치과위생사의 근골격계 증상 및 업무 관련요인

Abstract

[한글]

치과위생사의 진료활동에 있어서 일어날 수 있는 근골격계 질환의 증상을 조사,평가하기 위하여 미국 국립산업안전보건연구원(NIOSH)에서 정한 근골격계 질환의 질병 기준을 이용한 설문지로 조사한 후, 각각의 증상유무에 따라 작용하는 요인을 분석하였다.

서울,경기 지역 치과 병,의원에 근무하는 치과위생사 114명을 대상으로 2004년 3월 30일부터 4월 27일까지 KOSHA CODE에 의한 근골격계 증상 설문조사와 업무자세에 대한 비디오 촬영 및 인간공학적 평가(Rapid Entire Body Assessment, REBA)를 실시하였으며, 근골격계 예방관리 솔루션 프로그램을 적용하여 통증부위에 따른 근육과 증상원인 등에 대하여 알아보았다.

업무자세별 REBA 평가의 경우, 환자 보조업무의 위험도가 가장 높았으며 스켈링 업무는 ‘높음’, 교정 보조업무와 보철 보조업무 및 기구세척 업무는 ‘보통’의 위험도였고, 예약청구 업무는 위험수준은 낮았으나 조치수준은 필요할 수 있는 업무이었다.

조사대상자 114명중 통증 호소율은 83.3%이었고 어깨의 통증은 63.2%, 다리/발은 46.5%, 등/허리는 35.1%, 목은 25.4%, 손/손목은 21.1%, 팔/팔꿈치는 8.8% 순으로, 어깨, 다리/발의 통증 호소가 높았다.

신체 부위별 통증 호소 근육은 목, 어깨는 경판상근, 팔/팔꿈치는 삼두박근, 손/손목은 척측수근신근, 등/허리는 다열근, 다리/발은 가자미근에 통증을 많이 호소하였다.

[영문]To investigate the occurrence of musculoskeletal disorders among dental hygienists while providing their dental services, we used the musculoskeletal questionnaire of the U.S. National Institute for Occupational Safety and Health (NIOSH) and analyzed the work factors related to the occurrence of each symptom.

The subjects for this research comprise of 114 dental hygienists who worked in dental clinics in Seoul and Gyeonggi-do. The research was conducted from March 30, 2004 to April 27, 2004 using the following methods: assessing subjective symptoms of musculoskeletal disorders by questionnaire; photographing the subjects'' various working positions when conducting medical examination and treatment; analyzing the body postures using the Rapid Entire Body Assessment (REBA); and examining the muscles and causes of symptoms according to the regions of pain by applying the musculoskeletal disorder prevention solution program.

In the REBA evaluation, the patient-assistance tasks were shown to have the ''highest'' risk, while scaling tasks were classified as having ''high'' risk. The assistance tasks in occlusal correction and dental prosthesis had ''medium'' risk, and appointment and reception tasks had ''low'' risk but still needed a level of care.

The response rate for pain among the 114 subjects was 83.3%, according to the following frequency: shoulder (63.2%); leg and foot (46.5%); back and waist (35.1%); neck (25.4%); hand and wrist (21.1%); and arm and elbow (8.8%), respectively.

The muscles with the most intense pain by body part were the Splenius Cervicis on the neck, the Splenius Cervicis on the shoulder, the Triceps Brachii on the arm and elbow, the Musculus Extensor Carpi Ulnaris on the hand and wrist, the Musculi Multifid on the back and waist, and the Soleus muscle on the leg and foot, respectively.

The most influential factor was the working hour of over than 44 hours per week. In addition, aging and housekeeping chores affected pain, although they were not statistically significant.

Analysis results indicate that inappropriate working positions, long working hours, and high intensity of labor significantly lead to musculoskeletal risk factors and subjective symptoms. Thus, dental hygienists should avoid body stiffness by stretching after every work task in order to reduce the risks of musculoskeletal disorders, and ergonomic considerations should be incorporated in the interior design of dental clinics.