1.Prevalence and influencing factors of work-related knee pain among workers in shoemaking industry
Jingwen ZHANG ; Yan YANG ; Si HUANG ; Jiaxin ZHENG ; Liangying MEI ; Jianchao CHEN ; Bo SHEN ; Huadong ZHANG ; Zhongxu WANG ; Zhi WANG ; Ning JIA
Journal of Environmental and Occupational Medicine 2024;41(6):648-654
Background Shoemaking industry workers are prone to work-related musculoskeletal disorders (WMSDs) due to long-term awkward postures during the work process. There is little research on the prevalence and influencing factors of WMSDs in the knee region of this industry, and it should be taken seriously. Objective To estimate the prevalence of work-related knee pain among shoemaking workers and analyze the related influencing factors. Methods A total of 6982 shoemaking workers were selected from 26 shoemaking factories in Guangdong, Hubei, Fujian, Chongqing, Shandong, Zhejiang, and Jingxi by convenience sampling. Prevalence of work-related knee pain in past year, demographic characteristics, occupational related factors, and work posture were collected by a cross-sectional survey using the electronic version of Musculoskeletal Disorder Questionnaire. Logistic regression analysis was used to analyze the influencing factors that may lead to work-related knee pain. Results This survey collected 6982 valid questionnaires with a recovery rate of 98.3%. The prevalence of work-related knee pain of shoemaking workers in the past 12 months was 13.0% (908/6982). According to the results of logistic regression analysis, compared with workers with less than 5 years of service, workers with 5-10 years of service (OR=1.21, 95%CI: 1.02, 1.45) and more than 10 years (1.53, 95%CI: 1.27, 1.83) showed a higher risk of knee WMSDs; sometimes, often and very frequent (reference : rarely or never) long-term standing (OR=1.33, 95%CI: 1.08, 1.64; OR=2.67, 95%CI: 2.10, 3.39; OR=2.75, 95%CI: 2.08, 3.63) and sometimes, often and very frequent (reference: rarely or never) long-term squatting or kneeling (OR=1.80, 95%CI: 1.47, 2.21; OR=2.43, 95%CI: 1.58, 3.75; OR=3.22, 95%CI: 1.66, 6.24) increased the risk of knee pain: long-term bending (OR=1.59, 95%CI: 1.34, 1.89) and often repeated movement of lower limbs and ankles (OR=1.48, 95%CI: 1.25, 1.75) were also risk factors for knee WMSDs among shoemaking industry workers (P<0.05). Adequate rest time (OR=0.58, 95%CI: 0.49, 0.68) and able to stretch or change leg posture (OR=0.75, 95%CI: 0.64, 0.88) reduced the risk of knee WMSDs (P<0.05). Conclusion In the shoemaking industry, length of service and awkward postures are risk factors for knee pain. The shoemaking enterprises should ensure that workers have sufficient rest time, reduce long-term standing, squatting, kneeling, and bending postures, as well as lower limbs repetition in order to reduce the occurrence of knee WMSDs of workers.
2.Interpretation of T/WSJD 14.9-2024 Ergonomic Guidelines for the Prevention of Work-related Musculoskeletal Disorders: Part 9: Bus Driving Work
Wenyan HUANG ; Yaling ZOU ; Jie ZHANG ; Ning JIA ; Zhongxu WANG
China Occupational Medicine 2024;51(4):439-442
Bus drivers, as an important occupational group in urban public transportation system, are prone to suffer from work-related musculoskeletal disorders (WMSDs) due to prolonged fixed postures and repetitive movements. The T/WSJD 14.9-2024 Ergonomic Guidelines for the Prevention of Work-related Musculoskeletal Disorders: Part 9: Bus Driving Work is a recommended standard developed to prevent WMSDs among bus drivers. This standard, guided by the principles of T/WSJD 14.1-2020 Ergonomic Principle for the Prevention of Work-related Musculoskeletal Disorders: Part 1: General Principles, is based on a preliminary work of comprehensive review of domestic and international research, workplace on-site surveys and questionnaires, data analysis, and factor identification. It defines the scope of application, identifies relevant risk factors and potential affected body parts, and offers ergonomic solutions in the form of intervention examples. The issuance of this guideline as a organization standard will facilitate the promotion and implementation of intervention measures.
