Annals of Occupational and Environmental Medicine

  • 제23권3호
  • /
  • Pages.298-308
  • /
  • 2011
  • /
  • 1225-3618(pISSN)
  • /
  • 2052-4374(eISSN)
대한직업환경의학회 (The Korean Society of Occupational & Environmental Medicine)
권호 표지

전국표본조사를 통한 근골격계 부담 작업과 작업 관련 요통의 연관성 연구

Association between Physical Workload and Work-related Back Pain: A Nationwide Study

  • 오재일 (서울대학교 보건대학원 직업환경의학교실) ;
  • 유동현 (서울대학교 보건대학원 직업환경의학교실) ;
  • 백도명 (서울대학교 보건대학원 직업환경의학교실) ;
  • 박정선 (한국산업안전보건공단) ;
  • 조성일 (서울대학교 보건대학원 직업환경의학교실)
  • Oh, Jae-Il (Department of Occupational and Environmental Medicine, Graduate School of Public Health, Seoul National University) ;
  • Yoo, Dong-Hyun (Department of Occupational and Environmental Medicine, Graduate School of Public Health, Seoul National University) ;
  • Paek, Do-Myung (Department of Occupational and Environmental Medicine, Graduate School of Public Health, Seoul National University) ;
  • Park, Jung-Sun (Korea Occupational Safety and Health Agency) ;
  • Cho, Sung-Il (Department of Occupational and Environmental Medicine, Graduate School of Public Health, Seoul National University)
  • 발행 : 2011.09.30
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 본 연구는 근골격계 부담 작업과 작업 관련 요통 사이의 연관성을 확인하기 위해 설계되었다. 또한 본 연 구 결과를 다른 나라의 근로환경조사 결과와 비교하고 작업 관련 요통의 관리와 예방에 필요한 기초 자료를 제공하고자 하였다. 방법: 본 연구는 2006년도에 산업안전보건원구원에서 실시한 취업자 근로환경 전국표본조사 자료를 이용하여 실시되었다. 근골격계 부담 작업은 '서있거나 걸어 다니는 작업', '사람을 옮기는 작업', '중량물을 옮기는 작업', '손 팔을 반복적으로 움직이는 작업', '개인 보호구를 착용하는 작업'으로 구분하였다. 노출 정도는'거의 노출 안 됨', '근무시간의 1/4 노출됨', '근무시간의 1/2에서 3/4 노출됨', '거의 항상 노출됨'으로 구분하였다. 종적으로 다변량 로지스틱 회귀분석을 이용하여 작업별 노출 수준과 요통 사이의 연관성을 분석하였다. 결과: 분석 결과 '중량물을 옮기는 작업' ,'손 팔을 반복적으로 움직이는 작업'은 모든 노출군에서, '개인 보호구를 착용하는 작업'은 일부 노출군에서 연관성을 보였다. '서있거나 걸어 다니는 작업', '사람을 옮기는 작업'은 모든 노출군에서 연관성이 없는 것으로 나타났다. 결론: 이 연구는 특정 직종이나 사업장이 아닌 우리나라 전체 근로자를 대상으로 한 표본조사를 바탕으로 이루어졌다. 이를 통해 '중량물을 옮기는 작업', '손 팔을 반복적으로 움직이는 작업', '보호 장비를 착용하는 작업'이 작업 관련 요통과 연관성이 있는 것으로 나타났다. 특히 상지에 발생하는 근골격계 질환의 위험 요인으로 알려져 있는 '손 팔을 반복적으로 움직이는 작업'이 작업 관련 요통의 발생 위험도 증가시킬 가능성이 있다는 것을 확인할 수 있었다.

Objectives: To date, no population-based epidemiological studies have estimated the association between physical workload (standing or walking, carrying heavy loads, carrying people, repetitive hand or arm movements, wearing protective equipment) and work-related back pain in Korea. The purpose of this study was to evaluate the relationship between physical workload and work-related back pain using a nationwide survey. Methods: We analyzed data obtained from working men and women age 15 to 64 (n=10,043) who participated in the 2006 national working condition survey of random sample workers in Korea. Using both simple and multiple logistic regression analysis, the association between physical workload and workrelated back pain was evaluated. Results: Carrying heavy loads, repetitive hand or arm movements, and wearing protective equipment were associated with an increased risk of work-related back pain. Conclusions: This study identifies that an increased risk of work-related back pain related to the nature and intensity of the physical workload of the general working population in Korea. We also found a strong association between repetitive hand or arm movements and back pain.

