Psychological demands, low social support and repetitiveness: occupational factors associated with musculoskeletal pain in shoe industry workers

Abstract Introduction: musculoskeletal disorders (MSDs) are a major public health problem, causing great physical and psychological suffering, work disability, and imposing heavy costs on workers and society. Objective: to analyze shoe industry workers, estimating the prevalence and factors associated with MSDs of the neck region and upper limb. Method: a cross-sectional study carried out with a stratified random sample of 446 workers interviewed with use of a questionnaire. Sociodemographic, lifestyle and occupational variables (physical and psychosocial demands) were measured. Factor analysis was applied on variables related to physical demands and multiple logistic regression was used to identify the factors associated with the outcome. Results: MSD prevalence in previous 12 months was 47.3% in the neck, shoulder or upper back (proximal extremities) and 37.4% in distal extremities. MSDs in proximal extremities were associated with psychological demand, low supervisor support, working time at the company (≥ 8 years) and female sex. MSDs in distal extremities were associated with psychological demand, low supervisor support, repetitive strain injuries and female sex. Conclusion: MSDs in upper limbs were highly prevalent in the shoe industry, with psychosocial demands having a significant role on their occurrence, whose control requires intervention on working conditions.

摘要：肌肉骨骼疾病（musculoskeletal disorders, MSDs）是一类重大公共卫生问题，可造成严重的躯体与心理痛苦，导致劳动能力丧失，并给劳动者及社会带来沉重的经济负担。研究目的：本研究旨在针对制鞋行业劳动者开展分析，估算其颈部及上肢肌肉骨骼疾病的患病率，并明确相关影响因素。研究方法：本研究为横断面调查，采用分层随机抽样方法选取446名劳动者，通过问卷调查完成访谈。研究收集了社会人口学特征、生活方式及职业相关变量（包括躯体负荷与心理社会负荷）的数据；针对躯体负荷相关变量开展因子分析，并采用多重logistic回归分析识别与研究结局相关的影响因素。研究结果：过去12个月内，劳动者颈部、肩部或上背部（近端肢体）肌肉骨骼疾病患病率为47.3%，远端肢体患病率为37.4%。近端肢体肌肉骨骼疾病的相关影响因素包括心理社会负荷、主管支持度低下、司龄≥8年以及女性；远端肢体肌肉骨骼疾病的相关影响因素包括心理社会负荷、主管支持度低下、重复性劳损以及女性。研究结论：制鞋行业劳动者上肢肌肉骨骼疾病患病率较高，心理社会负荷在其发病过程中发挥了显著作用，因此需通过干预工作条件实现该类疾病的有效防控。