3.Changes of brain networks function in patients with primary dysmenorrhea during menstruation
Zhongxu ZHANG ; Cong ZHANG ; Yunsong ZHENG ; Feng ZHOU ; Yuan WANG ; Zhiqun WANG ; Xiaotong MA
Chinese Journal of Medical Imaging Technology 2024;40(11):1661-1666
Objective To investigate the changes of brain networks function in patients with primary dysmenorrhea(PDM)during menstruation based on topological attributes of brain network.Methods Brain resting-state functional MRI of 57 PDM patients(PDM group)and 50 healthy women(health control[HC]group)were prospectively collected within the first or the second day of menstruation.Clinical scores were obtained and compared between groups.Results Visual analogue scale,cox menstrual symptom scale,self-rating anxiety scale and self-rating depression scale scores in PDM group were all higher than those in HC group(all P<0.05).At the sparsity of 0.04-0.50,brain networks in both groups conformed to the small world attribute characteristics,and no significant difference of global attributes of brain network was found between groups(all P>0.05).The node efficiency(Ne)and node degree(Dc)of bilateral posterior cingulate gyrus(PCG),as well as De and node betweenness(Bc)of left middle frontal gyrus(MFG)in PDM group were all higher than those in HC group,while Ne and De of left inferior temporal gyrus in PDM group were lower than those in HC group(all P<0.01).Compared with HC group,the functional connections between left PCG and right calcarine fissure and surrounding cortex,right lingual gyrus and left MFG,as well as between right PCG and right dorsolateral superior frontal gyrus and left MFG,between right insula and left middle occipital gyrus enhanced in PDM group(all P<0.001).Conclusion In PDM patients,local brain networks function such as default mode network,central executive network and salience network were over-activated during menstruation,yet the overall brain network still had good coordination and organization.
4.Analysis of influencing factors of multi-site musculoskeletal disorders among workers in the chemical pharmaceutical industry
Zhiheng PENG ; Hai ZHANG ; Yinan HE ; Yuchao FENG ; Bo LUO ; Jinlan HUANG ; Yimin LIU ; Zhongxu WANG ; Ning JIA ; Zhi WANG
China Occupational Medicine 2023;50(6):601-606
{L-End}Objective To analyze the prevalence of multi-site work-related musculoskeletal disorders (WMSDs) and their influencing factors among workers in the chemical pharmaceutical industry. {L-End}Methods A total of 563 workers from three chemical pharmaceutical factories in Guangzhou City were selected as the research subjects using the judgment sampling method. The prevalence of multi-site WMSDs in the past 12 months was investigated using the electronic questionnaire of Chinese Version of Musculoskeletal Disorders Questionnaire. {L-End}Results The prevalence of multi-site WMSDs in the research subjects was 30.0% (169/563). The results of multivariable logistic regression analysis showed that workers who smoked regularly/frequently and those who had their hands above shoulder level for long periods of time had a lower risk of multi-site WMSDs than those who never/occasionally smoked (all P≤0.05). Workers with a high school, secondary specialty, college degree, or above had a lower risk of multi-site WMSDs than those with a middle school education or below (all P<0.05). The longer the daily working hours, the higher the risk of multiple WMSDs (all P<0.05). Workers with regular/frequently work shifts had a lower risk of multi-site WMSDs than those with none/occasional work shifts (P<0.05). {L-End}Conclusion The prevalence of multi-site WMSDs among workers in the chemical pharmaceutical industry is relatively high. The influencing factors are individual factors, unreasonable work organization and poor ergonomics factors.
