| Summary: | 碩士 === 國立臺灣大學 === 職業醫學與工業衛生研究所 === 99 === Occupational diseases not only cause labor disability, but also cause them death. The direct treatment costs and other indirect costs, such as human resources cost and prime cost, would be huge burden to countries. In recent years, occupational musculoskeletal disorder is one of the most serious occupational health problems in the world. The occupational musculoskeletal disorder cases accounted for 62.2% of total in Taiwan''s occupational injury and disease notification system in 2008 to 2010. Conditions of the upper-extremity cases (61.3%) were the most frequently reported, followed by cervical spine/lumbar spine cases (33.7%) and lower-extremity cases (2.0%). The arm/shoulder/neck claims cases of Taiwan labor insurance were increased in every year. The occupational upper-extremity musculoskeletal disorder seems to be a serious problem among workers.
Our aim was to assess the ecological association between upper-extremity musculoskeletal diseases standardized incidence rates and work-related risk factors. We used two types of data base. One was “Occupational injury and disease reporting system” from 2008 to 2010, and we screened out 1027 cases of those who suffered from upper-extremity musculoskeletal disorder in this reporting system. Then, we calculated standardized incidence rates (yearly age-adjusted incidence rates by sex) of upper-extremity musculoskeletal disorder (cases per 105 population per year) of all industries. Another data base was “Survey of perceptions of safety and health in the work environment in 2007 (Taiwan)” to regard as every industries work-related exposure data of national working population. We regressed standardized incidence rates for the specified upper-extremity musculoskeletal diseases (carpal tunnel syndrome, hand/wrist tendinitis, tendon or bursa in shoulder, lateral epicondylitis of elbow) against work-related exposure data, weighted by the size of sex-specific national populations.
We found male with upper-extremity musculoskeletal diseases were associated with repetitive hand movements, tiring or painful position, and vibration from hand tools. In female, upper-extremity musculoskeletal diseases were associated with whole body vibration, vibration from hand tools, high job strain, and longer working hours.
Not only physical factors cause upper-extremity musculoskeletal diseases, but also psychosocial factors would affect diseases. Therefore, we can improve the working conditions, redesign hand tool for user or management work time to decrease the incidence rate of upper-extremity musculoskeletal diseases.
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