| [Objective] Work-related musculoskeletal disorders (WRMDs) are the Musculoskeletal disorders ,which were resulted directly or indirectly from occupational harmful factors. WRMDs had a high prevalence rate and was involved in many industries. Many persons were suffered from WRMDs and their health, work abilities, and life quality were affected seriously. At the same time, it brought a heavy burden on individuals, society and the country and had become a main occupational health problem in many developed countries. The hazard of WRMDs had gradually aroused the universal concern of the developed governments and health research institutes. There was a high incidence of WRMDs in our country and its harm might have exceeded our expectation. The study was carried out to investigate the distribution of WRMDs among middle school teachers in Hangzhou and to get to know the harm of WRMDs by evaluating its effects on teachers' work abilities. The study also analyzed the main influencing factors of WRMDs among middle school teachers, and then brought forward some intervention measures on the basis of selected influencing factors in order to improve middle school teachers' life quality.[Methods] This study was a cross-sectional investigation. Teachers from 13 middle schools in Hangzhou were selected by cluster sampling considering the region balance and school's category. Questionnaire was used to collect related information. The contents and methods of the investigation included: 1) basic information of subjects, 2) musculoskeletal disorders of subjects in three different stages (ever, the recent one year, the recent one week) was investigated with Standardized Nordic Questionnaire for the Analysis of Musculoskeletal Symptoms, 3) teachers' work abilities were evaluated with Work Ability Index, 4) some occupational and unprofessional factors that might affect teachers' musculoskeletal disorders were investigated. Three indexes, ever prevalence rate, year prevalence rate, and week prevalence rate, were used in this study to describe the prevalence of WRMDs. And the day off rate because of WRMDs, hospital visiting rate because of WRMDs and Work Ability Index were used to describe the seriousness of WRMDs. The data were analyzed with Microsoft Visual FoxPro 6.0 and SAS 9.01 for Windows. T-test, Analysis of variance, Chi-square test and Rank sum test were used to test the differences of data. Analysis of Pearson correlation was applied to analyze the bivariate correlation according with normal distribution and Logistic regression was applied to evaluate the risk of possible factors. The data were analyzed at alpha level of 0.05.The study took strict quality control measures in research design, data collection and data collation and analysis to ensure the accuracy and reliability of the results.[Results] Totally 808 teachers were investigated in the study. And 784 questionnaires were returned including 718 qualified, with a recovery rate of 97.03% (784/808) and an effective of 91.58% (718/784). On the whole, the basic characteristics (age, working age) of effective respondents were balanced and comparable.The highest prevalence rate of WRMDs in middle school teachers of Hangzhou happened in the neck, with an ever prevalence rate of 55.01%, a year prevalence rate of 45.13%, and a week prevalence rate of 26.32% respectively, followed by those in shoulders(46.52%,38.02%,19.36%) and the low back(35.52%,29.39%,17.97%), the differences were statistically significant (P<0.05). The prevalence rate of mental workers ranked the first, followed by mental-manual workers and manual workers (p<0.01). The prevalence rate of female teachers was higher than that of male, and except a year prevalence (p=0.081) and a week prevalence in the low back (p=0.2731), the other differences were statistically significant (p<0.05). On the whole, there was no statistically significant differences of the prevalence rates in the neck, shoulders, and the low back with the increasing of the age (age<30, age≥30, age≥35, age≥40, age≥45, and age≥50) (p>0.05). But the prevalence rates in the neck, shoulders and the low back presented a trend as that of the middle aged were high and that of the young and the old were low. The highest prevalence rates happened in the age 30-40. Quiet similarly, there was no statistically significant differences of the prevalence rates in the neck, shoulders, and the low back with the increasing of the working age (working age<10 years, working age≥10 years, and working age>20 years) (p>0.05). But the prevalence rates presented a trend as that of the middle working aged were high and that of the young and the old were low. And the highest prevalence rate happened in the working age 10-20. The day off rate because of WRMDs was 12.67%, and the hospital visiting rate because of WRMDs was 3.06% in middle school teachers in Hangzhou.In the recent one year, the work ability of teachers suffered WRMDs was poorer than that of those without WRMDs (p<0.003). The work ability of teachers of all types of work suffered WRMDs was also poorer than that of those without WRMDs in the recent one year (p<0.05). The work ability of teachers suffered WRMDs and teachers without WRMDs had different component ratio (p<0.001). The percentage of those with poor and moderate work ability was significantly higher in teachers suffered WRMDs than that in teachers without WRMDs, and the percentage of those with excellent work ability was lower in teachers suffered WRMDs. The situation was quite similar as analyzed according to work types (p<0.001).Logistic regression was used to evaluate the possible risk factors of WRMDs. Logistic regression equation was established to count Standardized Partial Regression Coefficient, Odds Ratio and Confidence Interval. Four factors with statistical significance (p<0.01) were selected in the Logistic regression model, which were standing time per day, the times of bowing head per day, job fatigue, and job satisfaction. WRMDs in the neck was related to job satisfaction, job fatigue, and the times of bowing head per day. Standardized Partial Regression Coefficients of them were -0.2716, 0.2198, and 0.1823 respectively. Odds Ratios of them were 0.742 (95%CI:1.171-1.498), 1.240 (95%CI: 1.066-1.443), and 1.171 (95%CI:1.012-1.356) respectively. WRMDs in shoulders was related to job satisfaction and job fatigue. Standardized Partial Regression Coefficients of them were -0.186 and 0.286. And Odds Ratio of them were 0.815 (95%CI:0.708-0.938) and 1.324 (95%CI:1.171-1.498). WRMDs in the low back was related to job satisfaction, job fatigue, and standing time per day. Standardized Partial Regression Coefficients of them were -0.2422, 0.219, and 0.1863. Odds Ratios of them were 0.766 (95%CI:0.657-0.894) , 1.239 (95%CI: 1.069-1.436), and 1.212 (95%CI: 1.058-1.397).[Conclusion] The prevalence rates of WRMDs in the neck, shoulders and the low back among middle school teachers were 55.01%, 46.52% and 35.52% respectively in Hangzhou. The prevalence rate of mental workers was the highest, followed by mental-manual workers and manual workers. In female teachers the rate was significantly higher than that in male teachers. The work ability of the teachers with WRMDs was significantly poorer than those without WRMDs. The percentage of the teachers with poor or moderate work ability was also significantly higher in teachers with WRMDs than that in those without WRMDs, and the percentage with good work ability was significantly lower than that in those without WRMDs. The main influencing factors of WRMDs among middle school teachers include job satisfaction, job fatigue, standing time per day, and the times of bowing head per day. Of these factors, the times of bowing head per day, standing time per day, and job fatigue are risk factors, and job satisfaction is protective factor. The results of the study are valuable in making intervention measures and improving occupational life quantity of middle school teachers. In the future, it is important to further make sure of the main risk factors of WRMDs and the dose-response relationship between the risk factors and WRMDs, and thus more pertinent intervention measures can be taken.
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