5.Study on the relationship between local muscle fatigue and related metabolic biomarkers in simulated manual lifting
Siwu ZHONG ; Ning JIA ; Ying QU ; Xueyan ZHANG ; Qing XU ; Yan YANG ; Zhi WANG ; Zhongxu WANG
China Occupational Medicine 2023;50(6):607-612
{L-End}Objective To analyze the local muscle response under continuous ergonomic workload by simulating manual lifting, and to screen the sensitive metabolic biomarkers during fatigue process. {L-End}Methods A total of 13 healthy male volunteers were selected as the study subjects using simple random sampling method. Study subjects underwent repetitive simulated manual lifting for four periods (T1 to T4), each lasting 12 minutes. The degree of work-related fatigue in the forearm, upper arm, shoulder, back, and leg muscles, and the whole body was accessed using Borg 6-20 Rating of Perceived Exertion (RPE) Scale. The venous blood samples were collected from elbow between each two periods to detect the levels of eight metabolic biomarkers: ammonia, lactate, creatine kinase, lactate dehydrogenase (LDH), C-terminal telopeptide of type Ⅰ collagen (CTX-Ⅰ), C-terminal telopeptide of type Ⅱ collagen (CTX-Ⅱ), cartilage oligomeric matrix protein (COMP), and calcium ions. {L-End}Results The RPE scores of the study subjects for the muscles of five body parts and the whole body increased with the increasing lifting periods (all P<0.01). Fatigue was observed in all target muscles, with overall body fatigue occurring in the T2 period. The levels of ammonia, lactate, creatine kinase, LDH, COMP, and calcium ions in the serum of study subjects were higher in the T1 to T4 periods than in the T0 period (all P<0.05). The serum CTX-Ⅰ level was higher in the T1 and T3 periods than that in the T0 period (all P<0.05) , and the serum CTX-Ⅱ level was higher in the T1, T2 and T4 periods than that in the T0 period (all P<0.05). The level of these eight serum metabolic biomarkers fluctuated during the T1 to T4 periods. The serum creatine kinase level increased with the period of lifting (all P<0.05). The serum lactate level was higher in the T3 period than those in the T1 and T2 periods (all P<0.05). The serum LDH and calcium ion levels were higher in the T2 to T4 periods than that in the T1 period (all P<0.05). The serum COMP level was higher in the T2 and T3 periods than that in the T1 period (all P<0.05). Except for CTX-Ⅰ, the levels of other seven metabolic markers in serum were higher in individuals after fatigue than before fatigue (all P<0.05). {L-End}Conclusion Serum metabolic biomarkers such as ammonia, lactate, creatine kinase, calcium ions, LDH, CTX-Ⅱ, and COMP exhibit significant changes before and after fatigue. These metabolic biomarkers could be used as sensitive biomarkers for evaluating muscle fatigue during repetitive works.
6.Analysis on influencing factors of leg work-related musculoskeletal disorders among shipbuilding workers
Yan YANG ; Diwei JIANG ; Jiancheng ZENG ; Jingwen ZHANG ; Rugang WANG ; Hua SHAO ; Gang LI ; Yimin LIU ; Zhongxu WANG ; Ning JIA ; Zhi WANG
China Occupational Medicine 2023;50(6):620-625
{L-End}Objective To investigate the current status and influencing factors of leg work-related musculoskeletal disorders (WMSDs) in shipbuilding workers. {L-End}Methods A total of 3 393 shipbuilding workers from Guangdong Province, Liaoning Province, Shandong Province, and Beijing City were selected as the research subjects using the convenience sampling method. The Chinese Version of the Musculoskeletal Disorders Questionnaire was used to investigate the prevalence of leg WMSDs in the past year. A multivariate logistic regression model was used to analyze the influencing factors of leg WMSDs. {L-End}Results The prevalence of leg WMSDs in the research subjects was 11.3% (382/3 393). The result of multivariate logistic regression showed that the risk of leg WMSDs was higher in workers with a length of service >10 years than those with a length of service <5 years (P<0.05). Workers with frequent used of vibration tools at work had higher the risk of leg WMSDs (all P<0.05). Workers who did the same work every day, had insufficient rest time, had a shortage of department staff, and those who often repeated the same leg movements had a higher risk of leg WMSDs (all P<0.05). The risk of leg WMSDs in workers who sometimes stand for a long time was lower than that in workers who rarely stand for a long time (P<0.01). {L-End}Conclusion Length of service, rarely long-standing work, use of vibration tools at work, daily engagement in the same work, in-adequate rest time, shortage of department staff, and frequent repetition of the same leg movements are all influencing factors for leg WMSDs in shipbuilding workers.
