作業從業人員為肌肉骨骼傷害之危險族群之一。過去雖然已有許多研究針對勞工之肌肉骨骼傷害進行調查,然而多數研究常以問卷或現場訪視方式進行,較少實際量測勞工暴露;此外,經由問卷或現場訪談而得的結果與個人感受有極大相關,故主觀性極強。本研究利用北歐肌肉骨骼問卷調查表(NMQ)與軟式電子量角器對225名檳榔包填從業人員進行肌肉骨骼傷害調查,並對從業人員手腕及大拇指進行理學檢查篩檢測驗。問卷結果顯示92%的包填者過去一年內曾經歷肌肉骨骼不適症狀,其中96%表示其與工作相關,身體各部位不適症狀之盛行率前四位分別為肩膀(71.1%)、頸部(58.2%)、下背或腰(48.9%)及手或手腕(53.3%),症狀皆以痠痛為主。儀器量測結果顯示包填者手腕部長期處於尺偏及伸展,包填作業施力較前處理作業大,且伸肌群施力(%MVC)皆較屈肌群大。理學檢查結果顯示有54名(24%)從業人員疑似為腕道症候群及狄奎文氏肌腱鞘炎。本研究顯示檳榔包填者肩頸、下背及手/手腕部不適比例皆較國外手工編織地毯勞工(47.8%、35.2%、45.2%、38.2%)、公車司機(48%、52%、13%、11%)及國內廚務人員(26.7%、8%、20.8%、28.9%)為高。而其經常性低頭動作、身體維持固定姿勢及手腕重複動作可能是檳榔包填者肌肉骨骼痠痛之原因。雖檳榔包填作業屬低施力作業,然長期從事檳榔包填可能因上述因子導致肌肉骨骼傷害。檳榔包填從業人員肌肉骨骼傷害盛行率極高,未來各界對檳榔包填從業人員職業性傷害應投以更多的關注,降低從業人員因職業造成的傷害。
As the cases of musculoskeletal disorders have been increased in the past decade, it indicates many more workers are suffered from them than ever. Among all, betel nut stuffing workers are one of the high risk groups. Most previous studies on musculoskeletal disorders were based on questionnaires or interviews, instead of measuring the exposure levels. Additionally, the results from questionnaires or interviews usually are subject to personal bias. This study aimed to, by using Nordic Musculoskeletal Questionnaire (NMQ), characterize the musculoskeletal disorders among betel nut preparers in Taiwan and to identify the associated risk factors. Totally 386 preparers were approached and 225 agreed to be interviewed. The results indicated that the majority of the preparers were females. 92.0% of them experienced musculoskeletal problems for at least one body part and, among them, 96.0% attributed the disorders to their jobs. Due to neck bending posture and static body position in long duration while preparing bet nuts, higher prevalence rate of disorders was found in shoulders (71.1%), neck (58.2%) and hand/wrist (53.3%). The pain and sore were responded as the most complained symptom. Because the prevalence of musculoskeletal disorders in betel nut preparers were higher than those reported in hand-woven carpet workers, bus drivers and kitchen workers, further research and more concern on this industry are strongly recommended.
致謝 i
摘要 ii
Abstract iii
目錄 iv
圖目錄 vi
表目錄 vii
第一章 前言 1
1-1研究緣起 1
1-2研究目的 2
第二章 文獻回顧 3
2-1檳榔產業介紹 3
2-2職業性肌肉骨骼危害 7
2-3常見職業性肌肉骨骼危害 9
2-4各職業族群之肌肉骨骼危害 14
第三章 研究設計與方法 18
3-1研究架構 18
3-2研究對象 20
3-3研究工具 20
3-3-1問卷 20
3-3-2儀器設備及資料處理與分析 21
3-3-3理學檢查 27
3-3-4 MSDs人因工程檢核表 28
3-4資料處理與統計分析 29
第四章 結果與討論 31
4-1問卷調查結果 31
4-1-1基本資料分析 31
4-1-2工作描述 33
4-1-3身體部位傷痛之盛行率調查 36
4-1-4複邏輯斯迴歸分析 45
4-2人因工程檢核表結果 53
4-3理學檢查結果 55
4-3-1理學檢查分析 55
4-3-2理學檢查與問卷卡方檢定分析 57
4-3-3理學檢查與儀器量測受測者之問卷卡方檢定分析 60
4-4儀器量測結果 64
4-4-1角度分析 65
4-4-2肌電訊號分析 73
4-4-3 儀器量測結果之T檢定分析 76
第五章 結論與建議 82
參考文獻 84
附錄一 人體試驗審查通過證明函 91
附錄二 檳榔包填作業勞工肌肉骨骼傷害之問卷 92
附錄三 MSDs人因工程檢核表 103
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