| 摘要: | 近年來，隨著經濟發展與消費型態的改變，並在虛擬通路的經營與運作下，衍生出龐大的個人化配送服務商機。在宅配業特殊的工作性質下，有時會產生職業傷害，故有業者為永續經營，而進行改善勞工的作業條件。本研究主要探討改善後，宅配業勞工的肌肉骨骼體適狀況（如下背痛）與其危險因子（重點：全身振動和人工物料搬運）之相關性。
本研究以立意取樣的方式，選取國內一家貨運宅配公司進行調查，研究對象為宅配員（危險因子：駕車時之全身振動和人工搬運）和理貨員（人工搬運），共545 位，進行問卷、下背肌肉壓力疼痛閾值測量及全身振動之量測。
研究結果發現，下背/腰部、肩頸及手/手腕之痠痛或不舒服比例較高。下背症狀多為非特異性之急性下背痛，以背部拉傷和肌肉發炎為主。利用視覺類比刻度尺（visual analogue scale, VAS）和部分歐氏下背痛功能評估量表（Oswestry low back pain disability questionnaire, OLBPDQ）評估，症狀皆屬輕微且持續時間短。宅配員下背痛之盛行率及嚴重程度皆顯著高於理貨員，在整體下背肌肉壓力疼痛閾值顯著小於理貨員，表示宅配員下背肌肉忍受壓力能力較差，可能受到下背痛程度較嚴重所影響。另外，宅配員全身振動主要以X 軸和Z 軸向的振動方向危害較大，均能振動量大多超過「疲勞－降低效率境界」，易使駕駛者疲勞並降低工作效率，引起傷害。
校正相關危險因子後，顯示彎腰的搬運姿勢、工作時間過長及無習慣規律運動為主要造成下背痛之危險因子。宅配員下背痛風險顯著高於理貨員（OR＝1.94, 95% C.I＝1.02-4.51），與工作中長時間駕駛所暴露的全身振動有關。應定期實施教育訓練，並改善工作流程，以減少宅配業勞工的職業傷害。
The economic development, the new consumption behavior and the convenience of the virtual net work services have modiefied our delivery system these years. The alternative UPS type home delivery system is suggested, and many of the home delivery companies are emerged. For better protection of the musculoskeletal injuries, especially the ergonomically induced low back pain (LBP), are concerned in this thesis. The risk factors mainly are two: manual materials handling (MMH) and whole body vibration (WBV) during driving.
The study was conducted under the cooperation of a domestic home delivery company. A total of 545 workers in two major groups ─ Driver & Deliverer (DD) and Storage Sorter (SS) , are studied and compared. “Questionnaire in general” and “LBP information” were conducted and obtained. Visual analogue scale (VAS) and Oswestry low back pain disability questionnaire (OLBPDQ) were used for the LBP measurement. LBP was measured in muscle pressure pain thresholds (PPTs) and the WBV level was measured during driving.
It is found that the proportion of musculoskeletal disorders in low back/loins, shoulder, neck and hand/wrist were more prevalent. The main low back syndrome was acute and non-specific back strain and myositis. Making use of VAS and 4 items of OLBPDQ to evaluate the low back syndrome, the severity of selected members were all insignificant and the span of pain were short. The prevalence and the serious degree of LBP in ‘DD’ group were significantly higher than the ‘SS’ group. In entire low back muscle PPTs, the ‘DD’ were significantly lower than the ‘SS’. These meant that with the more serious the LBP, the worse of the low back muscle tolerance. Besides, the WBV of X-axis and Z-axis were more serious than the Y-axis to the drivers. Most of the average WBV doses exceeded the “fatigue-decreased proficiency thrshold” and may cause fatigue of the drivers, reducing the work efficiency and causing injury easily.
After adjusting related risk factors, it is found that the stoop posture, long overtime working and without regular exercise habit were the main risk factors. The risk of LBP in ‘DD’ was significantly higher than ‘SS’ (OR＝1.94, 95% C.I＝1.02-4.51), and was associated with WBV exposure from long-term driving. Training course and working procedure improvement are important to minimize the occupational injury of the home delivery labors. |