7. Study on the effect of spinal anesthesia on ventricular arrhythmias in acute myocardial ischemia-reperfusion in rats
Huabin ZHANG ; Zhongxu LUO ; Deguo WANG ; Huabin ZHANG ; Zhongxu LUO ; Min ZHONG ; Deguo WANG ; Huabin ZHANG ; Zongyuan HONG
Chinese Journal of Clinical Pharmacology and Therapeutics 2023;28(3):249-256
AIM: To explore the effect of spinal anesthesia on ventricular arrhythmia and involved mechanisms in myocardial ischemia-reperfusion (MIR) rats. METHODS: The rat MIR model was made by occlusion the left anterior descending coronary artery for 30 minutes and reperfusion for 45 minutes. Bupivacaine (0.05 mL / 100 g, 1 mg / kg) was injected slowly via intrathecal for spinal anesthesia. The electromyelogram at T2 thoracic spinal cord was recorded. Ventricular arrhythmias, cardiac function, myocardial damage were assessed by electrocardiography, echocardiography and TTC or HE staining. RESULTS: MIR reduced left ventricular short-axis shortening (LVFS) and left ventricular ejection fraction (LVEF), caused myocardial histological damage and ventricular arrhythmias, promoted spinal electrical discharge frequency and amplitude in T2 dorsal horn. Spinal injection of bupivacaine could significantly reduce spinal cord electrical activities and eliminate MIR-induced arrhythmias. Moreover, bupivacaine also significantly improved MIR-induced myocardial histological damage and cardiac function inhibition. CONCLUSION: Spinal anesthesia can reduce ventricular arrhythmias induced by MIR. The mechanism may be related to the effect of abolishing spinal nerve excitability.
8.Whole-body vibration exposure characterization in bus drivers of Haikou City: A comparison between two health risk assessment methods
Yun CHEN ; Longyi WANG ; Zhongxu WANG ; Ning JIA ; Qingsong CHEN
Journal of Environmental and Occupational Medicine 2023;40(11):1264-1269
Background Long-term exposure to whole-body vibration (WBV) will affect the health of occupational drivers. However, research on the characteristics of WBV exposure by urban bus drivers and health risk evaluation is still insufficient. Objective To identify the characteristics of occupational WBV exposure of bus drivers serving 31 bus routes provided by three branches of Haikou Public Transport Group, and to evaluate their occupational health risks related to WBV. Methods A total of 31 out of 142 bus routes run by three branches of Haikou Public Transport Group were selected to monitor WBV exposure of 31 bus drivers during driving. WBV parameters such as triaxial frequency weighted acceleration (awx, awy, awz) and triaxial crest factor (CFx, CFy, CFz) of the drivers were determined with a six-channel human vibration meter. Two methods, 8-hour daily value of the weighted root mean square average weighted vibration [A(8)] based on aw and 8-hour daily value of vibration dose [VDV(8)] based on vibration dose value (VDV), were used for health risk assessment and classified WBV health risk results into three levels (high, medium, and low) by the exposure action value (EAV) and exposure limit values (ELV) for A(8) and VDV(8) recommended by ISO 2631-1:1997. The two evaluation methods, A(8) and VDV(8), were compared by Fisher's exact test. Results Regarding the WBV parameters, the vector sum of acceleration (av) was 0.321-0.680 m·s−2, the VDV of monitoring interval was 3.824-10.174 m·s−1.75, and the VDV(8) was 6.039-13.505 m·s−1.75; their values in mean ± standard deviation were (0.480±0.100) m·s−2, (6.987±2.737) m·s−1.75, and (9.773±4.540) m·s−1.75, respectively. Positive correlations were found between awx and awz, av and awz, CFx and CFy, CFy and CFz. No bus route's WBV exposure level was graded as high health risk by either A(8) or VDV(8). The number of routes graded as low health risk by A(8) was 26, while the number by VDV(8) was 12. The consistency rates of health risk levels evaluated by the two methods were 66.7% (6/9), 54.6% (6/11), and 45.5% (5/11) for the three bus group branches, respectively. The difference in WBV health risk assessment results between the two evaluation methods was not statistically significant. Conclusion Positive correlations are found between triaxial acceleration and triaxial crest factor. There is no difference in the results of using A(8) and VDV(8) to evaluate health risks of WBV in urban bus routes.