키워드

참고문헌

  1. Wells R. Why have we not solved the MSD problem? Work 2009;34(1):117-21.
  2. Chiron E, Roquelaure Y, Ha C, Touranchet A, Chotard A, Bidron P, Ledenvic B, Leroux F, Mazoyer A, Goldberg M, Imbernon E. MSDs and job security of employees aged 50 years and over: a challenge for occupational health and public health. Sante Publique 2008;20 (Suppl3):S19-28.
  3. Shultz KS, Adams GA. Aging and Work in the 21st Century. Lawrence Erlbaum Associates. Mahwah. 2007. pp 13.
  4. Korea National Stastical Office. Korean statistical information service. Available: http://kosis.kr/abroad/abroad_01List.jsp [cited 10 February 2011].
  5. Korean Occupational Safety and Health Agency. Industrial disaster present situation stastics. Available: http://www.kosha.or.kr/board [cited 14 February 2011].
  6. Bahk JW, Roh SC. Relationship between self-reported symptoms of work-related musculoskeletal disorders and health related quality of life. Korean J Occup Environ Med 2007;19(2):156-63. (Korean)
  7. Morken T, Riise T, Moen B, Hauge SH, Holien S, Langedrag A, Pedersen S, Saue IL, Seljebo GM, Thoppil V. Low back pain and widespread pain predict sickness absence among industrial workers. BMC Musculoskeletal Disorders 2003;4:21. https://doi.org/10.1186/1471-2474-4-21
  8. Lee DH, Park SG, Leem JH, Kim HC, Kim DH, Kim JH, Lee SJ, Kim GW. Current status of sickness absences and early leaves from work among workers with work-related musculoskeletal symtoms in each body part, and relevant factors. Korean J Occup Environ Med 2010;22(4):364-70. (Korean)
  9. Coole C, Watson PJ, Drummond A. Low back pain patients' experiences of work modifications; a qualitative study. BMC Musculoskeletal Disorders 2010;11:277. https://doi.org/10.1186/1471-2474-11-277
  10. Macfarlane GJ, Thomas E, Papageorgiou AC, Croft PR, Jayson MI, Silman AJ. Employment and physical work activities as predictors of future low back pain. Spine 1997;22(10):1143-9. https://doi.org/10.1097/00007632-199705150-00015
  11. Genevay S, Cedraschi C, Courvoisier DS, Perneger TV, Grandjean R, Griesser AC, Monnin D. Work related characteristics of back and neck pain among employees of a Swiss University Hospital. Joint Bone Spine 2010 Nov 17. [Epub ahead of print]
  12. Kim IH, Geiger-Brown J, Trinkoff A, Muntaner C. Physically demanding workloads and the risks of musculoskeletal disorders in homecare workers in the USA. Health Soc Care Community 2010;18(5):445-55. https://doi.org/10.1111/j.1365-2524.2010.00916.x
  13. Krause N, Rugulies R, Ragland DR, Syme SL. Physical workload, ergonomic problems, and incidence of low back injury: a 7.5-year prospective study of San Francisco transit operators. Am J Ind Med 2004;46(6):570-85. https://doi.org/10.1002/ajim.20094
  14. Begue-Simon AM, Chaperon J. Preventing chronic back pain at the workplace: action-research at the workplace. Sante Publique 2008;20(5):433-43. https://doi.org/10.3917/spub.085.0433
  15. Kim YK, Kang DM, Koh SB, Son BC, Kim JW, Kim DW, Kim GH, Han SH. Risk factors of work-related musculoskeletal symptoms among motor engine assembly plant workers. Korean J Occup Environ Med 2004;16(4):488-98. (Korean)
  16. Chae HJ, Lee SW, Lee KJ, Moon JD. Characteristics of work-related musculoskeletal disorders and effect of intervention program in shipyard workers. Korean J Occup Environ Med 2002;14(4):468-77. (Korean)
  17. Kim JE, Kang DM, Shin YC, Son MA, Kim JW, Ahn JH, Kim YK, Moon DH. Risk factors of work-related musculoskeletal symptoms among shipyard workers. Korean J Occup Environ Med 2003;15(4):401-10. (Korean)
  18. Heo KH, Han YS, Jung HS, Koo JW. Musculoskeletal symptoms and related factors of golf caddies. Korean J Occup Environ Med 2003;16(1):92-102. (Korean)
  19. Park JS, Lee NR. First Korean working conditions survey : a comparison between South Korea and EU countries. Industrial Health 2009;47:50-4. https://doi.org/10.2486/indhealth.47.50
  20. Kim BY, Park CY, Yim HW, Koo JW, Lee KS. Selection of a high risk group and the effectiveness of an exercise program on musculoskeletal symptoms in small and medium sized enterprises. Korean J Occup Environ Med 2005;17(1):10-25. (Korean)
  21. Park SG, Lee JY. Characteristics and odds ratio of work related musculoskeletal disorders according to Job classification in small-to-medium-sized enterprises. Korean J Occup Environ Med 2004;16(4):422-35. (Korean)
  22. Nam KC, Jang SW, Jhun HJ, Park JT. Estimated number of korean workers with back pain and populationbased associated factors of back pain: data from the fourth Korea national health and nutrition examination survey. Korean J Occup Environ Med 2009;21(4):365-77. (Korean)
  23. Guo HR, Chang YC, Yeh WY, Chen CW, Guo YL. Prevalence of muscluoskeletal disorder among workers in Taiwan: a nationwide study. J Occup Health 2004;46(1):26-36. https://doi.org/10.1539/joh.46.26
  24. Burdorf A, Sorock G. Positive and negative evidence of risk factors for back disorders. Scand J Work Environ Health 1997;23:243-56. https://doi.org/10.5271/sjweh.217
  25. Morse T, Dillon C, Weber J, Warren N, Bruneau H, Fu R. Prevalence and reporting of occupational illness by company size: population trends and regulatory implications. Am J Ind Med 2004;45(4):361-70. https://doi.org/10.1002/ajim.10354
  26. Juul-Kristensen B, Jensen C. Self-reported workplace related ergonomic conditions as prognostic factors for musculoskeletal symptoms: the "BIT" follow up study on office workers. Occup Environ Med 2005;62: 188-94. https://doi.org/10.1136/oem.2004.013920
  27. Andersen JH, Haahr JP, Frost P. Risk factors for more severe regional musculoskeletal symptoms : a two-year prospective study oudy general working population. Arthritis & Rheumatism 2007;56:1355-64. https://doi.org/10.1002/art.22513
  28. Hoogendoorn WE, van Poppel MN, Bongers PM, Koes BW, Boute LM. Physical load during work and leisure time as risk factors for back pain. Scand J Work Environ Health 1999;25(5):387-403. https://doi.org/10.5271/sjweh.451
  29. Marshall PW, Patel H, Callaghan JP. Gluteus medius strength, endurance, and co-activation in the development of low back pain during prolonged standing. Hum Mov Sci 2011;30(1):63-73. https://doi.org/10.1016/j.humov.2010.08.017
  30. Barbini N, Squadroni R. Aging of health workers and multiple musculoskeletal complaints. G Ital Med Lav Ergon 2003;25(2):168-72.
  31. Gerbaudo L, Violante B. Relationship between musculoskeletal disorders and work-related awkward postureskeletala group of health care workers in a hospital. Med Lav 2008;99(1):29-39.
  32. Hodder JN, Holmes MW, Keir PJ. Continuous assessment of work activities and posture in long-term care nurses. Ergonomics 2010;53(9):1097-107. https://doi.org/10.1080/00140139.2010.502252
  33. Hoogendoorn WE, Bongers PM, de Vet HC, Douwes M, Koes BW, Miedema MC, Arie¨ns GA, Bouter LM. Flexion and rotation of the trunk and lifting at work are risk factors for low back pain: results of a prospective cohort study. Spine 2000;25(23):3087-92. https://doi.org/10.1097/00007632-200012010-00018
  34. Leroux I, Dionne CE, Bourbonnais R, Brisson C. Prevalence of musculoskeletal pain and associated factors in the Quebec working population. Int Arch Occup Environ Health 2005;78:379-86. https://doi.org/10.1007/s00420-004-0578-2
  35. Pope MH, Goh KL, Magnusson ML. Spine ergonomics. Annu Rev Biomed Eng 2002;4:49-68. https://doi.org/10.1146/annurev.bioeng.4.092101.122107
  36. Nelson NA, Hughes RE. Quantifying relationships between selected work-related risk factors and back pain: a systematic review of objective biomechanical measures and cost-related health outcomes. Int J Ind Ergon 2009;39(1):202-10. https://doi.org/10.1016/j.ergon.2008.06.003
  37. Kim DS, Cheong HW, Kwon YW. Wrist ratio as a risk factor of carpal tunnel syndrome. Korean J Occup Environ Med 2001;13(3):242-52. (Korean)
  38. Roelen CA, Schreuder KJ, Koopmans PC, Groothoff JW. Perceived job demands relate to self-reported health complaints. Occupational Medicine 2008;58:58-63. https://doi.org/10.1093/occmed/kqm134
  39. Moore B, van Sonnenberg E, Casola G, Novelline RA. The relationship between back pain and lead apron use in radiologists. Am J Roentgenol 1992;158(1):191-3. https://doi.org/10.2214/ajr.158.1.1530763
  40. Konitzer LN, Fargo MV, Brininger TL, Lim Reed M. Association between back, neck, and upper extremity musculoskeletal pain and the Individual body armor. J Hand Therapy 2008;21:143-8. https://doi.org/10.1197/j.jht.2007.10.017
  41. Yoo JI, Koo JW. Musculoskeletal symptoms and related factors for nurses and radiological technologists wearing a lead apron for radiation protection. Korean J Occup Environ Med 2004;16(2):166-77. (Korean)
  42. Burton AK, Tillotson KM, Symonds TL, Burke C, Mathewson T. Occupational risk factors for the firstonset and subsequent course of low back trouble. A study of serving police officers. Spine 1996;21(22):2612-20. https://doi.org/10.1097/00007632-199611150-00011
  43. Iwakiri K, Mori I, Sotoyama M, Horiguchi K, Ochiai T, Jonai H, Saito S. Survey on visual and musculoskeletal symptoms in VDT workers. Sangyo Eiseigaku Zasshi 2004;46(6):201-12. https://doi.org/10.1539/sangyoeisei.46.201
  44. Song HS, Yoo SK, Choi CK, Lee CG, Lee KS. Radiological flattening of lumbar lordosis and related factor in some Korean farmer. Korean J Occup Environ Med 2010;22(4):279-89. (Korean)