9.Work-related musculoskeletal disorders and their influencing factors among workers in a furniture factory
Jiancheng ZENG ; Yan YANG ; Siwu ZHONG ; Yimin LIU ; Zhongxu WANG ; Ning JIA ; Zhi WANG
Journal of Environmental and Occupational Medicine 2023;40(1):6-12
Background Furniture manufacturing is one of the typical labor-intensive industries, and workers in this industry face a high risk of work-related musculoskeletal disorders (WMSDs), which seriously affect the physical and mental health of workers. Objective To explore the prevalence and potential risk factors of WMSDs among workers in a large-scale furniture manufacturing factory. Methods A cross-sectional study of 3431 workers in a furniture factory in Guangdong Province was conducted from September to December 2019. Information including reported WMSDs in various body parts in the past year, demographic characteristics, work organization factors, job characteristics, and work postures was collected by an electronic version of Musculoskeletal Disorders Questionnaire. Pearson χ2 test and binary logistic regression were used to analyze the risk factors leading to WMSDs. Results The overall prevalence rate of WMSDs was 32.12% (1102/3431). The most common WMSDs symptoms occurred in the neck (16.85%), followed by the feet (15.27%), shoulders (14.81%), and hands (14.25%). The prevalence rates of WMSDs in the neck, shoulders, elbows, hands, legs, and feet were significantly different among different types of work (P<0.05). The results of multiple logistic regression analysis showed that individual factors, work organization factors, job characteristics, and awkward work postures were associated with the frequency of reporting WMSDs in specific parts of workers. Comparatively poor physical health (including moderate, poor, and very poor) was positively correlated with neck, shoulder, hand, and foot WMSDs (OR=1.479-4.077); working with an uncomfortable posture (OR=1.983) and doing the same task almost every day (OR=1.783) were positively correlated with neck pain; doing the same task almost every day (OR=2.408) and neck twisting for a long time (OR=1.830) were positively correlated with shoulder pain; bending wrists up and down frequently (OR=1.948) and bending wrists for a long time (OR=2.081) were positively correlated with hand pain; prolonged standing (OR=1.953) and often working overtime (OR=1.627) were positively correlated with feet pain; sufficient rest time was negatively correlated with WMSDs in the neck, shoulders, hands, and foot (OR=0.544-0.717). Conclusion The prevalence rate of WMSDs in furniture manufacturing workers is relatively high, and neck, feet, shoulders, and hands are the most involved body parts. The frequency of reporting WMSDs is related to individual factors, work organization factors, job characteristics, and awkward work postures.
10.Prevalence and influencing factors of work-related musculoskeletal disorders among workers in chemical pharmaceutical industry
Zhiheng PENG ; Weiyu MA ; Yinan HE ; Bo LUO ; Jinlan HUANG ; Hai ZHANG ; Jinwei ZHANG ; Zhongxu WANG ; Ning JIA ; Zhi WANG
Journal of Environmental and Occupational Medicine 2023;40(1):13-20
Background Work-related musculoskeletal disorders (WMSDs) are one of the major occupational health problems in the world. Pharmaceutical industry is an important part of China's national economy. At present, there are few related studies reported at home and abroad. Objective To investigate the status and influencing factors of WMSDs in chemical pharmaceutical industry. Methods A cross-sectional epidemiological survey was conducted among all workers from three chemical pharmaceutical enterprises in Guangzhou. The Musculoskeletal Disorders Questionnaire was used to collect information on demographic characteristics, symptoms of musculoskeletal disorders, types of work, work organization, and and work postures. Multiple logistic regression method was used to analyze the risk factors of WMSDs in chemical pharmaceutical workers. Results In this study, 563 workers were selected as subjects. The total prevalence rate of WMSDs symptoms in the chemical pharmaceutical workers was 43.9% (247/563), and the leading body part-specific prevalence rate from high to low was 34.3% in the lower back, 24.3% in the upper back, 24.0% in the shoulders, and 23.8% in the neck. The prevalence rate of WMSDs symptoms in multiple body parts (30.0%) was 2.16 times higher than that in single body part (13.9%), and the prevalence rate of WMSDs symptoms in four body parts was the highest (11.4%). The results of multiple logistic regression analysis showed that age ≥50 years (reference age <30 years) (OR=2.140, 95%CI: 1.054-4.345), often or very often (reference never/rarely) long-time head rotating (OR=2.695, 95%CI: 1.753-4.142) and long-time keeping arms above shoulders (OR=1.902, 95%CI: 1.108-3.265) increased the risk of reporting WMSDs symptoms (P<0.05). Regarding education level, workers with high school and technical secondary school (OR=0.333, 95%CI: 0.175-0.636) or college and above (OR=0.413, 95%CI: 0.216-0.790) education had a lower risk of reporting WMSDs symptoms than those with middle school or below (P<0.05). Conclusion The prevalence rate of reporting WMSDs symptoms in chemical pharmaceutical industry is high, the involving body parts are lower back, upper back, shoulders, and neck, and reporting simultaneous occurrence of WMSDs symptoms in multiple body parts is common. The chemical pharmaceutical manufacturers can reduce the risk of WMSDs by strengthening the training on workers' ergonomics knowledge, paying attention to the less educated personnel, protecting the elderly workers, and avoiding awkward work postures, like rotating head for a long time and raising arms over shoulders.

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